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lethargy
lightheadedness
confusion
tachycardia
dysrhythmias related to hypokalemia
nausea
vomiting
Respiratory Alkalosis S/S epigastric pain
numbness and tingling of the extremities
hyperventilation (tachypnea)
Encourage weight bearing exercises (such as walking because it can help maintain
A nurse is contributing to the plan of care for bone mass by reducing bone demineralization, thus helping to prevent osteoporosis.)
an older adult client who is at risk for
Osteoporosis. Which intervention should the
nurse include to prevent bone loss?
Mask (this disease requires droplet precautions)
A nurse is caring for a client who has
meningococal pneumonia. Which of the
following personal protective equipment
should the nurse use?
This type of insulin should be given at the same time everyday. (It is released over a
A nurse is reinforcing teaching with a client 24hr period)
who is taking insulin Glargine. What
information should the nurse include in the
teaching?
"I don't cross my legs anymore".
A home health nurse is reinforcing teaching
with a client about preventing complications
of peripheral vascular disease. What
statement by the client indicates that they
are adhering to the nurse's instructions?
Visitors must don a gown & gloves prior to entering the client's room.
A nurse is caring for a client who has a
methicillin-resistant Staphlococcus aureus
(MRSA) infections in a surgical wound. What
information should the nurse plan to share
with visitors?
Onset of nausea
A nurse is reinforcing teaching with a client
who has heart failure and a new prescription
for hydrochlorothiazide. What should the
client report to the provider?
Rephrase client instructions when not understood.
A nurse is reinforcing discharge teaching
with a client who has hearing loss. What
action should the nurse take when
communicating with the client?
Pulmonary Embolism
A nurse is caring for a client who is 1 day
post operative following a hip arthroplasty.
The client is exhibiting hypotension,
tachycardia, & tacky-nearly. The nurse
should recognize these findings as what
complication?
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Lack of sensation between the first and second toes
A nurse is monitoring a client who recently
had a cast placed on the right lower
extremity for a bone fracture. What finding
should the nurse recognize as abnormal?
Limit contact with large groups of people
A nurse reinforcing teaching with a client
who has systemic lupus erythematosus
(SLE) and is to begin taking
methylprednisolone orally. What should the
nurse include in the teaching?
Encourage the client to use an incentive spirometer every hour while awake
A nurse is caring for a client who is 24hr
postoperative following abdominal surgery &
has an NG tube. What action should the
nurse plan to take to decrease the risk of
postoperative complications?
Bradycardia
A nurse is collecting data from a client who
has chronic kidney disease with
hyperkalemia. What finding should the nurse
expect related to hyperkalemia?
Initiate oxygen at 4 L/min via nasal cannula
A nurse is assisting in the care of a client
who has manifestations of sepsis. What
provider prescriptions should the nurse
implement first?
"Tell me more about the way you are feeling."
A nurse is caring for a client who has
terminal pancreatic cancer. The client states,
"I don't think I can go on any longer." What
response should the nurse make?
Dysrhythmia
A nurse is collecting data from a client who
has hypokalemia. What finding should the
nurse identify as the priority?
Keep the skin dry and free of perspiration
A nurse is caring for a client who is in Buck's
traction. What intervention should the nurse
perform to reduce skin breakdown?
Have a designated stethoscope in the client's room
A nurse is contributing to the plan of care for
a client who has a methicillin-resistant
Staphylococcus aureus (MRSA) infections
and is on contract isolation precautions.
What action should the nurse take?
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lethargy
lightheadedness
confusion
tachycardia
dysrhythmias related to hypokalemia
nausea
vomiting
Respiratory Alkalosis S/S epigastric pain
numbness and tingling of the extremities
hyperventilation (tachypnea)
Encourage weight bearing exercises (such as walking because it can help maintain
A nurse is contributing to the plan of care for bone mass by reducing bone demineralization, thus helping to prevent osteoporosis.)
an older adult client who is at risk for
Osteoporosis. Which intervention should the
nurse include to prevent bone loss?
Mask (this disease requires droplet precautions)
A nurse is caring for a client who has
meningococal pneumonia. Which of the
following personal protective equipment
should the nurse use?
This type of insulin should be given at the same time everyday. (It is released over a
A nurse is reinforcing teaching with a client 24hr period)
who is taking insulin Glargine. What
information should the nurse include in the
teaching?
"I don't cross my legs anymore".
A home health nurse is reinforcing teaching
with a client about preventing complications
of peripheral vascular disease. What
statement by the client indicates that they
are adhering to the nurse's instructions?
Visitors must don a gown & gloves prior to entering the client's room.
A nurse is caring for a client who has a
methicillin-resistant Staphlococcus aureus
(MRSA) infections in a surgical wound. What
information should the nurse plan to share
with visitors?
Onset of nausea
A nurse is reinforcing teaching with a client
who has heart failure and a new prescription
for hydrochlorothiazide. What should the
client report to the provider?
Rephrase client instructions when not understood.
A nurse is reinforcing discharge teaching
with a client who has hearing loss. What
action should the nurse take when
communicating with the client?
Pulmonary Embolism
A nurse is caring for a client who is 1 day
post operative following a hip arthroplasty.
The client is exhibiting hypotension,
tachycardia, & tacky-nearly. The nurse
should recognize these findings as what
complication?
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Lack of sensation between the first and second toes
A nurse is monitoring a client who recently
had a cast placed on the right lower
extremity for a bone fracture. What finding
should the nurse recognize as abnormal?
Limit contact with large groups of people
A nurse reinforcing teaching with a client
who has systemic lupus erythematosus
(SLE) and is to begin taking
methylprednisolone orally. What should the
nurse include in the teaching?
Encourage the client to use an incentive spirometer every hour while awake
A nurse is caring for a client who is 24hr
postoperative following abdominal surgery &
has an NG tube. What action should the
nurse plan to take to decrease the risk of
postoperative complications?
Bradycardia
A nurse is collecting data from a client who
has chronic kidney disease with
hyperkalemia. What finding should the nurse
expect related to hyperkalemia?
Initiate oxygen at 4 L/min via nasal cannula
A nurse is assisting in the care of a client
who has manifestations of sepsis. What
provider prescriptions should the nurse
implement first?
"Tell me more about the way you are feeling."
A nurse is caring for a client who has
terminal pancreatic cancer. The client states,
"I don't think I can go on any longer." What
response should the nurse make?
Dysrhythmia
A nurse is collecting data from a client who
has hypokalemia. What finding should the
nurse identify as the priority?
Keep the skin dry and free of perspiration
A nurse is caring for a client who is in Buck's
traction. What intervention should the nurse
perform to reduce skin breakdown?
Have a designated stethoscope in the client's room
A nurse is contributing to the plan of care for
a client who has a methicillin-resistant
Staphylococcus aureus (MRSA) infections
and is on contract isolation precautions.
What action should the nurse take?
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