Practice Quizzes Fundamentals 1 -40 preguntas
Version 6
1.A nurse is assessing the heart sounds of a client who has developed chest pain that
becomesworse with inspiration. the nurse auscultates a high-pitched scratching
sound during both systole and diastole with diaphragm of the stethoscope
positioned at the left sternal border. Which of the following heart sounds should the
nurse document?
Pericardial friction rub
2.A nurse is obtaining the blood pressure in a client's lower extremity. Which of the
followingactions should the nurse take?
Place the bladder of the cuff over the posterior aspect of the thigh
3.A charge nurse is teaching adult cardiopulmonary resuscitation (CPR) to a group
of newly licensed nurses. Which of the following actions should the charge nurse
teach as the first response in CPR?
Confirm unresponsiveness
4.A nurse is caring for a client who requires a chest x-ray. Prior to the client being
transported for the procedure, which of the following actions should the nurse
take first?Identify the client using two identifiers
5.A nurse is caring for a child who is postoperative following a tonsillectomy.
Which of thefollowing actions should the nurse take?
Administer analgesics to the child on a routine schedule throughout the day and night.
6.A nurse is providing teaching to a client who has heart failure about how to
reduce his daily intake of sodium. Which of the following factors is the most
important in determining
, the client's ability to learn new dietary habits?
The involvement of the client in planning the change
7.A charge nurse is observing a newly licensed nurse perform tracheostomy care for
a client. Which of the following actions by the newly licensed nurse requires
intervention?
Obtaining cotton balls for the tracheostomy care
8.A nurse is preparing to perform mouth care for an unresponsive client.
Which of thefollowing actions should the nurse plan to take?
Raise the level of the bed
9.A nurse is witnessing a client sign an informed consent form for surgery.
Which of thefollowing describes what the nurse is affirming by this action?
The signature on the preoperative consent form is the client's
10.A nurse is preparing to provide tracheostomy care for a client. Which of the
followingactions should the nurse take first?
Perform hand higiene
11.A nurse is caring for an older adult client who becomes agitated when the nurse
requests that the client's dentures be removed prior to surgery. Which of the
following responses should the nurse make?
"What worries you about being without your teeth?"
12.A nurse in an oncology clinic is assessing a client who is undergoing treatment
for ovariancancer. Which of the following statements by the client indicates she is
experiencing psychological distress?
"I keep having nightmares about my upcoming surgery."
13.A nurse on a medical-surgical unit is caring for a client. Which of the
following actionsshould the nurse take first when using the nursing process?
Obtain client information
14.A nurse is caring for an older adult client who is violent and attempting to
disconnect herIV lines. The provider prescribes soft wrist restraints. Which of the
following actions should the nurse take while the client is in restraints?
Remove the restraints one at a time
15.A nurse is planning care for a client who reports abdominal pain. An
assessment by the nurse reveals the client has a temperature of 39.2 degrees C (102
degrees F), heart rate of 105/min, a soft contender abdomen, and census overdue
by 2 days. Which of the followingfindings should be the nurse's priority?
Temperature
16.A nurse is inserting an IV catheter for a client that results in a blood spill on her
gloved hand. The client has no documented bloodstream infection. Which of the
following actionsshould the nurse take?
Carefully remove the gloves and follow with hand hygiene
Version 6
1.A nurse is assessing the heart sounds of a client who has developed chest pain that
becomesworse with inspiration. the nurse auscultates a high-pitched scratching
sound during both systole and diastole with diaphragm of the stethoscope
positioned at the left sternal border. Which of the following heart sounds should the
nurse document?
Pericardial friction rub
2.A nurse is obtaining the blood pressure in a client's lower extremity. Which of the
followingactions should the nurse take?
Place the bladder of the cuff over the posterior aspect of the thigh
3.A charge nurse is teaching adult cardiopulmonary resuscitation (CPR) to a group
of newly licensed nurses. Which of the following actions should the charge nurse
teach as the first response in CPR?
Confirm unresponsiveness
4.A nurse is caring for a client who requires a chest x-ray. Prior to the client being
transported for the procedure, which of the following actions should the nurse
take first?Identify the client using two identifiers
5.A nurse is caring for a child who is postoperative following a tonsillectomy.
Which of thefollowing actions should the nurse take?
Administer analgesics to the child on a routine schedule throughout the day and night.
6.A nurse is providing teaching to a client who has heart failure about how to
reduce his daily intake of sodium. Which of the following factors is the most
important in determining
, the client's ability to learn new dietary habits?
The involvement of the client in planning the change
7.A charge nurse is observing a newly licensed nurse perform tracheostomy care for
a client. Which of the following actions by the newly licensed nurse requires
intervention?
Obtaining cotton balls for the tracheostomy care
8.A nurse is preparing to perform mouth care for an unresponsive client.
Which of thefollowing actions should the nurse plan to take?
Raise the level of the bed
9.A nurse is witnessing a client sign an informed consent form for surgery.
Which of thefollowing describes what the nurse is affirming by this action?
The signature on the preoperative consent form is the client's
10.A nurse is preparing to provide tracheostomy care for a client. Which of the
followingactions should the nurse take first?
Perform hand higiene
11.A nurse is caring for an older adult client who becomes agitated when the nurse
requests that the client's dentures be removed prior to surgery. Which of the
following responses should the nurse make?
"What worries you about being without your teeth?"
12.A nurse in an oncology clinic is assessing a client who is undergoing treatment
for ovariancancer. Which of the following statements by the client indicates she is
experiencing psychological distress?
"I keep having nightmares about my upcoming surgery."
13.A nurse on a medical-surgical unit is caring for a client. Which of the
following actionsshould the nurse take first when using the nursing process?
Obtain client information
14.A nurse is caring for an older adult client who is violent and attempting to
disconnect herIV lines. The provider prescribes soft wrist restraints. Which of the
following actions should the nurse take while the client is in restraints?
Remove the restraints one at a time
15.A nurse is planning care for a client who reports abdominal pain. An
assessment by the nurse reveals the client has a temperature of 39.2 degrees C (102
degrees F), heart rate of 105/min, a soft contender abdomen, and census overdue
by 2 days. Which of the followingfindings should be the nurse's priority?
Temperature
16.A nurse is inserting an IV catheter for a client that results in a blood spill on her
gloved hand. The client has no documented bloodstream infection. Which of the
following actionsshould the nurse take?
Carefully remove the gloves and follow with hand hygiene
