Questions & Answers Latest Update
2024-2025
Which of the following characteristics should the nurse identify as an external factor that
can impede learning for the participants? - CORRECT ANSWERS-Poor lighting in the
learning setting
A nurse is observing newly licensed nurse who is providing tracheostomy care for a
client. The nurse identifies proper performance of the procedure when the newly
licensed nurse selects which of the following solutions to clean the inner cannula? -
CORRECT ANSWERS-hydrogen peroxide
A nurse is caring for a client who has right sided heart failure. The client's partner exp
presses concern the the client will die. Which of the following responses should the
nurse make? - CORRECT ANSWERS-"It is difficult to see someone so sick. What have
you been told about your partner's prognosis?"
A nurse in a long-term care facility is assisting with an in-service for newly hired
assistive personnel about legal issues within the facility. Which of the following should
the nurse include as an example of assault? - CORRECT ANSWERS-Informing a client
the nurse is going to administer an injection even though the client refuses.
A nurse is collecting data from who is severe pain. Which of the following questions
should the nurse ask first? - CORRECT ANSWERS-"Where is your pain located?"
A nurse is reviewing the laboratory results for a client who is at
29 weeks gestation. For which of the following results should the nurse notify the
provider? - CORRECT ANSWERS-Platelet count 95,000 mm3
A nurse is performing a dressing change for a client who had abdominal surgery 5-days
ago. The nurse notes organs protruding from the incision. Which of the following act
ions should the nurse take? - CORRECT ANSWERS-Cover the exposed area with
sterile, saline-soaked dressings.
A nurse is speaking with the adult daughter of a client who has Alzheimer's disease.
The daughter states, "I love my dad, but caring for him is wearing me out." Which of the
following response should the nurse make? - CORRECT ANSWERS-"Let's discuss how
caring for your father is affecting your health.
A nurse is reinforcing teaching with a client who has a type 2 diabetes mellitus and re
ports waking during the night with tremors and anxiety. which of the following inform
,ation should the nurse provide to help the client manage his symptoms? - CORRECT
ANSWERS-Eat a bedtime snack
a Nurse is reinforcing teaching for a client who has a coronary artery disease and is
taking low-
dose aspirin daily. The nurse should include that this medication has which of the
following therapeutic following ects for CAD? - CORRECT ANSWERS-antiplatelets
A nurse is collecting data from a client who has an unprepared femur fracture and rate s
his pain as 8 on a scale of 0 to 10. The client is talking and caught with a visitor. Which
of the following of the prescribed medication should the nurse administer? - CORRECT
ANSWERS-Hydromorphone 5 mg orally.
A nurse is reinforcing preoperative teaching with a clientscheduled for a bowel retenti on
with ileostomy. which of the following descriptions should the nurse give of the ex
pected output from a mature ileostomy? - CORRECT ANSWERS-liquid with little odor
A nurse in a pediatric clinic is collecting the data from a school-age child whose injuries
are inconsistent with the parent's stated cause. Which of the following actions should
the nurse take? - CORRECT ANSWERS-Report the suspected abuse to a appropriate
agency.
A nurse is collecting data from a middle adult female client who is taking melatonin.
Which of the following responses to the med should the nurse expect? - CORRECT
ANSWERS-Improved sleep
A nurse on a pediatric unit is collecting data from four newly admitted clients. Which of
the following clients should the nurse identify as being at risk for urinary retention? -
CORRECT ANSWERS-A school-age child who has allergic rhinitis and is taking
diphenhydramine.
A nurse is preparing to administer purified protein derivative (PPD) to a client who has
suspected TB. Which of the following actions should the nurse plan to take? -
CORRECT ANSWERS-Ensure the injection produces a wheal on the skin
A client who is diagnosed with Parkinson's disease verbalizes frustration due to increas
e difollowingiculty with ambulation.
Which of the following responses should the nurs e take? - CORRECT ANSWERS-
Perform active ROM with your arms and legs two times a day.
A Nurse is collecting data from a client who has multiple fractures following a motor-
vehicle crash. For which of the following client statements - CORRECT ANSWERS-"I
am so frustrated. I cannot even open my milk carton for breakfast."
A nurse is reinforcing discharge teaching with a client who is postoperative following
transurethral resection of the prostate.
, Which of the following instructions should the n urse include in the teaching? -
CORRECT ANSWERS-perform Kegel exercises daily.
A nurse is reinforcing teaching about ways to reduce solid fat consumption with a clie nt
who has an elevate cholesterol level. which of the following strategies should the nurse
include in the teaching? - CORRECT ANSWERS-purchase beef that is a loin cut.
A nurse is assisting with the plan of care for a client following a
transurethral resection of the prostate. Which of the following interventions should the
nurse include in the plan of care? - CORRECT ANSWERS-The nurse should irrigate the
bladder using strict sterile technique and maintain closed catheter drainage system to
minimize the rick of infection.
A nurse is reviewing a client's electronic medical record and finds that an assistive per
sonnel recorder the client's temperature as 35.3 degrees Celsius (95.5 degrees F) 2 hrs
earlier. Which of the following actions should the nurse take firsT? - CORRECT
ANSWERS-check the clients temp
A nurse is receiving change-of-
shift report for four clients. Which of the following clients should the nurse see first? -
CORRECT ANSWERS-A client whose urinary output was 100mL for the past 12 hrs
A nurse in reinforcing teaching about weight loss with a female older adult client who is
overweight. Which of the following statements should the nurse include in teaching? -
CORRECT ANSWERS-keep fat intake to no more that 30% of daily caloric intake.
A nurse is collecting data from a client who has iron deficiency anemia. Which of the
following findings should the nurse expect? - CORRECT ANSWERS-difficulty
concentrating
A Nurse is collecting data from an older adult client who is 48 hr postoperative following
abdominal surgery. The provider writes a prescription to advance the client to a re gular
Diet. For which of the following findings should the nurse notify the provider? -
CORRECT ANSWERS-The client has absent bowel sounds
A parent brings her adolescent son to an urgent care center and states. "He is high on
something and needs help" The client is
exhibiting agitation and paranoia and reports visual hallucinations. The nurse should
suspect intoxication with which of the following substances? - CORRECT ANSWERS-
Methamphetamines
A nurse notices an assistive personnel taking a nap in the break room during he meal t
ime. The AP appears drowsy while performing routine tasks. Which of the following a
ctions should the nurse take? - CORRECT ANSWERS-Report the observations about
the ap to the unit's nurse manager.