x x x x x
x
2024 x
Low xlevels xof x_____ xare xassociated xwith xmalnutrition. x- x- xAlbumin x
x
An xelderly xclient xwith xa xfractured xleft xhip xis xon xstrict xbedrest. xWhich xnursing
xmeasure xis xessential xto xthe xclient's xnursing xcare? x
A. Massage xany xreddened xareas xfor xat xleast xfive xminutes. x
B. Encourage xactive xrange xof xmotion xexercises xon xextremities. x
C. Position xthe xclient xlaterally, xprone, xand xdorsally xin xsequence. x
D. Gently xlift xthe xclient xwhen xmoving xinto xa xdesired xposition. x- xD. xGently xlift xthe
xclient xwhen xmoving xinto xa xdesired xposition. x
x
The xnurse xis xadministering xmedications xthrough xa xnasogastric xtube x(NGT) xwhich
xis xconnected xto xsuction. xAfter xensuring xcorrect xtube xplacement, xwhat xaction
xshould xthe xnurse xtake xnext? x
A. Clamp xthe xtube xfor x20 xminutes. x
B. Flush xthe xtube xwith xwater. x
C. Administer xthe xmedications xas xprescribed. x
D. Crush xthe xtablets xand xdissolve xin xsterile xwater. x- xB. xFlush xthe xtube xwith xwater.
x
x
A xclient xwho xis xin xhospice xcare xcomplains xof xincreasing xamounts xof xpain. xThe
xhealthcare xprovider xprescribes xan xanalgesic xevery xfour xhours xas xneeded. xWhich
xaction xshould xthe xnurse ximplement? x
A. Give xan xaround-the-clock xschedule xfor xadministration xof xanalgesics. x
B. Administer xanalgesic xmedication xas xneeded xwhen xthe xpain xis xsevere. x
C. Provide xmedication xto xkeep xthe xclient xsedated xand xunaware xof xstimuli. x
D. Offer xa xmedication-free xperiod xso xthat xthe xclient xcan xdo xdaily xactivities. x- xA.
xGive xan xaround-the-clock xschedule xfor xadministration xof xanalgesics. x
x
When xassessing xa xclient xwith xwrist xrestraints, xthe xnurse xobserves xthat xthe
xfingers xon xthe xright xhand xare xblue. xWhat xaction xshould xthe xnurse ximplement
xfirst? xA. xLoosen xthe xright xwrist xrestraint. x
B. Apply xa xpulse xoximeter xto xthe xright xhand. x
C. Compare xhand xcolor xbilaterally. x
D. Palpate xthe xright xradial xpulse. x- xA. xLoosen xthe xright xwrist xrestraint. x
x
The xnurse xis xassessing xthe xnutritional xstatus xof xseveral xclients. xWhich xclient
xhas xthe xgreatest xnutritional xneed xfor xadditional xintake xof xprotein? xA. xA xcollege-
age xtrack xrunner xwith xa xsprained xankle. x
B. A xlactating xwoman xnursing xher x3-day-old xinfant. x
C. A xschool-aged xchild xwith xType x2 xdiabetes. x
D. An xelderly xman xbeing xtreated xfor xa xpeptic xulcer. x- xB. xA xlactating xwoman
xnursing xher x3-day-old xinfant. x
x
A xclient xis xin xthe xradiology xdepartment xat x0900 xwhen xthe xprescription xlevofloxacin
x(Levaquin) x500 xmg xIV xq24h xis xscheduled xto xbe xadministered. xThe xclient xreturns
xto xthe xunit xat x1300. xWhat xis xthe xbest xintervention xfor xthe xnurse xto ximplement? x
, A. Contact xthe xhealthcare xprovider xand xcomplete xa xmedication xvariance xform. x
B. Administer xthe xLevaquin xat x1300 xand xresume xthe x0900 xschedule xin xthe
xmorning. xC. xNotify xthe xcharge xnurse xand xcomplete xan xincident xreport xto
xexplain xthe xmissed xdose. x
D. xGive xthe xmissed xdose xat x1300 xand xchange xthe xschedule xto xadminister xdaily
xat x1300. x- xD. xGive xthe xmissed xdose xat x1300 xand xchange xthe xschedule xto
xadminister xdaily xat x1300. x
x
While xinstructing xa xmale xclient's xwife xin xthe xperformance xof xpassive xrange-of-
motion xexercises xto xhis xcontracted xshoulder, xthe xnurse xobserves xthat xshe xis
xholding xhis xarm xabove xand xbelow xthe xelbow. xWhat xnursing xaction xshould xthe
xnurse ximplement? xA. xAcknowledge xthat xshe xis xsupporting xthe xarm xcorrectly. x
B. Encourage xher xto xkeep xthe xjoint xcovered xto xmaintain xwarmth. x
C. Reinforce xthe xneed xto xgrip xdirectly xunder xthe xjoint xfor xbetter xsupport. x
D. Instruct xher xto xgrip xdirectly xover xthe xjoint xfor xbetter xmotion x- xA. xAcknowledge
xthat xshe xis xsupporting xthe xarm xcorrectly. x
x
What xis xthe xmost ximportant xreason xfor xstarting xintravenous xinfusions xin xthe xupper
xextremities xrather xthan xthe xlower xextremities xof xadults? x
A. It xis xmore xdifficult xto xfind xa xsuperficial xvein xin xthe xfeet xand xankles. x
B. A xdecreased xflow xrate xcould xresult xin xthe xformation xof xa xthrombosis. x
C. A xcannulated xextremity xis xmore xdifficult xto xmove xwhen xthe xleg xor xfoot xis xused.
xD. xVeins xare xlocated xdeep xin xthe xfeet xand xankles, xresulting xin xa xmore xpainful
xprocedure. x- xB. xA xdecreased xflow xrate xcould xresult xin xthe xformation xof xa
xthrombosis. x
x
The xnurse xobserves xan xunlicensed xassistive xpersonnel x(UAP) xtaking xa xclient's
xblood xpressure xwith xa xcuff xthat xis xtoo xsmall, xbut xthe xblood xpressure xreading
xobtained xis xwithin xthe xclient's xusual xrange. xWhat xaction xis xmost ximportant xfor xthe
xnurse xto ximplement? x
A. Tell xthe xUAP xto xuse xa xlarger xcuff xat xthe xnext xscheduled xassessment. x
B. Reassess xthe xclient's xblood xpressure xusing xa xlarger xcuff. x
C. Have xthe xunit xeducator xreview xthis xprocedure xwith xthe xUAPs. x
D. Teach xthe xUAP xthe xcorrect xtechnique xfor xassessing xblood xpressure. x- xB.
xReassess xthe xclient's xblood xpressure xusing xa xlarger xcuff. x
x
A xclient xis xto xreceive xcimetidine x(Tagamet) x300 xmg xq6h xIVPB. xThe xpreparation
xarrives xfrom xthe xpharmacy xdiluted xin x50 xml xof x0.9% xNaCl. xThe xnurse xplans xto
xadminister xthe xIVPB xdose xover x20 xminutes. xFor xhow xmany xml/hr xshould xthe
xinfusion xpump xbe xset xto xdeliver xthe xsecondary xinfusion? x- x150 xmL/hr x
x
Twenty xminutes xafter xbeginning xa xheat xapplication, xthe xclient xstates xthat xthe
xheating x
x
pad xno xlonger xfeels xwarm xenough. xWhat xis xthe xbest xresponse xby xthe x
xnurse?
A. xThat xmeans xyou xhave xderived xthe xmaximum xbenefit, xand xthe xheat xcan
xbe
x x
removed.
x
B. xYour xblood xvessels xare xbecoming xdilated xand xremoving xthe xheat xfrom xthe
xsite.