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VERIFIED QUESTIONS AND ANSWERS C C C
1. A nurse asks a client to stand with her feet together and her eyes open. Aftera few second
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s, the nurse asks the client to close her eyes. If the client beginsto fall, the nurse should in
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terpret this finding as a positive Romberg's test, indication what alteration?
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ANS Cerebellar dysfunction
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Cerebellar dysfunction causes a loss of position sense (proprioception) whichresults in p
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ositive Romberg's sign.
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2. A nurse is caring for a client who had human immunodeficiency virus (HIV). Which
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of the following types of isolation should the nurse implementto prevent the transmis
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sion of HIV?
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ANS Standard precautions
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3. a nurse is teaching a middle-
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,aged female client about disease preventionand health maintenance.Which of the follo
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wing diagnostic test should the nurse recommend as part of the client's routine?
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annual papanicolaou (pap) testingma
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mmogram every 2 years C C C
eye examination every 2 years
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annual colonoscopy C
ANS eye examination every 2 years
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4. A nurse is explaining Piaget's theory of cognitive development to a group of daycare p
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roviders for employees' children at an acute care facility. which of the following activitie
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s should the nurse include as an example of concreteoperational thinking?
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playing in the sand C C C
playing dress- C
up with old clothes collecting and tradi
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ng game cards
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describing interpersonal relationships
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ANS collecting and trading game cards
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5. A nurse is talking with a client whose provider recently informed him of terminal p
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,ancreatic cancer. When the client reports that he understands thefull impact of this dia
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gnosis, the nurse should identify that the client is in which of the following stages of d
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ying?
ANS Depression C
6. A nurse is planning care for a young adult client who has a terminal illness.Which of th
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e following concepts of death should the nurse consider for this client?
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ANS Death is viewed as an interruption of what might have been
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7. A nurse is changing the dressings for a client who has 2 Penrose drains nearan abdomina
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l incision. Which of the following adhering devices is the best choice for the nurse to use
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to decrease skin irritation?
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ANS Montgomery straps
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8. A nurse is caring for an older adult client who has an in-the-
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canal hearingaid. The client states that the hearing aid is making a whistling sound. Th
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e
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, nurse should identify which of the following factors as the source for thissound?
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ANS Excessive wax in the ear canal
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9. A nurses planning to administer pain medication to a client following ab-
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C dominal surgery. Which of the following actions should the nurse take first?use the pai
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n scale to determine the client's pain level
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discuss the adverse effects of pain medication with the clientobtain the clie
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nt's vital signs C C
check the client's allergies C C C
ANS use the pain scale to determine the client's pain level
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10. a nurse is teaching a client who is using a patient-
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controlled analgesia (PCA) pump to deliver morphine for pain management. which of th
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e followingstatements should the nurse identify as an indication that the client under-
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C stands the instructions? C C
I'll limit pushing the button so I don't get an overdose
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if I push the button and still have pain after 2 minutes, I'll push it againI'll ask m
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y niece to push the button when I am sleeping
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I can still use my transcutaneous electrical nerve stimulation unit while I'm pushing the
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