ACTUAL QUESTIONS AND CORRECT
ANSWERS/ALREADY GRADED A+
A post menopausal female client with osteopenia tells the
nurse that she has increased her physical activity and hopes
to participate in a charity walk event. How should the nurse
respond?
A Review the need for her to avoid large crowds of people.
B Affirm the benefits of increasing her weight bearing
activity.
C Teach her how to take her heart rate during prolonged
activity.
D Explain the need to limit physical activity to reduce
fracture risk.
B Affirm the benefits of increasing her weight bearing activity.
An older client returns to the clinic and receives refills on
several medications. The client shares concerns with the
nurse about having to take so many medications and asks if
one pill could be substituted for many of the others. Which
instruction should the nurse implement to address the
client's concerns?
A Use a medication reminder system to prevent forgetting to
take the right medications at the right time.
B Make certain a family member knows the name and use of
all medications currently being taken.
C Do not take any over-the-counter drugs while taking
,medications prescribed by a healthcare provider.
D Bring all medications, supplements, and herbs currently
being taken to the next clinic appointment.
D Bring all medications, supplements, and herbs currently being
taken to the next clinic appointment.
Rational Having the client bring the supply of medications,
supplements, and herbals that are currently being taken enables
the nurse to make an accurate medication assessment and
determine the risk for drug interactions. The nurse should ask
the client to bring all medications, supplements, and herbs to the
next.
An older adult client who is disoriented is brought to the
clinic by an adult child who asserts, "There is something just
not right in the head." Which action should the nurse
perform first?
A Arrange mental health and social service consultations for
the client.
B Send the client and adult child to the laboratory for a
prescribed hemogram.
C Review the history of the present problem as perceived by
the adult child.
D Request a referral to a neurologist after reviewing the
client's history.
C Review the history of the present problem as perceived by the
adult child.
During report, an older adult client, who had a right total
hip replacement three days ago, is described as intolerant of
pain. When assessing the client, the nurse finds that the
client cannot straighten the right foot which is pointing
,outward from the body. Which action should the nurse
take?
A Sit down and talk to the client in a nonjudgmental way
about effective ways to handle pain.
B Gently place a pillow on the outside of the leg to prevent
further rotation outward.
C Administer a PRN opioid analgesic immediately and
assess the client's response to the medication 30 minutes
later.
D Call the healthcare provider immediately and report that
the client's prosthesis is most likely dislocated.
D Call the healthcare provider immediately and report that the
client's prosthesis is most likely dislocated.
Signs of prosthesis dislocation include persistent pain unrelieved
by opioid analgesia accompanied by a clicking or popping sound
and shortening of the affected extremity with the foot in external
rotation. The healthcare provider should be notified at once that
the client is manifesting signs and symptoms consistent with
dislocation.
The nurse is caring for an older adult client with impaired
skin integrity resulting from shearing forces and pressure
that has manifested as a draining stage 3 sacral ulcer. Which
intervention is most important for the nurse to implement?
A Teach the family how to perform wound care.
B Encourage a diet high in protein.
C Daily range of motion exercises.
D Ensure that IV fluids are administered as prescribed.
B Encourage a diet high in protein.
An older client who is caring for her husband who had a
stroke has just learned that she needs to have oral surgery.
, She tells the nurse that she has no one to help her care for
her husband if she has the surgery. Which response should
the nurse provide the client?
A Recommend that the client's family return to the area to
help provide assistance.
B Tell her to consider hiring a private nurse during the
postoperative convalescence.
C Advise to have a case management evaluation of the
clients home environment
D Suggest social services be contacted to find a respite care
facility for her husband.
D Suggest social services be contacted to find a respite care
facility for her husband.
Rationale
Respite programs are services designed specifically to benefit
caregiver planned time away from the caregiving role. Respite
care can be utilized for a few hours, a day, or even a weekend.
The nurse should provide the caregiver information about
obtaining respite care.
In checking the dose of intravenous ticarcillin disodium
prescribed for an older client, the nurse notes that the 24
hour dosage is lower than the normal range. Which finding
supports the need for this reduced dosage?
A White blood cell count of 8,000/mm' (8 X 10%/L).
B Thin, fragile hand and arm veins.
C Serum creatinine of 3.5 mg/dL (310 umo/L).
D Inelastic skin turgor.