Professional Nursing Exam 3 Evolve Questions with Correct Answers Guaranteed Grade A (2025 Version).

Professional Nursing Exam 3 Evolve Questions with Correct Answers Guaranteed Grade A (2025 Version). You are preparing a presentation for your classmates regarding the clinical care coordination conference for a patient with terminal cancer. As part of the preparation, you have your classmates read the Nursing Code of Ethics for Professional Registered Nurses. Your instructor asks the class why this document is important. Which of the following statements best describes this code? A. Improves self-health care B. Protects the patient's confidentiality C. Ensures identical care to all patients D. Defines the principles of right and wrong to provide patient care D. Defines the principles of right and wrong to provide patient care An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, listens to her lung and heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed? A. Diagnosis B. Evaluation C. Assessment D. Implementation C. Assessment A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice is performed? A. Planning B. Evaluation C. Assessment D. Implementation D. Implementation A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with them. The nurse is acting as the patients: A. Educator B. Advocate C. Caregiver D. Case manager B. Advocate The nurse spends time with the patient and family reviewing the dressing change procedure for the patient's wound. The patient's spouse demonstrates how to change the dressing. The nurse is acting in which professional role? A. Educator B. Advocate C. Caregiver D. Case manager A. Educator The examination for registered nurse (RN) licensure is exactly the same in every state in the United States. This examination: A. Guarantees safe nursing care for all patients B. Ensures standard nursing care for all patients C. Ensures that honest and ethical care is provided D. Provides a minimal standard of knowledge for an RN in practice D. Provides a minimal standard of knowledge for an RN in practice Health care reform will bring changes in the emphasis of care. Which of the following models is expected from health care reform? A. Moving from an acute illness to a health promotion, illness prevention model B. Moving from illness prevention to a health promotion model C. Moving from an acute illness to a disease management model D. Moving from a chronic care to an illness prevention model A. Moving from an acute illness to a health promotion, illness prevention model A nurse meets with the registered dietician and physical therapist to develop a plan of care that focuses on improving nutrition and mobility for a patient. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? A. Patient-centered care B. Safety C. Teamwork and collaboration D. Informatics C. Teamwork and collaboration A critical care nurse is using a computerized decision support system to correctly position her ventilated patients to reduce pneumonia caused by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? A. Patient-centered care B. Safety C. Teamwork and collaboration D. Informatics D. Informatics The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patients. A nurse consultant decides to compare two types of treatment. The first is the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career? A. Clinical nurse specialist B. Nurse administrator C. Nurse educator D. Nurse researcher D. Nurse researcher Nurses in an acute care hospital are attending a unit based education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education? A. Continuing education B. Graduate education C. In-service education D. Professional Registered Nurse Education C. In-service education Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? (Select all that apply.) A. Caregiver B. Autonomy and accountability C. Patient advocate D. Health promotion E. Lobbyist A. Caregiver B. Autonomy and accountability C. Patient advocate D. Health promotion Which of the following Internet resources available can assist consumers when comparing quality care measures? (Select all that apply.) A. WebMD B. Hospital Compare C. Magnet Recognition Program D. Hospital Consumer Assessment of Healthcare E. The American Hospital Association's webpage. B. Hospital Compare D. Hospital Consumer Assessment of Healthcare Which of the following signs or symptoms in an opioid-naive patient is of greatest concern to the nurse when assessing the patient 1 hour after administering an opioid? A. Oxygen saturation of 95% B. Difficulty arousing the patient C. Respiratory rate of 10 breaths/min D. Pain intensity rating of 5 on a scale of 0 to 10 B. Difficulty arousing the patient A health care provider writes the following order for an opioid-naive patient who returned from the operating room following a total hip replacement: "Fentanyl patch 100 mcg, change every 3 days." On the basis of this order, the nurse takes the following action: A. Calls the health care provider and questions the order B. Applies the patch the third postoperative day C. Applies the patch as soon as the patient reports pain D. Places the patch as close to the hip dressing as possible A. Calls the health care provider and questions the order A patient is being discharged home on an around-the-clock (ATC) opioid for chronic back pain. Because of this order, the nurse anticipates an order for which class of medication? A. Opioid antagonists B. Antiemetics C. Stool softeners D. Muscle relaxants C. Stool softeners A new medical resident writes an order for oxycodone CR (Oxy Contin) 10 mg PO q2h prn. Which part of the order does the nurse question? A. The drug B. The time interval C. The dose D. The route B. The time interval The nurse reviews a patient's medical administration record (MAR) and finds that the patient has received oxycodone/acetaminophen (Percocet) (5/325), two tablets PO every 3 hours for the past 3 days. What concerns the nurse the most? A. The patient's level of pain B. The potential for addiction C. The amount of daily acetaminophen D. The risk for gastrointestinal bleeding C. The amount of daily acetaminophen A patient with chronic low back pain who took an opioid around-the-clock (ATC) for the past year decided to abruptly stop the medication for fear of addiction. He is now experiencing shaking chills, abdominal cramps, and joint pain. The nurse recognizes that this patient is experiencing symptoms of: A. Opioid toxicity. B. Opioid tolerance. C. Opioid addiction. D. Opioid withdrawal. D. Opioid withdrawal A patient with a 3-day history of a stroke that left her confused and unable to communicate returns from interventional radiology following placement of a gastrostomy tube. The patient has been taking hydrocodone/APAP 5/325 up to four tablets/day before her stroke for arthritic pain. The health care provider's order reads as follows: "Hydrocodone/APAP 5/325 1 tab, per gastrostomy tube, q4h, prn." Which action by the nurse is most appropriate? A. No action is required by the nurse because the order is appropriate. B. Request to have the order changed to around the clock (ATC) for the first 48 hours. C. Ask for a change of medication to meperidine (Demerol) 50 mg IVP, q3 hours, prn. D. Begin the hydrocodone/APAP when the patient shows nonverbal symptoms of pain. B. Request to have the order changed to around the clock (ATC) for the first 48 hours A patient rates his pain as a 6 on a scale of 0 to 10, with 0 being no pain and 10 being the worst pain. The patient's wife says that he can't be in that much pain since he has been sleeping for 30 minutes. Which is the most accurate resource for assessing the pain? A. Patient's self-report B. Behaviors C. Surrogate (wife) report D. Vital sign changes A. Patient's self-report When teaching a patient about transcutaneous electrical nerve stimulation (TENS), which information do you include? A. TENS works by causing distractions. B. TENS therapy does not require a health care provider's order. C. TENS requires an electrical source for use. D. TENS electrodes are applied near or directly on the site of pain. D. TENS electrodes are applied near or directly on the site of pain A postoperative patient currently is asleep. Therefore the nurse knows that: A. The sedative administered may have helped him sleep, but it is still necessary to assess pain. B. The intravenous (IV) pain medication given in recovery is relieving his pain effectively. C. Pain assessment is not necessary. D. The patient can be switched to the same amount of medication by the oral route. A. The sedative administered may have helped him sleep, but it is still necessary to assess the pain A patient is prescribed morphine patient-controlled analgesia (PCA). What is the correct order for administering PCA? 1. Program computerized PCA pump to deliver prescribed medication dose and lockout interval. 2. Check label of medication 3 times: when removed from storage, when brought to bedside, when preparing for assembly. 3. Administer loading dose of analgesia as prescribed. 4. Attach drug reservoir to infusion device, prime tubing, and attach needleless adapter to end of tubing. 5. Identify patient using two identifiers. 6. Insert and secure needleless adapter into injection port nearest patient. A. 1, 2, 4, 1, 6, 3 B. 2, 5, 1, 4, 6, 3 Correct C. 1, 2, 5, 4, 6, 3 D. 2, 5, 4, 1, 3, 6 B. 2, 5, 1, 4, 6, 3 A patient has returned from the operating room, recovering from repair of a fractured elbow, and states that her pain level is 6 on a 0-to-10 pain scale. She received a dose of hydromorphone just 15 minutes ago. Which interventions may be beneficial for this patient at this time? (Select all that apply.) A. Transcutaneous electrical nerve stimulation (TENS) B. Administer naloxone (Narcan) 2 mg intravenously C. Provide back massage D. Reposition the patient E. Withhold any pain medication and tell the patient that she is at risk for addiction A. Transcutaneous electrical nerve stimulation C. Provide back massage D. Reposition the patient Which of the following instructions is crucial for the nurse to give to both family members and the patient who is about to be started on a patient-controlled analgesia (PCA) of morphine? (Select all that apply.) A. Only the patient should push the button. Correct B. Do not use the PCA until the pain is severe. C. The PCA system can set limits to prevent overdoses from occurring. Correct D. Notify the nurse when the button is pushed. Incorrect E. Do not push the button to go to sleep. Correct A. Only the patient should push the button C. The PCA system can set limits to prevent overdoses from occurring E. Do not push the button to go to sleep When using ice massage for pain relief, which of the following is correct? (Select all that apply.) A. Apply ice using firm pressure over skin. Correct B. Apply ice for 5 minutes or until numbness occurs. Correct C. Apply ice no more than 3 times a day. D. Limit application of ice to no longer than 10 minutes. Incorrect E. Use a slow, circular steady massage. A. Apply ice using firm pressure over skin B. Apply ice for 5 minutes or until numbness occurs E. Use a slow, circular steady massage While caring for a patient with cancer pain, the nurse knows that a multimodal analgesia plan includes: (Select all that apply.) A. Using analgesics such as nonsteroidal antiinflammatory drugs (NSAIDs) along with opioids. Correct B. Stopping acetaminophen when the pain becomes very severe. C. Avoiding polypharmacy by limiting the use of medication to one agent at a time. D. Avoiding total sedation, regardless of the severity of the pain. Incorrect E. The use of adjuvants (co-analgesics) such as gabapentin (Neurontin) to manage neuropathic type pain. A. using analgesic such as nonsteroidal antiinflammatory drugs along with opioids E. The use of adjuvants such as gabapentin to manage neuropathic type pain The primary reason that family members should be included when a nurse teaches the patient preoperative exercises is so they can: A. Coach and encourage the patient after surgery. B. Demonstrate to the patient at home. C. Relieve the nurse by getting the patient to do the exercises every 2 hours. D. Practice with the patient while he or she is waiting to be taken to the operating room. A. Coach and encourage the patient after surgery In the postanesthesia care unit (PACU) the nurse notes that the patient is having difficulty breathing and suspects an upper-airway obstruction. The nurse would first: A. Suction the pharynx and bronchial tree. B. Give oxygen through a mask at 4 L/min. C. Ask the patient to use an incentive spirometer. D. Position the patient on one side with the face down and the neck slightly extended so the tongue falls forward. D. Position the patient on one side with the face down and the neck slightly extended so the tongue fall forward Because an older adult is at increased risk for respiratory complications after surgery, the nurse should: A. Withhold pain medications and ambulate the patient every 2 hours. B. Monitor fluid and electrolyte status every shift and vital signs with temperature every 4 hours. C. Orient the patient to the surrounding environment frequently and ambulate him or her every 2 hours. D. Encourage the patient to turn, deep breath, and cough frequently and ensure adequate pain control. D. Encourage the patient to turn, deep breath, and cough frequently and ensure adequate pain control .ID: You are a nurse in the postanesthesia care unit (PACU), and you note that your patient has a heart rate of 130 beats/min and a respiratory rate of 32 breaths/min; you also assess jaw muscle rigidity and rigidity of limbs, abdomen, and chest. What do you suspect, and which intervention is indicated? A. Infection: Notify surgeon and anticipate administration of antibiotics. B. Pneumonia: Listen to breath sounds, notify surgeon, and anticipate order for chest radiography. C. Hypertension: Check blood pressure, notify surgeon, and anticipate administration of antihypertensives. D. Malignant hyperthermia: Notify surgeon/anesthesia provider immediately, prepare to administer dantrolene sodium (Dantrium), and monitor vital signs frequently. D. Malignant hyperthermia: Notify surgeon/anesthesia provider immediately, prepare to administer dantrolene sodium, and monitor vital signs frequently After a surgical patient has been given preoperative sedatives, which safety precaution should a nurse take? A. Reinforce to patient to remain in bed or on the stretcher B. Raise the side rails and keep the bed or stretcher in the high position C. Determine if patient has any allergies to latex D. Obtain informed consent immediately after sedative administration A. Reinforce to patient to remain in bed or on the stretcher You have been given the following postoperative patients for care on your medical-surgical unit. On the basis of the information provided, which patient should you see first? A. A 75-year-old following hip replacement surgery who is complaining of moderate pain in the surgical site, with a heart rate of 92 B. A 57-year-old following hip replacement 6 hours earlier who is receiving intravenous patient-controlled analgesia (PCA) with a history of obstructive sleep apnea (OSA) (The pulse oximeter has been alarming and reading 85%.) C. A 36-year-old following bladder neck suspension who is 30 minutes late to receive her postoperative dose of antibiotic D. A 48-year-old following total knee replacement who needs help repositioning in bed B. A 57-year-old following hip replacement 6 hours earlier who is receiving intravenous patient-controlled analgesia (PCA) with a history of obstructive sleep apnea (OSA) (The pulse oximeter has been alarming and reading 85%.) A nurse is working in the preoperative holding area and is assigned to care for a patient who is having a prosthetic aortic valve placed. The nurse inserts an intravenous (IV) line and obtains vital signs. The patient has a temperature of 39° C (102° F), heart rate of 120, blood pressure (BP) of 84/50, and an elevated white blood cell (WBC) count. The nurse immediately notifies the surgeon of the patient's vital signs because: A. He or she needs to get the patient into the operating room (OR) quickly to start the surgery because of the low BP. B. The surgery may need to be delayed to recheck the patient's WBC count and investigate the source of fever before surgery. C. The nurse anticipates the need for a fluid bolus to increase the patient's BP. D. The nurse anticipates an order for a sedative to help calm the patient and decrease the heart rate. B. The surgery may need to be delayed to recheck the patient's WBC count and investigate the source of fever before surgery. You are caring for a 65-year-old patient 2 days after surgery and helping him ambulate down the hallway. The surgeon has ordered exercise as tolerated. Your assessment indicates that the patient's heart rate at baseline is 88. After walking approximately 30 yards down the hallway, the heart rate is 110. What should be your next action? A. Stop exercise immediately and have him sit in a nearby chair. B. Ask him how he feels; determine if there is any discomfort or shortness of breath; and, if not, continue exercise. C. Tell him that he needs to walk further to reach a heart rate of 120. D. Have him walk slower; he has reached his maximum. B. Ask him how he feels; determine if there is any discomfort or shortness of breath; and, if not, continue exercise. Obesity places patients at an increased surgical risk because of which of the following factors? (Select all that apply.) A. Risk for bleeding is increased. B. Ventilatory capacity is reduced C. Fatty tissue has a poor blood supply. D. Metabolic demands are increased. E. Physical mobility is often impaired. B. Ventilatory capacity is reduced C. Fatty tissue has a poor blood supply E. Physical mobility is often impaired You are caring for a patient after surgery who underwent a liver resection. His prothrombin time (PT) or an activated partial thromboplastin time (APTT) is greater than normal. He has low blood pressure; tachycardia; thready pulse; and cool, clammy, pale skin, and he is restless. You assess his surgical wound, and the dressing is saturated with blood. Which immediate interventions should you perform? (Select all that apply.) A. Notify the surgeon. B. Maintain intravenous (IV) fluid infusion and prepare to give volume replacement. C. Monitor the patient's vital signs every 15 minutes or more frequently until his condition stabilizes. D. Wean oxygen therapy. E. Provide comfort through bathing. A. Notify the surgeon B. Maintain IV fluid infusion and prepare to give volume replacement C. Monitor the patient's vital signs every 15 minutes or more frequently until his condition stabilizes The operating room (OR) and postanesthesia care unit (PACU) are high-risk environments for patients with a latex allergy. Which safety measures to prevent a latex reaction should the nurse implement? (Select all that apply.) A. Screening patients about food allergies known to have cross-reactivity to latex B. Having a latex allergy cart available at all times C. Communicating with the operating room (OR) team as soon as 24 to 48 hours in advance of the surgery when a latex-sensitive patient is identified D. Scheduling the latex-sensitive patient for the last operative case of the day E. Planning for the patient to be admitted to a private room after surgery A. Screening patients about food allergies known to have cross-reactivity to latex B. Having a latex allergy cart available at all times C. Communicating with the operating room (OR) team as soon as 24 to 48 hours in advance of the surgery when a latex-sensitive patient is identified A nurse is recovering a patient who received conscious sedation for cosmetic surgery. Which of the following is an advantage that conscious sedation has over general anesthesia? (Select all that apply.) A. Loss of sensation at the surgical site B. Reduction of fear and anxiety C. Amnesia about procedure D. Monitoring in phase I recovery E. Close monitoring for airway patency B. Reduction of fear and anxiety C. Amnesia about procedure Hand-off communications that occur between the postanesthesia care unit (PACU) nurse and the nurse on the postoperative nursing unit should be done when a patient returns to the nursing unit. Which are appropriate components of a safe and effective hand-off? (Select all that apply.) A. Vital signs, type of anesthesia provided, blood loss, and level of consciousness B. Uninterrupted time to review the recent pertinent events and ask questions C. Verification of the patient using one identifier and the type of surgery performed D. Review of pertinent events occurring in the operating room (OR) while at the nurses' station E. Location of patient's family members A. Vital signs, type of anesthesia provided, blood loss, and level of consciousness B. Uninterrupted time to review the recent pertinent events and ask questions E. Location of patient's family members The nurse is preparing to provide a patient with instructions for how to perform incentive spirometry. The patient will likely have incisional pain after returning from an elective colon resection. Which of the following steps for incentive spirometry is the patient likely to have the most difficulty performing? (Select all that apply.) A. Assuming semi-Fowler's or high-Fowler's position B. Setting the incentive spirometer device scale at the volume level to be attained C. Placing the mouthpiece of the incentive spirometer so lips completely cover the mouthpiece D. Inhaling slowly while maintaining constant flow through unit until it reaches goal volume E. Breathing normally for a short period between each of the 10 breaths on incentive spirometry F. Ending with two coughs after the end of 10 incentive spirometry breaths hourly A. Assuming semi-Fowler's or high-Fowler's position D. Inhaling slowly while maintaining constant flow through unit until it reaches goal volume F. Ending with two coughs after the end of 10 incentive spirometry breaths hourly A patient is admitted through the emergency department following a motorcycle crash with multiple orthopedic injuries. He goes to surgery for repair of fractures. He is postoperative day 3 from an open-reduction internal fixation of bilateral femur fractures and external fixator to his unstable pelvic fracture. Interventions that are necessary for prevention of venous thromboembolism in this high-risk postsurgical patient include: (Select all that apply.) A. Intermittent pneumatic compression stockings. B. Vitamin K therapy. C. Passive range-of-motion exercises every 4 hours. D. Subcutaneous heparin or enoxaparin (Lovenox). E. Continuous heparin drip with a goal of an international normalized ratio (INR) 5 times higher than baseline. A. Intermittent pneumatic compression stockings D. Subcutaneous heparin or e