UPDATE 2024/2025 WITH APPROVED QUESTIONS AND
ANSWERS |A+ GRADED
A nurse is caring for a client who is at 33 weeks of gestation following an amniocentesis. The
nurse should monitor the client for which of the following complications?
A. Vomiting
B. Hypertension
C. Epigastric pain
D. Contractions - D. Contractions
A nurse is providing teaching to an older adult client about methods to promote nighttime
sleep. Which of the following instructions should the nurse include?
A. Stay in bed at least 1 hr if unable to fall asleep
B. Take a 1 hr nap during the day
C. Perform exercises prior to bedtime
D. Eat a light snack before bedtime - D. Eat a light snack before bedtime
A nurse on a telemetry unit is caring for a client who becomes unconscious and whose
monitor displays ventricular tachycardia. Which of the following actions should the nurse
take first after determining the client does not have a palpable pulse?
A. Assess heart sounds
B. Defibrillate
C. Establish IV access
D. Administer epinephrine - B. Defibrillate
, A nurse is admitting a client who 1 week postpartum and reports excessive vaginal bleeding.
The nurse does not speak the same language as the client. The client's partner and 10-year-
old child are accompanying her. Which of the following actions should the
nurse take to gather the client's admission data?
A. Have the client's child translate
B. Allow the client's partner to translate
C. Request a female interpreter through the facility
D. Ask a nursing student who speaks the same language as the client to translate - C.
Request a female interpreter through the facility
A nurse is caring for a client who is febrile. To reduce the client's fever, the nurse applies a
cooling blanket. Which of the following findings indicates the client is having an adverse
reaction to the cooling?
a. Flushing
b. Tachycardia
c. Restlessness
d. Shivering - d. Shivering
A nurse is caring for a client who has deep-vein-thrombosis of the left lower extremity.
Which of the following actions should the nurse take? (Exhibit)
A. Position the client with the affected extremity lower than the heart
B. Withhold heparin IV infusion PTT- 30-40 seconds; x2 if on heparin
C. Administer acetaminophen
D. Massage the affected extremity every 4 hr - B. Withhold heparin IV infusion PTT- 30-40
seconds; x2 if on heparin
A nurse is reviewing assessment data from several clients. For which of the following clients
should the nurse recommend referral to a dietitian?
A. An older adult client who has a BMI of 24
B. A client who has a nonhealing leg ulcer
,C. An older adult client who has presbyopia
D. A client who has an albumin level of 3.7 g/dL (normal 3.4-5.4) - B. A client who has a
nonhealing leg ulcer
8. A nurse is providing discharge teaching to a client who has a chronic kidney disease and is
receiving hemodialysis. Which of the following instructions should the nurse include in the
teaching?
a. Eat 1 g/kg of protein per day
b. Take magnesium hydroxide for indigestion
c. Drink at least 3 L of fluid daily-
Consume foods high in potassium- restrict - a. Eat 1 g/kg of protein per day
A nurse is caring for a client who is receiving intermittent enteral tube feedings. Which of
the following places the client at risk for aspiration?
A. Sitting in a high-Fowler's position during the feeding
B. A history of gastroesophageal reflux disease
C. Receiving a high osmolarity formula
D. A residual of 65 mL 1 hr postprandial? - B. A history of gastroesophageal reflux disease
?A nurse is providing prenatal teaching to a client who is at 12 weeks of gestation. The nurse
should tell the client that she will undergo which of the following screening tests at 16
weeks of gestation?
A. Chorionic villus sampling- as early as 8 weeks
B. Cervical cultures for chlamydia- 1st appointment.
C. Nonstress test -28 weeks
D. Maternal serum alpha-fetoprotein- 16 to 18 weeks - D. Maternal serum alpha-
fetoprotein- 16 to 18 weeks
A nurse is caring for a client who is on bed rest. The nurse should recognize that which of
the following findings is a complication of immobility?
, A. Decreased serum calcium levels- increased serum calcium
B. Increased blood pressure- hypotension
C. Swollen area on calf
D. Urinary frequency- - C. Swollen area on calf
12. nA nnurse nin nacute ncare nmental nhealth nfacility nis nparticipating nin na nmedication-education
n group. n The n leader n of n the n group n uses n a n laissez-faire n leadership n style. n Which n of n the
n following n actions n should n the n nurse n expect n from n the n leader n during n the n session?
A n.The nleader nencourages ngroup nmembers nto nremain nsilent nuntil nquestions nare ncalled nfor
B. nThe nleader nlecture nabout nmedication nadverse neffects nto nthe ngroup nmembers
c. nThe nleader nallows nthe ngroup nto ndiscuss nwhatever nthey nwould nlike nto nregarding ntheir
medications
d. nThe nleader nhas ngroup nmembers nvote non nwhat nthey nwould nlike nto nlearn nabout nduring nthe
n session n - n n d. n The nleader n has n group n members n vote n on n what n they n would n like n to n learn n about
n during n the n session
n A nnurse nis nproviding nteaching nabout ndigoxin nadministration nto nthe nparents nof na ntoddler
n who n has n heart n failure. n Which nof n the n following n statements n should n the n nurse n include n in n the
n teaching?
A n"You ncan nadd nthe nmedication nto na nhalf-cup nof nyour nchild's nfavorite njuice."
B n"Repeat nthe ndose nif nyour nchild nvomits nwithin n1 nhour nafter ntaking nmedication." nX
C n"Limit nyour nchild's npotassium nintake nwhile nshe nis ntaking nthis nmedication."
D n"Have nyour nchild ndrink na nsmall nglass nof nwater nafter nswallowing nthe nmedication." n- n nD
n "Have n your n child n drink n a n small n glass n of n water n after n swallowing n the n medication."
n A nnurse nis nproviding nteaching nto na nclient nwho nhas na ndepressive ndisorder nand na nnew
n prescription n for n phenelzine. n Which n of n the n following n foods n should n the n nurse n instruct n the
client nto navoid?
A. nGrapefruit
B. nSpinach