COMPLETE QUESTIONS WITH CORRECT DETAILED AND VERIFIED ANSWERS
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A nurse is assisting with the plan of care for a client following a
transurethral resection of the prostate. Which of the following interventions should the nurse
include in the plan of care? - (ANSWERS)The nurse should irrigate the bladder using strict
sterile technique and maintain closed catheter drainage system to minimize the rick of infection.
A nurse is reviewing a client's electronic medical record and finds that an assistive per sonnel
recorder the client's temperature as 35.3 degrees Celsius (95.5 degrees F) 2 hrs earlier. Which of
the following actions should the nurse take firsT? - (ANSWERS)check the clients temp
A nurse is receiving change-of-
shift report for four clients. Which of the following clients should the nurse see first? -
(ANSWERS)A client whose urinary output was 100mL for the past 12 hrs
A nurse in reinforcing teaching about weight loss with a female older adult client who is
overweight. Which of the following statements should the nurse include in teaching? -
(ANSWERS)keep fat intake to no more that 30% of daily caloric intake.
A nurse is collecting data from a client who has iron deficiency anemia. Which of the following
findings should the nurse expect? - (ANSWERS)difficulty concentrating
A Nurse is collecting data from an older adult client who is 48 hr postoperative following
abdominal surgery. The provider writes a prescription to advance the client to a re gular Diet. For
which of the following findings should the nurse notify the provider? - (ANSWERS)The client
has absent bowel sounds
A parent brings her adolescent son to an urgent care center and states. "He is high on something
and needs help" The client is
exhibiting agitation and paranoia and reports visual hallucinations. The nurse should suspect
intoxication with which of the following substances? - (ANSWERS)Methamphetamines
,A nurse notices an assistive personnel taking a nap in the break room during he meal t ime. The
AP appears drowsy while performing routine tasks. Which of the following a ctions should the
nurse take? - (ANSWERS)Report the observations about the ap to the unit's nurse manager.
A nurse is reinforcing teaching with a client who has a fluid volume deficit about selec ting
foods that have a high water content. The nurse should include that which of the following raw
foods contains the highest amount of water per 1 cup serving? - (ANSWERS)cherry tomatoes
The nurse is position a client who is scheduled for a lumbar puncture. The nurse should assist the
client into which of the following positions? - (ANSWERS)lateral recumbent
A nurse is talking with a client whose son died in a motor- vehicle crash 2 weeks ago. The client
states "I really thought I'd be back to my usual routines by now, but I can't think of anythingelse
except my son is gone" Which of the following responses should the nurse make? -
(ANSWERS)Grieving for your son is hard work. It will take as much time as you need to come
to terms with your loss.
A nurse is assisting with monitoring a client who is at 40 weeks of gestation and is in active
labor. The nurse recognizes late deceleration on the fetal monitor tracing. Whichof the following
actions should the nurse take? - (ANSWERS)Place the client in the lateral position.
A nurse manager is providing an in-
service on hand hygiene to assistive personnel. which of the following information should the
nurse manager include in the in-service? - (ANSWERS)Remove rings when washing hands with
soap and water
A nurse is reinforcing home safety instructions with the parent of a newborn. Which of the
following statements should the nurse include in the instructions? - (ANSWERS)Place your
baby's crib away from heat vents.
A nurse is preparing to administer a client's morning medications.
Which of the follow ing actions should the nurse take to verify the client's identity? -
(ANSWERS)Scan the facility identification board.
, A nurse is caring for a client following a bronchoscopy procedure. Which of the following
actions should the nurse perform first? - (ANSWERS)check for a gag reflex
While administering a medication to a client, a nurse notices a trayed electrical cord connecting
the client's continuous passive motion machine to the electrical outlet. Which of the following
actions should the nurse take? - (ANSWERS)Remove the device from the client's room.
A nurse is caring for a client who is 4 hr postoperative following a total thyroidectomy. Which of
the following manifestations should the nurse report to the provider as indicating possible
hypocalcemia? - (ANSWERS)Tingling of fingers
A nurse is caring for a client who has a Penrose drain. To ensure proper placement an d
functioning of the drain, which of the following should the nurse expect to observe? -
(ANSWERS)The safety pin is present at the distal end of the drain.
A community health nurse is helping to reinforce teaching about hepatitis A with a group of
employees at a childcare facility.
Which of the following characteristics should t he nurse identify as an external factor that can
impede learning for the participants? - (ANSWERS)Poor lighting in the learning setting
A nurse is observing newly licensed nurse who is providing tracheostomy care for a client. The
nurse identifies proper performance of the procedure when the newly licensed nurse selects
which of the following solutions to clean the inner cannula? - (ANSWERS)hydrogen peroxide
A nurse is caring for a client who has right sided heart failure. The client's partner exp resses
concern the the client will die. Which of the following responses should the nurse make? -
(ANSWERS)"It is difficult to see someone so sick. Whathave you been told about your partner's
prognosis?"
A nurse in a long-term care facility is assisting with an in-service for newly hired assistive
personnel about legal issues within the facility. Which of the following should the nurse include
as an example of assault? - (ANSWERS)Informing a client the nurse is going to administer an
injection even though the client refuses.