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Which laboratory finding for an adult client is most critical for the nurse to
report to the healthcare provider?
A. Serum sodium 142mEq/L
B. Serum potassium 3.9mEq/L
C. Serum glucose 62 mg/dL
D. Blood urea nitrogen 18 mg/dL - ANSWER-C. Serum glucose 62 mg/dL
When conducting diet teaching for a client who was diagnosed with a
myocardial infarction, which snack foods should the nurse encourage the client
to eat? (Select all that apply)
A. Fresh vegetables with mayonnaise dip
B. Fresh turkey slices and berries
C. Chicken bouillon soup and toast
D. Soda crackers and peanut butter
E. Raw unsalted almonds and apples - ANSWER-B. Fresh turkey slices and
berries
C. Chicken bouillon soup and toast
E. Raw unsalted almonds and apples
,A client with a lower respiratory tract infection receives a prescription for
ciprofloxacin 500mg PO every 12 hours. When the client requests an afternoon
snack, which dietary choice should the nurse provide?
A. Cinnamon applesauce
B. Vanilla-flavored yogurt
C. Calcium-fortified juice
D. Low-fat chocolate milk - ANSWER-A. Cinnamon applesauce
When admitting a client with a diagnosis of transient ischemic attack (TIA),
which intervention is most important for the nurse to include in this client's plan
of care?
A. Assess bilateral breath sounds
B. Review client's daily medications
C. Initiate neurological monitoring every 2 hours
D. Palpate suprapubic region for urinary retention - ANSWER-C. Initiate
neurological monitoring every 2 hours
An older client's daughter calls the home health nurse and reports that her
mother has become forgetful and is very confused at night. The daughter stated
that her mother's behavior changed suddenly a few days ago and is now getting
worse. Which actions should the nurse take?
A. Encourage increased intake of high protein foods
B. Instruct the daughter to check her mother's temperature
C. Review the client's current food and medication allergies
D. Ask if the mother is experiencing any pain with urination
E. Determine if the mother has recently experienced a fall. - ANSWER-A.
Encourage increased intake of high protein foods
B. Instruct the daughter to check her mother's temperature
D. Ask if the mother is experiencing any pain with urination
,The nurse who works in labor and delivery is reassigned to the cardiac care unit
for the day because of a low census in labor and delivery. Which assignment is
best for the charge nurse to give this nurse?
A. Assist cardiac nurses with their assignments
B. Monitor the central telemetry
C. Perform the admission of a new client
D. Transfer a client to another unit - ANSWER-A. Assist cardiac nurses with
their assignments
The nurse is developing an educational program for older clients who are being
discharged with new antihypertensive medications. The nurse should ensure that
the education materials include which characteristics? (Select all that apply)
A. Uses common words with few syllables
B. Printed using a 12-point type font
C. Uses pictures to help illustrate complex ideas
D. Contains a list with definitions of unfamiliar terms
E. Written at a twelfth-grade reading level - ANSWER-A. Uses common words
with few syllables
C. Uses pictures to help illustrate complex ideas
D. Contains a list with definitions of unfamiliar terms
The nurse is providing care for a client with severe peripheral arterial disease
(PAD). The client reports a history of rest ischemia, with leg pain that occurs
during the night. Which action should the nurse take in response to this finding?
A. Elevate the legs to assess for color changes
B. Provide a heating pad for PRN use
C. Offer cold packs when the pain occurs
D. Suggest dangling the legs when pain occurs - ANSWER-C. Offer cold packs
when the pain occurs
, The nurse assess a client being treated for Herpes zoster (shingles). Which
assessments should the nurse include when evaluating the effectiveness of the
the treatment? (Select all that apply)
A. Functional ability
B. Skin integrity
C. Pain scale
D. Bowel sounds
E. heart sounds - ANSWER-A. Functional ability
B. Skin integrity
A heparin infusion is prescribed for a client who weighs 220 pounds. After
administering a bolus dose of 80 units/kg, the nurse calculates the infusion rate
for the heparin solution at 18 units/kg/hr. The available solution is Heparin
Sodium 25,000 units in 5% Dextrose injection 250mL. The nurse should
program the infusion pump to deliver how many mL/hour? - ANSWER-18
When providing client care the nurse identifies a problem and develops a related
clinical question. Next, the nurse intends to gather evidence so that the decision-
making process in response to the problem and clinical question is evidence-
based. When gathering evidence, which consideration is most important?
A. Past experience with similar problems
B. Relevance to the situation
C. Related personal values
D. Frequency that the problem occurs - ANSWER-B. Relevance to the situation
A client with rheumatoid arthritis (RA) starts a new prescription for etanercept
subcutaneously once weekly. The nurse should emphasize the importance of
reporting which problem to the healthcare provider?
A. Joint stiffness
B. Persistent fever
C. Headache