NR224 Exam 1 Questions with Correct Answers Latest Update 2025/2026
a. obtain culture specimens before initiating antimicrobials.
C. Encourage the client to rest and limit activity.
E. assist the client with oral hygiene frequently. - Answers A nurse is caring for an 82-year-old
client in the emergency department who has an oral body temperature of 38.3 C (101 F), pulse
rate 114/min, and respiratory rate 22/min. He is restless and his skin is warm. Which of the
following interventions should the nurse take? (select all that apply)
a. obtain culture specimens before initiating antimicrobials.
B. Restrict the client's oral fluid intake.
C. Encourage the client to rest and limit activity.
D. allow the client to shiver to dispel excess heat.
E. assist the client with oral hygiene frequently.
A. "Do not measure the client's temperature rectally." - Answers A nurse is instructing an
assistive personnel about caring for a client who has a low platelet count as a result of
chemotherapy. Which of the following instructions is the priority for measuring vital signs for
this client?
A. "Do not measure the client's temperature rectally."
B. "Count the client's radial pulse for 30 seconds and multiply it by 2."
C. "Do not let the client know you are counting her respirations."
D. "Let the client rest for 5 minutes before you measure her blood pressure."
A. place the client in semi-Fowler's position.
B. have the client rest an arm across the abdomen.
C. Observe one full respiratory cycle before counting the rate. - Answers A nurse is instructing a
group of nursing students in measuring a client's respiratory rate. Which of the following
guidelines should the nurse include? (Select all that apply.)
A. place the client in semi-Fowler's position.
B. have the client rest an arm across the abdomen.
C. Observe one full respiratory cycle before counting the rate.
D. Count the rate for 30 sec if it is irregular.
,E. Count and and report any signs the client demonstrates.
B. Ask the client if she is having pain. - Answers A nurse who is admitting a client who has a
fractured femur obtains a blood pressure reading of 140/94 mm Hg. The client denies any
history of hypertension. Which of the following actions should the nurse take first?
A. request a prescription for an antihypertensive medication.
B. Ask the client if she is having pain.
C. Request a prescription for antianxiety medication.
D. Return in 30 min to recheck the client's blood pressure.
A. turn the client's head to the side. - Answers A nurse is performing mouth care for a client who
is unconscious. Which of the following actions should the nurse take?
A. turn the client's head to the side.
B. place two fingers in the client's mouth to open.
C. Brush the client's teeth once per day.
D. Inject a mouth rinse into the center of the client's mouth.
A. inspect the feet daily
B. use moisturizing lotion on the feet.
E. wear cotton socks. - Answers A nurse is instructing a client who has diabetes mellitus about
foot care. Which of the following guidelines should the nurse include? (Select all that apply.)
A. inspect the feet daily
B. use moisturizing lotion on the feet.
C. Wash the feet with warm water and let them air dry.
D. use over-the-counter products to treat abrasions.
E. wear cotton socks.
A. schedule rest periods during morning care. - Answers A nurse is planning care for a client
who develops dyspnea and feels tired after completing her morning care. Which of the following
actions should the nurse include in the client's plan of care?
A. schedule rest periods during morning care.
B. discontinue morning care for 2 days.
, C. perform all care as quickly as possible.
D. ask a family member to come in to bathe the client.
A. face - Answers A nurse is beginning a complete bed bath for a client. After removing the
client's gown and placing a bath blanket over him, which of the following areas should the nurse
wash first?
A. face
B. feet
C. chest
D. arms
B. brush the dentures with a toothbrush and denture cleaner. - Answers A nurse is preparing to
perform denture care for a client. Which of the following actions should the nurse plan to take?
A. pull down and out at the back of the upper denture to remove.
B. brush the dentures with a toothbrush and denture cleaner.
C. rinse the dentures with hot water after cleaning them.
D. place the dentures in a clean, dry storage container after cleaning them.
B. instruct the client to tuck her chin when swallowing.
Rationale: tucking the chin when swallowing allows food to pass down the esophagus more
easily. - Answers A nurse is caring for a client who is at high risk for aspiration. Which of the
following actions should the nurse take?
A. give the client liquids.
B. instruct the client to tuck her chin when swallowing.
C. have the client use a straw.
D. encourage the client to lie down and rest after meals.
A. older adults are more prone to dehydration than younger adults are.
B. older adults need the same amount of most vitamins and minerals as younger adults do.
C. many older men and women need calcium supplementation. - Answers A nurse in a senior
center is counseling a group of older adults about their nutritional needs and considerations.
Which of the following information should the nurse include? (Select all that apply).
a. obtain culture specimens before initiating antimicrobials.
C. Encourage the client to rest and limit activity.
E. assist the client with oral hygiene frequently. - Answers A nurse is caring for an 82-year-old
client in the emergency department who has an oral body temperature of 38.3 C (101 F), pulse
rate 114/min, and respiratory rate 22/min. He is restless and his skin is warm. Which of the
following interventions should the nurse take? (select all that apply)
a. obtain culture specimens before initiating antimicrobials.
B. Restrict the client's oral fluid intake.
C. Encourage the client to rest and limit activity.
D. allow the client to shiver to dispel excess heat.
E. assist the client with oral hygiene frequently.
A. "Do not measure the client's temperature rectally." - Answers A nurse is instructing an
assistive personnel about caring for a client who has a low platelet count as a result of
chemotherapy. Which of the following instructions is the priority for measuring vital signs for
this client?
A. "Do not measure the client's temperature rectally."
B. "Count the client's radial pulse for 30 seconds and multiply it by 2."
C. "Do not let the client know you are counting her respirations."
D. "Let the client rest for 5 minutes before you measure her blood pressure."
A. place the client in semi-Fowler's position.
B. have the client rest an arm across the abdomen.
C. Observe one full respiratory cycle before counting the rate. - Answers A nurse is instructing a
group of nursing students in measuring a client's respiratory rate. Which of the following
guidelines should the nurse include? (Select all that apply.)
A. place the client in semi-Fowler's position.
B. have the client rest an arm across the abdomen.
C. Observe one full respiratory cycle before counting the rate.
D. Count the rate for 30 sec if it is irregular.
,E. Count and and report any signs the client demonstrates.
B. Ask the client if she is having pain. - Answers A nurse who is admitting a client who has a
fractured femur obtains a blood pressure reading of 140/94 mm Hg. The client denies any
history of hypertension. Which of the following actions should the nurse take first?
A. request a prescription for an antihypertensive medication.
B. Ask the client if she is having pain.
C. Request a prescription for antianxiety medication.
D. Return in 30 min to recheck the client's blood pressure.
A. turn the client's head to the side. - Answers A nurse is performing mouth care for a client who
is unconscious. Which of the following actions should the nurse take?
A. turn the client's head to the side.
B. place two fingers in the client's mouth to open.
C. Brush the client's teeth once per day.
D. Inject a mouth rinse into the center of the client's mouth.
A. inspect the feet daily
B. use moisturizing lotion on the feet.
E. wear cotton socks. - Answers A nurse is instructing a client who has diabetes mellitus about
foot care. Which of the following guidelines should the nurse include? (Select all that apply.)
A. inspect the feet daily
B. use moisturizing lotion on the feet.
C. Wash the feet with warm water and let them air dry.
D. use over-the-counter products to treat abrasions.
E. wear cotton socks.
A. schedule rest periods during morning care. - Answers A nurse is planning care for a client
who develops dyspnea and feels tired after completing her morning care. Which of the following
actions should the nurse include in the client's plan of care?
A. schedule rest periods during morning care.
B. discontinue morning care for 2 days.
, C. perform all care as quickly as possible.
D. ask a family member to come in to bathe the client.
A. face - Answers A nurse is beginning a complete bed bath for a client. After removing the
client's gown and placing a bath blanket over him, which of the following areas should the nurse
wash first?
A. face
B. feet
C. chest
D. arms
B. brush the dentures with a toothbrush and denture cleaner. - Answers A nurse is preparing to
perform denture care for a client. Which of the following actions should the nurse plan to take?
A. pull down and out at the back of the upper denture to remove.
B. brush the dentures with a toothbrush and denture cleaner.
C. rinse the dentures with hot water after cleaning them.
D. place the dentures in a clean, dry storage container after cleaning them.
B. instruct the client to tuck her chin when swallowing.
Rationale: tucking the chin when swallowing allows food to pass down the esophagus more
easily. - Answers A nurse is caring for a client who is at high risk for aspiration. Which of the
following actions should the nurse take?
A. give the client liquids.
B. instruct the client to tuck her chin when swallowing.
C. have the client use a straw.
D. encourage the client to lie down and rest after meals.
A. older adults are more prone to dehydration than younger adults are.
B. older adults need the same amount of most vitamins and minerals as younger adults do.
C. many older men and women need calcium supplementation. - Answers A nurse in a senior
center is counseling a group of older adults about their nutritional needs and considerations.
Which of the following information should the nurse include? (Select all that apply).
