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A 73-year-old female client had a hemiarthroplasty of the left hip yesterday due to a
fracture resulting from a fall. In reviewing hip precautions with the client, which
instruction should the nurse include in this client's teaching plan?
A. In 8 weeks you will be able to bend at the waist to reach items on the floor.
B. Place a pillow between your knees while lying in bed to prevent hip dislocation.
C. It is safe to use a walker to get out of bed, but you need assistance when walking.
D. Take pain medication 30 minutes after your physical therapy sessions. - Correct
Answer The client's affected hip joint following a hemiarthroplasty (partial hip
replacement) is at risk of dislocation for 6 months to a year following the procedure. Hip
precautions to prevent dislocation include placing a pillow between the knees to
maintain abduction of the hips (B). Clients should be instructed to avoid bending at the
waist (A), to seek assistance for both standing and walking until they are stable on a
walker or cane (C), and to take pain medication 20 to 30 minutes prior to physical
therapy sessions, rather than waiting until the pain level is high after their therapy.
Correct Correct Answerwer: B
A client is in the radiology department at 0900 when the prescription levofloxacin
(Levaquin) 500 mg IV q24h is scheduled to be administered. The client returns to the
unit at 1300. What is the best intervention for the nurse to implement?
A. Contact the healthcare provider and complete a medication variance form.
B. Administer the Levaquin at 1300 and resume the 0900 schedule in the morning.
C. Notify the charge nurse and complete an incident report to explain the missed dose.
D. Give the missed dose at 1300 and change the schedule to administer daily at 1300. -
Correct Answer To ensure that a therapeutic level of medication is maintained, the
nurse should administer the missed dose as soon as possible, and revise the
administration schedule accordingly to prevent dangerously increasing the level of the
medication in the bloodstream (D). The nurse should document the reason for the late
dose, but (A and C) are not warranted. (B) could result in increased blood levels of the
drug.
Correct Correct Answerwer: D
A client is receiving a cephalosporin antibiotic IV and complains of pain and irritation at
the infusion site. The nurse observes erythema, swelling, and a red streak along the
vessel above the IV access site. Which action should the nurse take at this time?
A. Administer the medication more rapidly using the same IV site.
B. Initiate an alternate site for the IV infusion of the medication.
C. Notify the healthcare provider before administering the next dose.
D. Give the client a PRN dose of aspirin while the medication infuses. - Correct Answer
A cephalosporin antibiotic that is administered IV may cause vessel irritation. Rotating
the infusion site minimizes the risk of thrombophlebitis, so an alternate infusion site
should be initiated (B) before administering the next dose. Rapid administration (A) of
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intravenous cephalosporins can potentiate vessel irritation and increase the risk of
thrombophlebitis. (C) is not necessary to initiate an alternative IV site. Although aspirin
has antiinflammatory actions, (D) is not indicated.
Correct Correct Answerwer: B
A client is to receive 10 mEq of KCl diluted in 250 ml of normal saline over 4 hours. At
what rate should the nurse set the client's intravenous infusion pump?
A. 13 ml/hour.
B. 63 ml/hour.
C. 80 ml/hour.
D. 125 ml/hour. - Correct Answer (B) is the correct calculation: To calculate this problem
correctly, remember that the dose of KCl is not used in the calculation. 250 ml/4 hours =
63 ml/hour.
Correct Correct Answerwer: B
A client is to receive cimetidine (Tagamet) 300 mg q6h IVPB. The preparation arrives
from the pharmacy diluted in 50 ml of 0.9% NaCl. The nurse plCorrect Answer to
administer the IVPB dose over 20 minutes. For how many ml/hr should the infusion
pump be set to deliver the secondary infusion? - Correct Answer The infusion rate is
calculated as a ratio proportion problem, i.e., 50 ml/ 20 min : x ml/ 60 min. Multiply
extremes and meCorrect Answer 50 × 60 /20x 1= 300/20=150
Correct Correct Answerwer: 150
A client who is 5' 5" tall and weighs 200 pounds is scheduled for surgery the next day.
What question is most important for the nurse to include during the preoperative
assessment?
A. What is your daily calorie consumption?
B. What vitamin and mineral supplements do you take?
C. Do you feel that you are overweight?
D. Will a clear liquid diet be okay after surgery? - Correct Answer Vitamin and mineral
supplements (B) may impact medications used during the operative period. (A and C)
are appropriate questions for long-term dietary counseling. The nature of the surgery
and anesthesia will determine the need for a clear liquid diet (D), rather than the client's
preference.
Correct Correct Answerwer: B
A client who is a Jehovah's Witness is admitted to the nursing unit. Which concern
should the nurse have for planning care in terms of the client's beliefs?
A. Autopsy of the body is prohibited.
B. Blood trCorrect Answerfusions are forbidden.
C. Alcohol use in any form is not allowed.
D. A vegetarian diet must be followed. - Correct Answer Blood trCorrect Answerfusions
are forbidden (B) in the Jehovah's Witness religion. Judaism prohibits (A). Buddhism
forbids the use of (C) and drugs. Many of these sects are vegetarian (D), but the direct
impact on nursing care is (B).
Correct Correct Answerwer: B
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A client who is in hospice care complains of increasing amounts of pain. The
healthcare provider prescribes an analgesic every four hours as needed. Which action
should the nurse implement?
A. Give an around-the-clock schedule for administration of analgesics.
B. Administer analgesic medication as needed when the pain is severe.
C. Provide medication to keep the client sedated and unaware of stimuli.
D. Offer a medication-free period so that the client can do daily activities. - Correct
Answer The most effective management of pain is achieved using an around-the-clock
schedule that provides analgesic medications on a regular basis (A) and in a timely
manner. Analgesics are less effective if pain persists until it is severe, so an analgesic
medication should be administered before the client's pain peaks (B). Providing comfort
is a priority for the client who is dying, but sedation that impairs the client's ability to
interact and experience the time before life ends should be minimized (C). Offering a
medication-free period allows the serum drug level to fall, which is not an effective
method to manage chronic pain (D).
Correct Correct Answerwer: A
A client with acute hemorrhagic anemia is to receive four units of packed RBCs (red
blood cells) as rapidly as possible. Which intervention is most important for the nurse to
implement?
A. Obtain the pre-trCorrect Answerfusion hemoglobin level.
B. Prime the tubing and prepare a blood pump set-up.
C. Monitor vital signs q15 minutes for the first hour.
D. Ensure the accuracy of the blood type match. - Correct Answer All interventions
should be implemented prior to administering blood, but (D) has the highest priority. Any
time blood is administered, the nurse should ensure the accuracy of the blood type
match in order to prevent a possible hemolytic reaction.
Correct Correct Answerwer: D
A client with chronic renal failure selects a scrambled egg for his breakfast. What action
should the nurse take?
A. Commend the client for selecting a high biologic value protein.
B. Remind the client that protein in the diet should be avoided.
C. Suggest that the client also select orange juice, to promote absorption.
D. Encourage the client to attend classes on dietary management of CRF. - Correct
Answer Foods such as eggs and milk (A) are high biologic proteins which are allowed
because they are complete proteins and supply the essential amino acids that are
necessary for growth and cell repair. Although a low-protein diet is followed (B), some
protein is essential. Orange juice is rich in potassium, and should not be encouraged
(C). The client has made a good diet choice, so (D) is not necessary.
Correct Correct Answerwer: A
A client with pneumonia has a decrease in oxygen saturation from 94% to 88% while
ambulating. Based on these findings, which intervention should the nurse implement
first?
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A 73-year-old female client had a hemiarthroplasty of the left hip yesterday due to a
fracture resulting from a fall. In reviewing hip precautions with the client, which
instruction should the nurse include in this client's teaching plan?
A. In 8 weeks you will be able to bend at the waist to reach items on the floor.
B. Place a pillow between your knees while lying in bed to prevent hip dislocation.
C. It is safe to use a walker to get out of bed, but you need assistance when walking.
D. Take pain medication 30 minutes after your physical therapy sessions. - Correct
Answer The client's affected hip joint following a hemiarthroplasty (partial hip
replacement) is at risk of dislocation for 6 months to a year following the procedure. Hip
precautions to prevent dislocation include placing a pillow between the knees to
maintain abduction of the hips (B). Clients should be instructed to avoid bending at the
waist (A), to seek assistance for both standing and walking until they are stable on a
walker or cane (C), and to take pain medication 20 to 30 minutes prior to physical
therapy sessions, rather than waiting until the pain level is high after their therapy.
Correct Correct Answerwer: B
A client is in the radiology department at 0900 when the prescription levofloxacin
(Levaquin) 500 mg IV q24h is scheduled to be administered. The client returns to the
unit at 1300. What is the best intervention for the nurse to implement?
A. Contact the healthcare provider and complete a medication variance form.
B. Administer the Levaquin at 1300 and resume the 0900 schedule in the morning.
C. Notify the charge nurse and complete an incident report to explain the missed dose.
D. Give the missed dose at 1300 and change the schedule to administer daily at 1300. -
Correct Answer To ensure that a therapeutic level of medication is maintained, the
nurse should administer the missed dose as soon as possible, and revise the
administration schedule accordingly to prevent dangerously increasing the level of the
medication in the bloodstream (D). The nurse should document the reason for the late
dose, but (A and C) are not warranted. (B) could result in increased blood levels of the
drug.
Correct Correct Answerwer: D
A client is receiving a cephalosporin antibiotic IV and complains of pain and irritation at
the infusion site. The nurse observes erythema, swelling, and a red streak along the
vessel above the IV access site. Which action should the nurse take at this time?
A. Administer the medication more rapidly using the same IV site.
B. Initiate an alternate site for the IV infusion of the medication.
C. Notify the healthcare provider before administering the next dose.
D. Give the client a PRN dose of aspirin while the medication infuses. - Correct Answer
A cephalosporin antibiotic that is administered IV may cause vessel irritation. Rotating
the infusion site minimizes the risk of thrombophlebitis, so an alternate infusion site
should be initiated (B) before administering the next dose. Rapid administration (A) of
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intravenous cephalosporins can potentiate vessel irritation and increase the risk of
thrombophlebitis. (C) is not necessary to initiate an alternative IV site. Although aspirin
has antiinflammatory actions, (D) is not indicated.
Correct Correct Answerwer: B
A client is to receive 10 mEq of KCl diluted in 250 ml of normal saline over 4 hours. At
what rate should the nurse set the client's intravenous infusion pump?
A. 13 ml/hour.
B. 63 ml/hour.
C. 80 ml/hour.
D. 125 ml/hour. - Correct Answer (B) is the correct calculation: To calculate this problem
correctly, remember that the dose of KCl is not used in the calculation. 250 ml/4 hours =
63 ml/hour.
Correct Correct Answerwer: B
A client is to receive cimetidine (Tagamet) 300 mg q6h IVPB. The preparation arrives
from the pharmacy diluted in 50 ml of 0.9% NaCl. The nurse plCorrect Answer to
administer the IVPB dose over 20 minutes. For how many ml/hr should the infusion
pump be set to deliver the secondary infusion? - Correct Answer The infusion rate is
calculated as a ratio proportion problem, i.e., 50 ml/ 20 min : x ml/ 60 min. Multiply
extremes and meCorrect Answer 50 × 60 /20x 1= 300/20=150
Correct Correct Answerwer: 150
A client who is 5' 5" tall and weighs 200 pounds is scheduled for surgery the next day.
What question is most important for the nurse to include during the preoperative
assessment?
A. What is your daily calorie consumption?
B. What vitamin and mineral supplements do you take?
C. Do you feel that you are overweight?
D. Will a clear liquid diet be okay after surgery? - Correct Answer Vitamin and mineral
supplements (B) may impact medications used during the operative period. (A and C)
are appropriate questions for long-term dietary counseling. The nature of the surgery
and anesthesia will determine the need for a clear liquid diet (D), rather than the client's
preference.
Correct Correct Answerwer: B
A client who is a Jehovah's Witness is admitted to the nursing unit. Which concern
should the nurse have for planning care in terms of the client's beliefs?
A. Autopsy of the body is prohibited.
B. Blood trCorrect Answerfusions are forbidden.
C. Alcohol use in any form is not allowed.
D. A vegetarian diet must be followed. - Correct Answer Blood trCorrect Answerfusions
are forbidden (B) in the Jehovah's Witness religion. Judaism prohibits (A). Buddhism
forbids the use of (C) and drugs. Many of these sects are vegetarian (D), but the direct
impact on nursing care is (B).
Correct Correct Answerwer: B
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A client who is in hospice care complains of increasing amounts of pain. The
healthcare provider prescribes an analgesic every four hours as needed. Which action
should the nurse implement?
A. Give an around-the-clock schedule for administration of analgesics.
B. Administer analgesic medication as needed when the pain is severe.
C. Provide medication to keep the client sedated and unaware of stimuli.
D. Offer a medication-free period so that the client can do daily activities. - Correct
Answer The most effective management of pain is achieved using an around-the-clock
schedule that provides analgesic medications on a regular basis (A) and in a timely
manner. Analgesics are less effective if pain persists until it is severe, so an analgesic
medication should be administered before the client's pain peaks (B). Providing comfort
is a priority for the client who is dying, but sedation that impairs the client's ability to
interact and experience the time before life ends should be minimized (C). Offering a
medication-free period allows the serum drug level to fall, which is not an effective
method to manage chronic pain (D).
Correct Correct Answerwer: A
A client with acute hemorrhagic anemia is to receive four units of packed RBCs (red
blood cells) as rapidly as possible. Which intervention is most important for the nurse to
implement?
A. Obtain the pre-trCorrect Answerfusion hemoglobin level.
B. Prime the tubing and prepare a blood pump set-up.
C. Monitor vital signs q15 minutes for the first hour.
D. Ensure the accuracy of the blood type match. - Correct Answer All interventions
should be implemented prior to administering blood, but (D) has the highest priority. Any
time blood is administered, the nurse should ensure the accuracy of the blood type
match in order to prevent a possible hemolytic reaction.
Correct Correct Answerwer: D
A client with chronic renal failure selects a scrambled egg for his breakfast. What action
should the nurse take?
A. Commend the client for selecting a high biologic value protein.
B. Remind the client that protein in the diet should be avoided.
C. Suggest that the client also select orange juice, to promote absorption.
D. Encourage the client to attend classes on dietary management of CRF. - Correct
Answer Foods such as eggs and milk (A) are high biologic proteins which are allowed
because they are complete proteins and supply the essential amino acids that are
necessary for growth and cell repair. Although a low-protein diet is followed (B), some
protein is essential. Orange juice is rich in potassium, and should not be encouraged
(C). The client has made a good diet choice, so (D) is not necessary.
Correct Correct Answerwer: A
A client with pneumonia has a decrease in oxygen saturation from 94% to 88% while
ambulating. Based on these findings, which intervention should the nurse implement
first?
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