GRADED
AMhomeMhealthMnurseMisMcaringMforMaMchildMwhoMhasMLymeMdisease.MWhichMofMtheMfollowingMisM
anMappropriateMactionMforMtheMnurseMtoMtake?M-
MEnsureMtheMstateMhealthMdepartmentMhasMbeenMnotified.
AMnurseMisMcaringMforMaMclientMwhoMhasMaMventedMNGMtubeMsetMtoMlowMintermittentMsuctionMand
MhasMvomited.MWhichMofMtheMfollowingMactionsMshouldMtheMnurseMperformMfirst? M-
MEvaluateMfunctioningMofMtheMsuctionMdevice.
WhileMperformingMaMroutineMassessment,MaMnurseMnoticesMfrayingMontoMtheMelectricalMcordM
ofMaMclient'sMcontinuousMpassiveMmotionM(CPM)device.MWhichMofMtheMfollowingMactionsMsh
ouldMtheMnurseMtakeMfirst?M-MRemoveMtheMdeviceMfromMtheMroom.
AMnurseMisMsettingMupMaMsterileMfieldMtoMperformMwoundMirrigationMforMaMclient.MWhichMofMtheMf
ollowingMactionsMshouldMtheMnurseMtakeMwhenMpouringMtheMsterileMsolution?M-
MRemoveMtheMcapMandMplaceMitMsterileMsideMupMonMaMcleanMsurface.
AMnurseMisMcreatingMaMplanMofMcareMforMaMfemaleMclientMwhoMhasMrecurrentMurinaryMtractMinfect
ions.MWhichMofMtheMfollowingMinterventionsMshouldMtheMnurseMincludeMinMtheMplan?M-
MWearMlooseMfittingMunderwear.
AMnurseMisMcaringMforManMinfantMwhoMhasMgastroenteritis.MWhichMofMtheMfollowingMassessmentsMf
indingsMshouldMtheMnurseMreportMtoMtheMprovider?M-
MSunkenMfontanelsMandMdryMmucousMmembranes.
AMnurseMisMconductingMhealthMpromotionMeducationMregardingMcontraindicationsMtoMcombination
MoralMcontraceptiveMuseMtoMaMgroupMofMwomen.MWhichMofMtheMfollowingMconditionsMshouldMtheMn
urseMincludeMinMtheMteaching?M-MHypertension
AMnurseMisMprovidingMteachingMtoMaMclientMwhoMhasMaMdepressiveMdisorderMandMaMnewMprescript
ionMforMamitriptyline.MWhichMofMtheMfollowingMstatementsMbyMtheMclientMindicatesMunderstandin
gMofMtheMteaching?M-
M"IMknowMitMwillMbeMaMcoupleMofMweeksMbeforeMtheMmedicationMhelpsMmeMfeelMbetter."
AMnurseMisMcaringMforMaMclientMwhoMisMimmobile.MWhichMofMtheMfollowingMinterventionsMisMappr
opriateMtoMpreventMcontracture?M-MAlignMaMtrochanterMwedgeMbetweenMtheMclient'sMlegs.
AMnurseMisMassessingMaMclientMwhoMisMpostoperativeMfollowingMabdominalMsurgeryMandMhasManMi
ndwellingMurinaryMcatheterMthatMisMdrainingMdarkMyellowMurineMatM25MmL/hr.MWhichMofMtheMfollo
wingMinterventionsMshouldMtheMnurseManticipate?M-
MObtainMaMurineMspecimenMforMcultureMandMsensitivity
AMnurseMisMreportingMaMclient'sMlaboratoryMtestsMtoMtheMproviderMtoMobtainMaMprescriptionMforMthe
Mclient'sMdailyMwarfarin.MWhichMofMtheMfollowingMlaboratoryMtestsMshouldMtheMnurseMplanMtoMrepo
rtMtoMobtainMtheMprescriptionMforMtheMwarfarin?M-MINR
, AMnurseMisMassessingMaMclientMwhoMisMtakingMhaloperidolMandMisMexperiencingMpseudoparkinsoni
sm.MWhichMofMtheMfollowingMfindingsMshouldMtheMnurseMdocumentMasMaMmanifestationMofMpseud
oparkinsonism?M-MShufflingMgait
AMnurseMisMcaringMforMaMclientMwhoMisMexperiencingMexpressiveMaphasiaMandMrightMhemiparesisMf
ollowingMaMstroke.MWhichMofMtheMfollowingMactionsMbyMtheMnurseMbestMpromotesMcommunication
MamongMstaffMcaringMforMtheMclient? M-
MHavingMinterdisciplinaryMteamMmeetingsMforMtheMclientMonMaMregularMbasis.
AMnurseMisMcaringMforMaM2-year-
oldMtoddler.MWhichMofMtheMfollowingMfoodMchoicesMshouldMtheMnurseMrecommendMtoMpromoteMin
dependenceMinMeating?M-MBananaMslices
AMnurseMonMaMmedical-
surgicalMunitMisMnotifiedMthatMaMmassMcasualtyMeventMhasMoccurredMinMtheMcommunity.MWhichMof
MtheMfollowingMactionsMshouldMtheMnurseMplanMtoMtake? M-
MRecommendMtoMtheMproviderMspecificMacuteMcareMclientsMforMdischarge.
AMnurseMisMreceivingMchange-of-
shiftMreportMforMfourMclients.MWhichMofMtheMfollowingMclientsMshouldMtheMnurseMassessMfirst?M-
MAMclientMwhoMwasMjustMgivenMaMglassMofMorangeMjuiceMforMlowMbloodMglucoseMlevel.
AMnurseMisMperformingMpostmortemMcareMforMaMrecentlyMdeceasedMclientMpriorMtoMtheMclient'sMfa
milyMvisit.MWhichMofMtheMfollowingMactionsMshouldMtheMnurseMplanMtoMtake?M-
MHoldMtheMclient'sMeyesMshutMforMaMfewMseconds.
AMnurseMisMadmittingMaMclientMwhoMhasMschizophrenia.MTheMclientMstates,M"I'mMhearingMvoices."M
WhichMofMtheMfollowingMresponsesMisMtheMpriorityMforMtheMnurseMtoMstate?M-
M"WhatMareMtheMvoicesMtellingMyou?"
AMnurseMisMadministeringMfurosemideMIVMbolusMtoMaMclientMwhoMhasMfluidMvolumeMexcess.MTheMn
urseMshouldMrecognizeMwhichMofMtheMfollowingMasManMindicationMthatMtheMmedicationMhasMbeenMe
ffective?
-MWeightMloss
AMnurseMisMcaringMforMaMclientMwhoMrequiresMnasotrachealMsuctioning.MIdentifyMtheMsequenceMthe
MnurseMshouldMfollowMtoMperformMsuctioning.M-M1.MTurnMonMtheMsuctionMandMsetMtheMpressure.
2. DonMsterileMgloves.
3. InsertMtheMcatheterMduringMtheMclient'sMinspiration.
4. ApplyMsuctionMwhileMrotatingMtheMcatheter.
5. RinseMtheMcatheterMtoMremoveMsecretions.
AMnurseMisMcaringMforMaMclientMwhoMisMinMaMcomaMandMisMscheduledMforMaMsurgicalMprocedure.MW
hichMofMtheMfollowingMactionsMshouldMtheMnurseMtake?M-
MDetermineMifMtheMclient'sMhealthMcareMsurrogateMisMawareMofMtheMrisksMandMbenefitsMofMtheMproce
dure.
AMnurseMisMpreparingMtoMadministerMvancomycinMIVMtoManMadultMclient.MTheMclientMasksMtheMnu
rseMifMtheMmedicationMcanMbeMgivenM2MhoursMearlier.MWhichMofMtheMfollowingMstatementsMshoul
dMtheMnurseMmake?M-M"IMcanMstartMtheMmedicationM30MminutesMearlier."