11.0 Questions and Answers | Latest
Version | 2025/2026 | Correct & Verified
A nurse is preparing a sterile dressing change. Which action should the nurse take to maintain
sterility?
A. Reach across the sterile field to retrieve supplies
B. ✔✔Open sterile supplies away from the body
C. Allow non-sterile items to come into contact with the sterile field
D. Touch the sterile field with ungloved hands
A nurse is caring for a client post-surgery who is at risk for deep vein thrombosis (DVT). Which
intervention is appropriate?
A. ✔✔Encourage early ambulation and leg exercises
B. Apply a heat pack to the legs
C. Place pillows under the client’s knees
D. Keep the client in a flat position at all times
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,A nurse is caring for a client who is receiving intravenous fluids. What is the priority action if
the nurse notices the infusion site is swollen and cool to the touch?
A. ✔✔Stop the infusion and remove the catheter
B. Increase the flow rate to prevent clotting
C. Apply a warm compress and massage the area
D. Reposition the client’s arm to improve circulation
A nurse is assessing a client’s vital signs. Which of the following is a normal range for an adult's
respiratory rate?
✔✔ A. 12 to 20 breaths per minute
B. 8 to 10 breaths per minute
C. 16 to 24 breaths per minute
D. 20 to 24 breaths per minute
A nurse is assisting a client with a gait belt during ambulation. Which action is appropriate?
A. Let the client walk without assistance
B. ✔✔Position the gait belt around the client’s waist
C. Hold the gait belt with both hands on the front
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,D. Apply the gait belt over the client’s clothing only
A nurse is caring for a client receiving oxygen therapy via nasal cannula. What is the most
important action for the nurse to take?
A. ✔✔Check for skin breakdown behind the ears
B. Set the oxygen flow rate to 6 L/min
C. Remove the cannula every hour for rest
D. Ensure the client is wearing a surgical mask
A nurse is preparing to teach a client about using an inhaler. Which statement indicates the client
needs further teaching?
A. ✔✔I will exhale fully before I use the inhaler
B. I will hold my breath for 10 seconds after using the inhaler
C. I will shake the inhaler before each use
D. I will inhale slowly while pressing down on the inhaler
A nurse is caring for a client who is at risk for skin breakdown. Which intervention is most
important?
A. ✔✔Reposition the client every 2 hours
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, B. Keep the client’s skin dry at all times
C. Apply baby powder to skin folds
D. Place pillows under the client’s feet
A nurse is caring for a client receiving pain medication. Which of the following should the nurse
monitor closely?
A. ✔✔Respiratory rate
B. Body temperature
C. Blood glucose levels
D. Urine output
A nurse is assisting a client with a full liquid diet. Which food item is appropriate for the nurse to
offer?
A. Scrambled eggs
B. ✔✔Creamed soup
C. Whole-grain toast
D. Fresh fruit
A nurse is performing a neurological assessment on a client. Which action should the nurse take?
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