Q NURSING 101 Comprehensive Nursing
Exam 100% Pass Guaranteed | Graded
A+
Question 1
A nurse is caring for a client who requires neutropenic precautions. Which of the
following actions should the nurse take? Select all that apply.
A. Request a prescription for the intranasal influenza vaccine for the client.
B. Place a surgical mask on the client during transport.
C. Remove fresh flowers from the client's room.
D. Assign the client to a private room.
E. Instruct the client to bathe daily.
Exact answer:B, C, D, E
Explanation: Neutropenic precautions are implemented to protect clients with
low neutrophil counts from infection. The correct actions include placing a surgical
mask on the client during transport (B), removing fresh flowers which can harbor
bacteria and fungi (C), assigning a private room to minimize exposure to
pathogens (D), and instructing daily bathing to reduce skin flora (E). The intranasal
influenza vaccine contains live attenuated virus and is contraindicated in
immunocompromised clients (A is incorrect).
Question 2
A nurse is teaching a client who has a fractured right femur and is ambulating with
crutches. Which of the following information should the nurse include?
,A. "Place the crutches 12 to 18 inches in front of your foot when walking."
B. "Ask your caregiver to stand on your unaffected side when you are walking."
C. "Move your unaffected leg to the next step first when descending stairs."
D. "Adjust the height of the crutches so the crutch pads are 2 to 3 finger widths
below your axillae."
Exact answer:D
Explanation: The correct crutch adjustment is to have the crutch pads positioned
2 to 3 finger widths below the axillae to prevent nerve damage (D). Crutches
should be placed approximately 6 inches (not 12-18 inches) in front and to the
side of the foot (A is incorrect). The caregiver should stand on the affected side (B
is incorrect). When descending stairs, the affected leg moves first, followed by the
crutches, then the unaffected leg (C is incorrect).
Question 3
A nurse is planning care for a client who has an indwelling urinary catheter. Which
of the following interventions should the nurse include?
A. Apply tension when securing the catheter tubing to the client's inner thigh.
B. Maintain the urinary drainage bag above the level of the client's bladder.
C. Empty the client's urinary drainage bag once it is completely full.
D. Cleanse the client's perineal area with soap and water.
Exact answer:D
Explanation: The perineal area should be cleansed with soap and water daily and
after each bowel movement to prevent infection (D). Tension should not be
applied to the tubing as it can cause trauma (A is incorrect). The drainage bag
must be kept below the level of the bladder to prevent backflow (B is incorrect).
The bag should be emptied when it is half to two-thirds full, not completely full (C
is incorrect).
,Question 4
A nurse is screening clients for those at risk for developing pressure injuries. The
nurse should recognize the client at highest risk is the client who:
A. Frequently slides down in the bed
B. Is experiencing constipation
C. Has an indwelling urinary catheter
D. Ambulates with a walker
Exact answer:A
Explanation: Friction and shear from sliding down in bed are major risk factors for
pressure injury development (A). Constipation (B) and indwelling urinary catheter
(C) are not direct pressure injury risk factors. Ambulating with a walker (D)
indicates mobility, which actually reduces risk. The Braden Scale assesses sensory
perception, moisture, activity, mobility, nutrition, and friction/shear.
Question 5
A nurse is talking with a client who has a colostomy. Which of the following
statements by the client would require follow-up?
A. "I should avoid drinking coffee and alcoholic beverages."
B. "I need to chew my food completely before swallowing."
C. "I can continue to swim in the pool every morning."
D. "I will wait until my pouch is full before emptying it."
Exact answer:D
Explanation: The client should empty the pouch when it is one-third to one-half
full to prevent leakage and skin breakdown. Waiting until it is completely full (D)
requires immediate follow-up and client education. Coffee and alcohol can
, increase output and should be avoided (A is correct). Chewing food completely
aids digestion (B is correct). Swimming is permitted with a colostomy (C is correct).
Question 6
A nurse is preparing a staff education program about verbal medication orders.
Which of the following information should the nurse include? Select all that apply.
A. "Repeat the verbal order back to the health care provider."
B. "Daily medications should be documented using the abbreviation Q.D."
C. "Include a '0' before decimals when writing the dosage of a medication."
D. "Verbal orders should be documented by the nurse that receives the order."
E. "Orders received via voicemail should be verified with the health care provider."
Exact answer:A, D, E
Explanation: Verbal orders must be repeated back to the provider to verify
accuracy (A). The nurse who receives the order must document it (D). Orders
received via voicemail require verification with the provider (E). The abbreviation
"Q.D." is on the ISMP's Do Not Use list and should be written as "daily" (B is
incorrect). A zero should precede a decimal point (e.g., 0.5 mg), but not follow it
(e.g., 5.0 mg) (C is incorrect).
Question 7
Florence Nightingale is recognized as the founder of modern nursing. In which
year did she establish the first nursing school?
A. 1820
B. 1854
C. 1860
D. 1876
Exam 100% Pass Guaranteed | Graded
A+
Question 1
A nurse is caring for a client who requires neutropenic precautions. Which of the
following actions should the nurse take? Select all that apply.
A. Request a prescription for the intranasal influenza vaccine for the client.
B. Place a surgical mask on the client during transport.
C. Remove fresh flowers from the client's room.
D. Assign the client to a private room.
E. Instruct the client to bathe daily.
Exact answer:B, C, D, E
Explanation: Neutropenic precautions are implemented to protect clients with
low neutrophil counts from infection. The correct actions include placing a surgical
mask on the client during transport (B), removing fresh flowers which can harbor
bacteria and fungi (C), assigning a private room to minimize exposure to
pathogens (D), and instructing daily bathing to reduce skin flora (E). The intranasal
influenza vaccine contains live attenuated virus and is contraindicated in
immunocompromised clients (A is incorrect).
Question 2
A nurse is teaching a client who has a fractured right femur and is ambulating with
crutches. Which of the following information should the nurse include?
,A. "Place the crutches 12 to 18 inches in front of your foot when walking."
B. "Ask your caregiver to stand on your unaffected side when you are walking."
C. "Move your unaffected leg to the next step first when descending stairs."
D. "Adjust the height of the crutches so the crutch pads are 2 to 3 finger widths
below your axillae."
Exact answer:D
Explanation: The correct crutch adjustment is to have the crutch pads positioned
2 to 3 finger widths below the axillae to prevent nerve damage (D). Crutches
should be placed approximately 6 inches (not 12-18 inches) in front and to the
side of the foot (A is incorrect). The caregiver should stand on the affected side (B
is incorrect). When descending stairs, the affected leg moves first, followed by the
crutches, then the unaffected leg (C is incorrect).
Question 3
A nurse is planning care for a client who has an indwelling urinary catheter. Which
of the following interventions should the nurse include?
A. Apply tension when securing the catheter tubing to the client's inner thigh.
B. Maintain the urinary drainage bag above the level of the client's bladder.
C. Empty the client's urinary drainage bag once it is completely full.
D. Cleanse the client's perineal area with soap and water.
Exact answer:D
Explanation: The perineal area should be cleansed with soap and water daily and
after each bowel movement to prevent infection (D). Tension should not be
applied to the tubing as it can cause trauma (A is incorrect). The drainage bag
must be kept below the level of the bladder to prevent backflow (B is incorrect).
The bag should be emptied when it is half to two-thirds full, not completely full (C
is incorrect).
,Question 4
A nurse is screening clients for those at risk for developing pressure injuries. The
nurse should recognize the client at highest risk is the client who:
A. Frequently slides down in the bed
B. Is experiencing constipation
C. Has an indwelling urinary catheter
D. Ambulates with a walker
Exact answer:A
Explanation: Friction and shear from sliding down in bed are major risk factors for
pressure injury development (A). Constipation (B) and indwelling urinary catheter
(C) are not direct pressure injury risk factors. Ambulating with a walker (D)
indicates mobility, which actually reduces risk. The Braden Scale assesses sensory
perception, moisture, activity, mobility, nutrition, and friction/shear.
Question 5
A nurse is talking with a client who has a colostomy. Which of the following
statements by the client would require follow-up?
A. "I should avoid drinking coffee and alcoholic beverages."
B. "I need to chew my food completely before swallowing."
C. "I can continue to swim in the pool every morning."
D. "I will wait until my pouch is full before emptying it."
Exact answer:D
Explanation: The client should empty the pouch when it is one-third to one-half
full to prevent leakage and skin breakdown. Waiting until it is completely full (D)
requires immediate follow-up and client education. Coffee and alcohol can
, increase output and should be avoided (A is correct). Chewing food completely
aids digestion (B is correct). Swimming is permitted with a colostomy (C is correct).
Question 6
A nurse is preparing a staff education program about verbal medication orders.
Which of the following information should the nurse include? Select all that apply.
A. "Repeat the verbal order back to the health care provider."
B. "Daily medications should be documented using the abbreviation Q.D."
C. "Include a '0' before decimals when writing the dosage of a medication."
D. "Verbal orders should be documented by the nurse that receives the order."
E. "Orders received via voicemail should be verified with the health care provider."
Exact answer:A, D, E
Explanation: Verbal orders must be repeated back to the provider to verify
accuracy (A). The nurse who receives the order must document it (D). Orders
received via voicemail require verification with the provider (E). The abbreviation
"Q.D." is on the ISMP's Do Not Use list and should be written as "daily" (B is
incorrect). A zero should precede a decimal point (e.g., 0.5 mg), but not follow it
(e.g., 5.0 mg) (C is incorrect).
Question 7
Florence Nightingale is recognized as the founder of modern nursing. In which
year did she establish the first nursing school?
A. 1820
B. 1854
C. 1860
D. 1876
