A nurse is teaching staff members about the legal terminology used in child abuse. What definition of
battery should the nurse include in the teaching?
Correct 3
The application of force to another person without lawful justification.
4
Behaving in a way that a reasonable person with the same education would not.
Battery means touching in an offensive manner or actually injuring another person. Battery refers to actual bodily
harm rather than threats of physical or psychological harm. Battery refers to harm against persons instead of
property. Behaving in a way that a reasonable person with the same education would not is the definition of
negligence.
65%of students nationwide answered this question correctly.
Which nursing interventions require a nurse to wear gloves? (Select all that apply.)
1
Giving a back rub.
Correct 2
Cleaning a newborn immediately after delivery.
Correct 3
Emptying a portable wound drainage system.
,Obtaining the blood pressure of a client who is human immunodeficiency virus (HIV) positive
Personal protective equipment (PPE) should be used because the newborn is covered with amniotic fluid and
maternal blood. PPE should be used because the nurse may be exposed to blood and fluid that are contained in
the portable wound drainage system. PPE is not required for a back rub; there is no indication that the nurse is in
contact with body secretions. PPE is not necessary when conducting an interview because it is unlikely that the
nurse will come in contact with the client's body fluids. PPE is not necessary when obtaining the blood pressure of
a client, even if the client is HIV positive.
60%of students nationwide answered this question correctly.
View Topics
A nurse is caring for a client with hemiplegia who is frustrated. How can the nurse motivate the client
toward independence?
Correct 3
Reinforce success in tasks accomplished.
Success is a basic motivation for learning. People receive satisfaction when a goal is reached. Progress toward long-
range goals often is not apparent readily and may be discouraging. Constructive criticism is an important aspect of
client teaching, but if it is not tempered with praise, it is discouraging. Demonstrating ways to promote self-
reliance is an important part of teaching, but it probably will not motivate the client.
65%of students nationwide answered this question correctly.
,A health care provider prescribes a standard walker (pick-up walker with rubber tips on all four legs).
The nurse identifies what clinical findings that indicate the client is capable of using a standard walker?
Correct 4
Strong upper arm strength and non–weight bearing on the affected extremity
A walker with four rubber tips on the legs requires more upper body strength than a rolling walker. A client who is
non–weight bearing on the affected extremity is able to use a standard walker. A rolling walker is more
appropriate for a client with weak upper arm strength and impaired stamina who is less able to lift up and move a
walker with four rubber tips. A client with unilateral paralysis is not a candidate for a standard walker; the client
must be able to grip and lift the walker with both upper extremities and move the walker forward. A rolling walker
is more appropriate for this client. A client with kyphosis is less able to lift up and move a walker with four rubber
tips.
62%of students nationwide answered this question correctly.
View Topics
To prevent footdrop in a client with a leg cast, the nurse should:
1
Encourage complete bed rest to promote healing of the foot.
2
Place the foot in traction.
Correct 3
Support the foot with 90 degrees of flexion.
4
Place an elastic stocking on the foot to provide support.
To prevent footdrop (plantar flexion of the foot due to weakness or paralysis of the anterior muscles of the lower
leg) in a client with a cast, the foot should be supported with 90 degrees of flexion. Bed rest can cause footdrop,
and 45 degrees is not enough flexion to prevent footdrop . Applying an elastic stocking for support also will not
prevent footdrop; a firmer support is required.
, Test-Taking Tip: On a test day, eat a normal meal before going to school. If the test is late in the morning, take a
high-protein snack with you to eat 20 minutes before the examination. The brain works best when it has the
glucose necessary for cellular function.
64%of students nationwide answered this question correctly.
View Topics
What should the nurse include in dietary teaching for a client with a colostomy?
1
Liquids should be limited to 1 L per day.
2
Non-digestible fiber and fruits should be eliminated.
3
A formed stool is an indicator of constipation.
Correct 4
The diet should be adjusted to include foods that result in manageable stools.
Each person will need to experiment with diet after a colostomy to determine what foods are best tolerated and
also produce stools that are manageable, depending on the type of colostomy. Liquids are typically not limited
unless there is a specific reason such as cardiac or renal disease. Food high in fiber such as fruit should be included
in the diet as tolerated. Depending on the type of colostomy and the diet, a formed stool is acceptable and does
not indicate a constipating diet.
STUDY TIP: Remember that intelligence plays a vital role in your ability to learn. However, being smart involves
more than just intelligence. Being practical and applying common sense are also part of the learning experience.
66%of students nationwide answered this question correctly.
A client with respiratory difficulties asks why the percussion procedure is being performed. The nurse
explains that the primary purpose of percussion is to:
battery should the nurse include in the teaching?
Correct 3
The application of force to another person without lawful justification.
4
Behaving in a way that a reasonable person with the same education would not.
Battery means touching in an offensive manner or actually injuring another person. Battery refers to actual bodily
harm rather than threats of physical or psychological harm. Battery refers to harm against persons instead of
property. Behaving in a way that a reasonable person with the same education would not is the definition of
negligence.
65%of students nationwide answered this question correctly.
Which nursing interventions require a nurse to wear gloves? (Select all that apply.)
1
Giving a back rub.
Correct 2
Cleaning a newborn immediately after delivery.
Correct 3
Emptying a portable wound drainage system.
,Obtaining the blood pressure of a client who is human immunodeficiency virus (HIV) positive
Personal protective equipment (PPE) should be used because the newborn is covered with amniotic fluid and
maternal blood. PPE should be used because the nurse may be exposed to blood and fluid that are contained in
the portable wound drainage system. PPE is not required for a back rub; there is no indication that the nurse is in
contact with body secretions. PPE is not necessary when conducting an interview because it is unlikely that the
nurse will come in contact with the client's body fluids. PPE is not necessary when obtaining the blood pressure of
a client, even if the client is HIV positive.
60%of students nationwide answered this question correctly.
View Topics
A nurse is caring for a client with hemiplegia who is frustrated. How can the nurse motivate the client
toward independence?
Correct 3
Reinforce success in tasks accomplished.
Success is a basic motivation for learning. People receive satisfaction when a goal is reached. Progress toward long-
range goals often is not apparent readily and may be discouraging. Constructive criticism is an important aspect of
client teaching, but if it is not tempered with praise, it is discouraging. Demonstrating ways to promote self-
reliance is an important part of teaching, but it probably will not motivate the client.
65%of students nationwide answered this question correctly.
,A health care provider prescribes a standard walker (pick-up walker with rubber tips on all four legs).
The nurse identifies what clinical findings that indicate the client is capable of using a standard walker?
Correct 4
Strong upper arm strength and non–weight bearing on the affected extremity
A walker with four rubber tips on the legs requires more upper body strength than a rolling walker. A client who is
non–weight bearing on the affected extremity is able to use a standard walker. A rolling walker is more
appropriate for a client with weak upper arm strength and impaired stamina who is less able to lift up and move a
walker with four rubber tips. A client with unilateral paralysis is not a candidate for a standard walker; the client
must be able to grip and lift the walker with both upper extremities and move the walker forward. A rolling walker
is more appropriate for this client. A client with kyphosis is less able to lift up and move a walker with four rubber
tips.
62%of students nationwide answered this question correctly.
View Topics
To prevent footdrop in a client with a leg cast, the nurse should:
1
Encourage complete bed rest to promote healing of the foot.
2
Place the foot in traction.
Correct 3
Support the foot with 90 degrees of flexion.
4
Place an elastic stocking on the foot to provide support.
To prevent footdrop (plantar flexion of the foot due to weakness or paralysis of the anterior muscles of the lower
leg) in a client with a cast, the foot should be supported with 90 degrees of flexion. Bed rest can cause footdrop,
and 45 degrees is not enough flexion to prevent footdrop . Applying an elastic stocking for support also will not
prevent footdrop; a firmer support is required.
, Test-Taking Tip: On a test day, eat a normal meal before going to school. If the test is late in the morning, take a
high-protein snack with you to eat 20 minutes before the examination. The brain works best when it has the
glucose necessary for cellular function.
64%of students nationwide answered this question correctly.
View Topics
What should the nurse include in dietary teaching for a client with a colostomy?
1
Liquids should be limited to 1 L per day.
2
Non-digestible fiber and fruits should be eliminated.
3
A formed stool is an indicator of constipation.
Correct 4
The diet should be adjusted to include foods that result in manageable stools.
Each person will need to experiment with diet after a colostomy to determine what foods are best tolerated and
also produce stools that are manageable, depending on the type of colostomy. Liquids are typically not limited
unless there is a specific reason such as cardiac or renal disease. Food high in fiber such as fruit should be included
in the diet as tolerated. Depending on the type of colostomy and the diet, a formed stool is acceptable and does
not indicate a constipating diet.
STUDY TIP: Remember that intelligence plays a vital role in your ability to learn. However, being smart involves
more than just intelligence. Being practical and applying common sense are also part of the learning experience.
66%of students nationwide answered this question correctly.
A client with respiratory difficulties asks why the percussion procedure is being performed. The nurse
explains that the primary purpose of percussion is to:
