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A,B,C questions and 100% verified
correct answers
A nurse is admitting a client who has antisocial personality disorder. Which of the
following client behaviors should the nurse identify as consistent with this disorder?
A. Compulsive attention to details
B. Avoids interacting with others
C. Uses others for personal gain
D. Socially awkward in group situations - Correct Answer C. Uses others for personal
gain
A nurse is interpreting the cardiac rhythm strip of a client who was admitted with
syncope. Which of the following images indicates that the client has atrial fibrillation? -
Correct Answer
A charge nurse on a pediatric unit is making assignments for a float nurse from the
medical unit. Which of the following clients is appropriate to assign to the float nurse?
A. A 10-year-old client who has pneumonia and is receiving respiratory treatments
B. A 4-year-old client who has a Wilms tumor and is receiving chemotherapy
C. An 8-month-old client who is scheduled for a surgical repair of a ventricular septal
defect tomorrow
D. A 14-year-old client who is scheduled for discharge today following placement of a
Harrington rod - Correct Answer A. A 10-year-old client who has pneumonia and is
receiving respiratory treatments
A nurse is assessing an infant who has water intoxication. Which of the following
findings should the nurse expect?
A. Generalized edema
B. Elevated urine specific gravity
C. Thready pulse
D. Increased hematocrit - Correct Answer A. Generalized edema
A nurse is discussing the z-track administration of hydroxyzine with a newly licensed
nurse. Which of the following statements indicates the newly licensed nurse
understands the purpose of the technique?
A. This technique prevents injury to the sciatic nerve
B. This technique decreases the risk of subcutaneous infiltration
C. This technique allows a larger amount of medication to be injected
D. This technique increases the absorption rate of the drug - Correct Answer This
technique decreases the risk of subcutaneous infiltration
,A nurse is creating a plan of care for a client who has anorexia nervosa. Which of the
following interventions should the nurse include in the plan?
A. Encourage the client to gain 2.3 kg per week
B. Weigh the client once per week throughout hospitalization
C. Monitor the client for 1 hr after meals
D. Allow the client to choose mealtimes - Correct Answer C. Monitor the client for 1 hr
after meals
A nurse is planning care for a child who has increased intracranial pressure with a
decrease in level of consciousness. Which of the following interventions should the
nurse include in the plan of care?
A. Perform active range-of-motion exercises
B. Maintain the head at a midline position
C. Suction the airway frequently
D. Perform neurological checks every 4 hrs - Correct Answer B. Maintain the head at a
midline position
10. A nurse is assessing a client who has delirium due to a febrile illness. Which of the
following findings should the nurse expect?
A. Hallucinations
B. Agnosia
C. Bradycardia
D. Aphasia - Correct Answer A. Hallucinations
A nurse is assessing a client who is receiving enteral feedings via a gastrostomy tube.
The nurse should identify that which of the following findings indicates fluid overload?
A. Diminished bowel sounds
B. Bradycardia
C. Hypotension
D. Bounding pulses - Correct Answer D. Bounding pulses
A nurse is caring for a client following an open colectomy. Which of the following
findings places the client at risk for delayed wound healing?
A. INR 1.1
B. Hyperemesis
C. HbA1c 5.6%
D. Uncontrolled pain - Correct Answer B. Hyperemesis
A home health nurse is reviewing treatment goals with a client who has diabetes
mellitus. The nurse should evaluate which of the following laboratory tests to determine
effective long-term management of blood glucose levels?
A. 3-hr oral glucose tolerance test
B. HbA1c
C. Fasting blood glucose test
D. Urinalysis for ketones - Correct Answer B. HbA1c
,A nurse is caring for a client who has neutropenia due to HIV. Which of the following
precautions should the nurse take while caring for this client?
A. Wear an N95 respirator
B. Insert an indwelling urinary catheter to monitor urinary output
C. Monitor the client's vital signs every 8 hr
D. Use a dedicated stethoscope - Correct Answer D. Use a dedicated stethoscope
A nurse is caring for a client who reports difficulty falling asleep at night. Which of the
following actions should the nurse take?
A. Encourage the client to ambulate in the hallway 1 hr before bedtime
B. Tell the client to avoid drinking fluids 1 hr before bedtime
C. Schedule routine care tasks during hours when the client is awake
D. Advise the client to leave the television in the room on when trying to fall asleep -
Correct Answer C. Schedule routine care tasks during hours when the client is awake
A nurse is planning care for a newborn who has hyperbilirubinemia and is to receive
phototherapy. Which of the following interventions should the nurse include?
A. Clothe the newborn in light cotton
B. Check the newborn's temperature every 8 hrs. (every 4)
C. Administer 120 mL of water between feedings
D. Place the newborn 45 cm (18 in) from the light source - Correct Answer D. Place the
newborn 45 cm (18 in) from the light source
A nurse is planning care for a client who has schizophrenia and is having difficulty
expressing their feelings. Which of the following referrals should the nurse make?
A. Art therapist
B. Speech-language pathologist
C. Social worker
D. Recreational therapist - Correct Answer A. Art therapist
A nurse is caring for a client who has heart failure and has started taking a loop diuretic.
Which of the following findings indicates the client is experiencing an adverse effect of
the medication?
A. Decreased reflexes
B. Weight gain of 1.4 kg
C. Increased urinary output
D. Jugular vein distention - Correct Answer A. Decreased reflexes
Loop diuretics cause excessive urination leading to hypotension and finally resulting in
decreased reflexes.
At the start of an evening shift on a cardiac unit, a licensed practical nurse brings the
nurse a list of client reports. Which of the following client reports should the nurse
assess first?
A. Constipation
B. Indigestion
, C. Swollen ankles
D. Urinary frequency - Correct Answer B. Indigestion
A nurse is caring for a client who has just returned to the unit following a bronchoscopy.
Which of the following actions by the assistive personnel requires the nurse to
intervene?
A. Encourages the client to use the incentive spirometer
B. Elevates the head of the client's bed
C. Offers oral fluids to the client
D. Checks the client's pulse oximetry - Correct Answer C. Offers oral fluids to the client
A nurse on a medical unit has just received change-of-shift report. Which of the
following clients should the nurse assess first?
A. A 68-year-old client who had a myocardial infarction 2 days ago and reports chest
pain 4 on a scale of 0 to 10
B. A 48-year-old client who has AIDS, pneumocystis pneumonia, and a temperature of
38.3 C (101F)
C. A 60-year-old client who has COPD, is receiving 2 L/min O2 via a nasal cannula, and
has an oxygen saturation of 89%
D. A 26-year-old female client who has pelvic inflammatory disease and is unable to
void - Correct Answer A 68-year-old client who had a myocardial infarction 2 days ago
and reports chest pain 4 on a scale of 0 to 10
A nurse is assessing a client prior to performing a blood draw. The nurse should identify
that an allergy to which of the following food can indicate that the client has an allergy to
latex?
A. Peanuts
B. Shellfish
C. Avocados
D. Eggs - Correct Answer C. Avocados
A nurse is preparing to witness a client's signature on an informed consent for a total
knee arthroplasty. Which of the following client statements indicates the nurse should
contact the surgeon?
A. I wonder if the metal in my knee will show up in airport screenings
B. The physical therapy has not been working, so I will need to have the surgery
C. I look forward to being able to bend my knee again when I sit in a chair
D. I am thankful there are no serious complications from this type of surgery - Correct
Answer D. I am thankful there are no serious complications from this type of surgery
A nurse is teaching the parent of a school-age child who has scabies about the
application of permethrin 5% cream. The nurse should include which of the following as
a potential adverse effect of the medication?
A. Burning
B. Discoloration
C. Photosensitivity
A,B,C questions and 100% verified
correct answers
A nurse is admitting a client who has antisocial personality disorder. Which of the
following client behaviors should the nurse identify as consistent with this disorder?
A. Compulsive attention to details
B. Avoids interacting with others
C. Uses others for personal gain
D. Socially awkward in group situations - Correct Answer C. Uses others for personal
gain
A nurse is interpreting the cardiac rhythm strip of a client who was admitted with
syncope. Which of the following images indicates that the client has atrial fibrillation? -
Correct Answer
A charge nurse on a pediatric unit is making assignments for a float nurse from the
medical unit. Which of the following clients is appropriate to assign to the float nurse?
A. A 10-year-old client who has pneumonia and is receiving respiratory treatments
B. A 4-year-old client who has a Wilms tumor and is receiving chemotherapy
C. An 8-month-old client who is scheduled for a surgical repair of a ventricular septal
defect tomorrow
D. A 14-year-old client who is scheduled for discharge today following placement of a
Harrington rod - Correct Answer A. A 10-year-old client who has pneumonia and is
receiving respiratory treatments
A nurse is assessing an infant who has water intoxication. Which of the following
findings should the nurse expect?
A. Generalized edema
B. Elevated urine specific gravity
C. Thready pulse
D. Increased hematocrit - Correct Answer A. Generalized edema
A nurse is discussing the z-track administration of hydroxyzine with a newly licensed
nurse. Which of the following statements indicates the newly licensed nurse
understands the purpose of the technique?
A. This technique prevents injury to the sciatic nerve
B. This technique decreases the risk of subcutaneous infiltration
C. This technique allows a larger amount of medication to be injected
D. This technique increases the absorption rate of the drug - Correct Answer This
technique decreases the risk of subcutaneous infiltration
,A nurse is creating a plan of care for a client who has anorexia nervosa. Which of the
following interventions should the nurse include in the plan?
A. Encourage the client to gain 2.3 kg per week
B. Weigh the client once per week throughout hospitalization
C. Monitor the client for 1 hr after meals
D. Allow the client to choose mealtimes - Correct Answer C. Monitor the client for 1 hr
after meals
A nurse is planning care for a child who has increased intracranial pressure with a
decrease in level of consciousness. Which of the following interventions should the
nurse include in the plan of care?
A. Perform active range-of-motion exercises
B. Maintain the head at a midline position
C. Suction the airway frequently
D. Perform neurological checks every 4 hrs - Correct Answer B. Maintain the head at a
midline position
10. A nurse is assessing a client who has delirium due to a febrile illness. Which of the
following findings should the nurse expect?
A. Hallucinations
B. Agnosia
C. Bradycardia
D. Aphasia - Correct Answer A. Hallucinations
A nurse is assessing a client who is receiving enteral feedings via a gastrostomy tube.
The nurse should identify that which of the following findings indicates fluid overload?
A. Diminished bowel sounds
B. Bradycardia
C. Hypotension
D. Bounding pulses - Correct Answer D. Bounding pulses
A nurse is caring for a client following an open colectomy. Which of the following
findings places the client at risk for delayed wound healing?
A. INR 1.1
B. Hyperemesis
C. HbA1c 5.6%
D. Uncontrolled pain - Correct Answer B. Hyperemesis
A home health nurse is reviewing treatment goals with a client who has diabetes
mellitus. The nurse should evaluate which of the following laboratory tests to determine
effective long-term management of blood glucose levels?
A. 3-hr oral glucose tolerance test
B. HbA1c
C. Fasting blood glucose test
D. Urinalysis for ketones - Correct Answer B. HbA1c
,A nurse is caring for a client who has neutropenia due to HIV. Which of the following
precautions should the nurse take while caring for this client?
A. Wear an N95 respirator
B. Insert an indwelling urinary catheter to monitor urinary output
C. Monitor the client's vital signs every 8 hr
D. Use a dedicated stethoscope - Correct Answer D. Use a dedicated stethoscope
A nurse is caring for a client who reports difficulty falling asleep at night. Which of the
following actions should the nurse take?
A. Encourage the client to ambulate in the hallway 1 hr before bedtime
B. Tell the client to avoid drinking fluids 1 hr before bedtime
C. Schedule routine care tasks during hours when the client is awake
D. Advise the client to leave the television in the room on when trying to fall asleep -
Correct Answer C. Schedule routine care tasks during hours when the client is awake
A nurse is planning care for a newborn who has hyperbilirubinemia and is to receive
phototherapy. Which of the following interventions should the nurse include?
A. Clothe the newborn in light cotton
B. Check the newborn's temperature every 8 hrs. (every 4)
C. Administer 120 mL of water between feedings
D. Place the newborn 45 cm (18 in) from the light source - Correct Answer D. Place the
newborn 45 cm (18 in) from the light source
A nurse is planning care for a client who has schizophrenia and is having difficulty
expressing their feelings. Which of the following referrals should the nurse make?
A. Art therapist
B. Speech-language pathologist
C. Social worker
D. Recreational therapist - Correct Answer A. Art therapist
A nurse is caring for a client who has heart failure and has started taking a loop diuretic.
Which of the following findings indicates the client is experiencing an adverse effect of
the medication?
A. Decreased reflexes
B. Weight gain of 1.4 kg
C. Increased urinary output
D. Jugular vein distention - Correct Answer A. Decreased reflexes
Loop diuretics cause excessive urination leading to hypotension and finally resulting in
decreased reflexes.
At the start of an evening shift on a cardiac unit, a licensed practical nurse brings the
nurse a list of client reports. Which of the following client reports should the nurse
assess first?
A. Constipation
B. Indigestion
, C. Swollen ankles
D. Urinary frequency - Correct Answer B. Indigestion
A nurse is caring for a client who has just returned to the unit following a bronchoscopy.
Which of the following actions by the assistive personnel requires the nurse to
intervene?
A. Encourages the client to use the incentive spirometer
B. Elevates the head of the client's bed
C. Offers oral fluids to the client
D. Checks the client's pulse oximetry - Correct Answer C. Offers oral fluids to the client
A nurse on a medical unit has just received change-of-shift report. Which of the
following clients should the nurse assess first?
A. A 68-year-old client who had a myocardial infarction 2 days ago and reports chest
pain 4 on a scale of 0 to 10
B. A 48-year-old client who has AIDS, pneumocystis pneumonia, and a temperature of
38.3 C (101F)
C. A 60-year-old client who has COPD, is receiving 2 L/min O2 via a nasal cannula, and
has an oxygen saturation of 89%
D. A 26-year-old female client who has pelvic inflammatory disease and is unable to
void - Correct Answer A 68-year-old client who had a myocardial infarction 2 days ago
and reports chest pain 4 on a scale of 0 to 10
A nurse is assessing a client prior to performing a blood draw. The nurse should identify
that an allergy to which of the following food can indicate that the client has an allergy to
latex?
A. Peanuts
B. Shellfish
C. Avocados
D. Eggs - Correct Answer C. Avocados
A nurse is preparing to witness a client's signature on an informed consent for a total
knee arthroplasty. Which of the following client statements indicates the nurse should
contact the surgeon?
A. I wonder if the metal in my knee will show up in airport screenings
B. The physical therapy has not been working, so I will need to have the surgery
C. I look forward to being able to bend my knee again when I sit in a chair
D. I am thankful there are no serious complications from this type of surgery - Correct
Answer D. I am thankful there are no serious complications from this type of surgery
A nurse is teaching the parent of a school-age child who has scabies about the
application of permethrin 5% cream. The nurse should include which of the following as
a potential adverse effect of the medication?
A. Burning
B. Discoloration
C. Photosensitivity
