GUIDE WITH SCENARIOS AND VERIFIED
ANSWERS UPDATED 2026
◉A nurse is reviewing the medical record of a client who has a family
history of gallstones. Which of the following findings should the nurse
identify as a risk factor for developing cholecystitis? Answer: Client is
taking atorvastatin
◉A nurse is assessing a client who is receiving morphine via a PCA
pump to manage postoperative pain. The client has a heart rate of 66/min
and a respiratory rate of 9/min. Which of the following medications
should the nurse anticipate the provider will prescribe for the client?
Answer: Naloxone
◉A nurse is teaching a client who has gastroesophageal reflux disease
about ways to prevent reflux. Which of the following information should
the nurse include in the teaching? Answer: Plan to finish eating at least
3 hr before bedtime
◉A nurse is assessing a client who has a calcium level of 6.3 mg/dL.
Which of the following findings should the nurse expect? Answer:
Circumoral tingling
,◉A nurse is leading a small group discussion in an acute care mental
health facility when one client suddenly begins to experience a panic
attack. Which of the following actions should the nurse take? Answer:
Remain with the client until manifestations subside
◉A nurse in an emergency department is assessing a client who reports
severe constipation. The nurse should identify which of the following
findings as an indication that the client might have a small-bowel
obstruction? Answer: Visible peristaltic waves in the upper abdomen
◉A nurse is reviewing the urinalysis results of a client who has
completed a 14-day course of ciprofloxacin to treat pyelonephritis.
Which of the following values should indicate to the nurse that the client
has a continuing infection? Answer: Positive leukocyte esterase
◉A nurse is providing discharge teaching for a client who had
lithotripsy to break up calculi in the right kidney. Which of the following
findings should the nurse instruct the client to report to the provider?
Answer: Painful urination
◉A nurse is reviewing the medical record of a client who has a peptic
ulcer. Which of the following findings is a priority to report to the
provider? Answer: Hemoglobin 7.6 mg/dL
, ◉A nurse in an emergency department is caring for a client whose ABG
results are pH 7.31, PaCO2 50mm Hg, and HCO3- 25 mEq/L after
experiencing an airway obstruction. Which of the following
interventions is the nurse's priority for this client? Answer: Apply
oxygen therapy to the client
◉A nurse is assessing a client who has Graves' disease. Which of the
following findings should the nurse expect? Answer: Exophthalmos
◉A nurse is providing teaching to a client who has a hearing impairment
and has a new prescription for a hearing aid. Which of the following
client statements indicates an understanding of the teaching? Answer: "I
will make sure the hearing aid is off before inserting it in my ear"
◉A nurse is assessing a client who has an ulcer due to peripheral
vascular disease. Which of the following findings should the nurse
identify as an indication that the client has a venous ulcer rather than an
arterial ulcer? Answer: Discoloration and edema of the right ankle
◉A nurse is providing home care instructions to a client who had a
short-arm plaster cast applied for a wrist fracture. Which of the
following instructions should the nurse include? Answer: Elevate the
wrist above heart level
◉A nurse is providing discharge planning for a client who has
gestational diabetes. Which of the following interventions should the