,1 of 55
When changing a client’s post-operative wound dressing, the nurse notes yellow purulent drainage. What
action should the nurse take?
a. Notify the health care provider
b. Cover the wound with clean gauze and secure
c. Irrigate the wound with sterile and leave open to air
d. Irrigate the wound with normal saline and pack with gauze
2 of 55
The healthcare provider provider prescribes enteral feeds of jevity 1.2 cal at 66ml/hour over 20 hours, and
free water flushes of 225 ml q 4 hours*24 h via nasogastric tube. How many ml of total fluid will the
client receive in 24 hours? (Enter numerical value only. If rounding is required, round to one decimal
place.)
ANS: 2670
3 of 55
The nurse prepares to administer a medication that comes in tablet form through a client’s gastrostomy
tube. Which actions should the nurse implement? (Select all that apply)
a. Position client in Fowlers position
b. Aspirate gastric contents at the start and end of the procedure
c. Mix crushed medication with tube feeding
d. Pour dissolved medication into a syringe and inject into G tube
e. Flush tube with 30cc of lukewarm water prior and after the medication administration
4 of 55
The nurse notes that a client who is receiving oxygen by nasal cannula continues to remove the oxygen
prongs from the nares. What action should the nurse take?
a. Tape the oxygen tubing to the client’s nares
b. Increase the oxygen flow rate
c. Assess why the client removes the nasal cannula
d. Change the nasal cannula to a mask
6 of 55
Blood Pressure 136/80 mm/Hg
Heart Rate 88 beats/min
Respiratory Rate 20 breaths/min
Oxygen Saturation 92% on 2L oxygen
, Temperature 37 C (99.6F) oral
When changing a client’s post-operative wound dressing, the nurse notes yellow purulent drainage. What
action should the nurse take?
a. Notify the health care provider
b. Cover the wound with clean gauze and secure
c. Irrigate the wound with sterile and leave open to air
d. Irrigate the wound with normal saline and pack with gauze
2 of 55
The healthcare provider provider prescribes enteral feeds of jevity 1.2 cal at 66ml/hour over 20 hours, and
free water flushes of 225 ml q 4 hours*24 h via nasogastric tube. How many ml of total fluid will the
client receive in 24 hours? (Enter numerical value only. If rounding is required, round to one decimal
place.)
ANS: 2670
3 of 55
The nurse prepares to administer a medication that comes in tablet form through a client’s gastrostomy
tube. Which actions should the nurse implement? (Select all that apply)
a. Position client in Fowlers position
b. Aspirate gastric contents at the start and end of the procedure
c. Mix crushed medication with tube feeding
d. Pour dissolved medication into a syringe and inject into G tube
e. Flush tube with 30cc of lukewarm water prior and after the medication administration
4 of 55
The nurse notes that a client who is receiving oxygen by nasal cannula continues to remove the oxygen
prongs from the nares. What action should the nurse take?
a. Tape the oxygen tubing to the client’s nares
b. Increase the oxygen flow rate
c. Assess why the client removes the nasal cannula
d. Change the nasal cannula to a mask
6 of 55
Blood Pressure 136/80 mm/Hg
Heart Rate 88 beats/min
Respiratory Rate 20 breaths/min
Oxygen Saturation 92% on 2L oxygen
, Temperature 37 C (99.6F) oral
