Fundamentals Final Test Bank
A nurse caring for a client who has an infected wound removes a dressing saturated with blood
and purulent drainage. How should the nurse dispose of the dressing material?
A. Discard the dressing in the bedside trash receptacle.
B. Dispose of the dressing in a biohazardous waste container.
C. Enclose the dressing in a single clear plastic bag and discard in the bedside trash receptacle.
- ANS B. Dispose of the dressing in a biohazardous waste container.
A nurse is caring for a female client who has recurrent kidney stones and is scheduled for an
intravenous pyelogram. Which of the following statements should the nurse report to the
provider?
A. "I drink at least 2 quarts of fluid every day."
B. "The last time I voided it was painful and red-tinged."
C. "My period ended 2 days ago."
D. "I don't eat shellfish because it gives me hives." - ANS D. "I don't eat shellfish because it
gives me hives."
A nurse is preparing to administer 40 mEq of potassium chloride in 45% sodium chloride (NaCl)
500 mL IV to infuse 10 mEq/hr. The nurse should set the IV pump to deliver how many mL/hr?
(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a
trailing zero.)
CALCULATION - ANS 125 mL/hr
A nurse working for a home agency is assessing an older adult male client. Which of the
following findings is the priority for the nurse to address?
A. Swollen gums
B. Pruritus
C. Urinary Hesitancy
D. Dysphagia - ANS D. Dysphagia
A nurse is going to give a presentation about preventing deep-vein thrombosis (DVT). Which of
the following should the nurse include as a risk factor for this disorder? (Select all that apply.)
BMI of 20
Recent long flight
Hypertension
High calcium intake
Immobility - ANS Flights
,Immobility
A nurse is teaching a client who has a prescription of a nasogastric tube (NG) to treat a pyloric
obstruction. Which of the following rationales for the use of the nasogastric tube should the
nurse include in the teaching?
A. Determine the pH of the gastric secretions.
B. Supply nutrients via tube feedings.
C. Decompress the stomach.
D. Administer medications. - ANS C. Decompress the stomach.
A nurse provides a back massage as a palliative care measure to a client who is unconscious,
grimacing, and restless. Which of the following findings should the nurse identify as indicating a
therapeutic response? (Select all that apply.)
The shoulders droop.
The facial muscles relax.
The respiratory rate increases.
The pulse is within the expected range.
The client draws his legs up into a fetal position. - ANS The shoulders droop.
The facial muscles relax.
The pulse is within the expected range.
A nurse is assessing a client who is postoperative and has anemia due to excess blood loss
following surgery. Which of the following findings should the nurse expect?
A. Fatigue
B. Hypertension
C. Bradycardia
D. Diarrhea - ANS A. Fatigue
A nurse is reviewing the arterial blood gas (ABG) results of a client who the provider suspects
has metabolic acidosis. Which of the following results should the nurse expect to see?
A. pH below 7.35
B. HCO3 above 26 mEq/L
C. PaO2 below 70 mmHg
D. PaCO2 above 45 mmHg - ANS A. pH below 7.35
A hospice nurse is reviewing the prescriptions for a client who is receiving palliative care. Which
of the following prescriptions should the nurse expect? (Select all that apply.)
Provide skin care with a moisture barrier cream.
Administer artificial tear PRN.
, Obtain vital signs every 2 hr.
Perform mouth care every hour.
Administer oxygen 2L/min via nasal cannula. - ANS Provide skin care with a moisture barrier
cream.
Administer artificial tear PRN.
Perform mouth care every hour.
Administer oxygen 2L/min via nasal cannula.
A nurse is planning care for a client who is postoperative and at risk of paralytic ileus. Which of
the following interventions should the nurse plan to take to promote peristalsis?
A. Increase ambulation.
B. Decrease fluid intake.
C. Increase protein intake.
D. Offer the client the bedpan every 2 hr. - ANS A. Increase ambulation.
A nurse has completed care procedures for a client who requires airborne precautions. Which of
the following items of personal protective equipment (PPE) should the nurse remove last?
A. Mask
B. Gloves
C. Gown
D. Goggles - ANS A. Mask
A nurse is providing teaching to an assistive personnel (AP) about caring for clients with
restraints. Which of the following statements by the AP indicates an understanding of the
teaching?
A. "I will tie restraints in double knots."
B. "I will tie a restraint to the portion of the bed that moves when the head of the bed is moved."
C. "I will ensure that restraints fit tightly against the client."
D. "I will put four side rails up if a client is confused." - ANS B. "I will tie a restraint to the portion
of the bed that moves when the head of the bed is moved."
A nurse is teaching a new group of assistive personnel (AP) about the importance of hand
hygiene. Which of the following statements should the nurse include?
A. "If you wear gloves, you do not have to wash your hands."
B. "Rub all surfaces of your hands with an alcohol rub for 20 to 30 seconds."
C. "Use an alcohol rub when your hands are visibly soiled."
D. "If you don't have an infection, your hands won't infect others." - ANS B. "Rub all surfaces of
your hands with an alcohol rub for 20 to 30 seconds."
A nurse caring for a client who has an infected wound removes a dressing saturated with blood
and purulent drainage. How should the nurse dispose of the dressing material?
A. Discard the dressing in the bedside trash receptacle.
B. Dispose of the dressing in a biohazardous waste container.
C. Enclose the dressing in a single clear plastic bag and discard in the bedside trash receptacle.
- ANS B. Dispose of the dressing in a biohazardous waste container.
A nurse is caring for a female client who has recurrent kidney stones and is scheduled for an
intravenous pyelogram. Which of the following statements should the nurse report to the
provider?
A. "I drink at least 2 quarts of fluid every day."
B. "The last time I voided it was painful and red-tinged."
C. "My period ended 2 days ago."
D. "I don't eat shellfish because it gives me hives." - ANS D. "I don't eat shellfish because it
gives me hives."
A nurse is preparing to administer 40 mEq of potassium chloride in 45% sodium chloride (NaCl)
500 mL IV to infuse 10 mEq/hr. The nurse should set the IV pump to deliver how many mL/hr?
(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a
trailing zero.)
CALCULATION - ANS 125 mL/hr
A nurse working for a home agency is assessing an older adult male client. Which of the
following findings is the priority for the nurse to address?
A. Swollen gums
B. Pruritus
C. Urinary Hesitancy
D. Dysphagia - ANS D. Dysphagia
A nurse is going to give a presentation about preventing deep-vein thrombosis (DVT). Which of
the following should the nurse include as a risk factor for this disorder? (Select all that apply.)
BMI of 20
Recent long flight
Hypertension
High calcium intake
Immobility - ANS Flights
,Immobility
A nurse is teaching a client who has a prescription of a nasogastric tube (NG) to treat a pyloric
obstruction. Which of the following rationales for the use of the nasogastric tube should the
nurse include in the teaching?
A. Determine the pH of the gastric secretions.
B. Supply nutrients via tube feedings.
C. Decompress the stomach.
D. Administer medications. - ANS C. Decompress the stomach.
A nurse provides a back massage as a palliative care measure to a client who is unconscious,
grimacing, and restless. Which of the following findings should the nurse identify as indicating a
therapeutic response? (Select all that apply.)
The shoulders droop.
The facial muscles relax.
The respiratory rate increases.
The pulse is within the expected range.
The client draws his legs up into a fetal position. - ANS The shoulders droop.
The facial muscles relax.
The pulse is within the expected range.
A nurse is assessing a client who is postoperative and has anemia due to excess blood loss
following surgery. Which of the following findings should the nurse expect?
A. Fatigue
B. Hypertension
C. Bradycardia
D. Diarrhea - ANS A. Fatigue
A nurse is reviewing the arterial blood gas (ABG) results of a client who the provider suspects
has metabolic acidosis. Which of the following results should the nurse expect to see?
A. pH below 7.35
B. HCO3 above 26 mEq/L
C. PaO2 below 70 mmHg
D. PaCO2 above 45 mmHg - ANS A. pH below 7.35
A hospice nurse is reviewing the prescriptions for a client who is receiving palliative care. Which
of the following prescriptions should the nurse expect? (Select all that apply.)
Provide skin care with a moisture barrier cream.
Administer artificial tear PRN.
, Obtain vital signs every 2 hr.
Perform mouth care every hour.
Administer oxygen 2L/min via nasal cannula. - ANS Provide skin care with a moisture barrier
cream.
Administer artificial tear PRN.
Perform mouth care every hour.
Administer oxygen 2L/min via nasal cannula.
A nurse is planning care for a client who is postoperative and at risk of paralytic ileus. Which of
the following interventions should the nurse plan to take to promote peristalsis?
A. Increase ambulation.
B. Decrease fluid intake.
C. Increase protein intake.
D. Offer the client the bedpan every 2 hr. - ANS A. Increase ambulation.
A nurse has completed care procedures for a client who requires airborne precautions. Which of
the following items of personal protective equipment (PPE) should the nurse remove last?
A. Mask
B. Gloves
C. Gown
D. Goggles - ANS A. Mask
A nurse is providing teaching to an assistive personnel (AP) about caring for clients with
restraints. Which of the following statements by the AP indicates an understanding of the
teaching?
A. "I will tie restraints in double knots."
B. "I will tie a restraint to the portion of the bed that moves when the head of the bed is moved."
C. "I will ensure that restraints fit tightly against the client."
D. "I will put four side rails up if a client is confused." - ANS B. "I will tie a restraint to the portion
of the bed that moves when the head of the bed is moved."
A nurse is teaching a new group of assistive personnel (AP) about the importance of hand
hygiene. Which of the following statements should the nurse include?
A. "If you wear gloves, you do not have to wash your hands."
B. "Rub all surfaces of your hands with an alcohol rub for 20 to 30 seconds."
C. "Use an alcohol rub when your hands are visibly soiled."
D. "If you don't have an infection, your hands won't infect others." - ANS B. "Rub all surfaces of
your hands with an alcohol rub for 20 to 30 seconds."
