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RN ATI Fundamentals Test Bank, Latest Complete Questions & answers All Chapters, A+ Rated guide.

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RN ATI Fundamentals (10.0) Chapter 1 1. A nurse is discussing restorative health care with a newly licensed nurse. Which of the following examples should the nurse include in the teaching? (Sele... ct all that apply.) a. Home health care b. Rehabilitation facilities c. Diagnostic centers d. Skilled nursing facilities e. Oncology centers 2. A nurse is explaining the various types of health care coverage clients might have to a group of nurses. Which of the following health care financing mechanisms should the nurse include as federally funded? (Select all that apply.) a. Preferred provider organization (PPO) b. Medicare c. Long-term care insurance d. Exclusive provider organization (EPO) e. Medicaid 3. A nurse manager is developing strategies to care for the increasing number of clients who have obesity. Which of the following actions should the nurse include as a primary health care strategy? a. Collaborating with providers to perform obesity screenings during routine office visits. b. Ensuring the availability of specialized beds in rehabilitation centers for clients who have obesity. c. Providing specialized intraoperative training in surgical treatments for obesity. d. Educating acute care nurses about postoperative complications related to obesity. 4. A nurse is discussing the purpose of regulatory agencies during a staff meeting. Which of the following tasks should the nurse identify as the responsibility of state licensing boards? a. Monitoring evidence-based practice for clients who have a specific diagnosis. b. Ensuring that health care providers comply with regulations. c. Setting quality standards for accreditation of health care facilities. d. Determining whether medications are safe for administration to clients. 5. A nurse is explaining the various levels of health care services to a group of newly licensed nurses. Which of the following examples of care or care settings should the nurse classify as tertiary care? (Select all that apply.) a. Intensive care unit b. Oncology treatment center c. Burn center d. Cardiac rehabilitation e. Home health care Chapter 2 1. A nurse is caring for a group of clients on a medical surgical unit. For which of the following client care needs should the nurse initiate a referral for a social worker? (Select all that apply.) a. A client who has terminal cancer requests hospice care in the home. b. A client asks about community resources available for older adults. c. A client states, “I would like to have my child baptized before surgery.” d. A client requests an electric wheelchair for use after discharge. e. A client states, “I do not understand how to use a nebulizer.” 2. A goal for a client who has difficulty with self-feeding due to rheumatoid arthritis is to use adaptive devices. The nurse caring for the client should initiate a referral to which of the following members of the interprofessional care team? a. Social worker b. Certified nursing assistant c. Registered dietitian d. Occupational therapist 3. A client who is postoperative following knee arthroplasty is concerned about the adverse effects of the medication prescribed for pain managements. Which of the following members of the interprofessional care team can assist the client in understanding the medication’s effects? (Select all that apply.) a. Provider b. Certified nursing assistant c. Pharmacist d. Registered nurse e. Respiratory therapist 4. A client who had a cerebrovascular accident has persistent problems with dysphagia. The nurse caring for the client should initiate a referral with which of the following members of the interprofessional care team? a. Social worker b. Certified nursing assistant c. Occupational therapist d. Speech-language pathologist 5. A nurse is acquainting a group of newly licensed nurses with the roles of the various members of the health care team they will encounter on a medical-surgical unit. When providing examples of the types of tasks CNAs can perform, which of the following client activities should the nurse include? (Select all that apply.) a. Bathing b. Ambulating c. Toileting d. Determining pain level e. Measuring vital signs Chapter 3 1. A nurse is caring for a client who decides not to have surgery despite significant blockages of the coronary arteries. The nurse understands that this client’s choice is an example of which of the following ethical principles? a. Fidelity b. Autonomy c. Justice d. Nonmaleficence 2. A nurse offers pain medication to a client who is postoperative prior to ambulation. The nurse understands that this aspect of care delivery is an example of which of the following ethical principles? a. Fidelity b. Autonomy c. Justice d. Beneficence 3. A nurse is instructing a group of newly license nurses about the responsibilities organ donation and procurement involve. When the nurse explains that all clients waiting for a kidney transplant have to meet the same qualifications, the newly licensed nurses should understand that this aspect of care delivery is an example of which of the following ethical principles? a. Fidelity b. Autonomy c. Justice d. Nonmaleficence 4. A nurse questions a medication prescription as too extreme in light of the client’s advanced age and unstable status. The nurse understands that this action is an example of which of the following ethical principles? a. Fidelity b. Autonomy c. Justice d. Nonmaleficence 5. A nurse is instructing a group of newly licensed nurses how to know and what to expect when ethical dilemmas arise. Which of the following situations should the newly licensed nurses identify as an ethical dilemma? a. A nurse on a medical-surgical unit demonstrates signs of chemical impairment. b. A nurse overhears another nurse telling an older adult client that if he doesn’t stay in bed, she will have to apply restraints. c. A family has conflicting feelings about the initiation of enteral tube feedings for their father, who is terminally ill. d. A client who is terminally ill hesitates to name their partner on their durable power of attorney form. Chapter 4 1. A nurse observes an assistive personnel (AP) reprimanding a client for not using the urinal properly. The AP tells the client that diapers will be used next time the urinal is used improperly. Which of the following torts is the AP committing? a. Assault b. Battery c. False imprisonment d. Invasion of privacy 2. A nurse is caring for a competent adult client who tells the nurse, “I am leaving the hospital this morning whether the doctor discharges me or not.” The nurse believes that this is not in the client’s best interest, and prepares to administer a PRN sedative medication the client has not requested along with the scheduled morning medication. Which of the following types of tort is the nurse about to commit? a. Assault b. False imprisonment c. Negligence d. Breach of confidentiality 3. A nurse in a surgeon’s office is providing preoperative teaching for a client who is scheduled for surgery the following week. The client tells the nurse that “I plan to prepare my advance directives before I come to the hospital.” Which of the following statements mad by the client should indicate to the nurse an understanding of advance directives? a. “I’d rather have my brother make decisions for me, but I know it has to be my wife.” b. “I know they won’t go ahead with the surgery unless I prepare these forms.” c. “I plan to write that I don’t want them to keep me on a breathing machine.” d. “I will get my regular doctor to approve my plan before I hand it in at the hospital.” 4. A nurse is caring for a client who is about to undergo an elective surgical procedure. The nurse should take which of the following actions regarding informed consent? (Select all that apply.) a. Make sure the surgeon obtained the client’s consent. b. Witness the client’s signature on the consent form. c. Explain the risks and benefits of the procedure. d. Describe the consequences of choosing not to have the surgery. e. Tell the client about alternatives to having the surgery. 5. A nurse has noticed several occasions in the past week when another nurse on the unit seemed drowsy and unable to focus on the issue at hand. Today, the nurse was found asleep in a chair in the break room not during a break time. Which of the following actions should the nurse take? a. Alert the American Nurses Association. b. Fill out an incident report. c. Report the observations to the nurse manager on the unit. d. Leave the nurse alone to sleep. Chapter 5 1. A nurse is preparing information for a change-of-shift report. Which of the following information should the nurse include in the report? a. Input and output for the shift b. Blood pressure from the previous day c. Bone scan scheduled for today. d. Medication routine from the medication administration record 2. A nurse manager is discussing the HIPAA Privacy Rule with a group of newly hired nurses during orientation. Which of the following information should the nurse manager include? (Select all that apply.) a. A single electronic record passwords is provided for nurse on the same unit. b. Family members should provide a code prior to receiving client health information. c. Communication of client information can occur at the nurses’ station. d. A client can request copy of their medical record. e. A nurse can photocopy a client’s medical record for transfer to another facility. 3. A charge nurse is reviewing documentation with a group of newly licensed nurses. Which of the following legal guidelines sold be followed when documenting in a client’s record? (Select all that apply.) a. Cover errors with correction fluid and write in the correct information. b. Put the date and time on all entries. c. Document objective data, leaving out opinions. d. Use as many abbreviations as possible. e. Wait until the end of the shift to document. 4. A nurse is discussing occurrences that require completion of an incident report with a newly licensed nurse. Which of the following should the nurse include in the teaching? (Select all that apply.) a. Medication error b. Needlesticks c. Conflict with provider and nursing staff d. Omission of prescription e. Missed specimen collection of a prescribed laboratory test 5. A nurse is receiving a provider’s prescription by telephone for morphine for a client who is reporting moderate to severe pain. Which of the following nursing actions are appropriate? (Select all that apply.) a. Repeat the details of the prescription back to the provider. b. Have another nurse listen to the telephone prescription. c. Obtain the provider’s signature on the proscription within 24 hr. d. Decline the verbal prescription because it is not an emergency situation. e. Tell the charge nurse that the provider has prescribed morphine by telephone. Chapter 6 1. A nurse on a medical-surgical unit has received change-of-shift report and will care for four clients. Which of the following tasks should the nurse assign to an assistive personnel (AP)? a. Updating the plan of care for a client who is postoperative b. Reinforcing teaching with a client who is learning to walk using a quad cane c. Reapplying a condom catheter for a client who has urinary incontinence d. Applying a sterile dressing to a pressure injury 2. A nurse manager is assigning care of a client who is being admitted from the PACU following thoracic surgery. The nurse manager should assign the client to which of the following staff members? a. Charge nurse b. Registered nurse (RN) c. Practical nurse (PN) d. Assistive personnel (AP) 3. A nurse is delegating the ambulation of a client who had knee arthroplasty 5 days ago to an AP. Which of the following information should the nurse share with the AP? (Select all that apply.) a. The roommate ambulates independently. b. The client ambulates wearing slippers over antiembolic stockings. c. The client uses a front-wheeled walker when ambulating. d. The client had pain medication 30 min ago. e. The client is allergic to codeine. 4. A charge nurse is assigning client care for four clients. Which of the following tasks should the nurse assign to a PN? a. Creating a plan of care for a client who is recovering following a stroke. b. Assessing a pressure injury on a client who is on bed rest. c. Providing nasopharyngeal suctioning for a client who has pneumonia. d. Teaching a client who has asthma to use a metered-dose inhaler. 5. A nurse is preparing an in-service program about delegation. Which of the following are components of the five rights of delegation? (Select all that apply.) a. Right place b. Right supervision and evaluation c. Right direction and communication d. Right documentation e. Right circumstances Chapter 7 1. By the second postoperative day, a client has not achieved satisfactory pain relief. Based on this evaluation, which of the following actions should the nurse take, according to the nursing process? a. Reassess the client to determine the reasons for inadequate pain relief. b. Wait to see whether the pain lessens during the next 24 hr. c. Change the plan of care to provide different pain relief interventions. d. Teach the client about the plan of care for managing the pain. 2. A charge nurse is observing a newly licensed nurse care for a client who reports pain. The nurse checked the client’s MAR and noted the last dose of pain medication was 6 hr ago. The prescription reads every 4 hr PRN for pain. The nurse administered the medication and checked with the client 40 min later, when the client reported improvement. The newly licensed nurse left out which of the following steps of the nursing process? a. Assessment b. Planning c. Intervention d. Evaluation 3. A charge nurse is reviewing the steps of the nursing process with a group of nurses. Which of the following data should the charge nurse identify as objective data? (Select all that apply.) a. Respiratory rate is 22/min with even, unlabored respirations. b. The client’s partner states, “They said they hurt after walking about 10 minutes.” c. The client’s pain rating is 3 on a scale of 0 to 10 d. The client’s skin is pink, warm, and dry. e. The assistive personnel reports that the client walked with a limp. 4. A charge nurse is talking with a newly licensed nurse and is reviewing nursing interventions that do not require a provider’s prescription. Which of the following interventions should the charge nurse include? a. Writing a prescription for morphine sulfate as needed for pain b. Inserting a nasogastric (NG) tube to relieve gastric distention c. Showing a client how to use progressive muscle relaxation d. Performing a daily bath after the evening meal e. Repositioning a client every 2 hr to reduce pressure injury risk 5. A nurse is discussing the nursing process with a newly licensed nurse. Which of the following statements by the newly licensed nurse should the nurse identify as appropriate for the planning step of the nursing process? a. “I will determine the most important client problems that we should address.” b. “I will review the past medical history on the client’s record to get more information.” c. “I will carry out the new prescriptions from the provider.” d. “I will ask the client if their nausea has resolved.” Chapter 8 1. A nurse is caring for a client who is 24 hr postoperative following an inguinal hernia repair. The client is tolerating clear liquid well, has active bowel sounds, and is expressing a desire for “real food.” The nurse tells the client “I will call the surgeon and ask for a change in diet.” The surgeon hears the nurse’s report and prescribes a full liquid diet. The nurse used which of the following levels of critical thinking? a. Basic b. Commitment c. Complex d. Integrity 2. A nurse receives a prescription for an antibiotic for a client who has cellulitis. The nurse checks the client’s medical record, discovers that the client is allergic to the antibiotic, and call the provider to request a prescription for a different antibiotic. Which of the following critical thinking attitudes did the nurse demonstrate? a. Fairness b. Responsibility c. Risk-taking d. Creativity 3. A newly licensed nurse is considering strategies to improve critical thinking. Which of the following actions should the nurse take? (Select all that apply.) a. Find a mentor. b. Use a journal to write about the outcomes of clinical judgments. c. Review articles about evidence-based practice. d. Limit consultations with other professionals involved in a client’s care. e. Make quick decisions when unsure about a client’s needs. 4. A nurse is caring for a client who has a new prescription for antihypertensive medication. Prior to administering the medication, the nurse uses an electronic database to gather information about the medication and the effects it might have on this client. Which of the following components of critical thinking is the nurse using when he reviews the medication information? a. Knowledge b. Experience c. Intuition d. Competence 5. A nurse uses a head-to-toe approach to conduct a physical assessment of a client who will undergo surgery the following week. Which of the following critical thinking did the nurse demonstrate? a. Confidence b. Perseverance c. Integrity d. Discipline Chapter 9 1. A nurse is performing an admission assessment for an older adult client. After gathering the assessment data and performing the review od systems, which of the following actions is a priority for the nurse? a. Orient the client to their room. b. Conduct a client care conference. c. Review medical prescriptions. d. Develop a plan of care. 2. A nurse is admitting a client who has acute cholecystitis to a medical-surgical unit. Which of the following actions are essential steps of the admission procedure? (Select all that apply.) a. Explain the roles of other care delivery staff. b. Begin discharge planning. c. Inform the client that advance directives are required for hospital admission. d. Document the client’s wishes about organ donation. e. Introduce the client to their roommate. 3. A nurse is caring for a client who had a stroke and is scheduled for transfer to a rehabilitation center. Which of the following tasks are the responsibility of the nurse at the transferring facility? (Select all that apply.) a. Ensure that the client has possession of their valuables. b. Confirm that the rehabilitation center has a room available at the time of transfer. c. Assess how the client tolerates the transfer. d. Give a verbal transfer report via telephone. e. Complete a transfer form for the receiving facility. 4. A nurse is preparing the discharge summary for a client who has had knee arthroplasty and is going home. Which of the following information about the client should the nurse include in the discharge summary? (Select all that apply.) a. Advance directive status. b. Follow-up care. c. Instructions for diet and medications. d. Most recent vital sign data. e. Contact information for the home health care agency. 5. As part of the admission process, a nurse at a long-term care facility is gathering a nutrition history for a client who has dementia. Which of the following components of the nutrition evaluation is the priority for the nurse to determine from the client’s family? a. Body mass index b. Usual times for meals and snacks c. Favorite foods d. Any difficulty swallowing Chapter 10 1. When entering a client’s room to change a surgical dressing, a nurse notes that the client is coughing and sneezing. Which of the following actions should the nurse take when preparing the sterile field? a. Keep the sterile field at least 6 ft away from the client’s bedside. b. Instruct the client to refrain from coughing and sneezing during the dressing change. c. Place a mask on the client to limit the spread of microorganisms into the surgical wound. d. Keep a box of facial tissue for the client to use during the dressing change. 2. A nurse as removed a sterile pack from its outside cover and placed it on a clean work surface in preparation for an invasive procedure. Which of the following flaps should the nurse unfold first? a. The flap closest to the body b. The right side flap c. The left side flap d. The flap farthest from the body 3. A nurse is wearing sterile gloves in preparation for performing a sterile procedure. Which of the following objects can the nurse touch without breaching sterile technique? (Select all that apply.) a. A bottle containing a sterile solution b. The edge of the sterile drape at the base of the field c. The inner wrapping of an item on the sterile field d. An irrigation syringe on the sterile field e. One gloved hand with the other gloved hand 4. A nurse is reviewing hand hygiene techniques with a group of assistive personnel (AP). Which of the following instructions should the nurse include when discussing handwashing? (Select all that apply.) a. Apply 3 to 5 mL of liquid soap to dry hands. b. Wash the hands with soap and water for at least 15 seconds. c. Rinse the hands with hot water. d. Use a clean paper towel to turn off hand faucets. e. Allow the hands to air dry after washing. 5. A nurse has prepared a sterile field for assisting a provider with a chest tube insertion. Which of the following events should the nurse recognize as contaminating the sterile field? (Select all that apply.) a. The provider drops a sterile instrument onto the near side of the sterile field. b. The nurse moistens a cotton ball with sterile normal saline and places it on the sterile field. c. The procedure is delayed 1 hr because the provider receives an emergency call. d. The nurse turns and speak to someone who enters through the door behind the nurse. e. The client’s hand brushes against the outer edge of the sterile field. Chapter 11 1. A nurse is caring for a client who has severe acute respiratory syndrome (SARS). The nurse knows that health care professionals are required to report communicable and infectious diseases. Which of the following illustrate the rationale for reporting? (Select all that apply.) a. Planning and evaluating control and prevention strategies. b. Determining public health priorities. c. Ensuring proper medical treatment. d. Identifying endemic disease. e. Monitoring for common-source outbreaks. 2. A nurse is caring for a client who has a cough for 3 weeks and is beginning to cough up blood. The client has manifestations of which of the following conditions? a. Allergic reaction b. Ringworm c. Systemic lupus erythematosus d. Tuberculosis 3. A nurse is caring for a client who reports a severe sore throat, pain when swallowing, and swollen lymph nodes. The client is experiencing which of the following stages of infection? a. Prodromal b. Incubation c. Convalescence d. Illness 4. A charge nurse is reviewing with a newly hired nurse the difference in manifestations of a localized versus a systemic infection. Which of the following are manifestations of a systemic infection? (Select all that apply.) a. Fever b. Malaise c. Edema d. Pain or tenderness e. Increase in pulse and respiratory rate 5. A nurse is contributing to the plan of care for a client who is being admitted to the facility with a suspected diagnosis of pertussis. Which of the following interventions should the nurse include? (Select all that apply.) a. Place the client in a room that as a negative air pressure of at least six exchanges per hour. b. Wear a mask when providing care within 3 ft of the client. c. Place a surgical mask on the client if transportation to another department is unavoidable. d. Use sterile gloves when handling soiled linens. e. Wear a gown when performing care that might result in contamination from secretions. Chapter 12 1. A nurse is caring for a client who fell at a nursing home. The client is oriented to person, place, and time and can follow directions. Which of the following actions should the nurse take to decrease the risk of another fall? (Select all that apply.) a. Place a belt restraint on the client when they are sitting on the bedside commode. b. Keep the bed in its lowest position with all side rails up. c. Make sure that the client’s call light is within reach. d. Provide the client with nonskid footwear. e. Complete a fall-risk assessment. 2. A nurse manager is reviewing with nurses on the unit in the care of a client who has had a seizure. Which of the following statements by a nurse requires further instruction? a. “I will place the client on their side.” b. “I will go to the nurses’ station for assistance.” c. “I will note the time that the seizure begins.” d. “I will prepare to insert an airway.” 3. A nurse observes smoke coming from under the door of the staff’s lounge. Which of the following actions is the nurse’s priority? a. Extinguish the fire. b. Activate the fire alarm. c. Move clients who are nearby. d. Close all open doors on the unit. 4. A nurse is caring for a client who has a history of falls. Which of the following actions is the nurse’s priority? a. Complete a fall-risk assessment. b. Educate the client and family about fall risks. c. Eliminate safety hazards from the client’s environment. d. Make sure the client uses assistive aids in their possession. 5. A nurse discovers a small paper fire in a trash can in a client’s bathroom. The client has been taken to safety and the alarm has been activated. Which of the following actions should the nurse take? a. Open the windows in the client’s room to allow smoke to escape. b. Obtain a class C fire extinguisher to extinguish the fire. c. Remove all electrical equipment from the client’s room. d. Place wet towels along the base of the door to the client’s room. Chapter 13 1. A nurse is providing discharge instructions to a client who has a prescription for oxygen use at home. Which of the following information should the nurse include? (Select all that apply.) a. Family members who smoke must be at least 10 ft from the client when oxygen is in use. b. Nail polish should not be used near a client who is receiving oxygen. c. A “No Smoking” signs should be placed on the front door. d. Cotton bedding and clothing should be replaced with items made from wool. e. A fire extinguisher should be readily available in the home. 2. A nurse educator is presenting module on basic first aid for newly licensed home health nurses. The client who has heat stroke will have which of the following? a. Hypotension b. Bradycardia c. Clammy skin d. Bradypnea 3. A nurse educator is conducting a parenting class for new guardians of infants. Which of the following statements made by a participant indicated understanding? a. “I will set my water heater at 130oF.” b. “Once my baby can sit up, they should be safe in the bathtub.” c. “I will place my baby on their stomach to sleep.” d. “Once my infant starts to push up, I will remove the mobile from over the crib.” 4. A home health nurse is discussing the dangers of carbon monoxide poisoning with a client. Which of the following information should the nurse include? a. Carbon monoxide has a distinct odor. b. Water heaters should be inspected every 5 years. c. The lungs are damaged from carbon monoxide inhalation. d. Carbon monoxide binds with hemoglobin in the body. 5. A home health nurse is discussing the dangers of food poisoning with a client. Which of the following information should the nurse include? (Select all that apply.) a. Most food poisoning is caused by a virus. b. Immunocompromised individuals are at increased risk for complications from food poisoning. c. Clients who are at high risk should eat or drink only pasteurized dairy products. d. Healthy individuals usually recover from the illness in a few weeks. e. Handling raw and fresh food separately can prevent food poisoning. Chapter 14 1. A nurse is caring for a client who is receiving enteral feedings due to dysphagia. Which of the following bed positions should the nurse use for safe care of this client? a. Supine b. Semi-Fowler’s c. Semi-prone d. Trendelenburg 2. A nurse is caring for a client who is sitting in a chair and asks to return to bed. Which of the following actions is the nurse’s priority at this time? a. Obtain a walker for the client to use to transfer back to bed. b. Call for additional staff to assist with the transfer. c. Use a transfer belt to assist the client back into bed. d. Determine the client’s ability to help with transfer. 3. A nurse is instructing a client who has COPD about using the orthopneic position to relieve shortness of breath. Which of the following statements should the nurse make? a. “Lie on your back with our head and shoulders supported by a pillow.” b. “Have your head turned to the side while you lie on your stomach.” c. “Have a table beside your bed so you can sit on the bedside and rest your arms on the table.” d. “Lie on your side with your top arm resting on the bed and your weight on your hip.” 4. A nurse manager is reviewing guidelines for preventing injury with staff nurses. Which of the following instructions should the nurse manager include? (Select all that apply.) a. Request assistance when repositioning a client. b. Avoid twisting your spine or bending at the waist. c. Keep your knees slightly lower than your hips when sitting for long periods of time. d. Use smooth movements when lifting and moving clients. e. Take a break from repetitive movements every 2 to 3 hr to flex and stretch your joints and muscles. 5. A nurse educator is reviewing proper body mechanics during employee orientation. Which of the following statements should the nurse identify as an indication that an attendee understands the teaching? (Select all that apply.) a. “My line of gravity should fall outside my base of support.” b. “The lower my center of gravity, the more stability I have.” c. “To broaden my base of support, I should spread my feet apart.” d. “When I lift an object, I should hold it as close to my body as possible.” e. “When pulling an object, I should move my front foot forward.” Chapter 15 1. A nurse is caring for multiple clients during a mass casualty event. Which of the following clients is the nurse’s priority? a. A client who received crush injuries to the chest and abdomen and is expected to die. b. A client who has a 4-inch laceration to the head. c. A client who has partial-thickness and full-thickness burns to his face, neck and chest. d. A client who has a fractured fibula and tibia. 2. A nurse educator is teaching staff members about facility protocol in the event of a tornado. Which of the following should the nurse include? (Select all that apply.) a. Open doors to client rooms. b. Place blankets over clients who are confined to beds. c. Move beds away from the windows. d. Draw shades and close drapes. e. Instruct ambulatory clients in the hallways to return to their rooms. 3. An occupational health nurse is caring for an employee who was exposed to an unknown dry chemical, resulting in a chemical burn. Which of the following interventions should the nurse include in the plan of care? a. Irrigate the affected area with running water. b. Wash the affected area with antibacterial soap. c. Brush the chemical off the skin and clothing. d. Leave the clothing in place until emergency personnel arrive. 4. A security officer is reviewing actions to take in the event of a bomb threat by phone to a group of nurses. Which of the following statements by a nurse indicates understanding? a. “I will get the caller off the phone as soon as possible so I can alert the staff.” b. “I will begin evacuating clients using the elevators.” c. “I will not as any questions and just let the caller talk.” d. “I will listen for background noises.” 5. A nurse on a medical surgical unit is informed that a mass casualty event occurred in the community and that is necessary to discharge stable clients to make beds available for injury victims. Which of the following clients should the nurse recommend for discharge? (Select all that apply.) a. A client who is dehydrated and receiving IV fluid and electrolytes. b. A client who has a nasogastric tube to treat a small bowel obstruction. c. A client who is scheduled for elective surgery. d. A client who has chronic hypertension and blood pressure 135/85 mmHg. e. A client who has acute appendicitis and is scheduled for an appendectomy. Chapter 16 1. A nurse is caring for a young adult at a college health clinic. Which of the following actions should the nurse take first? a. Give the client information about immunization against meningitis. b. Tell the client to have a TB skin test every 2 years. c. Determine the client’s health risks. d. Teach the client about exercise recommendations. 2. A nurse in a clinic is planning health promotion and disease prevention strategies for a client who has multiple risk factors for cardiovascular disease. Which of the following interventions should the nurse include? (Select all that apply.) a. Help the client see the benefits of their actions. b. Identify the client’s support systems. c. Suggest and recommend community resources. d. Devise and set goals for the client. e. Teach stress management strategies. 3. A nurse in a health clinic is caring for a 210year client who tells the nurse that their last physical exam was in high school. Which of the following health screenings should the nurse expect the provider to perform for this client? a. Testicular examination b. Blood glucose c. Fecal occult blood d. Prostate-specific antigen 4. A nurse at a health department is planning strategies related to heart disease. Which of the following activities should the nurse include as part of primary prevention? a. Providing cholesterol screening b. Teaching about a healthy diet c. Providing information about antihypertensive medications d. Developing a list of cardiac rehabilitation programs 5. A nurse at a provider’s office is talking about routine screenings with a 45-year-old female client who has no specific family history of cancer or diabetes mellitus. Which of the following client statements indicates that the client understands how to proceed? a. “So I don’t need the colon cancer procedure for another 2 or 3 years.” b. “For now, I should continue to have a mammogram each year.” c. “Because the doctor just did a Pap smear, I’ll come back next year for another one.” d. “I had my glucose test last year, so I won’t need it again for 4 years.” Chapter 17 1. A nurse is observing a client drawing up and mixing insulin. Which of the following findings should the nurse identify as an indication that psychomotor learning has taken place? a. The client is able to discuss the appropriate technique. b. The client is able to demonstrate the appropriate technique. c. The client states an understanding of the process. d. The client is able to write the steps on a piece of paper. 2. A nurse in a provider’s office is collecting data from the caregiver of a 12-month-old infant who asks if the child is old enough for toilet training. Following an educational session with the nurse, the client agrees to postpone toilet training until the child is older. Learning has occurred in which of the following domains? a. Cognitive b. Affective c. Psychomotor d. Kinesthetic 3. A nurse is providing preoperative education for a client who will undergo a mastectomy the next day. Which of the following statements should the nurse identify as an indication that the client is ready to learn? a. “I don’t want my spouse to see my incision.” b. “Will you give me pain medicine after the surgery” c. “Can you tell me about how long the surgery will take?” d. “My roommate listens to everything I say.” 4. A nurse is preparing an instructional session for a client about managing stress incontinence. Which of the following actions should the nurse take first when meeting with the client? a. Encourage the client to participate actively in learning. b. Select instructional materials. c. Identify goals the nurse and the client agree are reasonable. d. Determine what the client knows about stress incontinence. 5. A nurse is evaluating how well a client learned the information presented in an instructional session about following a heart-healthy diet. Which of the following actions should the nurse take to evaluate the client’s learning? a. Encourage the client to ask questions. b. Ask the client to explain how to select or prepare meals. c. Encourage the client to fill out an evaluation form about how the nurse presented the information. d. Ask whether the client has resources for further instruction on this topic. Chapter 18 1. A nurse is talking with the parents of a 6-month-old infant about gross motor development. Which of the following gross motor skills are expected findings in the next 3 months? (Select all that apply.) a. Rolls from back to front b. Bears weight on legs c. Walks holding onto furniture d. Sits unsupported e. Sits down from standing position 2. A nurse is reviewing safety measures with the parent of an 8-month-old infant. Which of the following statements by the parent indicates an understanding of safety for the infant? a. “My baby loved to play with the crib gym, but I took it out of the crib.” b. “I just bought a soft mattress so my baby will sleep better.” c. “My baby really likes sleeping on the fluffy pillow we just got.” d. “”I put the baby’s car seat out of the way on the table after I put him in it.” 3. A nurse is reviewing car seat safety with the parents of a 1-month-old infant. When reviewing car seat use, which of the following instructions should the nurse include? a. Use a car seat that has a three-point harness system. b. Position the car seat so that the infant is rear-facing. c. Secure the car seat in the front passenger seat of the vehicle. d. Convert to a booster seat after 12 months. 4. A nurse is assessing a 2-week-old newborn during a routine checkup. Which of the following findings should the nurse expect? a. Sleeps 14 to 16 hr each day. b. Posterior fontanel closed. c. Pincer grasp present. d. Hands remain in a closed position. e. Current weight same as birth weight. 5. The mother of a 7-month-old infant tells the nurse at the pediatric clinic that her baby has been fussy with occasional loose stools since she started feeding him fruits and vegetables. Which of the following responses should the nurse make? (Select all that apply.) a. “It might be good to add bananas, as they can help with loose stools.” b. “Let’s make a list of the foods your baby is eating so we can spot any problems.” c. “Did the changes begin after you started one particular food?” d. “Has your baby been vomiting since starting these new foods?” e. “Most babies react with a little indigestion when you start new foods.” Chapter 19 1. A nurse is giving a presentation about accident to a group of parents of toddlers. Which of the following accident-prevention strategies should the nurse include? (Select all that apply.) a. Store toxic agents in locked cabinets. b. Keep toilet seats up. c. Turn pot handles toward the back of the stove. d. Place safety gates across stairways. e. Make sure balloons are fully inflated. 2. A nurse is planning diversionary activities for toddlers on an inpatient unit. Which of the following activities should the nurse include? (Select all that apply.) a. Building models. b. Working with clay. c. Filling and emptying containers. d. Playing with blocks. e. Looking at books. 3. A nurse is teaching the parents of a toddler about discipline. Which of the following actions should the nurse suggest? a. Establish consistent boundaries for the toddler. b. Place the toddler in a room with the door closed. c. Inform the toddler how you feel when he misbehaves. d. Use favorite snack to reward the toddler. 4. A mother tells the nurse that her 2-year-old toddler has temper tantrums and says “no” every time the mother tries to help them get dressed. The nurse should recognize the toddler is manifesting which of the following stages of development? a. Trying to increase her independence. b. Developing a sense of trust. c. Establishing a new identity. d. Attempting to master a skill. 5. A nurse is reviewing nutritional guidelines with the parents of a 2-year-old toddler. Which of the following parent statements should indicate to the nurse an understanding of the teaching? a. “I should keep feeding my son whole milk until he is 3 years old.” b. “It’s okay for me to give my son a cup of apple juice with each meal.” c. “I’ll give my son about 2 tablespoons of each food at mealtimes.” d. “My son loves popcorn, and I know it is better for him than sweets.” Chapter 20 1. A nurse is talking with the guardian of a 4-year-old child who reports that the child is waking up with nightmares. Which of the following interventions should the nurse suggest? a. Offer the child a large snack before bedtime. b. Allow the child to watch an extra 30 min of TV in the evening. c. Have the child go to bed at a consistent time every day. d. Increase physical activity before bedtime. 2. A nurse is planning diversionary activities for preschoolers on an inpatient pediatric unit. Which of the following activities should the nurse include? (Select all that apply.) a. Assembling puzzles. b. Pulling wheeled toys. c. Using musical toys. d. Playing with puppets. e. Coloring with crayons. 3. A nurse is preparing to administer medications to a preschooler. Which of the following strategies should the nurse implement to increase the child’s cooperation in taking medications? (Select all that apply.) a. Reassure the child an injection will not hurt. b. Mix oral medications in a large glass of milk. c. Offer the child choices when possible. d. Have the guardians bring in a favorite toy from home. e. Engage the child in pretend play with a toy medical kit. 4. A nurse is reviewing the Centers for Disease Control and Prevention’s (CDC) immunization recommendations with the guardian of preschoolers. Which of the following vaccines should the nurse include in this discussion? (Select all that apply.) a. Heamophilus influenzae type B b. Varicella c. Polio d. Hepatitis A e. Seasonal influenza 5. A nurse is talking with guardians who are concerned about several issues with their preschooler. Which of the following issues should the nurse identify as the priority? a. “My child mimics the way my partner and I dress.” b. “My child has temper tantrums every time we tell them to do something they don’t want to do.” c. “I think my child truly believes that toys have personalities and can talk.” d. “I feel bad when I see my child trying so hard to button their shirt.” Chapter 21 1. A nurse is talking with caregivers of a 12-year-old child. Which of the following issues verbalized by the caregivers should the nurse identify as the priority? a. “We just don’t understand why our child can’t keep up with the other kids in simple activities like running and jumping.” b. “Our child keeps trying to find ways around our household rules. They always want to make deals with us.” c. “We think our child is trying too hard to excel in math just to get the top grades in the class.” d. “Our child likes to sing and worries it will make the other kids want to laugh.” 2. A nurse is planning diversionary activities for school-age children on an inpatient pediatric unit. Which of the following activities should the nurse include? (Select all that apply.) a. Building models. b. Playing video games. c. Reading books. d. Using toy carpentry tools. e. Playing board games. 3. A nurse is evaluating teaching about nutrition with the guardians of an 11-year-old child. Which of the following statements should indicate to the nurse an understanding of the teaching? a. “Our child wants to eat as much as we do, but we’re afraid It will lead to becoming overweight.” b. “Our child skips lunch sometimes, but we figure it’s okay as long as we eat a healthy breakfast and dinner.” c. “We limit fast-food restaurant meals to three times a week now.” d. “We reward school achievements with a point system instead of pizza or ice cream.” 4. A nurse is talking with the caregivers of a 10-yeaar-old child who is concerned that their child is becoming secretive, including closing the door when showering and dressing. Which of the following responses should the nurse make? a. “Perhaps you should try to find out what is happening behind those closed doors.” b. “Suggest that the door be left ajar for safety reasons.” c. “At this age, children tend to become modest and value their privacy.” d. “You should establish a disciplinary plan to stop this behavior.” 5. A nurse is planning a health promotion and primary prevention class for the caregivers of school-age children. Which of the following actions should the nurse plan to take? (Select all that apply.) a. Provide information about the risk of childhood obesity. b. Discuss the danger of substance use disorder. c. Promote discussion about sexual issues. d. Recommend the school-age child sit in the front seat of the car. e. Reinforce stranger awareness. Chapter 22 1. A nurse is teaching the guardian of a 12-year-old male client about manifestations of puberty. The nurse should explain that which of the following physical changes occur first? a. Appearance of downy hair on the upper lip b. Hair growth in the axillae c. Enlargement of the testes and scrotum d. Deepening of the voice 2. A nurse on a pediatric unit is caring for an adolescent who has multiple fractures. Which of the following interventions should the nurse take? (Select all that apply.) a. Suggest that the guardians bring in video games to play. b. Provide a television and movies for the adolescent to watch. c. Limit visitors to the adolescent’s immediate family. d. Involve the adolescent in treatment decisions when possible. e. Allow the adolescent to perform morning self-care. 3. A nurse is reviewing CDC’s immunization recommendations with the guardians of an adolescent. Which of the following recommendations should the nurse include in this discussion? (Select all that apply.) a. Rotavirus b. Varicella c. Herpes zoster d. Human papilloma virus e. Seasonal influenza 4. A nurse is talking with an adolescent who is having difficulty dealing with several issues. Which of the following issues should the nurse identify as the priority? a. “I kind of like this boy in my class, but he doesn’t like me back.” b. “I want to hang out with the kids in the science club, but the jocks pick on them.” c. “I am so fat, I skip meals to try to lose weight.” d. “My dad wants me to be a lawyer like him, but I just want to dance.” 5. A nurse is preparing a wellness presentation for families about health screening for adolescents. Which of the following information should the nurse include? (Select all that apply.) a. Obtain a periodic mental evaluation. b. Discuss prevention of sexually transmitted infections. c. Regularly screen for tuberculosis. d. Provide education about drug and alcohol use. e. Teach monthly breast examination. Chapter 23 1. A nurse is instructing a young adult client about health promotion and illness prevention. Which of the following statements indicates understanding? a. “I already had my immunizations as a child, so I’m protected in that area.” b. “It is important to schedule routine health care visits even if I a feeling well.” c. “I will just go to an urgent care center for my routine medical care.” d. “There’s no reason to seek help if I am feeling stressed because it’s just part of life.” 2. A nurse is reviewing CDC immunization recommendations with a young adult client. Which of the following vaccines should the nurse recommend as routine, rather than catch-up, during young adulthood? (Select all that apply.) a. Influenza b. Measles, mumps, rubella c. Pertussis d. Tetanus e. Polio 3. A charge nurse is explaining the various stages of the lifespan to a group of newly licensed nurses. Which of the following examples should the charge nurse include as a developmental task for a young adult? a. Becoming actively involved in providing guidance to the next generation. b. Adjusting to major changes in roles and relationships due to losses. c. Devoting time to establishing an occupation. d. Finding oneself “sandwiched” between and being responsible for two generations. 4. A nurse is counseling a young adult who describes having difficulty dealing with several issues. Which of the following statements should the nurse identify as the priority to assess further? a. “I have my own apartment not, but it’s not easy living away from my guardians.” b. “It’s been so stressful for me to even think about having my own family.” c. “I don’t even know who I am yet, and now I’m supposed to know what to do.” d. “My partner is pregnant, and I don’t think I have what it takes to be a good parent.” 5. A nurse is reviewing safety precautions with a group of young adults at a community health fair. Which of the following recommendations should the nurse include to address common health risks for this age group? (Select all that apply.) a. Install bath rails and grab bars in bathrooms. b. Wear a helmet while skiing. c. Install a carbon monoxide detector. d. Secure firearms in a safe location. e. Remove throw rugs from the home. Chapter 24 1. A charge nurse is explaining the various stages of the lifespan to a group of newly licensed nurses. Which of the following examples should the nurse include as a developmental task for middle adulthood? a. The client evaluates their behavior after a social interaction. b. The client states they are learning to trust others. c. The client wishes to find meaningful friendships. d. The client expresses concerns about the next generations. 2. A nurse is collecting data to evaluate a middle adult’s psychosocial development. The nurse should expect middle adults to demonstrate which of the following developmental tasks? (Select all that apply.) a. Develop an acceptance of diminished strength and increased dependence on others. b. Spend time focusing on improving job performance. c. Welcome opportunities to be creative and productive. d. Commit to finding friendship and companionship. e. Become involved with community issues and activities. 3. A nurse is collecting history and physical examination data from a middle adult. The nurse should expect to find decreases in which of the following physiologic functions? (Select all that apply.) a. Metabolism b. Ability to hear low-pitched sounds. c. Gastric secretions d. Far vision e. Glomerular filtration 4. A nurse is preparing a health promotion course for a group of middle adults. Which of the following strategies should the nurse recommend? (Select all that apply.) a. Eye examination every 1 to 3 years b. Decrease intake of calcium supplements c. DXA screening for osteoporosis d. Increase intake of carbohydrate in the diet e. Screening for depressive disorders 5. A nurse is counselling a middle adult client who describes having difficulty dealing with several issues. Which of the following client statements should the nurse identify as the priority to assess further? a. “I am struggling to accept that my parents are aging and need so much help.” b. “It’s been so stressful for me to think about having intimate relationships.” c. “I know I should volunteer my time for a good cause, but maybe I’m just selfish.” d. “I love my grandchildren, but my child expects me to relive my parenting days.” Chapter 25 1. A nurse is counselling an older adult who describes having difficulty with several issues. Which of the following problems verbalized by the client should the nurse identify as the priority? a. “I spent my whole life dreaming about retirement, and now I wish I had my job back.” b. “It’s been so stressful for me to have to depend on my child to help around the house.” c. “I just heard my friend Al died. That’s the third one in 3 months.” d. “I keep forgetting which medications I have taken during the day.” 2. A nurse is providing teaching for an older adult client who has lost 4.5 kg (9.9 lb) since the last admission 6 months ago. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) a. “Eat three large meals a day.” b. “Eat your meals in front of the television.” c. “Eat foods that are easy to eat, such as finger foods.” d. “Invite family members to eat meals with you.” e. “Exercise every day to increase appetite.” 3. A nurse is planning a presentation for a group of older adults about health promotion and disease prevention. Which of the following interventions should the nurse plan to recommend? (Select all that apply.) a. HPV immunization b. Pneumococcal immunization c. Yearly eye examination d. Periodic mental health screening e. Annual fecal occult blood 4. A nurse is talking with an older adult client about improving nutritional status. Which of the following interventions should the nurse recommend? (Select all that apply.) a. Increase protein intake to increase muscle mass. b. Decrease fluid intake to prevent urinary incontinence. c. Increase calcium intake to prevent osteoporosis. d. Limit sodium intake to prevent edema. e. Increase fiber intake to prevent constipation. 5. A nurse is collecting data from an older adult client as part of a comprehensive physical examination. Which of the following findings should the nurse expect as associated with aging? (Select all that apply.) a. Skin thickening b. Decreased height c. Increased saliva production d. Nail thickening e. Decreased bladder capacity Chapter 26 1. A nurse provides and introduction to a client as the first step of comprehensive physical examination. Which of the following strategies should the nurse use with this client? (Select all that apply.) a. Address the client with the appropriate title and their last name. b. Use a mix of open- and closed-ended questions. c. Reduce environmental noise. d. Have the client complete a printed history form. e. Perform the general survey before the examination. 2. A nurse is a provider’s office is documenting findings following an examination performed for a client new to the practice. Which of the following parameters should the nurse include as part of the general survey? (Select all that apply.) a. Posture b. Skin lesions c. Speech d. Allergies e. Immunization status 3. A nurse is collecting data for a client’s comprehensive physical examination. After inspecting the client’s abdomen, which of the following skill of the physical examination process should the nurse perform next? a. Olfaction b. Auscultation c. Palpation d. Percussion 4. A nurse is preparing to perform a comprehensive physical examinations of an older adult client. Which of the following interventions should the nurse use in consideration of the client’s age? (Select all that apply.) a. Expect the session to be shorter than for a younger client. b. Plan to allow plenty of time for position changes. c. Make sure the client has any essential sensory aids in place. d. Tell the client to take their time answering questions. e. Invite the client to use the bathroom before beginning the examination. 5. A nurse in a provider’s office is performing a physical examination of an adult client. Which part of the hands should the nurse use during palpation for optimal assessment of skin temperature? a. Palmar surface b. Fingertips c. Dorsal surface d. Base of the fingers Chapter 27 1. A nurse is caring for a client in the emergency department who has an oral body temperature of 38.3oC (101oF), pulse rate 114/min, and respiratory rate 22/min. The client is restless with warm skin. Which of the following interventions should the nurse take? (Select all that apply.) a. Obtain culture specimens before initiating antimicrobials. b. Restrict the client’s oral fluid intake. c. Encourage the client to rest and limit activity. d. Allow the client to shiver to dispel excess heat. e. Assist the client with oral hygiene frequently. 2. A nurse is instructing an AP about caring for a client who has a low platelet count. Which of the following instructions is the priority for measuring vital signs for this client? a. “Do not measure the client’s temperature rectally.” b. “Count the client’s radial pulse for 30 seconds and multiply it by 2.” c. “Do not let the client know you are counting their respirations.” d. “Let the client rest for 5 minutes before you measure their BP.” 3. A nurse is instructing a group of assistive personnel in measuring a client’s respiratory rate. Which of the following guidelines should the nurse include? (Select all that apply.) a. Place the client in semi-Fowler’s position. b. Have the client rest an arm across the abdomen. c. Observe one full respiratory cycle before counting the rate. d. Count the rate for 30 sec if it is irregular. e. Count and report any sighs the client demonstrates. 4. A nurse is measuring BP of a client who has a fractured femur. BP is 140/94 mmHg, and the client denies any history of HTN. Which of the following actions should the nurse take first? a. Request a prescription for an antihypertensive medication. b. Ask the client if they are having pain. c. Request a prescription for an antianxiety medication. d. Return in 30 min to recheck the client’s BP. 5. A nurse is performing an admission assessment on a client. The nurse determines the client’s radial pulse rate is 68/min and the simultaneous apical pulse is 84/min. what is the client’s pulse deficit (per minutes)? 16 Chapter 28 1. A nurse is a provider’s office is preparing to test a client’s cranial nerve function. Which of the following should the nurse include when testing cranial nerve V? (Select all that apply.) a. “Close your eyes.” b. “Tell me what you can taste.” c. “Clench your teeth.” d. “Raise your eyebrows.” e. “Tell me when you feel a touch.” 2. A nurse is assessing a client’s thyroid gland as part of a comprehensive physical examination. Which of the following findings should the nurse expect? (Select all that apply.) a. Palpating the thyroid in the lower half of the neck. b. Visualizing the thyroid on inspection of the neck. c. Hearing a bruit when auscultating the thyroid. d. Feeling the thyroid ascend as the client swallows. e. Finding symmetric extension off the traches on both sides of the midline. 3. A nurse is assessing an adult client’s internal ear canals with an otoscope as part of a head and neck examination. Which of the following actions should the nurse take? (Select all that apply.) a. Pull the auricle down and back. b. Insert the speculum slightly down and forward. c. Insert the speculum 2 to 2.5 cm (0.8 to 1 in) d. Make sure the speculum does not touch the ear canal. e. Use the light to visualize the tympanic membrane in a cone shape. 4. A nurse is caring for a client who asks what their Snellen eye test results mean. The client’s visual acuity is 20/30. Which of the following responses should the nurse make? a. “Your eyes see at 20 feet what visually unimpaired eyes see at 30 feet.” b. “Your right eye can see the chart clearly at 20 feet, and your left eye can see the chart clearly at 30 feet.” c. “Your eyes see at 30 feet what visually unimpaired eyes see at 20 feet.” d. “Your left eye can see the chart clearly at 20 feet, and your right eye can see the chart clearly at 30 feet.” 5. A nurse is performing a head and neck examination for an older adult client. Which of the following age-related findings should the nurse expect? (Select all that apply.) a. Reddened gums b. Lowered vocal pitch c. Tooth loss d. Glare intolerance e. Thickened eardrums Chapter 29 1. A nurse in a provider’s office is preparing to perform a breast examination for an older adult client who is postmenopausal. Which of the following findings should the nurse expect? (Select all that apply.) a. Smaller nipples b. Less adipose tissue c. Nipple discharge d. More pendulous e. Nipple inversion 2. A nurse in a provider’s office is preparing to auscultate and percuss a client’s thorax as part of a comprehensive physical examination. Which of the following findings should the nurse expect? (Select all that apply.) a. Rhonchi b. Crackles c. Resonance d. Tactile fremitus e. Bronchovesicular sounds 3. During an abdominal examination, a nurse in a provider’s office determines that a client has abdominal distention. The protrusion is at midline, the skin over the area is taut, and the nurse notes no involvement of the flanks. Which of the following possible causes of distention should the nurse suspect? a. Fat b. Fluid c. Flatus d. Hernias 4. During a cardiovascular examination, a nurse in a provider’s office places the diaphragm of the stethoscope on the left midclavicular line at the fifth intercostal space. Which of the following data is the nurse attempting to auscultate? (Select all that apply.) a. Ventricular gallop b. Closure of the mitral valve c. Closure of the pulmonic valve d. Apical heart rate e. Murmur 5. A nurse in a provider’s office is preparing to auscultate and percuss a client’s abdomen as part of a comprehensive physical examination. Which of the following findings should the nurse expect? (Select all that apply.) a. Tympany b. High-pitched clicks c. Borborygmi d. Friction rubs e. Bruits Chapter 30 1. A nurse in a provider’s office is preparing to assess a client’s skin as part of a comprehensive physical examination. Which of the following findings should the nurse expect? (Select all that apply.) a. Capillary refill less than 3 seconds b. 1+ pitting edema in both feet c. Pale nail beds in both hands d. Thick skin on the soles of the feet e. Numerous macules on the face darker than the surrounding skin color 2. A nurse is assessing an older adult client who has significant tenting of the skin over the forearm. Which of the following factors should the nurse consider as a cause for this finding? (Select all that apply.) a. Thin, parchment-like skin b. Loss of adipose tissue c. Dehydration d. Diminished skin elasticity e. Excessive wrinkling 3. A nurse is assessing postoperative circulation of the lower extremities for a client who had knee surgery. The nurse should test which of the following? (Select all that apply.) a. Range of motion b. Skin color c. Edema d. Skin lesions e. Skin temperature 4. A nurse is performing skin assessment on a group of clients. Which of the following lesions should the nurse identify as vesicles (Select all that apply.) a. Acne b. Warts c. Psoriasis d. Herpes simplex e. Varicella 5. A nurse is performing an integumentary assessment for a group of clients. Which of the following findings should the nurse recognize as requiring immediate intervention? a. Pallor b. Cyanosis c. Jaundice d. Erythema Chapter 31 1. A nurse in a provider’s office is preparing to assess a young adult client’s musculoskeletal system as part of a comprehensive physical examination. Which of the following findings should the nurse expect? (Select all that apply.) a. Concave thoracic spine posteriorly b. Exaggerated lumbar curvature c. Concave lumbar spine posteriorly d. Exaggerated thoracic curvature e. Muscle slightly larger on the dominant side 2. A nurse, who is assessing a client’s neurologic system, should ask the client to close their eyes and identify which of the following items? a. A word the nurse whispers 30cm from the ear b. A number the nurse traces on the palm of the hand c. The vibration of a tuning fork the nurse places on the foot d. A familiar object the nurse places in the hand 3. A nurse is caring for a client who reports pain with internal rotation of the right shoulder. This discomfort can affect the client’s ability to perform which of the following activities? a. Exercising the deltoid muscle when using hand weights b. Brushing the hair on the back of the head c. Fastening or zipping closures on the back while dressing d. Reaching into cabinet above the sink 4. A nurse is performing a neurologic examination for a client. Which of the following assessments should the nurse perform to test the client’s balance? (Select all that apply.) a. Romberg test b. Heel-to-toe walk c. Snellen test d. Spinal accessory function e. Rosenbaum test 5. A nurse is collecting data from an older adult client as part of a neurologic examination. Which of the following findings should the nurse expect as changes associated with aging? (Select all that apply.) a. Slower light touch sensation b. Some vision and hearing decline c. Slower fine finger movement d. Some short-term memory decline e. Decreased risk of depression Chapter 32 1. A nurse is caring for a client who states, “I have to check with my partner and see if they think I am ready to go home.” The nurse replies, “How do you feel about going home today?” Which clarifying technique is the nurse using to enhance communication with the client? a. Pacing b. Reflecting c. Paraphrasing d. Restating 2. Which of the following actions should the nurse take when demonstrating an empathic presence to a client? (Select all that apply.) a. Use an open posture. b. Write down what the client says to avoid forgetting details. c. Establish and maintain eye contact d. Nod in agreement with the client throughout the conversation. e. Sit facing the client. 3. A nurse is caring for a client who is concerned about being discharged to home with a new colostomy because of being an avid swimmer. Which of the following statements should the nurse make? (Select all that apply.) a. “You will do great! You just have to get used to it.” b. “Why are you worried about going home?” c. “Your daily routines will be different when you get home.” d. “Tell me about the support system you’ll have after you leave the hospital.” e. “It sounds like you are not sure how to having a colostomy will affect swimming.’ 4. Which of the following strategies should a nurse use to establish a helping relationship with a client? a. Make sure the communication is equally distributed between the nurse’s and client’s desires. b. Encourage the client to communicate their thoughts and feelings. c. Give the nurse-client relationship communication no time limits. d. Allow communication to occur spontaneously throughout the nurse-client relationship. 5. A nurse is caring for a school-age child who is sitting in a chair. To facilitate effective communication, which of the following actions should the nurse take? a. Touch the child’s arm. b. Sit at eye level with the child. c. Stand facing the child. d. Stand with a relaxed posture. Chapter 33 1. A nurse is caring for a client whose partner passed away 4 months ago. The client has a recent diagnosis of DM. the client is tearful and states, “How could you possibly understand what I am going through?” Which of the following responses should the nurse make? a. “It takes time to get over the loss of a loved one.” b. “You are right. I cannot really understand. Perhaps you’d like to tell me more about what you’re feeling.” c. “Why don’t you try something to take your mind off your troubles, like watching a funny movie.” d. “I might not share your exact situation, but I do know what people go through when they deal with a loss.” 2. A nurse is caring for a client awaiting transport to the surgical suite for a coronary artery bypass graft. Just as the transport team arrives, the nurse takes the client’s vital signs and notes an elevation in BP and HR. the nurse should recognize this response as which part of general adaptation syndrome (GAS)? a. Exhaustion stage b. Resistance stage c. Alarm stage d. Recovery stage 3. A nurse is caring for a client who has left-sided hemiplegia resulting from a CVA accident. The client works as a carpenter and is now experiencing a situational role change based on physical limitations. The client is the primary wage earner in the family. Which of the following describes the client’s role problem? a. Role conflict b. Role overload c. Role ambiguity d. Role strain 4. A nurse is caring for a client who has a new diagnosis of type 2 DM. Which of the following nursing interventions for stress, coping, and adherence to the treatment plan should the nurse initiate at this time? (Select all that apply.) a. Suggest coping skills for the client to use in this situation. b. Allow the client to provide input in the treatment plan. c. Assist the client with time management, and address the client’s priorities. d. Provide extensive instructions on the client’s treatment regimen. e. Encourage the client in the expression of feelings and concerns. 5. A nurse is caring for a family who is experiencing crisis. Which of the following approaches should the nurse use when working with a family using an open structure for coping with crisis? a. Prescribing tasks unilaterally. b. Delegating care to one member c. Speaking to the primary client privately d. Convening a family meeting Chapter 34 1. A nurse in an ambulatory care clinic is caring for a client who had a mastectomy 6 months ago. The client tells the nurse that there has been a decreased desire for sexual relations since the surgery, stating “My body is so different now.” Which of the following responses should the nurse make? a. “Really, you look just fine to me. There’s no need to feel undesirable.” b. “I’m interested in finding out more about how your bod feels to you.” c. “Consider an afternoon at a spa. A facial will make you feel more attractive.” d. “It’s still too soon to expect to feel normal. Give it a little more time.” 2. A nurse is caring for a group of clients on a medical surgical unit. Which of the following clients are at increased risk for body-image disturbances? (Select all that apply.) a. A client who had a laparoscopic appendectomy. b. A client who had a mastectomy. c. A client who had a left above-the-knee amputation. d. A client who had a cardiac catheterization. e. A client who had a stroke with right-sided hemiplegia. 3. A nurse is caring for a client who is 3 days postoperative following a below-the-knee amputation as a result of a motor-vehicle crash. Which of the following statements indicates that the client has a distorted body image? a. “I’ll be able to function exactly as I did before the accident.” b. “I just can’t stop crying.” c. “I am so mad at that guy who hit us. I wish he lost a leg.” d. “I don’t even want to look at my leg. You can check the dressing.” 4. A nurse is caring for a client who is recovering from a MI and a cardiac catheterization. The client states: “I am concerned that things might be a little, you know, ‘different’ with my partner when I got home.” Which of the following statements should the nurse make? a. “Sounds like something you should discuss with them when you get home.” b. “It sounds like your are concerned about sexual functioning. Let’s discuss your concerns.” c. “Oh, I wouldn’t be too concerned. Things will be fine as soon as we get you home.” d. “Just make sure you take your medication as directed, and you should be fine.” 5. A nurse is teaching a group of clients how to care for their colostomies. Which of the following statements indicates as issue with self-concept? a. “I was having difficulty with attaching the appliance at first, but my partner was able to help.” b. “I’ll never be able to care for this at home. Can’t you just send a nurse to the house?” c. “I met a neighbor who also has a colostomy, and they taught me a few things.” d. “It can take me a while to get the hang of things. I have to admit, I am pretty nervous.” Chapter 35 1. A nurse is using an interpreter to communicate with a client. Which of the following actions should the nurse use when communicating with a client and family member? (Select all that apply.) a. Talk to the interpreter about the family while the family is in the room. b. Determine client understanding several times during the conversation. c. Look at the interpreter when asking the family questions. d. Use lay terms if possible. e. Do not interrupt the interpreter and the family as they talk. 2. A nurse is caring for two clients who report following the same religion. Which of the following information should the nurse consider when planning care for these clients? a. Members of the same religion share similar feelings about their religion. b. A shared religion background generates mutual regard for one another. c. The same religious beliefs can influence individuals differently. d. The nurse and client should discuss the differences and commonalities in their beliefs. 3. A nurse enters the room of a client who is crying while reading from a religious book and asks to be left alone. Which of the following actions should the nurse take? a. Contact the hospital’s spiritual services. b. Ask what is making the client cry. c. Ensure no visitors or staff enter the room for a short time period. d. Turn on the television for a distraction. 4. A nurse is discussing the plan of care for a client who reports following Islamic practices. Which of the following statements by the nurse indicates culturally responsive care to the client? a. “I will make sure the menu includes kosher options.” b. “I will ask the client if the want to schedule some times to pray during the day.” c. “I will avoid discussing care when the client’s family is around.” d. “I will make sure daily communion is available for this client.” 5. A nurse is caring for a client who tells the nurse that based on religious values and mandates, a blood transfusion is not acceptable treatment option. Which of the following responses should the nurse make? a. “I believe in this case you should make an exception and accept the blood transfusion.” b. “I know your family would approve of your decision to have a blood transfusion.” c. “Why does your religion mandate that you cannot receive any blood transfusions?” d. “Let’s discuss the necessity for a blood transfusion with your religious and spiritual leaders and come to a reasonable solution.” Chapter 36 1. A nurse is caring for a client who has terminal lung cancer. The nurse observes the client’s family assisting with all ADLs. Which of the following rationales for self-care should the nurse communicate to the family? a. Allowing the client to function independently will strengthen muscles and promote healing. b. The client needs privacy at times for self-reflecting and organizing life. c. The client’s sense of loss can be lessened through retaining control of some areas of life. d. Performing ADLs is a requirement prior to discharge from an acute care facility. 2. A nurse is caring for a client who has stage IV lung cancer and is 3 days postoperative following a wedge resection. The client states, “I told myself that I would go through with the surgery and quit smoking, if I could just live long enough to attend my child’s wedding.” Based on the Kubler-Ross model, which stage of grief is the client experiencing? a. Anger b. Denial c. Bargaining d. Acceptance 3. A nurse is consoling the partner of a client who just died after a long battle liver cancer. The grieving partner states, “I hate them for leaving me.” Which of the following statements should the nurse make to facilitate mourning for the partner? (Select all that apply.) a. “Would you like to contact the chaplain to come and speak with you?” b. “You will feel better soon. You have been expecting for a while now.” c. “Let’s talk about your children and how they are going to react.” d. “You know, it is quite normal to feel anger toward your loved one at this time.” e. “Tell me more about how are you feeling.” 4. A nurse is caring for a client who has a terminal illness. Death is expected within 24 hr. The client’s family is at the bedside and asks the nurse what to expect at this time. Which of the following findings should the nurse include? a. Regular breathing pattern. b. Warm extremities. c. Increased urine output. d. Decreased muscle tone. 5. A nurse is about to perform postmortem care of a client. The family wishes to view the body. Which of the following actions should the nurse take? (Select all that apply.) a. Remove the dentures from the body. b. Make sure the body is lying completely flat. c. Apply fresh linens and place a clean gown on the body. d. Remove all equipment from the bedside. e. Dim the lights in the room. Chapter 37 1. A nurse is performing mouth care for a client who is unconscious. Which of the following actions should the nurse take? a. Turn the client’s head to the side. b. Place two fingers in the client’s mouth to open it. c. Brush the client’s teeth once per day. d. Inject a mouth rinse into the center of the client’s mouth. 2. A nurse is instructing a client who has DM about foot care. Which of the following guidelines should the nurse include? (Select all that apply.) a. Inspect the feet daily. b. Use moisturizing on the feet. c. Wash the feet with warm water and left them air dry. d. Use OTC products to treat abrasions. e. Wear cotton socks. 3. A nurse is planning care for a client who develops dyspnea and feels tired after completing morning care. Which of the following actions should the nurse include in the client’s plan of care? a. Schedule rest periods during morning care. b. Discontinue morning care for 2 days. c. Perform all care as quickly as possible. d. Ask a family member to come in to bathe the client. 4. A nurse is beginning a complete bed bath for a client. After removing the client’s gown and placing a bath blanket over the body, which of the following areas should the nurse wash first? a. Face b. Feet c. Chest d. Arms 5. A nurse is preparing to perform denture care for a client. Which of the following actions should the nurse plan to take? a. Pull down and out at the back of the upper denture to remove. b. Brush the dentures with a toothbrush and denture cleaner. c. Rinse the dentures with hot water after cleaning them. d. Place the dentures in a clean, dry storage container after cleaning them. Chapter 38 1. A nurse in a provider’s office is caring for a client who states that, for the past week, “I have felt tired during the day and cannot sleep at night.” Which of the following responses should the nurse ask when collecting data about the client’s difficulty sleeping? (Select all that apply.) a. “Have your working hours changed recently?” b. “Do you feel confused in the late afternoon?” c. “Do you drink coffee, tea, or other caffeinated drinks? If so, how many cups per day?” d. “Has anyone ever told you that you seem to stop breathing for a few seconds while you are asleep?” e. “Tell me about you personal stress you are experiencing.” 2. A nurse is talking with a client about ways to help sleep and rest. Which of the following recommendations should the nurse give to the client to promote sleep and rest? (Select all that apply.) a. Practice muscle relaxation techniques. b. Exercise each morning. c. Take an afternoon nap. d. Alter the sleep environment for comfort. e. Limit fluid intake at least 2 hr before bedtime. 3. A nurse is caring for a client who has been following the facility’s routine and bathing in the morning. However, at home, the client always takes a warm bath just before bedtime. Now the client is having difficulty sleeping at night. Which of the following actions should the nurse take first? a. Rub the client’s back for 15 min before bedtime. b. Offer the client warm milk and crackers at 2100. c. Allow the client to take a bath in the evening. d. Ask the provider for a sleeping medication. 4. A nurse is preparing a presentation at a local community center about sleep hygiene. When explaining REM sleep, which of the following characteristics should the nurse include? (Select all that apply.) a. REM sleep provides cognitive restoration. b. REM sleep lasts about 90 min. c. It is difficult to awaken a person in REM sleep. d. Sleepwalking occurs during REM sleep. e. Vivid dreams are common during REM sleep. 5. A nurse is instructing a client who has a narcolepsy about measures that might help with self-management. Which of the following statements should the nurse identify as an indication that the client understands the instructions? a. “I’ll add plenty of carbohydrates to my meals.” b. “I’ll take a short nap whenever I feel a little sleepy.” c. “I’ll make sure I stay warm when I am at my desk at work.” d. “It’s okay to drink alcohol as long as I limit it to one drink per day.” Chapter 39 1. A nurse is caring for a client who is at high risk for aspiration. Which of the following actions should the nurse take? a. Give the client thing liquids. b. Instruct the client to tuck their chin when swallowing. c. Have the client use a straw. d. Encourage the client to lie down and rest after meals. 2. A nurse is preparing a presentation about basic nutrients for a group of high school athletes. She should explain that which of the following nutrients provides the body with the most energy? a. Fat b. Protein c. Glycogen d. Carbohydrates 3. A nurse is caring for a client who requires a low-residue diet. The nurse should expect to see which of the following foods on the client’s meal tray? a. Cooked barley b. Pureed broccoli c. Vanilla custard d. Lentil soup 4. A nurse is caring for a client who weighs 80 kg (176 lb) and is 1.6 m (5 ft 3 in) tall. Calculate the BMI and determine whether the client’s BMI indicates a healthy weight, underweight, overweight, or obese. 5. A nurse in a senior center is counseling a group of older adults about their nutritional needs and considerations. Which of the following information should the nurse include? (Select all that apply.) a. Older adults are more prone to dehydration that younger adults are. b. Older adults need the same amount of most vitamins and minerals as younger adults do. c. Many older men and women need calcium supplementation. d. Older adults need more calories that they did when they were younger. e. Older adults should consume a diet low in carbohydrates. Chapter 40 1. A nurse is caring for a client who has been sitting in a chair for 1 hr. which of the following complications is the greatest risk to the client? a. Decreased subcutaneous fat b. Muscle atrophy c. Pressure injury d. Fecal impaction 2. A nurse is caring for client who is postoperative. Which of the following interventions should the nurse take to reduce the risk of thrombus development? (Select all that apply.) a. Instruct the client not to perform the Valsalva maneuver. b. Apply elastic stockings. c. Review laboratory values for total protein level. d. Place pillows under the client’s knees and lower extremities. e. Assist the client to change positions often. 3. A nurse is planning care for a client who is on bed rest. Which of the following interventions should the nurse plan to implement? a. Encourage the client to perform antiembolic exercises every 2 hr. b. Instruct the client to cough and deep breathe every 4 hr. c. Restrict the client’s fluid intake. d. Reposition the client every 4 hr. 4. A nurse is evaluating a client’s understanding of the use of a sequential compression device. Which of the following client statements indicates client understanding? a. “This device will keep me from getting sores on my skin.” b. “This device will keep the blood pumping through my leg.” c. “With this device on, my leg muscles won’t get weak.” d. “This device is going to keep my joints in good shape.” 5. A nurse is instructing a client, who has an injury of the left lower extremity, about the use of cane. Which of the following instructions should the nurse include? (Select all that apply.) a. Hold the cane on the right side. b. Keep two points of support on the floor. c. Place the cane 38 cm (15 in) in front of the feet before advancing. d. After advancing the cane, move the weaker leg forward. e. Advance the stronger leg so that it aligns evenly with the cane. Chapter 41 1. A nurse at a clinic is collecting data about pain from a client who reports severe abdominal pain. The nurse asks the client if there has been any accompanying nausea and vomiting. Which of the following pain characteristics is the nurse attempting to determine? a. Presence of associated manifestations. b. Location of the pain c. Pain quality d. Aggravating and relieving factors 2. A nurse is collecting data from a client who is reporting pain despite taking analgesia. Which of the following actions should the nurse take to determine the intensity of the client’s pain? a. Ask the client what precipitates the pain. b. Question the client about the location of the pain. c. Offer the client a pain scale to measure their pain. d. Use open-ended questions to identify the client’s pain sensations. 3. A nurse is discussing the care of a group of clients with a newly licensed nurse. Which of the following clients should the newly licensed nurse identify as experiencing chronic pain? a. A client who has a broken femur and reports hip pain. b. A client who has incisional pain 72 hr following pacemaker insertion. c. A client who has food poisoning and reports abdominal cramping. d. A client who has episodic back pain following a fall 2 years ago. 4. A nurse is monitoring a client for adverse effects following the administration of an opioid. Which of the following effects should the nurse identify as an adverse effect of opioids? (Select all that apply.) a. Urinary incontinence b. Diarrhea c. Bradypnea d. Orthostatic hypotension e. Nausea 5. A nurse is caring for a client who is receiving morphine via PCA infusion device after abdominal surgery. Which of the following statements indicates that the client knows how to use the device? a. “I’ll wait to use the device until it’s absolutely necessary.” b. “I’ll be careful about pushing the button too much so I don’t get an overdose.” c. “I should tell the nurse if the pain doesn’t stop while I am using this device.” d. “I will ask my adult child to push the dose button when I am sleeping.” Chapter 42 1. A nurse is caring for a client scheduled for abdominal surgery. The client reports being worried. Which of the following actions should the nurse take? a. Offer information on a relaxation technique and ask if they are interested in trying it. b. Request a social worker to see the client to discuss meditation. c. Attempt to use biofeedback techniques with the client. d. Tell the client many people feel the same way before surgery and to think of something else. 2. A nurse is assessing a client as part of an admission history. The client reports drinking an herbal tea every afternoon at work to relieve stress. Tea includes which of the following ingredients? a. Chamomile b. Ginseng c. Ginger d. Echinacea 3. A nurse is reviewing complementary and alternative therapies with a group of a newly licensed nurses. Which of the following interventions are mind-body therapies? (Select all that apply.) a. Art therapy b. Acupressure c. Yoga d. Therapeutic touch e. Biofeedback 4. A nurse is teaching a group of newly licensed nurses on complementary and alternative therapies they can incorporate into their practice without the need for specialized licensing or certification. Which of the following should the nurse encourage them to use? (Select all that apply.) a. Guided imagery b. Massage therapy c. Meditation d. Music therapy e. Therapeutic touch 5. A nurse is planning to use healing intention with a client who is recovering from a lengthy illness. Which of the following is the priority action to take before attempting this particular mind-body intervention? a. Tell the cli3nt the goal of therapy is to promote healing. b. Ask whether the client is comfortable with using prayer. c. Encourage the client to participate actively for best results. d. Instruct the client to relax during the therapy. Chapter 43 1. A nurse is caring for a client who will perform fecal occult blood testing at home. Which of the following information should be included when explaining the procedure to the client? a. Eating more protein is optimal prior to testing. b. One stool specimen is sufficient for testing. c. A red color change indicates a positive test. d. The specimen cannot be contaminated with urine. 2. A nurse is providing dietary teaching for a client who reports constipation. Which of the following foods should the nurse recommend? a. Macaroni and cheese b. One medium apple with skin c. One cup of plain yogurt d. Roast chicken and white rice 3. A nurse is assessing a client who has had diarrhea for 4 days. Which of the following findings should the nurse expect? (Select all that apply.) a. Bradycardia b. Hypotension c. Elevated temperature d. Poor skin turgor e. Peripheral edema 4. While a nurse is administering a cleansing edema, the client reports abdominal cramping. Which of the following actions should the nurse take? a. Have the client hold their breath briefly and bear down. b. Clamp the enema tubing. c. Remind the client that cramping is common at this time. d. Raise the level of the enema fluid container. 5. A nurse is preparing to administer a cleansing enema to an adult client in preparation for a diagnostic procedure. Which of the following steps should the nurse take? (Select all that apply.) a. Warm the enema solution prior to instillation. b. Position the client on the left side with the right leg flexed forward. c. Lubricate the rectal tube or nozzle. d. Slowly insert the rectal tube about 5 cm (2 in). e. Hang the enema container 61 cm (24 in) above the client’s anus. Chapter 44 1. A nurse is teaching a client who reports stress urinary incontinence. Which of the following instructions should the nurse include? (Select all that apply.) a. Limit total daily fluid intake. b. Decrease or avoid caffeine. c. Take calcium supplements. d. Avoid drinking alcohol. e. Used the Cred maneuver. 2. A client who has an indwelling catheter reports a need to urinate. Which of the following actions should the nurse take? a. Check to see whether the catheter is patent. b. Reassure the client that it is not possible for them to urinate. c. Re-catheterize the bladder with a larger-gauge catheter. d. Collect a urine specimen for analysis. 3. A nurse is caring for a client who has a prescription for a 24-hr urine collection. Which of the following actions should the nurse take? a. Discard the first voiding b. Keep the urine in a single container at room temperature. c. Dispose of the last voiding. d. Ask the client to urinate into the toilet, stop midstream, and finish urinating into the specimen container. 4. A nurse is reviewing factors that increase the risk of UTIs with a client who has recurrent UTIs. Which of the following factors should the nurse include? (Select all that apply.) a. Frequent sexual intercourse b. Lowering of testosterone levels c. Wiping from front to back to clean the perineum d. Location of the urethra closer to the anus e. Frequent catheterization 5. A nurse is preparing to initiate a bladder-retraining program for a client who has incontinence. Which of the following actions should the nurse take? (Select all that apply.) a. Restrict the client’s intake of fluids during the daytime. b. Have the client record urination time. c. Gradually increase the urination intervals. d. Remind the client to hold urine until the next scheduled urination time. e. Provide a sterile container for urine. Chapter 45 1. A nurse is caring for a client who has a stroke and has aphasia. Which of the following interventions should the nurse use to promote communications with this client? (Select all that apply.) a. Speak at a higher volume to the client. b. Make sure only one person speaks at a time. c. Avoid discouraging the client by indicating that they cannot be understood. d. Allow plenty of time for the client to respond. e. Use brief sentences with simple words. 2. A nurse is caring for a client who has an amphetamine toxicity and has sensory overload. Which of the following interventions should the nurse implement? a. Immediately complete a thorough assessment. b. Encourage visitors to distract the client. c. Provide a private room, and limit stimulation. d. Speak at a higher volume to the client. 3. A nurse is caring for a client who reports difficulty hearing. Which of the following assessment findings indicate a sensorineural hearing loss in the left ear? (Select all that apply.) a. Weber test showing lateralization to the right ear b. Light reflex at 10 o’clock in the left ear c. Indications of obstruction in the left ear canal d. Rinne tests showing less time for air and bone conduction e. Rinne test showing air conduction less than bone conduction in the left ear 4. A nurse is caring for a client who has several risk factors for hearing loss. Which of the following medications the client currently takes should alert the nurse to a further risk for ototoxicity? (Select all that apply.) a. Furosemide b. Ibuprofen c. Cimetidine d. Simvastatin e. Amiodarone 5. A nurse is reviewing instructions with a client who has a searing loss and has just started wearing hearing aids. Which of the following statements should the nurse identify as an indication that the client understands the instructions? a. “I use the damp cloth to clean the outside part of my hearing aids.” b. “I clean the ear molds of my hearing aids with rubbing alcohol.” c. “I keep the volume of my hearing aids turned up so I can hear better.” d. “I take the batteries out of my hearing aids when I take them off at night.: Chapter 46 1. A nurse is caring for a client who is 1 day postoperative and reports a pain level of 10 on a scale of 0 to 10. After reviewing the client’s medication administration record, which of the following medications should the nurse administer? a. Meperidine 75 mg IM b. Fentanyl 50 mcg/hr transdermal patch c. Morphine 2 mg IV d. Oxycodone 10 mg PO 2. A nurse is teaching a client about medications at discharge. Which of the following statements should the nurse identify as an indication that the client understands the instructions? a. “I can open the time-release capsule with the beads in it and sprinkle them on my oatmeal.” b. “If I am having difficulty swallowing, I will add the liquid medication to a prepared package of pudding.” c. “I can crush the enteric coated pill, if needed.” d. “I will eat two crackers with the pain pills.” 3. A nurse is teaching a client how to administer medication through a jejunostomy tube. Which of the following instructions should the nurse include? a. “Flush the tube before and after each medication.” b. “Mix your medications with your enteral feeding.” c. “Push tablets through the tube slowly.” d. “Mix all the crushed medications prior to dissolving them in water.” 4. A nurse is preparing to inject heparin subcutaneously for a client who is postoperative. Which of the following actions should the nurse take? a. Use a 22-gauge needle. b. Select a site on the client’s abdomen. c. Use the Z-track technique to displace the skin on the injection site. d. Observe for bleb formation to confirm proper placement. 5. A nurse is teaching an adult client how to administer ear drops. Which of the following statements should the nurse identify as an indication that the client understands? a. “I will straighten my ear canal by pulling my ear down and back.” b. “I will gently apply pressure with my finger to the front part of my ear after putting in the drops.” c. “I will insert the nozzle of the ear drop bottle snug into my ear before squeezing the drops in.” d. “After the drops are in, I will place a cotton ball all the way into my ear canal.” Chapter 47 1. A nurse prepares an injection of morphine to administer to a client who reports pain, then asks a second nurse to give the injection because another assigned client needs to use a bedpan. Which of the following actions should the second nurse take? a. Offer to assist the client who needs the bedpan. b. Administer the injection the other nurse prepared. c. Prepare another syringe and administer the injection. d. Tell the client who needs the bedpan to wait while the nurse gives someone else medication. 2. A nurse is reviewing a client’s prescribed medications at the beginning of the day shift. Which of the following 0900 medications can be given anytime between 0700 and 1100? (Select all that apply.) a. A once-daily multivitamin b. Eye drops prescribed every 3 hr c. An antibiotic prescribed every 8 hr d. A blood pressure pill prescribed twice daily e. A subcutaneous injection prescribed once weekly 3. A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands the process? a. “A second nurse enters the prescription into the client’s medical record.” b. “Another nurse should listen to the phone call.” c. “The provider can clarify the prescription when they sign the health record.” d. “I should omit the ‘read back’ if this is a one-time prescription.” 4. A nurse educator is teaching newly licensed nurses about safe medication administration. Which of the following statements indicates understanding? (Select all that apply.) a. “I will observe for adverse effects.” b. “I will monitor for therapeutic effects.” c. “I will prescribe the appropriate dose.” d. “I will change the dose if adverse effects occur.” e. “I will refuse to give a medication if I believe it is unsafe.” 5. A nurse reviewing a client’s health record notes a new prescription for lisinopril 10 mg PO once every day. The nurse should identify this as which of the following types of prescription? a. Single b. Stat c. Routine d. Now Chapter 48 1. A nurse is preparing to administer methylprednisolone 10 mg by IV bolus. The amount available is methylprednisolone injection 40 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Do not use a trailing zero.) 0.3mL 2. A nurse is preparing to administer lactated Ringer’s (LR) IV 100 mL over 15 min. The nurse should set the IV infusion pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero.) 400mL/hr 3. A nurse is preparing to administer 0.9% sodium chloride (0.9% NaCl) 250 mL IV to infuse over 30 min. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should adjust the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Do not use a trailing zero.) 83 gtt/min 4. A nurse is preparing to administer metoprolol 200 mg PO daily. The amount available is metoprolol 100 mg/tablet. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Do not use a trailing zero.) 2 tablets 5. A nurse is preparing to administer ketorolac 0.5 mg/kg IV bolus every 6 hr to a school-age child who weighs 66 lb. The amount available is ketorolac injection 30 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) 0.5 mL 6. A nurse is preparing to administer dextrose 5% in water (D5W) 1,000 mL IV to infuse over 10 hr. The nurse should set the IV infusion pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero.) 100 mL/hr 7. A nurse is preparing to administer acetaminophen 320 mg PO every 4 hr PRN for pain. The amount available is acetaminophen liquid 160 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) 10 mL 8. A nurse is preparing to administer dextrose 5% in lactated Ringer’s (D5LR) 1,000 mL to infuse over 6 hr. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should adjust the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Do not use a trailing zero.) 42 gtt/min Chapter 49 1. A nurse is demonstrating how to insert an IV catheter. Which of the following statements by a nurse viewing the demonstration indicates understanding of the procedure? a. “I will thread the needle all the way into the vein until the hub rests against the insertion site after I see a flashback of blood.” b. “I will insert the needle into the client’s skin at an angle of 10 to 30 degrees with the bevel up.” c. “I will apply pressure approximately 1.2 inches below the insertion site prior to removing the needle.” d. “I will choose a vein in the antecubital fossa for IV insertion due to its size and easily accessible location.” 2. A nurse is collecting data from a client who is receiving IV therapy and reports pain in the arm, chills, and “not feeling well.” The nurse notes warmth, edema, induration, and red streaking on the client’s arm close to the IV insertion site. Which of the following actions should the nurse plan to take first? a. Obtain a specimen for culture. b. Apply a warm compress. c. Administer analgesics. d. Discontinue the infusion. 3. During new employee orientation, a nurse is explaining how to prevent IV infections. Which of the following statements by an orientee indicates understanding of the preventive strategies? a. “I will leave the IV catheter in place after the client completes the course of IV antibiotics.” b. “As long as I am working with the same client, I can use the same IV catheter for my second insertion attempt.” c. “If my client needs to use the rest room, it would be safer to disconnect their IV infusion as long as I clean the injection port thoroughly with an antiseptic swab.” d. “I will replace any IV catheter when I suspect contamination during insertion.” 4. A nurse on the IV team is conducting an in-service education program about the complications of IV therapy. Which of the following statements by an attendee indicates an understanding of the manifestations of infiltration? (Select all that apply.) a. “The temperature around the IV site is cooler.” b. “The rate of the infusion increases.” c. “The skin at the IV site is red.” d. “The IV dressing is damp.” e. “The tissue around the venipuncture site is swollen.” 5. A nurse is caring for a client receiving dextrose 5% in 0.9% sodium chloride IV at 120 mL/hr. Which of the following statements by the client should alert the nurse to suspect fluid overload? (Select all that apply.) a. “I feel lightheaded.” b. “I feel as though my heart is racing.” c. “I feel a little short of breath.” d. “The nurse technician told me that my blood pressure was 150 over 90.” e. “I think my ankles are less swollen.” Chapter 50 1. A nurse is collecting data from a client who takes haloperidol to treat schizophrenia. Which of the following findings should the nurse document as extrapyramidal symptoms (EPSs)? (Select all that apply.) a. Orthostatic hypotension b. Tremors c. Acute dystonia d. Decreased level of consciousness e. Restlessness 2. A nurse is teaching a client who has a new prescription for oxybutynin about managing the medication’s anticholinergic effects. Which of the following instructions should the nurse include? (Select all that apply.) a. Take sips of water frequently. b. Wear sunglasses when outdoors in sunlight. c. Use a soft toothbrush when brushing teeth. d. Take the medication with an antacid. e. Urinate prior to taking the medication. 3. A nurse is reviewing a client’s medications. They include cimetidine and imipramine. Knowing that cimetidine decreases the metabolism of imipramine, the nurse should identify that this combination is likely to result in which of the following effects? a. Decreased therapeutic effects of cimetidine b. Increased risk of imipramine toxicity c. Decreased risk of adverse effects of cimetidine d. Increased therapeutic effects of imipramine 4. A nurse in an outpatient clinic is caring for a client who has a new prescription for an antihypertensive medication. Which of the following instructions should the nurse give the client? a. “Get up and change positions slowly.” b. “Avoid eating aged cheese and smoked meat.” c. “Report any usual bruising or bleeding to the doctor immediately.” d. “Eat the same amount of foods that contain vitamin K every day.” 5. A nurse in an outpatient surgical center is admitting a client for a laparoscopic procedure. The client has a prescription for preoperative diazepam. Prior to administering the medication, which of the following actions is the nurse’s priority? a. Teaching the client about the purpose of the medication b. Giving the medication at the administration time the provider prescribed c. Identifying the client’s medication allergies d. Documenting the client’s anxiety level Chapter 51 1. To promote adherence with medication self-administration, a nurse is making recommendations for an older adult client. Which of the following instructions should the nurse include? (Select all that apply.) a. Adjust dosages according to daily weight. b. Place pills in daily pill holders. c. Ask for liquid forms if the client has difficulty swallowing pills. d. Ask a relative to assist periodically. e. Request child-resistant caps on medication containers. 2. A client in a provider’s office tells the nurse that “I fast for several days each week to help control my weight.” The client takes several medications for various chronic issues. The nurse should explain to the client that which of the following mechanisms that results from fasting puts her at risk for medication toxicity? a. Increasing the metabolism of the medications over time b. Increasing the protein-binding response c. Increasing medications’ transit time through the intestines d. Decreasing the excretion of medications 3. A nurse is preparing medications for a preschooler. Which of the following factors should the nurse identify as altering how a medication affects children? (Select all that apply.) a. Increased gastric acid production b. Immature liver c. Higher body water content d. Increased absorption of topical medications e. Increased gastric emptying time 4. A nurse is teaching a client who is lactating about taking medications. Which of the following actions should the nurse recommend to minimize in the entry of medication into breast milk? a. Drink 8 oz of milk with each dose of medication. b. Use medications that have an extended half-life. c. Take each dose right after breastfeeding. d. Pump breast milk and freeze it prior to feeding to the newborn. 5. A nurse in an outpatient clinic is teaching a client who is in the first trimester of pregnancy. Which of the following statements should the nurse make? a. “You will need to get a rubella immunization if you haven’t had one prior to pregnancy.” b. “You can safely take over-the-counter medications.” c. “You should avoid any vitamin preparations containing iron.” d. “Your provider can prescribe medication for nausea if you need it.” Chapter 52 1. A nurse is reviewing the medical record of a client who has a blood glucose of 260 mg/dL and no documented history of diabetes mellitus. Which of the following types of medications can cause hyperglycemia as an adverse effect? (Select all that apply.) a. Diuretics b. Corticosteroids c. Oral anticoagulants d. Opioid analgesics e. Antipsychotics 2. A nurse teaching a client how to check blood glucose levels. The nurse should include which of the following instructions about transferring blood onto the reagent portion of the test strip? a. Smear the blood onto the strip. b. Squeeze the blood onto the strip. c. Touch the puncture to stimulate bleeding. d. Hold the test strip next to the blood on the fingertip. 3. A nurse attempting to collect a capillary blood specimen via finger stick for blood glucose monitoring is unable to obtain an adequate drop of blood for the reagent strip. Which of the following actions should the nurse take first? a. Puncture another finger to obtain a capillary specimen. b. Test the urine with a urine reagent strip. c. Wrap the hand in a warm, moist cloth. d. Perform a venipuncture to obtain a venous sample. 4. A nurse is teaching self-monitoring of blood glucose (SMBG) to a client who has diabetes mellitus. Which of the following instructions should the nurse include? (Select all that apply.) a. Perform SMBG once daily at bedtime. b. Wipe the hand with an alcohol swab. c. Hold the hand in a dependent position prior to the puncture. d. Place the puncturing device perpendicular to the site. e. Prick the outer edge of the fingertip for the blood sample Chapter 53 1. A nurse is assessing a client who has an acute respiratory infection, increasing the risk for hypoxemia. Which of the following findings are early indications that should alert the nurse that the client is developing hypoxia? (Select all that apply.) a. Restlessness b. Tachypnea c. Bradycardia d. Confusion e. Hypertension 2. A provider is discharging a client who has a prescription for home oxygen therapy via nasal cannula. Client and family teaching by the nurse should include which of the following instructions? (Select all that apply.) a. Apply petroleum jelly around and inside the nares. b. Remove the nasal cannula during mealtimes. c. Check the position of the cannula frequently. d. Report any nausea or difficulty breathing. e. Post “No Smoking” signs in prominent locations. 3. A nurse is caring for a client who is having difficulty breathing. The client is lying in bed and is already receiving oxygen therapy via nasal cannula. Which of the following interventions is the nurse’s priority? a. Increase the oxygen flow. b. Assist the client to Fowler’s position. c. Promote removal of pulmonary secretions. d. Obtain a specimen for arterial blood gases. 4. A nurse is preparing to perform endotracheal suctioning for a client. The nurse should follow which of the following guidelines? (Select all that apply.) a. Apply suction while withdrawing the catheter. b. Perform suctioning on a routine basis every 2 to 3 hr. c. Maintain medical asepsis during suctioning. d. Use a new catheter for each suctioning attempt. e. Apply suction for 10 to 15 seconds. 5. A nurse is caring for a client who has a tracheostomy. Which of the following actions should the nurse take when providing tracheostomy care? (Select all that apply.) a. Apply the oxygen source loosely if the SpO2 decreases during the procedure. b. Use surgical asepsis to remove and clean the inner cannula. c. Clean the outer cannula surfaces in a circular motion from the stoma site outward. d. Replace the tracheostomy ties with new ties. e. Cut a slit in gauze squares to place beneath the tube holder. Chapter 54 1. A nurse is delivering an enteral feeding to a client who has an NG tube in place for intermittent feedings. When the nurse pours water into the syringe after the formula drains from the syringe, the client asks the nurse why the water is necessary. Which of the following responses should the nurse make? a. “Water helps clear the tube so it doesn’t get clogged.” b. “Flushing helps make sure the tube stays in place.” c. “This will help you get enough fluids.” d. “Adding water makes the formula less concentrated.” 2. A nurse is caring for a client who is receiving continuous enteral feedings. Which of the following nursing interventions is the highest priority when the nurse suspects aspiration of the feeding? a. Auscultate breath sounds. b. Stop the feeding. c. Obtain a chest x-ray. d. Initiate oxygen therapy. 3. A nurse is preparing to instill an enteral feeding for a client who has an NG tube in place. Which of the following actions is the nurse’s highest assessment priority before performing this procedure? a. Check how long the feeding container has been open. b. Verify the placement of the NG tube. c. Confirm that the client does not have diarrhea. d. Make sure the client is alert and oriented. 4. A nurse is caring for a client in a long-term care facility who is receiving enteral feedings via an NG tube. Which of the following actions should the nurse complete prior to administering the tube feeding? (Select all that apply.) a. Auscultate bowel sounds. b. Assist the client to an upright position. c. Test the pH of gastric aspirate. d. Warm the formula to body temperature. e. Discard any residual gastric contents. 5. A nurse is preparing to insert an NG tube for a client who requires gastric decompression. Which of the following actions should the nurse perform before beginning the procedure? (Select all that apply.) a. Review a signal the client can use if feeling any distress. b. Lay a towel across the client’s chest. c. Administer oral pain medication. d. Obtain a Dobhoff tube for insertion. e. Have a petroleum-based lubricant available. Chapter 55 1. A nurse is caring for a client who is 2 days postoperative following an appendectomy and has type I diabetes mellitus. Their Hgb is 12 g/dL and BMI is 17.1. The incision is approximated and free of redness, with scant serous drainage on the dressing. The nurse should recognize that the client has which of the following risk factors for impaired wound healing? (Select all that apply.) a. Extremes in age b. Chronic illness c. Low hemoglobin d. Malnutrition e. Poor wound care 2. A nurse is collecting data from a client who is 5 days postoperative following abdominal surgery. The surgeon suspects an incisional wound infection and has prescribed antibiotic therapy for the nurse to initiate after collecting wound and blood specimens for culture and sensitivity. Which of the following findings should the nurse expect? (Select all that apply.) a. Increase in incisional pain b. Fever and chills c. Reddened wound edges d. Increase in serosanguineous drainage e. Decrease in thirst 3. A nurse educator is reviewing the wound healing process with a group of nurses. The nurse educator should include in the information which of the following alterations for wound healing by secondary intention? (Select all that apply.) a. Stage 3 pressure injury b. Sutured surgical incision c. Casted bone fracture d. Laceration sealed with adhesive e. Open burn area 4. A client who had abdominal surgery 24 hr ago suddenly reports a pulling sensation and pain in their surgical incision. The nurse checks the surgical wound and finds it separated with viscera protruding. Which of the following actions should the nurse take? (Select all that apply.) a. Cover the area with saline-soaked sterile dressings. b. Apply an abdominal binder snugly around the abdomen. c. Use sterile gauze to apply gentle pressure to the exposed tissues. d. Position the client supine with the hips and knees bent. e. Offer the client a warm beverage (herbal tea). 5. A nurse is caring for a client who is at risk for developing pressure injury. Which of the following interventions should the nurse use to help maintain the integrity of the client’s skin? (Select all that apply.) a. Keep the head of the bed elevated 30°. b. Massage the client’s bony prominences frequently. c. Apply cornstarch liberally to the skin after bathing. d. Have the client sit on a gel cushion when in a chair. e. Reposition the client at least every 3 hr while in bed. Chapter 56 1. A nurse is discussing direct and indirect contact modes of transmission of infection at a staff education session. Which of the following incidents should the nurse include as examples of the direct mode of transmission? (Select all that apply.) a. Blood spurting from an arterial wound splashes into a nurse’s eye. b. A nurse has a needlestick injury. c. A mosquito bites a hiker in the woods. d. A nurse finds a hole in their glove while handling a soiled dressing. e. A person fails to wash their hands after using the bathroom and touches a client. 2. A nurse in a residential care facility is assessing an older adult client. Which of the following findings should the nurse identify as atypical indications of infection in this client? (Select all that apply.) a. Urinary incontinence b. Malaise c. Acute confusion d. Fever e. Agitation 3. A nurse is preparing to admit a client who is suspected to have pulmonary tuberculosis. Which of the following actions should the nurse plan to perform first? a. Implement airborne precautions. b. Obtain a sputum culture. c. Administer antituberculosis medications. d. Recommend a screening test for family members. 4. A nurse in a primary care clinic is assessing a client who has a history of herpes zoster. Which of the following findings suggests that the client has postherpetic neuralgia? a. Linear clusters of vesicles on the right shoulder b. Purulent drainage from both eyes c. Decreased white blood cell count d. Report of continued pain following resolution of the rash 5. A charge nurse is teaching a newly licensed nurse about the care of a client who has methicillin-resistant Staphylococcus aureus (MRSA). Which of the following statements should the charge nurse identify as an indication that the newly licensed nurse understands the teaching? a. “I should obtain a specimen for culture and sensitivity after the first dose of an antimicrobial.” b. “MRSA is usually resistant to vancomycin, so another antimicrobial will be prescribed.” c. “I will protect others from exposure when I transport the client outside the room.” d. “To decrease resistance, antimicrobial therapy is discontinued when the client is no longer febrile.” Chapter 57 1. A nurse is performing an admission assessment on a client who has hypovolemia due to vomiting and diarrhea. The nurse should expect which of the following findings? (Select all that apply.) a. Distended neck veins b. Hyperthermia c. Tachycardia d. Syncope e. Decreased skin turgor 2. A nurse on a medical-surgical unit is caring for a group of clients. The nurse should identify that which of the following clients is at risk for hypovolemia? a. A client who has nasogastric suctioning b. A client who has chronic constipation c. A client who has syndrome of inappropriate antidiuretic hormone d. A client who took an toxic dose of sodium bicarbonate antacids 3. A nurse is reviewing the laboratory test results for a client who has an elevated temperature. The nurse should identify which of the following findings is a manifestation of dehydration? (Select all that apply.) a. Hct 55% b. Blood osmolarity 260 mOsm/kg c. Blood sodium 150 mEq/L d. Urine specific gravity 1.035 e. Blood creatinine 0.6 mg/dL 4. A nurse on a medical-surgical unit is caring for a group of clients. For which of the following clients should the nurse expect a prescription for fluid restriction? a. A client who has a new diagnosis of adrenal insufficiency b. A client who has heart failure c. A client who is receiving treatment for diabetic ketoacidosis d. A client who has abdominal ascites 5. A nurse is planning care for a client who has dehydration. Which of the following actions should the nurse include? a. Administer antihypertensive on schedule. b. Check the client’s weight each morning. c. Notify the provider of a urine output greater than 30 mL/hr. d. Encourage independent ambulation four times a day. Chapter 58 1. A nurse is planning care for a client who has hypernatremia. Which of the following actions should the nurse include in the plan of care? a. Infuse hypotonic IV fluids. b. Implement a fluid restriction. c. Increase sodium intake. d. Administer sodium polystyrene sulfonate. 2. A nurse is reviewing the medical record of a client who has hypocalcemia. The nurse should identify which of the following findings as a risk factor for the development of this electrolyte imbalance? a. Crohn’s disease b. Postoperative following appendectomy c. History of bone cancer d. Hyperthyroidism 3. A nurse receives a laboratory report for a client indicating a potassium level of 5.2 mEq/L. When notifying the provider, the nurse should expect which of the following actions? a. Starting an IV infusion of 0.9% sodium chloride b. Consulting with dietitian to increase intake of potassium c. Initiating continuous cardiac monitoring d. Preparing the client for gastric lavage 4. A nurse is collecting data from a client who has hypercalcemia as a result of long-term use of glucocorticoids. Which of the following findings should the nurse expect? (Select all that apply.) a. Hyperreflexia b. Confusion c. Positive Chvostek’s sign d. Bone pain e. Nausea and vomiting 5. A nurse is providing education for a client who has severe hypomagnesemia and is prescribed oral magnesium sulfate. Which of the following information should the nurse include in the teaching? a. “Avoid green, leafy vegetables while taking this medication.” b. “You should receive a prescription for a thiazide diuretic to take with the magnesium.” c. “You should eliminate whole grains from your diet until your magnesium level increases.” d. “Report diarrhea while taking this medication.” [Show More]

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