Question

A client has been admitted through the Emergency Department with a diagnosis of renal calculi. While waiting for test results, the client cries out "can I please have something for pain?" Which nursing action is most appropriate?

Answer 1

Correct Answers:

Administer opioid analgesics as ordered.

Rationale :

🔵 Severe renal colic produces intense visceral pain that typically requires opioid-level analgesia for relief.

🔵 Providing timely analgesia is part of priority comfort/safety, aligning with pain‑management standards.

🔵 Orders are present, so the nurse should act; non‑pharmacologic coaching alone is insufficient in acute colic.

🔵 Adequate pain control facilitates diagnostics and cooperation with imaging/urine straining.

🔵 Early control can blunt the sympathetic stress response, reducing tachycardia and hypertension.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 2

Correct Answers:

unsafe manner. "I will identify the patients using their birth dates and room numbers."

Rationale :

🟢 Two identifiers must be approved (e.g., name + DOB); room number is not an acceptable identifier.

🟢 Sterile gloves for central‑line dressing changes help prevent CLABSI → Safe practice.

🟢 Fit‑tested N95 for Airborne Precautions (e.g., TB, measles) is required → Safe.

🟢 Checking medication labels at least twice improves med safety (triple check is often taught; ≥2 is aligned) → Safe.

🟢 Daily catheter necessity assessment prevents CAUTI → Safe.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 3

Correct Answers:

Elevated uric acid levels
Diet high in animal protein
Frequent urinary tract infections (UTIs)
Excessive intake of calcium based anacids
Inadequate fluid intake

Rationale :

🟡 Elevated uric acid promotes uric acid stones and can nucleate calcium oxalate.

🟡 High animal protein increases acid load and uricosuria, favoring stone formation.

🟡 Frequent UTIs (especially urease‑producing) increase risk of struvite stones.

🟡 Excess calcium‑based antacids raise urinary calcium → hypercalciuria risk.

🟡 Inadequate fluid intake concentrates urine solutes, increasing crystal precipitation.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 4

Correct Answers:

The nurse calls the respiratory therapist to meet and educate the patient how to administer breathing treatments at home.

Rationale :

🟠 In collaboration, nurses coordinate with other disciplines to meet patient needs.

🟠 Respiratory therapy specializes in aerosol therapy/device teaching, ideal for COPD self‑management.

🟠 Interprofessional education improves adherence and technique (e.g., nebulizer use, cleaning).

🟠 Joint planning enhances transition‑of‑care, decreasing readmissions.

🟠 This directly exemplifies nurse–RT collaboration for patient outcomes.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 5

Correct Answers:

Constipation or altered bowel habits
Abdominal distention and tenderness
Elevated white blood cell count
Elevated temperature

Rationale :

🟢 Constipation/altered bowel habits are common due to colonic inflammation.

🟢 Abdominal distention/tenderness (often LLQ) reflect inflamed diverticula.

🟢 Leukocytosis (↑WBC) signals inflammatory response.

🟢 Fever (↑temperature) is typical in acute infection.

🟢 RLQ pain would suggest appendicitis, not classic diverticulitis (usually LLQ).

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 6

Correct Answers:

It is a severe vesicant and can cause tissue necrosis and even loss of limb.

Rationale :

🟠 Promethazine is a vesicant; extravasation can cause severe tissue necrosis.

🟠 Reports include blistering, arterial spasm, and potential limb ischemia.

🟠 Prefer PO/PR/IM routes; if IV is necessary, dilute well and use a large, patent vein per policy.

🟠 Vigilant site assessment is required if any IV antiemetic is used.

🟠 This aligns with injury prevention and patient safety standards.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 7

Correct Answers:

Sodium restriction

Rationale :

🟢 Sodium restriction helps reduce fluid retention and edema in heart failure.

🟢 Lower sodium decreases blood volume, reducing preload and cardiac workload.

🟢 This dietary intervention helps control hypertension, a common HF contributor.

🟢 Restricting sodium supports effectiveness of diuretics.

🟢 It reduces risk of pulmonary congestion and dyspnea.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 8

Correct Answers:

Decreased use of pain medications
Decreased staff resignations
Increased job satisfaction of the staff
Decreased length of stay for patients

Rationale :

🔵 Decreased pain medication use reflects improved multimodal care and comfort.

🔵 Lower staff resignations show enhanced teamwork satisfaction.

🔵 Higher job satisfaction is linked to positive work culture through collaboration.

🔵 Shorter length of stay results from coordinated, efficient care planning.

🔵 All reflect evidence-based benefits of interprofessional collaboration.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 9

Correct Answers:

A nurse receives a sodium level from the lab: sodium 130. The nurse reads it back to the lab to confirm the result with patient identifiers.

Rationale :

🟡 Closed-loop communication ensures accuracy of critical values.

🟡 Reading back results prevents transcription or hearing errors.

🟡 Using two identifiers aligns with NPSG patient safety goals.

🟡 Critical values like sodium 130 need confirmation and prompt intervention.

🟡 Demonstrates adherence to Joint Commission standards

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 10

Correct Answers:

Collect urine for an ordered urine specimen.
Assist a client with ambulation using a gait belt.
Feed a client who has mild dysphagia after being cleared by speech therapy.

Rationale :

🟣 Collecting urine specimens is within UAP scope.

🟣 Assisting ambulation with gait belt is safe, non-complex care.

🟣 Feeding cleared clients is appropriate basic care.

🟣 Teaching and medication administration require licensed staff, not UAP.

🟣 Delegation ensures safe workload distribution.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

NUR105_Final Assessment_SU2

No.

1 :
A client has been admitted through the Emergency Department with a diagnosis of renal calculi. While waiting for test results, the client cries out "can I please have something for pain?" Which nursing action is most appropriate?

2 :
The experienced LPN is instructing a newly hired LPN about the importance of providing safe care in alignment with the National Patient Safety Goals (NPSG). Indicate whether the following statements describe care provided in a safe or unsafe manner.

3 :
A nurse is educating a client on risk factors for renal calculi (kidney stones). Which of the following modifiable factors increase the client's risk of developing renal calculi? (Select all that apply.)

4 :
Nurses are caring for a patient experiencing an acute exacerbation of COPD. Which action relates to the concept of Collaboration?

5 :
A client is admitted with a suspected diagnosis of diverticulitis. Which of the following clinical manifestations should the nurse expect to assess in this client?(Select all that apply.)

6 :
Why is promethazine (phenergan) intravenous route often avoided?

7 :
Which therapeutic dietary measure is the most common for chronic heart failure?

8 :
nurse mentor is explaining the benefits of collaborative practice to a nurse new to a facility. Which of the following research-based benefits is the nurse likely to identify as positive outcomes of collaboration?

9 :
Which scenario correctly demonstrates nursing care consistent with safety standards and National Patient Safety Goals?

10 :
A nurse in a long-term care facility is planning task assignments for the day. Which tasks should the nurse assign to the UAP? Select all that apply.

Connect With Us

NUR105_Final Assessment_SU2

No.

1 : A client has been admitted through the Emergency Department with a diagnosis of renal calculi. While waiting for test results, the client cries out "can I please have something for pain?" Which nursing action is most appropriate?

2 : The experienced LPN is instructing a newly hired LPN about the importance of providing safe care in alignment with the National Patient Safety Goals (NPSG). Indicate whether the following statements describe care provided in a safe or unsafe manner.

3 : A nurse is educating a client on risk factors for renal calculi (kidney stones). Which of the following modifiable factors increase the client's risk of developing renal calculi? (Select all that apply.)

4 : Nurses are caring for a patient experiencing an acute exacerbation of COPD. Which action relates to the concept of Collaboration?

5 : A client is admitted with a suspected diagnosis of diverticulitis. Which of the following clinical manifestations should the nurse expect to assess in this client?(Select all that apply.)

6 : Why is promethazine (phenergan) intravenous route often avoided?

7 : Which therapeutic dietary measure is the most common for chronic heart failure?

8 : nurse mentor is explaining the benefits of collaborative practice to a nurse new to a facility. Which of the following research-based benefits is the nurse likely to identify as positive outcomes of collaboration?

9 : Which scenario correctly demonstrates nursing care consistent with safety standards and National Patient Safety Goals?

10 : A nurse in a long-term care facility is planning task assignments for the day. Which tasks should the nurse assign to the UAP? Select all that apply.

1 :
A client has been admitted through the Emergency Department with a diagnosis of renal calculi. While waiting for test results, the client cries out "can I please have something for pain?" Which nursing action is most appropriate?

2 :
The experienced LPN is instructing a newly hired LPN about the importance of providing safe care in alignment with the National Patient Safety Goals (NPSG). Indicate whether the following statements describe care provided in a safe or unsafe manner.

3 :
A nurse is educating a client on risk factors for renal calculi (kidney stones). Which of the following modifiable factors increase the client's risk of developing renal calculi? (Select all that apply.)

4 :
Nurses are caring for a patient experiencing an acute exacerbation of COPD. Which action relates to the concept of Collaboration?

5 :
A client is admitted with a suspected diagnosis of diverticulitis. Which of the following clinical manifestations should the nurse expect to assess in this client?(Select all that apply.)

6 :
Why is promethazine (phenergan) intravenous route often avoided?

7 :
Which therapeutic dietary measure is the most common for chronic heart failure?

8 :
nurse mentor is explaining the benefits of collaborative practice to a nurse new to a facility. Which of the following research-based benefits is the nurse likely to identify as positive outcomes of collaboration?

9 :
Which scenario correctly demonstrates nursing care consistent with safety standards and National Patient Safety Goals?

10 :
A nurse in a long-term care facility is planning task assignments for the day. Which tasks should the nurse assign to the UAP? Select all that apply.