Question

An 80-year-old Hispanic female is admitted to the Nursing Home after being hospitalized with bilateral lower leg ulcers. Her medical history includes a history of Osteoarthritis, Peripheral Vascular Disease (PVD) and Chronic Obstructive Pulmonary disease (COPD). At the time of admission her leg ulcers were a Stage II. Her admitting vital signs are: BP 120/60, 98.6, 64 regular, 24 and pain rated 3/10-pain is dull at both leg ulcer sites. Physician orders include: Regular diet, activity level as tolerated and oxygen at 2 liters prn for dyspnea. (keep Oxygen saturation between 92 and 96%). Which assessment finding is most consistent with COPD?

Answer 1

Correct Answers:

Adventitious lung sounds

Rationale :

🫁 Chronic obstructive pulmonary disease (COPD) causes chronic airflow limitation resulting from airway inflammation, mucus production, and structural changes within the lungs.

🫁 Clients with COPD commonly have adventitious breath sounds, including wheezes, rhonchi, or diminished breath sounds.

🫁 Wheezing can occur when air moves through narrowed airways caused by bronchospasm and inflammation.

🫁 Rhonchi may develop when mucus or secretions accumulate within the larger airways.

🫁 The client's respiratory rate of 24 breaths/min also indicates mild tachypnea and is consistent with increased respiratory effort that may occur with COPD.

🫁 The prescription for oxygen at 2 L/min PRN for dyspnea further reflects the client's chronic respiratory condition.

🫁 The prescribed oxygen saturation target of 92% to 96% indicates the importance of monitoring oxygenation while managing the client's respiratory status.

🫁 Therefore, adventitious lung sounds are the assessment finding most consistent with the client's COPD.

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Answer 2

Correct Answers:

"I started on an antidepressant two weeks ago, my energy is coming back but not I'm not in a happier mood."

Rationale :

🧠 During the early weeks of antidepressant therapy, a client's energy level may improve before the depressed mood significantly improves.

🧠 Most antidepressants require several weeks to achieve their full therapeutic effect on mood.

🧠 This period is particularly important because increased energy and motivation may give a severely depressed client greater ability to act on suicidal thoughts that are still present.

🧠 The statement indicates that the client's energy has improved, while the underlying depressed mood has not yet resolved.

🧠 The nurse should therefore perform a direct and thorough assessment for suicidal ideation, intent, plan, and access to means.

🧠 Suicide risk can temporarily increase during the early phase of antidepressant treatment, making close monitoring essential.

🧠 The client should also be encouraged to report any new or worsening suicidal thoughts, agitation, behavioral changes, or severe mood deterioration immediately.

🧠 Therefore, this statement represents the greatest immediate safety concern and requires priority follow-up by the nurse.

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Answer 3

Correct Answers:

Quality and Safety Education for Nurses

Rationale :

🎓 Quality and Safety Education for Nurses (QSEN) was developed to prepare nurses with essential quality and safety competencies needed in healthcare practice.

🎓 QSEN emphasizes the knowledge, skills, and attitudes (KSAs) nurses need to provide safe, high-quality patient care.

🎓 The framework identifies six major competencies: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics.

🎓 These competencies help nursing students and new graduate nurses transition their academic preparation into safe clinical practice.

🎓 Patient-centered care emphasizes recognizing the patient as a partner and respecting individual preferences, needs, and values.

🎓 Safety and quality improvement help nurses identify healthcare risks, prevent errors, and improve patient outcomes.

🎓 Evidence-based practice and informatics support clinical decision-making using current evidence and healthcare technology.

🎓 Therefore, Quality and Safety Education for Nurses (QSEN) is the project associated with developing the competencies nurses need for safe and effective practice.

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Answer 4

Correct Answers:

0.5ml

Rationale :

Working

💉 Formula:

Amount to administer = Desired dose ÷ Dose on hand × Volume

💉 Desired dose: 5,000 units

💉 Dose on hand: 10,000 units

💉 Volume on hand: 1 mL

5,000 units ÷ 10,000 units × 1 mL = 0.5 mL

= 0.5 mL

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Answer 5

Correct Answers:

Competent nursing practice

Rationale :

⚖️ Competent nursing practice is the nurse's best legal safeguard against allegations of malpractice.

⚖️ Nurses are expected to provide care according to established standards of practice and within their legal scope of practice.

⚖️ Malpractice occurs when a nurse breaches the expected standard of care and that breach results in harm to a client.

⚖️ Maintaining current knowledge, clinical skills, and professional competence decreases the likelihood of preventable errors and patient injury.

⚖️ Competent practice includes appropriate assessment, intervention, communication, delegation, documentation, and evaluation of nursing care.

⚖️ The nurse should also follow facility policies, professional standards, and applicable Nurse Practice Acts.

⚖️ Accurate and timely documentation supports competent practice by providing evidence of the care that was actually delivered.

⚖️ Therefore, consistently providing safe, competent nursing care is the strongest legal protection against malpractice claims.

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Answer 6

Correct Answers:

A resident with osteoarthritis

Rationale :

🦴 Osteoarthritis is a chronic degenerative joint disorder that commonly causes persistent or recurrent joint pain and stiffness.

🦴 Chronic pain generally persists beyond the expected period of tissue healing and may continue for months or years.

🦴 Osteoarthritis involves progressive deterioration of articular cartilage and changes in the underlying bone and surrounding joint structures.

🦴 Clients commonly experience aching joint pain, stiffness, decreased mobility, and reduced range of motion.

🦴 Pain may worsen with activity or weight-bearing and improve somewhat with rest.

🦴 Because osteoarthritis is a long-term condition, pain management often requires ongoing pharmacologic and nonpharmacologic interventions.

🦴 Chronic pain can affect the resident's mobility, sleep, mood, independence, and quality of life.

🦴 Therefore, a resident with osteoarthritis is the best example of a resident experiencing chronic pain.

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Answer 7

Correct Answers:

"You are safe here."

Rationale :

🛡️ A person who has experienced rape or sexual assault may feel frightened, vulnerable, powerless, or unsafe.

🛡️ The nurse's immediate therapeutic priority is to establish a sense of physical and emotional safety.

🛡️ Saying “You are safe here” provides reassurance without blaming, judging, or pressuring the client to disclose information.

🛡️ The nurse should use a calm, supportive, nonjudgmental approach and allow the client as much control over decisions as possible.

🛡️ Restoring a sense of control and autonomy is particularly important because sexual assault involves a profound violation of personal control.

🛡️ The nurse should explain examinations and procedures before performing them and obtain the client's consent throughout the evaluation.

🛡️ Questions should be necessary, objective, and asked sensitively without implying that the client was responsible for the assault.

🛡️ Therefore, “You are safe here” is the most appropriate therapeutic statement because it communicates immediate safety, support, and respect.

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Answer 8

Correct Answers:

The patient is tearful and sad and continuously discusses her losses.

Rationale :

🌹 Grieving is a normal emotional response to an actual, anticipated, or perceived loss.

🌹 A terminally ill client may experience anticipatory grief as death approaches and losses become increasingly apparent.

🌹 Being tearful and sad represents emotional manifestations commonly associated with the grieving process.

🌹 Continuously discussing losses demonstrates that the client is actively recognizing and processing the changes and losses associated with terminal illness.

🌹 These losses can include declining health, independence, relationships, future plans, roles, and ultimately life itself.

🌹 The nurse should encourage the client to express feelings openly rather than attempting to stop or minimize expressions of sadness.

🌹 Therapeutic interventions include active listening, presence, emotional support, and acknowledgment of the client's feelings.

🌹 Therefore, the client's tearfulness, sadness, and repeated discussion of losses provide the strongest evidence supporting the nursing diagnosis of grieving.

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Answer 9

Correct Answers:

Placing ID tags as directed on the body and covering provided.

Rationale :

⚖️ Correct identification of the deceased is an essential legal responsibility during postmortem care.

⚖️ The nurse must follow facility policy for placing the required identification tags on the body and/or shroud.

⚖️ Accurate identification prevents serious errors such as misidentification or release of the body to the wrong family or funeral home.

⚖️ Identification information is typically verified against the client's medical record and identification band according to institutional policy.

⚖️ The nurse should maintain the deceased client's dignity, privacy, and confidentiality throughout postmortem care.

⚖️ Special procedures may be required when the death involves an autopsy, medical examiner, coroner, or organ/tissue donation.

⚖️ Proper identification also supports the legal chain of custody when the death requires forensic investigation.

⚖️ Therefore, correctly placing identification tags as directed is the nursing action most specifically associated with a legal responsibility during postmortem care.

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Answer 10

Correct Answers:

two and one half tablets

Rationale :

Working

💊 Formula:

Tablets to administer = Desired dose ÷ Dose available

💊 Desired dose: 50 mg

💊 Dose available: 20 mg/tablet

50 mg ÷ 20 mg/tablet = 2.5 tablets

=2.5 tablets

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IHCC final exam Summer 2026

No.

2 :
"I started an antidepressant two weeks ago. My energy is returning, but I still don't feel any happier."

3 :
What is the name of the project that was started to help new graduate nurses build their needed competencies?

4 :
Your patient is to receive heparin 5000 units SC every 12 hours. The available Heparin is 10,000 units per mL. Calculate the amount to be given in each dose.

Working

= 0.5 mL

5 :
Which of the following is the nurse's best legal safeguard against any malpractice issue?

6 :
Which of the following residents would be classified as having chronic pain?

7 :
Which of the following statements should the emergency department nurse make to a victim of a rape?

9 :
Which of the following nursing actions is a legal responsibility of post mortem care?

10 :
The physician prescribed 50 mg of a medication to be given to a patient daily. The pharmacy dispenses the medication as 20 mg scored tablets. How many tablet(s) will be given to the patient each day?

Working

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IHCC final exam Summer 2026

No.

2 : "I started an antidepressant two weeks ago. My energy is returning, but I still don't feel any happier."

3 : What is the name of the project that was started to help new graduate nurses build their needed competencies?

4 : Your patient is to receive heparin 5000 units SC every 12 hours. The available Heparin is 10,000 units per mL. Calculate the amount to be given in each dose.

Working

= 0.5 mL

5 : Which of the following is the nurse's best legal safeguard against any malpractice issue?

6 : Which of the following residents would be classified as having chronic pain?

7 : Which of the following statements should the emergency department nurse make to a victim of a rape?

9 : Which of the following nursing actions is a legal responsibility of post mortem care?

10 : The physician prescribed 50 mg of a medication to be given to a patient daily. The pharmacy dispenses the medication as 20 mg scored tablets. How many tablet(s) will be given to the patient each day?

Working

2 :
"I started an antidepressant two weeks ago. My energy is returning, but I still don't feel any happier."

3 :
What is the name of the project that was started to help new graduate nurses build their needed competencies?

4 :
Your patient is to receive heparin 5000 units SC every 12 hours. The available Heparin is 10,000 units per mL. Calculate the amount to be given in each dose.

5 :
Which of the following is the nurse's best legal safeguard against any malpractice issue?

6 :
Which of the following residents would be classified as having chronic pain?

7 :
Which of the following statements should the emergency department nurse make to a victim of a rape?

9 :
Which of the following nursing actions is a legal responsibility of post mortem care?

10 :
The physician prescribed 50 mg of a medication to be given to a patient daily. The pharmacy dispenses the medication as 20 mg scored tablets. How many tablet(s) will be given to the patient each day?