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ATI LPN Adult Medical surgical with NGN-2020

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Exam Details !

Title : ATI LPN Adult Medical surgical with NGN-2020

Type : Nursing

Category : LPN Nursing Exam(s)

Subcategory : LPN ATI Exams

Domain : Medical-Surgical

Fragment : N/A

Module : LPN-NURSING

Exam Status : active

Rating : 95.00%

Attempts Allowed : 100

Exam Year : 2020

Duration : 145 minutes

Total Questions : 75

Passing Score : 90%

Difficulty : Medium

Instructions : This assessment evaluates your knowledge of adult medical-surgical nursing and your ability to apply critical thinking in clinical scenarios. Read each question carefully and select the most appropriate answer.

Description : Exam is designed to assess the practical nursing student's knowledge and application of core concepts related to adult health. This exam covers physiological integrity and the management of care for clients experiencing common medical-surgical conditions across body systems.

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1 :
A nurse is caring for a client who is at risk for anaphylaxis due to bee stings. When reinforcing teaching about the use of an automatic epinephrine injector, which of the following actions is the priority?

Instruct the client to store the injector at room temperature.

Inform the client to seek medical attention following administration of the injection.

Have the client perform a return demonstration of the equipment.

Review the signs of anaphylaxis with the client.

Hint : 💉 Always seek care after use

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

2 :
A nurse is assisting in the care of a client who has a pulmonary embolism and is experiencing dyspnea. Which of the following actions should the nurse take first?

Administer heparin to the client.

Encourage the client to cough and deep breathe.

Obtain the client's vital signs.

Place the client in high-Fowler's position.

Hint : 🫁 Sit them up immediately

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

3 :
A nurse is caring for a client who has pneumonia with dyspnea. The client's ABG results are pH 7.30, PaCO2 50 mm Hg, HCO3 26 mEq/L. The nurse should recognize that the client has which of the following acid-base imbalances?

Metabolic alkalosis

Respiratory alkalosis

Metabolic acidosis

Respiratory acidosis

Hint : 🫁 CO₂ high = respiratory cause

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

4 :
A nurse is reviewing laboratory values of a client who has severe dyspnea. Which of the following laboratory values indicates heart failure?

Potassium 4.0 mEq/L

Calcium 9.0 mg/dL

Sodium 140 mEq/L

Brain natriuretic peptide 275 pg/mL

Hint : 🫀 BNP = Heart strain indicator

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

5 :
A nurse is contributing to the plan of care for a client who has heart failure. Which of the following actions should the nurse include in the plan?

Encourage fluids.

Measure vital signs every 8 hr.

Obtain weight weekly.

Allow frequent rest periods.

Hint : 🛏️ Rest protects cardiac output

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

6 :
A nurse is performing tracheostomy care for a client who has a chronic tracheostomy. Which of the following actions should the nurse take?

Allow space for one finger to be placed under the tube ties.

Apply suction pressure while inserting the catheter into the trachea.

Suction the client for 20 seconds with each pass.

Cleanse around the stoma with povidone-iodine.

Hint : 🧵 One-finger rule for safety

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

7 :
A nurse is reinforcing teaching with a client who wants to lose 0.9 kg (2 lb) of body fat per week. The nurse knows that 0.45 kg (1 lb) of body fat is equal to 3,500 calories. The nurse should instruct the client to reduce his daily caloric intake by how many calories? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Hint : 📉 2 lbs/week = 1000 kcal/day cut

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

8 :
A nurse is reinforcing teaching with a client who will undergo a colonoscopy the following week. Which of the following instructions should the nurse include?

Administer enemas 2 days before the procedure.

Restrict the diet to clear liquids for 1 to 3 days before the procedure.

Expect the provider to schedule another procedure to remove any polyps.

Do not eat or drink anything except water for 12 hr before the procedure.

Hint : 🍽️ 12-hour fasting for a clear colon.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

9 :
A nurse is reinforcing teaching with a client who is 24 hr postoperative following a total hip arthroplasty. Which of the following instructions should the nurse include in the teaching?

Perform range of motion by adducting the hip.

Sit in a straight-backed chair.

Cleanse the surgical incision with hydrogen peroxide.

Apply moist heat to the incision while in bed.

Hint : 🧍‍♂️ Proper alignment for healing.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

10 :
A nurse is reviewing vital signs obtained by an assistive personnel on a group of clients. The previous vital signs for each of the clients were obtained 4 hr earlier. Which of the following changes should the nurse identify as the priority finding?

Temperature change from 36.6° C (97.8° F) to 38.8° C (101.9° F)

Heart rate change from 110/min to 68/min

Blood pressure change from 118/78 mm Hg to 86/50 mm Hg

Respiratory rate change from 12/min to 20/min

Hint : ⚡ Prioritize low blood pressure.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

11 :
A nurse is caring for a client who has partial-thickness burns on 50% of his body and is receiving total parenteral nutrition. The nurse should actively monitor the client for which of the following?

Increased serum glucose levels

Intermittent abdominal pain

Absent bowel sounds

Decreased calcium levels

Hint : 🍬 Monitor for elevated blood sugar.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

12 :
A nurse is reinforcing teaching with a client who has angina. Which of the following statements by the client indicates an understanding of the teaching?

"I will take four nitroglycerin sublingual tablets if I have chest pain."

"I will notify emergency response if I have sudden jaw pain."

"I will wait 30 minutes before taking action if I have heartburn."

"I will have hot, dry, and flushed skin if I am having a heart attack."

Hint : 🚨 Jaw pain is a sign for immediate help

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

13 :
A nurse in an urgent care facility is collecting data from a client who was stung by a wasp. Which of the following findings indicates the client is experiencing anaphylaxis?

Hypertension

Difficulty swallowing

Bilateral tinnitus

Petechial rash on the abdomen

Hint : ⚡signals airway issues.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

14 :
A nurse is caring for a client in hospice care who is dying. The client's partner expresses concern that the client is sleeping more than in the previous week. Which of the following is an appropriate response by the nurse?

"I will call the provider to discuss your concerns."

"Encourage your partner to wake up to interact with family members."

"I can ask the provider to prescribe a medication that will minimize drowsiness."

"Sitting quietly near the bedside can provide comfort and support."

Hint : 💖 Comfort through quiet presence.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

15 :
A nurse is reinforcing teaching with a client who has psoriasis. Which of the following treatment options should the nurse include in the teaching?

Oil-based ointment

Phototherapy

Benzoyl peroxide

Dermabrasion

Hint : 🌞 Ultraviolet light treatment for psoriasis.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

16 :
A nurse is collecting data from a client about her current pain status. Which of the following questions should the nurse ask to determine the quality of the client's pain?

"Could you rate your pain on a scale from 0 to 10?"

"What does your pain feel like?"

"Do you have any pain this morning?"

"Is your pain the same as it has been?"

Hint : 💬 sensation of pain

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

17 :
A nurse is reinforcing teaching with a client about strategies to prevent hypertension. Which of the following statements by the client indicates an understanding of the teaching?

"With a BMI of 30, I should focus on maintaining my current weight."

"I should consume no more than 2,000 milligrams of sodium per day."

"I should exercise for 30 minutes three times per week."

"I should consume fish once per week."

Hint : 🧂 Limit sodium for heart health.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

18 :
A nurse is reinforcing teaching with a client who is recovering from gastroenteritis and is beginning oral intake. Which of the following foods should the nurse recommend?

Lime ice popsicle

Vanilla pudding

Orange juice

Cream of broccoli soup

Hint : 🍦 Choose clear liquids first.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

19 :
A nurse is caring for a client who is 1 day postoperative following an appendectomy. Which of the following findings should the nurse report?

Temperature 37.2° C (99° F)

Hypoactive bowel sounds in all four quadrants

Red streaks along the incision

Serosanguineous drainage at the incision site

Hint : 🚨 Red streaks signal infection.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

20 :
A nurse is contributing to the plan of care for a client who has disuse syndrome following cast removal from a lower extremity. Which of the following referrals should the nurse include in the plan of care?

Occupational therapist

Social worker

Herbalist

Dietitian

Hint : 🖋️ Occupational therapy aids recovery.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

21 :
A nurse is reinforcing teaching with a client who has a BMI of 32 and wants to lose weight. Which of the following statements should the nurse make to promote the client's weight loss?

"Include refined grains as a good carbohydrate in your diet."

"Reward yourself with special foods for achieving short-term goals."

"Plan your meals so up to 40 percent of your calories come from fats."

"Consume 500 fewer calories per day than your estimated calorie needs."

Hint : 🍎 Moderate calorie deficit works.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

22 :
A nurse is collecting admission history data from a client who is in a semi-private room. Which of the following data is the priority for the nurse to address?

History of generalized anxiety disorder

Recent exposure to tuberculosis

Reports periodic migraine headaches

Experiences nocturia

Hint : 🦠 TB exposure needs isolation.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

23 :
A nurse is assisting with discharge teaching for a client who requires oropharyngeal suctioning at home. The nurse should ensure that which of the following equipment is available for use at home?

Yankauer catheter

Sterile gloves

Water-soluble lubricant

Oropharyngeal airway

Hint : 🧑‍⚕️ Yankauer catheter for suctioning.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

24 :
A nurse is reinforcing teaching with a client who is scheduled to have a colonoscopy. Which of the following information should the nurse include in the teaching?

"You will be moderately sedated during the procedure."

"You may drink full liquids until 6 hours before the procedure."

"You should warm the liquid bowel preparation before drinking it."

"You will lie on your right side for the procedure."

Hint : 💉Sedation for comfort

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

25 :
A nurse is obtaining a medication history from a client who is to start taking nitroglycerin for chest discomfort with activity. Which of the following medications should the nurse instruct the client to avoid taking within 24 hours of using nitroglycerin?

Metformin

Atorvastatin

Omeprazole

Sildenafil

Hint : 💊 Avoid sildenafil with nitroglycerin.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

26 :
A nurse is contributing to the plan of care for a client who reports difficulty eating due to chronic arthritis. Which of the following interventions should the nurse include in the plan?

Obtain a referral for physical therapy.

Have an assistive personnel feed the client.

Ask the provider for a prescription for a pureed diet.

Apply foam handles to the client's eating utensils.

Hint : 🛠️ Foam handles for easier grip.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

27 :
A nurse is contributing to the plan of care for a client who reports difficulty eating due to chronic arthritis. Which of the following interventions should the nurse include in the plan?

Obtain a referral for physical therapy.

Have an assistive personnel feed the client.

Ask the provider for a prescription for a pureed diet.

Apply foam handles to the client's eating utensils.

Hint : 🛠️ Foam handles for easier grip.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

28 :
A nurse is reinforcing teaching with a client who has heart failure and a new prescription for furosemide. The nurse should instruct the client to monitor for which of the following adverse effects?

Agitation

Ringing in ears

Metallic taste

Rhinitis

Hint : 👂Report ringing ears immediately.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

29 :
A nurse is reviewing laboratory values for a client who is receiving long-term NSAID therapy for rheumatoid arthritis. Which of the following values should the nurse report to the provider?

BUN 40 mg/dL

Hematocrit 45%

Total bilirubin 0.8 mg/dL

PaO2 90 mm Hg

Hint : 💧 Elevated BUN signals kidney concern

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

30 :
A nurse is monitoring a client who is undergoing a blood transfusion of packed RBCs. The nurse should recognize that which of the following findings indicates fluid overload?

Dyspnea

Bradycardia

Fever

Pruritus

Hint : 💨 Monitor for difficulty breathing.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

31 :
A nurse is preparing a client for a sigmoidoscopy. In which of the following positions should the nurse place the client?

Orthopneic

Knee-chest

Trendelenburg

Prone

Hint : 🧍‍♂️ Best position

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

32 :
A nurse is caring for a client who is experiencing muscle spasms and has a new prescription for an aquathermia pad. Which of the following actions should the nurse take?

Use safety pins to secure the pad in place.

Cover the pad prior to use.

Apply the pad for 45 minutes at a time.

Fill the pad with sterile water.

Hint : 🛋️ Prevent burns with covering.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

33 :
A nurse is providing care for a client who has hemophilia and is bleeding from a small laceration on his arm. After applying a sterile dressing, which of the following actions should the nurse take next?

Maintain direct pressure over the site.

Reinforce the dressing over the site.

Obtain a radial pulse.

Check whether the bleeding has stopped.

Hint : 🩹Apply pressure to stop bleeding.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

34 :
A nurse is assisting in the plan of care for a client who has constipation after receiving opioid medication for incisional pain. Which of the following actions should the nurse take first?

Auscultate the client's abdomen for bowel sounds.

Provide the client privacy with a set time to defecate.

Encourage the client to increase oral intake of fluids.

Administer a fiber-based laxative to the client.

Hint : 👂 Listen for bowel sounds first.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

35 :
A nurse in a provider's office is reinforcing teaching about disease prevention with an older adult client. Which of the following immunizations should the nurse recommend to the client?

Pneumococcal

Human papillomavirus (HPV)

Measles, mumps, and rubella (MMR)

Tuberculosis

Hint : 💉Get vaccinated for pneumonia.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

36 :
A nurse is reinforcing teaching about liquid iron supplements with a client who has anemia. Which of the following information should the nurse include in the teaching?

Mix iron supplements with milk to prevent staining of the teeth.

Check for orange-colored stools after 4 days of treatment.

Reduce gastric distress by taking iron supplements with an antacid.

Take iron supplements between meals for maximum absorption.

Hint : 🍊 Take iron on an empty stomach.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

37 :
A nurse on the oncology unit is evaluating a client's response after receiving a dose of aprepitant. Which of the following therapeutic effects should the nurse expect?

Decreased incisional pain

Absence of dizziness

Decreased dysrhythmias

Absence of nausea

Hint : 🍽️ Prevents nausea effectively

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

38 :
A nurse is reinforcing teaching with a client who is scheduled for a cardiac catheterization. Which of the following should the nurse tell the client to expect during injection of the contrast medium?

Numbness in the fingertips

Pain in the jawline

Urge to urinate

Feeling of heat

Hint : 🔥 Sensation of warmth expected.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

39 :
A nurse is reinforcing teaching about decreasing the risk of osteoporosis to a client who is postmenopausal. Which of the following instructions should the nurse include in the teaching?

Increase daily intake of vitamin E.

Limit vitamin D intake.

Add a weight-bearing exercise regimen.

Take calcium carbonate supplements once a day with breakfast.

Hint : 🏋️‍♀️Exercise to strengthen bones.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

40 :
A nurse is collecting data from a client who is African-American. Which of the following areas should the nurse check to determine the presence of pallor?

Antecubital space

Pinna of the ear

Abdomen

Conjunctiva

Hint : 👁️ Check the conjunctiva for pallor.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

41 :
A nurse is reinforcing teaching with a client who is scheduled for a cardiac catheterization. Which of the following should the nurse tell the client to expect during injection of the contrast medium?

Numbness in the fingertips

Pain in the jawline

Urge to urinate

Feeling of heat

Hint : 🔥 Warmth from contrast injection.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

42 :
A nurse is caring for a client who is receiving intermittent bolus enteral feedings through a jejunostomy tube. Which of the following actions should the nurse take?

Flush the tube with 90 mL of sterile water before and after the feeding.

Administer the feeding solution at a cold temperature.

Elevate the head of the client's bed for 1 hour after the feeding.

Rotate the jejunostomy tube once per day.

Hint : 🛏️ Elevate bed to prevent aspiration.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

43 :
A nurse is assisting in the plan of care for a client who is dehydrated and is receiving IV fluid replacement. Which of the following interventions should the nurse contribute to the plan of care?

Offer oral fluids every 4 hours.

Monitor pulse pressure every 6 hours.

Check for neck vein distention.

Limit oral fluids prior to bedtime.

Hint : 🩺Check for neck vein distention.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

44 :
A nurse is reinforcing teaching with a client who has streptococcal pharyngitis. Which of the following actions is appropriate for the nurse to include in the plan of care?

Place the client in a negative airflow room.

Implement droplet precautions.

Place the client on a fluid restriction.

Obtain a throat culture after the initial dose of antibiotics.

Hint : 🦠 Use droplet precautions for strep.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

45 :
A nurse is caring for a client who is visually impaired. When delivering the client's meal tray, which of the following actions should the nurse take?

Describe the food placement as though the plate were a clock.

Provide the client with small-handled adaptive utensils.

Discourage conversations during the client's mealtime.

Arrange for an assistive personnel to feed the client.

Hint : 🍽️ Use clock placement for food.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

46 :
A nurse is caring for a client who is visually impaired. When delivering the client's meal tray, which of the following actions should the nurse take?

Describe the food placement as though the plate were a clock.

Provide the client with small-handled adaptive utensils.

Discourage conversations during the client's mealtime.

Arrange for an assistive personnel to feed the client.

Hint : 💉 Keep insulin at room temperature.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

47 :
A nurse is collecting data from a client who has been admitted with suspected appendicitis. Which of the following findings is the nurse's priority to report to the provider?

Loss of appetite

Temperature 37.8° C (100° F)

WBC count 15,000/mm³

Rigid, board-like abdomen

Hint : 🚨 Rigid abdomen signals emergency.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

48 :
A nurse is evaluating a client's acceptance of having a new ileostomy. Which of the following statements by the client indicates acceptance?

"I wish my sexual relationship with my partner was like it was before."

"I look forward to having normal bowel movements again."

"I will attend a support group to help me handle difficulties when they occur."

"I have my partner empty the bag for me, so I don't have to look at it."

Hint : 💪 Positive coping with support.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

49 :
A nurse is caring for a client who has a terminal illness and is in the active phase of dying. The client refuses further hydration and nourishment. Which of the following actions should the nurse take?

Ask the client's health care surrogate for permission to withhold nourishment.

Provide regular oral care for the client with a moist swab.

Request a prescription for IV fluids.

Explain the importance of oral hydration to the client.

Hint : 💧Moist swabs for comfort.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

50 :
A nurse is reinforcing discharge teaching with a client who had an abdominal hysterectomy 2 days ago. Which of the following instructions should the nurse include in the teaching?

Avoid climbing stairs for 8 weeks.

Expect bright red vaginal bleeding for 1 week following surgery.

Douche with warm water to remove vaginal discharge.

Take a shower rather than a tub bath.

Hint : 🚿 Shower, not bath, for healing.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

51 :
A home health nurse is reinforcing teaching with an older adult client about safety precautions to take in the home. Which of the following instructions should the nurse include?

Have the furnace inspected every 2 years.

Place area rugs on wooden floors.

Place white tape on the edges of stairs.

Run wires and cords under carpeting.

Hint : 🛑 Tape for stair safety.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

52 :
A nurse is caring for a client who is experiencing muscle spasms and has a new prescription for an aquathermia pad. Which of the following actions should the nurse take?

Use safety pins to secure the pad in place.

Cover the pad prior to use.

Apply the pad for 45 minutes at a time.

Fill the pad with sterile water.

Hint : 💧 Cover to prevent burns.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

53 :
A nurse is assisting in the plan of care for a client who has constipation after receiving opioid medication for incisional pain. Which of the following actions should the nurse take first?

Auscultate the client's abdomen for bowel sounds.

Provide the client privacy with a set time to defecate.

Encourage the client to increase oral intake of fluids.

Administer a fiber-based laxative to the client.

Hint : 🩺 Listen for bowel sounds first.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

54 :
A nurse is reinforcing teaching with a client who has COPD and reports shortness of breath and little appetite. Which of the following instructions should the nurse include in the teaching?

Limit fluid intake during meals.

Eat lighter, low-calorie foods first.

Consume three regular meals daily.

Eliminate dairy products.

Hint : 💧 Limit fluids during meals.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

55 :
A nurse is collecting data from a client who had a left hemispheric stroke. Which of the following findings should the nurse report to the provider immediately?

Right-sided weakness

Difficulty speaking

Inability to follow directions

A change in pupil size

Hint : ⚠️ Pupil changes need urgent care.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

56 :
A nurse is reviewing the medical record of a client who has hypertension and a new prescription for propranolol. Which of the following findings should the nurse identify as a contraindication for taking propranolol?

Irritable bowel syndrome

Migraine headaches

Glaucoma

Asthma

Hint : 💨 Avoid propranolol with asthma.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

57 :
A nurse is caring for a client who is receiving peritoneal dialysis. Which of the following actions should the nurse take?

Use safety pins to secure the pad in place.

Cover the pad prior to use.

Apply the pad for 45 minutes at a time.

Fill the pad with sterile water.

Hint : 💧 Cover pad to prevent burns.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

58 :
A nurse has received change-of-shift report for four clients. Which of the following clients should the nurse attend to first?

A client who had abdominal surgery 2 days ago and the incision line is separating

A client who fell 12 hours ago and reports pain as 4 on a scale of 0 to 10

A client who has a chronic tracheostomy and is intermittently coughing up clear sputum

A client who has Clostridium difficile and has liquid stools

Hint : ⚠️ Wound separation

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

59 :
A nurse is collecting data about immunizations from a 65-year-old client who has no identified risk factors for disease. The nurse should identify the client's need for which of the following immunizations?

Measles, mumps, and rubella

Human papilloma virus

Inactivated polio virus

Herpes zoster

Hint : 💉 Vaccine for shingles.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

60 :
A nurse in a long-term care unit is assisting in the care of a client who has Alzheimer's disease. Which of the following actions should the nurse take?

Keep the lights dimmed.

Alternate the client's daily routine.

Participate in reminiscence therapy with the client.

Raise the four side rails on the client's bed.

Hint : 🧠 Engage in memory sharing.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

61 :
A nurse is reinforcing teaching about a transcutaneous electrical nerve stimulation (TENS) unit for a client who has a herniated intervertebral disk. Which of the following statements by the client indicates an understanding of the teaching?

"The TENS unit should be applied at least 6 inches from the actual site of my pain."

"I should adjust the TENS unit until I feel a tingling sensation."

"I will need to charge the TENS unit for 2 hours each day."

"The TENS unit administers a continuous dose of pain medication."

Hint : ⚡Adjust until tingling felt.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

62 :
A charge nurse is reinforcing teaching about infection control with a newly licensed nurse. Which of the following actions by the newly licensed nurse indicates an understanding of the teaching?

Performs hand hygiene with hands at elbow level

Cleans a blood spill with chlorine bleach

Instructs a female client to wipe her perineal area from back to front

Rolls soiled linen with clean side in before placing it in laundry bag

Hint : 🧴 Clean spills with bleach.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

63 :
A nurse is caring for a client who has a tracheostomy tube. Upon data collection, the nurse observes the client is restless and hears crackles in the lungs. Which of the following interventions should the nurse take?

Instill saline into the tubing.

Check the cuff pressure.

Increase the humidification.

Perform suctioning.

Hint : 💨 Suction to clear airway.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

64 :
A nurse is collecting data for an older adult client who has cystitis. Which of the following findings should the nurse expect? (Select all that apply)

Pruritus

Bradycardia

Hematuria

Confusion

Dysuria

Hint : 🚻 Look for pain, blood, confusion.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

65 :
A nurse is caring for a client who has been receiving epoetin alfa in preparation for a hip arthroplasty. Which of the following findings indicates that the medication has been effective?

Hemoglobin 11 g/dL

WBC count 9,000/mm³

PT 12 seconds

Total calcium 10 mg/dL

Hint : 🩸 Look for hemoglobin increase.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

66 :
A nurse enters a client's room and sees smoke coming from the trash can next to the client's bed. Which of the following actions should the nurse take first?

Pull the fire alarm panel.

Obtain a fire extinguisher.

Remove the client from the room.

Close the door to the client's room.

Hint : 🔥 Remove client first.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

67 :
A nurse is caring for a client who has a distal radius fracture with a short arm cast applied. Which of the following actions should the nurse take?

Position the fractured arm below the level of the client's heart.

Immobilize the client's fingers using a hand splint.

Use a hair dryer to blow hot air into the cast to relieve itching.

Perform neurovascular checks of the affected extremity every 2 hours.

Hint : 🩺Check neurovascular status frequently.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

68 :
A nurse is collecting data from a client who is experiencing opioid toxicity. Which of the following findings should the nurse expect?

Pupillary dilation

Respiratory Depression

Chest pain

Diaphoresis

Hint : 💨Watch for slow breathing.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

69 :
A nurse is assisting with care for a client who received a tuberculin skin test 72 hours ago. When collecting data from the test site, which of the following findings indicates a need for further testing?

Palpable area of induration, greater than 10 mm (0.4 in) in diameter

Area of ecchymosis, greater than 12 mm (0.5 in) in diameter

Tenderness at the injection site

Nonpalpable area of redness, less than 5 mm (0.2 in) in diameter

Hint : 🦠 Induration >10 mm suggests TB.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

70 :
A nurse is transporting a client who has pneumonia and is on droplet precautions to radiology. Which of the following safety measures should the nurse take while transporting the client?

The nurse should wear a mask during transport.

The nurse should wear a gown during transport.

The client should wear a mask during transport.

The client should wear a gown during transport.

Hint : 😷 Mask for droplet precautions.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

71 :
A nurse is reinforcing teaching with a client who has anemia and has a prescription for ferrous sulfate. Which of the following foods should the nurse recommend that the client consume to increase the absorption of this medication?

Oatmeal

Raw oranges

Cheese

Baked potatoes

Hint : 🍊 Pair iron with vitamin C.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

72 :
A nurse is assisting with the plan of care for a client who has botulism poisoning. Which of the following interventions should the nurse include in the plan?

Check for increased salivation.

Administer clindamycin hydrochloride.

Place in contact isolation.

Monitor for muscle paralysis.

Hint : 💉 muscle weakness and paralysis.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

73 :
A nurse is caring for a client who is postoperative following a total thyroidectomy for hyperthyroidism. Which of the following findings should the nurse identify as the priority?

Oral temperature 39° C (102.2° F)

Serum calcium level 9.2 mg/dL

Moderate amount of serosanguineous drainage on dressings

Report of a sore throat

Hint : 🌡️ High fever indicates thyroid storm.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

74 :
A nurse is collecting data from an older adult client who has a potassium level of 3.2 mEq/L. Which of the following findings should the nurse expect?

Difficulty swallowing

Diarrhea

Hyperreflexia

Muscle weakness

Hint : 💪 Look for muscle weakness.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

75 :
A nurse is examining the abdominal wound of a client who is 3 days postoperative following a hemicolectomy. Which of the following findings indicates a wound infection?

Redness around the incision line

Serous wound drainage

Crusting along the incision

Bruising around the wound

Hint : 🩹 increased redness around the incision.

Correct Answers:

No Correct Answers Available !

Rationale :

Rationale to be Available Soon

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Ans

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1 : A nurse is caring for a client who is at risk for anaphylaxis due to bee stings. When reinforcing teaching about the use of an automatic epinephrine injector, which of the following actions is the priority?

2 : A nurse is assisting in the care of a client who has a pulmonary embolism and is experiencing dyspnea. Which of the following actions should the nurse take first?

3 : A nurse is caring for a client who has pneumonia with dyspnea. The client's ABG results are pH 7.30, PaCO2 50 mm Hg, HCO3 26 mEq/L. The nurse should recognize that the client has which of the following acid-base imbalances?

4 : A nurse is reviewing laboratory values of a client who has severe dyspnea. Which of the following laboratory values indicates heart failure?

5 : A nurse is contributing to the plan of care for a client who has heart failure. Which of the following actions should the nurse include in the plan?

6 : A nurse is performing tracheostomy care for a client who has a chronic tracheostomy. Which of the following actions should the nurse take?

8 : A nurse is reinforcing teaching with a client who will undergo a colonoscopy the following week. Which of the following instructions should the nurse include?

9 : A nurse is reinforcing teaching with a client who is 24 hr postoperative following a total hip arthroplasty. Which of the following instructions should the nurse include in the teaching?

10 : A nurse is reviewing vital signs obtained by an assistive personnel on a group of clients. The previous vital signs for each of the clients were obtained 4 hr earlier. Which of the following changes should the nurse identify as the priority finding?

11 : A nurse is caring for a client who has partial-thickness burns on 50% of his body and is receiving total parenteral nutrition. The nurse should actively monitor the client for which of the following?

12 : A nurse is reinforcing teaching with a client who has angina. Which of the following statements by the client indicates an understanding of the teaching?

13 : A nurse in an urgent care facility is collecting data from a client who was stung by a wasp. Which of the following findings indicates the client is experiencing anaphylaxis?

14 : A nurse is caring for a client in hospice care who is dying. The client's partner expresses concern that the client is sleeping more than in the previous week. Which of the following is an appropriate response by the nurse?

15 : A nurse is reinforcing teaching with a client who has psoriasis. Which of the following treatment options should the nurse include in the teaching?

16 : A nurse is collecting data from a client about her current pain status. Which of the following questions should the nurse ask to determine the quality of the client's pain?

17 : A nurse is reinforcing teaching with a client about strategies to prevent hypertension. Which of the following statements by the client indicates an understanding of the teaching?

18 : A nurse is reinforcing teaching with a client who is recovering from gastroenteritis and is beginning oral intake. Which of the following foods should the nurse recommend?

19 : A nurse is caring for a client who is 1 day postoperative following an appendectomy. Which of the following findings should the nurse report?

20 : A nurse is contributing to the plan of care for a client who has disuse syndrome following cast removal from a lower extremity. Which of the following referrals should the nurse include in the plan of care?

21 : A nurse is reinforcing teaching with a client who has a BMI of 32 and wants to lose weight. Which of the following statements should the nurse make to promote the client's weight loss?

22 : A nurse is collecting admission history data from a client who is in a semi-private room. Which of the following data is the priority for the nurse to address?

23 : A nurse is assisting with discharge teaching for a client who requires oropharyngeal suctioning at home. The nurse should ensure that which of the following equipment is available for use at home?

24 : A nurse is reinforcing teaching with a client who is scheduled to have a colonoscopy. Which of the following information should the nurse include in the teaching?

25 : A nurse is obtaining a medication history from a client who is to start taking nitroglycerin for chest discomfort with activity. Which of the following medications should the nurse instruct the client to avoid taking within 24 hours of using nitroglycerin?

26 : A nurse is contributing to the plan of care for a client who reports difficulty eating due to chronic arthritis. Which of the following interventions should the nurse include in the plan?

27 : A nurse is contributing to the plan of care for a client who reports difficulty eating due to chronic arthritis. Which of the following interventions should the nurse include in the plan?

28 : A nurse is reinforcing teaching with a client who has heart failure and a new prescription for furosemide. The nurse should instruct the client to monitor for which of the following adverse effects?

29 : A nurse is reviewing laboratory values for a client who is receiving long-term NSAID therapy for rheumatoid arthritis. Which of the following values should the nurse report to the provider?

30 : A nurse is monitoring a client who is undergoing a blood transfusion of packed RBCs. The nurse should recognize that which of the following findings indicates fluid overload?

31 : A nurse is preparing a client for a sigmoidoscopy. In which of the following positions should the nurse place the client?

32 : A nurse is caring for a client who is experiencing muscle spasms and has a new prescription for an aquathermia pad. Which of the following actions should the nurse take?

33 : A nurse is providing care for a client who has hemophilia and is bleeding from a small laceration on his arm. After applying a sterile dressing, which of the following actions should the nurse take next?

34 : A nurse is assisting in the plan of care for a client who has constipation after receiving opioid medication for incisional pain. Which of the following actions should the nurse take first?

35 : A nurse in a provider's office is reinforcing teaching about disease prevention with an older adult client. Which of the following immunizations should the nurse recommend to the client?

36 : A nurse is reinforcing teaching about liquid iron supplements with a client who has anemia. Which of the following information should the nurse include in the teaching?

37 : A nurse on the oncology unit is evaluating a client's response after receiving a dose of aprepitant. Which of the following therapeutic effects should the nurse expect?

38 : A nurse is reinforcing teaching with a client who is scheduled for a cardiac catheterization. Which of the following should the nurse tell the client to expect during injection of the contrast medium?

39 : A nurse is reinforcing teaching about decreasing the risk of osteoporosis to a client who is postmenopausal. Which of the following instructions should the nurse include in the teaching?

40 : A nurse is collecting data from a client who is African-American. Which of the following areas should the nurse check to determine the presence of pallor?

41 : A nurse is reinforcing teaching with a client who is scheduled for a cardiac catheterization. Which of the following should the nurse tell the client to expect during injection of the contrast medium?

42 : A nurse is caring for a client who is receiving intermittent bolus enteral feedings through a jejunostomy tube. Which of the following actions should the nurse take?

43 : A nurse is assisting in the plan of care for a client who is dehydrated and is receiving IV fluid replacement. Which of the following interventions should the nurse contribute to the plan of care?

44 : A nurse is reinforcing teaching with a client who has streptococcal pharyngitis. Which of the following actions is appropriate for the nurse to include in the plan of care?

45 : A nurse is caring for a client who is visually impaired. When delivering the client's meal tray, which of the following actions should the nurse take?

46 : A nurse is caring for a client who is visually impaired. When delivering the client's meal tray, which of the following actions should the nurse take?

47 : A nurse is collecting data from a client who has been admitted with suspected appendicitis. Which of the following findings is the nurse's priority to report to the provider?

48 : A nurse is evaluating a client's acceptance of having a new ileostomy. Which of the following statements by the client indicates acceptance?

49 : A nurse is caring for a client who has a terminal illness and is in the active phase of dying. The client refuses further hydration and nourishment. Which of the following actions should the nurse take?

50 : A nurse is reinforcing discharge teaching with a client who had an abdominal hysterectomy 2 days ago. Which of the following instructions should the nurse include in the teaching?

51 : A home health nurse is reinforcing teaching with an older adult client about safety precautions to take in the home. Which of the following instructions should the nurse include?

52 : A nurse is caring for a client who is experiencing muscle spasms and has a new prescription for an aquathermia pad. Which of the following actions should the nurse take?

53 : A nurse is assisting in the plan of care for a client who has constipation after receiving opioid medication for incisional pain. Which of the following actions should the nurse take first?

54 : A nurse is reinforcing teaching with a client who has COPD and reports shortness of breath and little appetite. Which of the following instructions should the nurse include in the teaching?

55 : A nurse is collecting data from a client who had a left hemispheric stroke. Which of the following findings should the nurse report to the provider immediately?

56 : A nurse is reviewing the medical record of a client who has hypertension and a new prescription for propranolol. Which of the following findings should the nurse identify as a contraindication for taking propranolol?

57 : A nurse is caring for a client who is receiving peritoneal dialysis. Which of the following actions should the nurse take?

58 : A nurse has received change-of-shift report for four clients. Which of the following clients should the nurse attend to first?

59 : A nurse is collecting data about immunizations from a 65-year-old client who has no identified risk factors for disease. The nurse should identify the client's need for which of the following immunizations?

60 : A nurse in a long-term care unit is assisting in the care of a client who has Alzheimer's disease. Which of the following actions should the nurse take?

61 : A nurse is reinforcing teaching about a transcutaneous electrical nerve stimulation (TENS) unit for a client who has a herniated intervertebral disk. Which of the following statements by the client indicates an understanding of the teaching?

62 : A charge nurse is reinforcing teaching about infection control with a newly licensed nurse. Which of the following actions by the newly licensed nurse indicates an understanding of the teaching?

63 : A nurse is caring for a client who has a tracheostomy tube. Upon data collection, the nurse observes the client is restless and hears crackles in the lungs. Which of the following interventions should the nurse take?

64 : A nurse is collecting data for an older adult client who has cystitis. Which of the following findings should the nurse expect? (Select all that apply)

65 : A nurse is caring for a client who has been receiving epoetin alfa in preparation for a hip arthroplasty. Which of the following findings indicates that the medication has been effective?

66 : A nurse enters a client's room and sees smoke coming from the trash can next to the client's bed. Which of the following actions should the nurse take first?

67 : A nurse is caring for a client who has a distal radius fracture with a short arm cast applied. Which of the following actions should the nurse take?

68 : A nurse is collecting data from a client who is experiencing opioid toxicity. Which of the following findings should the nurse expect?

69 : A nurse is assisting with care for a client who received a tuberculin skin test 72 hours ago. When collecting data from the test site, which of the following findings indicates a need for further testing?

70 : A nurse is transporting a client who has pneumonia and is on droplet precautions to radiology. Which of the following safety measures should the nurse take while transporting the client?

71 : A nurse is reinforcing teaching with a client who has anemia and has a prescription for ferrous sulfate. Which of the following foods should the nurse recommend that the client consume to increase the absorption of this medication?

72 : A nurse is assisting with the plan of care for a client who has botulism poisoning. Which of the following interventions should the nurse include in the plan?

73 : A nurse is caring for a client who is postoperative following a total thyroidectomy for hyperthyroidism. Which of the following findings should the nurse identify as the priority?

74 : A nurse is collecting data from an older adult client who has a potassium level of 3.2 mEq/L. Which of the following findings should the nurse expect?

75 : A nurse is examining the abdominal wound of a client who is 3 days postoperative following a hemicolectomy. Which of the following findings indicates a wound infection?

1 :
A nurse is caring for a client who is at risk for anaphylaxis due to bee stings. When reinforcing teaching about the use of an automatic epinephrine injector, which of the following actions is the priority?

2 :
A nurse is assisting in the care of a client who has a pulmonary embolism and is experiencing dyspnea. Which of the following actions should the nurse take first?

3 :
A nurse is caring for a client who has pneumonia with dyspnea. The client's ABG results are pH 7.30, PaCO2 50 mm Hg, HCO3 26 mEq/L. The nurse should recognize that the client has which of the following acid-base imbalances?

4 :
A nurse is reviewing laboratory values of a client who has severe dyspnea. Which of the following laboratory values indicates heart failure?

5 :
A nurse is contributing to the plan of care for a client who has heart failure. Which of the following actions should the nurse include in the plan?

6 :
A nurse is performing tracheostomy care for a client who has a chronic tracheostomy. Which of the following actions should the nurse take?

8 :
A nurse is reinforcing teaching with a client who will undergo a colonoscopy the following week. Which of the following instructions should the nurse include?

9 :
A nurse is reinforcing teaching with a client who is 24 hr postoperative following a total hip arthroplasty. Which of the following instructions should the nurse include in the teaching?

10 :
A nurse is reviewing vital signs obtained by an assistive personnel on a group of clients. The previous vital signs for each of the clients were obtained 4 hr earlier. Which of the following changes should the nurse identify as the priority finding?

11 :
A nurse is caring for a client who has partial-thickness burns on 50% of his body and is receiving total parenteral nutrition. The nurse should actively monitor the client for which of the following?

12 :
A nurse is reinforcing teaching with a client who has angina. Which of the following statements by the client indicates an understanding of the teaching?

13 :
A nurse in an urgent care facility is collecting data from a client who was stung by a wasp. Which of the following findings indicates the client is experiencing anaphylaxis?

14 :
A nurse is caring for a client in hospice care who is dying. The client's partner expresses concern that the client is sleeping more than in the previous week. Which of the following is an appropriate response by the nurse?

15 :
A nurse is reinforcing teaching with a client who has psoriasis. Which of the following treatment options should the nurse include in the teaching?

16 :
A nurse is collecting data from a client about her current pain status. Which of the following questions should the nurse ask to determine the quality of the client's pain?

17 :
A nurse is reinforcing teaching with a client about strategies to prevent hypertension. Which of the following statements by the client indicates an understanding of the teaching?

18 :
A nurse is reinforcing teaching with a client who is recovering from gastroenteritis and is beginning oral intake. Which of the following foods should the nurse recommend?

19 :
A nurse is caring for a client who is 1 day postoperative following an appendectomy. Which of the following findings should the nurse report?

20 :
A nurse is contributing to the plan of care for a client who has disuse syndrome following cast removal from a lower extremity. Which of the following referrals should the nurse include in the plan of care?

21 :
A nurse is reinforcing teaching with a client who has a BMI of 32 and wants to lose weight. Which of the following statements should the nurse make to promote the client's weight loss?

22 :
A nurse is collecting admission history data from a client who is in a semi-private room. Which of the following data is the priority for the nurse to address?

23 :
A nurse is assisting with discharge teaching for a client who requires oropharyngeal suctioning at home. The nurse should ensure that which of the following equipment is available for use at home?

24 :
A nurse is reinforcing teaching with a client who is scheduled to have a colonoscopy. Which of the following information should the nurse include in the teaching?

25 :
A nurse is obtaining a medication history from a client who is to start taking nitroglycerin for chest discomfort with activity. Which of the following medications should the nurse instruct the client to avoid taking within 24 hours of using nitroglycerin?

26 :
A nurse is contributing to the plan of care for a client who reports difficulty eating due to chronic arthritis. Which of the following interventions should the nurse include in the plan?

27 :
A nurse is contributing to the plan of care for a client who reports difficulty eating due to chronic arthritis. Which of the following interventions should the nurse include in the plan?

28 :
A nurse is reinforcing teaching with a client who has heart failure and a new prescription for furosemide. The nurse should instruct the client to monitor for which of the following adverse effects?

29 :
A nurse is reviewing laboratory values for a client who is receiving long-term NSAID therapy for rheumatoid arthritis. Which of the following values should the nurse report to the provider?

30 :
A nurse is monitoring a client who is undergoing a blood transfusion of packed RBCs. The nurse should recognize that which of the following findings indicates fluid overload?

31 :
A nurse is preparing a client for a sigmoidoscopy. In which of the following positions should the nurse place the client?

32 :
A nurse is caring for a client who is experiencing muscle spasms and has a new prescription for an aquathermia pad. Which of the following actions should the nurse take?

33 :
A nurse is providing care for a client who has hemophilia and is bleeding from a small laceration on his arm. After applying a sterile dressing, which of the following actions should the nurse take next?

34 :
A nurse is assisting in the plan of care for a client who has constipation after receiving opioid medication for incisional pain. Which of the following actions should the nurse take first?

35 :
A nurse in a provider's office is reinforcing teaching about disease prevention with an older adult client. Which of the following immunizations should the nurse recommend to the client?

36 :
A nurse is reinforcing teaching about liquid iron supplements with a client who has anemia. Which of the following information should the nurse include in the teaching?

37 :
A nurse on the oncology unit is evaluating a client's response after receiving a dose of aprepitant. Which of the following therapeutic effects should the nurse expect?

38 :
A nurse is reinforcing teaching with a client who is scheduled for a cardiac catheterization. Which of the following should the nurse tell the client to expect during injection of the contrast medium?

39 :
A nurse is reinforcing teaching about decreasing the risk of osteoporosis to a client who is postmenopausal. Which of the following instructions should the nurse include in the teaching?

40 :
A nurse is collecting data from a client who is African-American. Which of the following areas should the nurse check to determine the presence of pallor?

41 :
A nurse is reinforcing teaching with a client who is scheduled for a cardiac catheterization. Which of the following should the nurse tell the client to expect during injection of the contrast medium?

42 :
A nurse is caring for a client who is receiving intermittent bolus enteral feedings through a jejunostomy tube. Which of the following actions should the nurse take?

43 :
A nurse is assisting in the plan of care for a client who is dehydrated and is receiving IV fluid replacement. Which of the following interventions should the nurse contribute to the plan of care?

44 :
A nurse is reinforcing teaching with a client who has streptococcal pharyngitis. Which of the following actions is appropriate for the nurse to include in the plan of care?

45 :
A nurse is caring for a client who is visually impaired. When delivering the client's meal tray, which of the following actions should the nurse take?

46 :
A nurse is caring for a client who is visually impaired. When delivering the client's meal tray, which of the following actions should the nurse take?

47 :
A nurse is collecting data from a client who has been admitted with suspected appendicitis. Which of the following findings is the nurse's priority to report to the provider?

48 :
A nurse is evaluating a client's acceptance of having a new ileostomy. Which of the following statements by the client indicates acceptance?

49 :
A nurse is caring for a client who has a terminal illness and is in the active phase of dying. The client refuses further hydration and nourishment. Which of the following actions should the nurse take?

50 :
A nurse is reinforcing discharge teaching with a client who had an abdominal hysterectomy 2 days ago. Which of the following instructions should the nurse include in the teaching?

51 :
A home health nurse is reinforcing teaching with an older adult client about safety precautions to take in the home. Which of the following instructions should the nurse include?

52 :
A nurse is caring for a client who is experiencing muscle spasms and has a new prescription for an aquathermia pad. Which of the following actions should the nurse take?

53 :
A nurse is assisting in the plan of care for a client who has constipation after receiving opioid medication for incisional pain. Which of the following actions should the nurse take first?

54 :
A nurse is reinforcing teaching with a client who has COPD and reports shortness of breath and little appetite. Which of the following instructions should the nurse include in the teaching?

55 :
A nurse is collecting data from a client who had a left hemispheric stroke. Which of the following findings should the nurse report to the provider immediately?

56 :
A nurse is reviewing the medical record of a client who has hypertension and a new prescription for propranolol. Which of the following findings should the nurse identify as a contraindication for taking propranolol?

57 :
A nurse is caring for a client who is receiving peritoneal dialysis. Which of the following actions should the nurse take?

58 :
A nurse has received change-of-shift report for four clients. Which of the following clients should the nurse attend to first?

59 :
A nurse is collecting data about immunizations from a 65-year-old client who has no identified risk factors for disease. The nurse should identify the client's need for which of the following immunizations?

60 :
A nurse in a long-term care unit is assisting in the care of a client who has Alzheimer's disease. Which of the following actions should the nurse take?

61 :
A nurse is reinforcing teaching about a transcutaneous electrical nerve stimulation (TENS) unit for a client who has a herniated intervertebral disk. Which of the following statements by the client indicates an understanding of the teaching?

62 :
A charge nurse is reinforcing teaching about infection control with a newly licensed nurse. Which of the following actions by the newly licensed nurse indicates an understanding of the teaching?

63 :
A nurse is caring for a client who has a tracheostomy tube. Upon data collection, the nurse observes the client is restless and hears crackles in the lungs. Which of the following interventions should the nurse take?

64 :
A nurse is collecting data for an older adult client who has cystitis. Which of the following findings should the nurse expect? (Select all that apply)

65 :
A nurse is caring for a client who has been receiving epoetin alfa in preparation for a hip arthroplasty. Which of the following findings indicates that the medication has been effective?

66 :
A nurse enters a client's room and sees smoke coming from the trash can next to the client's bed. Which of the following actions should the nurse take first?

67 :
A nurse is caring for a client who has a distal radius fracture with a short arm cast applied. Which of the following actions should the nurse take?

68 :
A nurse is collecting data from a client who is experiencing opioid toxicity. Which of the following findings should the nurse expect?

69 :
A nurse is assisting with care for a client who received a tuberculin skin test 72 hours ago. When collecting data from the test site, which of the following findings indicates a need for further testing?

70 :
A nurse is transporting a client who has pneumonia and is on droplet precautions to radiology. Which of the following safety measures should the nurse take while transporting the client?

71 :
A nurse is reinforcing teaching with a client who has anemia and has a prescription for ferrous sulfate. Which of the following foods should the nurse recommend that the client consume to increase the absorption of this medication?

72 :
A nurse is assisting with the plan of care for a client who has botulism poisoning. Which of the following interventions should the nurse include in the plan?

73 :
A nurse is caring for a client who is postoperative following a total thyroidectomy for hyperthyroidism. Which of the following findings should the nurse identify as the priority?

74 :
A nurse is collecting data from an older adult client who has a potassium level of 3.2 mEq/L. Which of the following findings should the nurse expect?

75 :
A nurse is examining the abdominal wound of a client who is 3 days postoperative following a hemicolectomy. Which of the following findings indicates a wound infection?