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    Exam Review

    1. While caring for a client with a full thickness burn covering 40% of the body surface area (BSA), the nurse observes purulent drainage at the wound. Before reporting this finding to the healthcare provider, the nurse should note which of the client's laboratory values?
      A)Hematocrit.
      B)Neutrophil count.
      C)Serum blood glucose (BG) level.
      D)Serum albumin.
    2. A client with chronic obstructive pulmonary disease (COPD) smokes two packs of cigarettes per day and is admitted to the hospital for a respiratory infection. The client reports difficulty controlling respiratory distress at home when using the rescue inhaler. Which comment from the client indicates to the nurse that the client is not using the inhaler properly?
      A)"I always shake the inhaler several times before I start."
      B)"After I squeeze the inhaler and swallow, I always feel a slight wave of nausea, but it goes away."
      C)"I never use the inhaler unless I am feeling really short of breath."
      D)"I have a hard time inhaling and holding my breath after I squeeze the inhaler, but I do my best."
      E)None
      F)None
    3. When the nurse attempts to teach self-administration of insulin injections to a client who is newly diagnosed with type 1 diabetes mellitus (DM), the client tells the nurse in a loud voice to leave the room. Which action should the nurse take?
      A)Encourage client to implement relaxation techniques.
      B)Refer client to the social worker for support therapy.
      C)Leave the client's room and return later in the day.
      D)Explain that insulin is a life-saving drug for the client.
    4. A client is admitted with an exacerbation of heart failure secondary to chronic obstructive pulmonary disease (COPD). Which observation(s) by the nurse require immediate intervention to reduce the likelihood of harm to this client? Select all that apply.(SATA)
      A)A full pitcher of water is on the bedside table.
      B)A saline lack is present in the right forearm.
      C)A low sodium diet tray was brought to the room.
      D)A bedside commode is positioned near the bed.
      E)The client is lying in a supine position in bed.
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    Exam Review

    1. A client with metastatic cancer who was taking hydromorphone PO at home is now receiving the medication IV while in the hospital. To evaluate if the client is receiving an equianalgesic dose of the hydromorphone, which assessment should the nurse complete?
      A)Level of consciousness.
      B)Respiratory rate.
      C)Blood pressure.
      D)Pain scale.
    2. An older adult client is admitted with the medical diagnosis of possible cerebral vascular accident (CVA). The client has facial paralysis and cannot move the left side of the body. When entering the room, the nurse finds the client's spouse tearful and trying unsuccessfully to give the client a drink of water. Which action should the nurse take?
      A)Ask the spouse to stop and assess the client's swallowing reflex.
      B)Give the spouse a straw to help facilitate the client's drinking.
      C)Obtain thickening powder before providing any more fluids.
      D)Assist the spouse and carefully give the client small sips of water.
    3. A newly hired unlicensed assistive personnel (UAP) is assigned to a home healthcare team along with two experienced UAPs. Which intervention should the home health nurse implement to ensure adequate care for all clients?
      A)Assign the newly hired UAP to clients who require the least complex level of care.
      B)Review the UAP's skills checklist and experience with the person who hired the UAP.
      C)Ask the most experienced UAP on the team to partner with the newly hired UAP.
      D)Evaluate the newly hired UAP's level of competency by observing the UAP deliver care.
    4. A client is admitted with an exacerbation of heart failure secondary to chronic obstructive pulmonary disease (COPD). Which observation(s) by the nurse require immediate intervention to reduce the likelihood of harm to this client? Select all that apply.(SATA)
      A)A full pitcher of water is on the bedside table.
      B)A saline lack is present in the right forearm.
      C)A low sodium diet tray was brought to the room.
      D)A bedside commode is positioned near the bed.
      E)The client is lying in a supine position in bed.
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    Exam Review

    1. When providing client care, the nurse identifies a problem and develops a related clinical question. Next, the nurse intends to gather evidence so that the decision-making process in response to the problem and clinical question is evidence-based. When gathering evidence, which consideration is most important?
      A)Past experience with similar problems.
      B)Frequency that the problem occurs.
      C)Related personal values.
      D)Relevance to the situation.
    2. A parent brings their 2-month-old infant to the clinic to receive the recommended primary vaccines. Which instruction should the nurse provide the parent about care of the infant after the injections?
      A)Administer children's aspirin to help prevent inflammation.
      B)Keep the infant home from daycare for the next two days.
      C)Apply a cool pack to the injection site to reduce discomfort.
      D)Any level of fever is serious and should be reported right away.
    3. Which instruction should the nurse provide to a client who is preparing to have a cystoscopy?
      A)Report any painful urination, blood in urine, or fever.
      B)Lay prone for 24 hours after the procedure.
      C)Avoid strenuous activity and sports for at least 2 weeks.
      D)Report any allergies to shellfish or iodine.
    4. The nurse is preparing for discharge a client with a history of celiac disease who now has developed multiple sclerosis. Which instruction is most important for the nurse to include in the discharge teaching plan?
      A)Avoid extreme environmental temperatures.
      B)Increase daily intake of sodium in diet.
      C)Use a walker when weakness occurs.
      D)Take prescribed cortisone accurately.
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    Exam Review

    1. After years of struggling with weight management, a middle-aged adult client is evaluated for gastroplasty. The client has experienced difficulty with managing diabetes mellitus and hypertension, but is approved for surgery. Which intervention is most important for the nurse to include in this client's plan of care?
      A)Monitor for urinary incontinence.
      B)Observe for signs of depression.
      C)Provide a wide variety of meal choices.
      D)Apply sequential compression stockings.
    2. A client is admitted to the intensive care until (ICU) with a spinal cord injury following a motor vehicle collision. Which nurse should be contacted to coordinate the progression of the client's care?
      A)Adult nurse practitioner.
      B)Risk management nurse.
      C)Neurology unit. supervisor.
      D)Nurse case manager.
    3. The healthcare provider prescribes amoxicillin 5 grams PO daily, in equally divided doses to be administered every 8 hours. The medication is available in a bottle labeled, "Amoxicillin suspension 200 mg/5 mL." How many mL should the nurse administer every 8 hours? (Enter numeric value only. If rounding is required, round to the nearest tenth.)
    4. A client presents to the emergency department with nausea, vomiting, and diarrhea. While obtaining the history and physical assessment, the nurse discovers that the client's significant other is recovering from COVID 19. After obtaining a nasal swab to test the client for COVID 19, which action is most important for the nurse to take?
      A)Institute droplet precautions, place client in a private room, and keep the door closed.
      B)Explain to the client to inform others that they may have been potentially exposed in the last 14 days.
      C)Start an IV infusion for antiviral drug to be administered for positive COVID 19 test results.
      D)Counsel family members to monitor for illness symptoms for 2 weeks after last contact with patient.
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    Exam Review

    1. The healthcare provider prescribes a low-fiber diet for a client with ulcerative colitis. Which food selection indicates to the nurse that the client understands the prescribed diet?
      A)Baked potato with skin, raw carrots.
      B)Roast pork, fresh strawberries.
      C)Roasted turkey, canned vegetables.
      D)Pancakes, whole-grain cereals.
    2. A client has developed atrial fibrillation with a ventricular rate of 150 beats/minute observed via telemetry. The client's blood pressure is 80/40 mm Hg. Which finding is most important for the nurse to report to the healthcare provider?
      A)Abnormal level of consciousness.
      B)Headache with sudden onset.
      C)Nausea with vomiting.
      D)Flat jugular vein distention (JVD) at 45 degrees.
    3. The parent of a 7-month-old brings the infant to the clinic because the skin in the diaper area is excoriated and red, but there are no blisters or bleeding. The parent reports no evidence of watery stools. Which nursing intervention should the nurse implement?
      A)Ask the parent to decrease the infant's intake of fruits for 24 hours.
      B)Tell the parent to cleanse with soap and water at each diaper change.
      C)Encourage the parent to apply lotion with each diaper change.
      D)Instruct the parent to change the child's diaper more often.
    4. The nurse is teaching an older client about the prevention of osteoporosis. Which foods should the nurse recommend to the client to increase in the diet?
      A)Water and herbal teas.
      B)Fresh fruits and vegetables.
      C)Low fat dairy products.
      D)Iron-rich meats.
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    Exam Review

    1. The healthcare provider prescribes the antibiotic cefdinir 300 mg PO every 12 hours for a client with a postoperative wound infection. Which foods should the nurse encourage this client to eat?
      A)Fresh fruits.
      B)Green leafy vegetables.
      C)Yogurt or buttermilk.
      D)Avocados and cheese.
    2. A client who is receiving radiation treatment for laryngeal cancer has developed xerostomia and mucositis. The nurse determines the client has an imbalanced nutritional intake and is consuming less than body requirements. Which factor is the most likely cause for this problem?
      A)Nausea.
      B)Fatigue.
      C)Altered taste sensation.
      D)Pain when eating.
    3. In caring for a client who is receiving linezolid IV for nosocomial pneumonia, which assessment finding is most important for the nurse to report to the healthcare provider?
      A)Watery diarrhea.
      B)Increased fatigue.
      C)Nausea and headache.
      D)Yellow-tinged sputum.
    4. When developing a teaching plan for a client with newly diagnosed type 1 diabetes mellitus, the nurse should explain that an increased thirst is an early sign of diabetic ketoacidosis (DKA). Which action should the nurse instruct the client to implement if this sign of DKA occurs?
      A)Resume normal physical activity.
      B)Drink electrolyte fluid replacements.
      C)Measure urine output over the next 24 hours.
      D)Give a dose of regular insulin as prescribed.
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