Exam Review
- A nurse on a unit is assisting with the care of a group of clients. Which of the following observations by the nurse requires intervention?A)A nursing colleague printing material that does not obtain identifiable information from a client's electronic medical record (EMR) for professional use.B)A nursing colleague discussing a client's treatment plan with another nurse on the unit as part of the end-of-shift handoff report.C)A nursing colleague discussing a client's diagnosis with another staff member on the unit who is not involved in the client's care.D)A nursing colleague documenting vitals in the electronic medical record (EMR) of a client that the colleague is caring for.
- A nurse is assisting with the care of a client. Select the 3 findings that require immediate follow up(SATA)A)Heart rateB)Pedal pulsesC)Breath soundsD)Abdominal dressingE)Respiratory rateF)Oxygen saturation
- A nurse is assisting with the care of a client. Select the 3 findings that require immediate follow up(SATA)A)Heart rateB)Pedal pulsesC)Breath soundsD)Abdominal dressingE)Respiratory rateF)Oxygen saturation
- A nurse is assisting in the care of clients on a postpartum unit. Which of the following events should the nurse identify as needing to initiate a security alert for?A)A hospital volunteer leaves the unit with the newborn to allow caregiver to rest.B)Another nurse on the unit requests to take the newborn to the nursery to obtain newborn screeningC)An assistive personnel weighs and bathes the newborn in an empty client room.D)The caregiver and newborn have matching hospital identification bracelets
Page 1 of 44
Exam Review
- A nurse is assisting with the care of a client on an orthopedic unit. Drag words from the choices below to fill in each blank in the following sentence. The client is at risk for developing ▾ compartment syndromeand▾ osteomyelitisDropdown 1:Option 1: fat embolism syndromeOption 2: compartment syndromeOption 3: deep vein thrombosisOption 4: osteomyelitisDropdown 2:Option 1: fat embolism syndromeOption 2: compartment syndromeOption 3: deep vein thrombosisOption 4: osteomyelitis
- A nurse is caring for a client who is requesting assistance with smoking cessation. The nurse should anticipate a prescription for which of the following medications?A)DisulfiramB)MethadoneC)BupropionD)Naltrexone
- A nurse is discussing health practices with the mother of a toddler who is from a different cultural background than the nurse. Which of the following statements by the mother indicates that she practices cupping?A)“I insert needles into meridian lines of my child's body to help with pain relief.”B)"I rub the edge of a coin lengthwise on my child's back when he is sick."C)“I sometimes place a bottle containing steam against my child's skin."D)"I apply petroleum jelly with garlic along my child's wrist to treat infectious disease."
- A nurse is assisting in the care of an older adult client who was admitted from a long-term care facility. Select the 3 findings that require immediate follow-up.(SATA)A)Respiratory rateB)Oxygen saturation levelC)Chronic health conditionD)TremorsE)Current level of consciousnessF)Heart rate
Page 2 of 44
Exam Review
- A nurse on a mental health unit is assisting with the care of a client. Complete the following sentence by using the lists of options. The client is at risk for ▾ Suicideas evidenced by the client's▾ Suicidal ideation.Dropdown 1:Option 1: SuicideOption 2: Self mutilationOption 3: Substance abuseDropdown 2:Option 1: Suicidal ideationOption 2: Acute stress disorderOption 3: Borderline personality disorder
- A nurse is reinforcing teaching with a parent of a child who has asthma about the administration of montelukast. Which of the following statements by the parent indicates an understanding of the teaching?A)" I will give this medication to my child once daily in the evening."B)"I will give this medication to my child every 2 hours if he is wheezingC)"It takes 2 months of scheduled use before this medication is effective."D)"I can stop giving my child this medication if he is taking a steroid,"
- A nurse is reinforcing discharge teaching with the caregiver of a client who has dependent personality disorder. Which of the following Instructions should the nurse include in the teaching?A)Limit the client's social interactions.B)Maintain a verbal no harm contract with the clientC)Assume responsibility for making the clients decisions.D)Encourage the client to be assertive
- A nurse is reinforcing teaching with a newly licensed nurse about caring for a client who has a history of dysphagia. Which of the following instructions should the nurse include in the teaching?A)Provide thin liquids to help the client swallowB)Give the client a straw to use for drinkingC)Place oral suction equipment next to the client's bedsideD)Use a needleless syringe to instill feedings.
Page 3 of 44
Exam Review
- A nurse is assisting in the care of a client suspected of having a tuberculosis infection. Which of the following personal protective equipment should the nurse wear when in the client's room?A)GownB)GlovesC)Dosimeter badgeD)N95 respirator
- A nurse is collecting data from a client who is 2 days postoperative following abdominal surgery. Which of the following findings is a manifestation that can indicate an infection?A)Pain rating of 4 on a scale of 0 to 10B)Temperature of 37.2° C (99.0°F)C)increased urinary outputD)Elevated WBC count
- A nurse is assisting in the care of a group of clients. For which of the following client events should the nurse complete an incident report?A)A client has difficulty voiding following the removal of an indwelling catheterB)A client reports nausea following the administration of morphine.C)A client who has type 2 diabetes mellitus did not eat their breakfastD)A client's arm is edematous at the peripheral IV site.
- A nurse is assisting with the care of an 18-year-old client who was recently admitted. Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.✓Focus on the client's underlying feelings of dysphoria and lack of control.✓Provide a structured meal environment.✓Anorexia nervosa✓Cardiac function with ECG✓Weight on a daily basisActions to Take Choices✓Focus on the client's underlying feelings of dysphoria and lack of control.✕Encourage the client to limit fasting✓Provide a structured meal environment.✕Accept the client's belief about "forbidden" foods.✕Provide the client with foods that have a variety of texturesPotential Condition Choices✕Bulimia nervosa✓Anorexia nervosa✕Avoidant/restrictive food intake disorder✕Binge eating disorderParameters to Monitor Choices✕Calcium level✕Vital signs every 8 hrs✓Cardiac function with ECG✕Behavior 15 min after meals✓Weight on a daily basis
Page 4 of 44
Exam Review
- A nurse is assisting with the care of client in a clinic. Based on the information in the client's medical record, which of the following findings require immediate follow-up? Select the 4 findings that require immediate follow-up by the nurse.(SATA)A)Witnessing the death of their parents and siblingB)Attends school regularlyC)Client experiences nightmaresD)Blood pressure 122/80 mm HgE)Heart rate 99/minF)Startles easy during thunderstormG)Friend reporting client is not themselvesH)Smoking marijuana to clear their mind
- A nurse is talking with a client who refuses a blood transfusion for religious reasons. Which of the following responses should the nurse make?A)"You have a right to change your mind."B)“I’m sure that everything will be all right, regardless of your decision”C)“If I were you, I would contact your spiritual director.”D)“Making this decision is wrong”
- A nurse is assisting with the care of a client Drag 1 condition and 1 client finding to fill in each blank in the following sentence. The client is at risk for developing▾ serotonin syndrome due to▾ adverse effects of paroxetine.Dropdown 1:Option 1: AgoraphobiaOption 2: bulimiaOption 3: maniaOption 4: serotonin syndromeOption 5: hypertensive crisisDropdown 2:Option 1: abdominal painOption 2: recent fallOption 3: adverse effects of paroxetineOption 4: anxietyOption 5: feelings of hopelessness
- A nurse is assisting with the care of a client. The nurse is collecting data from the client. Drag words from the choices below to fill in each blank in the following sentence. The nurse should identify that ▾ emotional labilityand ▾ fear of abandonmentindicate manifestations of borderline personality disorder.Dropdown 1:Option 1: elevated body temperatureOption 2: tactile hallucinationsOption 3: emotional labilityOption 4: increased heart rateOption 5: fear of abandonmentDropdown 2:Option 1: elevated body temperatureOption 2: tactile hallucinationsOption 3: emotional labilityOption 4: increased heart rateOption 5: fear of abandonment
Page 5 of 44
Exam Review
- A nurse is reinforcing teaching with the family of a client who is terminally ill about the grief process. Which of the following information should the nurse include in the teaching?A)"The grieving process should be complete within 1 year."B)"Anger toward the health care staff is expected."C)"The stages of grief occur in sequential order"D)"Anticipatory grieving prolongs the grief process”
- A nurse is contributing to the plan of care for a client who has ascites due to cirrhosis. Which of the following interventions should the nurse recommend to include in the plan?A)Measure the client's abdominal girth day.B)Position the client supine with legs elevatedC)Restrict the client's sodium intake to 3 g per dayD)Keep the client's daily protein intake below 0.8 g/kg
- A nurse is reinforcing teaching about hand hygiene with a newly licensed nurse. Which of the following information should the nurse include in the teaching?A)Apply friction to hands for 10 seconds.B)interface the fingers while rubbing hands together.C)Dry hands starting from forearm to fingers.D)Use hot water to wash hands.
- A nurse is assessing a client two weeks postpartum. Which of the following statements by the client indicates a need for further evaluation?A)“I am so relieved the baby looks like my mother."B)"My appetite has really increased."C)"My labor was so long. I'm glad it's over."D)"I really wish I had a girl instead”
Page 6 of 44