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70 Cards in this Set
- Front
- Back
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The father of the 1-day-old son works the evening shift (1500-2300)at another hospital. Which plan is the priority to meet the needs of thisfather? |
1. Encourage the father to call his wife after work.
2. Instruct the father about visiting policy and suggest AM visitation. 3. Adjust visiting hours to meet the new parents’ needs. 4. Present a change of visiting hours to the appropriate hospital committee. |
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The nurse believes a co-worker is diverting narcotics for personal consumption.The nurse approaches the nurse manager to report the suspicions. Which statementby the nurse is BEST? |
1. "After my co-worker has been on duty, the clients often need repeated doses of pain medication. I have seen them sleeping on duty three times."
2. "I saw my co-worker downtown after work. They were acting really strange, like they didn’t even recognize me." 3. "I think my co-worker is stealing narcotics because they are always acting euphoric and seem high." 4. "My co-worker is hanging around with drug dealers, and I think I saw tracks on their arms." |
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The client diagnosed with chronic obstructive pulmonary disease (COPD)is admitted with an acute exacerbation. The client's vital signs are B/P 162/100,pulse 78, respirations 30 and labored with wheezing. The nurse should questionwhich order? |
Select all that apply:
1. Theophylline 0.7 mg/kg/h IV. 2. Tetracycline hydrochloride 250 mg IM qd. 3. Ipratropium bromide inhaler 2 inhalations qid. 4. Propranolol hydrochloride 40 mg PO bid. 5. IV of Normal Saline at 200mL per hour. |
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A husband and wife meet at the mental health clinic to make an appointmentfor family therapy. Suddenly, the wife begins to sob loudly. As the nurseapproaches, the husband says, "I guess we just don’t get along." Whichresponse by the nurse is most appropriate? |
1. "Your wife seems to be upset by the situation."
2. "Perhaps you should both go home now." 3. "Try to think about what precipitated her crying." 4. "The situation is difficult for both of you." |
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The nurse cares for the client receiving chemotherapy. The client hasa WBC count of 1,200/mm3(1.2 x 109/L).Which action should the nurse take first? |
1. Check temperature q4h.
2. Monitor urine output. 3. Assess for bleeding gums. 4. Obtain an order for blood cultures. |
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A woman is in active labor with her first child when her membranes rupture.She voices concern to the nurse that she is afraid of having a "dry labor."Which response by the nurse is most appropriate? |
1. "The amniotic fluid provides only minimal lubrication for the labor process."
2. "The amniotic sac may impede the progress of labor and is often ruptured artificially." 3. "Labor is only slightly more difficult with early rupture of the amniotic sac." 4. "Because there is limited amniotic fluid, additional fluids will be supplied." |
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The nurse performs an ice massage for the client in chronic pain. Thenurse is most concerned if whichfinding is observed? |
1. Redness or inflammation of the tissue.
2. Mottling or graying of the tissue. 3. The client states that they feel a burning and tingling sensation in the area. 4. The client states that they feel a numbness and a cold sensation in the area. |
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The nurse cares for the client with this cardiac rhythm strip. |
The nurse should question which order? 1. Administer lidocaine 50 mg IV push for PVCs inexcess of six per minute.2. Administer atropine sulfate 0.05 mg IV for symptomatic bradycardia3. Anticipate scheduling the client for a temporary pacemakerif the pulse continues to decrease.4. Mix 10 ml of 1:5,000 solution of isoproterenol in 500 ml D5Wfor sustained bradycardia below 30. |
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The nurse cares for the client who had a cholecystectomy. Which observationis most important for the nurseto report to the next shift? |
1. Resting after receiving IM pain medication.
2. No bowel sounds present. 3. IV infusing at 100 ml/h. 4. Breath sounds decreased in both lower lobes. |
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The nurse in the outpatient clinic plans care for the older client withleft-sided weakness due to a stroke. The client has a history of hypertensionand osteoporosis. It is most importantfor the nurse to encourage the client to increase which implementation? |
X |
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The nurse visits the young adult at home with a diagnosis of hepatitisA. Which statement, if made by the client to the nurse, indicates that furtherteaching is needed? |
Select all that apply: 1. "I have been very careful to wash my hands after I go to thebathroom."2. "I have had to take acetaminophen several timesthis week for this sinus infection I have." 3. "I have been very careful not to handle my child’s toysor eating utensils."4. "My husband has been preparing all of the meals since I’vebeen sick."5. "My spouse had the Hep B vaccine so they aresafe." 6. "I have to sleep in a separate room from my spouse." |
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The nurse is caring for a client in a manic phase of bipolar disorder.It is most important for the nurseto offer which meal? |
1. Tuna salad sandwich and orange slices.
2. Bologna sandwich and french fries. 3. Milkshake and banana. 4. Fried chicken and tossed salad. |
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Which action should the nurse instruct the client to complete first to establish a normal urinary pattern? |
1. Urinate every two hours.
2. Record each time the client urinates. 3. Keep a record of daily fluid intake. 4. Stay near a bathroom. |
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The nurse on the OB floor receives report about four pregnant womenin active labor. In which order should the nurse see the women? Place the answers in order of priority.All options must be used. |
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The nurse plans care for the client who had surgery for an ileal conduit2 days ago. It is most importantfor the nurse to take which action? |
1. Remove the appliance regularly, and clean the skin with antiseptic solution.
2. Apply a close-fitting drainage bag to the stoma. 3. Massage the skin around the stoma with an emollient. 4. Expose the area around the stoma to air twice a day. |
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Which nursing action is most appropriateafter intubating a postoperative client who had a respiratory arrest? |
1. Soak the intubation equipment in concentrated Betadine solution.
2. Place the intubation blade in a bag, and arrange for gas sterilization. 3. Soak the intubation blade in Cidex solution. 4. Wash the equipment with soap and water and allow to air-dry. |
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The nurse in the pediatrician’s office instructs the parents ofthe toddler about a scheduled magnetic resonance imaging (MRI). The nursetells the parents the child should be sedated using chloral hydrate priorto the MRI. The parents ask if they can administer the medication at homeso that the toddler will be asleep when they arrive at the hospital. Whichresponse by the nurse is most appropriate? |
is permissible."
2. "The medication should be administered at the hospital." 3. "The child should be awake when arriving at the hospital." 4. "Are you sure you can handle your sedated toddler?" |
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The nurse performs diet teaching for a client with a spinal cord injuryat S3. Which meal, if chosen by the client, indicates to the nurse that teachingis effective? |
1. Cheeseburger with tomato and onion.2. Spaghetti with meat sauce and green beans. 3. Tuna fish sandwich with orange juice. 4. Grilled cheese sandwich and chocolate pudding.
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The nurse screens the 8-month-old girl in a well-baby clinic. The nurseknows the parent understands growth and development if the parent makes whichstatement?
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Select all that apply: 1. "My daughter has almost doubled her birth weight."2. "When I walk in the room, my child smiles atme."3. "When she is around her grandpa, my child cries."4. "My daughter can't quite say "mama" yet."5. "My child should be able to do a large piece puzzle by now."6. "I will use a pillow to support her all the time." |
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The 16-year-old is brought by her parents to the outpatient clinic fortreatment of pelvic inflammatory disease (PID). While the nurse obtains ahistory, the client says bitterly, "My parents are mean and don’t reallycare about me." Which response by the nurse is best? |
1. "You feel your parents don’t care aboutyou?"2. "Your parents brought you to the clinic, didn’t they?"3. "I am sure that your parents have your best interests at heart."4. "Did you have a disagreement with your parents?"
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The client diagnosed with end-stage metastatic cancer of the breastis admitted to the hospital. It is most importantfor the nurse to take which action? |
1. Suction the client frequently.
2. Provide an air mattress. 3. Turn the client every two hours. 4. Give the client frequent baths. |
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One hour after receiving 7 units of regular insulin, the client presentswith diaphoresis, pallor, and tachycardia. Which action should the nurse take first? |
1. Notify the health care provider.
2. Call the lab for a blood glucose level. 3. Offer the client milk and crackers. 4. Administer glucagon. |
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The 11-month-old baby is having trouble gaining weight after dischargefrom the hospital. Which action by the nurse is best? |
1. Observe the child at mealtime.
2. Inquire about the child’s eating patterns. 3. Weigh the baby each month. 4. Attempt to feed the baby for the mother. |
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The client recieves chlorpromazine 400 mg/day for four weeks. The clientexperiences an oral temperature of 105°F (40.5°C), severe rigidity,oculogyric crisis, and severe hypertension. It is most importantfor the nurse to take which action? |
1. Administer PRN benztropine mesylate immediately.
2. Hold the chlorpromazine, and notify the health care provider stat. 3. Place the client in isolation on bedrest in semi-Fowler’s position. 4. Administer acetaminophen 500 mg, and place the client on a cooling mattress. |
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The client comes to the clinic for a glycosylated hemoglobin assay (HbA1c).The result is 6%. The nurse should take which action? |
1. Document the findings in the chart.
2. Call the health care provider about orders to adjust the insulin dosage. 3. Give the client 15 g of carbohydrates. 4. Ask the client to list the foods eaten in the last 24 hours. |
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The school-aged child informs the school nurse that the right knee "doesn’tfeel right." Which action should the nurse take first? |
1. Instruct the child to extend the right leg.
2. Put both of the child’s legs through range of motion. 3. Advise the child to soak the right knee in warm water. 4. Compare the appearance of the right knee with the left knee. |
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The nurse cares for the client receiving treatment for hypoparathyroidism.The nurse determines that treatment is successful if which finding is observed? |
1. The client’s output is 1,500 ml of clear, straw-colored urine.
2. The client is unable to state his name. 3. The client denies numbness and tingling. 4. The client loses 3 lb in 1 week. |
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The nurse in the newborn nursery receives report from the previous shift.In which order should the nurse see the infants? Place the answers in order ofpriority. All options must be used. |
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The nurse plans care for the client with Graves' disease. The nurseshould intervene if the client drinks which fluid? |
Select all that apply:
1. Iced coffee. 2. Diet Cola. 3. Orange juice. 4. Hot tea. 5. Apple Juice. 6. Milk. |
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After the anesthesiologist administers an epidural to a woman in labor,which nursing action has the highest priority? |
1. Decrease IV fluids.
2. Assess the fetal heart monitor. 3. Place the mother on her right side. 4. Obtain the blood pressure. |
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The client visits the rape-crisis clinic one week after being assaulted.The client is currently taking alprazolam 0.25 mg PO q 6 hours for anxiety.Which statement, if made by the client to the nurse, reflects a correct understandingof this medication? |
Select all that apply:
1. "I will make an appointment when I want to stop taking this." 2. "I should not take this with anything but water." 3. "I guess I need to stop drinking white wine." 4. "This medication will help me forget and go on." 5. "I can take it whenever I feel upset." |
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The nurse cares for clients in a rehabilitation facility. The nursingteam reports a client recovering from a hip fracture has repeatedly "transferredherself to the floor." Which action, if taken by the nurse, is best? |
1. Place the call light within the client’s reach.
2. Remove the footrests from the wheelchair. 3. Observe the client rise from a sitting to a standing position. 4. Place a Posey vest restraint on the client. |
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The client had a thoracotomy three hours ago. For the past two hours,there has been 100 ml/hour of bloody chest drainage. Which action should thenurse take first? |
1. Increase the IV fluid rate.
2. Administer oxygen at 5 L/minute per oxygen mask. 3. Elevate the head of the bed. 4. Advise the health care provider (HCP) of the amount of drainage. |
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While the client is receiving parenteral nutrition (PN), it is most important for the nurse to monitor whichsigns and symptoms? |
1. Vital signs and level of consciousness.
2. Arterial blood gases and liver enzymes. 3. Serum glucose and electrolytes. 4. Skin turgor and daily weights. |
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The health care provider prescribes ciprofloxacin for the client. Whichinstruction should the nurse include about this medication? |
Select all that apply.
1. "Drink plenty of fluids." 2. "You may take this medication with your multivitamin." 3. "Eliminate dairy products from your diet." 4. "Always take this medication with meals." 5. "You should avoid exposure to the sun while on this medication" 6. "Try to avoid caffeine while you take this medication." |
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The nurse on postpartum prepares four clients for discharge. It is most important for the nurse to refer whichclient for home care? |
1. A 15-year-old who vaginally delivered a 7-lb male 2 days ago.
2. An 18-year-old multipara who delivered a 9-lb female by cesarean section 2 days ago. 3. A 20-year-old multipara who delivered 1 day ago and reports cramping. 4. A 22-year-old who delivered by cesarean section and reports burning on urination. |
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The client is to receive regional anesthesia (spinal anesthesia) duringsurgery. Which finding is the most importantnursing implication regarding this anesthesia? |
1. Adequately hydrate the client. 2. NPO client for at least 12 hours. 3. Assess the client for any allergies to iodine preparations.4. Determine the specific gravity of the urine.
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The client has a cataract removed from the left eye. Which action isimportant for the nurse to take in the immediate postoperative period? |
Select all that apply. 1. Position the client on the right side with thehead slightly elevated. 2. Place the client on the left side to protect the eye. 3. Perform sensory neurological checks every two hours. 4. Maintain complete bedrest for the first 48 hours. 5. Assess client's level of consciousness.6. Asses client knowledge of home care. |
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The client diagnosed with a tumor of the pituitary gland has a transsphenoidalhypophysectomy. The nurse plans care for the client two days after surgery.It is most important for the nurse to monitor which finding? |
1. Complete blood count (CBC).
2. Temperature. 3. Specific gravity of urine. 4. Intracranial pressure. |
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The client has an order for hydrochlorothiazide 50 mg qd. The nurseknows that further teaching is needed if the client makes which statement? |
Select all that apply.
1. "I should not operate heavy machinery." 2. "I should drink five glasses of liquid per day." 3. "This medication will cause my urine to turn orange." 4. "I should eat dried apricots each day." 5. "I should take this medication on an empty stomach |
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A LPN/LVN contacts the nurse to say that they have shingles on theirback. Which statement by the nurse is best? |
1. "You can’t take care of clients for 14 days."
2. "Come to work as scheduled." 3. "You can’t care for clients until the lesions are crusted." 4. "Please contact your health care provide." |
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The infant of a mother diagnosed with diabetes has a blood glucose of90 mg/dL (5 mmol/L) and a total serum calcium level of 7.0 mg/dL (1.8 mmol/L).The nurse should anticipate that which medication would be administered IV? |
1. Insulin.
2. Glucose. 3. Phenobarbital. 4. Calcium gluconate. |
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The nurse performs hypertension screening at the local grocery store.It is most important for the nurseto complete which task? |
1. Use a blood pressure cuff that overlaps the arm at least 4 inches.
2. Support the client’s arm above the level of the heart. 3. Take two readings at least five minutes apart. 4. Take the blood pressure after the client has exercised for 10 minutes. |
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Which finding indicates that a client is beginning to develop a trustingrelationship with the nurse? |
1. The client describes delusions to the nurse.
2. The client can describe his/her feelings to the nurse. 3. The nurse feels more comfortable with the client. 4. The client reports feeling less anxious. |
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The nurse cares for the client with a long leg cast on the right leg.The nurse notes that the right foot is pale and cool to the touch, and theclient continues to report pain even though an analgesic was administered45 minutes ago. Which action should the nurse should take first? |
1. Apply a heating pad to the client’s right toes.
2. Repeat the dose of the analgesic stat. 3. Remove the cast immediately. 4. Notify the health care provider immediately. |
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The nurse cares for the client after dental surgery. The dentist prescribesibuprofen 600 mg PO. The nurse is most concernedif the client makes which statement? |
1. "I was treated for a peptic ulcer two years ago."
2. "I had a transurethral resection of the prostate (TURP) last year." 3. "I attend Weight Watchers." 4. "I have been having problems with gout." |
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The nurse obtains a health history from the client in the medical clinic.The client states, "I think I have an ulcer." Which response by the nurseis best? |
1. "Do you have a burning pain in the epigastric region?"
2. "Do you have sharp pain in your lower abdomen?" 3. "Do you have right shoulder pain with vomiting?" 4. "Do you have heartburn when you lie down?" |
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The nurse cares for the neonate diagnosed with an infection. The nurseis most concerned if which findingis observed? |
1. Heart rate of 150 bpm.
2. Axillary temperature of 96°F (35.5°C). 3. Weight increase of 4 oz. 4. Respiratory rate of 65 at rest. |
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The psychiatric client admitted involuntarily asks the nurse to maila letter to the President. The client states that the letter will make thePresident regret his actions to prevent homosexuals from serving in the military.Which response by the nurse is best? |
1. Accept the letter and place it in the client’s medical record.
2. Read the client’s letter and decide if it is appropriate to mail. 3. Call the client’s health care provider and inform them of the letter. 4. Discourage the client from sending the letter, but mail it if client insists. |
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During administration of oral medications to an elderly, confused client, the client states, "These pills look funny. They belong to the lady down the hall." Which is the BEST response by the nurse?
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1. "Your health care provider has ordered new medications for you. They will help you get well."
2. "Remember yesterday when I brought your medications? They look the same." 3. "I’ll explain why you are receiving these medications." 4. "I’ll be back after I check your medications again." |
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The nurse discusses symptoms of the onset of labor with the 26-year-oldprimipara. Which statement, if made by the client to the nurse, indicatesthe client understands the teaching? |
Select all that apply.
1. "I will note an increase in fetal movement." 2. "I may feel a gush of fluid run down my legs." 3. "I may see some blood in my vaginal discharge." 4. "I may experience a low backache." 5. "Labor contractions are always evenly spaced apart." |
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At a health-screening clinic, an adult male client’s total plasmacholesterol level is 200 mg/dL (5.2 mmol/L). Which action by the nurse isBEST? |
1. Refer the client to the health care provider for appropriate medication.
2. Refer the client to the dietitian. 3. Obtain a diet history. 4. Recheck the cholesterol level in two years. |
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When working with an adolescent diagnosed with hypertension and obesity,it is most important for the nurseto make which suggestion? |
1. Avoid participating in organized sports.
2. Join an adolescent weight reduction support group. 3. Limit socialization with friends of normal weight. 4. Adhere to a 1,000-calorie low-fat diet. |
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The nurse cares for a client immediately after an abdominal aortic aneurysmrepair. Vital signs are blood pressure 100/70, pulse 120, respirations 24,urine output 75 ml during the past three hours. Which action is a priority for this client? |
1. Weigh the client.
2. Obtain an EKG. 3. Decrease the rate of the IV fluids, and start nasal oxygen. 4. Maintain bedrest, and evaluate for a decrease in CVP readings. |
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The nurse performs teaching for a client receiving isoniazid 300 mgPO daily. The nurse identifies that teaching is successful if the client makeswhich statement? |
1. "My urine will turn brown."
2. "I will take this medication for two weeks." 3. "I shouldn’t take any other medication while taking this drug." 4. "I should not drink any alcoholic beverages." |
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An adolescent is admitted for insertion of a Harrington rod due to scoliosis.In preparation for the immediate postoperative care, the nurse should includewhich information in the teaching plan for this client? |
1. Take 10 deep breaths every 2 hours.
2. Get on the bedpan by lifting the hips. 3. Soft diet as tolerated. 4. Elevate legs 10 times every 4 hours. |
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The nurse learns that a staff member providing care to the client diagnosedwith cytomegalovirus is in early pregnancy. Which action, if taken by thenurse, is best? |
1. Reassign the pregnant staff member to care for other clients.
2. Instruct the staff member to contact her health care provider. 3. Ask the staff member how she is feeling about her pregnancy. 4. Ensure that the staff member follows standard precautions. |
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The nurse encounters a client diagnosed with psychosis coming out ofthe room nude. Which response by the nurse is best? |
1. "Come with me. You need to get dressed."
2. "Why are you coming into the hallway undressed?" 3. "Being naked in the hallway is inappropriate. Return to your room to get dressed." 4. "Do I need to get a male nurse to help you get dressed?" |
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The client on suicide precautions asks for a razor to shave her legs.When the nurse tells the client that she must remain with the client, theclient responds, "Don’t you trust me?" Which response by the nurse is best? |
1. "It is against hospital policy to allow clients on suicide precautions to have razors unsupervised."
2. "I trust you, but your health care provider said a nurse has to watch you if you want to shave your legs." 3. "Wouldn’t you rather wait until you are feeling better before you try to shave your legs?" 4. "You have been having thoughts about wanting to hurt yourself recently, so I’ll stay with you." |
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The 76-year-old woman has a medical history that includes hypertensionwith cardiac involvement. A public health nurse visits this client regularlyand on each visit records vital signs. Which finding should the nurse expectfor this client? |
Select all that apply.
1. Pulse 110 2. Blood pressure 120/80. 3. Temperature 99.8°F (37.7°C) 4. Temperature 98.6°F (37°C) 5. Pulse 80 6. Blood pressure 150/85 |
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The 74-year-old man is brought by his daughter to the emergency room.When asked his name, he is unable to remember it and appears to be disheveled,restless, and confused. His daughter says that she has been caring for himat home for the last year, but he "ran away" after they had an argument abouthis deteriorating personal hygiene. She found him several hours later sittingin the street. She confides to the nurse that she feels horrible about yellingat her father. Which is the best responseby the nurse? |
1. "We all do things that we are sorry for later."
2. "Don’t feel guilty because he is confused." 3. "Your father’s illness must be difficult for both of you." 4. "The social worker will be able to help you with this problem." |
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The nurse supervises care of a group of children in a day care facility.The nurse should intervene in which situation? |
1. A 4-year-old is given paper to write to a pen pal.
2. A 7-year-old is playing with an electric train set. 3. A 9-year-old is performing magic tricks for his friends. 4. A 12-year-old discusses collecting canned goods for the holidays. |
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The client who is terminal is on a unit with limited visiting hoursthat restrict children younger than 12 years of age from visiting. Which nursingaction has the highest priority? |
1. Explain the visiting hours to the client’s family.
2. Propose a policy change to the medical and nursing staff. 3. Allow flexibility with family members’ visitation. 4. Encourage the family to call the unit between visiting hours. |
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The client is diagnosed with otosclerosis and is admitted for a stapedectomy.It is most important for the nurseto ask which question? |
1. "Have you noticed fluid draining from your left ear?"
2. "Have you had problems hearing for your entire life?" 3. "Did you require speech therapy when you were a child?" 4. "When did you notice that your hearing was impaired?" |
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The nurse obtains a health history from the client taking phenytoinsodium. It is MOST important for the nurse to report which client statementto the health care provider? |
1. "I’ve had several ‘blackouts’ in the past year."
2. "My mother has seizures, and this medication does not work for her." 3. "I don’t know when I had my last menstrual period." 4. "I took this medicine several years ago but stopped when my urine turned pink." |
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The client is treated for the deep venous thromboembolism with IV unfractionatedheparin. The nurse is concerned if which finding is observed? |
Select all that apply. 1. Increased anxiety.2. Decreased heart rate.3. Increased activated partial thromboplastin time (aPTT).4. Decreased level of consciousness.5. Client takes Ginkgo for memory.6. Small pinpoint red marks are noted on the client'sarms. |
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The nurse cares for the client diagnosed with a stroke with right-sidedparalysis. It is MOST appropriate for the nurse to take which action? |
1. Insert a Foley catheter.
2. Assist the client to ambulate three times per day. 3. Determine if assistance is needed with feeding. 4. Position the client on the right side. |
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The client begins taking haloperidol 5 mg tid. It is MOST importantfor the nurse to share which information with the client? |
1. "Do not eat aged cheese, beer, or red wine."
2. "Rise slowly when standing." 3. "Suck on hard candy." 4. "Avoid pretzels, potato chips, and carbonated beverages." |
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A nursing student with a history of breast cancer reports to the nurseon the unit that the nursing student has just developed shingles on theirtrunk. Which action by the nurse is best? |
1. Suggest that the nursing student contact their health care provider.
2. Assign the nursing student to clients that are not high risk. 3. Inform the nursing student that they cannot care for clients. 4. Restrict the nursing student from performing invasive procedures. |
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The nurse explains the use of transcutaneous electrical nerve stimulation(TENS) to the client diagnosed with sciatica. Which action, if performed bythe client, indicates to the nurse that further teaching is necessary? |
Select all that apply.
1. The client applies a conducting gel before applying the electrodes. 2. The client places the electrodes on the side of the body opposite from the painful area. 3. The client turns up the voltage until they feels a prickly "pins and needles" sensation. 4. The client adjusts the voltage based on the relief of pain she/he experiences. 5. The client turns up the voltage until mild twitching of the extremity begins. 6. The client turns on the unit before applying the electrodes. |
