1.A nurse is assessing a client who received 2 units of packed RBCs 48 hrs ago. Which of the following findings should indicate to the nurse that the therapy has been effective?
2.A nurse working in a n emergency depa
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1.A nurse is assessing a client who received 2 units of packed RBCs 48 hrs ago. Which of the following findings should indicate to the nurse that the therapy has been effective?
2.A nurse working in a n emergency department is triaging four clients. Which of the following clients should the nurse recommend for treatment first?
3.A nurse is preparing t o administer mannitol 0.2g/kg IV bolus over 5 min as a test dose to a client who has severe oliguria. The client weighs 198lb. What is t he amount in grams the nurse should administer?
4.A nurse is conduction a physical examination for an adolescent and is assessing the range of motion of the legs. W hich of the following images indicates the adolescent is abducting the hip joint?
5. A nurse is caring for a c lient who has hyperthyroidism. Which of the following findings should the nurse expect?
6.A nurse is assessing a school-aged child who has bacterial meningitis. Which of the following findings should the n urse expect?
7. A nurse is assessing a newborn’s heart rate. Which of the following actions should the nurse take?
8.A nurse is preparing t o assist with a thoracentesis for a client who has pleurisy. The nurse should plan to perform which of the following actions?
9.A nurse in the ED is a ssessing a preschooler who has a facial laceration. The nurse should identify which of the f ollowing findings as a potential indication of child sexual abuse?
10. A nurse is preparing t o teach about dietary management to a client who has Crohn’s disease and an enteroenteric f istula. Which of the following nutrients should the nurse instruct the client to decrease in their d iet
11.
A nurse is caring for a c lient who has a prescription for a continuous passive motion (CPM) machine following a total knee arthroplasty. Which of the following actions should the nurse take?
12.
A nurse is preparing t o initiate IV access for an older adult client. Which of the following sites should the nurse select when initiating the IV for the client?
A nurse preceptor is evaluating the performance of a newly l icensed nurse. Which of the following actions by the n ewly licensed nurse requires intervention by the preceptor?
Starts a task then determine what supplies a re needed.
The preceptor should intervene and instruct the newly licensed nurse to gather supplies before performing client tasks to practice effective time management.
A nurse manager is preparing an educational session about advocacy for a group of nurses. The nurse manager s hould include which of the following i nformation in the teaching?
Advocacy is a leadership role that helps others to self-actualize.
The nurse manager should teach that advocacy is a leadership role that can help others to grow personally and professionally through self-actualization.
A nurse is admitting a client who has pneumonia. The nurse should initiate which of the following isolation precautions for the client?
Droplet
The nurse should initiate droplet precautions for this client by placing the client in a private room and wearing a surgical mask when caring for the client. Pneumonia is transmitted by droplet particles.
A nurse has just received change of shift report on four clients. Which of the following clients should the nurse assess first?
A client who is postoperative with abdominal distention and no bowel sounds.
Using the acute vs chronic approach to client care, the nurse should first assess the client who is postoperative with abdominal distention and no bowel sounds because these manifestations are an indication of paralytic i leus.
During a change of shift report, a night shift nurse informs the day shift nurse that a newly admitted client was d isoriented and combative during the night. Which of the following actions should the day shift nurse take?
Move the client to a room near the nurses’ station.
The day shift nurse should move the client to a room near the nurses’ station to enhance the staff’s ability to keep the client under frequent observation.
A nurse is reviewing the laboratory results of a toddler who has hemophilia A. Which of the aPTT values should the nurse expect?
45 seconds
This value is above the expected reference r ange of 30-40 seconds and indicates a risk for spontaneous bleeding, which is a manifestation of hemophilia A.
A nurse is planning care for a client who has rheumatoid arthritis. Which of the following interventions should the nurse include in the plan?
Increase the client’s dietary iron intake.
Clients who have rheumatoid arthritis require foods h igh in protein, vitamins, and iron to promote tissue repair. The nurse should encourage the client to increase their intake of dietary iron.
A nurse is an outpatient mental health facility i s assessing a child who has autism spectrum disorder. Which of t he following manifestations should the nurse expect?
Strict adherence to routines
The nurse should identify that a child who has autism spectrum disorder can exhibit strict adherence to routines or rituals, a fixation to specific objects, and resistance to change.
A nurse is caring for a c lient who had a stroke 6 hr ago. Which of the following interventions should the nurse implement to reduce the risk of increased intracranial pressure (ICP)?
Place the client in a quiet environment.
The nurse should keep the client’s environment quiet to minimize the risk of increasing ICP.
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