A nurse is preparing to mix short-acting and intermediate-acting insulin in one syringe to
administer to a client who has type 1 diabetes mellitus. Identify the sequence the nurse
should follow. 1: Draw up the volume o
...
A nurse is preparing to mix short-acting and intermediate-acting insulin in one syringe to
administer to a client who has type 1 diabetes mellitus. Identify the sequence the nurse
should follow. 1: Draw up the volume of insulin from the intermediate-acting
insulin vial.
2: Inject the volume of air equal to the amount of insulin to withdraw from the
intermediate-acting insulin vial.
3: Inject the volume of air equal to the insulin dose form the short-acting insulin vial
4: Withdraw the prescribed amount of insulin form the short-acting insulin vial.
5: Withdraw the prescribed amount of insulin form the intermediate-acting insulin vial.
A nurse is assessing a client who wears partial dentures and reports mouth pain. Which
of the following actions should the nurse take? Advise the client to rinse their mouth
and dentures after each meal.
A nurse is planning care for a client who has dysphagia and is at risk for aspiration.
Which of the following referrals should the nurse make? Speech-language
pathologist
A nurse is planning teaching for a client who has a new diagnosis of type 2 diabetes
mellitus. Which of the following actions should the nurse take prior to performing the
teaching? (select all that apply) - Establish the client's learning needs
- Determine the client's literacy level
- Evaluate the client's readiness for learning
- Identify the client's learning style
A nurse is preparing to notify the provider about a change in a client's status. Which of
the following information should the nurse plan to include in the "background" portion of
the SBAR communication tool? Previous treatments
A nurse is providing discharge teaching to a client who has a new prescription for home
oxygen therapy utilizing a compressed oxygen system. Which of the following
statements by the client indicates an understanding of the teaching? "I will store
oxygen tanks in an upright position"
A nurse is caring for a client who has terminal cancer. The client begins to cry and says,
"I am afraid of dying." Which of the following responses should the nurse make? "It
must me a very difficult time for you."
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A nurse is assessing a client's coping skills. Which of the following should the nurse
identify as an internal stressor? Fear of medical test results
A nurse is performing postmortem care for an older client who had just died. Which of
the following actions should the nurse take? Identify the client using two identifiers
A nurse has administered 5 mL of medication to a client via NG tube. Then used 30 mL
of water to flush the tue both before and after the instillation. the nurse should document
which of the following amounts as liquid intake for the client? 65 mL
A nurse is performing a family assessment for a client who has recently developed
paraplegia following a stroke. Which of the following actions should the nurse take first?
Determine how the client views the concept of family
A nurse is caring for a client who reports having insomnia due to increased stress.
Which of the following actions should the nurse take first? Determine the source of
the client's stress
A nurse is caring for a client who had a stroke and is immobile. Which of the following
actions should the nurse take to maintain the client's skin integrity? Use an alcohol-free
barrier product
A nurse receives a telephone prescription form the provider, who states, "four milligrams
of morphine diluted with 5 milliliters of sterile water intravenous each morning at nine
o'clock before client dressing changes." Which of the following entries by the nurse
indicates correct transcription of the prescription? Morphine 4 mg IV bolus daily at
0900 before dressing change, dilute medication with 5 mL of sterile water
A nurse in a long-term care facility is planning to use therapeutic tough for a group of
selected clients who have chronic pain. The nurse should identify that the use of
therapeutic touch is contraindicated for which of the following patients? A client who
has chronic back pain and a history of physical maltreatment
A nurse is preparing to delegate task for multiple clients at the beginning of the shift.
Which of the following tasks should the nurse delegate to an assistive personnel (AP)?
Assist a client with ambulation
A home health nurse is making an initial assessment visit to an older client who has
type 1 diabetes mellitus. Which of the following statements should the nurse make to
evaluate the clients ability ot measure blood glucose accurately? "Please use your
glucometer and show me the results."
A nurse is caring for a client who has an ankle sprain and a prescription for an
aquathermia pad. Which of the following actions should the nurse take? Cover the
pad with a pillowcase before application.
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A nurse is preparing to administer drops to a client. Which of the following actions
should the nurse take? Rest the non-dominant hand on the clients forehead while
instilling the drops.
...using progressive relaxation techniques. Which of the following statements by the
client indicates an understanding of the teaching? "I'll compare the sensations I feel
when I tense my muscles to what I feel when I relax them."
A home health nurse is teaching about oral care to the family of a client who is in a
coma. Which of the following task should the nurse instruct the family to perform first?
Place the client in a side-lying position
A nurse is creating a plan of care for a client who requires suture removal. Which of the
following actions should the nurse plan to take? Cut the sutures as close to the
skin as possible.
A nurse is evaluating preoperative teaching with a client who is to undergo surgery with
general anesthesia. Which of the following statements by the client indicates an
understanding of the teaching? "I should remove nail polish form my fingers before
surgery."
A nurse is moving a client up in bed with assistance of another nurse. Which of the
following actions should the nurse take? Positions the client's arms across their chest.
RN in a rehab unit is assessing a group of clients who have a TBI. The RN should
identify that which of the following clients requires a priority referral? A client who
consistently coughs after drinking liquids
A RN is assessing a client who has hypokalemia. Which of the following findings should
the NR expect? Decreased bowel sounds
RN is preparing to assess a client's cardiac function by auscultating heart sounds at the
cardiac landmarks. Which of the following areas should the RN identify as the pulmonic
area? (hotspot question) D (right sternal border, second intercostal space)
RN is assessing a client who has an NG tube and is receiving continuous enteral
feedings. The nurse auscultates coarse crackles in the client's lungs. After discontinuing
the feeding, which actions should the RN take next? Position the client on their side
A RN is applying a new transdermal patch to a client. Which of the following actions
should the RN take? Wear gloves when applying the patch
A RN is reviewing the medical record of a client is postoperative. Based on the info in
the medical record, which of the following actions should the RN take first?Obtain a RX
for IV fluids
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A RN is assessing an older adult client who has become increasingly confused and
agitated in the last 48 hrs. Which of the following conditions should the nurse expect?
UTI
A home health RN is teaching a client who has a latex allergy about items typically
found in the home that can trigger an allergic reaction. Which of the following items
should the RN instruct the client to avoid? (Select all that apply) -Dishwashing
gloves
-Adhesive tape
-Bananas
-Rubber bands
A charge RN is providing an in-service about client advocacy to a group of newly
licensed RN. Which of the following examples should the RN include? Providing
information about advance directives to a client
A RN is reviewing data in a client's medical record. Which of the following info should
the RN expect to find in the discharge summary section? List of community
resources
A nurse is providing teaching to a client who has a new dx of type 1 DM. The client
expresses feelings of hopelessness about managing the disease. Which of the following
actions should the RN take first? Explore the client's past coping mechanisms
A RN manager is teaching a group of newly licensed RN's about procedures are within
their scope of practice. Which if the following examples should the RN include in the
teaching? Monitoring a continuous intra-arterial infusion of a thrombolytic medication
A RN is completing a preadmi
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