1. A nurse is reviewing the laboratory results for a client who is at 32 gestation. For which of the following results should the nurse notify the provider?
a. Hgb 12 g/dL
b. Platelet count 90,000/mm2
c. Hematocrit 37
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1. A nurse is reviewing the laboratory results for a client who is at 32 gestation. For which of the following results should the nurse notify the provider?
a. Hgb 12 g/dL
b. Platelet count 90,000/mm2
c. Hematocrit 37%
d. Creatinine 0.7 mg/dL
2. After receiving change-of-shift report, which of the following clients should the nurse collect data from first?
a. A client who has a history of pancreatitis and reports severe abdominal pain
b. A client who has heart failure and reports severe dyspnea
c. A client who is scheduled for abdominal surgery in 1 hrs
d. A postoperative client who has diabetes mellitus and a blood glucose of 280 mg/dK
3. A nurse is preparing a client for surgery. The client tells the nurse that he is concerned about the safety of a large sum of money in his wallet. Which of the following actions is appropriate for the nurse to take?
a. Place the money in an envelope and lock it in the client’s medication drawer
b. Contact security personnel to place the money in the facility safe
c. Hold the money for the client until he returns from surgery
d. Label the money and leave it with the unit secretary.
4. A nurse is preparing to instill an otic suspension into an adult client’ ear. Which of the following methods should the nurse plan to use?
a. Pull the auricle upward and outward.
b. Pull the auricle downward and backward.
c. Pull the auricle upward and backward.
d. Pull the auricle downward an outward.
5. A nurse is caring for an older adult client who has pneumonia. When reinforcing teaching about the diagnosis age- related changes with the client’s family, which of the following alterations should the nurse include?
a. Increased inflation of the basilar lungs
b. Increased elasticity of the thoracic cage
c. Hypertrophy of the bronchial mucous gland
d. Hyperactive cough reflex
6. A client is participating in an anger management session explain that his recent behavior are related to his job loss. Which of the following mechanism is the client using?
a. Projection
b. Rationalism
c. Repression
d. Sublimation
7. A nurse is reinforcing teaching with the client who is about to undergo a thoracentesis. Which if the following statements by the client indicates an understanding of the information?
a. “I will have general anesthesia during the procedure.”
b. “I will lie flat for 6 hours before the procedure.”
c. “I will have the chest x-ray following the procedure.”
d. “I will breathe deeply through my nose during the procedure.”
8. A nurse is reviewing the medical record of a client who is requesting an oral contraceptive. Which of the following findings should the nurse identify as a contraindication to the use of oral contraceptive?
a. History of renal calculi
b. Migraines with aura
c. BMI of 26
d. History of cholecystectomy
9. A nurse is reinforcing discharge teaching about transmission precautions with a client who has Hepatitis C. Which of the following information should the nurse include?
a. Avoid sharing razors with other family members.
b. Clean toilet surfaces with bleach after each use
c. Advice family members to receive a hepatitis c immunization
d. Do not prepare food for other family member s while infectious.
10. A nurse is preparing to administer an IM injection to a client. To reduce the risk of a needle stick injury, the nurse should take which of the following actions?
a. Place a cap hold securely on the used needle a before disposal.
b. Recap the needle using a one-handed scoop approach before proper disposal.
c. Dispose of the used needle immediately in a puncture proof sharps container.
d. Detach and dispose of the use needle promptly following injection.
11. A nurse is reinforcing teaching with a client who has new prescription for levothyroxine. Which of the following statements indicates understanding of the instructions?
a. “I should take this medication with meals.”
b. This medication will take 2 weeks to reach full effectiveness.”
c. “I need to take this medication for the rest of my life.”
d. “If I forget to take the medication, I can double the next dose.”
12. A nurse is caring for a client who is receiving prazosin. The client’s blood pressure is 100/60 mm Hg. which of the following actions should the nurse take?
a. Administer a reversal agent
b. Initiate cardiac monitoring
c. Instruct the client to stand up slowly
d. Inform the client to report urinary retention
13. A nurse is reinforcing teaching about colostomy care with a client. Which of the following client statements indicate an understanding of how to care for the colostomy?
a. I will cleanse the stoma site gently with an antiseptic solution.
b. I will contact my doctor right away if my stoma is red
c. I will cut the water opening 1 inch bigger than my stoma.
d. I will empty the colostomy bag when is I one half full.
14. A nurse is reinforcing teaching with a client who has a permanent pacemaker in place. Which of the following statements by the client indicates an understanding of the teaching?
a. “I should have my doctor replace the battery in the pacemaker in a year.”
b. “I need to record my pulse rate daily.”
c. “I should avoid taking tub baths.”
d. “I will remove my microwave oven from my house.”
15. A nurse is collecting data from a parent of a preschooler at a well-child visit. Which of the following findings is a contraindication to a measles, mumps and rubella (MMR) immunization?
a. Family history of allergies to penicillin
b. Erythema at injection site with previous immunization.
c. Long-term use of immunosuppressants
d. Current use of antimicrobial therapy.
16. A nurse is reinforcing teaching with a client who has a vitamin C deficiency. Which of the following foods should the nurse include as having the highest vitamin C content?
a. 1 cup yogurt
b. 1 cup raw broccoli
c. 1 large baked potato
d. 1 cup boiled carrots
17. A nurse is checking the home environment of a client for safety hazards. Which of the following items require intervention by the nurse?
a. The television set is turned to a loud volume
b. The dining room table has low chairs with no armrests
c. The bedroom extension cord is placed under a heavy nightstand
d. The living room contains wall to wall carpeting.
18. A nurse is caring for a 17-yr. old client who is admitted for an emergency appendectomy. Which of the following is an appropriate action by the nurse in obtaining informed consent?
a. Have the client’s older sibling give consent if parent is not available.
b. Delay the procedure if the provider cannot contact the parents.
c. Witness the signature of the client’s parents when he arrives.
d. Obtain verbal consent from the client while waiting for the parents to arrive.
19. A nurse is reinforcing teaching with a parent about appropriate snacks for a toddler. Which of the following food should the nurse include?
a. Marshmallows
b. Graham crackers
c. Almonds
d. Carrot sticks
20. A nurse is preparing to catheterize a client’s bladder to check for residual urine. The nurse should schedule this procedure at which of the following times?
a. Right after the client void
b. When the client feels an urge to void
c. While voiding on a bedpan
d. Before obtaining a bladder scan.
21. A nurse is caring for a client who has viral pneumonia. Which of the following actions should the nurse take?
a. Place the client in a private room
b. Administer azithromycin
c. Recommend a pneumococcal immunization.
d. Limit fluid intake to 1L per day.
22. A nurse is collecting data from a client who has diabetes mellitus. Which of the following indicates the client might be experiencing diabetic ketoacidosis?
a. Negative urine ketones
b. Kussmaul respirations
c. Hypoglycemia
d. Anuria
23. A nurse receives a verbal order for a client to receive a stat dose of meperidine 100 mg PO. She administers the medication, charts the administration and then realizes she has administered phenytoin 100 mg. which of the following actions should the nurse take first?
a. Check client’s vital signs.
b. Complete an incident report.
c. Notify the provider
d. Administer the meperidine.
24. A nurse is caring for a client and begins to suspect he is experiencing transference. Which of the following client statements should the nurse identify as an indicator of transference?
a. I’m going to inform my provider that I’m going to quit taking my medication
b. I don’t want to talk to you about how I’m feeling right now
c. I feel really close to you because you remind me of my ex-boyfriend.
d. I feel happy about the progress I have been making in my life.
25. A nurse is reinforcing teaching about self- administration of nasal drops with a client. Which of the following position should the nurse recommend for installation of the drops?
a. Sims’
b. Prone
c. Supine
d. Orthopneic
26. A nurse is assisting with triaging clients in a mass casualty situation. The nurse should recommend that which of the following clients receive care first?
a. A client who has a head injury and whose pupils are fixed and dilated.
b. A client who has a dislocated shoulder and reports a pain level of 8 on a scale from 0 to 10
c. A client who has 20.3 cm 8 in scalp laceration with inter mitten bleeding.
d. A client who has diminished breath sounds and paradoxical chest movement.
27. A nurse is caring for a client who has a methicillin-resistant Staphylococcus aureus (MRSA) infection. Which of the following actions should the nurse plan to take?
a. Place the client in a negative-pressure airflow room.
b. Wear a mask when working within 3 feet of the client.
c. Limit visitors to family members.
d. Don a gown and gloves when providing perineal care.
28. A nurse in the newborn nursery is collecting data about a newborn’s Moro reflex. Which of the following actions should the nurse take to elicit this reflex?
a. Turn the newborn’s head quickly to one side while he is sleeping.
b. Place a finger in the newborn’s palm
c. Strike the crib surface on which the newborn is lying
d. Hold the newborn upright with one foot touching the crib surface.
29. A nurse working in an inpatient mental health facility is assisting with the plan of care for a client who has anorexia nervosa. Which of the following should the nurse recommend including in the plan of care?
a. Encourage the client to gain 1.4 kg (3lb) per week
b. Initiate a 3500 calories/day diet.
c. Maintain continuity of staff members.
d. Administer an antiemetic before meals.
30. A nurse is caring for a client who has chronic illness. In which phase of the therapeutic relationship should the nurse help the client develop problem-solving skills?
a. Preinteraction phase
b. Working phase
c. Orientation phase
d. Termination phase
31. A nurse is collecting data from a client who has Hepatitis A. Which of the following findings should the nurse expect?
a. Splenomegaly
b. Abdominal pain
c. Irregular heart rate
d. Tarry stools
32. A nurse is reinforcing teaching with an adolescent who has a new prescription for cefazolin, for which of the following findings should the nurse instruct the adolescent to monitor and report to the provider?
a. Constipation
b. Elevated skin patches
c. Ringing in the ears
d. Depression
33. A nurse is assisting with the client admission of a client who has mononucleosis. Which of the following precaution should the nurse initiate?
a. Airborne
b. Droplet
c. Contact
d. Protective environment
34. A nurse is reinforcing teaching with a client diagnosed with osteoarthritis who reports joint pain, swelling a stiffness. Which of the following client statement indicates understanding of the teaching?
a. I will sleep on a soft mattress.
b. I will apply a heating pad to make my hands feel better.
c. I will take aspirin on an empty stomach.
d. I will exercise my joint as much as I can when they are inflamed.
35. A nurse is caring for a toddler who is admitted to the patient unit and is 2 hours postoperative following a tonsillectomy. Which of the following findings is a sign of hemorrhage?
a. Dark brown emesis.
b. Temperature of 37.7 degree Celsius (99.8 F)
c. Frequent swallowing
d. Respiratory rate of 24/min
36. A nurse in a mental health facility is reviewing the laboratory report for four clients. Which of the following results should the nurse report to the provider immediately?
a. WBC count of 8.000/mm3 for. A client who has schizophrenia and takes clozapine.
b. BUN levels of 14 mg/dl level for a client who has anorexia nervosa.
c. Sodium level of 130 mEq/L for a client who has bipolar disorder and takes lithium.
d. Potassium level of 3.8 mEq/L for a client who has bulimia nervosa.
37. A nurse is reinforcing discharge teaching with an older adult client’s family about safety precautions when administering a tap water enema to the clients. Which of the following should the nurse include in the instructions?
a. Instruct the client to bear down during rectal tube insertion.
b. Administer a second enema if result is not clear.
c. Assist the client to a right sim’s position. d. Insert the rectal tube in the direction of
the client’s umbilicus.
38. A nurse is reinforcing teaching with a client
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