1. A nurse is preparing to administer an injection of an opioid medication to a client. The nurse
draws out 1 mL of the medication from a 2 mL vial.
... [Show More] Which of the following actions should the
nurse take? - Ask another nurse to observe the medication wastage
2. A nurse is preparing to administer 0.9% sodium chloride 750 mL IV to infuse over 7 hr. The nurse
should set the infusion pump to deliver how many mL/hr? (round to nearest whole number. Use
a leading zero if it applies. Do not use a trailing zero) - 107... 750mL/7hr = 107.14
3. A nurse is educating a client who has a terminal illness about declining resuscitation in a living
will. The client asks, "What would happen if I arrived at the emergency department and I had
difficulty breathing?" Which of the following responses should the nurse make? - we would give
you oxygen through a tube in your nose
4. A nurse is caring for a client who is postoperative and refuses to use an incentive spirometer
following major abdominal surgery. Which of the following actions is the nurse's priority? -
determine the reasons why the client is refusing to use the incentive spirometer
5. A nurse on a medical-surgical unit is caring for a client who has a new prescription for wrist
restraints. Which of the following actions should the nurse take? - pad the clients wrists before
applying the restraints
6. A nurse is talking with an older adult client who is contemplating retirement. The client states, "I
keep thinking about how much I enjoy my job. I'm not sure I want to retire." Which of the
following responses should the nurse make? - let's talk about how the change in your job status
will affect you
7. a nurse is caring for a client who has a pharyngeal diphtheria. Which of the following types of
transmission precautions should the nurse initiate? - droplet8. a nurse is caring for a group of clients. which of the following actions should the nurse take to
prevent the spread of infection? - place a client who has tuberculosis in a room with negativepressure airflow
9. a nurse is assessing an older adult client's risk for falls. which of the following assessments
should the nurse use to identify the client's safety needs? (select all that apply) - pupil clarity,
visual fields, visual acuity
10. A nurse in a long-term care facility is caring for a client who dies during the nurse's shift. Identify
the sequence in which the nurse should perform the following steps. -
1) obtain the pronouncement of death from the provider
2)remove the tubes and indwelling lines
3) wash the client's body
4) ask the client's family if they would like to view the body
5) place a name tag on the body
11. a client who is postoperative is verbalizing pain as a 2 on a pain scale of 0 to 10. which of the
following statements should the nurse identify as an indication that the client understands the
preoperative teaching she received about pain management? - it might help me to listen to
music while i'm lying in bed
12. a nurse is teaching a client and his family how to care for the client's tracheostomy at home.
which of the following instructions should the nurse include in the teaching? - use tracheostomy
covers when outdoors
13. a nurse is admitting a client who is having an exacerbation of heart failure. in planning this
client's care, when should the nurse initiate discharge planning? - during the admission process
14. a nurse is assessing a client who reports increased pain following physical therapy. which of the
following questions should the nurse ask when assessing the quality of the client's pain? - is your
pain sharp or dull?
15. a nurse is caring for a child who has a prescription for a blood transfusion. the child's parents
have refused the treatment due to their religious beliefs. which of the following actions should
the nurse take? - examine personal values about the issue16. a nurse is reviewing a client's fluid and electrolyte status. which of the following findings should
the nurse report to the provider? - potassium 5.4 mEq/L
17. a nurse is caring for a client who has a respiratory infection. Which of the following techniques
should the nurse use when performing nasotracheal suctioning for the client? - apply
intermittent suction when withdrawing the catheter
18. a nurse is caring for a client who has a sodium level of 125 mEq/L. which of the following
findings should the nurse expect? - abdominal cramping
19. a nurse is assessing a client's readiness to learn about insulin self-administration. which of the
following statements should the nurse identify as an indication that the client is ready to learn? -
i can concentrate best in the morning
20. a nurse is preparing a change-of-shift report. which of the following tools or documents should
the nurse use to communicate continuity of care? - situation, background, assessment, and
recommendation (SBAR)
21. a nurse is caring for a client who has an aggressive form of prostate cancer. the provider briefly
discusses treatment options and leaves the client's room. when the nurse asks if the client
would like to discuss any concerns, the client declines. which of the following statements should
the nurse make? - i am available to talk if you should change your mind
22. a nurse is caring for a client who is postoperative and is exhibiting signs of hemorrhagic shock.
the nurse notifies the surgeon, who tells the nurse to continue to measure the client's vital signs
every 15 min and to report back in 1 hr. Which of the following actions should the nurse take
next? - notify the nursing manager
23. a nurse is preparing an education program for staff about advocacy. which of the following
information should the nurse include? - advocacy ensures client's safety, health and rights
24. a nurse is providing discharge instructions to a client who will be using a walker. which of the
following client statements indicates an understanding of the teaching? - i will hire someone to
trim the tree that hangs low over the stairs of my front porch25. a nurse is caring for a client who requires an NG tube for stomach decompression. which of the
following actions should the nurse take when inserting the NG tube? - have the client take sips
of water to promote insertion of the NG tube into the esophagus [Show Less]