1. A nurse is reinforcing teaching with a client who has HIV and is being discharged
to home. Which of the following instructions should the nurse
... [Show More] include in the
teaching?
1) Take temperature once a day.
2) Wash the armpits and genitals with a gentle cleanser daily.
3) Change the litter boxes while wearing gloves.
4) Wash dishes in warm water. - 1) Take temperature once a day
2. A nurse is caring for a client who is postoperative following a tracheostomy, and
has copious and tenacious secretions. Which of the following is an acceptable
method for the nurse to use to thin this client's secretions?
1) Provide humidified oxygen.
2) Perform chest physiotherapy prior to suctioning.
3) Prelubricate the suction catheter tip with sterile saline when suctioning the airway.
4) Hyperventilate the client with 100% oxygen before suctioning the airway.. - 1)
Provide humidified oxygen.
3. Following admission, a client with a vascular occlusion of the right lower extremity
calls the nurse and reports difficulty sleeping because of cold feet. Which of the
following nursing actions should the nurse take to promote the client's comfort?
1) Rub the client's feet briskly for several minutes.
2) Obtain a pair of slipper socks for the client.
3) Increase the client's oral fluid intake.
4) Place a moist heating pad under the client's feet. - 2) Obtain a pair of slipper
socks for the client.
4. A nurse is caring for a client is who is 4 hr postoperative following a transurethral
resection of the prostate (TURP). Which of the following is the priority finding for the
nurse report to the provider?
1) Emesis of 100 mL
2) Oral temperature of 37.5° C (99.5° F)
3) Thick, red-colored urine
4) Pain level of 4 on a 0 to 10 rating scale - 3
5. A nurse is caring for a client who has a temperature of 39.7° C (103.5° F) and has
a prescription for a hypothermia blanket. The nurse should monitor the client for
which of the following adverse effects of the hypothermia blanket?
1) Shivering
2) Infection
3) Burns
4) Hypervolemia - 1
6. A nurse is reinforcing teaching about exercise with a client who has type 1
diabetes mellitus. Which of the following statements by the client indicates an
understanding of the teaching?
1) "I will carry a complex carbohydrate snack with me when I exercise."
2) "I should exercise first thing in the morning before eating breakfast."
3) "I should avoid injecting insulin into my thigh if I am going to go running."
4) "I will not exercise if my urine is positive for ketones - 4
7. A nurse notes a small section of bowel protruding from the abdominal incision of a
client who is postoperative. After calling for assistance, which of the following actions
should the nurse take first? 1) Cover the client's wound with a moist, sterile dressing.
2) Have the client lie supine with knees flexed.
3) Check the client's vital signs.
4) Inform the client about the need to return to surgery. - 1
8. A nurse is collecting data from a client who has alcohol use disorder and is
experiencing metabolic acidosis. Which of the following manifestations should the
nurse expect?
1) Cool, clammy skin.
2) Hyperventilation
3) Increased blood pressure
4) Bradycardia - 2
9. A nurse is reinforcing discharge teaching with a client following a cataract
extraction. Which of the following should the nurse include in the teaching?
1) Avoid bending at the waist.
2) Remove the eye shield at bedtime.
3) Limit the use of laxatives if constipated.
4) Seeing flashes of light is an expected finding following extraction. - 1
10.A nurse is caring for a client who has heart failure and has been taking digoxin
0.25 mg daily. The client refuses breakfast and reports nausea. Which of the
following actions should the nurse take first?
1) Suggest that the client rests before eating the meal.
2) Request a dietary consult.
3) Check the client's vital signs.
4) Request an order for an antiemetic - 3 [Show Less]