CAPSTONE PROCTORED MODULE 3 ATI QUIZ 90 QUESTIONS AND ANSWERS
CAPSTONE QUIZ MODULE 3
1. A nurse is developing a plan of care for an older adult who is
... [Show More] at risk for falls. Which of the following actions should the nurse plan to include in the plan? (SATA)
A. Lock beds and wheelchairs when not providing care
B. Administer a sedative at bedtime
C. Provide information about home safety checks D. Teach balance and strengthening exercises
E. Place the bedside table within the clients reach
2. A nurse is providing teaching to a client who has schizophrenia about thioridazine. Which of the following instructions should the nurse include in the teaching?
A. Report any sign of infection to the provider immediately
B. Expect your blood pressure to increase
C. Easy bruising may occur while taking this medication
D. Muscle rigidity is an expected adverse effect during the first few days of therapy
3. A nurse is teaching a client who has a new prescription for amoxicillin clavulanate to treat pharyngitis. Which of the following statements by the client indicates an understanding of the teaching?
A. I will double my dose if I miss one
B. I should take this medication on an empty stomach between meals
C. I will take medication until my sore throat goes away D. I will stop taking this medication if I develop itching
4. A nurse is preparing to administer medications to four clients. The nurse should administer medications to which of the following clients first?
A. A client who has pneumonia a WBC count of 11,500/mm3 and is prescribed piperacillin
B. A client who is post coronary artery bypass graft (CABG) has total cholesterol of 318mg/dl and is prescribed atorvastatin
C. A client who has anemia hemoglobin of 11g/dl and is prescribed epoetin alfa
D. A client who has renal failure, a serum potassium of 5.8/mEq/L and is prescribed sodium polystyrene sulfonate
5. A nurse caring for a client who is vomiting. Which of the following actions should the nurse take first?
A. Administer an antiemetic to the client
B. Notify housekeeping
C. Prevent the client from aspirating
D. Providing the client with an emesis basin
6. A nurse is providing teaching to a parent of a child who has celiac disease. The nurse should include which of the following food choices for this child?
A. Rice
B. Barley
C. Wheat
D. Rye
7. A nurse is caring for a client who is postoperative and has a prescription stockings. which of the following actions should the nurse take?
A. Check the stockings for wrinkles
B. Apply the stockings while the client is sitting in a chair
C. Measure the size of the client’s foot
D. Remove the stockings once each day
8. A nurse is teaching a client about which foods she should include in her low fiber diet. Which of the following statements indicates the client understands the teaching?
A. A fresh pear would be a good snack option
B. I can prepare refried beans for supper C. I should choose white rice as a side dish
D. Bran cereal would be a good breakfast choice
9. A client is prescribed 1g potassium phosphate IV to be infused continuously over 6 hr. Available is 1 g potassium phosphate in 250ml dextrose 5% water (D5W). The nurse should set the IV pump to run at how many ml/hr? (round nearest whole number)
42
10. a nurse is assessing a client who has a hip fracture. Which of the following findings should the nurse expect?
A. Hip pallor
B. Leg abduction C. Muscle spasms
D. Leg lengthening
11. A nurse is reviewing the medical record of a client who has a new prescription for clozapine for the treatment of schizophrenia. Which of the following findings indicates a contraindication to clozapine?
A. Fasting blood glucose 120mg/dl
B. Asthma
C. Hypertension
D. WBC count 3,300/mm
12. A nurse is teaching a client who reports insomnia about promoting rest and sleep. Which of the following statements should the nurse identify as an indication that the client understands the instructions?
A. I will walk briskly for 30minute before bedtime
B. I will have a cup of hot cocoa immediately before bedtime C. I will no longer have a glass of wine before bedtime
D. I will do my muscle relaxation techniques each afternoon
13. A nurse is planning care for an older adult client who is at risk for developing pressure ulcers. Which of the following interventions should the nurse use to help maintain the integrity of the client’s skin?
A. Elevate the head of the bed no more than 45
B. Apply cornstarch to keep sensitive skin area dry
C. Massage the skin over the client’s bony prominences D. Use a transfer device to lift the client up in bed
14. A nurse is teaching an older adult client who has left sided weakness about cane use. Which of the following instructions should the nurse include?
A. Hold the cane with your left hand
B. Move the cane forward 18 inches with each step C. When walking move your left foot forward first
D. Keep your elbow straight when you hold the cane
15. A nurse is planning care for a client who has dehydration and is receiving a continuous IV infusion of 0.9% sodium chloride. Which of the following intervention should the nurse include in the plan of care?
A. Monitor the client’s intake and output every 6 hr
B. Administer furosemide to the client
C. Check the client’s IV infusion every 8hr
D. Offer the client 240 ml (8oz) of oral fluids every 4hr
16. A nurse is teaching a client who has a new diagnosis of type 1diabetes mellitus about self- administration of insulin. Which of the following instructions should the nurse include?
A. Store the current bottle of insulin at room temperature
B. Massage the injection site after removing the needle
C. Pull back on the plunger after injecting the insulin
D. Use each syringe up to six times
17. A nurse is reviewing a clients lab result. Which of the following lab values should the nurse report to the provider?
A. Magnesium 1.9mEq/L
B. Potassium 3.6mEq/L C. Sodium 126 mEq/L
D. Chloride 99 mEq/L
18. A nurse is teaching a female client who is experiencing alcohol withdrawal about chlordiazepoxide. Which of the following information should the nurse include in the teaching?
A. This medication may increase your blood pressure
B. Breast tenderness may occur with this medication
C. You can double the dose of medication if you feel anxious D. Notify the provider if pregnancy is desired or suspected
19. A nurse is teaching a female client who has anxiety disorder about alprazolam. Which of the following information should the nurse include in the teaching?
A. This medication may increase your blood pressure
B. Use a reliable form of contraception while taking this medication
C. If a dose is missed double the next dose of medication
D. Do not eat age cheeses while taking this medication
20. A nurse is caring for an older adult client. The nurse informs the client that straining while defecating can cause which of the following?
A. Diarrhea
B. Gastric ulcer
C. Dilated pupils D. Dysrhythmias
21. A nurse manager is presenting to a group of unit nurses the categories regulated under the controlled substances Act. Which of the following medication prescriptions should the nurse include under schedule II?
A. Buprenorphine hydrochloride (3) B. Hydrocodone bitartrate (2)
C. Diazepam (4) D. Morphine (2)
22. A nurse is caring for a client following an esophagogastroduodenoscopy (EGD) procedure. Which of the following assessments is the nurse’s priority?
A. Level of consciousness
B. Pain
C. Nausea
D. Gag reflex
23. A nurse is providing teaching to a client who has a new prescription for lisinopril. Which of the following statements by the nurse indicates an understanding of the teaching?
A. I should take this medication with food B. I should report a cough to my provider
C. I should expect to have facial swelling when taking this medication
D. I should increase my intake of potassium rich foods
24. A nurse is teaching an older adult client who reports constipation. Which of the following instructions should the nurse include in the teaching?
A. Increase dietary intake of raw vegetables
B. Limit activity
C. Dink four to five glasses of water daily
D. Bear down hard when defecating
25. A nurse in a clinic sees a client who has an acute asthma exacerbation. Which of the following medications should reduce the symptoms?
A. Cromolyn via metered dose inhaler
B. Budesonide via dry powder inhaler
C. Montelukast orally
D. Albuterol via jet nebulizer
26. A nurse is caring for a client who requires total parenteral nutrition (TPN). Which of the following actions should the nurse take when finding that the TPN solution is infusing too rapidly?
A. Sit the client upright
B. Stop the TPN infusion
C. Turn the client on his left side
D. Prepare to add insulin to the TPN infusion
27. A nurse is teaching a client about foods that are included on a clear liquid diet. Which of the following food choices made by the client indicates the need for further teaching?
A. Gelatin
B. Broth
C. Popsicle D. Yogurt
28. A nurse is caring for a client who has an indwelling urinary catheter and a prescription for a urine specimen for culture and sensitivity. Which of the following actions should the nurse take?
A. Wipe the area of needleless port with sterile water
B. Insert the needle into the needless port at a 60 angle C. Withdraw 3 to 5 ml of urine from the port
D. Don sterile gloves
29. A nurse is assessing a client who has asthma. Which of the following areas should the nurse evaluate as the most reliable indicator of central cyanosis?
A. Oral mucosa
B. Conjunctivae
C. Soles of the feet
D. Ear lobes
30. A nurse is teaching a client who has hypertension and a new prescription for atenolol. Which of the following findings should the nurse include as adverse effects of this medication?
A. Cough
B. Tremor
C. Constipation D. Bradycardia
31. A nurse is planning preoperative care for a client who will undergo surgery. Which of the following is the priority action by the nurse?
A. Discuss if family members will assist with postoperative care
B. Review the clients current home environment
C. Identify the clients usual coping mechanism
D. Determine what the client knows about the surgery
32. A nurse is completing discharge to a client about nutrition therapy for wound healing following major surgery. Which of the following vitamins that promote wound healing should the nurse include in the teaching? (SATA)
A. Vitamin B12 B. Vitamin C C. Vitamin K
D. Vitamin D E. Vitamin A
33. A nurse is preparing to admit a client to the PACU who received a competitive neuromuscular blocking agent. Which of the following items should the nurse place at the client’s bedside?
A. Defibrillator machine
B. Chest tube equipment
C. Central venous catheter tray D. Bag valve mask device
34. A nurse is preparing to administer aspirin 650mg PO every 12 hr. The amount available is aspirin 325mg tablets. How many tablets should the nurse administer? (nearest whole number)
2
35. A nurse should teach which of the following clients requiring crutches about how to use a three-point gait?
A. A client who has a right femur fracture with no weight bearing on the affected leg
B. A client who has bilateral leg braces due to paralysis of the lower extremities
C. A client who has bilateral knee replacements with partial weight bearing on both legs
D. A client who is able to bear full weight on both lower extremities
36. A nurse is caring for a client who has bilateral eye patches in place following an injury. When the client’s food tray arrives, which of the following interventions should the nurse take to promote independence in eating?
A. Explain to the client that her tray is here and place her hands on it
B. Ask the client if she would prefer a liquid diet
C. Assign assistive personnel to feed the client
D. Describe to the client the location of the food on the tray
37. a nurse is preparing to perform a 12-lead electrocardiogram. Which of the following instructions should the nurse provide to the client?
A. Try to remain still once I have attached the gel pads
B. I will be placing electrodes on your breast
C. I will lower the head your bed so you can lie first
D. Try to hold your breath until this procedure is complete
38. A nurse is monitoring an older adult female client who had a myocardial infarction (MI) for the development of an acute kidney injury. Which of the following findings should the nurse identify as indicating an increased risk of acute kidney injury (AKI)?
A. Magnesium 2.0mEQ/L
B. Blood urea nitrogen (BUN) 20mg/dL
C. Serum Osmolality 290 mOsm/kg H2O D. Serum creatinine 1.8mg/dl
39. A nurse is teaching a client who has tuberculosis and is to start combination drug therapy. Which of the following medications should the nurse plan to administer? (SATA)
A. Acyclovir
B. Pyrazinamide C. Isoniazid
D. Montelukast E. Rifampin
40. A nurse is teaching a client who has a new prescription for clopidogrel. Which of the following instructions should the nurse include?
A. Take this medication with food
B. Take this medication three times daily
C. You might have to stop taking this medication 5 days before any planned surgeries
D. Expect to have black colored stools while taking medication
41. A nurse is assessing a client who has carpal tunnel syndrome. The nurse should expect which of the following findings?
A. Positive Chvostek’s sign
B. Cool extremities
C. Positive Phalen’s sign
D. Decreased radial pulse
42. A nurse is planning to administer an IM injection into a client’s deltoid muscle. Which of the following actions should the nurse take?
A. Use a 21-gauge needle for the injection B. Inject the medication at a 90 angle
C. Inject the medication 12.7cm (5in) below the…
43. A nurse is teaching a client who has a new prescription for sumatriptan tablets to treat migraine headaches. Which of the following instructions should the nurse include?
A. Chew tablet well before swallowing
B. Report swelling of eyelids after dosage
C. Repeat dose in 1 hour for unrelieved headache
D. Take daily to prevent headache
44. A nurse is caring for a client who had a left hip arthroplasty. Which of the following interventions should the nurse use to prevent dislocation?
A. Maintain foam wedge between legs
B. Monitor for shortening of the affected leg
C. Encourage use of elastic stockings
D. Avoid flexing the hips more than 60
45. A nurse is caring for a client who had toral thyroidectomy and a serum calcium level of 7.6mg/dl. Which of the following findings should the nurse expect?
A. Shortened QT intervals
B. Hypoactive deep tendon reflexes C. Tingling of the extremities
D. Constipation
46. A nurse is preparing to administer enoxaparin to a client. Which of the following actions should the nurse plan to take?
A. Aspirate for a blood return before depressing the plunger
B. Insert the needle at a 45-degree angle
C. Administer the medication 2.54cm (1in) from the umbilicus
D. The nurse should not expel the air bubble in the prefilled syringe
47. A nurse is planning care for a client who has cirrhosis and ascites. Which of the following interventions should the nurse include in the plan of care?
A. Increase the client’s sodium intake
B. Increase the client’s saturated fat intake
C. Decrease the client’s carbohydrate intake D. Decrease the client’s fluid intake
48. A nurse is teaching a client who has a new prescription for ferrous sulfate. Which of the following statements by the client indicates an understanding of the teaching?
A. I should expect dark tarry stools
B. I should expect increased bruising
C. I will not get as many infections
D. I will expect the color of my urine to be amber
49. A nurse is caring for a client who has a prescription for a clear liquid diet. Which of the following foods should the nurse allow the client to have?
A. Lemon sherbet
B. Milkshake
C. Vanilla ice cream D. Grape juice
50. A nurse is teaching a client who is scheduled for a CT scan of the head with contrast. Which of the following statements by the client indicates a need for further teaching?
A. I will not eat or drink 4hr prior to the procedure
B. I will keep my head still during the procedure
C. I will feel a warm sensation when the dye is injected D. I can take my morning dose of metformin
51. A nurse is assessing a client following a head injury and a brief loss of consciousness. Which of the following findings should the nurse report to the provider?
A. Glasgow Coma scale (GCS) score of 12
B. Edematous bruise on forehead
C. Small drops of clear fluid in left ear
D. Pupils are 4min and reactive to light
52. A nurse is teaching a client who is in her first trimester of pregnancy about over the counter medications that are a pregnancy risk category B. Which of the following medications should the nurse include?
A. Naproxen
B. Aspirin
C. Ibuprofen
D. Acetaminophen
A, C, and D are category B; Aspirin is category D in 1st trimester
53. A nurse is preparing to measure a client’s level of oxygen saturation and observes edema of both hands and thickened toenails. The nurse should apply the pulse oximeter probe to which of the following locations?
A. Finger B. Earlobe
C. Toe
D. Skin fold
54. A nurse is caring for a child who is allergic to penicillin. The nurse should verify which of the following prescriptions with the provider?
A. Amphotericin B
B. Amoxicillin clavulanate
C. Erythromycin
D. Gentamicin
55. a nurse is caring for a client who has hypertension and has hypertension and has a potassium of 6.8mEq/L. Which of the following action should the nurse take?
A. Suggest that the client use a salt substitute B. Obtain a 12 lead ECG
C. Obtain a blood sample for a serum sodium level
D. Advise the client to add citrus juices and bananas to her diet
56. The nurse asks a client who is about to have a cardiac catheterization about any allergies. The client states I always get a rash when I eat shellfish. Which of the following is the priority nursing action?
A. Attach a wrist band indicating the client’s allergy
B. Ask the client if any other foods cause such a reaction
C. Notify the dietary department of the client’s allergy D. Notify the provider of the client’s allergy
57. A nurse is teaching the partner of a client who had a stroke about manifestations of dysphagia. Which of the following statements by the client’s partner indicates the need for further teaching?
A. I will monitor my husband for coughing while he is eating
B. I will monitor my husband for pocketing food in his mouth
C. I will monitor for a change in my husband voice after he swallows
D. I will monitor my husband for tilting his head forward when he swallows
58. A nurse is caring for a client who reports difficulty sleeping while in the hospital. Which of the following actions taken by the assistive personnel (AP) while the client is sleeping should prompt the nurse to intervene?
A. Closes the door to the clients room
B. Flushes the clients toilet after emptying the urinary catheters drainage bag
C. Measures the clients vital signs routinely
D. Asks a group of nurses in the half to speak quietly
59. A nurse is caring for a client who is postoperative following a cholecystectomy and reports pain. Which of the following actions should the nurse take? (SATA)
A. Change the client’s position B. Identify the clients pain level
C. Remind the client to use incisional splinting
D. Assist the client to ambulate E. Offer the client a back rub
60. A nurse is performing a pain assessment for a client who is alert. The nurse should recognize that which of the following measures is the most reliable indicator of pain?
A. Self-report of pain
B. Nonverbal behavior
C. Severity of the condition
D. Vital signs
61. A nurse is assessing a client who is being admitted from the PACU following an abdominal hysterectomy. Which of the following assessments is the nurse’s priority?
A. Urinary output
B. Pain level
C. Oxygen saturation
D. Abdominal dressing
62. A nurse is preparing to discontinue a client’s indwelling urinary catheter. Which of the following actions should the nurse take first?
A. Measure and document the urine in the drainage bag
B. Remove the tape or device securing the catheter to the client’s thigh
C. Position the client supine
D. Deflate the catheter balloon using a sterile syringe
63. A nurse is teaching about levothyroxine with a client who has primary hypothyroidism. Which of the following statements should the nurse use when teaching the client?
A. Take this medication until your symptoms are gone and then discontinue
B. Symptoms improve immediately after starting the medication
C. The medication decreases the overproduction of the thyroid hormone thyroxine D. Tremors nervousness and insomnia may indicate your dose is too high
64. A nurse is assessing a client 15min after administering morphine sulfate 2 mg via IV push. The nurse should identify which of the following findings as an adverse effect of the medication?
A. Sleepy, but arousing when her name is called
B. SaO2 94%
C. Respiratory rate 8/min
D. Pain level of 6 on a scale from 0 to 10
65. A nurse is caring for a client who has not voided for 8hr following the removal of an indwelling urinary catheter. Which of the following actions should be the nurse take first?
A. Provide assistance bathroom
B. Insert a straight catheter
C. Increase fluids
D. Perform a bladder scan
66. A nurse is teaching a client about how to use her new hearing aids. Which of the following statements should the nurse identify as an indication that the client needs further instruction?
A. I will not use hairspray if I am wearing the hearing aids B. I will clean the hearing aids with alcohol wipes
C. I will change the batteries once a week
D. I will expect the hearing aids to whistle when I cup my hand over them
67. A nurse is caring for a client who was exposed to anthrax. Which of the following antibiotics should the nurse plan to administer?
A. Fluconazole
B. Tobramycin C. Ciprofloxacin
D. Vancomycin
68. A nurse is caring for a client who has impaired mobility. Which of the following support devices should the nurse plan to use prevent the client from developing plantar flexion contractures?
A. Sheepskin heel pad B. Footboard
C. Trochanter roll
D. Abduction pillow
69. A nurse is caring for a client who had a stroke involving right cerebral hemisphere. The nurse should monitor for which of the following findings?
A. Deficits in the right visual field
B. Unable to discriminate words and letters
C. Motor retardation
D. Poor impulse control
70. A nurse is caring for a client who just had a flexible bronchoscopy. Which of the following nursing actions is appropriate?
A. Irrigate the clients throat every 4 hr
B. Withhold food and liquids until the clients gag reflex returns
C. Suction the client’s oropharynx frequently
D. Have the client refrain from talking for 24hr
71. A nurse is assessing a client’s wound dressing and observes a watery red drainage. The nurse should document this drainage as which of the following?
A. Purulent
B. Serous
C. Sanguineous
D. Serosanguineous
72. A nurse at a provider’s office is providing teaching to a client who is taking chemotherapy and losing weight. Which of the following should the nurse recommend increasing calorie and protein intake? (SATA)
A. Top fruits with yogurt B. Add cream to soups
C. Increase fluids during meals
D. Use milk instead of water in recipes
E. Dip meats in eggs and breadcrumbs before cooking
73. A nurse is teaching a client who has left hemiparesis how to use a cane. Which of the following instructions should the nurse include?
A. Place the cane approximately 61cm (24 in) in front of her feet before advancing
B. Advance the right leg and the cane together to support the weaker leg
C. Remove the rubber tip when using the cane
D. Hold the cane on the right side to provide support for the weaker leg
74. A nurse is preparing to administer digoxin 0.25mg PO daily. The amount available is digoxin 0.125mg tablets. How many tablets should the nurse administer? (nearest whole number)
2
75. A nurse is presenting educational materials for a group of middle-aged clients about menopausal hormone therapy following total hysterectomy. Which of the following information should the nurse include in the information?
A. Take at different times of the day
B. Prevents from having a cerebral hemorrhage C. Prevents osteoporotic fractures
D. Take an extra dose if missed a day
76. A nurse is preparing to administer furosemide 40mg IV. Available is furosemide 10mg/1ml. How many ml should the nurse administer per dose?
4
77. A nurse receives report about assigned clients at the start of the shift. Which of the following clients should the nurse plan to see first?
A. A client who experienced a vaginal birth 24hr ago and reports no bleeding
B. A client who experienced a cesarean birth 4hr ago and reports pain
C. A client who has preeclampsia with a BP of 138/90mm Hg
D. A client who is scheduled for discharge following laparoscopic tubal ligation
78. A nurse is caring for a client who has urinary incontinence. Which of the following actions should the nurse implement to prevent the development of skin breakdown?
A. Request a prescription for the insertion of an indwelling urinary catheter
B. Check the clients shin every 8hr for signs of breakdown C. Apply a moisture barrier ointment to the client’s skin
D. Clean the client’s skin and perineum with hot water after each episode of incontinence
79. A nurse is talking with a client who is about to start using transcutaneous electrical nerve stimulation (TENS) to manage chronic pain. Which of the following statements should the nurse identify as an indication that the client needs further teaching?
A. I wish I didn’t have to attach the electrodes to my skin
B. I’II need to shave the hair off the skin where I place the electrodes
C. I hope I don’t have to take as many pain pills
D. It’s unfortunate that I have to be in the hospital for this treatment
80. The nurse is evaluating a client who had a cardiac catheterization with a left antecubital insertion site. Which of the following pulses should the nurse palpate?
A. Brachial pulse in the right arm
B. Radial pulse in the right arm
C. Brachial pulse in the left arm D. Radial pulse in the left arm
81. A nurse is providing dietary teaching for a client who has a burn injury and adheres to a vegan diet. The nurse should recommend which of the following foods as the best source of protein to promote wound healing?
A. One cup of brown rice
B. One cup of pureed avocado C. One cup of lentils
D. One cup of orange juice
82. A nurse is caring for a client who has asthma and is taking fluticasone. The nurse should monitor the client for which of the following adverse effects?
A. Polyuria
B. Oral candidiasis
C. Hypertension
D. Hypoglycemia
83. A nurse is teaching a client who has diabetes mellitus and a new prescription for prednisone for a rash. Which of the following statements by the client indicates the need for further teaching?
A. I might have a hard time falling asleep while taking prednisone
B. I might feel a little emotional when I am on this medicine
C. I might need to increase (decrease?) my regular insulin during this time
D. I will gradually stop the prednisone when my rash goes away
84. A nurse is monitoring a client following a thoracentesis. The nurse should identify which of the following manifestations as a complication and contact the provider immediately?
A. Increased heart rate
B. Decreased temperature
C. Serosanguineous drainage from the puncture site
D. Discomfort at the puncture site
85. Purpose of radionuclide imaging? [Show Less]