................the nurse observes a colleague going home with printed copies of client
information in a uniform pocket. Which action should the nurse
... [Show More] take?
a. File a detailed incident report with the specific hiring facility.
b. Warn the colleague that their actions are unprofessional.
c. Comment anonymously about the action of a staff discussion board.
d. Communicate the colleague’s actions to the unit charge nurse.
The nurse is evaluating a tertiary prevention program for clients with cardiovascular disease
implemented in a rural health clinic. Which outcome indicate the program is effective?
a. At-risk clients received an increased number of routine health screenings.
b. Clients reported having new confidence in making healthy food choices.
c. Clients who incurred disease complications promptly received rehabilitation.
d. Client relapse rate of 30% in a 5-year community-wide anti-smoking campaign.
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who uses
oxygen at 2 L/minute per nasal cannula continuously. The nurse observes that the client is
having increased shortness of breath with respirations at 23 breaths/minute. Which action
should the nurse implement first?
a. Determine if the client is experiencing any anxiety.
b. Auscultate the client’s bilateral lung sounds and oxygen saturation.
c. Notify the healthcare provider about the client’s distress.
d. Assessthe delivery mechanism of the oxygen tank, tubing, and cannula.
Which statement by a client who is 24 hours post-subtotal thyroidectomy requires an
immediate investigation by the nurse?
a. “When I get out of bed quickly, I feel a little dizzy.”
b. “The dressing over my incision feelslike it is too tight.”
c. “I’m most comfortable when the head of the bed is raised.”
d. “This IV infusion makes me urinate more often than usual.”
An older adult male who is in his early 70’s is admitted to the emergency department because of
a COPD exacerbation. This client is struggling to breathe and the healthcare team is preparing
for endotracheal intubation. The spouse’s wife, who is 30 years younger than the client, asks the
nurse to stop the procedure and provide the nurse a copy of the client’s living will. Which action
should the nurse take?
a. Facilitate a family meeting with the palliative care team.
b. Notify the healthcare provider of the client’s wishes.
c. Place a certified copy of the living will in the client’s record.
d. Alert the nursing staff of the client’s don’t resuscitate status.
An unlicensed assistive personnel (UAP) is assigned to provide personal care for a client whose
prescribed activity is bedrest with bedside commode use. The UAP reports to the nurse that the
client is so obese that the UAP feels unable to safely assist the client in transferring from the bed
to the bedside commode. How should the nurse respond?
a. Determine the client’s level of mobility and need for assistance.
b. Instruct the UAP that all clients deserve equal care.
c. Advice the client to maintain bedrest so that safety can be ensured.
d. Assign another UAP to care for the client.
A nurse determines that more than 25% of the students at a middle school are overweight. The
nurse presents the information at the parent-teacher meeting. What action is most important
for the nurse to include in the meeting?
a. Provide information on ways to increase activity for the family.
b. Have several teachers talk about health risks associated with obesity.
c. Distribute a shopping list of suggested healthy snack items.
d. Determine the parents’ degree of concern about their children’s weight.
After several months of chronic fatigue, morning stiffness, and join pain, a young adult is
diagnosed with rheumatoid arthritis, and the healthcare provider prescribes prednisone. Which
education should the nurse provide the client with regard to taking prednisone?
a. Take prednisone doses before meals on an empty stomach.
b. Wear sunglasses when exposed to bright sunlight.
c. If sequential doses are missed, notify the healthcare provider.
d. Schedule a monthly laboratory visit for a complete blood count.
The psychiatric nurse is caring for clients on an adolescent unit. Which client requires the
nurse’s immediate attention?
a. A 16-year-old client diagnosed with major depression who refuses to participate in group.
b. A 14-year-old client with anorexia nervosa who is refusing to eat the evening snack.
c. An 18-year-old client with antisocial behavior who is being yelled at by other clients
d. A 17-year-old client diagnosed with bipolar disorder who is pacing around the lobby..
The nurse caring for a child with mononucleosis can expect the child to exhibit which symptoms?
a. Positive Epstein-Barr, and malaise.
b. Ear pain and fever.
c. Elevated WBC and sedimentation rate.
d. Increased BUN and serum creatinine.
A client arrives for an annual physical exam and complains of having calf pain. The client’s health
history reveals peripheral atrial disease. Which question should the nurse ask the client about
expected finding related to chronic arterial symptoms?
a. Were your legs ever suddenly swollen, red, warm, and painful?
b. Does the calf pain occur when walking short distances?
c. Did you receive treatment for weeping ulcers on lower legs?
d. Have you experienced ankle edema and varicose veins?
. The nurse is preparing to send a client to the cardiac catheterization lab for an angioplasty.
Which client report is most important for them to explore further prior to the start of the
procedure?
a. Drank a glass of water in the past 2 hours.
b. Reports left chest wall pain prior to admission.
c. Verbalize a fear of being in a confined space.
d. Experience facialswelling after eating crab.
The nurse is assessing a 4-year-old child with eczema. The child’s skin is dry and scaly, and the
mother reports that the child frequently scratches the lesions on the skin to the point of causing
bleeding. Which guideline is indicated for care of this child?
a. Keep the nails trimmed short.
b. Apply baby lotion to the skin twice daily.
c. Bathe the child daily with bath oil.
d. Allow the child to wear only 100% cotton clothing.
A new mother on the postpartum unit runs out of the room screaming that her newborn infant’s
crib is empty and the baby is missing. What action should the nurse take first?
a. Determine if the newborn is in the nursery.
b. Activate the lockdown procedure.
c. Ask the mother if any visitors were expected to arrive.
d. Match ID bands of all infants and mothers on the unit.
While providing a health history, a female client tells the clinic nurse that she frequently thinks
about hurting herself. Which question is most important for the nurse to ask?
a. “Do you often have feeling of sadness?”
b. “Are you having problems concentrating?”
c. “Have you though about taking your life?”
d. “What problems are you facing right now?”
A college student brings a dorm roommate to the campus clinic because the roommate has
been talking to someone who is not present. The client tells the nurse that the voices are saying,
“kill, kill.” What question should the nurse ask the client next?
a. “When did these voices begin?”
b. “Have you taken any hallucinogens?”
c. “Are you planning to obey the voices?”
d. “Do you believe the voices are real?” [Show Less]