VATI RN GREENLIGHT EXAM
A nurse is planning care for a client who has a new diagnosis of HIV. Which of the following client statements should the nurse
... [Show More] address first? Correct Answer: I can't seem to gain any weight
A nurse is performing disaster triage following a natural disaster. Which of the following should the nurse identify as the highest priority to receive care? Correct Answer: A client who has agonal respirations
A nurse is caring for a client who reports chest pain. Which of the following laboratory findings indicates myocardial damage? Correct Answer: Troponin I 1.8 ng/mL
A nurse is providing teaching to the parent of a child who has pediculosis capitis. Which of the following information should be included in the teaching? Correct Answer: Store nonwashable items in plastic bags for 14 days
A nurse is assessing a client who is 8 hr postoperative following a right-modified radical mastectomy. Which of the following should the nurse recognize as the priority finding? Correct Answer: Coughing frothy, pink secretions
A nurse in a newborn nursery is performing assessments on four neonates that are all less than 24 hr old. The nurse should plan to notify the provider of which of the following findings? Correct Answer: Pinna below the outer canthus of the eye
An assistive personnel tells the nurse that several client measurements were obtained with morning vital signs. Which of the following clients should the nurse plan to assess first? Correct Answer: A 4-year-old who has closed head injury and a heart rate of 60/min
A nurse is planning the discharge of an infant who has tetralogy of Fallot. The nurse anticipates the need for which of the following equipment? Correct Answer: Pulse oximeter
A home health nurse is assessing a client who is recovering from an acute myocardial infarction (MI). Which of the following assessment findings should the nurse report to the provider as a possible indication of left-sided heart failure? Correct Answer: Bilateral lung crackles
A nurse is performing a nutritional assessment on a client who has a calcium deficiency. The nurse should identify that the client is at risk for which of the following? Correct Answer: Osteogenesis
A nurse is caring for a client who was involuntarily admitted to the psychiatric unit following a failed suicide attempt. The provider prescribes a medication that is part of an experimental treatment. Which of the following actions should the nurse take? Correct Answer: Witness consent before medication administration
A nurse is providing education to the mother of a toddler who has pertussis. Which of the following statements by the parent indicates the teaching has been effective? Correct Answer: If I get pregnant, I should check with my provider about receiving a pertussis booster
A school nurse is assessing a child who has scabies. Which of the following is an expected finding? Correct Answer: Red, itchy papules on child's groin area
A nurse is caring for a client who is at risk for developing diabetes insipidus (DI) following a severe head injury. Which assessment finding indicates to the nurse that the client is developing DI? Correct Answer: Urine output 250 mL/hr
A nurse is caring for a client who is 2 hr postoperative following an ileal conduit procedure for bladder cancer. For which of the following findings should the nurse notify the provider? Correct Answer: A dusky-colored stoma
A nurse on the orthopedic floor is completing the morning assessments on several clients. Which of the following clients has the greatest risk for fat embolism syndrome (FES)? Correct Answer: A 24-year- old male who has a casted femur fracture
A nurse in the clinic is providing information to a client who has mastitis of left breast. The client asks the nurse, Does this mean that I must stop nursing my baby?" Which of the following is an appropriate statement by the nurse? Correct Answer: No, you can continue to nurse from both your breasts
A nurse is reviewing morning laboratory values for several clients. Which of the following findings is the highest priority for the nurse to report to the provider? Correct Answer: A client who is prescribed digoxin and furosemide and has a potassium level of 3.1 mEq/L
A nurse is preparing to provide education about electroconvulsive therapy (ECT) for a client who has major depressive disorder. Which of the following should the nurse include in the teaching? Correct Answer: A general anesthetic administered prior to ECT treatments
A nurse is teaching a client who has left-leg weakness how to use a standard walker. Which of the following actions by the client indicates a need for further teaching? Correct Answer: Moves the left leg and walker ahead together
A nurse is teaching a client who has left-leg weakness how to use a standard walker. Which of the following actions by the client indicates a need for further teaching? Correct Answer: Places the walker 2 feet forward with each step
A nurse is caring for a client who has a diagnosis of antisocial personality disorder. The nurse should expect the client to demonstrate which of the following? Correct Answer: Poor impulse control
A home health nurse is reviewing treatment goals with a client who has diabetes mellitus. The nurse should evaluate which of the following laboratory tests to determine effective long-term management of blood glucose levels? Correct Answer: HbA1c
A nurse is planning care for a client who takes haloperidol for the treatment of schizophrenia. Which of the following should the nurse include in the plan of care? Correct Answer: Screen the client for tardive dyskinesia
A nurse is evaluating the results of the above urinalysis done for a preschool age child. The nurse should identify that these findings are consistent with which of the following renal disorders? Correct Answer: Pyelonephritis
At the beginning of the day shift, a team leader delegates the following tasks to the assistive personnel (AP): bathe four clients, distribute fresh water, obtain morning vital signs. At noon, the nurse asks the AP to transport one client to physical therapy. The AP reports two clients still need baths. Which of the following is an appropriate strategy for the nurse to delegate more effectively in the future? Correct Answer: Set a clear time frame for the completion of each task
A nurse is caring for a client who has a hearing impairment. When speaking to the client, the nurse should incorporate which communication methods? Correct Answer: Rephrase sentences the client does not understand
A nurse is discussing the Z-track administration of hydroxyzine hydrochloride with a newly licensed nurse. Which of the following statements indicates the newly licensed nurse understands the purpose of the technique? Correct Answer: This technique decreases the risk of subcutaneous infiltration
A nurse is reviewing medical records for four clients. Which of the following represents appropriate documentation? Correct Answer: Lovenox 30 mg SC every 12 hr
A nurse is performing postmortem care on an older adult client. Which of the following actions is appropriate to take? Correct Answer: Place absorbent pads under the buttocks area
A nurse is discussing a living will with a client. Which of the following statement indicates an understanding of this document? Correct Answer: It communicates my wishes for end-of-life care
A nurse on a medical-surgical unit is caring for a group of clients. Which of the following clients would benefit from a three-way indwelling catheter? Correct Answer: A female client who is prone to development of blood clots in the urine
A nurse is planning dietary intervention for a client who is immobile due to pelvic and femur fractures. Which of the following should the nurse include in the plan? Correct Answer: Provide a high-protein diet
A nurse is assessing a client who is preparing for surgery. The client tells the nurse, "If something happens to me from which I cannot recover, I don't want to go on a ventilator." Which of the following is an appropriate response by the nurse? Correct Answer: You're concerned that something may go wrong?
A nurse manager at a public health clinic is concerned about the rising number of sexually transmitted infections in the community. The purpose of which of the following is to generate new ideas to address the public health concern? Correct Answer: A brainstorming session with nurses
A nurse is planning care for a client who has neutropenia. Which of the following nursing interventions is appropriate to include in the care plan? Correct Answer: Remove fresh flowers from the clients room
A nurse is planning to admit a client who has hyperthyroidism. Which of the following rooms is appropriate for the nurse to assign this client to? Correct Answer: A room near the nurse's station
A nurse is caring for a client who is experiencing acute mania. Which of the following actions should the nurse include in the plan of care? Correct Answer: Provide high-calorie nutritional supplements
A nurse is preparing to provide discharge teaching to a client who has an ileal conduit due to treatment for bladder cancer. Which of the following instructions should the nurse include in the teaching? Correct Answer: Rinse the reusable pouch with hot water
A nurse is providing teaching to an adolescent who has cystic fibrosis and has a prescription for pancrelipase. Which of the following should the nurse include in the teaching? Correct Answer: Take with meals
A nurse is planning to provide community education about viral hepatitis. Which of the following should the nurse plan to include in the teaching Correct Answer: Clients who have a history of viral hepatitis are unable to donate blood
An AP at a long-term care facility reports to the nurse that another AP has spent the entire morning on the phone and has not completed the morning assignment. Which of the following is an appropriate action by the nurse? Correct Answer: Ask the AP what work remains to be completed on the assignment
A nurse is caring for a client who is receiving enteral nutrition. Which of the following indicates a need to decrease the rate of the enteral feeding? Correct Answer: Poor skin turgor
A nurse in a prenatal clinic is caring for an adolescent client who is in her third trimester of pregnancy. The nurse identifies that the client is at an increased risk for which of the following? Correct Answer: Postpartum depression
A nurse is caring for a group of clients. The nurse should request a referral for a speech language pathologist for which of the following clients? Correct Answer: A client who has difficulty swallowing
A nurse is caring for a client who is prescribed furosemide. The nurse understands this medication is used to treat which of the following client conditions? Correct Answer: Rales in lower lobes of lungs
A nurse is admitting an infant who has bacterial meningitis. Which of the following actions should the nurse take first? Correct Answer: Minimize environmental stimuli
A nurse is caring for a client who has cirrhosis of the liver. Which of the following actions by the nurse is appropriate? Correct Answer: Monitor for abdominal ascites
A nurse is caring for a client who reports difficulty falling asleep at night. Which of the following suggestions should the nurse recommend? Correct Answer: Eat a bedtime snack containing carbohydrates
A nurse is planning to perform wound irrigation for a client who has an open secondary wound. When creating a sterile field, which of the following actions should the nurse take? Correct Answer: Place the lid of a bottle of sterile solution within the sterile field
A nurse is assessing laboratory values on a client who has taken an overdose of acetaminophen. The nurse should expect which of the following laboratory values indicative of organ damage from the overdose? Correct Answer: Alanine aminotransferase (ALT)
A nurse is caring for a client who is nulliparous and in the first stage of labor. The last internal assessment revealed 100% cervical effacement with 5 cm of dilatation. At the end of the last contraction, the nurse observes a large gush of fluid coming out of the client's perineal area. Which of the following is a priority action by the nurse? Correct Answer: Check the FHR
A community health nurse is performing a vision screening on a 4-month-old infant. When shining a light source into the infant's visual field, which of the following is an expected finding? Correct Answer: The infant's eyes turn toward the light
A nurse is providing discharge teaching to a client who is postpartum and plans to breastfeed. Which of the following should the nurse recommend the client increase in her diet during lactation? Correct Answer: Iron
A nurse volunteers to assist after witnessing a mass casualty incident involving a train derailment. Which of the following clients should the nurse immediately and completely immobilize? Correct Answer: A client who reports substernal chest pain
A nurse is writing a plan of care for a client who is homebound and has stage 2 Alzheimer's disease. Which of the following should the nurse include in the plan of care? Correct Answer: Assist with money management
A nurse is caring for a client with fractured ribs, has developed thrombophlebitis, and is being treated with a heparin drip. The client develops hematuria and has an activated partial thromboplastin time aPTT of 100 seconds. Which of the following actions should the nurse take first? Correct Answer: Turn off the heparin drip
A nurse is teaching a client who has a new prescription for digoxin. Which of the following should the nurse include in the teaching? Correct Answer: Notify your provider if you experience muscle weakness
A nurse is planning care for a newborn who has hyperbilirubinemia and is to receive phototherapy. Which of the following interventions should the nurse include? Correct Answer: Place the newborn 45 cm (18 in) from the light source [Show Less]