NUR 356 Exam 1

Question 1

In passing the physician for your patient in the hospital hall, he smiles and mentions he will be ordering an x-ray. You enter the patient’s room to find her crying. She states “Dr. X was so abrupt and rude. I have never been treated so badly. I want to talk to a supervisor”. As the nurse, your best initial response it?

• A. “What level of supervisor do you want to talk to?”
• B. “Dr. X is always rude to everyone. Don’t take it personally.”
• C. “What do you want to talk to the supervisor about? Perhaps I can help.”
• D. “You seem upset.”

Answer 1

D. “You seem upset”.

Question 2

As a nurse, which of the following is your first priority of providing care?

A. Patient needs a dressing change.
B. Patient needs suctioning.
C. Patient is in pain
D. Patient is incontinent

Answer 2

B. Patient needs suctioning

This is Airway Maintenance. Use the ABCs first then move to safety and physical needs, emotional usually comes last.

Question 3

A patient is scheduled for surgery. When getting ready to obtain the informed consent, the patient tells the nurse,” I have no idea what is going to happen. I couldn’t ask any questions”. The nurse does not allow the patient to sign the permit and notifies the health care provider of the situation. Which role is the nurse displaying?

A. Manager
B. Patient educator
C. Patient advocate
D. Clinical nurse specialist

Answer 3

C. Patient advocate

Question 4

Which findings will alert the nurse that stress is present when making a clinical decision? (select all that apply.)

A. Tense muscles
B. Reactive responses 
C. Trouble concentrating 
D. Very tired feelings 
E. Managed emotions

Answer 4

A. Tense muscles
B. Reactive responses
C. Trouble concentrating
D. Very tired feelings

Question 5

An example of nursing activity that best reflects the American Nurses Association’s definition of nursing is

A. Treating dysrhythmias that occur in a patient in the coronary care unit.
B. Diagnosing a patient with a feeding tube as being at risk for aspiration.
C. Setting up protocols for treating patients in the emergency department.
D. Offering anti-anxiety drugs to a patient with a disturbed sleep pattern.

Answer 5

B. Diagnosing a patient with a feeding tub as being at risk for aspiration.

Question 6

A nurse working on the medical-surgical unit at an urban hospital would like to become certified in medical-surgical nursing. The nurse knows that this process would most likely require

A. a bachelor’s degree in nursing
B. formal education in advanced nursing practice
C. experience for a specific period in medical-surgical nursing
D. membership in a medical-surgical nursing specialty organization

Answer 6

C. experience for a specific period in medical-surgical nursing

Question 7

The nurse is assigned to care for a newly admitted patient. Number in order the steps for using the nursing process to prioritize care. (Number 1 is first step, and number 5 is the last step).

 \_\_Evaluate whether the plan was effective.
\_\_\_ Identify any health problems.
\_\_\_ Collect patient information.
\_\_\_ Carry out the plan.
\_\_\_ Decide a plan of action.

Answer 7

1) Collect patient information
2) Identify any health problems
3) Decide a plan of action
4) Carry out the plan
5) Evaluate whether the plan was effective

Question 8

Using the SBAR format, number in the order the steps for how the nurse would communicate information with the provider. (Number 1 is the first step, and number 4 is the last step.)

____ “I would like you to order an IV medication and come evaluate the patient as soon as possible.”
____ “This is Nurse M.H. I am calling from the unit because your patient, D.R., has a new onset of atrial fibrillation.”
____ “The atrial fibrillation started about 10 minutes ago. The heart rate is 124; BP 90/60. The patient is experiencing dizziness.”
____ “D.R., who is 2 days postoperative for a bowel resection for diverticulitis, has a history of mitral valve disease.”

Answer 8

1) “This is Nurse M.H. I am calling from the unit because your patient, D.R., has a new onset of atrial fibrillation.”
2) “D.R., who is 2 days postoperative for a bowel resection for diverticulitis, has a history of mitral valve disease.”
3) “The atrial fibrillation started about 10 minutes ago. The heart rate is 124; BP 90/60. The patient is experiencing dizziness.”
4) “I would like you to order an IV medication and come evaluate the patient as soon as possible.”

Question 9

The nurse is caring for a diabetic patient in the ambulatory surgical unit who has undergone wound debridement. Which task is appropriate for the nurse to delegate to unlicensed assistive personnel (UAP)?

a. Check the patient’s vital signs.
b. Assess the patient’s pain level.
c. Palpate the patient’s pedal pulses.
d. Monitor the patient’s IV catheter site.

Answer 9

a. Check the patient’s vital signs.

Question 10

The nurse’s role in addressing the National Patient Safety Goals established by The Joint Commission includes (select all that apply)

a. answering all patient monitoring alarms promptly.
b. memorizing all the rules published by The Joint Commission.
c. obtaining a correct list of the patient’s medications on admission.
d. encouraging patients to be actively involved in their own health care.
e. using side rails and alarm systems as necessary to prevent patient falls.

Answer 10

a. answering all patient monitoring alarms promptly.
c. obtaining a correct list of the patient’s medications on admission.
e. using side rails and alarm systems as necessary to prevent patient falls.

Question 11

Advantages of using informatics in health care delivery are (select all that apply)

a. reduced need for nurses in acute care.
b. increased patient anonymity and confidentiality.
c. the ability to achieve and maintain high standards of care.
d. access to standard plans of care for many health problems.
e. improved communication of the patient’s health status to the health care team.

Answer 11

c. the ability to achieve and maintain high standards of care.
d. access to standard plans of care for many health problems.
e. improved communication of the patient’s health status to the health care team.

Question 12

When using evidence-based practice, the nurse

a. must use clinical practice guidelines developed by national health agencies.
b. should use findings from randomized controlled trials to plan care for all patient problems.
c. uses clinical decision making and judgment to decide what evidence is appropriate for a specific clinical situation.
d. analyzes the relationship of nursing interventions to patient outcomes to discover evidence for patient interventions.

Answer 12

c. uses clinical decision making and judgment to decide what evidence is appropriate for a specific clinical situation.

Question 13

Determination of whether an event is a stressor is based on a person’s

a. tolerance.
b. perception.
c. adaptation.
d. stubbornness.

Answer 13

b. perception

Question 14

The nurse would expect which finding in a patient because of the physiologic effect of stress on the reticular formation?

a. An episode of diarrhea while awaiting painful dressing changes
b. Refusal to communicate with nurses while awaiting a cardiac catheterization
c. Inability to sleep the night before beginning to self-administer insulin injections
d. Increased blood pressure, decreased urine output, and hyperglycemia after a car accident

Answer 14

c. Inability to sleep the right before beginning to self-administer insulin injections.
Reticular formation - trouble sleeping

Question 15

The nurse uses knowledge of the effects of stress on the immune system by encouraging patients to

a. sleep for 10 to 12 hours per day.
b. avoid exposure to upper respiratory tract infections.
c. receive regular immunizations when they are stressed.
d. use emotion-focused rather than problem-focused coping strategies.

Answer 15

b. avoid exposure to upper respiratory tract infections

Question 16

The nurse recognizes that a person who has chronic stress could be at higher risk for (select all that apply)

a. osteoporosis.
b. fibromyalgia.
c. colds and flu.
d. high blood pressure.
e. high serum cholesterol.

Answer 16

b. fibromyalgia
c. colds and flu
d. high blood pressure

Question 17

The nurse recognizes that a patient with newly diagnosed breast cancer is using an emotion-focused coping process when she

a. joins a support group for women with breast cancer.
b. considers the pros and cons of the various treatment options.
c. delays treatment until her family can take a weekend trip together.
d. tells the nurse that she has a good prognosis because the tumor is small.

Answer 17

a. joins a support group for women with breast cancer.

Question 18

During a stressful circumstance that is unchangeable, which type of coping strategy is the most effective?

a. Avoidance
b. Coping flexibility
c. Emotion-focused coping
d. Problem-focused coping

Answer 18

c. Emotion-focused coping

Question 19

A nurse is caring for a young adult at a college health clinic. Which of the following actions should the nurse take first?

A. Give the client information about immunization against meningitis
B. Tell the client to have a TB skin test every 2 years
C. Determine the client’s health risks
D. Teach the client about exercise recommendations

Answer 19

C. Determine the client’s health risks

Question 20

A nurse in a clinic is planning health promotion and disease prevention strategies for a client who has multiple risk factors for cardiovascular disease. Which of the following interventions should the nurse include? (Select all that apply).

A. Help the client see the benefits of their actions
B. Identify the client’s support systems
C. Suggest and recommend community resources
D. Devise and set goals for the client
E. Teach stress management strategies

Answer 20

A. Help the client see the benefits of their actions
B. Identify the client’s support systems
C. Suggest and recommend community resources
E. Teach stress management strategies

Question 21

A nurse in a health clinic is caring for a 21 year old client who tells the nurse that their last physical exam was in high school. Which of the following health screenings should the nurse expect the provider to perform for this client?

A. Testicular examination
B. Blood glucose
C. Fecal occult blood
D. Prostate specific antigen

Answer 21

A. Testicular examination

Question 22

A nurse at a health department is planning strategies related to heart disease. Which of the following activities should the nurse include as part of primary prevention?

A. Providing cholesterol screening
B. Teaching about a healthy diet
C. Providing information about antihypertensive medications
D. Developing a list of cardiac rehabilitation programs.

Answer 22

B. Teaching about a healthy diet

Question 23

A nurse at a provider’s office is talking about routine screenings with a 45 year old female client who has no specific family history of cancer or diabetes mellitus. Which of the following client statements indicates that the client understands how to proceed?

A. “So I don’t need the colon cancer procedure for another 2 to 3 years.”
B. “For now, I should continue to have a mammogram each year.”
C. “Because the doctor just did a Pap smear, I’ll come back next year for another one.”
D. “I had my blood glucose test last year, so I won’t need it again for 4 years.”

Answer 23

B. “For now, I should continue to have a mammogram each year.”

Question 24

A nurse is caring for a client awaiting transport to the surgical suite for a coronary artery bypass graft. Just as the transport team arrives, the nurse takes the client’s vital signs and notes an elevation in blood pressure and heart rate. The nurse should recognize this response as part of the general adaptation syndrome (GAS).

A. Exhaustion stage
B. Resistance stage
C. Alarm stage
D. Recovery stage

Answer 24

C. Alarm stage

Question 25

A nurse is caring for a client who has left sided hemiplegia resulting from a cerebrovascular accident. The client works as a carpenter and is not experiencing a situational role change based on physical limitations. The client is the primary wage earner in the family. Which of the following describes the client’s role problem? A. Role Conflict B. Role overload C. Role ambiguity D. Role strain

Answer 25

A. Role Conflict

Question 26

A nurse is caring for a client who has a new diagnosis of type 2 diabetes mellitus. Which of the following nursing interventions for stress, coping, and adherence to the treatment plan should the nurse initiate at this time (select all that apply). A. Suggest coping skills for the client to use in this situation. B. Allow the client to provide input in the treatment plan. C. Assist the client with time management, and address the client's priorities. D. Provide extensive instructions on the client's treatment regimen. E. Encourage the client in the expression of feeling and concerns.

Answer 26

B. Allow the client to provide input in the treatment plan. C. Assist the client with time management, and address the client's priorities. E. Encourage the client in the expression of feelings and concerns.

Question 27

A nurse is caring for a family who is experiencing a crisis. Which of the following approaches should the nurse use when working with a family using an open structure for coping with crisis? A. Prescribing tasks unilaterally B. Delegating care to one member C. Speaking to the primary client privately D. Convening a family meeting

Answer 27

D. Convening a family meeting

Question 28

A nurse is assessing a parent who lost a 12-year old child in a car crash 2 years ago. Which of the following findings indicates the client is exhibiting manifestations of prolonged grieving? A. Leaves the child's room exactly as it was before the loss B. Volunteers at a local children's hospital C. Talks about the child in the past tense D. Visits the child's grave every week after worship service.

Answer 28

A. Leaves the child's room exactly as it was before the loss

Question 29

A nurse is caring for a 48-year-old client who is grieving following the death of her husband seven months ago. The client reports that she has lost 30 lb, and is having difficulty sleeping. Which of the following factors indicate the client is experiencing maladaptive grieving? A. The client is 48 years old B. The client's husband died seven months ago C. The client has lost 30 lb. D. The client is having difficulty sleeping

Answer 29

B. The client's husband died seven months ago

Question 30

The nurse is caring for a group of clients on a mental health unit. Which of the following should the nurse recognize as a maladaptive defense mechanism? A. A client slams a drawer after misplacing her wallet. B. A man buys his partner a gift after flirting with his secretary. C. A client forgets to schedule needed appointments when fearing chemotherapy. D. A client ignores the thought of pain when scheduled for oral surgery

Answer 30

C. A client forgets to schedule needed appointments when fearing chemotherapy.

Question 31

A nurse is caring for a 4-year old child who has a new diagnosis of diabetes mellitus and is distressed after an insulin injection. Which of the following play activities should the nurse recognize is therapeutic in helping the child deal with the injection? A. A needless syringe and a doll B. A video game C. A story about a child who has diabetes. D. A period of play in the playroom

Answer 31

A. A needless syringe and a doll

Question 32

A nurse at a college campus mental health counseling center is caring for a student who just failed an examination. The student spends the session berating the teacher and the course. The nurse should recognize this behavior as which of the following defense mechanism? A. Conversion B. Projection C. Undoing D. Regression

Answer 32

B. Projection

Question 33

A nurse is caring for a client who was involved in heavy combat and observed war casualties. The nurse should suspect that the client is suffering from PTSD if the client makes which of the following statement? A. "I check any room I enter because the enemy is still after me and could be hiding anywhere" B. "My child was born with a birth defect due to an exposure I had overseas" C. "I killed four enemy soldiers with my bare hands and save my entire battalion" D. "In my dreams, all I can see are the wounded reaching out and trying to grab me"

Answer 33

D. "In my dreams, all I can see are the wounded reaching out and trying to grab me"

Question 34

A nurse is assessing a client who is experiencing chronic stress. Which of the following findings should the nurse expect? A. Hypotension B. Viral infection C. Increased energy D. Increased cognitive awareness

Answer 34

B. Viral infection

Question 35

A nurse is admitting a client who has experienced a weight loss of 11kg (25b) in the past 3 months. The client weighs 40kg (88lb) and believes she is fat. Which of the following aspects of care should the nurse consider the first priority for this client? A. Identify the client's nutritional status B. Request a mental health consult C. Plan therapeutic diet for the client D. Provide a structured environment for the client

Answer 35

A. Identify the client's nutritional status

Question 36

A nurse in a mental health clinic is discussing guided imagery with a newly licensed nurse. Which of the following clients should the nurse suggest offering the therapy to? A. Post-traumatic stress disorder B. Schizophrenia C. Pedophilia D. Paranoid personality disorder

Answer 36

A. Post-traumatic stress disorder

Question 37

The patient health history and physical examination provide the nurse with information primarily to a. diagnose a medical problem. b. investigate a patient’s signs and symptoms. c. classify subjective and objective patient data. d. identify nursing diagnoses and collaborative problems.

Answer 37

d. identify nursing diagnoses and collaborative problems.

Question 38

The nurse would place information about the patient’s concern that his illness is threatening his job security in which functional health pattern? a. Role-relationship b. Cognitive-perceptual c. Coping–stress tolerance d. Health perception–health management

Answer 38

a. Role-relationship

Question 39

The nurse is preparing to examine a patient’s abdomen. Place in order the proper steps for an abdominal assessment, using the numbers 1–4, with 1 = the first technique and 4 = the last technique: ___ Inspection ___ Palpation ___ Percussion ___ Auscultation

Answer 39

1) Inspection 2) Auscultation 3) Percussion 4) Palpation

Question 40

Which situation would require the nurse to obtain a focused assessment (select all that apply)? a. A patient denies a current health problem. b. A patient reports a new symptom during rounds. c. A previously identified problem needs reassessment. d. A baseline health maintenance examination is needed. e. A patient with an emergent problem needs immediate care.

Answer 40

b. A patient reports a new symptom during rounds | c. A previously identified problem needs reassessment

Question 41

Which technique is most appropriate when using motivational interviewing with a patient who tells you that he is ready to start a weight-loss program? a. Confirm that the patient is serious about losing weight. b. Insist that the patient consider an organized group weight-loss program. c. Focus on the patient’s strengths to support his optimism that he can successfully lose weight. d. Ask a prescribed set of questions to increase the patient’s awareness of his dietary behaviors.

Answer 41

c. Focus on the patient’s strengths to support his optimism that he can successfully lose weight.

Question 42

Which is the priority patient teaching strategy when limited time is available? a. Setting realistic goals that have high priority for the patient b. Referring the patient to a nurse educator in private practice c. Observing more experienced nurse-teachers to learn how to teach faster and more efficiently d. Providing reading materials for the patient instead of discussing information the patient needs to learn

Answer 42

a. Setting realistic goals that have high priority for the patient

Question 43

The nurse needs to include caregivers in patient teaching primarily because (select all that apply) a. caregivers provide all the care for patients after discharge. b. they might feel rejected if they are not included in the teaching. c. patients have better outcomes when their caregivers are involved. d. the patient may be too ill or too stressed to fully understand the teaching. e. caregivers are responsible for the overall management of the patient’s care.

Answer 43

c. patients have better outcomes when their caregivers are involved. d. the patient may be too ill or too stressed to fully understand the teaching.

Question 44

Which patient characteristic enhances the teaching-learning process? a. Moderate anxiety b. High self-efficacy c. Being in the precontemplative stage of change d. Being able to laugh about the current health problem

Answer 44

b. High self-efficacy

Question 45

What would be the priority teaching goal for a middle-aged Hispanic woman about methods to relieve symptoms of menopause? a. Prevent the development of future disease. b. Maintain the patient’s current state of health. c. Provide information on possible treatment options. d. Change the patient’s beliefs about herbal supplements.

Answer 45

c. Provide information on possible treatment options.

Question 46

A patient tells the nurse that she enjoys talking with others and sharing experiences but often falls asleep when reading. Which teaching strategy would be most effective with this patient? a. Formal lecture b. Journal writing c. Web-based program d. Small group discussion

Answer 46

d. Small group discussion

Question 47

The nurse has taught a family caregiver how to administer insulin. Evaluation of the caregiver’s learning would include a. monitoring the patient’s glucose readings. b. arranging for follow-up with a home care nurse. c. asking the caregiver to “show back” the ability to administer insulin. d. asking the caregiver what was helpful about the teaching experience.

Answer 47

c. asking the caregiver to “show back” the ability to administer insulin.

Question 48

A nurse is evaluating the outcomes for an outpatient client who has depression. Which of the following client statements indicates a need for further evaluation? A. "I had a great trip to the Smokey Mountains." B. "Going back to work has been okay." C. "I just don't like going to the movies like I used to." D. "I can't wait to have my family together next weekend."

Answer 48

C. "I just don't like going to the movies like I used to."

Question 49

A nurse is planning care for a client who has acute dysphagia. Which of the following nursing interventions should be included in the plan of care? A. Providing a straw for consumption of liquids B. Encouraging larger bites C. Placing the client in semi-Fowlers position during meals D. Instructing the client to tilt head forward when swallowing

Answer 49

D. Instructing the client to tilt head forward when swallowing

Question 50

A nurse is assessing a client who is being admitted from the PACU following an abdominal hysterectomy. Which of the following assessments in the nurse's priority? A. Oxygen saturation B. Abdominal dressing C. Urinary output D. Pain level

Answer 50

A. Oxygen saturation

Question 51

A nurse is assessing a client who has a fracture of the femur. The nurse obtains vital signs on admission and again in 2 hours. Which of the following changes in assessment should indicate the nurse that the client could be developing a serious complication? A. Increased respiratory rate from 18 to 44/min B. Increased oral temperature from 36.6C (97.8F) to 37C (98.6F) C. Increased blood pressure from 112/68 to 120/72 mmHg D. Increased heart rate from 68 to 72/min

Answer 51

A. Increased respiratory rate from 18 to 44/min

Question 52

A nurse is teaching a client who has rheumatoid arthritis about increasing physical rest as part of her treatment plan. Which of the following outcomes of this intervention should the nurse document as a goal for this client? A. Reduced joint stress B. Maintenance of joint function C. Suppression of the inflammatory process D. Decreased stiffness

Answer 52

A. Reduced joint stress

Question 53

A nurse is planning care for a client who has terminal cancer and has a prescription for morphine. Which of the following interventions should the nurse include in the plan of care? A. Instruct the client to take diphenoxylate/atropine 5mg PO twice a day. B. Instruct the client to actively cough to prevent a buildup of secretion in the airway C. Instruct the client to stop taking the morphine if itching develops D. Instruct the client to keep room lights dim during waking hours

Answer 53

B. Instruct the client to actively cough to prevent a buildup of secretion in the airway

Question 54

The nurse is developing a plan of care for a client who has a fracture to achieve the outcome of functional healing. To assist in meeting this goal, which of the following nursing interventions is the highest priority? A. Maintain immobilization and alignment B. Provide optimal nutrition and hydration C. Promote independence in activities of daily living D. Provide relief from pain and discomfort

Answer 54

A. Maintain immobilization and alignment

Question 55

A nurse is receiving change-of-shift report for a group of assigned clients. The nurse anticipates which of the following activities first in delivering client care using the nursing process? A. Critically analyze client data to determine priorities B. Collect and organize client data C. Set client-centered, measurable and realistic goals D. Determine effectiveness of interventions

Answer 55

B. Collect and organize client data

Question 56

A nurse in a clinic is interviewing a client who will undergo diagnostic testing. The nurse should ask about a client potential allergies during which phase of the nursing process? A. Planning B. Evaluation C. Assessment D. Implementation

Answer 56

C. Assessment

Question 57

A nurse is caring for a client who is prescribed bedrest. The plan of care indicates that the client perform isometric exercise every 2 hr. Which of the following actions should the nurse take as directed by the plan of care? A. Ask the client to move her arms and legs while applying slight resistance. B. Move the client's limbs through their complete range of motion C. Have the client move each limb independently through its complete range of motion D. Instruct the client to tighten muscle groups for a short period, and then relax.

Answer 57

D. Instruct the client to tighten muscle groups for a short period, and then relax.

Question 58

A nurse is caring for a client who lost all his possessions in a house fire and states, "I have no idea what I am going to do. I cannot think right now." Which of the following actions should the nurse take? A. Identify other housing options and sources of transportation B. Notify the facility chaplain to request scheduling an appointment C. Confirm that everything will be all right because belongings can be replaced D. Maintain eye contact with client and summarize the client's feelings

Answer 58

D. Maintain eye contact with client and summarize the client's feelings

Question 59

A nurse is reinforcing teaching about transdermal nitroglycerin to a client who has stable angina. Which of the following statements by the client indicates teaching has been effective? A. I should leave the patch on for 16 to 20 hours each day B. I will apply a new patch in the same location each day C. The patch should be effective within an hour of being applied D. The medication is not absorbed as well when placed on the abdomen.

Answer 59

C. The patch should be effective within an hour of being applied

Question 60

A nurse in a provider's office is orienting a newly licensed nurse on how to position a client for a vaginal examination. The nurse should include in the teaching to place the client in which of the following positions? A. Lithotomy B. Dorsal Recumbent C. Prone D. Lateral Recumbent

Answer 60

A. Lithotomy

Question 61

A nurse is reinforcing teaching to a client who has aphasia. Which of the following actions by the nurse is appropriate when communicating with the client? A. Raising her voice level when speaking to the client B. Asking the client open-ended questions C. Clarifying client statements with the family as needed D. Having the client use eye blinks to indicate yes or no

Answer 61

D. Having the client use eye blinks to indicate yes or no

Question 62

A nurse is caring for a client who has osteoarthritis and is considering treatment with acupuncture. Which of the following is acceptable for the nurse to include in discussion with the client? A. Acupuncture is loosely regulated by the federal government B. Acupuncture has been discredited by scientific research C. Acupuncture is though to be effective only as a placebo D. Acupuncture has been proven to reduce pain and increase function

Answer 62

D. Acupuncture has been proven to reduce pain and increase function

Question 63

A nurse discovers that a client who is diagnosed with dementia received the wrong medication. Which of the following should be the nurse's first action? A. Inform the nurse manager B. Determine the client's condition C. Notify the provider D. Complete an incident report

Answer 63

B. Determine the client's condition

Question 64

A nurse is caring for a client who had a cerebrovascular accident and is having difficulty swallowing. Which of the following health care professionals should attend the client's next interdisciplinary team meeting to address this complication? A. Speech pathologist B. Occupational therapist C. Social worker D. Respiratory therapist

Answer 64

A. Speech pathologist

Question 65

A nurse is caring for an older adult client who has an allergy to sulfa, is taking valproic acid for a seizure disorder, and has been newly diagnosed with osteoarthritis. The client states, "I keep seeing commercials on TV for celebrex and I want to try it and see if it will help my pain." Upon review of scientific evidence, the nurse should inform the client of which of the following? A. Celecoxib is contraindicated in clients taking valproic acid. B. Celecoxib is contraindicated in older adults C. Celecoxib is contraindicated in clients with a seizure disorder D. Celecoxib is contraindicated in clients with an allergy to sulfonamide

Answer 65

D. Celecoxib is contraindicated in clients with an allergy to sulfonamide

Question 66

A nurse is reinforcing teaching about performing suctioning to a client who is being discharged following a tracheostomy. Which of the following behaviors by the client best indicate to the nurse that teaching has been effective? A. Self-reporting the ability to perform the procedure B. Answering appropriately when questioned orally C. Responding accurately on a written examination D. Demonstrating independent performance of the procedure

Answer 66

D. Demonstrating independent performance of the procedure

Question 67

A nurse is reinforcing teaching about HIV with a group of high school students. Which of the following information is appropriate for the nurse to include? A. Medications will eliminate HIV in most clients B. Adolescents are at a lower risk for developing HIV C. Initial HIV symptoms are often similar to the flu D. Using condoms ensures the prevention of HIV during sexual intercourse.

Answer 67

C. Initial HIV symptoms are often similar to the flu

Question 68

A nurse is caring for a client who has nausea and a prescription for promethazine 25mg IM. Which of the following is appropriate when preparing a medication for administration from an ampule? A. Use a filter needle to administer the promethazine B. Expel air bubbles back into the ampule C. Set the ampule on a flat surface to withdraw the promethazine. D. Break the ampule toward the body.

Answer 68

C. Set the ampule on a flat surface to withdraw the promethazine.

Question 68

A nurse is caring for a client who is diagnosed with active pulmonary tuberculosis and is taking isoniazid and ethambutol. Which of following manifestations reported by the client necessitate the discontinuation of ethambutol? A. Loss of color discrimination B. Nausea and vomiting C. Red-orange discoloration to body fluids D. Edema of feet and hands

Answer 68

A. Loss of color discrimination

Question 69

A nurse is reviewing the documentation of a newly licensed nurse. Which of the following actions by the newly licensed nurse while documenting requires the nurse preceptor to intervene? A. Including in a client's nurses' note that an incident report was completed after a medication error. B. Drawing horizontal lines through blank spaces left in the nurses' notes followed by a signature C. Refusing to chart the vital signs taken by another nurse on a client's graphic flow sheet D. Documenting the provider was contacted to clarify a questionable prescription.

Answer 69

A. Including in a client's nurses' note that an incident report was completed after a medication error.

Question 70

A nurse is caring for a client who has cancer. The client has decided to stop treatment and requests a referral to hospice. By making the referral as requested, the nurse is illustrating which of the following ethical principles? A. Justice B. Autonomy C. Veracity D. Fidelity

Answer 70

B. Autonomy

Question 70

A nurse in a local clinic is caring for a female client who is 35 years old. Which of the following screenings should the nurse recommend to the client? A. Mammogram every year to detect breast cancer B. Colonoscopy every 10 years to detect colon cancer C. Dermatologist evaluation every 3 years to detect skin cancer D. Complete eye examination every year to detect eye disorders

Answer 70

C. Dermatologist evaluation every 3 years to detect skin cancer

Question 71

A nurse is caring for a client who is receiving intermittent enteral tube feedings and having diarrhea after each feeding. Which of the following actions should the nurse take in an attempt to prevent diarrhea after subsequent feedings? A. Chill formular prior to administration B. Verify feeding tube placement C. Reduce the rate of feedings D. Place the client supine during feedings.

Answer 71

C. Reduce the rate of feedings

Question 72

A nurse is caring for a client who is 24 hr postoperative following an inguinal hernia repair. The client is tolerating clear liquids well, has active bowel sounds, and it expressing a desire for "real food." The nurse tells the client, "I will call the surgeon and ask for a change in diet." The surgeon hears the nurse's report and prescribes a full liquid diet. The nurse used which of the following levels of critical thinking? A. Basic B. Commitment C. Complex D. Integrity

Answer 72

A. Basic

Question 73

A nurse receives a prescription for an antibiotic for a client who has cellulitis. The nurse checks the client's medical record, discovers that the client is allergic to the antibiotic, and calls the provider to request a prescription for a different antibiotic. Which of the following critical thinking attitudes did the nurse demonstrate? A. Fairness B. Responsibility C. Risk-taking D. Creativity

Answer 73

B. Responsibility

Question 74

A newly licensed nurse is considering strategies to improve critical thinking. Which of the following actions should the nurse take? (Select all that apply). A. Find a mentor B. Use a journal to write about the outcomes of clinical judgments C. Review articles about evidence-based practice D. Limit consultations with other professionals involved in client's care E. Make quick decisions when unsure about a client's needs.

Answer 74

A. Find a mentor B. Use a journal to write about the outcomes of clinical judgments C. Review articles about evidence-based practice

Question 75

A nurse is caring for a client who has a new prescription for antihypertensive medication. Prior to administering the medication, the nurse uses an electronic database to gather information about the medication and the effects it might have on this client. Which of the following components of critical thinking is the nurse using when he reviews the medication information? A. Knowledge B. Experience C. Intuition D. Competence

Answer 75

A. Knowledge

Question 76

A nurse uses a head to toe approach to conduct a physical assessment of a client who will undergo surgery the following week. Which of the following critical thinking attitudes did the nurse demonstrate? A. Confidence B. Perseverance C. Integrity D. Discipline

Answer 76

D. Discipline

Question 77

A nurse is observing a client drawing up and mixing insulin. Which of the following findings should the nurse identify as an indication that psychomotor learning has taken place? A. The client is able to discuss the appropriate technique. B. The client is able to demonstrate the appropriate technique C. The client states an understanding of the process D. The client is able to write the steps on a piece of paper.

Answer 77

B. The client is able to demonstrate the appropriate technique

Question 78

The nurse in a provider's office is collecting data from the caregiver of a 12 month old infant who asks if the child is old enough for toilet training. Following an educational session with the nurse, the client agrees to postpone toilet training until the child is older. Learning has occurred in which of the following domains? A. Cognitive B. Affective C. Psychomotor D. Kinesthetic

Answer 78

B. Affective

Question 79

A nurse is providing preoperative education for a client who will undergo a mastectomy the next day. Which of the following statements should the nurse identify as an indication that the client is ready to learn? A. I don't want my spouse to see my incision B. Will you give me pain medicine after the surgery? C. Can you tell me about how long the surgery will take? D My roommate listens to everything I say

Answer 79

C. Can you tell me about how long the surgery will take?

Question 80

A nurse is preparing an instructional session for a client about managing stress incontinence. Which of the following actions should the nurse take first when meeting with the client? A. Encourage the client to participate actively in learning B. Select instructional materials C. Identify goals the nurse and client agree are reasonable D. Determine what the client knows about stress incontinence.

Answer 80

D. Determine what the client knows about stress incontinence.

Question 81

A nurse is evaluating how well a client learned the information presented in an instructional session about following a heart healthy diet. Which of the following actions should the nurse take to evaluate the client's learning/ A. Encourage the client to ask questions B. Ask the client to explain how to select or prepare meals C. Encourage the client to fill out an evaluation form about how the nurse presented the information D. Ask whether the client has resources for further instruction on this topic.

Answer 81

B. Ask the client to explain how to select or prepare meals

Question 82

``` The use of diagnostic reasoning involves a rigorous approach to clinical practice and demonstrates that critical thinking cannot be done: A. logically. B. haphazardly. C. independently. D. systematically. ```

Answer 82

B. haphazardly.

Question 83

``` The nursing process organizes your approach while delivering nursing care. To provide the best professional care to patients, nurses need to incorporate nursing process and: A. decision making. B. problem solving. C. intellectual standards. D. critical thinking skills. ```

Answer 83

D. critical thinking skills.

Question 84

``` A patient newly diagnosed with diabetes needs to learn how to use a glucometer. Use of a glucometer constitutes: A. affective learning. B. cognitive learning. C. motivational learning. D. psychomotor learning. ```

Answer 84

D. psychomotor learning.

Question 85

A nurse is caring for a client who is experiencing unexpected manifestations with several body systems. Which of the following priority setting frameworks should the nurse use to prioritize clients assessments? A. Acute vs. chronic B. ABCDE C. Lease restrictive/least invasive D. Survival potential

Answer 85

B. ABCDE

Question 86

A nurse is caring for a client who is confused and trying to remove their peripheral IV. Using the least restrictive/lease invasive priority setting framework, which of the following actions should the nurse take first? A. Apply soft limb restraints to the client's wrists B. Administer an anti-anxiety medication to the client intramuscularly (IM) C. Cover the IV site with an elastic bandage D. Request a prescription a central venous catheter.

Answer 86

C. Cover the IV site with an elastic bandage

Question 87

A nurse has received change-of-shift report for a group of clients. Which of the following clients should the nurse plan to see first? A. A client who is receiving a blood transfusion and reports urticaria B. A client who has back pain and is requesting a muscle relaxant medication C. A client who has an ankle sprain and requests toileting assistance D. A client who has chronic migraine and reports a headache

Answer 87

A. A client who is receiving a blood transfusion and reports urticaria

Question 88

A nurse is assessing a client using the ABCDE priority-setting approach. Which of the following actions should the nurse take when completing the exposure component of this priority setting method? (Select all that apply). A. Observe the client's lower extremities for indications of deep vein thrombosis B. Obtain a respiratory rate for one full minute C. Measure the client's temperature D. Check the client for bruising E. Obtain a blood pressure measurement

Answer 88

A. Observe the client's lower extremities for indications of deep vein thrombosis C. Measure the client's temperature D. Check the client for bruising

Question 89

A nurse is caring for a client who reports feeling inferior and states that they are not good enough. The nurse should recognize that these feelings fall under which of the following categories of Maslow's Hierarchy of Needs? A. Love and belonging B. Self-actualization C. Safety D. Self-esteem

Answer 89

D. Self-esteem

Question 89

A nurse is providing education on priority setting frameworks to a group of newly licensed nurses. Which of the following statements should the nurse make regarding the safety and risk reduction priority setting framework? A. "When using this framework, clients are prioritized using a color-coded system". B. "This framework uses the least restrictive measures first as long as the client's safety is maintained" C. "When using this framework, the nurse will encourage the client to have social relationships through group interaction." D. "This framework assigns the highest priority to the situation that poses a threat to the client's physical well-being."

Answer 89

D. "This framework assigns the highest priority to the situation that poses a threat to the client's physical well-being."

Question 90

A nurse is reviewing the medical records of four clients. Which of the following clients should the nurse identify as the priority for care? A. A client who received digoxin and has a heart rate of 48/min B. A client who received pain medication and has a respiratory rate of 14/min C. A client who has a urinary tract infection and temperature of 37.9 D. A client who has anemia and a blood pressure of 118/78 mmHg

Answer 90

A. A client who received digoxin and has a heart rate of 48/min

Question 91

A nurse in a rehab facility has received report on four clients. Which of the following should the nurse evaluate first? A. A client who has peripheral vascular disease and reports numbness in the toes B. A client who has depression and is easily distracted C. A client who has Alzheimer's disease and is unable to complete activities of daily living D. A client who had abdominal surgery 10 days ago and reports feeling his incision pop

Answer 91

D. A client who had abdominal surgery 10 days ago and reports feeling his incision pop

Question 92

A nurse is caring for a client who has a urinary tract infection. The client is disoriented and found wandering on another unit. Which of the following actions should the nurse take first? A. Ensure all four side rails are up B. Administer a prescribed sedative C. Place the client in soft wrist restraints. D. Move the client to a room near the nurses' station

Answer 92

D. Move the client to a room near the nurses' station