PN Fundamentals Questions and
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A nurse at a rehabilitation facility is assisting with the
admission of a client who has left hemiplegia following a
stroke. Which of the following actions should the nurse take
first? Ans: Determine the client's mental status
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A nurse is planning care for a client who practices Judaism.
Which of the following questions should the nurse ask the
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client to better understand how he practices Judaism? Ans:
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"Do you observe the Sabbath?"
Rationale: Some clients who practice Judaism might avoid a
number of activities on the Sabbath, including medical
procedures and business transactions
A nurse is caring for a client who has a visual impairment.
When setting up the client's meal tray, the nurse should take
which of the following actions? Ans: Describe food placement
using the numbers on the face of a clock
By using the numbers of a clock to describe the placement of
food on the client's plate, the nurse is providing the client an
opportunity to eat independently.
A nurse is reinforcing teaching with a male client about clean
intermittent self-catheterization. Which of the following
instructions should the nurse include? Ans: Wash the catheter
with soap and water after use
Rationale: Medical aseptic technique is used for clean
intermittent self-catheterization. Therefore, the client should
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wash the catheter with soap and water and store it in a clean
place. The client should replace the catheter before it becomes
dry and brittle.
A nurse is caring for a client who has a terminal illness. Which
of the following is an expected response by a family member
during the anger stage of grieving? Ans: The family member
criticizes care provided by the nurse
A nurse is assisting with the plan of care for a client who is
dying. Which of the following interventions should the nurse
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include in the plan of care? Ans: Allow family to assist the
client with personal hygiene
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A nurse is preparing to collect blood samples from an older
adult client. Which of the following actions should the nurse
take when performing venipuncture? Ans: Apply the
tourniquet over the client's sleeve
A nurse is collecting data from a client who is receiving a
continuous IV infusion of lactated Ringer's for dehydration.
Which of the following findings indicates infiltration of the
solution into the subcutaneous area? Ans: The area around the
infusion site is cool to the touch
Rationale: Swelling, coolness, paleness, and discomfort at the
infusion site indicate infiltration. The nurse should stop the
infusion and discontinue the IV line
A nurse is reinforcing teaching about home safety with a client
who is at risk for falls. Which of the following client
statements indicates an understanding of the teaching? Ans: I
will secure all of my electrical cords to the baseboard
A nurse is reinforcing teaching about sleep promotion with a
client who reports having difficulty sleeping. Which of the
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following client statements indicates an understanding of the
teaching? Ans: I should play music that relaxes me before I go
to bed
Rationale: The client should establish a relaxing routine such
as taking a warm bath, reading, or listening to soothing
sounds, such as soft music. The client should avoid playing
music while sleeping because this can be a distraction and
interrupt sleep.
A nurse is reinforcing teaching with the partner of a client who
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has left-sided weakness about how to safely move the client
from a bed to a chair at home. which of the following
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statements by the partner indicates an understanding of the
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teaching? Ans: I'll bend at the knees when lifting to get better
leverage
A nurse is reinforcing teaching about health promotion with an
older adult client. Which of the following instructions to the
client is an example of secondary prevention? Ans: Participate
in screenings for tuberculosis
A nurse is monitoring an assistive personnel (AP) who is
measuring a client's oxygen saturation using a pulse oximeter.
Which of the following observations by the nurse indicates
that the AP is correctly performing the task? Ans: The AP
chooses a site with a capillary refill of less than 2 seconds.
Rationale: The nurse should evaluate that the AP is performing
the task correctly by choosing a site with a capillary refill of
less than 2 seconds. The oximeter probe calculates the
percentage of oxygen in hemoglobin. Decreased peripheral
circulation will result in an inaccurate reading.
A nurse is reviewing the laboratory results of a client who has
malnutrition and has been receiving total parenteral nutrition