2026/2027 COMPLETE TEST-BANK | Questions and Answers
with Rationales | Graded A+ | 100% Guaranteed Pass.
A nurse on a med surge unit is caring for a client who is post-op following an emergency
appendectomy
Exhibit 1 - VS
Temp 37.7, HR 82, RR 16, BP 127/80, O2 99% on RA
Exhibit 2 - Assessment
Ht 157.7cm
Wt 90kg
BLE warm to touch, pedal pulses 2+ b/l; spider veins noted on BLE; distended veins noted on
RLE
Exhibit 3 - RN Notes
Client reports pain at abd incision site as 4/10; reports RLE pain as 5/10 and itchy; reports RLE
pain has been intermittent for ~2 mo; denies current LLE pain
Specify what condition the client is most likely experiencing, 2 actions the nurse should take,
and two parameters the nurse should monitor to assess the client's progress
Condition Experiencing: Varicose veins
Actions to take: elevate extremity, apply graduated compression stockings
Parameters to monitor: Edema of RLE, Pruritis of RLE
A nurse is caring for a preschooler on a pediatric unit. After reviewing the assessment
findings, which of the following actions should the nurse take? Select 4 actions the nurse
should take.
Discontinue IV Medication
TEST BANK 1
,Administer 0.9% NaCl IV
Administer epinephrine IM
Monitor VS frequently
A nurse is caring for a client who is 24 hr postop following a c-section. Drag 1 condition and 1
client finding to fill in each blank:
The client is at risk for developing __A__ as evidenced by __B__.
A - Seizures
B - BP
A nurse is caring for a client who has schizophrenia in an inpatient facility. Click to highlight
the findings that require immediate follow up.
UNKNOWN RESPONSE
A nurse is caring for a client who is in the spinal cord injury unit.
Exhibit 1 - RN Notes
Day 1; 1700: Client admitted to SCI 3 ays ago following C7 injury. Urinary output 800 mL in
indwelling urinary catheter over last 12 hrs
Day 2; 0600: Client has nonproductive cough. Urinary output 100 mL in indwelling urinary
catheter over last 6 hr.
Exhibit 2 - VS
Day 1, 2200: Temp 37.2, HR 74, RR 20, BP 110/60, O2 95% on RA
Day 2, 0600: Temp 37.8, HR 54, RR 26, BP 96/60, O2 90% on RA
Exhibit 3 - PE
Day 1, 1700 - Lung sounds diminished in lower lobes. Deep tendon reflexes (DTR) are biceps
1+, triceps 1+, patella 0, and ankle 0 b/l. Skin is cool, pale, and dry to touch.
Day 2, 0600: Adventitious lung sounds auscultated in lower lobes b/l. Abdomen distended w/
hypoactive bowel sounds.
Fill in the blank: The nurse should first address the client's __A__ followed by the client's
__B__.
TEST BANK 2
,A - Oxygen saturation
B - Urinary output
A nurse is teaching home wound care to the family of a child who has a large wound. Which of
the following interventions should the nurse recommend?
A. Apply OTC cream if the wound becomes infected
B. Clean the wound twice a day with povidone-iodine
C. Apply heat to the wound for 10 min, four times per day
D. Double-bag soiled dressings in plastic bags for disposal
D
The client should double-bag soiled dressings in plastic bags to prevent the spread of
microorganisms to other household members. OTC products should not be used without
consulting their provider. Povidone-iodine is toxic and should only be used to clean
equipment and intact skin. Heat is contraindicated for wound therapy.
A nurse is caring for a client in the emergency department (ED).
0600:
Client presents with acute altered mental status. Client has a history of frequent ED visits for
alcohol intoxication. Client states that they had an episode of binge drinking yesterday
afternoon. Client awoke this morning on the living room floor trembling and flushed;
remembers having intense dreams and was afraid they had a seizure so they called a family
member to bring them to the ED.
Client reports their average alcohol intake has been "two or three beers" after work each day
and "more on the weekends" for the past 6 months.
Client reports headache, nausea, agitation, and is noted to be diaphoretic.
0800:
Client states "I've got bugs crawling on me. Get them off me!" Client tremulous and
diaphoretic.
TEST BANK 3
, History and Physical:
Alcohol use disorder
Delirium tremens
Nicotine use disorder
Hypertension, diet and exercise controlled.
Vital Signs
0 - Answer ✓✓a. Initiate seizure precautions
c. Perform a Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar)
d. Administer chlordiazepoxide
e. Maintain a low-stimulation environment
f. Administer thiamine
A home health nurse is evaluating a school-age child who has cystic fibrosis. The nurse should
initiate a request for high-frequency chest compression vest in response to which of the
following parent statements?
"My child doesn't like to sit still for nebulizer treatments."
"I think that my child has been running a fever over the last couple of days."
"My child has only a small amount of mucus after percussion therapy."
"I am concerned about my child's future participation in team sports." - Answer ✓✓"My child
has only a small amount of mucus after percussion therapy."
A nurse is caring for a client who has type 1 diabetes mellitus and reports severe ankle pain
after falling off a stepstool at home. Which of the following prescriptions should the nurse
clarify with the provider?
TEST BANK 4