ANSWERS (VERIFIED AND WELL DETAILED ANSWERS) LATEST
2025/2026
A nurse is caring for a client who is at 33 weeks of gestation following an
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amniocentesis. The nurse should monitor the client for which of the following
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complications?
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A. Vomiting
B. Hypertension
C. Epigastric pain M
D. Contractions - CORRECT ANSWER- D. Contractions M M M M M
A nurse is providing teaching to an older adult client about methods to promote
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nighttime
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sleep. Which of the following instructions should the nurse include?
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A. Stay in bed at least 1 hr if unable to fall asleep
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B. Take a 1 hr nap during the day
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C. Perform exercises prior to bedtime
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D. Eat a light snack before bedtime - CORRECT ANSWER- D. Eat a light snack
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before bedtime
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A nurse on a telemetry unit is caring for a client who becomes unconscious and
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whose monitor displays ventricular tachycardia. Which of the following actions
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should the nurse take first after determining the client does not have a palpable
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pulse?
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A. Assess heart sounds M M
,B. Defibrillate
C. Establish IV access M M
D. Administer epinephrine - CORRECT ANSWER- B. Defibrillate
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A nurse is admitting a client who 1 week postpartum and reports excessive vaginal
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bleeding. The nurse does not speak the same language as the client. The client's
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partner and 10-year-old child are accompanying her. Which of the following
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actions should the
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nurse take to gather the client's admission data?
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A. Have the client's child translate
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B. Allow the client's partner to translate
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C. Request a female interpreter through the facility
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D. Ask a nursing student who speaks the same language as the client to translate -
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CORRECT ANSWER- C. Request a female interpreter through the facility
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A nurse is caring for a client who is febrile. To reduce the client's fever, the nurse
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applies a cooling blanket. Which of the following findings indicates the client is
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having an adverse reaction to the cooling?
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a. Flushing
b. Tachycardia
c. Restlessness
d. Shivering - CORRECT ANSWER- d. Shivering M M M M M
A nurse is caring for a client who has deep-vein-thrombosis of the left lower
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extremity. Which of the following actions should the nurse take? (Exhibit)
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A. Position the client with the affected extremity lower than the heart
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,B. Withhold heparin IV infusion PTT- 30-40 seconds; x2 if on heparin
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C. Administer acetaminophen M
D. Massage the affected extremity every 4 hr - CORRECT ANSWER- B.
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Withhold heparin IV infusion PTT- 30-40 seconds; x2 if on heparin
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A nurse is reviewing assessment data from several clients. For which of the
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following clients should the nurse recommend referral to a dietitian?
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A. An older adult client who has a BMI of 24
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B. A client who has a nonhealing leg ulcer
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C. An older adult client who has presbyopia
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D. A client who has an albumin level of 3.7 g/dL (normal 3.4-5.4) - CORRECT
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ANSWER- B. A client who has a nonhealing leg ulcer
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8. A nurse is providing discharge teaching to a client who has a chronic kidney
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disease and is receiving hemodialysis. Which of the following instructions should
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the nurse include in the teaching?
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a. Eat 1 g/kg of protein per day
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b. Take magnesium hydroxide for indigestion
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c. Drink at least 3 L of fluid daily-
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Consume foods high in potassium- restrict - CORRECT ANSWER- a. Eat 1 g/kg
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of protein per day
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A nurse is caring for a client who is receiving intermittent enteral tube feedings.
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Which of M
the following places the client at risk for aspiration?
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A. Sitting in a high-Fowler's position during the feeding
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, B. A history of gastroesophageal reflux disease
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C. Receiving a high osmolarity formula M M M M
D. A residual of 65 mL 1 hr postprandial? - CORRECT ANSWER- B. A history
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of gastroesophageal reflux disease
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?A nurse is providing prenatal teaching to a client who is at 12 weeks of gestation.
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The nurse should tell the client that she will undergo which of the following
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screening tests at 16 weeks of gestation?
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A. Chorionic villus sampling- as early as 8 weeks M M M M M M M
B. Cervical cultures for chlamydia- 1st appointment.
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C. Nonstress test -28 weeks M M M
D. Maternal serum alpha-fetoprotein- 16 to 18 weeks - CORRECT ANSWER- D.
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Maternal serum alpha-fetoprotein- 16 to 18 weeks
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A nurse is caring for a client who is on bed rest. The nurse should recognize that
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which of
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the following findings is a complication of immobility?
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A. Decreased serum calcium levels- increased serum calcium M M M M M M
B. Increased blood pressure- hypotension M M M
C. Swollen area on calf M M M
D. Urinary frequency- - CORRECT ANSWER- C. Swollen area on calf
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12. A nurse in acute care mental health facility is participating in a medication-
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education group. The leader of the group uses a laissez-faire leadership style.
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Which of the following actions should the nurse expect from the leader during the
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session?
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