ANSWERS AND RATIONALE LATEST 2025/2026
BUN
Rationale:
BUN levels indicate kidney function. The nurse should review the lab level to
determine if the client can tolerate the IV contrast dye during the procedure. -
CORRECT ANSWER A nurse is collecting data on a client who is scheduled for a
cardiac catheterization. Which of the following laboratory levels should the nurse
review prior to the procedure?
Determine the client's daily elimination habits. - CORRECT ANSWER A nurse is
assisting in the plan of care regarding bowel retraining for a client who has a
cervical spinal cord injury. Which of the following interventions should the nurse
plan to implement first?
"You should have a pneumococcal immunization every 10 years." - CORRECT
ANSWER A nurse is discussing health screening guidelines with an older adult
client. Which of the following statements should the nurse include?
-"I never forget to rinse my mouth after using my budesonide inhaler."
-"Between office visits, I keep a record of how many times I use my albuterol
inhaler."
-"I use my albuterol inhaler before I go swimming." - CORRECT ANSWER A nurse is
reinforcing teaching with a client who has asthma. Which of the following client
,statements indicates an understanding of the ruse of budesonide and albuterol
inhalers? SATA
Small liquid stools - CORRECT ANSWER A nurse in a long-term care facility is
collecting data from a client who reports fullness in the rectum and abdominal
cramping. Which of the following findings should indicate to the nurse that the
client might have a fecal impaction?
Change the sheepskin liner weekly - CORRECT ANSWER A nurse is reinforcing
teaching with the family of a client who has a cervical injury and has a halo vest in
place. Which of the following safety precautions should the nurse include in
teaching?
Mohs surgery is a horizontal shaving of thin layers of the tumor - CORRECT
ANSWER A nurse in an oncology clinic is reinforcing teaching about Mohs surgery
with a client who has skin cancer. Which of the following information should the
nurse include in the teaching?
History of treatment for blood clots - CORRECT ANSWER A nurse is collecting data
from a 55-year-old female client who reports vaginal dryness and hot flashes. The
client is interested in trying hormone replacement therapy (HRT). Which of the
following should the nurse recognize as a contraindication to HRT?
"I understand that pea-sized lumps are normal." - CORRECT ANSWER A nurse is
reinforcing teaching with an adolescent client regarding testicular self-
examination. Which of the following statements by the client demonstrates an
understanding of the teaching?
, Hgb 11 g/dL - CORRECT ANSWER A nurse is reviewing the laboratory results of a
client who has chronic kidney failure and is receiving epoetin Alfa. The nurse
should identify that which of the following laboratory values indicates the
treatment is effective?
Creatinine 1.9 mg/dL
Rationale:
Creatinine 1.9 mg/dL is not within the expected reference range. Therefore, the
nurse should report the finding to the provider before the client has a CT scan
with an IV contrast agent. This finding places the client at risk for developing
contrast-induced nephropathy. - CORRECT ANSWER A nurse is reviewing the
laboratory results of a client who is scheduled for a CT scan with an IV contrast
agent. Which of the following laboratory findings should the nurse report to the
provider prior to the procedure?
Allow for 30 min of rest before meals - CORRECT ANSWER A nurse is caring for a
client who had an acute ischemic stroke 1 day ago. Which of the following actions
should the nurse take to reduce the risk for aspiration?
Recommend a referral for a speech language pathologist.
Rationale:
The greatest risk to the client following a stroke is injury from aspiration.
Therefore, the first intervention the nurse should include in the plan of care is to
recommend a referral for a speech language pathologist. A speech language
pathologist can conduct a swallow study to determine the client's risk for
aspiration, provide teaching to the client regarding swallowing techniques, and