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1 of 42
Term
A primary care provider admitted a client experiencing hypertensive
crisis because of the failure to take his prescribed medications. To
determine learning needs, which client assessment by the nurse would
have the highest priority?
a.age
b. perception of the effects of hypertension
c. ability to purchase needed medications
d. support system
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c. c. ability to purchase needed
"are you comfortable, Mrs. Smith?"
medications
a.complete a fall-risk assessment
, c. "I revised my favorite recipe to
be lower in fat"
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2 of 42
Term
The nurse is communicating with a well-oriented older adult client in
a long-term care setting. Which statement best reflects respectful
and caring communication?
a. "are we ready for our shower?"
b. "it's time to go to the dining room, honey"
c. "are you comfortable, Mrs. Smith?"
d. "you would rather wear the slacks, wouldn't you?"
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b. "I am worried about Mr. Black's
blood pressure. It is not decreasing c. "are you comfortable, Mrs.
even with the new antihypertensive Smith?"
medication."
b. "I will go to the nurse' station
for assistance" d. the flap farthest from the body
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3 of 42
,Term
A nurse is caring for a client who fell at a nursing home. The client is
oriented to person, place, and time and can follow directions. Which of
the following actions should the nurse take to decrease the risk of
another fall? Select all that apply.
a. place a belt restraint on the client when they are sitting on
the bedside commode
b. keep the bed in its lowest position with all side rails up
c. make sure that the client's call light is within reach
d. provide the client with nonskid footwear
e. complete a fall-risk assessment
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c. the inner wrapping of an item on the sterile field
d. an irrigation syringe appropriately placed on the sterile field
e. one gloved hand with the other gloved hand
c. make sure that the client's call light is within reach
d. provide the client with nonskid footwear
e. complete a fall-risk assessment
b. wash the hands with soap and water for at least 15 seconds
d. use a clean paper towel to turn off hand faucets
b. "I am worried about Mr. Black's blood pressure. It is not decreasing even with
the new antihypertensive medication."
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4 of 42
Definition
Keep house plants and cleaning agents out of
reach Look for paint chips which can expose infants
to lead Have poison control hotline readily
available
Place poisons, paint, and gasoline in a locked cabinet
Keep all medications in child-proof containers and locked up; also
dispose of any unused medications
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A nurse is caring for a client who has an infection. Sort the manifestations the nurse
would expect to find if the infection is localized or systemic.
a.fever
b. malaise
c. edema
d. pain or tenderness
e. increase in pulse and respiratory rate
A nurse is performing a primary survey for a client who has a life-threatening
condition. In which order should the nurse perform the assessment? (1-5)
a.check the client's LOC
b. check the client's airway
c. check the client's exposure to adverse elements
d. check the client's ventilation
e. check the client's circulation