Question 1 of 180:
A nurse is caring for a client who refuses a blood transfusion. Which of the following actions should the
nurse take?
• Notify risk management about the client’s refusal.
• Document the client’s refusal in the medical record.
• Inform the client that the transfusion is mandatory.
• Suggest that the client explore alternative therapies.
,Correct answer:
• Document the client’s refusal in the medical record.
It is essential to document the client's refusal of treatment in the medical record, as this ensures there is
an official record of the client's wishes. This also protects both the client and the healthcare provider
from potential legal issues.
Question 2 of 180:
A nurse is caring for a client at a clinic.
,Admission Assessment:
1 week ago:
Client reports that manifestations of hopelessness and disinterest are lessened, but present. Sleep
disturbance continues. Provider increased paroxetine to 30 mg daily. Return to clinic in 1 week.
2 weeks ago:
Client with a history of generalized anxiety disorder and major depressive disorder. Client presents with
increased hopelessness, disinterest, and a change in sleep and appetite over several months. Client is
currently taking fluoxetine 20 mg daily for the past year. Fluoxetine discontinued and paroxetine 10 mg
daily started. Return to clinic in 1 week.
Complete the following sentence by using the list of options:
The client is at risk for developing Select due to Select.
The client is at risk for developing:
• Serotonin syndrome
• Depressive relapse
• Medication side effects (e.g., anxiety, insomnia)
, Question 3 of 180:
A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the
nurse identify as a manifestation of pulmonary congestion?
• Frothy, pink sputum
• Weight gain
• Bradypnea
• Jugular vein distention
Correct answer:
A nurse is caring for a client who refuses a blood transfusion. Which of the following actions should the
nurse take?
• Notify risk management about the client’s refusal.
• Document the client’s refusal in the medical record.
• Inform the client that the transfusion is mandatory.
• Suggest that the client explore alternative therapies.
,Correct answer:
• Document the client’s refusal in the medical record.
It is essential to document the client's refusal of treatment in the medical record, as this ensures there is
an official record of the client's wishes. This also protects both the client and the healthcare provider
from potential legal issues.
Question 2 of 180:
A nurse is caring for a client at a clinic.
,Admission Assessment:
1 week ago:
Client reports that manifestations of hopelessness and disinterest are lessened, but present. Sleep
disturbance continues. Provider increased paroxetine to 30 mg daily. Return to clinic in 1 week.
2 weeks ago:
Client with a history of generalized anxiety disorder and major depressive disorder. Client presents with
increased hopelessness, disinterest, and a change in sleep and appetite over several months. Client is
currently taking fluoxetine 20 mg daily for the past year. Fluoxetine discontinued and paroxetine 10 mg
daily started. Return to clinic in 1 week.
Complete the following sentence by using the list of options:
The client is at risk for developing Select due to Select.
The client is at risk for developing:
• Serotonin syndrome
• Depressive relapse
• Medication side effects (e.g., anxiety, insomnia)
, Question 3 of 180:
A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the
nurse identify as a manifestation of pulmonary congestion?
• Frothy, pink sputum
• Weight gain
• Bradypnea
• Jugular vein distention
Correct answer:
