and Correct Detailed Answers Already Graded A+
A nurse is caring for a client who has an implanted venous access port. Which of
the following should the nurse use to assess the port?
a. An angiocatheter
b. A butterfly needle
c. A non-coring needle
d. A 25 gauge needle - CORRECT ANSWER-c. A non-coring needle
A nurse is caring for a client who has pneumonia and tells the nurse, "I feel like an
elephant is sitting on my chest." The client is weak and unable to walk. After the
nurse indicates chest pain protocol, which of the following is the priority
diagnostic test?
a. PT and INR
b. 12 lead ECG
c. Chest X-ray
d. Serum potassium - CORRECT ANSWER-b. 12 lead ECG
,A nurse is assessing the growth and development of a 3 y/o child. Which of the
following questions should the nurse ask the parent to determine if the child is
exhibiting typical developmental expectations?
a. "Can your child draw a stick figure?"
b. "Can your child catch and throw a small ball?"
c. "Can your child ride a tricycle?"
d. "Can your child name five colors?" - CORRECT ANSWER-c. "Can your child
ride a tricycle?"
A nurse is preparing to assess fetal heart tones for a client who is at 12 weeks of
gestation. Which of the following actions should the nurse take?
a. Measure the fundal height to determine the placement of the ultrasound
stethoscope
b. Perform Leopold maneuvers prior to auscultating the FHR
c. Position the ultrasound stethoscope above the symphysis pubis to assess the
FHR
d. Place the client in a side-lying position prior to assessing the FHR - CORRECT
ANSWER-c. Position the ultrasound stethoscope above the symphysis pubis to
assess the FHR
,A nurse is assessing a client who has a chest tube with a water seal drainage
system. Upon assessment, the nurse notes tidaling in the water seal. Which of the
following is an explanation for the tidaling?
a. There is a loop of tubing below the drainage system
b. The system is working properly
c. The lung has re-expanded
d. The tubing is partially obstructed by clots - CORRECT ANSWER-b. The
system is working properly
A charge nurse on a medical surgical unit is assisting with the emergency response
plan following an external disaster in the community. In anticipation of multiple
client admissions, which of the following current clients should the nurse
recommend for early discharge?
a. A client who is receiving heparin for DVT
b. A client who is 1 day postoperative following a vertebroplasty
c. A client who has COPD and a respiratory rate of 44/min
d. A client who has cancer with a sealed implant for radiation therapy -
CORRECT ANSWER-a. A client who is receiving heparin for DVT
A nurse is caring for a client who has ESRD. The client's adult child asks the nurse
about becoming a living kidney donor for her father. Which of the following
, conditions in the child's medical history should the nurse identify as a
contraindication to the procedure?
a. Osteoarthritis
b. HTN
c. Amputation
d. Primary glaucoma - CORRECT ANSWER-b. HTN
A nurse is caring for a client who is 4 days postpartum. Which of the following
assessment findings should the nurse expect? (SATA)
a. Foul perineal odor
b. Fundus displaced to the right
c. Lochia serosa
d. Fundus 4 cm (1.6 in) below the umbilicus
e. Postpartum chill - CORRECT ANSWER-c. Lochia serosa
d. Fundus 4 cm (1.6 in) below the umbilicus
A nurse is caring for a client who has given informed consent for ECT. Just before
the procedure, the client tells the nurse she is considering not going forward with
the treatment. Which of the following statements by the nurse is appropriate?
a. "You don't have to go through with the treatment."