2026/2027 Update) 180 Actual
Questions with Verified Answers|100%
Correct Answers| Graded A+
Question:
The client tells the clinic nurse that the client is thinking about using
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nicotine polacrilex (Nicorette). Which question is MOST important for the
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nurse to ask? i,- i,-
i,- 1. "Have you tried other methods to stop smoking?"
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i,- 2. "How long have you been smoking?"
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i,- 3. "Have you ever had chest pain?"
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i,- 4. "Do you have a partial dental bridge?"?
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Answer:
1) Assessment: outcome not priority but may be appropriate; can be
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asked as part of assessment
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2) Assessment: outcome not priority but may be appropriate; should be
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assessed for further teaching i,- i,- i,-
,3) CORRECT - Assessment: outcome priority; action of nicotine is
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vasoconstriction; increases heart rate and myocardial oxygen i,- i,- i,- i,- i,- i,- i,-
consumption; increased risk of angina and myocardial infarction i,- i,- i,- i,- i,- i,- i,-
4) Assessment: outcome may be appropriate but not priority; gum is place
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between cheek and gums; may stain dental work
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Question:
The nurse cares for the client with a client controlled analgesia (PCA)
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pump. The nurse determines that the client has pressed the button 11
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times and received 6 doses of morphine during the last hour. Which is the
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MOST appropriate action for the nurse to take?
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i,- 1. Assess the patency of the PCA IV tubing.
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i,- 2. Determine the client's understanding of the PCA pump function.
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i,- 3. Obtain an order to begin a PCA infusion of fentanyl.
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i,- 4. Ask the client to describe the pain.?
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Answer:
1) Assessment: outcome not priority but may be appropriate; if tubing is
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obstructed, alarm is activated i,- i,- i,-
2) Assessment: outcome may be appropriate but not priority; more
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important to determine pain level, description of the pain, region and
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radiation of the pain, and relieving factors
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,3) Implementation: outcome not desired; more important to assess
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severity of pain and pain relief first
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4) CORRECT - Assessment: outcome priority; must validate that client is in
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pain before implementation
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Question:
A pregnant woman receives an epidural anesthetic. After administration of
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the epidural anesthetic, the client's blood pressure changes from 120/84
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to 94/50. Which action by the nurse is MOST appropriate?
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i,- 1. Place the client flat on her back.
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i,- 2. Elevate the head of the bed 30 degrees.
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i,- 3. Place the client on her left side with her legs flexed.
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i,- 4. Place the client supine with the foot of the bed elevated.?
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Answer:
1) Implementation: outcome not desired; no increase in venous return
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2) Implementation: outcome not desired; will decrease venous return
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3) CORRECT - Implementation: outcome desired; will increase venous
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return and cardiac output; fetal pressure on inferior vena cava reduced
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, 4) Implementation: outcome not desired; elevation of legs will increase
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venous return, but fetal pressure on vena cava will prevent blood return to
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heart
Question:
A nursing order, "Increase fluid intake" is written for a client diagnosed
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with dehydration. Which finding BEST indicates improving fluid status?
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i,- 1. Urinary output of 1,500 mL in 24 hours.
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i,- 2. Serum hematocrit 52%.
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i,- 3. Oral fluid intake of 900 mL in 24 hours.
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i,- 4. Blood pressure of 100/82.?
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Answer:
1) CORRECT - Assessment: outcome priority; increased amounts of
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antidiuretic hormone secreted; urine output decreased and concentrated
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2) Assessment: outcome not priority; indicates that blood is
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hemoconcentrated
3) Assessment: outcome not priority; normal intake is 1,500 mL in 24 hours
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4) Assessment: outcome not priority; normal BP is 120/80
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