NR341 COMPLEX ADULT HEALTH EXAM 1 TEXTBOOK QUESTIONS
AND 100% CORRECT ANSWERS AND RATIONALES LATEST UPDATE
2026-2027 ALREADY GRADED A+
A nurse is monitoring a client who is post operative and unable to respond to
questions. Which of the following nonverbal behaviors should the nurse identify as
an indication that the client has pain? (Select all that apply.)
A. Restlessness
B. Grimacing
C. Moaning
D. Clenching
E. Drowsiness - ANS... -A, B, D
(Restlessness is correct. Clients who have uncontrolled pain often become restless
and anxious in response to the discomfort.
Grimacing is correct. Facial movements such as grimacing, tightly closing the
eyes, and biting the lower lip are behavioral indicators of pain.
Moaning is incorrect. Moaning, groaning, crying, and screaming are vocalizations,
not nonverbal behaviors, that indicate pain.
Clenching is correct. Clenching the teeth and biting the lower lip are common
findings in clients who have pain.
Drowsiness is incorrect. Agitation and aggressiveness, not drowsiness, are
common indicators of pain.)
A nurse is caring for a client who is one day post operative following gynecologic
surgery and reports incisional pain. Which of the following actions should the
nurse take first?
A. determine the time the client last received pain medication.
B. Measure the clients vital signs, including temperature.
C. ask the client to rate her pain on a scale of from 0 to 10.
D. re-position the client and offer her a back rub. - ANS... -C
,(Using evidence-based practice, the nurse should first determine the severity of the
client's pain by using a standard pain scale. Then the nurse can plan the appropriate
interventions.)
A nurse is planning care for a client who is post operative. Which of the following
statements about pain management should the nurse consider when implementing
client care? (Select all that apply.)
A. use of analgesics will eventually lead to addiction.
B. each clients expression of pain may be different and individualized.
C. Patient controlled analgesia (PCA) offers a constant level of opioids within
therapeutic range.
D. Pain level and tolerance can be assessed using a scale from 0 to 10.
E. The client will express the feeling of pain both verbally and nonverbally. -
ANS... -B, C, D, E
(Use of analgesics will eventually lead to addiction is incorrect. The administration
of analgesics does not lead to addiction. This is a common misconception about
pain management.)
A nurse is caring for a client your request prescription pain medication. Which of
the following actions should the nurse perform first?
A. re-position the client.
B. administer the medication.
C. determine the location of the pain.
D. review the effects of the pain medication. - ANS... -C
(The first action the nurse should take using the nursing process is to assess the
client. By determining the location of the pain, the nurse can take the necessary
steps to alleviate the client's pain, such as administering pain medication,
repositioning the client, and teaching the client about the effects of the
medication.)
A nurse is applying a cold compress for a client who has pain and minor swelling
in a suture laceration on the forearm. Which of the following assessments should
the nurse use to determine whether the treatment is effective?
A. inspecting the site for reduced swelling
B. monitoring the clients pulse rate
C. asking the client to rate the pain
, D. having the client perform range of motion of the affected arm - ANS... -C
(Pain is a subjective experience. The nurse should encourage the client to quantify
the pain on a pain scale before, during, and after cold application to determine its
effectiveness.)
A nurse is caring for a group of older adult clients. Which of the following
manifestations indicates one of the clients is experiencing delirium?
A. A client wants to know the current time while there is a clock on the wall.
B. A client attempts to climb out of bed and repeatedly states she must get home.
C. A client requests extra blankets when the thermostat in the room indicates 25.6
Degrees C (78 F).
D. A client refuses to get out of bed and has no motivation to attend to daily
hygiene. - ANS... -B.
(Delirium is characterized by a change in cognition that occurs over a short period
of time. It results from a secondary physiological condition (e.g., infection,
surgery, prolonged hospitalization, hypoxia, fever, medications) and is a transient
disorder. Although delirium can occur with any age, it is more common in older
adults. It frequently progresses in the evening hours and is sometimes called
"sundown syndrome." Delirium is characterized by alterations in memory,
agitation, restlessness, illusions, or hallucinations. A client who becomes acutely
confused and agitated may be showing manifestations of delirium.)
A community health nurse is providing teaching to the family of a client who has
primary dementia. Which of the following manifestations should the nurse tell the
family to expect?
A. Decreased auditory and visual acuity.
B. Decreased display of emotion.
C. Personality traits that are opposite of original traits.
D. Forgetfulness gradually progressing to disorientation. - ANS... -D.
(Dementia usually appears first as forgetfulness. Other manifestations may be
apparent only upon neurologic examination or cognitive testing. Loss of
functioning progresses slowly from impaired language skills and difficulty with
AND 100% CORRECT ANSWERS AND RATIONALES LATEST UPDATE
2026-2027 ALREADY GRADED A+
A nurse is monitoring a client who is post operative and unable to respond to
questions. Which of the following nonverbal behaviors should the nurse identify as
an indication that the client has pain? (Select all that apply.)
A. Restlessness
B. Grimacing
C. Moaning
D. Clenching
E. Drowsiness - ANS... -A, B, D
(Restlessness is correct. Clients who have uncontrolled pain often become restless
and anxious in response to the discomfort.
Grimacing is correct. Facial movements such as grimacing, tightly closing the
eyes, and biting the lower lip are behavioral indicators of pain.
Moaning is incorrect. Moaning, groaning, crying, and screaming are vocalizations,
not nonverbal behaviors, that indicate pain.
Clenching is correct. Clenching the teeth and biting the lower lip are common
findings in clients who have pain.
Drowsiness is incorrect. Agitation and aggressiveness, not drowsiness, are
common indicators of pain.)
A nurse is caring for a client who is one day post operative following gynecologic
surgery and reports incisional pain. Which of the following actions should the
nurse take first?
A. determine the time the client last received pain medication.
B. Measure the clients vital signs, including temperature.
C. ask the client to rate her pain on a scale of from 0 to 10.
D. re-position the client and offer her a back rub. - ANS... -C
,(Using evidence-based practice, the nurse should first determine the severity of the
client's pain by using a standard pain scale. Then the nurse can plan the appropriate
interventions.)
A nurse is planning care for a client who is post operative. Which of the following
statements about pain management should the nurse consider when implementing
client care? (Select all that apply.)
A. use of analgesics will eventually lead to addiction.
B. each clients expression of pain may be different and individualized.
C. Patient controlled analgesia (PCA) offers a constant level of opioids within
therapeutic range.
D. Pain level and tolerance can be assessed using a scale from 0 to 10.
E. The client will express the feeling of pain both verbally and nonverbally. -
ANS... -B, C, D, E
(Use of analgesics will eventually lead to addiction is incorrect. The administration
of analgesics does not lead to addiction. This is a common misconception about
pain management.)
A nurse is caring for a client your request prescription pain medication. Which of
the following actions should the nurse perform first?
A. re-position the client.
B. administer the medication.
C. determine the location of the pain.
D. review the effects of the pain medication. - ANS... -C
(The first action the nurse should take using the nursing process is to assess the
client. By determining the location of the pain, the nurse can take the necessary
steps to alleviate the client's pain, such as administering pain medication,
repositioning the client, and teaching the client about the effects of the
medication.)
A nurse is applying a cold compress for a client who has pain and minor swelling
in a suture laceration on the forearm. Which of the following assessments should
the nurse use to determine whether the treatment is effective?
A. inspecting the site for reduced swelling
B. monitoring the clients pulse rate
C. asking the client to rate the pain
, D. having the client perform range of motion of the affected arm - ANS... -C
(Pain is a subjective experience. The nurse should encourage the client to quantify
the pain on a pain scale before, during, and after cold application to determine its
effectiveness.)
A nurse is caring for a group of older adult clients. Which of the following
manifestations indicates one of the clients is experiencing delirium?
A. A client wants to know the current time while there is a clock on the wall.
B. A client attempts to climb out of bed and repeatedly states she must get home.
C. A client requests extra blankets when the thermostat in the room indicates 25.6
Degrees C (78 F).
D. A client refuses to get out of bed and has no motivation to attend to daily
hygiene. - ANS... -B.
(Delirium is characterized by a change in cognition that occurs over a short period
of time. It results from a secondary physiological condition (e.g., infection,
surgery, prolonged hospitalization, hypoxia, fever, medications) and is a transient
disorder. Although delirium can occur with any age, it is more common in older
adults. It frequently progresses in the evening hours and is sometimes called
"sundown syndrome." Delirium is characterized by alterations in memory,
agitation, restlessness, illusions, or hallucinations. A client who becomes acutely
confused and agitated may be showing manifestations of delirium.)
A community health nurse is providing teaching to the family of a client who has
primary dementia. Which of the following manifestations should the nurse tell the
family to expect?
A. Decreased auditory and visual acuity.
B. Decreased display of emotion.
C. Personality traits that are opposite of original traits.
D. Forgetfulness gradually progressing to disorientation. - ANS... -D.
(Dementia usually appears first as forgetfulness. Other manifestations may be
apparent only upon neurologic examination or cognitive testing. Loss of
functioning progresses slowly from impaired language skills and difficulty with
