1. The nurse working on a medical-surgical unit has been made aware of the following
client situations. The nurse should first plan to assess the client who?
a) Has DM II and has had a premal blood glucose of 85 mg/dl and now has a post meal
blood glucose of 220mg/dl.
b) Is 24 hours post-op from ABD surgery and has wound drainage and has changed
from sanguineous to serosanguinous over the past 2 hours
c) Has an acute pancreatitis and reports an unchanged pain level from 7 on a scale of
0- 10, 30 min after receiving a prescribed oral pain medication.
d) Is receiving preparation for a colonoscopy and whose blood pressure was 128/74
mm Hg at the last reading and is now 106/60mm HG
2. The nurse has received the hand-oO report and is assigning tasks to UAP. Which of
the following tasks should the nurse instruct the UAP to perform FIRST?
a) Deliver a lunch tray to a client who is returning from radiology and has been NPO
since breakfast.
b) Obtain a capillary blood glucose on a client who had a hypoglycemic episode 30min
ago and relieved dextrose IV.
c) Turn and reposition a client who was last turned 2 hours ago
d) Obtain a sputum specimen from a client who has suspected TB
3. The nurse working on a pediatric unit has received the hand-oO report and is
reviewing client data and orders. Which of the following clients should the nurse
plan to see first?
a) The school age child who has DM I and requires blood glucose monitoring.
b) The infant who has a diagnosis of pertussis and is receiving oxygen via NC
c) The adolescent who was admitted with sickle cell crisis and is being discharged
home
d) The toddler who has bilat arm casts and needs to be fed their breakfast.
4. A newly hired nurse is discussing health care economics and fiscal responsibility
with the nurse preceptor. Which of the following statements about fiscally
responsible practice by the newly hired nurse requires follow-up?
a) Following best practice guidelines based on evidence demonstrates fiscal
responsibility.
b) Engaging in safe clinical practice to avoid personal injuries is an example of fiscal
responsibility.
c) Involving the family in client care activities is an example of fiscal responsibility
d) Completing assigned nursing care during scheduled hours is a way to demonstrate
fiscal responsibility.
5. The nurse preceptor is observing a newly hired nurse teach a client who has pelvic
inflammatory disease about self-care. The client does not speak English. Which of
the following actions by the newly hired nurse requires intervention by the nurse
preceptor?
, a) Providing written instructions to the client in their primary language.
b) Having a family member who speaks both English and the clients language interpret
the instructions
c) Contacting the charge nurse to obtain assistance from a facility-approved
interpreter.
d) Utilizing a facility-approved telephone interpretation service to conduct the
teaching.
6. The nurse working in the L&D unit is caring for a client in labor whose membranes
just spontaneously ruptured. Which of the following findings is a priority for the
nurse to report to the primary health care provider?
a) Contractions lasting 60 sec
b) 4 contractions in a 10 min period
c) A maternal temp of 99.5
d) New appearance of late decelerations
7. The nurse preceptor is observing a newly hired nurse care for assigned clients.
Which of the following actions by the newly hired nurse indicates correct care?
a) Administering oral pain meds to a client 30 min prior to hospital discharge.
b) Placing a N95 respirator mask on a client who has active TB in preparation for
transport to a long-term care facility
c) Using a 23-guage, 1inch needles when administering a medication in the deltoid
muscle.
d) Teaching a client who has a new ileostomy to empty the ostomy bag 30 min after
eating a meal.
8. The nurse working in an outpatient care clinic is assessing client who are waiting to
be seen. Which of the following clients should the nurse have the PCHP see first?
a) 57 yo male who has graves disease and has an intolerance to heat with diaphoresis
b) 37 yo who has PKD and lumbar pain when ambulating in the hallway.
c) 45 yo who has pleurisy and is reporting worsening of SOB.
d) 15 yo who reports the development of a bull’s eye rash 2 days after being on a
camping trip
9. The nurse is being made aware of the following client situations. The nurse should
first plan to see the client who has?
a) Neutropenia, a recent WBC of 3,000 and is eating homemade cookies brought in by
a visitor.
b) Cervical cancer is receiving internal radiation therapy, and whose partner has been
visiting at the bedside the past 2 hours.
c) Bone marrow suppression, receiving epotin alfa, and has a change in blood
pressure from 140/94 to 124/80mm Hg over the past hour.
d) Thrombocytopenia and has a family member t=who has brought fresh fruit and
flowers into the clients room.
client situations. The nurse should first plan to assess the client who?
a) Has DM II and has had a premal blood glucose of 85 mg/dl and now has a post meal
blood glucose of 220mg/dl.
b) Is 24 hours post-op from ABD surgery and has wound drainage and has changed
from sanguineous to serosanguinous over the past 2 hours
c) Has an acute pancreatitis and reports an unchanged pain level from 7 on a scale of
0- 10, 30 min after receiving a prescribed oral pain medication.
d) Is receiving preparation for a colonoscopy and whose blood pressure was 128/74
mm Hg at the last reading and is now 106/60mm HG
2. The nurse has received the hand-oO report and is assigning tasks to UAP. Which of
the following tasks should the nurse instruct the UAP to perform FIRST?
a) Deliver a lunch tray to a client who is returning from radiology and has been NPO
since breakfast.
b) Obtain a capillary blood glucose on a client who had a hypoglycemic episode 30min
ago and relieved dextrose IV.
c) Turn and reposition a client who was last turned 2 hours ago
d) Obtain a sputum specimen from a client who has suspected TB
3. The nurse working on a pediatric unit has received the hand-oO report and is
reviewing client data and orders. Which of the following clients should the nurse
plan to see first?
a) The school age child who has DM I and requires blood glucose monitoring.
b) The infant who has a diagnosis of pertussis and is receiving oxygen via NC
c) The adolescent who was admitted with sickle cell crisis and is being discharged
home
d) The toddler who has bilat arm casts and needs to be fed their breakfast.
4. A newly hired nurse is discussing health care economics and fiscal responsibility
with the nurse preceptor. Which of the following statements about fiscally
responsible practice by the newly hired nurse requires follow-up?
a) Following best practice guidelines based on evidence demonstrates fiscal
responsibility.
b) Engaging in safe clinical practice to avoid personal injuries is an example of fiscal
responsibility.
c) Involving the family in client care activities is an example of fiscal responsibility
d) Completing assigned nursing care during scheduled hours is a way to demonstrate
fiscal responsibility.
5. The nurse preceptor is observing a newly hired nurse teach a client who has pelvic
inflammatory disease about self-care. The client does not speak English. Which of
the following actions by the newly hired nurse requires intervention by the nurse
preceptor?
, a) Providing written instructions to the client in their primary language.
b) Having a family member who speaks both English and the clients language interpret
the instructions
c) Contacting the charge nurse to obtain assistance from a facility-approved
interpreter.
d) Utilizing a facility-approved telephone interpretation service to conduct the
teaching.
6. The nurse working in the L&D unit is caring for a client in labor whose membranes
just spontaneously ruptured. Which of the following findings is a priority for the
nurse to report to the primary health care provider?
a) Contractions lasting 60 sec
b) 4 contractions in a 10 min period
c) A maternal temp of 99.5
d) New appearance of late decelerations
7. The nurse preceptor is observing a newly hired nurse care for assigned clients.
Which of the following actions by the newly hired nurse indicates correct care?
a) Administering oral pain meds to a client 30 min prior to hospital discharge.
b) Placing a N95 respirator mask on a client who has active TB in preparation for
transport to a long-term care facility
c) Using a 23-guage, 1inch needles when administering a medication in the deltoid
muscle.
d) Teaching a client who has a new ileostomy to empty the ostomy bag 30 min after
eating a meal.
8. The nurse working in an outpatient care clinic is assessing client who are waiting to
be seen. Which of the following clients should the nurse have the PCHP see first?
a) 57 yo male who has graves disease and has an intolerance to heat with diaphoresis
b) 37 yo who has PKD and lumbar pain when ambulating in the hallway.
c) 45 yo who has pleurisy and is reporting worsening of SOB.
d) 15 yo who reports the development of a bull’s eye rash 2 days after being on a
camping trip
9. The nurse is being made aware of the following client situations. The nurse should
first plan to see the client who has?
a) Neutropenia, a recent WBC of 3,000 and is eating homemade cookies brought in by
a visitor.
b) Cervical cancer is receiving internal radiation therapy, and whose partner has been
visiting at the bedside the past 2 hours.
c) Bone marrow suppression, receiving epotin alfa, and has a change in blood
pressure from 140/94 to 124/80mm Hg over the past hour.
d) Thrombocytopenia and has a family member t=who has brought fresh fruit and
flowers into the clients room.
