ASSESSMENT 2026 TEST BANK
QUESTIONS WITH 100% COMPLETE VERIFIED ANSWERS
. If a client develops core pulmonale (right-sided heart failure), the
nurse would expect to observe
1. increasing respiratory difficulty seen with exertion.
2. cough productive of a large amount of thick, yellow mucus.
3. peripheral edema and anorexia.
4. twitching of extremities. - ans3
. The nursing team includes two RNs, one LPN/LVN, and one
nursing assistant. The nurse should consider the assignments
appropriate if the nursing assistant is assigned to care for
1. a client with Alzheimer's requiring assistance with feeding.
2. a client with osteoporosis complaining of burning on urination.
3. a client with scleroderma receiving a tube feeding.
4. a client with cancer who has Cheyne-Stokes respirations. - ans1
A 23-year-old man is admitted with a subdural hematoma and
cerebral edema after a motorcycle accident. Which of the following
symptoms should the nurse expect to see INITIALLY?
1. Unequal and dilated pupils.
2. Decerebrate posturing.
3. Grand mal seizures.
4. Decreased level of consciousness. - ans4
A 23-year-old woman at 32-weeks gestation is seen in the
outpatient clinic. Which of the following findings, if assessed by
the nurse, would indicate a possible complication?
1. The client's urine test is positive for glucose and acetone.
2. The client has 1+ pedal edema in both feet at the end of the day.
3. The client complains of an increase in vaginal discharge.
4. The client says she feels pressure against her diaphragm when the baby moves. - ans1
A 38-year-old woman is returned to her room after a subtotal
thyroidectomy for treatment of hyperthyroidism. Which of the
following, if found by the nurse at the patient's bedside, is
nonessential?
1. Potassium chloride for IV administration.
2. Calcium gluconate for IV administration.
3. Tracheostomy set-up.
4. Suction equipment. - ans1
A 59-year-old woman with bipolar disorder is receiving
haloperidol (Haldol) 2 mg PO tid. She tells the nurse, "Milk is
,coming out of my breasts." Which of the following responses by
the nurse is BEST?
1. "You are seeing things that aren't real."
2. "Why don't we go make some fudge."
3. "You are experiencing a side effect of Haldol."
4. "I'll contact your physician to change your medication." - ans3
A 69-year-old client is undergoing his second exchange of
intermittent peritoneal dialysis (IPD). Which of the following
would require an intervention by the nurse?
,1. The client complains of pain during the inflow of the dialysate.
2. The client complains of constipation.
3. The dialysate outflow is cloudy.
4. There is blood-tinged fluid around the intra-abdominal catheter. - ans3
A charge nurse is discussing the responsibility of nurses carig for clients who have C. difficile.
Which of the following information should the nurse include in the teaching?
a) Assign the client to a room with a negative air-flow system
b) Use alcohol-based hand sanitizer when leaving the clients room
c) clean contaminated surfaces in the clients room with a phenol solution
d) have family members wear a gown and gloves when visiting - ansD
A client diagnosed with dementia wanders the halls of the locked nursing unit during the day.
To ensure the client's safety while walking in the halls, the nurse should do which of the
following?
1. Administer PRN haloperidol (Haldol) to decrease the need to walk.
2. Assess the client's gait for steadiness.
3. Restrain the client in a geriatric chair.
4. Administer PRN lorazepam (Ativan) to provide sedation. - ans2
A client has a history of oliguria, hypertension, and peripheral edema.
Current lab values are: BUN -25, K+ -4.0 mEq/L. Which nutrient
should be restricted in the client's diet?
1. Protein.
2. Fats.
3. Carbohydrates.
4. Magnesium. - ans1
a client has a new prescription for spironilactone ( aldactone ) which of the following laboratory
value should the nurse recognized as a reason to withhold the morning dose of the medication
and notify the provider - ansserum potassium 5.2
a client has prescription for valproic ( Depakote) which of the following laboratory value should
the nurse anticipate monitor for the client taking this medication - ansthrombocytes, amylase
count and liver function test
A client is admitted with a diagnosis of acute appendicitis. When assessing the abdomen, the
nurse would expect to find rebound tenderness at which location?
a) Left lower quadrant
b) Left upper quadrant
c) Right upper quadrant
d) Right lower quadrant - ansD
A client is being discharged with sublingual nitroglycerin
(Nitrostat). The client should be cautioned by the nurse to
1. take the medication five minutes after the pain has started.
2. stop taking the medication if a stinging sensation is absent.
, 3. take the medication on an empty stomach.
4. avoid abrupt changes in posture. - ans4