Reduction of Risk Potential- Ch. 52-Ch. 54
1. A nurse is reviewing the medical record of a client who has a blood glucose of 260 mg/dL and no
documented history of diabetes mellitus. Which of the following types of medications can cause hyperglycemia
as an adverse effect? (Select all that apply.)
A. Diuretics
B. Corticosteroids
C. Oral anticoagulants
D. Opioid analgesics
E. Antipsychotics
2. A nurse teaching a client how to check blood glucose levels. The nurse should include which of the following
instructions about transferring blood onto the reagent portion of the test strip?
A. Smear the blood onto the strip.
B. Squeeze the blood onto the strip.
C. Touch the puncture to stimulate bleeding.
D. Hold the test strip next to the blood on the fingertip.
3. A nurse attempting to collect a capillary blood specimen via finger stick for blood glucose monitoring is
unable to obtain an adequate drop of blood for the reagent strip. Which of the following actions should the nurse
take first?
A. Puncture another finger to obtain a capillary specimen.
B. Test the urine with a urine reagent strip.
C. Wrap the hand in a warm, moist cloth.
D. Perform a venipuncture to obtain a venous sample.
4. A nurse is teaching self-monitoring of blood glucose (SMBG) to a client who has diabetes mellitus. Which of
the following instructions should the nurse include? (Select all that apply.)
A. Perform SMBG once daily at bedtime.
B. Wipe the hand with an alcohol swab.
C. Hold the hand in a dependent position prior to the puncture.
D. Place the puncturing device perpendicular to the site.
E. Prick the outer edge of the fingertip for the blood sample.
, 1. A nurse is assessing a client who has an acute respiratory infection, increasing the risk for hypoxemia. Which
of the following findings are early indications that should alert the nurse that the client is developing hypoxia?
(Select all that apply.)
A. Restlessness
B. Tachypnea
C. Bradycardia
D. Confusion
E. Hypertension
2. A provider is discharging a client who has a prescription for home oxygen therapy via nasal cannula. Client
and family teaching by the nurse should include which of the following instructions? (Select all that apply.)
A. Apply petroleum jelly around and inside the nares.
B. Remove the nasal cannula during mealtimes.
C. Check the position of the cannula frequently.
D. Report any nausea or difficulty breathing.
E. Post “No Smoking” signs in prominent locations.
3. A nurse is caring for a client who is having difficulty breathing. The client is lying in bed and is already
receiving oxygen therapy via nasal cannula. Which of the following interventions is the nurse’s priority?
A. Increase the oxygen flow.
B. Assist the client to Fowler’s position.
C. Promote removal of pulmonary secretions.
D. Obtain a specimen for arterial blood gases.
4. A nurse is preparing to perform endotracheal suctioning for a client. The nurse should follow which of the
following guidelines? (Select all that apply.)
A. Apply suction while withdrawing the catheter.
B. Perform suctioning on a routine basis every 2 to 3 hr.
C. Maintain medical asepsis during suctioning.
D. Use a new catheter for each suctioning attempt.
E. Apply suction for 10 to 15 seconds.
1. A nurse is reviewing the medical record of a client who has a blood glucose of 260 mg/dL and no
documented history of diabetes mellitus. Which of the following types of medications can cause hyperglycemia
as an adverse effect? (Select all that apply.)
A. Diuretics
B. Corticosteroids
C. Oral anticoagulants
D. Opioid analgesics
E. Antipsychotics
2. A nurse teaching a client how to check blood glucose levels. The nurse should include which of the following
instructions about transferring blood onto the reagent portion of the test strip?
A. Smear the blood onto the strip.
B. Squeeze the blood onto the strip.
C. Touch the puncture to stimulate bleeding.
D. Hold the test strip next to the blood on the fingertip.
3. A nurse attempting to collect a capillary blood specimen via finger stick for blood glucose monitoring is
unable to obtain an adequate drop of blood for the reagent strip. Which of the following actions should the nurse
take first?
A. Puncture another finger to obtain a capillary specimen.
B. Test the urine with a urine reagent strip.
C. Wrap the hand in a warm, moist cloth.
D. Perform a venipuncture to obtain a venous sample.
4. A nurse is teaching self-monitoring of blood glucose (SMBG) to a client who has diabetes mellitus. Which of
the following instructions should the nurse include? (Select all that apply.)
A. Perform SMBG once daily at bedtime.
B. Wipe the hand with an alcohol swab.
C. Hold the hand in a dependent position prior to the puncture.
D. Place the puncturing device perpendicular to the site.
E. Prick the outer edge of the fingertip for the blood sample.
, 1. A nurse is assessing a client who has an acute respiratory infection, increasing the risk for hypoxemia. Which
of the following findings are early indications that should alert the nurse that the client is developing hypoxia?
(Select all that apply.)
A. Restlessness
B. Tachypnea
C. Bradycardia
D. Confusion
E. Hypertension
2. A provider is discharging a client who has a prescription for home oxygen therapy via nasal cannula. Client
and family teaching by the nurse should include which of the following instructions? (Select all that apply.)
A. Apply petroleum jelly around and inside the nares.
B. Remove the nasal cannula during mealtimes.
C. Check the position of the cannula frequently.
D. Report any nausea or difficulty breathing.
E. Post “No Smoking” signs in prominent locations.
3. A nurse is caring for a client who is having difficulty breathing. The client is lying in bed and is already
receiving oxygen therapy via nasal cannula. Which of the following interventions is the nurse’s priority?
A. Increase the oxygen flow.
B. Assist the client to Fowler’s position.
C. Promote removal of pulmonary secretions.
D. Obtain a specimen for arterial blood gases.
4. A nurse is preparing to perform endotracheal suctioning for a client. The nurse should follow which of the
following guidelines? (Select all that apply.)
A. Apply suction while withdrawing the catheter.
B. Perform suctioning on a routine basis every 2 to 3 hr.
C. Maintain medical asepsis during suctioning.
D. Use a new catheter for each suctioning attempt.
E. Apply suction for 10 to 15 seconds.
