Questions and Answers Updated (Verified Revised Full
Exam)
1. A pt presses the call bell and requests pain medication for a severe headache.
To assess the quality of the pt. Pain, which approach should the nurse use?
- CORRECT ANSWER Ask the patient to describe the pain
2. The nurse is wearing personal protective equipment while caring for a pt. When
exiting the room, which PPE should be removed first?
- CORRECT ANSWER Gloves
3. An older pt is brought to the ED with a sudden onset of confusion that occurred
after experiencing a fall at home. The daughter, who has power of attorney, has
brought the client's prescriptions. Which information should the nurse provide first
when reporting to the healthcare provider using SBAR communication?
- CORRECT ANSWER Increasing confusion of the pt.
4. A pt tells the nurse about working out with a personal trainer and swimming three
times a week in an effort to lose weight and sleep better. The pt states that it still
is taking hours to fall asleep at night. Which action should the nurse implement?
- CORRECT ANSWER Ask the pt for a description of the exercise schedule that is
being followed
5. 2 days prior to discharge from the rehab facility, the nurse is teaching a pt who is
recovering from Guillain-Barre syndrome about home. Which actions should the
nurse include when providing discharge teaching to the pt and spouse? SATA
- CORRECT ANSWER -review safe transfer strategies
-develop a nutritional plan
-help identify community support
6. The nurse implements a tertiary prevention program for type 2 diabetes in a rural
health clinic. Which outcome indicates that the program was effective?
- CORRECT ANSWER pt who develop disease complications promptly received
rehabilitation
, 7. The nurse has received funding to design a health promotion project for African
American women who are at risk for developing breast cancer. Which resource is
most important in designing this program? - CORRECT ANSWER participation
of community leaders in planning the program
8. A pt with multiple injuries is being treated in the burn trauma unit just hours after
the injuries occurred. The healthcare provider instructs the nurse to avoid auto
contamination when performing dressing changes. Which intervention is most
important for the nurse to implement?
- CORRECT ANSWER use gown, mask, and gloves with dressing changes
1. A pt is recovering in the critical care unit following a cardiac cath. IV nitro and
heparin are infusing. The pt is sedated but responds to instructions. After
changing positions, the pt complains of pain at the right groin insertion site. What
action should the nurse implement?
- CORRECT ANSWER Stimulate the pt to take deep breaths
2. Prior to obtaining a trapeze bar for a pt with limited mobility, which pt assessment
is most important for the nurse to obtain?
- CORRECT ANSWER upper body muscle strength
3. While the nurse is assessing an older pt fall risk, the pt reports living at home
alone and never falling. Which action should the nurse take?
- CORRECT ANSWER Continue to obtain pt data needed to complete the fall risk
survey
4. The nurse is feeding an older adult who was admitted with aspiration pneumonia.
The pt is weak and begins coughing while attempting to drink through a straw.
Which intervention should the nurse implement?
- CORRECT ANSWER Teach coughing and deep breathing exercises
5. The nurse is teaching the pt about home care after surgery for an ileal conduit
placement. When reviewing the information, which statement should the nurse
recognize as needing additional education?
- CORRECT ANSWER Empty the pouch when it is half full.
6. A 12 week gestation is admitted to the antepartum unit with a dx of hyperemesis
gravidarum. Which action is most important for the nurse to implement?
- CORRECT ANSWER initiate prescribed IV fluids