Answers 2024
1. A nurse is assisting with the care of a client who was admitted to the emergency
department (ED).: Schizophrenia
- Pressured speech
- Social impairment
- Grandiose delusions
Bipolar 1 Disorder
- Pressured speech
- Social impairment
- Grandiose delusions
2. A nurse is caring for a client who is 12 hr postoperative following a total hip arthroplasty. Which of
the following actions should the nurse take?: Place an abduction wedge between the client's legs
when in bed.
3. A nurse is evaluating the safe use of electrical equipment by a newly hired assistive personnel
(AP). Which of the following actions by the AP demon- strates an understanding of the proper use of
electrical equipment?: Grasps the plug of a device in the client's room to pull it straight out from
the wall
4. A nurse is assisting with the care of an adolescent in the emergency department (ED).: -
skin findings
- temperature
- WBC count
- casual blood glucose
- potassium
- pain
5. A nurse is assisting with the care of a client admitted with profuse vomiting and abdominal pain.: -
peritonitis
- bowel obstruction
6. A nurse on the medical-surgical unit is assisting with the care of a client who was admitted
from the emergency department (ED).: - confusion
- sodium level
7. A nurse is assisting with care of a client who is on 24-hr observation.: - hemorrhage
- thrombocytopenia
8. A nurse is caring for a client who is postoperative following a perineal prostatectomy. For each
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Answers 2024
potential postoperative complication below, click to specify the nursing intervention that the nurse
should implement.: - offer the client a sitz bath to relieve pain and promote healing
- encourage the client to drink prune juice to relieve constipation
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Answers 2024
- instruct the client to perform calf pump and foot circle exercises to promote venous return and
reduce the risk of a deep vein thrombosis.
9. A nurse is collecting data on a newborn who is 3 days old.: - temperature of
36.4° C (97.5° F)
- Weight 2,545 g (5 lb 9 oz) 12% weight loss
- Breastfeeding every 3 to 5 hr for 5 to 10 min.
- Birth parent reports nipple discomfort throughout the feeding
- Mild tremors noted when awake
10.A nurse on a mental health unit is caring for a client. For each nursing action, click to specify if
the nursing action is anticipated or contraindicated for the client.: ANTICIPATED:
- Offer high calorie snacks frequently.
- Initiate suicide precautions.
- Encourage the client to attend group therapy.
CONTRAINDICATED:
- Allow the client to sleep with their hands beneath the blanket.
11.A nurse is assisting in the care of a client who is postoperative following administration of
general anesthesia.: ACTIONS:
- administer dantrolene
- administer oxygen
CONDITION:
-malignant hyperthermia
PARAMETERS:
- monitor for hypercapnia
- monitor for muscle tension
12.A nurse is assisting with the care of a client who has a new diagnosis of anorexia nervosa.
Complete the following sentence by using the lists of options.: - electrolyte imbalance
- fear of weight gain
13.A nurse is assisting with the care of a client who has bulimia nervosa. Drag words from the
choices below to fill in each blank in the following sentence.: - cardiovascular abnormalities
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