Multidimensional Care I - Exam 1
B. Have the client record urination times.
C. Gradually increase the urination intervals.
D. Remind the client to hold urine until the
next scheduled urination time. - ANS A nurse is preparing to initiate a bladder-retraining
program for a client who has incontinence.
Which of the following actions should the
Nurse take? (Select all that apply.)
A. Restrict the client's intake of
fluids during the daytime.
B. Have the client record urination times.
C. Gradually increase the urination intervals.
D. Remind the client to hold urine until the
next scheduled urination time.
E. Provide a sterile container for urine.
A. Frequent sexual intercourse
D. Location of the urethra closer to the anus
E. Frequent catheterization - ANS A nurse is reviewing factors that increase the risk
of urinary tract infections (UTIs) with a client who
has recurrent UTIs. Which of the following factors
should the nurse include? (Select all that apply.)
A. Frequent sexual intercourse
B. Lowering of testosterone levels
C. Wiping from front to back to clean the perineum
D. Location of the urethra closer to the anus
E. Frequent catheterization
B. Decrease or avoid caffeine.
D. Avoid drinking alcohol. - ANS A nurse is teaching a client who reports stress urinary
incontinence. Which of the following instructions
should the nurse include? (Select all that apply.)
A. Limit total daily fluid intake.
B. Decrease or avoid caffeine.
C. Take calcium supplements.
D. Avoid drinking alcohol.
E. Use the Credé maneuver
,A. Guided imagery
C. Meditation
D. Music therapy - ANS A nurse is teaching a group of newly licensed
nurses on complementary and alternative
therapies they can incorporate into their practice
without the need for specialized licensing or
certification. Which of the following should the nurse
encourage them to use? (Select all that apply.)
A. Guided imagery
B. Massage therapy
C. Meditation
D. Music therapy
E. Therapeutic touch
A. Art therapy
C. Yoga
E. Biofeedback - ANS A nurse is reviewing complementary and
alternative therapies with a group of newly licensed
nurses. Which of the following interventions are
mind-body therapies? (Select all that apply.)
A. Art therapy
B. Acupressure
C. Yoga
D. Therapeutic touch
E. Biofeedback
C. Make sure that the client's call light is within reach
D. Provide the client with nonskid footwear
E. Complete a fall-risk assessment - ANS A nurse is caring for a client who fell at a nursing
home. The client is oriented to person, place,
and time and can follow directions. Which of the
following actions should the nurse take to decrease
the risk of another fall? (Select all that apply.)
A. Place a belt restraint on the client when they
are sitting on the bedside commode.
B. Keep the bed in its lowest position
with all side rails up.
C. Make sure that the client's call light is within reach.
D. Provide the client with nonskid footwear.
E. Complete a fall-risk assessment.
, C. Move clients who are nearby - ANS A nurse observes smoke coming from under
the door of the staff's lounge. Which of the
following actions is the nurse's priority?
A. Extinguish the fire.
B. Activate the fire alarm.
C. Move clients who are nearby.
D. Close all open doors on the unit.
A. Complete a fall-risk assessment - ANS A nurse is caring for a client who has a history of
falls.
Which of the following actions is the nurse's priority?
A. Complete a fall-risk assessment.
B. Educate the client and family about fall risks.
C. Eliminate safety hazards from
the client's environment.
D. Make sure the client uses assistive
aids in their possession.
D. Place wet towels along the base of the door to the client's room - ANS A nurse discovers a
small paper fire in a trash can
in a client's bathroom. The client has been taken
to safety and the alarm has been activated. Which
of the following actions should the nurse take?
A. Open the windows in the client's
room to allow smoke to escape.
B. Obtain a class C fire extinguisher
to extinguish the fire.
C. Remove all electrical equipment
from the client's room.
D. Place wet towels along the base of
the door to the client's room.
-R- Rescue and remove all patients in immediate danger.
-A- Activate the alarm.
-C- Confine the fire by closing doors and windows and turning off oxygen and electrical
equipment; ventilate patients who are on life support with a bag-valve mask
-E- Extinguish the fire using an appropriate extinguisher - ANS Fire response follows the RACE
sequence, what does each letter stand for?
P - pull the pin
A - aim at the base of the fire
B. Have the client record urination times.
C. Gradually increase the urination intervals.
D. Remind the client to hold urine until the
next scheduled urination time. - ANS A nurse is preparing to initiate a bladder-retraining
program for a client who has incontinence.
Which of the following actions should the
Nurse take? (Select all that apply.)
A. Restrict the client's intake of
fluids during the daytime.
B. Have the client record urination times.
C. Gradually increase the urination intervals.
D. Remind the client to hold urine until the
next scheduled urination time.
E. Provide a sterile container for urine.
A. Frequent sexual intercourse
D. Location of the urethra closer to the anus
E. Frequent catheterization - ANS A nurse is reviewing factors that increase the risk
of urinary tract infections (UTIs) with a client who
has recurrent UTIs. Which of the following factors
should the nurse include? (Select all that apply.)
A. Frequent sexual intercourse
B. Lowering of testosterone levels
C. Wiping from front to back to clean the perineum
D. Location of the urethra closer to the anus
E. Frequent catheterization
B. Decrease or avoid caffeine.
D. Avoid drinking alcohol. - ANS A nurse is teaching a client who reports stress urinary
incontinence. Which of the following instructions
should the nurse include? (Select all that apply.)
A. Limit total daily fluid intake.
B. Decrease or avoid caffeine.
C. Take calcium supplements.
D. Avoid drinking alcohol.
E. Use the Credé maneuver
,A. Guided imagery
C. Meditation
D. Music therapy - ANS A nurse is teaching a group of newly licensed
nurses on complementary and alternative
therapies they can incorporate into their practice
without the need for specialized licensing or
certification. Which of the following should the nurse
encourage them to use? (Select all that apply.)
A. Guided imagery
B. Massage therapy
C. Meditation
D. Music therapy
E. Therapeutic touch
A. Art therapy
C. Yoga
E. Biofeedback - ANS A nurse is reviewing complementary and
alternative therapies with a group of newly licensed
nurses. Which of the following interventions are
mind-body therapies? (Select all that apply.)
A. Art therapy
B. Acupressure
C. Yoga
D. Therapeutic touch
E. Biofeedback
C. Make sure that the client's call light is within reach
D. Provide the client with nonskid footwear
E. Complete a fall-risk assessment - ANS A nurse is caring for a client who fell at a nursing
home. The client is oriented to person, place,
and time and can follow directions. Which of the
following actions should the nurse take to decrease
the risk of another fall? (Select all that apply.)
A. Place a belt restraint on the client when they
are sitting on the bedside commode.
B. Keep the bed in its lowest position
with all side rails up.
C. Make sure that the client's call light is within reach.
D. Provide the client with nonskid footwear.
E. Complete a fall-risk assessment.
, C. Move clients who are nearby - ANS A nurse observes smoke coming from under
the door of the staff's lounge. Which of the
following actions is the nurse's priority?
A. Extinguish the fire.
B. Activate the fire alarm.
C. Move clients who are nearby.
D. Close all open doors on the unit.
A. Complete a fall-risk assessment - ANS A nurse is caring for a client who has a history of
falls.
Which of the following actions is the nurse's priority?
A. Complete a fall-risk assessment.
B. Educate the client and family about fall risks.
C. Eliminate safety hazards from
the client's environment.
D. Make sure the client uses assistive
aids in their possession.
D. Place wet towels along the base of the door to the client's room - ANS A nurse discovers a
small paper fire in a trash can
in a client's bathroom. The client has been taken
to safety and the alarm has been activated. Which
of the following actions should the nurse take?
A. Open the windows in the client's
room to allow smoke to escape.
B. Obtain a class C fire extinguisher
to extinguish the fire.
C. Remove all electrical equipment
from the client's room.
D. Place wet towels along the base of
the door to the client's room.
-R- Rescue and remove all patients in immediate danger.
-A- Activate the alarm.
-C- Confine the fire by closing doors and windows and turning off oxygen and electrical
equipment; ventilate patients who are on life support with a bag-valve mask
-E- Extinguish the fire using an appropriate extinguisher - ANS Fire response follows the RACE
sequence, what does each letter stand for?
P - pull the pin
A - aim at the base of the fire
