CORRECT ACTUAL QUESTIONS AND
CORRECTLY WELL DEFINED ANSWERS
LATEST 2024 – 2025 ALREADY GRADED A+
A nurse is reinforcing teaching with a client who has a history of calcium oxalate,
kidey stones.
Which of the following statements by the client indicates an understanding of the
instructions
- I'll be sure to eliminate peanuts from my diet - ANSWERS-I'll be sure to eliminate
peanuts from my diet
Peanuts are a source of oxalate; therefore, the client should avoid them to reduce
the formation of calcium oxalate stones. Certain fruits, nuts, grains, and legumes
contain oxalate, and the client should minimize or eliminate intake of these foods.
A nurse is collecting data from a client who reports dizziness, vertigo, and is
preforming the
Romberg test. Which of the following instructions should the nurse give the
clients about this test.
- stand with your feet a part
,-hold your arm out in front of you
- Open your eyes
- walking straight line - ANSWERS-Open your eyes
The nurse should instruct the client to stand with their feet together and eyes
open. Then the client should close their eyes to determine if they lose balance.
The test is negative if the client can remain upright and keep balance with
minimal swaying and without moving their feet to another position. A positive
test can indicate a dysfunction of the cerebellum or inner ear.
A nurse examining a client's rhythm strips notices no visible P waves but many
small, erratic
spikes throughout the strip as well as variable ventricular rate. The nurse should
identify and
report this pattern as which of the following dysrhythmias?
- Atrial Fibrillation - ANSWERS-- Atrial Fibrillation
A nurse is reinforcing teaching with a male client who has right sided hemiparesis
about
preforming ADL's. Which of the following instructions should the nurse include in
the teaching
-Comb your hair with the unaffected arm
-Dress your unaffected side first
,choose clothing with buttons
-shave with your affected side - ANSWERS-Comb your hair with the unaffected
arm
The nurse should instruct the client to brush their hair with the unaffected arm to
reduce frustration and increase independence and self-esteem.
A nurse is collecting data from a client and auscultates intermittent high-pitched
sounds during inspiration over the lower base of the lungs. The nurse should
identify this finding as which of the following lungs sounds
- Fine crackles
-stridor
-rhonchi
-friction - ANSWERS-- Fine crackles
Fine crackles are auscultated in the base of the lungs as air moves through airway
secretions. Fine crackles are intermittent, high-pitched sounds heard more often
during inspiration.
A nurse is collecting data from a client who has coronary artery disease. Which of
the following
manifestations should the nurse identify as an indication that the client has
angina ( SatA)
, - Chest Discomfort Radiated
- Pain lasting less that 15mins
- Pain that is relieved with rest - ANSWERS-- Chest Discomfort Radiated
- Pain lasting less that 15mins
- Pain that is relieved with res
A nurse is receiving change-of-shift report for a group of clients. Which of the
following clients
should the nurse plan to see first?
- A client who has diabetes mellitus with diaphoretic - ANSWERS-A client who has
diabetes mellitus with diaphoretic
When using the urgent vs. nonurgent approach to client care, the nurse should
determine that the priority action is to attend to a client who has diabetes
mellitus and is diaphoretic. Diaphoresis is a manifestation of hypoglycemia and
can lead to decreased cerebral function. The nurse should check the client's blood
glucose and administer a fast-acting glucose as prescribed.
A nurse is assisting with the care of four clients. Which of the following clients is
the priority for
the nurse to see
-A client who has chest tubes and an oxygen Sat of 90%