A nurse is performing a focused assessment for a client who has dysrhythmia. Which of
the following indicates ineffective cardiac contractions?
a) carotid bruit
b) heart murmur
c) pulse deficit
d) bounding radial pulse - CORRECT ANSWER c) pulse deficit
A nurse is preparing to transfer a client from a chair to the client's bed. The client can
bear partial weight and has upper body strength. Which of the following devices should
the nurse use to transfer the client?
a) stand-assist lift
b) footboard
c) slide boards
d) mechanical lift with a full body sling - CORRECT ANSWER a) stand-assist lift
A charge nurse is making assignments for the upcoming shift. Which of the following
client assignments should the charge nurse assign to a licensed practical nurse (LPN)?
a) a client who has received moderate (conscious) sedation
b) a client who was just admitted with multiple rib fractures.
c) a client who is scheduled for a bone marrow transplant.
d) a client who has dehydration and inflammatory bowel disease. - CORRECT
ANSWER d) a client who has dehydration and inflammatory bowel disease.
A nurse is caring for a client who has a prescription for a narcotic medication. After the
medication is administered, the nurse is left with an unused portion. Which of the
following actions should the nurse take?
a) send the remaining medication back to pharmacy.
b) save medication for the next medication administration.
c) discard the medication with another nurse as a witness.
d) throw out the medication into the garbage. - CORRECT ANSWER c) discard the
medication with another nurse as a witness.
, A nurse is updating a plan of care after an evaluation of a client who has dysphagia.
Which of the following interventions should the nurse include in the plan?
a) Ask the client to tilt their head back when swallowing
b) Have the client sit upright for 1 hour following meals.
c) Administer liquids to the client using a syringe.
d) Allow the client to rest of 10 min prior to eating. - CORRECT ANSWER b) Have the
client sit upright for 1 hour following meals.
A nurse is assessing the IV infusion site of client who reports pain at the site. The site is
red and there is warmth along the course of the vein. Which of the following actions
should the nurse take?
a) initiate a new IV line below the original insertion site.
b) discontinue the infusion.
c) raise the head of the bed.
d) obtain a culture from the area of the insertion site. - CORRECT ANSWER b)
discontinue the infusion.
A nurse is preparing to perform a routine abdominal assessment for a client. Which of
the following actions should the nurse take?
a) document shiny, taut skin as an expected finding.
b) perform palpitation after auscultation.
c) listen for 1 minute before documenting absent bowel sounds.
d) perform auscultation immediately after the client has consumed a meal. - CORRECT
ANSWER b) perform palpitation after auscultation.
A nurse is discussing immunity with a client who has received an immunization. The
nurse should identify that an immunization functions as part of the which of following
types of immunity?
a) passive immunity.
b) active immunity.
c) cellular immunity.
d) acquired immunity. - CORRECT ANSWER d) acquired immunity.
A nurse is reviewing the medical records of a group of older adult clients. The nurse
should identify that which of the following is a risk factor that places older clients at an
increased risk for developing infections?
a) overproduction of lymphocytes.
b) elevated albumin levels.
c) lowered immune system function.
d) increased body fat. - CORRECT ANSWER c) lowered immune system function.
the following indicates ineffective cardiac contractions?
a) carotid bruit
b) heart murmur
c) pulse deficit
d) bounding radial pulse - CORRECT ANSWER c) pulse deficit
A nurse is preparing to transfer a client from a chair to the client's bed. The client can
bear partial weight and has upper body strength. Which of the following devices should
the nurse use to transfer the client?
a) stand-assist lift
b) footboard
c) slide boards
d) mechanical lift with a full body sling - CORRECT ANSWER a) stand-assist lift
A charge nurse is making assignments for the upcoming shift. Which of the following
client assignments should the charge nurse assign to a licensed practical nurse (LPN)?
a) a client who has received moderate (conscious) sedation
b) a client who was just admitted with multiple rib fractures.
c) a client who is scheduled for a bone marrow transplant.
d) a client who has dehydration and inflammatory bowel disease. - CORRECT
ANSWER d) a client who has dehydration and inflammatory bowel disease.
A nurse is caring for a client who has a prescription for a narcotic medication. After the
medication is administered, the nurse is left with an unused portion. Which of the
following actions should the nurse take?
a) send the remaining medication back to pharmacy.
b) save medication for the next medication administration.
c) discard the medication with another nurse as a witness.
d) throw out the medication into the garbage. - CORRECT ANSWER c) discard the
medication with another nurse as a witness.
, A nurse is updating a plan of care after an evaluation of a client who has dysphagia.
Which of the following interventions should the nurse include in the plan?
a) Ask the client to tilt their head back when swallowing
b) Have the client sit upright for 1 hour following meals.
c) Administer liquids to the client using a syringe.
d) Allow the client to rest of 10 min prior to eating. - CORRECT ANSWER b) Have the
client sit upright for 1 hour following meals.
A nurse is assessing the IV infusion site of client who reports pain at the site. The site is
red and there is warmth along the course of the vein. Which of the following actions
should the nurse take?
a) initiate a new IV line below the original insertion site.
b) discontinue the infusion.
c) raise the head of the bed.
d) obtain a culture from the area of the insertion site. - CORRECT ANSWER b)
discontinue the infusion.
A nurse is preparing to perform a routine abdominal assessment for a client. Which of
the following actions should the nurse take?
a) document shiny, taut skin as an expected finding.
b) perform palpitation after auscultation.
c) listen for 1 minute before documenting absent bowel sounds.
d) perform auscultation immediately after the client has consumed a meal. - CORRECT
ANSWER b) perform palpitation after auscultation.
A nurse is discussing immunity with a client who has received an immunization. The
nurse should identify that an immunization functions as part of the which of following
types of immunity?
a) passive immunity.
b) active immunity.
c) cellular immunity.
d) acquired immunity. - CORRECT ANSWER d) acquired immunity.
A nurse is reviewing the medical records of a group of older adult clients. The nurse
should identify that which of the following is a risk factor that places older clients at an
increased risk for developing infections?
a) overproduction of lymphocytes.
b) elevated albumin levels.
c) lowered immune system function.
d) increased body fat. - CORRECT ANSWER c) lowered immune system function.
