VERIFIED CORRECT ANSWERS
1. A nurse administers NPH insulin to a client. Which of the following
entries should the nurse make in the client's medical record?
NPH insulin, Z-track, at 1200 to right ventrogluteal site
NPH insulin given IV push prior to breakfast
8 units NPH insulin, subcutaneous, right lateral upper thigh at 0700
8 units NPH insulin injected at 15-degree angle to forearm
2. Why is it important for a nurse to use finger pads when palpating the
breasts during an assessment?
A. To apply more pressure
B. To enhance sensitivity and detect abnormalities
C. To avoid discomfort for the client
D.To ensure a faster assessment
3. A nurse notices that a colleague has left their computer logged in while
attending to a patient. What should the nurse do to uphold patient
confidentiality?
Wait for the colleague to return and remind them to log out.
Log out of the colleague's account to secure the information.
Ignore the situation as it is not their responsibility.
Document the incident in the electronic medical record.
4. Explain why depression is prioritized as the primary mental health
,assessment for older adult clients in nursing practice.
It is the most common mental health issue among older adults.
, It has the most severe consequences if left
untreated. It is easier to assess than other mental
health conditions. It is often mistaken for normal aging.
5. Which of the following tasks can a nurse perform independently within
their scope of practice?
A. Changing the form of a medication for a client who is unable to
swallow
B.Inserting an endotracheal tube for a client experiencing
respiratory distress
C. Inserting a Salem sump tube for gastric decompression
D.Inserting a subclavian central venous access device
6. The nurse is assessing a client's edema on her left foot. The nurse presses
the client's skin on the top of the foot and the result is an indention depth of
4 mm that lasts no longer than 15 seconds after removing finger pressure.
The nurse would document this finding as:
2+ Pitting Edema
4+ Pitting Edema
1+ Pitting Edema
3+ Pitting Edema
7. Explain the role of a health care proxy in advance directives and how it
differs from a living will.
A. A health care proxy is a document that outlines treatment
preferences, while a living will appoints someone to make decisions.
B. A health care proxy allows a person to make decisions for
another, while a living will specifies the patient's treatment wishes.
, C. Both documents serve the same purpose and can be used
interchangeably.
D.A health care proxy is only relevant in emergency situations, while
a living will is always in effect.
8. Explain why inserting a Salem sump tube for gastric decompression is
considered within the scope of nursing practice, while other listed tasks are
not.
A. Nurses are trained to perform all invasive procedures.
B. Inserting a Salem sump tube is a common nursing intervention for
managing gastric contents.
C. All tasks require a physician's order.
D.Nurses can perform any task if they feel competent.
9. A nurse is caring for a patient with severe peripheral vascular disease
who requires continuous monitoring of oxygen saturation. Given the
patient's condition, what alternative methods could the nurse consider to
ensure accurate readings?
Using a standard finger probe and documenting any discrepancies.
Implementing a transcutaneous oxygen monitor on the patient's
skin.
Placing the pulse oximeter on the patient's toe to assess
circulation. Relying solely on visual assessment of the patient's
skin color.
10. A nurse in the emergency department is caring for a group of clients.
The nurse should identify that which of the following tasks is within the
nurse's cope of practice?
Changing the form of a medication for a client who is unable to
swallow