A nurse is caring caring for a client who has a recently admitted to an inpatient mental health unit.
the client tells the nurse he is not coming out of his room anymore because other client on the unit
makes fun of him. which of the following response by the nurse is appropriate? - (ANSWER)B) " you
feel upset by the response of other."
A nursing admitting a client who has active tuberculosis. which of the following intervention is
appropriate? - (ANSWER)A. Place the client in a room that is ventilated outside.
A nurse is reinforcing teaching with the parent of a toddler who has difficulty falling asleep. which of
the following instruction should the nurse include? - (ANSWER)A. establish a bedtime routine.
A nurse is collecting data from an 18 month- old toddler at a well-child visit. which of the following
finding should the nurse report to the provider? - (ANSWER)C. Toddler can say four words.
A nurse is planning to administer morphine IM to a client using Z track method. Identify the order of
steps the nurse should take to administer the medication using this method. place the steps in order. -
(ANSWER)A. Insert the needle at a 90-degree angle.
B. Use the ulna side of the nondominant hand to pull the skin.
C. Inject the medication approximately 2.5cm (1in) into the skin.
D. Clean the skin
E.Aspirate for blood return
A nurse discovers a fire in a trash can in a patient's room. which of the following action should the
nurse take first? - (ANSWER)A. Extinguish the fire.
,B. Shut the door to the client room.
C. Pull the fire alarm.
D. Walk the client to the waiting room.
A nurse is teaching a client who is about to undergo an upper gastrointestinal series with fluoroscopy.
which of the following information should the nurse provide? - (ANSWER)D. " you will have to drink a
contrast medium before the test."
A nurse is reinforcing teaching with a client who has a new diagnosis of myasthenia gravis (MG) and a
prescription for neostigmine. which of the following information should the nurse include in the about
action of the medication? - (ANSWER)A. Improve muscle strength.
A nurse is caring for a school-age child whose family adheres to vegan diet in the home. the nurse
should recognize the child is at risk for deficiency of which of the following? - (ANSWER)C. Vitamin D
A nurse is assisting with the admission of a client who attempted suicide. when the nurse processes
the client's belongings, which of the following items should the nurse remove from the client's
suitcase? - (ANSWER)D. Perfume
A nurse is collecting data from a client who is one day postoperative following a total hip arthroplasty
and has deep- vein thrombosis. which of the following findings should the nurse expect in the affected
extremity? - (ANSWER)D. Dull, aching pain.
A nurse is a prenatal clinic is reinforcing teaching with a client about a nonstress test . which of the
following statements should the nurse include? - (ANSWER)D. " you will be asked to press a button
when you feel the baby move."
A nurse is planning to administer an ophthalmic medication to a client. which of the following actions
will minimize systemic absorption of the medication? - (ANSWER)A. apply light pressure to the inner
canthus just after instilling the eye drops.
, A nurse is caring for a client who has a new colostomy. he voices a reluctance about resuming sexual
relations.which of the following is an appropriate response by the nurse? - (ANSWER)D. "I'm available
if you'd like to talk about your concerns."
A nurse is caring for a client who is receiving warfarin 5mg po daily. Which of the following laboratory
values should the nurse check prior to administering the medication? - (ANSWER)A.PT
B. Serum potassium
C. INR
D. serum sodium
E. BUN
A.PT
C.INR
E.BUN
A nurse is contributing to the plan of care for a school-age child who has sickle-cell disease and is
experiencing a vaso-occlusive crisis. which of the following should the nurse recommend including in
the plan of care? - (ANSWER)C. perform passive range of motion exercises
A nurse is discussing including report with a group of newly licensed nurses. The nurse should include
that which of the following situations requires completion of an incident report? - (ANSWER)C. A
nurse collects data from a client who reports severe pain and finds a dose of hydro-morphine in the
client's bed.
A nurse in a long-term care facility has received change of shift report about four clients. which of the
following clients should the nurse attend to first? - (ANSWER)B. A client who has COPD and dementia
and was agitated during the night shift.
A nurse is reinforcing teaching with a client who is about to undergo a thoracentesis. which of the
following statements by the client indicates an understanding of the information? - (ANSWER)C. " I will
have a chest X-ray following procedure."