ANSWERS EXAM WITH RATIONALE
ACTUAL EXAM WITH A STUDY GUIDE AND PRACTICE EXAM
| GUARANTEED PASS | LATEST UPDATE
a nurse is caring for a client who is admitted for observation
and has full ROM. Which is the best manner to encourage
the client to void?
- urinal
- bedpan
- bedside commode
- client bathroom - CORRECT ANSWER client bathroom
a nurse is reviewing psychosocial stages of development for
a school-age child. What would be an expected behavioral
finding for this child?
- personalize values and beliefs and base reasoning on
ethical fairness principles. Establish close relationships.
Have influences that help with formation of healthy self-
concept, such as family & friends (no, this is young adults
20-35 years)
- develop sense of personal identity that family expectations
influence. peer relationships develop as support system.
concerned with body images that media portray (no, this is
adolescents 12-20 years)
- develop sense of industry through advances in learning.
strive to develop healthy self-respect by finding out in what
,areas they excel. peer groups play important role in social
development (YES)
- take on new experiences and when unable to accomplish
task may feel guilty or misbehave. generally dont exhibit
stranger anxiety. unders - CORRECT ANSWER develop
sense of industry through advances in learning. strive to
develop healthy self-respect by finding out in what areas
they excel. peer groups play important role in social
development
this is expected in school-age children 6-12 years
a menopausal client is having difficulty getting to sleep and
asks what actions she should incorporate in her daily
routine to promote sleep. The nurse would encourage, which
of the below measures to promote sleep?
- consume a warm drink before bedtime (no, limit fluids 2-4
hrs before bed)
- take an evening walk before bedtime (no, limit exercise at
least 2 hrs before bed)
- take an afternoon nap (no, establish a bedtime routine and
regular sleep pattern)
- limit alcohol and nicotine prior to bedtime (YES) - CORRECT
ANSWER limit alcohol and nicotine prior to bedtime
limiti alcohol, caffeine, & nicotine at least 4 hr before
bedtime
,a nurse is caring for a client w heart failure who has
evidence of dyspnea, bibasilar crackles & frothy sputum,
what dietary recommendations should be provided to this
client in management of their heart failure?
- decrease protein intake (no, want to increase protein for
HF)
- decrease sodium intake (YES)
- increase fluid intake (no, want to restrict intake to 2 L per
day)
- decrease calcium intake (no, theres no recommendations
on calcium with HF) - CORRECT ANSWER decrease sodium
intake
it is encourage to stop smoking, reduce sodium intake,
monitor fluid intake, restricting intake to 2 L per day. it is
also encouraged to increase protein intake to 1.12 g/kg and
consume small, frequent meals that are soft, easy to chew
foods.
a nurse is caring for an older pt with delirium. which
intervention will most effectively reduce the clients risk for
falls?
- use of a night light
- demonstrate how to use call light
- place bedside table in close proximity
- hourly rounding by the nurse - CORRECT ANSWER hourly
rounding by the nurse
, all options are important/effective interventions but hourly
rounding is the MOST effective
a nurse is caring for a client receiving radiation treatments
for cancer. the pt states he is experiencing dryness, redness
and scaling at the treatment area. which of the following
should the nurse instruct the client to do?
- sit in the sun for 15 min per day (no, pts receiving radiation
should avoid exposing irradiated areas to sun)
- apply moist heat to the area twice daily (no, moist heat
should be avoided over irradiated areas)
- liberally apply prescribed lotion to the area (YES)
- wash the affected area daily with antimicrobial soap (no,
antimicrobial soaps can be harsh and further traumatize new
epidermal cells) - CORRECT ANSWER liberally apply
prescribed lotion to the area
hydrating lotions are commonly prescribed to treat
irradiated areas. the client should avoid applying other
lotions not prescribed by the radiologist to affected areas
a nurse is providing teaching about the mediterranean diet
to a pt who has a new diagnosis of HTN. which of the
following statements by the pt indicates a need for further
teaching?
- "i will limit my intake of red meat to twice weekly" (YES)