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1. A nurse is reviewing lab results for a client taking furosemide. Which finding should the nurse
report?
a. Sodium 138 mEq/L
✅ b. Potassium 3.1 mEq/L
c. Chloride 100 mEq/L
d. Calcium 9.2 mg/dL
2. A client with COPD is receiving oxygen therapy. Which action should the nurse take?
a. Set oxygen to 6 L/min
b. Use a nonrebreather mask
✅ c. Maintain oxygen at 2 L/min via nasal cannula
d. Apply oxygen continuously at 100%
3. A nurse is teaching a client how to use a metered-dose inhaler. Which statement indicates
understanding?
✅ a. “I will inhale slowly while pressing the inhaler.”
b. “I’ll exhale quickly after inhaling the medication.”
c. “I should use my inhaler immediately after eating.”
d. “I don’t need to shake the inhaler before use.”
4. Which of the following findings should a nurse report for a client taking digoxin?
✅ a. Heart rate of 56/min
b. Serum potassium of 4.2 mEq/L
c. Digoxin level of 1.0 ng/mL
d. Blood pressure of 130/80 mm Hg
5. A nurse is caring for a client post-thyroidectomy. Which finding requires immediate intervention?
a. Hoarse voice
b. Difficulty sleeping
✅ c. Stridor
d. Mild neck pain
,6. A client with schizophrenia says, “The aliens are watching me.” What’s the appropriate response?
a. “You’re imagining things.”
✅ b. “I don’t see anything, but I understand this is real to you.”
c. “Let’s talk about something else.”
d. “You must be confused.”
7. A client has a stage III pressure injury. Which intervention is appropriate?
✅ a. Apply a hydrocolloid dressing
b. Use alcohol-based cleanser
c. Leave the wound open to air
d. Massage the area around the wound
8. A nurse is caring for a client who is NPO but keeps requesting water. What is the priority action?
✅ a. Explain the reason for NPO status
b. Give small sips of water
c. Call the provider for a diet change
d. Provide oral hydration with ice chips
9. A client is to start lisinopril. Which statement by the client requires further teaching?
a. “I’ll rise slowly from a sitting position.”
✅ b. “I’ll use salt substitutes to season my food.”
c. “I will check my blood pressure regularly.”
d. “I may feel lightheaded at first.”
10. Which food should a nurse recommend to increase iron intake?
a. Milk
✅ b. Red meat
c. Applesauce
d. White rice
11. A nurse is caring for a client who is at 33 weeks of gestation following an amniocentesis. The
nurse should monitor the client for which of the following complications?
A. Vomiting
B. Hypertension
, C. Epigastric pain
D. Contractions ✅
12. A nurse is providing teaching to an older adult client about methods to promote nighttime sleep.
Which of the following instructions should the nurse include?
A. Stay in bed at least 1 hr if unable to fall asleep
B. Take a 1 hr nap during the day
C. Perform exercises prior to bedtime
D. Eat a light snack before bedtime ✅
13. A nurse on a telemetry unit is caring for a client who becomes unconscious and whose monitor
displays ventricular tachycardia. Which of the following actions should the nurse take first after
determining the client does not have a palpable pulse?
A. Assess heart sounds
B. Defibrillate ✅
C. Establish IV access
D. Administer epinephrine
14. A nurse is admitting a client who is 1 week postpartum and reports excessive vaginal bleeding. The
nurse does not speak the same language as the client. The client's partner and 10-year-old child are
accompanying her. Which of the following actions should the nurse take to gather the client's admission
data?
A. Have the client's child translate
B. Allow the client's partner to translate
C. Request a female interpreter through the facility ✅
D. Ask a nursing student who speaks the same language as the client to translate
15. A nurse is caring for a client who is febrile. To reduce the client's fever, the nurse applies a cooling
blanket. Which of the following findings indicates the client is having an adverse reaction to the
cooling?
A. Flushing
B. Tachycardia
C. Restlessness
D. Shivering ✅