QUESTIONS AND ANSWERS.VSU
2023.Download to score A
1. A nurse administers the influenza vaccine to a client in a clinic. Within 15 minutes
after
the immunization was given, the client complains of itchy and watery eyes, increased
anxiety, and difficulty breathing. The nurse expects that the first action in the sequence
of
care for this client will be to
A) Maintain the airway
B) Administer epinephrine 1:1000 as ordered
C) Monitor for hypotension with shock
D) Administer diphenhydramine as ordered
The correct answer is B: Administer epinephrine 1:1000 as ordered .
2. Which of these children at the site of a disaster at a child day care center
would the
triage nurse put in the "treat last" category?
A) An infant with intermittent bulging anterior fontanel between crying episodes
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QUESTIONS AND ANSWERS.VSU
2023.Download to score A
B) A toddler with severe deep abrasions over 98% of the body
C) A preschooler with 1 lower leg fracture and the other leg with an upper leg fracture
D) A school-age child with singed eyebrows and hair on the arms
The correct answer is B: A toddler with severe deep abrasions over 98% of the body .
3. When admitting a client to an acute care facility, an identification bracelet is
sent up
with the admission form. In the event these do not match, the nurse’s best action is to
A) Change whichever item is incorrect to the correct information
B) Use the bracelet and admission form until a replacement is supplied
C) Notify the admissions office and wait to apply the bracelet
D) Make a corrected identification bracelet for the client
The correct answer is C: notify the admissions office and wait to apply the bracelet
4. The nurse is having difficulty reading the health care provider's written order that
was
written right before the shift change. What action should be taken?
A) Leave the order for the oncoming staff to follow-up
B) Contact the charge nurse for an interpretation
C) Ask the pharmacy for assistance in the interpretation
D) Call the provider for clarification
The correct answer is D: Call the provider for clarification
5. An adult client is found to be unresponsive on morning rounds. After checking
for
responsiveness and calling for help, the next action that should be taken by the nurse is
to:
A) check the carotid pulse
B) deliver 5 abdominal thrusts
C) give 2 rescue breaths
D) open the client's airway
The correct answer is D: open the client''s airway
6. A client has an order for 1000 ml of D5W over an 8 hour period. The nurse
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QUESTIONS AND ANSWERS.VSU
2023.Download to score A
discovers
that 800 ml has been infused after 4 hours. What is the priority nursing action?
A) Ask the client if there are any breathing problems
B) Have the client void as much as possible
C) Check the vital signs
D) Auscultate the lungs
The correct answer is D: Auscultate the lungs
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QUESTIONS AND ANSWERS.VSU
2023.Download to score A
7. Following change-of-shift report on an orthopedic unit, which client should
the nurse
see first?
A) 16 year-old who had an open reduction of a fractured wrist 10 hours ago
B) 20 year-old in skeletal traction for 2 weeks since a motor cycle accident
C) 72 year-old recovering from surgery after a hip replacement 2 hours ago
D) 75 year-old who is in skin traction prior to planned hip pinning surgery. The
correct answer is C: 72 year-old recovering from surgery after a hip replacement 2
hours ago
8. A nurse observes a family member administer a rectal suppository by having
the
client lie on the left side for the administration. The family member pushed the
suppository until the finger went up to the second knuckle. After 10 minutes the
client
was told by the family member to turn to the right side and the client did this. What is
the
appropriate comment for the nurse to make?
A) Why don’t we now have the client turn back to the left side.
B) That was done correctly. Did you have any problems with the insertion?
C) Let’s check to see if the suppository is in far enough.
D) Did you feel any stool in the intestinal tract?
The correct answer is B: That was done correctly. Did you have any problems with
the
insertion?
9. A client with a diagnosis of Methicillin resistant Staphylococcus aureus (MRSA)
has
died. Which type of precautions is the appropriate type to use when performing
postmortem care?
A) airborne precautions
B) droplet precautions