AND ANSWERS
Which of the following statements should the nurse include in the assessment? a) Tell me about
your siblings b) Tell me what kind of music you like c) Tell me how often do you drink alcohol d)
Tell me about your school schedule - ANSWERSAssessment for adolescent with conduct
disorder
Which of the following actions by the client requires the nurse to intervene? a) Holding the
newborn in face position b) Asking the father to change the newborn's diaper c) Requesting the
nurse take the newborn nursery so she can rest d) Viewing the newborn's actions to be
uncooperative - ANSWERSNurse observing bonding with newborn
Which of the following findings should indicate that the medication is effective? a) Weight loss
b) Decreased blood pressure c) Absence of seizures d) Decrease inflammation -
ANSWERSEffectiveness of levothyroxin
Which instructions would you include in the teaching? a) Contact provider if the cord still turns
black b) Clean the base of the cord with hydrogen peroxide daily c) Keep the cord dry until it
falls off d) The cord stump will fall off in five days - ANSWERSDischarge teaching for cord care
Which of the following findings indicates decreased cardiac output? a) Shivering b) Oliguria c)
Bradypnea d) Constricted pupils - ANSWERSIndication of decreased cardiac output
Which of the following client should the nurse identify as the priority? a) A client that has
massive head trauma b) A client has full thickness burns to face and trunk c) A client with
indications of hypovolemic shock d) A client with open fracture of the lower extremity -
ANSWERSPriority client in mass casualty triage
Which of the following clients should the nurse assess first? c) A client whose chronic kidney
disease with cloudy diasylate outflow - ANSWERSClient with chronic kidney disease
,A client who has ileal conduit and mucus in the pouch. - ANSWERSClient with ileal conduit
Client pleasant arteriovenous additional vibration palpated. - ANSWERSPleasant arteriovenous
vibration
A client whose chronic kidney disease with cloudy diasylate outflow. - ANSWERSChronic kidney
disease
A client was transurethral resection of the prostate with a red tinged urine in the bag. -
ANSWERSTransurethral resection of the prostate
The following is an appropriate nursing intervention for a client just received the first dose of
lisinopril: Provide standby assist with the client from bed. - ANSWERSLisinopril nursing
intervention
The nurse should expect head compression when reviewing the monitor tracing and notes early
decelerations. - ANSWERSEarly decelerations in labor
The following laboratory value is an indication for hemodialysis: glomerular filtration rate of 14
mL/minute. - ANSWERSIndication for hemodialysis
An appropriate action for the nurse to take is to heat the skin one minute prior to placing the
program. - ANSWERSContinuous pulse oximetry for infants
The nurse should plan to assess the client placed in restraints due to aggressive behavior first. -
ANSWERSClient in restraints
, A new limited client has a history of 4.5 kg weight loss in the past two months. -
ANSWERSWeight loss in mental health client
Client is receiving a PRN dose of health heard all two hours ago for increased anxiety. -
ANSWERSPRN dose for anxiety
Applied he'll be receiving his first ECT treatment today. - ANSWERSFirst ECT treatment
Hypnosis promotes increased control of her pain perception during contractions. -
ANSWERSHypnosis in labor
Focuses on the biofeedback as a relaxation technique. - ANSWERSHypnosis
Promotes increased control of pain perception during contractions. - ANSWERSHypnosis
Uses therapeutic touch to reduce anxiety during labor. - ANSWERSHypnosis
Provides instruction to minimize pain. - ANSWERSHypnosis
An example is saying 'I steal things because it's the only way I can keep my mind off my bad
marriage'. - ANSWERSReaction Formation
Glaucoma is identified as a contraindication. - ANSWERSContraindication for Isosorbide
Mononitrate
Obtain a cardiac rehabilitation consult. - ANSWERSAcute Myocardial Infarction Intervention
WBC 3,000/mm3 should be reported to the provider. - ANSWERSLaboratory Value Reporting