Fundamentals Exam 1 Elsevier Questions

B. cover the infected site with a dressing

A client with an abdominal wound infected with methicillinresistant Staphylococcus aureus (MRSA) is scheduled for a computed tomography (CT) scan of the abdomen. To ensure client and visitor safety during transport, the nurse should implement which precaution? A. No special precautions are required B. Cover the infected site with a dressing C. Drape the client with a covering labeled biohazardous D. Place a surgical mask on the client.

A. Increase oral fluid intake to 2 to 3 L/day.

A client with limited mobility is being discharged. To prevent urinary stasis and formation of renal calculi, what should the nurse instruct the client to do? A. Increase oral fluid intake to 2 to 3 L/day. B. Maintain bed rest after discharge C. limit fluid intake to 1 L/day D. Void at least every hour.

D. the client will be free of signs and symptoms of infection by discharge

The nurse creates a plan of care for a client with a risk of infection. Which is the most desirable expected outcome for the client? A. all nursing functions will be completed by discharge B. All invasive intravenous lines will remain patent C. the client will remain awake, alert, and oriented at all times D. the client will be free of signs and symptoms of infection by discharge

C. assess the client's drug intake and ensure that the individual does not leave the healthcare facility.

A nurse is caring for a client who has been admitted to a healthcare facility for the treatment of sinus disorders. The nurse discovers that the client is a cocaine addict. What task followed by the nurse is the best way to deal with the situation? A. teach the client about safe medication storage and the danger of polypharmacy B. educate the client about his or her correct body mechanics and promote stress management C. assess the client's drug intake and ensure that the individual does not leave the healthcare facility. D. Assist with adequate personal hygiene, nutrition, and hydration and provide emotional support to the family.

A. Hand washing before and after providing care

A nurse is teaching continuing care assistants about ways to prevent the spread of infection. It would be appropriate for the nurse to emphasize that the cycle of the infectious process must be broken, which is accomplished primarily through what? A. Hand washing before and after providing care B. Cleaning all equipment with an approved disinfectant after use C. Wearing personal protective equipment (PPE) when providing client care D. using medical and surgical aseptic techniques at all times

A. safety

The nurse is caring for an elderly patient with dementia. Which client need should the nurse prioritize while providing care? A. safety B. self-esteem C. Self-actualizaiton D. love and belonging

C. encourage early mobility

To prevent thrombophlebitis in the immediate postoperative period, which action is most important for a nurse to include in the client's plan of care. A. Increase fluid intake B. restrict fluids C. encourage early mobility D. Elevate the knee gatch of the bed

A. Airborne B. Contact E. Standard

When caring for a client with varicella and disseminated herpes zoster, the nurse should implement which types of precautions? ( select all that apply) A. airborn B. contact C. Droplet D. Hazardous wastes E. Standard

A. "I will clean my comb in ammonia water" D. "I should use a dilute vinegar solution to loosen the nits" E. "I should use a shampoo treatment once every 24 hours"

While assessing a client's hair, a nurse notices that the client has head lice. The nurse teaches the client about hair hygiene and lice control. Which statements made by the client indicates and understanding of the teaching (select all that apply) A. "I will clean my comb in ammonia water" B. "I should use lindane-containing shampoo" C. "I should shampoo my hair in a tub or shower" D. "I should use a dilute vinegar solution to loosen the nits" E. "I should use a shampoo treatment once every 24 hours"

B. a client has multiple fainting episodes due to lack of poor nutrition.

A nurse is assessing different situations on the basis of Maslow's hierarchy of needs. Which situation will the nurse address first on priority basis? A. A client feels that he/she leads a completely worthless life. B. a client has multiple fainting episodes due to lack of proper nutrition C. A client shows signs of lack of interest in carrying out social interactions D. A client conveys to the nurse that he/she is estranged from all family members

C. Meet the client's comfort, hygiene, and nutritional needs.

The nurse is assisting with the end-of-life care of an older adult. Which activity is performed when the nurse views family as context? A. assess the resources available to the family. B. meet the client's family's comfort and nutritional needs C. Meet the client's comfort, hygiene, and nutritional needs. D. Determine the family's need for rest and their stage of coping.

A. provide perineal care

The nurse is caring for a client who had a hip replacement 2 days prior. After removing a bedpan from under the client what is a priority nursing intervention? A. Provide perineal care B. Turn and position the client C. give a complete bed bath D. Document the bowel movement

A. The nurse should provide a protective environment B. The nurse should assist with personal hygiene D. the nurse should promote activities that reinforce reality

The nurse is caring for a community-dwelling older adult who is suffering from confusion. Which are the best nursing interventions in this situation (select all that apply) A. The nurse should provide a protective environment B. The nurse should assist with personal hygiene C. The nurse should educate the client about correct body mechanics D. The nurse should promote activities that reinforce reality E. The nurse should teach the client's caregiver proper feeding techniques .

C. Contact precautions

The nurse receives a report on a newly admitted client who is positive for Clostridium difficile. Which category of isolation would the nurse implement for this client? A. Airborne precautions B. Droplet precautions C. Contact precautions D. Protective environment

B. Cutting nails after soaking them for 10 minuets in warm water.

While assessing the nails of a client with diabetes, the nurse finds that the skin on the client's hands and feet are dry due to infection. What could be the reason for this dryness? A. Applying moisturizing lotion between toes B. Cutting nails after soaking them for 10 minuets in warm water. C. Cutting nails straight across and even with the tops of the fingers or toes D. Using sharp objects to poke or dig under the toenail or under the cuticle.

A. safety

a nurse is teaching a client how to use the call bell/ call light system. Which level of Maslow's hierarchy of needs does this nursing action address A. safety B. self-esteem C. Physiological D. interpersonal

A. Loss of turgor C. decreased night vision D. Decreased mobility of ribs

A nurse is assessing an older adult during a regular checkup. Which findings during the assessment are normal? (Select all that apply) A. Loss of turgor B. Urinary incontinence C. Decreased night vision D. Decreased mobility of ribs E. increased sensitivity to odors.

B. Foster human dignity and maintain the best possible functioning, protection, and safety. D. Show the caregiver techniques to dress, fee, and toilet the older adult. E. Protect the client's rights and provide support to maintain the physical and mental health of family members

A nurse is caring for a community-dwelling older adult with dementia. What interventions should the nurse take to ensure the client's well-being? (select all that apply) A. Obtain the client's drug history and educate the older adult about safe medication storage B. Foster human dignity and maintain the best possible functioning, protection, and safety. C. teach the client to be cautious of false advertisements that promise a cure for the disease. D. Show the caregiver techniques to dress, feed, and toilet the older adult. E. Protect the client's rights and provide support to maintain the physical and mental health of family members

b. Put the client in a high Fowler position

A nurse is providing morning hygiene to a bedridden client who was admitted for exacerbation of chronic obstructive pulmonary disease (COPD). What is the priority nursing intervention with the client becomes short of breath during the care> A. obtain a pulse oximeter to determine the client's oxygen saturation level B. put the client In a high fowler position C. Darken the lights and provide a rest period of at least 15 minuets. D. Continue the hygiene activities while reassuring the client

B. "You will need to apply them in the morning before you lower your legs from the bed to the floor"

A nurse teaches a client about wearing thigh-high anti-embolism elastic stockings. What would be appropriate to include in the instructions? A. "You do not need to wear them while you are awake, but it is important to wear them right." B. "You will need to apply them in the morning before you lower your legs from the bed to the floor" C. "If they bother you, you can roll them down to your knees while you are resting or sitting down" D. "You can apply them either in the morning or at bedtime, but only after the legs are lowered to the floor"