question set #1

A client has been admitted with folic acid deficiency anemia. Which referral would most likely be appropriate for the nurse to make? 1-alcoholic anonymous 2-American sickle cell anemia association 3-pernicious anemia society 4-aplastic anemia support group

1

A client is admitted to the pediatric unit with a diagnosis to rule out TB. What room assignment should the charge nurse make? 1-private room 2-private room and place on protective isolation 3-room with a client diagnosed with a respiratory infection 4-room with a client who is 24hrs post appendectomy

1

What room assignment by the charge nurse is most appropriate for a client who is being admitted with poor appetite, malaise, and temp of 101.5F? 1-private room 2-room with a client who has biliary colic 3-room with a client who is 3 days post op hip replacement 4-room with a client who is in skeletal traction due to a broken femur

1

Which client should the nurse see first? 1-53yr old client with chest pain scheduled for a stress test today 2-62yr old client with mild SOB and COPD 3-66yr old client with angina scheduled for a cardiac cath 4-78yr old client who had a left hemispheric stroke 4 days ago

1

Which ethical principle is involved when a nurse reports a medication error to the PCP? 1-nonmaleficence 2-beneficence 3-justice 4-fidelity

1 -nonmaleficence is do no harm to the client -beneficence-compassion and kindness -justice-distribution of resources -fidelity-truth telling

Which client would be appropriate for the RN to assign to the LPN? (SATA) 1-client with cast to right leg requiring pain medication 2-client with chronic emphysema experiencing mild shortness of breath 3-client one day post kidney transplant 4-client two days post percutaneous endoscopic gastrostomy placement 5-client prescribed antibiotics for cystitis

1,2,4,5

A child weighing 75lbs is admitted to the unit with a diagnosis of bacterial meningitis. The child has been started on an IV of D5 NS at 100ml/hr and IV antibiotic therapy has been initiated. Which assessment finding would need to be reported immediately to the HCP? (SATA) 1-UO 28ml/hr 2-change in LOC 3-temp of 101.2F 4-increase of 5mm Hg in systolic BP from baseline 5-sodium level of 130

1,2,5

Which interventions are appropriate for the nurse to initiate for a left sided stroke? (SATA) 1-position client to left side, supported by pillows 2-assess for dysphagia 3-apply hand cones to right hand 4-place high top tennis shoes on feet 5-massage sacral area that is slightly red 6-inform about procedures using a calm approach

1,3,4,6 since clients after a stroke are at risk for dysphagia, you wouldn't give them juice. It's a safety hazard

Which tasks should the charge nurse complete at the end of the shift before leaving for the day? (SATA) 1-talk to each nurse about concerns related to assigned clients 2-call the family of a client suffering from dementia to discuss long term care placement 3-briefly assess every client 4-prepare to report each client's status for the oncoming staff 5-receive report from the ED on a new client

1,4,5

The nurse educator has provided education to newly hired emergency department nurses regarding mandatory reporting laws. Which suspected instances provided by the new nurses indicates to the nurse educator that education was effective. (SATA) 1-financial abuse of an elder 2-negligence of a colleague 3-spousal abuse denied by the victim 4-gunshot victim 5-client diagnosed with gonorrhea 6-client diagnosed with west nile virus

1,4,5,6

A client with hemophilia has been scheduled for extraction of wisdom teeth. The nurse anticipates that the client will receive what priority intervention before this procedure 1-prophylactic antibiotics 2-a unit of cryoprecipitate 3-packed RBC 4-fresh frozen plasma

2

At a monthly staff meeting in a long-term care facility, the charge nurse requests staff input to create new activities for the clients. An RN has been assigned to gather information for staff consideration. What method would provide the RN with the best data for this project? 1-ask client families which activities they would like to have available 2-research professional articles for guidelines to activities in long term care 3-have clients peruse a variety of games and select what interests them 4-contact other facilities to inquire what types of programs they provide

2

A nurse is working with community officials to decrease the incidence of violence in the community. Which primary preventative measures might the nurse suggest? (SATA) 1-provide a safe haven for victims of violence 2-provide educational programs about types of violence 3-form a neighborhood watch program 4-develop a media campaign identifying risk factors of potential abuse 5-provide for the immediate removal of a victim of violence from the home

2,3,4

The nurse is caring for a client with sickle cell disease. Besides anemia and infection, what are other common symptom areas of SCD the nurse tells the client? (SATA) 1-chest pain 2-leg ulcers 3-eye problems 4-hand-foot syndrome 5-joint complications 6-increased growth at puberty

2,3,4,5

A client who is ventilator dependent is scheduled to be discharged home. What is the most critical assessment for the nurse case manager to make? 1-financial stability for home health care 2-long term home care needs 3-safe home environment 4-home medical equipment needed

3

While the postpartum nurse was in report, four client called the nurse's station for assistance. Which client should the nurse see first? 1-client with three dime sized clots on her perineal pad 2-breastfeeding client who is reporting uterine cramping 3-client reporting blood running down legs upon standing 4-client who had an epidural and is now reporting a headache

3

which task would be appropriate for the labor, delivery, recovery, postpartum charge nurse to assign to an LPN 1-administration IV pain medication to a client three days postoperative cesarean section 2-drawing a trough vancomycin level on a client 3 days postpartum with bilateral mastitis 3-reinforce how to perform perineal care to a primipara who is four hours postpartum 4-drawing routine admission labs on a client admitted in final stages of labor.

3

The nurse manager is making rounds in a long-term care facility and discovers an unfamiliar client standing in the hallway in a puddle of liquid. What is the nurse manager's priority action? 1-ask client to state name and room number 2-find dry clothes and clean client completely 3-wipe up puddle of liquid and call housekeeping 4-contact unit charge nurse to identify the client

3 get rid of the safety hazard

After shift report, which client should the nurse see first? 1-eight yr old that is in skeletal traction 2-six-year-old who is 5hrs postop appendectomy 3-unattended two yr old admitted for a sleep study 4-four yr old cerebral palsy child with a trach admitted for a UTI

3 safety

A 12-year-old female, with a history of juvenile rheumatoid arthritis, is being admitted for re-evaluation. The child reported these symptoms for the last week: temperature of 102.9F at 4PM yesterday, increased pain in joints, loss of appetite, and fatigue. What would be an appropriate room assignment by the charge nurse? 1-private room 2-rooming with a 12yr old male in skeletal traction 3-rooming with a 10yr old female that has been admitted for sickle cell 4-rooming with a 14-month-old female that has been admitted for orthopedic surgery

3-allows each other to relate

A school-aged child is being admitted for probable viral meningitis. What arrangement does the nurse need to make in order to prepare for this client? 1-private room 2-negative air-flow room 3-droplet precautions including mask 4-needs standard precautions only

4

The nurse is reviewing the plan of care for a client during the first day post craniotomy. Which actions can the nurse delegate to an experienced LPN working in the ICU? (SATA) 1-determine Glasgow coma scale 2-check ET cuff pressure every shift 3-reposition client from side to side 4-administer acetaminophen via nasogastric tube for temp greater than 101F 5-monitor I&O every hour

4,5

fluent aphasia

speech is present but contains little meaningful communication -damage to the Wernicke area of the brain