Basics of Nursing Practice

The professional obligation of a nurse to assume responsibility for actions is referred to as: 1.Accountability. 2.Individuality. 3.Responsibility. 4.Bioethics

1.Accountability.

When caring for a client who is receiving enteral feedings, the nurse should take which measure to prevent aspiration? 1.Elevate HOB 30-45 degrees. 2.Decrease flow rate at night. 3.Check for residual daily. 4.Irrigate regularly with warm tap water

1.Elevate HOB 30-45 degrees.

Nurses care for clients in a variety of age groups. In which age group is the occurrence of chronic illness the greatest? 1.Older adults 2.Adolescents 3.Young children 4.Middle-aged adults

1.Older adults

Which drug does a nurse anticipate may be prescribed to produce diuresis and inhibit formation of aqueous humor for a client with glaucoma? 1.Chlorothiazide (Diuril) 2.AcetaZOLAMIDE (Diamox) 3.Bendroflumethiazide (Naturetin) 4.Demecarium bromide (Humorsol)

2.AcetaZOLAMIDE (Diamox)

A client with cancer is informed that the chemotherapy is no longer working and that death is inevitable. Keeping in mind Kübler-Ross's stages of death and dying, place the following nursing interventions that are most appropriately associated with each stage in order from the stage of denial to acceptance. 1.Redirect negative feelings constructively. 2.Avoid confronting the client. 3.Help the client celebrate the simple pleasures in everyday life. 4.Provide maximal comfort measures 5.Help the client identify realistic versus unrealistic goals.

1.Avoid confronting the client. 2.Redirect negative feelings constructively. 3.Help the client identify realistic versus unrealistic goals. 4.Help the client celebrate the simple pleasures in everyday life. 5.Provide maximal comfort measures

A nurse is evaluating the appropriateness of a family member's initial response to grief. What is the most important factor for the nurse to consider? 1.Personality traits 2.Educational level 3.Cultural background 4.Past experiences with death

3.Cultural background

A nurse overhears an unlicensed assistive personnel (UAP) talking with a client about the client's marital and family problems. The nurse identifies that the UAP is providing false reassurance when the UAP states: 1."I agree; I think you should get a divorce." 2."Everything will be fine, just wait and see." 3."You should be glad that you have such a loving family." 4."In the scheme of things, you do not have a major problem."

2."Everything will be fine, just wait and see."

A pharmacy technician arrives on the nursing unit to deliver opioids and, following hospital protocol, asks the nurse to receive the medications. The nurse is assisting a confused and unsteady client back to the client's room. How should the nurse respond to the technician? 1."I can't receive them right now. Please wait a few minutes or come back." 2."Please leave the medications and sign-out sheet in a location where I can see them." 3."Please bring them to me and I will be sure to put them away in a couple of minutes." 4."I can't receive them right now. Please give them to the unlicensed assistive personnel (UAP)."

1."I can't receive them right now. Please wait a few minutes or come back."

What nursing actions best promote communication when obtaining a nursing history? (Select all that apply.) 1.Establishing eye contact 2.Paraphrasing the client's message 3.Asking "why" and "how" questions 4.Using broad, open-ended statements 5.Reassuring the client that there is no cause for alarm 6.Asking questions that can be answered with a "yes" or "no"

1.Establishing eye contact 2.Paraphrasing the client's message 4.Using broad, open-ended statements

What should the nurse consider when obtaining an informed consent from a 17-year-old adolescent? 1.If the client is allowed to give consent. 2.The client cannot make informed decisions about health care. 3.If the client is permitted to give voluntary consent when parents are not available. 4.The client probably will be unable to choose between alternatives when asked to consent.

1.If the client is allowed to give consent.

Alternative therapy measures have become increasingly accepted within the past decade, especially in the relief of pain. Which methods qualify as alternative therapies for pain? (Select all that apply.) 1.Prayer 2.Hypnosis 3.Medication 4.Aromatherapy 5.Guided imagery

1.Prayer 2.Hypnosis 4.Aromatherapy 5.Guided imagery

A client who has been battling cancer of the ovary for seven years is admitted to the hospital in a debilitated state. The health care provider tells the client that she is too frail for surgery or further chemotherapy. When making rounds during the night, the nurse enters the client's room and finds her crying. Which is the most appropriate intervention by the nurse? 1.Sit down quietly next to the bed and allow her to cry. 2.Pull the curtain and leave the room to provide privacy for the client. 3.Explain to the client that her feelings are expected and they will pass with time. 4.Observe the length of time the client cries and document her difficulty accepting her impending death.

1.Sit down quietly next to the bed and allow her to cry.

During an admission assessment the nurse discovers that a client has a stage 1 pressure ulcer. Which is the priority nursing action? 1.Turn and reposition the client every 2 hours. 2.Cover the ulcer with an occlusive transparent dressing. 3.Clean the ulcer with hydrogen peroxide and leave it open to the air. 4.Provide the client with a diet high in vitamin C, zinc, and protein.

1.Turn and reposition the client every 2 hours.

The client asks the nurse to recommend foods that might be included in a diet for diverticular disease. Which foods would be appropriate to include in the teaching plan? (Select all that apply.) 1.Whole grains 2.Cooked fruit and vegetables 3.Nuts and seeds 4.Lean red meats 5.Milk and eggs

1.Whole grains 2.Cooked fruit and vegetables 5.Milk and eggs

A nurse teaches a client about wearing thigh-high anti-embolism elastic stockings. What would be appropriate to include in the instructions? 1."You do not need to wear them while you are awake but it is important to wear them at night." 2."You will need to apply them in the morning before you lower your legs from the bed to the floor." 3."If they bother you, you can roll them down to your knees while you are resting or sitting down." 4."You can apply them either in the morning or at bedtime but only after the legs are lowered to the floor."

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

When providing care for a client with a nasogastric (NG) tube, the nurse should take measures to prevent what serious complication? 1.Skin breakdown 2.Aspiration pneumonia 3.Retention ileus 4.Profuse diarrhea

2.Aspiration pneumonia

A toddler screams and cries noisily after parental visits, disturbing all the other children. When the crying is particularly loud and prolonged, the nurse puts the crib in a separate room and closes the door. The toddler is left there until the crying ceases, a matter of 30 or 45 minutes. Legally, how should this behavior be interpreted? 1.Limits had to be set to control the child's crying. 2.The child had a right to remain in the room with the other children. 3.The child had to be removed because the other children needed to be considered. 4.Segregation of the child for more than half an hour was too long a period of time.

2.The child had a right to remain in the room with the other children.

A client has a stage III pressure ulcer. Which nursing intervention can prevent further injury by eliminating shearing force? 1.Maintain the head of the bed at 35 degrees or less. 2.With the help of another staff member, use a drawsheet when lifting the client in bed. 3.Reposition the client at least every 2 hours and support the client with pillows. 4.At least once every 8 hours, perform passive range-of-motion exercises of all extremities.

2.With the help of another staff member, use a drawsheet when lifting the client in bed.

A client comes to the medical clinic complaining of headaches. The nurse measures the blood pressure at 172/114. What should the nurse do first? 1.Page the on-call health care provider and continue to monitor the blood pressure. 2.Administer ibuprofen and have the client rest quietly for 20 minutes. 3.Elevate the head of the bed, provide reassurance, and reassess the blood pressure. 4.Place the client in the supine position, administer oxygen, and notify the health care provider.

3.Elevate the head of the bed, provide reassurance, and reassess the blood pressure.

The nurse recognizes that a common conflict experienced by the older adult is the conflict between: 1.Youth and old age 2.Retirement and work 3.Independence and dependence 4.Wishing to die and wishing to live

3.Independence and dependence

A nurse identifies that an older adult has not achieved the desired outcome from a prescribed proprietary medication. When assessing the situation, the client shares that the medication is too expensive and the prescription was never filled. What is an appropriate nursing response? 1.Ask the pharmacist to provide a generic form of the medication. 2.Encourage the client to acquire the medication over the internet. 3.Inform the health care provider of the inability to afford the medication. 4.Suggest that the client purchase insurance that covers prescription medications

3.Inform the health care provider of the inability to afford the medication.

A nurse has provided discharge instructions to a client who received a prescription for a walker to use for assistance with ambulation. The nurse determines that the teaching has been effective when the client: 1.Picks up the walker and carries it for short distances. 2.Uses the walker only when someone else is present. 3.Moves the walker no more than 12 inches in front of the client during use. 4.States that a walker will be purchased on the way home from the hospital

3.Moves the walker no more than 12 inches in front of the client during use.

The triage nurse in the emergency department receives four clients simultaneously. Which of the clients should the nurse determine can be treated last? 1.Multipara in active labor 2.Middle-aged woman with substernal chest pain 3.Older adult male with a partially amputated finger 4.Adolescent boy with an oxygen saturation of 91%

3.Older adult male with a partially amputated finger

Nursing actions for the older adult should include health education and promotion of self-care. Which is most important when working with the older adult client? 1.Encouraging frequent naps 2.Strengthening the concept of ageism 3.Reinforcing the client's strengths and promoting reminiscing 4.Teaching the client to increase calories and focusing on a high carbohydrate diet

3.Reinforcing the client's strengths and promoting reminiscing

When nurses are conducting health assessment interviews with older clients, they should: 1.Leave a written questionnaire for clients to complete at their leisure 2.Ask family members rather than the client to supply the necessary information 3.Spend time in several short sessions to elicit more complete information from the clients 4.Keep referring to previous questions to ascertain that the information given by clients is correct

3.Spend time in several short sessions to elicit more complete information from the clients

A nurse in the surgical intensive care unit is caring for a client with a large surgical incision. The nurse reviews a list of vitamins and expects that which medication will be prescribed because of its major role in wound healing? 1.Vitamin A (Aquasol A) 2.Cyanocobalamin (Cobex) 3.Phytonadione (Mephyton) 4.Ascorbic acid (Ascorbicap)

4.Ascorbic acid (Ascorbicap)

A client is admitted to the hospital because of multiple chronic health problems. What is the priority nursing intervention at this time? 1.Advising the client to join a support group immediately after discharge. 2.Assuring the family that staff members will take care of the client's needs. 3.Reminding the client to keep medical follow-up appointments after discharge. 4.Conducting a multidisciplinary staff conference early during the client's hospitalization

4.Conducting a multidisciplinary staff conference early during the client's hospitalization

A nurse in the health clinic is counseling a college student who recently was diagnosed with asthma. On what aspect of care should the nurse focus? 1.Teaching how to make a room allergy-free. 2.Referring to a support group for individuals with asthma. 3.Arranging with the college to ensure a speedy return to classes. 4.Evaluating whether the necessary lifestyle changes are understood

4.Evaluating whether the necessary lifestyle changes are understood

A nurse is supportive of a child receiving long-term rehabilitation in the home rather than in a health care facility. Why is living with the family so important to a child's emotional development? 1.It provides rewards and punishment. 2.The child's development is supported. 3.It reflects the mores of a larger society. 4.It is where child's identity and roles are learned.

4.It is where child's identity and roles are learned

A client is hospitalized because of severe depression. The client refuses to eat, stays in bed most of the time, does not talk with family members, and will not leave the room. The nurse attempts to initiate a conversation by asking questions but receives no answers. The nurse is frustrated and tells the client that if there is no response, the nurse will leave and the client will remain alone. How should the nurse's behavior be interpreted? 1.A system of rewards and punishment is being used to motivate the client. 2.Leaving the client alone allows time for the nurse to think of other strategies. 3.This behavior indicates the client's desire for solitude that the nurse is respecting. 4.This threat is considered assault, and the nurse should not have reacted in this manner.

4.This threat is considered assault, and the nurse should not have reacted in this manner.