Prep U Exam

When teaching a client with intertrigo about prescribed skin care measures, the nurse should include which important instruction to prevent Candida albicans overgrowth?

"Never apply cornstarch to the affected areas."

A nurse is completing the intake record for a client with chronic pancreatitis. The client has had the following intake during the previous 8 hours. How many milliliters should the nurse record as the client's intake? Record your answer using a whole number.Intake:4 oz apple juice½ cup fruit-flavored gelatin6 oz water500 ml 0.45% sodium chloride IV

920

A nurse is assigned to care for four clients. Which client should a nurse assess first?

A postoperative client who just returned from surgery and is vomiting

Parents report to the nurse that their 4-year-old child often lies and makes up wild stories. What is the most appropriate response by the nurse?

Acknowledge your child by saying, 'That's a pretend story.'"

A child hospitalized with right-sided heart failure is tearful and states, "My parents do not want me to have any activity and I always need to rest." Which action by the nurse is mostappropriate?

Ask the child if he would like assistance in sharing concerns with the parents.

A nurse is caring for a client with active tuberculosis who is homeless. The client is almost ready for discharge; however, the nurse is concerned about the client's ability to follow the medical regimen. Which nursing intervention would best promote adherence with the treatment plan after discharge?

Assist with referring the client to a social worker for discharge.

A client who has experienced a stroke is unable to move without help. Which intervention should the nurse perform to reduce this client's risk for developing a common complication of immobility?

Change the client's position every 1 to 2 hours.

The health care provider requests four prescriptions for a client with diabetes who has an infected foot ulcer. Which prescription should the nurse complete first?

Draw a CBC, metabolic panel, and creatinine now.

A nurse is caring for a client with a nasogastric (NG) tube who is two days postsubtotal gastrectomy. Which intervention should the nurse perform?

Gently irrigate the tube with normal saline.

The nurse cares for a client who has been performing respiratory exercises. Which action should the nurse take to determine the effectiveness of the exercises?

Obtain pulse oximetry reading

The nurse is teaching a female client about preventing osteoporosis. Which of the following teaching points is correct?

The recommended daily allowance of calcium may be found in a wide variety of foods.

A nurse is teaching a primigravida who delivered a baby 24 hours ago about breastfeeding. Which instructions should the nurse include in the teaching? Select all that apply.

Wash the nipples with water after each feeding. Break suction after feeding by sliding a finger into the baby's mouth before removing the breast.

A client who's single and living alone delivers a premature neonate. Which intervention would be included in her treatment plan?

a request for a social service visit in the hospital

A positive Mantoux test indicates that the client:

has produced an immune response.

Which symptom should the nurse expect to find in a client with increased blood plasma levels of thyroxine?

heat intolerance

The nurse is caring for a 2-year-old with bacterial meningitis. After a computed tomography scan is completed, the child will have a lumbar puncture performed. However, the computerized tomography (CT) scan reveals increased intracranial pressure (ICP). The lumbar puncture should not be performed in this child in order to prevent which complication?

herniating the brain stem

The nurse is teaching a client with a T4 spinal cord injury and paralysis of the lower extremities how to transfer from the bed to a wheelchair. The nurse should instruct the client to move:

his upper body to the wheelchair first.

A client has just received a renal transplant and has started cyclosporine therapy to prevent graft rejection. Which condition indicates to the nurse that the client is experiencing a major adverse effect related to the medication?

infection

A client undergoing treatment for paranoia refuses to take his risperidone, stating, "I think it's poisoned." Which action by the nurse is appropriate?

omitting the dose and notifying the health care provider

A client in labor requires an episiotomy. Which complication should the nurse have the client report to the health care provider after the procedure?

prolonged dyspareunia

A nurse brings gifts and flirts with a 16-year-old male client who's undergoing rehabilitation after sustaining a spinal cord injury that left him paralyzed below the waist. When a coworker confronts the nurse, the nurse replies, "He knows it's just in fun." How should the coworker handle this ethical dilemma?

report the situation to the nursing supervisor

A client in active labor requests a holistic approach to labor and birth. Which intervention provided would meet this client's needs during the labor and birth process?

use of Reiki

A client is ready to be discharged after arthroscopic knee surgery. Which information would the nurse expect the health care provider to write on the discharge instructions?

"Take acetaminophen with codeine every 4 hours as necessary for pain relief."

A nurse is reinforcing education for a client on testicular self-examinations and testicular cancer. Which information should the nurse include?

"Testicular cancer is one of the highly curable types of cancer."

A client and spouse are seeking treatment for infertility after having difficulty becoming pregnant. Which statement made by the client does the nurse determine is causing the most"stressful aspect of treatment"?

"We have to schedule sexual intercourse with our busy lives."

A client at 32 weeks' gestation and leaking amniotic fluid is placed on an external fetal monitor. The monitor indicates uterine irritability, and contractions are occurring every 4 to 6 minutes. The health care provider orders nifedipine. Which educational statement is appropriate for this client?

"You may feel flushed and feel your heart beating faster."

A client is admitted for pneumonia secondary to human immunodeficiency virus (HIV). The nurse asks unlicensed assistive personnel (UAP) to give the client a bed bath. The UAP is hesitant to bathe the client for fear that he or she will contract the virus. Which statements would be most appropriate for the nurse to include in the response? Select all that apply.

- "I know you're frightened, but by taking proper precautions, there's little to no risk of acquiring HIV." - "The use of personal protective equipment (PPE) may prevent the unintentional transmission of diseases in situations where you may come in contact with blood, body fluids, or secretions."

A nurse is reinforcing education with a client diagnosed with osteoporosis about the prescribed diet. Which food would the nurse identify as the best source of calcium?

1 cup of low fat yogurt

A client with asthma is receiving a theophylline preparation to promote bronchodilation. Because of the risk of drug toxicity, the nurse must monitor the client's serum theophylline level closely. When reviewing this client's chart, which range will the nurse identify as the therapeutic theophylline concentration?

10 to 20 mcg/ml

The nurse is caring for a child with cystic fibrosis. Ranitidine 4 mg/kg/day every 12 hours is ordered. The child weighs 20 kg. How many milligrams per dose should the nurse give the child? Record your answer using a whole number.

40

Therapy for Kawasaki disease includes IV gamma globulin, prescribed at 400 mg/kg/day for 4 days. The child weighs 10 kg. What's the daily dose for this child? Record your answer using a whole number.

4000

During neonatal resuscitation immediately after delivery, chest compressions should be initiated when the heart rate falls below how many beats per minute?

60

At her follow-up examination, a client who's 6 weeks postpartum tells the nurse that she's exhausted and sore from breast-feeding and wants to formula-feed her baby. She also mentions that she feels like a failure and finds it increasingly difficult "just to get out of bed in the morning." Which intervention should the nurse attempt before notifying the physician?

Acknowledging the client's feelings, asking about other life stressors, and identifying the client's support system

The nurse is caring for a client with gastroenteritis who has nausea, vomiting, and diarrhea. Which priority action should the nurse perform to maintain the client's nutritional status?

Administer promethazine 25 mg before meals.

When reviewing medications for a pharmacology examination, the nursing student recognizes which drugs may be abused because of tolerance and physiologic dependence?

Alprazolam and phenobarbital

The nurse refers a client with severe anxiety to a psychiatrist for medication evaluation. The nurse expects the physician is most likely to prescribe which psychotropic drug regimen for this client?

Buspirone, 5 mg orally three times per day

A client who gave birth by cesarean 3 days ago is bottle-feeding her neonate. While collecting data, the nurse notes that vital signs are stable, the fundus is four fingerbreadths below the umbilicus, small amount of lochia rubra, and the client reports discomfort in her breasts, which are hard and warm to touch. Which action would be most appropriate?

Encourage the client to wear a supportive bra.

A 3-year-old sibling of a neonate is diagnosed with pertussis. The parent gives a history of having been immunized as a child. What should be included in reinforcing education of the parent about possible infection of the neonate?

Erythromycin should be administered prophylactically to the neonate.

A nurse on the psychiatric unit realizes that she typically fails to administer medications according to schedule. What's the best way for the nurse to improve her medication administration practice?

Evaluate her current practice and devise an improvement plan.

A client is preparing to undergo abdominal paracentesis. Which nursing interventions should be performed before the procedure? Select all that apply.

Explain the procedure to the client. Make sure informed consent was obtained. Instruct the client to void.

An unlicensed assistive personnel (UAP) frequently disappears from the floor without telling anyone and when returning to the floor, their clothing smells strongly of smoke. What steps should the nurse take to eliminate this behavior? Using the options below, place the steps in chronologic order.

Keep notes with dates and times this behavior is observed. Approach the UAP privately to discuss the issue. Try to work with the UAP to schedule daily breaks. Observe the UAP's behavior for signs of improvement. Report the UAP to the charge nurse if the behavior remains unchanged.

A nurse is assisting in developing a teaching plan on rape prevention. Which guideline would have priority in this plan?

Learn ways to defend yourself

A nursing student is studying for an examination on the immune and hematologic systems. Which response given by the student would indicate to the nursing instructor that the student has a good understanding of blood component therapy?

Plasma is frozen immediately and lasts up to one year before being discarded.

A client is exhibiting anxiety, which is evidenced by muscle tension, distractibility, and increased heart rate and blood pressure. Which nursing intervention has priority?

Remain with the client and use a soft voice and reassuring approach.

A nurse is reinforcing discharge instructions to the parents of a child who had a tonsillectomy. Which instruction is the most important?

The child shouldn't drink from straws.

A nurse is caring for a pregnant client who is scheduled to undergo an amniotomy to induce labor. After the procedure, which client goal should take the highest priority?

The fetus will maintain adequate tissue perfusion.

The nurse is reviewing a client's goals and expected outcomes on the plan of care. The nurse expects that the goals will incorporate which statements? Select all that apply.

The goals are measurable. The goals include target dates for achievement.

A nurse mentor assists a novice nurse in positioning a laboring client to the hands/knees position. After delivery, the novice nurse asked why was the client put into this position. Which rationale would the mentor provide for repositioning the client?

The health care provider noted the prolapsed cord."

A nurse is assisting with developing an education plan for a client diagnosed with type 1 diabetes. Which method is most effective for educating the client about self-administration of insulin?

a discussion and demonstration between the nurse and the client

When reviewing the laboratory studies from a child with tricuspid atresia, which finding would the nurse expect to observe?

acidosis

A client falls and sustains a large laceration to the left forearm. The injury begins bleeding profusely. What is the nurse's immediate action?

apply direct pressure to the arm

A client is placed on several medications after having a myocardial infarction (MI). Which drug class is part of the medication regimen for this client that will protect the ischemic myocardium by decreasing catecholamines and sympathetic nerve stimulation?

beta blockers

A nurse is interviewing a 16-year-old female at a clinic who reports that her boyfriend has exposed her to herpes. With primary genital herpes or herpes simplex type 2, what finding would the nurse expect to observe in the teen during the initial outbreak?

burning or tingling on the vulva, perineum, or vagina

A client experiences weight loss, abdominal distention, crampy abdominal pain, and intermittent diarrhea after the birth of her second child. Diagnostic tests reveal gluten-induced enteropathy. Which foods would the nurse instruct the client to eliminate from her diet permanently?

cereal grains (except rice and corn)

A nurse is explaining treatment to the parents of a child with hypertrophic scarring. Which method would be the best for controlling this condition?

compression garments

An older adult client seeks help for chronic constipation. This is a common problem for older adult clients due to what factor related to aging?

decreased abdominal strength

A client with major depression begins to improve and participates in treatment programs on the unit. Which client behavior would best indicate to the team that the client is ready for discharge?

discusses plans to return home and continue outpatient treatment

Following a splenectomy, a client has a hemoglobin (Hb) level of 7.5 g/dl and has vertigo when getting out of bed. The nurse suspects abnormal orthostatic changes. The vital sign values that would most support the nurse's suspicions are:

drop in blood pressure and rise in heart rate.

Parents of a child with asthma are trying to identify possible allergens in their household. Which common inhaled allergen will be a priority for the parents to attempt to eliminate?

dust mites

When caring for a client with a diagnosis of type 2 diabetes mellitus, which diagnostic test(s) would the nurse anticipate being performed? Select all that apply.

fasting blood glucose glycosylated hemoglobin postprandial glucose

A nurse is planning care for a client diagnosed with acute hepatitis A. What is the primarymode of transmission for hepatitis A?

fecal contamination and oral ingestion

The physician prescribes lithium carbonate for a client who has just been diagnosed with bipolar disorder. Now the nurse is teaching the client about signs and symptoms of lithium toxicity, which include:

lethargy, vomiting, and diarrhea.

A nurse prepares to care for a client who has just transferred from the emergency department to the medical-surgical floor. Which is the most effective action that the nurse should take to prevent microbial transmission?

meticulous hand hygiene

The emergency room nurse is caring for a client who fell, breaking the tibia. The nurse determines that a client understands the risk of compartment syndrome when knowing to report which early symptom following treatment?

paresthesia

The nurse is providing care for a client who has had a stroke. Since the onset of symptoms, the client has been experiencing left-sided hemianopsia. Which nursing interventions would be appropriate? Select all that apply.

place the client's belongings on the right side of the bed stand on the right side of the bed when providing care

Which nursing measure is helpful when mouth ulcers develop as an adverse effect of chemotherapy?

provide a bland, moist, soft diet

The client is asking the nurse a question regarding the Mantoux test for tuberculosis. The nurse should base her response on the fact that the:

skin test doesn't differentiate between active and dormant tuberculosis infection.