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A client seen in the neighborhood clinic reports " eye problems" and generalized weakness that became markedly worse after using a friend's hot tub. The client provides long, detailed responses to initial demographic questions. What is the best question for the nurse to ask at this time? Select one: a. " How do you feel the hot tub is responsible for your worsening condition?" b. " Can you tell me more about the eye problems?" c. " Was the weather the same each time you used the hot tub?" d. " Could you try to be a little briefer in your answers so I can best help you?"

b. " Can you tell me more about the eye problems?"

A nursing student is caring for a client with a stroke who is experiencing unilateral neglect. The nurse would intervene if the student plans to use which of the following strategies to help the client adapt to the defict? Select one: a. Tells the client to scan the environment. b. Approaches the client from the unaffected side. c. Places the bed side articles on the affected side. d. Moves the commode and chair to the affected side.

b. Approaches the client from the unaffected side.

A nurse who works in a oncology clinic is assessing a client who has arrived for a 2-month follow-up follow-up appointment following chemotherapy. The nurse notes that the client's skin appears yellow. Which blood tests should be done to further explore this clinical sign? Select one: a. Platelet count b. Liver function tests ( LFTs) c. Blood urea nitrogen creatinine d. Complete blood count ( CBC)

b. Liver function tests ( LFTs)

A community health nurse is focusing current health promotion efforts on diseases that are disproportionately represented among ethnic and racial minorities. Which of the following diseases should the nurse likely address? Select all that apply. Select one or more: a. COPD b. Alzheimer's disease c. Human immunodeficiency virus (HIV) d. cancer e. heart disease

c. Human immunodeficiency virus (HIV) d. cancer e. heart disease

During a client's recovery from stroke, the nurse should be aware of predictors of stroke outcome in order to help clients and families set realistic goals. What are the predictors of stroke outcome? Select all that apply. Select one or more: a. Race b. gender c. National Institutes of Health Stroke Scale (NIHSS) score d. LOC at time of admission e. Age

c. National Institutes of Health Stroke Scale (NIHSS) score d. LOC at time of admission e. Age

Because phenytoin ( Dilantin) was ordered stat for a client who was just admitted to the nursing unit from the emergency department, which assessments are of highest priority for the nurse to perform? Select one: a. Hydration status and emotional response to seizures b. Blood urea nitrogen, creatinine, and urine output c. Seizure activity, mental status, and respiratory status d. Electrolytes, serum osmolality, and leg edema

c. Seizure activity, mental status, and respiratory status

An oncology nurse educator is providing health education to a client who has been diagnosed woth skin cancer. The client's wife has asked about the differences between normal cells and cancer cells. What characteristic of a cell should the educator cite? Select one: a. Chromosomes contained in cancer cells are more durable and stable than those of normal cells. b. The nuclei of cancer cells are unusually large, but regular shaped. c. Malignant cells possess greater mobility than body cells. d. Malignant cells contain proteins called tumor-associated antigens.

d. Malignant cells contain proteins called tumor-associated antigens.

The nurse observes a child starting to have a seizure. After assessing the airway, what should the highest priority of the nurse? Select one: a. Administer diazepam. b. Inset an artificial airway. c. Restrain the extremities to protect the child from injury. d. Observe and record seizure activity.

d. Observe and record seizure activity.

After a subarachnoid hemorrhage, the client's laboratory results indicate a serum sodium level of less than 126 mEq/L. What is the nurse's most appropriate action? Select one: a. administer a bolus of normal saline as prescribed b. facilitate testing for hypothalmic dysfunction c. prepare the client for thrombolytic therapy as prescribed d. prepare to administer 3% NaCl by IV as prescribed

d. prepare to administer 3% NaCl by IV as prescribed

The educator is teaching a client about type 2 diabetes. The educator recognizes that the client understands the primary treatment for type 2 diabetes when the client states what? Select one: a. "I will make sure to follow the weight-loss plan designed by the dietitian." b. "I will make sure I call the diabetic educator when I have questions about my insulin." c. "I read that a pancreas transplant will provide a cure for my diabetes." d. "I will take my oral antidiabetic agents when my morning blood sugar is high."

a. "I will make sure to follow the weight-loss plan designed by the dietitian."

The pathophysiology of an ischemic stroke involves the ischemic cascade, which includes the following steps: 1. Change in pH 2. Blood flow decreases 3. A switch to anaerobic respiration 4. Membrane pumps fail 5. Cells cease to function 6. Lactic acid is generated Put these steps in order in which they occur: Select one: a. 236145 b. 352416 c. 635241 d. 162534

a. 236145

The nurse is describing some of the major characteristics of cancer to a client who has recently received a diagnosis of malignant melanoma. When differentiating between benign and malignant cancer cells, the nurse should explain differences in which of the following aspects? Select all that apply. Select one or more: a. Ability to spread b. Rate of growth c. Size of cells d. Ability to cause death e. Cell contents

a. Ability to spread b. Rate of growth d. Ability to cause death

An adult client with leukemia will soon begin chemotherapy. What would the nurse do to combat the most common adverse effects of chemotherapy? Select one: a. Administer an antiemetic. b. Administer a tumor antibiotic c. Administer an anticoagulant. d. Administer an antimetabolite.

a. Administer an antiemetic.

The hospice nurse has just admitted a new client to the program. What principle guides hospice care? Select one: a. Care addresses the needs of the client as well as the needs of the family. b. The focus of all aspects of care is solely on the client. c. Care is focused on the client centrally and the family peripherally. d. The care team prioritizes the client's physical needs and the family is responsible for the client's emotional needs.

a. Care addresses the needs of the client as well as the needs of the family.

A client newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should the nurse describe? Select one: a. Nausea and vomiting b. Confusion c. Altered glucose metabolism d. Pruritus (itching)

a. Nausea and vomiting

A client with type 1 diabetes has told the nurse that his most recent urine test for ketones was positive. What is the nurse's most plausible conclusion based on this assessment finding? Select one: a. The client's insulin levels are inadequate b. The client would benefit from a dose of metformin c. The client should withold his next scheduled dose of insulin d. The client should promptly eat some protein and carbohydrates

a. The client's insulin levels are inadequate

The nurse is caring for a client in the emergency department and is implementing evidence-based practice (EBP). What considerations should inform the nurse's evidence-based care? Select all that apply Select one or more: a. The nurse's expertise and judgment b. The nurse's preferences c. Cost considerations d. Valid and reliable research e. The nurse's expertise and judgment

a. The nurse's expertise and judgment d. Valid and reliable research e. The nurse's expertise and judgment

A nurse on a medical-surgical unit has asked to represent the unit on the hospital's quality committee. When describing quality improvement programs to nursing colleagues and members of other health disciplines, what characteristic should the nurse cite? Select one: a. These programs emphasize the need for evidence-based practice. b. These programs establish consequences for health care professionals' actions. c. These programs seek to justify health care costs and systems. d. These programs identify specific incidents related to quality.

a. These programs emphasize the need for evidence-based practice.

A hospital's written policies and procedures are being reviewed as part of an accreditation process. Which policies are congruent with the principles of culturally competent nursing care? Select all that apply. Select one or more: a. a policy that outlines the appropriate use of translation services b. a policy guiding staff in the care of clients with different values c. a policy that gives priority to clients who are immigrants d. a policy that requires staff from different cultures on each unit e. a policy that establishes flexible regulations pertaining to visitors

a. a policy that outlines the appropriate use of translation services b. a policy guiding staff in the care of clients with different values e. a policy that establishes flexible regulations pertaining to visitors

A gerontologic nurse has been working hard to change the negative perceptions of the elderly. What negative perceptions of older adults have been identified in the literature? Select all that apply. Select one or more: a. decreased excretion of potassium b. decreased renal blood flow c. increased conservation of sodium d. decreased kidney mass e. increased total body water

a. decreased excretion of potassium b. decreased renal blood flow d. decreased kidney mass

The nurse is performing a cultural nursing assessment of a newly admitted client. What should the nurse include in the assessment? Select all that apply. Select one or more: a. health practices b. subgroups c. family structure d. cultural beliefs e. values

a. health practices c. family structure d. cultural beliefs e. values

A client is brought to the emergency department by the paramedics. The client is a type 2 diabetic and is experiencing hyperglycemic hyperosmolar syndrome (HHS). The nurse should identify what components of HHS? Select all that apply. Select one or more: a. hypernatremia b. glycosuria c. hyperglycemia d. dehydration e. leukocytosis

a. hypernatremia b. glycosuria c. hyperglycemia d. dehydration

he nurse is providing discharge teaching to a client who had hypophosphatemia during his time in hospital. The client has a diet prescribed that is high in phosphate. What foods should you teach this client to include in his diet? Select all that apply. Select one or more: a. liver b. milk c. beef d. poultry e. green vegetables

a. liver b. milk d. poultry

The nurse is caring for a client admitted to the medical-surgical unit after an injury. The client states I hurt so bad. I suffer from chronic pain anyway, and now it is so much worse. When planning the client's care, what variables should the nurse consider? Select all that apply. Select one or more: a. resources that can assist the client with pain mangement b. the advantages and disadvantages of available pain-relief strategies c. the differences between acute and intermittent pain d. how the presence of pain affects clients and families e. the influence of the client's cognition on her pain

a. resources that can assist the client with pain mangement b. the advantages and disadvantages of available pain-relief strategies d. how the presence of pain affects clients and families

A client with type 2 diabetes has been managing his blood glucose levels using diet and metformin. Following an ordered increase in the client's daily dose of metformin, the nurse should prioritize which of the following assessments? Select one: a. reviewing the client's creatinine and BUN levels b. assessing the clients for signs of impaired liver function c. monitoring the client's neutrophil levels d. monitoring the client's level of consciousness behavior

a. reviewing the client's creatinine and BUN levels

As a member of the stroke team, the nurse knows that thrombolytic therapy carries the potential for the benefit and the thrombolytic therapy? Select all that apply. Select one or more: a. Sudden symptom onset b. Current anticoagulation therapy c. INR above 1.0 d. Symptom onset greater than 3 hours prior to admission e. Recent intracranial pathology

b. Current anticoagulation therapy d. Symptom onset greater than 3 hours prior to admission e. Recent intracranial pathology

A medication regimen has controlled the seizures of an adult client for for several days and includes the medication phenytion ( Dilantin). Prior to discharge, the nurse should place highest priority on including which information in the teaching plan? select all that apply. Select one or more: a. The client cannot drive a vehicle permanently. b. Slide effects may include confusion and headach. c. Adherence to medication therapy is essential to avoid recurrence of seizures. d. Many seizure disorders will eventually stop on their own. e. Lab work for drug levels will need to be done routinely.

b. Slide effects may include confusion and headach. c. Adherence to medication therapy is essential to avoid recurrence of seizures. e. Lab work for drug levels will need to be done routinely.

A client diagnosed with transient ischemic attacks (TIAs) is scheduled for a carotid endarterectomy. The nurse explains that this procedure will be done for what purpose? Select one: a. To prevent seizure activity that is common following a TIA b. To remove atherosclerotic plaques blocking cerebral flow c. To decrease cerebral edema d. To determine the cause of the TIA

b. To remove atherosclerotic plaques blocking cerebral flow

The nurse is caring for a young adult client with a diagnosis of cerebral palsy who has been admitted for the relief of painful contractures in his lower extremities. When creating a nursing care plan for this client, what variables should the nurse consider? Select all that apply. Select one or more: a. client's gender b. client's comorbid conditions c. type of procedure being performed d. prior effectiveness in relieving the pain e. changes in neurologic function due to the procedure

b. client's comorbid conditions c. type of procedure being performed d. prior effectiveness in relieving the pain e. changes in neurologic function due to the procedure

An older adult client with type 2 diabetes is brought to the emergency department by his daughter. The client is found to have a blood glucose level of 600 mg/dL (33.3 mmol/L). The client's daughter reports that the client recently had a gastrointestinal virus and has been confused for the last 3 hours. The diagnosis of hyperglycemic hyperosmolar syndrome (HHS) is made. What nursing action would be a priority? Select one: a. administration of antihypertensive medications b. fluid and electrolyte replacement c. reversing acidosis by administering insulin d. administering sodium bicarbonate intravenously

b. fluid and electrolyte replacement

Nursing care during the immediate recovery period from an ischemic stroke should include which of the following? Select one: a. initiating early mobilization b. positioning to avoid hypoxia c. maximizing PaCO2 d. administering hypertonic IV solution

b. positioning to avoid hypoxia

The nurse is teaching a client about some of the health consequences of uncontrolled hypertension. What health problems should the nurse describe? Select all that apply. Select one or more: a. venous insufficiency b. retinal hemorrhage c. Cerebrovascular disease d. right ventricular hypertrophy e. transient ischemic attacks (TIA)

b. retinal hemorrhage c. Cerebrovascular disease e. transient ischemic attacks (TIA)

A nurse is conducting a class on how to self-manage insulin regimens. A client asks how long a vial of insulin can be stored at room temperature before it goes bad. What would be the nurse's best answer? Select one: a. "If a vial of insulin will be used up within 21 days, it may be kept at room temperature." b. "If a vial of insulin will be used up within 1 week, it may be kept at room temperature." c. "If you are going to use up the vial within 1 month, it can be kept at room temperature." d. "If a vial of insulin will be used up within 2 weeks, it may be kept at room temperature."

c. "If you are going to use up the vial within 1 month, it can be kept at room temperature."

The health care provider has explained to a client that the client has developed diabetic neuropathy in his right foot. Later that day, the client asks the nurse what causes diabetic neuropathy. What would be the nurse's best response? Select one: a. "Research has shown that diabetic neuropathy is caused by fluctuations in blood sugar that have gone on for years." b. "The cause is not known for sure but it is thought to have something to do with ketoacidosis." c. "The cause is not known for sure but it is thought to involve elevated blood glucose levels over a period of years." d. "Research has shown that diabetic neuropathy is caused by a combination of elevated glucose and ketone levels."

c. "The cause is not known for sure but it is thought to involve elevated blood glucose levels over a period of years."

A rehabilitation nurse caring for a client who has had a stroke is approached by the client's family and asked why the client has to do so much for herself when she is obviously struggling. What would be the nurse's best answer? Select one: a. "We are trying to help her be as useful as she possibly can." b. "We aren't here to care for her the way the hospital staff did; we are here to help her get better so she can go home." c. "The focus on care in a rehabilitation facility is to help the client to resume as much self-care as possible" d. "Rehabilitation means helping clients do exactly what they did before their stroke."

c. "The focus on care in a rehabilitation facility is to help the client to resume as much self-care as possible"

The nurse is reviewing the medication administration record of a female client who possesses numerous risk factors for stroke. Which of the woman's medications carries the greatest potential for reducing her risk of stroke? Select one: a. Lorazepam 1mg SL BID PRN b. Calcium carbonate 1000mg PO BID c. Aspirin 81 PO BID d. Naproxen 250 PO BID

c. Aspirin 81 PO BID

The hospice nurse is caring for a client with cancer who is living at home. The nurse has explained to the client and the family that the client is at risk for hypercalcemia and has educated them on that signs and symptoms of this health problem. What else should the nurse teach this client and family to do to reduce the client's risk of hypercalcemia? Select one: a. Restrict calcium intake b. Laxatives should be taken daily. c. Consume 2 to 4 of fluid daily d. Avoid the use of stool softeners

c. Consume 2 to 4 of fluid daily

The nurse is caring for a client who is to begin receiving external radiation for a malignant tumor of the neck. While providing client education, what potential adverse effects should the nurse discuss with the client? Select one: a. Alopecia b. Cognitive changes c. Impaired nutrition status d. Diarrhea

c. Impaired nutrition status

uring a client's recovery from stroke, the nurse should be aware of predictors of stroke outcome in order to help clients and families set realistic goals. What are the predictors of stroke outcome? Select all that apply. Select one or more: a. gender b. race c. LOC at time of admission d. age e. National Institutes of Health Stroke Scale (NIHSS) score

c. LOC at time of admission d. age e. National Institutes of Health Stroke Scale (NIHSS) score

As a member of the stroke team, the nurse knows that thrombolytic therapy carries the potential for benefit and for harm. The nurse should be cognizant of what contraindications for thrombolytic therapy? Select all that apply. Select one or more: a. INR above 1.0 b. Sudden symptom onset c. Symptom onset greater than 3 hours prior to admission d. Current anticoagulation therapy e. Recent intracranial pathology

c. Symptom onset greater than 3 hours prior to admission d. Current anticoagulation therapy e. Recent intracranial pathology

The nurse is caring for an adult client who has developed a mild oral yeast infection following chemotherapy. What actions should the nurse encourage the client to perform? Select all that apply. Select one or more: a. Eat spicy food to aid in eradicating. b. Scrub the tongue with a firm-bristled toothbrush. c. Use a lip lubricant. d. Rinse the mouth with normal saline. e. Use dental floss every 24 hours.

c. Use a lip lubricant. d. Rinse the mouth with normal saline. e. Use dental floss every 24 hours.

A diabetes nurse is assessing a client's knowledge of self-care skills. What would be the most appropriate way for the educator to assess the client's knowledge of nutritional therapy in diabetes? Select one: a. have the client's family describe what he typically eats b. ask the client to describe a typical day's food intake c. ask the client to keep a food diary and review it with the nurse d. have the client describe an optimally healthy meal

c. ask the client to keep a food diary and review it with the nurse

A client has been living with type 2 diabetes for several years, and the nurse realizes that the client is likely to have minimal contact with the health care system. In order to ensure that the client maintains adequate blood sugar control over the long term, what should the nurse recommend? Select one: a. regular consultation of websites that address diabetes management b. weekly telephone "check-ins" with an endocrinologist c. participation in a support group for persons with diabetes d. ask the client to describe a typical day's food intake e. participation in clinical trials relating to antihyperglycemics

c. participation in a support group for persons with diabetes

A nurse is teaching basic survival skills to a client newly diagnosed with type 1 diabetes. What topic should the nurse address? Select one: a. signs and symptoms of diabetic nephropathy b. management of diabetic ketoacidosis c. recognition of hypoglycemia and hyperglycemia d. effects of surgery and pregnancy on blood sugar levels

c. recognition of hypoglycemia and hyperglycemia

As a member of the stroke team, the nurse knows that thrombolytic therapy carries the potential for benefit and for harm. The nurse should be cognizant of what contraindications for thrombolytic therapy? Select all that apply. Select one or more: a. INR above 1.0 b. sudden symptom onset c. symptoms onset greater than 3 hours prior to admission d. current anti-coagulation therapy e. recent intracranial pathology

c. symptoms onset greater than 3 hours prior to admission d. current anti-coagulation therapy e. recent intracranial pathology

The nurse is caring for a client recovering from an ischemic stroke. What intervention best addresses a potential complication after an ischemic stroke? Select one: a. keeping a urinary catheter in situ for the full duration of recovery b. providing frequent small meals rather than three larger meals c. teaching the client to perform deep breathing and coughing exercises d. limiting intake of insoluable fiber

c. teaching the client to perform deep breathing and coughing exercises

A nurse is assessing a client who has diabetes for the presence of peripheral neuropathy. The nurse should question the client about what sign or symptom that would suggest the possible development of peripheral neuropathy? Select one: a. persistently cold feet b. acute pain, unrelieved by rest c. the presence of a tingling sensation d. pain that does not respond to analgesia

c. the presence of a tingling sensation

A client with diabetes calls the clinic reporting a flu bug. What should the nurse tell the client to do? Select all that apply. Select one or more: a. "Ensure that you check your blood glucose every hour." b. "Take your usual dose of insulin." c. "For now, check your urine for ketones every 8 hours." d. "Try to eat small amounts of carbs, if possible." e. "Make sure to stick to your normal diet."

d. "Try to eat small amounts of carbs, if possible."

A nurse is creating a plan of care for an oncology client and one of the identified nursing diagnoses is risk for infection related to myelosuppression. What intervention addresses a leading cause of infection-related death in oncology clients? Select one: a. Assess the integrity of the client's mucosa regularly. b. Assist the client with hygiene, as needed. c. Encourage several small meals daily. d. Provide skin care to maintain skin integrity

d. Provide skin care to maintain skin integrity

The home health nurse is assisting a client and his family in planning the client's return to work after surgery and the development of postsurgical complications. The nurse is preparing a plan of care that addresses the client's multifaceted needs. To which level of Maslow hierarchy of basic needs does the client's need for self-fulfillment relate? Select one: a. Transcendence b. Physiologic c. Love and belonging d. Self-actualization

d. Self-actualization

A client has just been diagnosed with type 2 diabetes. The physician has prescribed an oral antidiabetic agent that will inhibit the production of glucose by the liver and thereby aid in the control of blood glucose. What type of oral antidiabetic agent did the health care provider prescribe for this client? Select one: a. an alpha-glucosidase inhibitor b. a sulfonylurea c. a thiazolidinedione d. a biguanide

d. a biguanide

An elderly client with diabetes comes to the clinic with her daughter. The nurse reviews foot care with the client and her daughter. Why would the nurse feel that foot care is so important to this client? Select one: a. oral antihyperglycemics have the possible adverse effect of decreased circulation to the lower extremities b. hypoglycemia is linked with a risk for falls; this risk is elevated in older adults with diabetes c. an elderly client with foot ulcers experiences severe foot pain due to the diabetic polyneuropathy d. avoiding foot ulcers may mean the difference between institutionalization and continued independent living

d. avoiding foot ulcers may mean the difference between institutionalization and continued independent living

The nurse is trying to communicate with a client with a stroke and aphasia. Which of the following actions by the nurse would be least helpful to the client? Select one: a. speaking to the client at a slower rate b. looking directly at the client during attempts at speech c. allowing plenty of time for the client to respond d. completing the sentences that the client can not finish

d. completing the sentences that the client can not finish

When preparing to discharge a client home, the nurse has met with the family and warned them that the client may exhibit unexpected emotional responses. The nurse should teach the family that these responses are typically a result of what cause? Select one: a. changes in brain activity during sleep and wakefulness b. unmet physiologic needs c. temporary changes in metabolism d. frustration around changes in function and communication

d. frustration around changes in function and communication

A client is diagnosed with a right-sided stroke. The client is now experiencing hemianopsia. How might the nurse help the client manage her potential sensory and perceptional difficulties? Select one: a. keep the lighting in the client's room low b. place the client's clock on the affected side c. approach the client on the side where vision is impaired d. place the client's extremities where she can see them

d. place the client's extremities where she can see them

The nurse is caring for a client diagnosed with an ischemic stroke and knows that effective positioning of the client is important. Which of the following should be integrated into the client's plan of care? Select one: a. the clients hip joint should be maintained in a flexed position b. the client should be in a supine position unless ambulating c. the client should be placed in Trendelenburg position two to three times daily to promote cerebral perfusion d. the client should be placed in a prone position for 15 to 30 minutes several times a day

d. the client should be placed in a prone position for 15 to 30 minutes several times a day


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