P&P Quizzes

A nurse is caring for a client with chronic obstructive pulmonary disease (COPD). The nurse explains to the client that COPD is a chronic disease. Why is COPD considered a chronic disease? a. It persists for a long time. b. It has a gradual onset and lasts for a long time. c. It takes a long time to cure. d. It is a sequela of acute illness.

b. It has a gradual onset and lasts for a long time.

A nurse is administering a subcutaneous injection to a client. What is the maximum volume that the nurse may administer by this route? a. 1 ml b. 3 ml c. 0.05 ml d. 2.5 ml

a. 1 ml

Which part of the client's record is commonly used to document specific client variables, such as vital signs? a. critical paths b. flow sheets c. progress notes d. nursing notes

b. flow sheets

A client who is receiving medication via a metered-dose inhaler asks the nurse, "Why don't I put the inhaler mouthpiece in my mouth when I use the medication?" Which response by the nurse would be most appropriate? a. "Your mouth would contaminate the inhaler and medication." b. "This helps you to ensure that you swallow the medication." c. "The medication is more easily trapped in the oropharynx." d. "The mist that forms is better inhaled into your airways."

d. "The mist that forms is better inhaled into your airways."

The nurse is caring for four clients. Which client does the nurse identify as the highest risk for social readjustment concerns? a. 40-year-old who was fired from work last month b. 32-year-old who has recently been incarcerated c. 54-year-old who is undergoing marital separation d. 77-year-old whose spouse just died

d. 77-year-old whose spouse just died

A nurse is reviewing the previous medical history of a new client and is cross-referencing the client's preadmission medication regimen with the current medication orders. The nurse reads that the client was taking ginseng on a regular basis, but another nurse is adamant that this is not considered to be a "medication." The nurse should be aware that a medication is defined as: a. a substance that affects health status. b. a nonnutritional substance that is taken for health purposes. c. any physical substance that the client ingests in any form. d. a chemical substance that changes body function.

d. a chemical substance that changes body function.

The nurse applies an alcohol-based hand rub upon entering the client's room. The client becomes upset stating, "You did not wash your hands!" Which response by the nurse is most appropriate? a. "Alcohol-based hand rub provides the greatest reduction in microbial counts on the skin." b. "I won't be touching you, so using the alcohol hand rub is the quickest method to perform hand hygiene." c. "We only wash our hands when they are visibly soiled." d. "Washing the hands with soap and water is not necessary."

a. "Alcohol-based hand rub provides the greatest reduction in microbial counts on the skin."

The nurse is teaching an unlicensed assistive personnel (UAP) about fire safety. Which UAP statement requires immediate nursing intervention? a. "Only certain members of the health care team can extinguish a fire." b. "I will rescue clients from harm before doing anything else." c. "I will close the door to the room where the fire is after clients have been removed." d. "After clients are evacuated from the room with the fire, the alarm can be sounded."

a. "Only certain members of the health care team can extinguish a fire."

A client being discharged from the hospital asks the nurse, "When I go visit my family out of state, should I take my living will with me, or do I need a new one for that state?" Which is the most appropriate response by the nurse? a. "Take it with you. It is recognized universally in the United States." b. "We have it on file here, so any hospital can call and get a copy." c. "A living will can only be used in the state in which it was created." d. "As long as your family knows your medical wishes, you will not need it."

a. "Take it with you. It is recognized universally in the United States."

A client who is bedridden is scheduled to receive subcutaneous injections of heparin at 8:00 a.m. and 8:00 p.m. each day. The client's medication administration record would present these times as: a. 0800 and 2000 b. 0800 and 2200 c. 800 and 2200 d. 0800 and 1800

a. 0800 and 2000

A nurse is caring for a client who is admitted to the infection control room of a health care facility with AIDS and acute diarrhea. Which isolation measure is taken in the infection control room? a. A private bathroom is provided for flushing of contaminated liquids. b. Housekeeping personnel clean the infection control room first. c. The door to the room is kept open for cross-ventilation. d. The sink is located outside the room for handwashing.

a. A private bathroom is provided for flushing of contaminated liquids.

The nurse is preparing discharge teaching for a client with diabetes. Which information should the nurse include? Select all that apply. a. Appropriate use of a glucometer b. Community resources c. Instructions to follow up with the health care provider d. Meal planning e. Ways to pay for hospitalization and outpatient care charges

a. Appropriate use of a glucometer b. Community resources c. Instructions to follow up with the health care provider d. Meal planning

The nurse is caring for a 70-year-old client with a fractured wrist. Which is the best method to determine whether the client has retained the information taught? a. Ask the client to recall after approximately 15 minutes. b. Observe the change in client's behavior for a month. c. Test the client on the health education and information imparted. d. Ask the client to administer the doses of drug himself.

a. Ask the client to recall after approximately 15 minutes.

When caring for a client at the health care facility, the nurse observes that the client is having difficulty understanding the health education. Which action is most appropriate? a. Assess for cultural differences. b. Replace one-on-one teaching with written materials. c. Delegate the health education to a colleague.

a. Assess for cultural differences.

A nurse is caring for a client who has started phototherapy for seasonal affective disorder. Which instruction should the nurse give the client to prevent the recurrence of symptoms? a. Avoid abrupt discontinuation of the therapy. b. Try to relax during the therapy. c. Maintain good fluid intake during therapy. d. Take phototherapy for 2 to 6 hours.

a. Avoid abrupt discontinuation of the therapy.

The nurse has inserted a peripheral intravenous catheter into a client. What is the appropriate action when a blood return is not obtained? a. Change the site of catheter insertion. b. Begin infusing the IV fluid. c. Pinch the IV tubing to prohibit initial infusion. d. Insert the IV catheter further.

a. Change the site of catheter insertion.

Which is the primary goal of continuity of care? a. Ensuring a smooth and safe transition between different health care settings b. Increasing clients' knowledge base and improving their health maintenance behaviors c. Minimizing nurses' legal liability during client transitions between health care institutions d. Controlling costs and maximizing client outcomes after discharge from the hospital

a. Ensuring a smooth and safe transition between different health care settings

Which client growth needs are included in the love and belonging level of Maslow's hierarchy? (Select all that apply.) a. Friendships b. Family c. Intimacy d. Self-respect e. Status

a. Friendships b. Family c. Intimacy

A nurse cares for a client with congestive heart failure. The nurse administers a prescribed dose of furosemide intravenously after noting an increase in dyspnea and audible wheezing. The nurse's action demonstrates which step in the nursing process? a. Implementation b. Assessment c. Evaluation d. Planning

a. Implementation

Moderate sedation is prescribed for a client who will have a closed reduction of the left shoulder. Which outcome is expected after administering moderate sedation? a. The client is relaxed, emotionally comfortable, and conscious. b. The client can tolerate long therapeutic surgical procedures. c. The client's consciousness level can be monitored by equipment. d. The client can respond verbally despite physical immobility.

a. The client is relaxed, emotionally comfortable, and conscious.

A health care provider has ordered an ECG for a client with a report of chest pain. Apart from obtaining the equipment needed to conduct the test, what important task should the nurse perform before the test is administered? a. The nurse should check the instruments that require electric power. b. The nurse should cover the examination table with a sheet. c. The nurse should keep a lined receptacle nearby for disposal of soiled items. d. The nurse should cover the examination table with a paper dispensed from a roll.

a. The nurse should check the instruments that require electric power.

A nurse is delegating some aspects of client hygiene to an unlicensed care provider and is ensuring the care provider has adequate knowledge to safely perform shaving. With which client would the use of a razor be contraindicated? a. a man who has a history of stroke and who takes oral anticoagulants b. a man who had an unkempt beard and mustache upon admission c. a man who has a history of type 1 diabetes and who takes insulin daily d. a man who is the early stages of Alzheimer's disease

a. a man who has a history of stroke and who takes oral anticoagulants

An illegal immigrant with no health insurance sustained life-threatening injuries in an automobile accident. Which action in this case demonstrates the ethical principle of justice? a. Telling the client honest information about the client's medical condition and prognosis b. Airlifting the client to a local trauma center for emergency surgery c. Avoiding treating the client so as to not do any additional harm d. Filing the paperwork for the client to receive retroactive health insurance

b. Airlifting the client to a local trauma center for emergency surgery

The nurse works in an urban hospital and cares for a diverse population of clients. Which action(s) by the nurse demonstrates the delivery of culturally sensitive care to clients? Select all that apply. a. allowing the client to keep a religious necklace on until going into the operating room b. asking the client questions regarding health care beliefs related to the client's culture c. indicating that the cultural groups should adapt to the Anglo-American culture d. integrating the client's cultural practices when assisting with the creation of the plan of care e. maintaining direct eye contact during conversations with all cultural groups

a. allowing the client to keep a religious necklace on until going into the operating room b. asking the client questions regarding health care beliefs related to the client's culture d. integrating the client's cultural practices when assisting with the creation of the plan of care

A nurse organizes client data using the SOAP format. Which information would be recorded under "S" of this acronym? a. client reports of pain b. client's chief report c. client history d. client interventions

a. client reports of pain

One of the nursing achievements in the Crimean War was that the death rate of soldiers dropped from 60% to 1%. What is the most appropriate reason for the fall in the death rate? a. decreased rate of infection and gangrene b. increased funds courtesy of donations from families c. college-based education and training of nurses d. increased motivation among the soldiers

a. decreased rate of infection and gangrene

A client is receiving treatment in the intensive care unit for sepsis, a systemic infection that poses a grave threat to the body's homeostasis. The body is adapting to numerous threats, a process that primarily involves the integration of what body systems? Select all that apply. a. endocrine system b. central nervous system c. integumentary system d. autonomic nervous system e. cerebellar system

a. endocrine system b. central nervous system c. integumentary system

A client who suffered a stroke is discharged from a health care unit and the nurse is assigned to provide nursing care to the client at home. This is an example of which kind of care? a. extended care b. tertiary care c. secondary care d. primary care

a. extended care

A lead nurse is removing personal protective equipment after dressing the infected wounds of a client. Which is the priority nursing action? a. handwashing before leaving the client's room b. remove the garments that are most contaminated c. make contact between two contaminated surfaces d. make contact between two clean surfaces

a. handwashing before leaving the client's room

The nurse has worn a gown and gloves while caring for a client in contact isolation. How will the nurse appropriately remove this personal protective equipment (PPE)? a. remove gloves, remove gown, wash hands b. remove gloves, wash hands, remove gown c. remove gown, remove gloves, wash hands d. remove gown, wash hands, remove gloves

a. remove gloves, remove gown, wash hands

A nurse who works on a palliative care unit has participated in several clinical scenarios that have required the application of ethics. Ethics is best defined as: a. the principles that determine whether an act is right or wrong. b. moral values that are considered to be universal. c. the relationship between law and culture. d. the laws that govern acceptable and unacceptable behavior.

a. the principles that determine whether an act is right or wrong.

A client reports to the nurse, "Sleep really isn't necessary." Which teaching by the nurse is appropriate? Select all that apply. a. "Sleep can make your moods fluctuate over time." b. "Sleep helps you to learn easier and remember more." c. "Sleep helps your immune system to fight off infections." d. "Sleep helps your blood flow to the brain." e. "Sleep takes time, which can be stressful for some people."

b. "Sleep helps you to learn easier and remember more." c. "Sleep helps your immune system to fight off infections." d. "Sleep helps your blood flow to the brain."

A client is admitted to the health care facility with hypoglycemia. After the client is stable, the nurse discovers that the client has not taken the prescribed medicines. The client believes that eating saffron will keep blood sugar under control. What is the most appropriate response by the nurse? a. "Let me inform the health care provider that you are not taking your medicines." b. "What would you think about taking the medicines, too, and benefitting from both?" c. "Yes, I agree that you should continue taking saffron for diabetes."

b. "What would you think about taking the medicines, too, and benefitting from both?"

A nurse is examining a client with cirrhosis of the liver for edema. The nurse notes that the indentation remains for several seconds and the skin swelling is obvious on inspection. How should the nurse quantify the severity of the finding? a. 1+ pitting edema b. 2+ pitting edema c. 5+ brawny edema d. 3+ pitting edema

b. 2+ pitting edema

The nurse is preparing to administer insulin to an older client who is frail and has failure to thrive. At what angle will the nurse plan to insert the needle into the client? a. 90 degrees b. 45 degrees c. 20 to 30 degrees d. 10 to 15 degrees

b. 45 degrees

The nurse is performing care for a client in the end stage of cancer. How can the nurse best facilitate the client and family's ability to cope? Select all that apply. a. Encourage the family to leave and let the nurse take over care. b. Assist the client and family with the preparation for end-of-life. c. Assist the client with activities of daily living (ADLs). d. Inform the family that there is nothing they can do for their loved one. e. Refer the client and family to hospice services.

b. Assist the client and family with the preparation for end-of-life. c. Assist the client with activities of daily living (ADLs). e. Refer the client and family to hospice services.

The nurse is creating a professional development presentation about medication orders. Which teaching will the nurse include? Select all that apply. a. U and IU are acceptable abbreviations to use. b. Be extra cautious with look-alike and sound-alike drugs. c. The health care providers must sign all orders. d. Use abbreviations as much as possible. e. The prescribing provider is the only person accountable for drug orders.

b. Be extra cautious with look-alike and sound-alike drugs. c. The health care providers must sign all orders.

A client who has started using contact lenses visits a health care facility with an eye infection. The nurse observes that the client also has an eye abrasion. What could be the possible reason for the eye infection? a. Contact lenses were colored. b. Contact lenses were not cleaned. c. Contact lenses were new. d. Contact lenses were rigid.

b. Contact lenses were not cleaned.

A nurse is caring for a 45-year-old male client who lost function in both of his legs due to an automobile accident. Which of the following should the nurse do first to personalize the learning? a. Prepare the training plan for the client. b. Gather pertinent information from the client. c. Develop confidence in the client. d. Analyze the client's behavior.

b. Gather pertinent information from the client.

A nurse on a home visit to a healthy older adult client finds that too much clutter has accumulated in the house. What is the most appropriate nursing diagnosis for the client? a. Disturbed sensory perception b. Impaired home maintenance c. Impaired walking d. Impaired mobility

b. Impaired home maintenance

During assessment, the nurse observes that the client has a yellow discoloration on the skin. What is the nurse's appropriate action? a. Assess oxygen saturation level. b. Inspect the sclera and mucous membranes. c. Observe for cyanosis or ecchymosis. e. Auscultate the lungs and abdomen.

b. Inspect the sclera and mucous membranes.

The nurse is working in an acute care setting and performs primary, secondary, and tertiary prevention. Which activity performed by the nurse is classified as tertiary prevention? a. Promoting safety in the home b. Instructing a client on how to use crutches c. Assessing a client's blood glucose level d. Counseling a client about a low-sodium diet

b. Instructing a client on how to use crutches

The nurse is caring for an older adult client. Which gerontologic consideration regarding laboratory values does the nurse anticipate? a. Baseline laboratory values are not needed for comparison. b. Laboratory values change minimally or not at all. c. Vitamins and minerals do not affect laboratory values. d. Chronic conditions do not impact laboratory results.

b. Laboratory values change minimally or not at all.

A nurse is assisting a health care provider in examining a client. During the procedure, the nurse hands the health care provider one instrument at a time. What other method can the nurse use to assist the health care provider promptly and properly? a. Check with the health care provider before handing over any instrument. b. Place the instruments near the health care provider's dominant hand. c. Place all the necessary instruments near the health care provider.

b. Place the instruments near the health care provider's dominant hand.

A nurse is working with an adult client who has been admitted with hyperglycemia following a period of poor glycemic control. The nurse has many similarities to the client with regard to age, gender, and socioeconomic status but is careful to utilize therapeutic communication techniques rather than social communication. How does therapeutic communication differ from social communication? a. Therapeutic communication focuses on the requirements of the nurse while social communication is more reciprocal. b. Therapeutic communication is focused on a particular goal while social communication is more superficial in content. c. Therapeutic communication focuses primarily on problems while social communication addresses positive aspects of the client's life. d. Therapeutic communication relies heavily on technical medical vocabulary while social communication uses colloquialisms.

b. Therapeutic communication is focused on a particular goal while social communication is more superficial in content.

A nurse needs to combine two different prescribed drugs in a syringe and then administer them to a client with influenza. Which precaution should the nurse take when combining drugs? a. Expel both the drugs separately in a vial before use. b. Withdraw exact amounts of each drug from each container. c. Mix the two drugs together thoroughly before administering. d. Shake the two drug containers before withdrawing.

b. Withdraw exact amounts of each drug from each container.

The client is self-monitoring blood pressure at home and reports that every reading is 150/90 mmHg. What is the priority nursing intervention? a. provide the client with a larger blood pressure cuff b. ask the client to demonstrate self-blood pressure assessment c. recommend lower sodium in the client's diet d. report readings to primary care provider

b. ask the client to demonstrate self-blood pressure assessment

A nurse warns a client that he may fall off his bed during a seizure attack if he does not put up the side rails of the bed. Before leaving the client's room, the nurse puts up the side rails, but after the nurse has left, the client lowers them again. Later, the client has a fall from the bed and holds the nurse responsible for it. Which legal provision protects the nurse in this case? a. common law b. assumption of risk c. statute of limitations

b. assumption of risk

A nurse is using an IV port when administering medication to a client. Which IV administration has the greatest potential to cause life-threatening changes? a. continuous administration b. bolus administration c. electronic infusion device d. secondary administration

b. bolus administration

A client who practices Islam dies at the hospital surrounded by family members. Which action by the nurse demonstrates cultural sensitivity related to the client's death? a. allowing the family to remain present when the nurse washes the client prior to shrouding b. consulting the family member prior to performing post-mortem care c. informing the family members they may say their goodbyes so that care can be provided d. having the family members consult with the funeral home for transport

b. consulting the family member prior to performing post-mortem care

The home health nurse is performing an assessment related to the client's ability to manage activities of daily living in the home environment. Which assessment is the nurse performing? a. focused assessment b. functional assessment c. comprehensive assessment d. database assessment

b. functional assessment

A nurse is assisting a neurologist, who is assessing the norepinephrine (noradrenaline) level of a client who is reporting stress. Which function does norepinephrine (noradrenaline) perform? a. transmits sensation of pain b. heightens arousal and increases energy c. stabilizes mood and regulates temperature d. promotes coordinated movement

b. heightens arousal and increases energy

A nurse is making a bed for a client confined to bed due to coma. Which position should the nurse place the client in to facilitate bedmaking? a. supine position b. lateral position c. prone position d. Fowler's position

b. lateral position

A nurse is caring for a client with subnormal temperature. Which actions should the nurse perform to provide heat to the client's internal organs? a. warm blankets in a blanket warmer b. provide warm fluids c. raise the room temperature d. apply layers of dry clothing

b. provide warm fluids

A neurosurgeon has performed a cordotomy on a client having intractable pain. Which procedure is involved in a cordotomy? a. connecting electromyography machine to control pain b. surgical interruption of pain pathways in the spinal cord c. surgical sectioning of a nerve root close to the spinal cord d. delivering bursts of electricity to the skin and underlying nerves

b. surgical interruption of pain pathways in the spinal cord

A client admitted for hernioplasty is discharged two days later than the calculated time due to postoperative complications. The client is insured through a capitation scheme. In the event of late discharge of the client, who is at loss? a. the insurers b. the hospital c. the doctors d. the client

b. the hospital

A licensed practical nurse is planning a move to a new state and intends to begin practicing as soon as possible. This nurse should be aware that: a. a probationary period of up to one year may be required for the nurse to obtain a job in the new state. b. there may be differences in the scope of practice when a practical nurse relocates to a new state. c. an LPN or LVN may not normally practice outside of the state where he or she was educated. d. practical nurses may have to retake the NCLEX-PN in order to gain an out-of-state license.

b. there may be differences in the scope of practice when a practical nurse relocates to a new state.

The poison control nurse receives a call from the caregiver of a young school-age child who may have ingested a poisonous substance. Which is the priority response by the nurse? a. "Induce vomiting while you wait for emergency personnel to arrive." b. "What do you think that the child might have ingested?" c. "Check breathing and heart rate." d. "At what time did the child ingest the substance?"

c. "Check breathing and heart rate."

The nurse is educating a client and spouse about sudden jerking that occurs during sleep. What is the most appropriate nursing response? a. "When oxygen levels drop during sleep, muscles will jerk suddenly." b. "Sudden jerking movements can indicate vivid dreaming." c. "Sudden twitches that occur during the early phases of sleep are common." d. "Those are hypnogogic twitches that happen during REM sleep."

c. "Sudden twitches that occur during the early phases of sleep are common."

A client with abdominal incisions experiences excruciating pain when trying to cough. What should the nurse do to reduce the client's discomfort when coughing? a. Administer prescribed pain medication just before coughing. b. Ask the client to lie in a lateral position when coughing. c. Administer prescribed pain medication 30 minutes before deliberately attempting to cough. d. Ask the client to drink plenty of water before coughing.

c. Administer prescribed pain medication 30 minutes before deliberately attempting to cough.

A nurse is interacting with a client in the outpatient surgical unit intraoperatively. What is the nurse's priority responsibility? a. Establishing a nurse-client rapport b. Providing emotional support for the client and family c. Client safety d. Educating the client about postoperative protocols

c. Client safety

A health care provider is examining the client during the client's initial physical examination. After collecting all the data, the health care provider writes R/O in the medical records and suggests some more tests and examinations. What does the health care provider mean by R/O? a. revise order b. record out c. rule out d. refill out

c. rule out

The health care provider has prescribed an enteric-coated naproxen for arthritic pain to a client who typically prefers a liquid or chewable medication. Which instruction should the nurse provide the client to ensure the medication is taken appropriately? a. Crushing or chewing can cause the medication to be ineffective for pain relief. b. The potency of the medication will be increased due to early exposure to gastrointestinal acids if crushed or chewed. c. Do not chew the medication as disrupting the enteric coating can cause irritation in the lining of the stomach. d. Particles of the crushed medication can be inhaled causing respiratory irritation.

c. Do not chew the medication as disrupting the enteric coating can cause irritation in the lining of the stomach.

The client reports, "I have a few drinks with friends every week." Which nursing action exemplifies using a focused assessment in this case? a. Interviewing friends to ascertain the client's exercise habits b. Asking the client to discuss social functioning c. Obtaining data regarding the amount and frequency of drinking d. Performing an abdominal assessment

c. Obtaining data regarding the amount and frequency of drinking

The nurse is caring for a client with visual impairment who has been prescribed two different types of eye drops. Which nursing intervention will best assist the client in differentiating between the bottles of drops? a. Teach the client to place bottles on different ends of the table. b. Color code the bottles with different colors of pens. c. Place a rubber band snugly around one of the bottles. d. Write the names of the medications on the bottle.

c. Place a rubber band snugly around one of the bottles.

In preparation for discharge, the nurse is reviewing information related to new dietary guidelines with the client. This is an example of which step in discharge planning? a. Assessing the client's needs and identifying problems b. Developing goals with the client c. Providing client education d. Making home health care referrals

c. Providing client education

A 50-year-old client reports to a primary care unit with an open wound due to a fall in the bathroom. Which nursing actions represent caring skills? a. The nurse informs the client that the wound is small and will heal easily. b. The nurse inspects and examines the wound for swelling. c. The nurse cleans the wound and applies a dressing to it. d. The nurse tells the client to take care while on slippery surfaces.

c. The nurse cleans the wound and applies a dressing to it.

A nurse needs to count a client's heart rate. For which reason would the nurse assess the client's apical pulse? a. The blood pressure is elevated. b. The carotid pulse is bounding. c. The radial pulse is difficult to obtain. d. A baseline pulse rate is needed.

c. The radial pulse is difficult to obtain.

A client had an argument at work about his salary. The client has been consuming a lot of caffeine. The client suffers from insomnia and gets angry quickly. Which technique should the nurse promote to help the client? a. Negative coping strategy b. Nontherapeutic coping strategy c. Therapeutic coping strategy d. Sensory manipulation strategy

c. Therapeutic coping strategy

A nurse consults with a nurse practitioner trained to perform acupressure to teach the method to a client being discharged. What process is involved in this pain relief measure? a. biofeedback b. percutaneous electrical nerve stimulation c. cutaneous stimulation d. patient controlled analgesia

c. cutaneous stimulation

A client with an infection on the genitalia visits a health care facility. In order to inspect the infection, the nurse assists the client into a reclining position with knees bent. What type of position has the nurse placed the client in for inspection? a. lithotomy position b. knee-chest position c. dorsal recumbent position d. Sims' position

c. dorsal recumbent position

A nurse at a health care facility provides information, assistance, and encouragement to clients during the various phases of nursing care. In which activity does the nurse use counseling skills? a. telling a client to localize the pain in the abdomen b. encouraging a client to walk without support c. educating a group of 13-year-old children about AIDS d. assisting a lactating parent in feeding the infant

c. educating a group of 13-year-old children about AIDS

A nurse greets a new client and asks the client to accompany the nurse to an appropriate location for assessment. During this initial interaction with the client, the nurse is able to ascertain the client's: a. coping skills. b. health maintenance. c. level of consciousness. d. judgment and insight.

c. level of consciousness.

A client who is a drug addict visits a health care facility for treatment. During counseling, he discloses that he took to drugs because it helped him deal with stressful situations. The nurse explains that he is not using the correct coping strategy to overcome his stress-related problems. What kind of strategy has the client used in this case? a. stress-reduction strategy b. antidepressant strategy c. nontherapeutic coping strategy d. therapeutic coping strategy

c. nontherapeutic coping strategy

A nurse is working with a client who is in postoperative day 2 following a total knee replacement. The client has briefly mobilized using a wheeled walker and with the assistance of the physical therapist. However, the client is reluctant to progress further with mobilization for fear of injuring herself. In response to this, the nurse has liaised with the physical therapist to create a plan of care that creates specific goals for the client's mobility. In doing so, this nurse has exemplified what role? a. nurse as educator b. nurse as delegator c. nurse as collaborator d. nurse as caregiver

c. nurse as collaborator

A male client has always prided himself in maintaining good health and is consequently shocked at his recent diagnosis of diabetes. The nurse has asked the client, "How do you think your diabetes is going to affect your lifestyle?" The nurse has utilized which of the following interviewing techniques? a. validating question b. reflective question c. open-ended question d. closed question

c. open-ended question

A nurse has assessed a client's blood pressure near the beginning of a shift and obtained a systolic blood pressure of 138 mmHg and a diastolic blood pressure of 71 mmHg. The systolic blood pressure: a. corresponds directly to the client's heart rate. b. represents the client's blood pressure between heartbeats. c. represents peak pressure in the client's arteries. d. peaks when the client's heart is filling with blood.

c. represents peak pressure in the client's arteries.

A nurse is conducting a mental status assessment for a client admitted to a health care facility following a motor vehicle accident. Under which conditions would the nurse need to collect more objective assessment data? a. when the client is able to recall previous events b. when the client is able to think clearly c. when the client has taken an overdose of drugs d. when the client pays attention to the nurse's instruction

c. when the client has taken an overdose of drugs

Which is an example of a subjective finding that the nurse would likely obtain when performing a review of systems (ROS)? a. A blood glucose level of 108 mg/dL b. Grip weakness in the right hand c. Crackles in bilateral lung bases d. A client report of shooting pain up the left leg

d. A client report of shooting pain up the left leg

A nurse is preparing an operating room theatre for a surgical procedure. Which point regarding the principles of surgical asepsis should the nurse keep in mind when preparing sterilized surgical instruments? a. When a sterile item touches something that is not sterile, it may not be contaminated. b. Any partially uncovered sterile package need not be considered contaminated. c. Sterility may not be preserved even when one sterile item touches another sterile item. d. A commercially packaged surgical item is not considered sterile if past expiration date.

d. A commercially packaged surgical item is not considered sterile if past expiration date.

A nurse is administering a piggyback infusion to a client with partial-thickness or second-degree burns. Which describes the most important feature of a piggyback infusion? a. Medication is given all at one time as quickly as possible. b. Medication locks are changed every 72 hours. c. The primary IV solution is infused by gravity. d. A parenteral drug is given in tandem with an IV solution.

d. A parenteral drug is given in tandem with an IV solution.

Which action will the nurse perform in the assessment phase of the nursing process? a. Determine whether the client's goals for wellness have been met. b. Develop a plan to manage the client's health problems. c. Identify a nursing concern based on a potential health risk. d. Ask the client whether the they have cultural preferences.

d. Ask the client whether the they have cultural preferences.

A client having acute pain tells the nurse that her pain has gradually reduced, but that she fears it could recur and become chronic. What is a characteristic of chronic pain? a. Chronic pain will lead to psychological imbalance. b. Chronic pain eases with healing and eventually disappears. c. Chronic pain can be severe in its initial stages. d. Chronic pain has far-reaching effects on the client.

d. Chronic pain has far-reaching effects on the client.

A nurse has noticed that an older adult's hearing aid frequently produces a shrill, high-pitched noise. What possible solution should the nurse suggest to this problem with feedback? a. Encourage the client to clean their hearing aids frequently. b. Encourage the client to change the batteries in the hearing aid frequently. c. Encourage the client to ensure that cerumen does not accumulate in the ears. d. Encourage the client to make sure the hearing aid is fully inserted in the ear canal.

d. Encourage the client to make sure the hearing aid is fully inserted in the ear canal.

A nurse is taking care of a client during the immediate postoperative period. Which duty performed during the immediate postoperative period is most important? a. Prepare a room for the client's return. b. Assess the client's health constantly. c. Ensure the safe recovery of surgical clients. d. Monitor the client for complications.

d. Monitor the client for complications.

The telehealth nurse receives a call stating that upon entering a family member's home, two people have been found semi-conscious with a bright cherry red skin color. They are reporting nausea and headache, and are unable to move. Which initial direction will the nurse provide? a. Allow emergency personnel to apply oxygen. b. Wait inside until emergency personnel arrive. c. Recommend that carbon monoxide detectors be installed in the home. d. Open doors and windows.

d. Open doors and windows.

A nurse is aware that clear and accurate communication is necessary whenever clients are transferred or referred. Which situation best demonstrates a referral? a. The nurse gives report to the hospital's radiology department before a client is sent down for an x-ray. b. A client is moved from a subacute hospital unit to the intensive care unit following a hypertensive crisis. c. A client is relocated from the orthopedic ward to a rehabilitation ward after recovery from a knee replacement. d. The nurse arranges for a client with a diabetic foot ulcer to see a podiatrist in a community.

d. The nurse arranges for a client with a diabetic foot ulcer to see a podiatrist in a community.

An individual has come into contact with a coworker who has influenza. The person is now in the incubation stage of infection. What is true of this stage of infection? a. The person's immune system is successfully destroying the influenza virus. b. Viral levels in the person's blood are at a peak. c. The person is likely experiencing vague, nonspecific effects of influenza. d. The person is currently not experiencing symptoms of the flu.

d. The person is currently not experiencing symptoms of the flu.

What is the goal of the nurse in a helping relationship with a client? a. To provide hands-on physical care b. To ensure safety while caring for the client c. To facilitate the client's interactions with others d. To assist the client to identify and achieve goals

d. To assist the client to identify and achieve goals

A nurse is performing an assessment of a newly admitted hospital client and has documented the client as being a member of the Native American/First Nations subculture. A subculture is best described as: a. a cultural group with values that are incongruent with those of the dominant culture. b. a cultural group that has fewer than 5 million members. c. a unique cultural group with unspecified geographic origins. d. a unique cultural group that exists within the larger culture.

d. a unique cultural group that exists within the larger culture.

A nurse is teaching a client to correctly administer an inunction in order to maximize therapeutic effect. Which product is an inunction? a. barrier cream applied to a client's peristomal skin b. moisturizing cream applied to a client's dry skin c. potassium chloride elixir used to treat a client's hypokalemia d. hydrocortisone cream applied to a client's rash

d. hydrocortisone cream applied to a client's rash

The circulating nurse is observing a surgical technician donning a surgical gown. Which action by the technician indicates that the nurse should intervene to maintain sterile donning technique? a. unfolding the gown while avoiding contact with the floor b. picking up the gown at the sterile neckline c. holding the gown away from the body and other unsterile objects d. inserting an arm within each sleeve while touching the outer surface of the gown

d. inserting an arm within each sleeve while touching the outer surface of the gown

The nurse managers of a home health care office wish to maximize nurses' freedom to characterize and record client conditions and situations in the nurses' own terms. Which documentation format is most likely to promote this goal? a. FOCUS charting c. SOAP notes d. narrative notes e. charting by exception

d. narrative notes

The nurse has delegated oral care for an unconscious client to an unlicensed assistive personnel (UAP). Which UAP action requires immediate nursing intervention? a. applying petroleum jelly to lips b. mixing equal parts baking soda and table salt in warm water to be used to remove accumulated secretions c. moistening oral swabs before inserting them into the mouth d. placing the client supine to perform mouth care

d. placing the client supine to perform mouth care

A client who experienced domestic violence for years states to the nurse, "I know I should not feel this way, but every time I think of my former spouse, I get a horrible headache and have to go lie down." Which nursing intervention reflects practice according to the Neuromatrix Theory? a. asking client how sensory stimuli produces pain b. requesting health care provider to order the client's opioid medication c. administering backrub when client's head hurts d. removing items from the room that remind client of former spouse

d. removing items from the room that remind client of former spouse

A nurse should perform hand hygiene in which circumstance? a. only after removing gloves b. after making contact with an item in a public space c. whenever the nurse has not performed hand hygiene for 15 minutes d. whenever hands are visibly soiled

d. whenever hands are visibly soiled