Patient-centered care
The nurse is caring for a client with tuberculosis. Which suggestions from the nurse will be beneficial for the client? Select all that apply. 1 "Take the daily dose during daytime." 2 "Avoid exposure to any inhalation irritants." 3 "Eat foods that are rich in protein, vitamins C and B." 4 "Cover the mouth and nose with a tissue when coughing or sneezing." 5 "Avoid sputum specimens for 2 to 4 weeks once drug therapy is initiated."
2- "Avoid exposure to any inhalation irritants: 3-"Eat foods that are rick in protein, vitamins C and B" 4- "Cover the mouth and nose with a tissue when coughing or sneezing."
After a craniotomy a child is returned to the postanesthesia care unit. What is the rationale for the nurse's positioning of the child in the semi-Fowler position? 1-Cardiac workload is decreased, and oxygenation is facilitated. 2-Cranial drainage is increased, thus preventing cerebral fluid accumulation. 3-Subdural pressure is decreased, and recovery from anesthesia is enhanced. 4-Thoracic cavity expansion is increased, and pressure on the diaphragm is reduced.
2- Cranial drainage is increased, thus preventing cerebral fluid accumulation.
At what age should a nurse instruct a parent that his or her child will have finicky eating habits? 1-One year old 2-Two years old 3-Four years old 4-Five years old
3- Four years old
A client with Guillain-Barré syndrome has been hospitalized for three days. Which assessment finding indicates a need for more frequent monitoring? 1-Localized seizures 2-Skin desquamation 3-Hyperactive reflexes 4-Ascending weakness
4- Ascending weakness
Tinea unguium
fungal infection of the nails
Before major abdominal surgery for cancer, a client says to a nurse, "I really don't think this is cancer at all. I'll bet they won't find anything." Which is the most appropriate initial response by the nurse? 1-"I can understand why you'd like to believe that." 2-"I hope you're right, although tests indicate cancer." 3-"It must be difficult to be facing such serious surgery." 4-"You think the healthcare provider may have made a wrong diagnosis?"
1- "I can understand why you'd like to believe that."
The nurse administers a second dose of inactivated polio vaccine (IPV) to a 4-month-old child. When does the child receive the third dose of IPV? 1-6 months of age 2-4 to 6 years of age 3-8 to 9 months of age 4-12 to 14 years of age
1- 6 months of age
Which instruction from the nurse to an 80-year-old client with thinning of a subcutaneous layer would be most beneficial? 1-Dress warmly in cold weather 2-Use soaps with high fat content 3-Change the position of bed once every 5 hours 4-Apply moisturizer immediately after bathing
1- Dress warmly in cold weather
The nurse is planning care for the family of a preschool-age child who has a chronic illness. Which activities should the nurse recommend to decrease the risk for compassion fatigue? Select all that apply. 1-Exercising 2-Moving away 3-Developing a hobby 4-Fostering social relationships 5-Sleeping more than twelve hours each night
1- Exercising 3- Developing a hobby 4- Fostering social relationships
A client had a bypass graft because of an abdominal aortic aneurysm. Postoperative prescriptions include measurements of the client's abdominal girth. Which serious problem may be indicated by an increasing abdominal girth? 1-Graft leakage 2-Bowel puncture 3-Abdominal infection 4-Postoperative flatulence
1- Graft leakage
in which part of the client's body is the amphiarthroidial joint located? 1-Pelvis 2-Elbow 3-Cranium 4-Shoulder
1- Pelvis
A client with the diagnosis of panic disorder jumps when spoken to, complains of feeling uneasy, and says, "It's as though something bad is going to happen." Which action by the nurse is most therapeutic at this time? 1-Stay with the client to be a calming presence. 2-Encourage the client to communicate with the staff. 3-Allow the client to set the parameters for the interaction. 4-Help the client to understand the cause of the feelings described.
1- Stay with the client to be a calming presence.
Two days after being discharged a new mother calls the clinic stating that she is not sure that her baby is receiving enough breast milk. What information does the nurse need to determine whether the infant is being fed adequately? 1-Voids four times before 2 pm 2-Sleeps 3.5 to 4 hours between feedings 3-Has two or more bowel movements each day 4-Nurses 5 minutes on the first breast and 10 on the other
1- Voids four times before 2 pm
A client exhibits blurred and double vision and muscular weakness, and diagnostic tests are prescribed. The client is informed that a diagnosis of multiple sclerosis (MS) has been made. The client becomes visibly upset. How should the nurse respond? 1."That must have really shocked you. Tell me what the healthcare provider told you about it." 2"You should see a psychiatrist who will help you cope with this overwhelming news." 3"Don't worry; early treatment often alleviates symptoms of the disease." 4"You should be glad that we caught it early so it can be cured."
1. "That must have really shocked you. Tell me what the healthcare provider told you about it."
A healthcare provider prescribes enoxaparin 30 mg subcutaneously daily. Which measure would the nurse take when administering this medication? 1-Push over 2 minutes. 2-Administer in the abdomen. 3-Rub site after administration. 4-Remove air pocket from prepackaged syringe before administration.
2- Admin in the abdomen
Which families should the nurse provide information to regarding safe sleeping habits as a priority during a scheduled health maintenance visit for a preschool-age child? Select all that apply. 1-Irish American 2-Asian American 3-African American 4-Hispanic American 5-Caucasian American
2- Asian 3- African 4- Hispanic
What is an important nursing intervention in the care of a hospitalized toddler with cystic fibrosis? 1-Discouraging coughing 2-Performing postural drainage 3-Encouraging active exercise 4-Providing small, frequent feedings
2- Performing postural drainage
A client with a diagnosis of Graves disease refuses to have radioactive iodine (RAI) therapy, and a subtotal thyroidectomy is performed. What should the nurse do postoperatively to reduce the risk of thyroid storm? 1-Provide a high-calorie diet. 2-Prevent infection at the surgical site. 3-Encourage postoperative breathing exercises. 4-Demonstrate how to support the neck after surgery.
2- Prevent infection at the surgical site.
A person who is hospitalized for alcoholism becomes boisterous and belligerent and verbally threatens the nurse. What is the mostappropriate response by the nurse? 1-Placing the client in restraints 2-Sedating and placing the client in a controlled environment 3-Encouraging the client to play table tennis with another client 4-Setting firm limits on the client's behavior and enforcing adherence to them
2- Sedating and placing the client in a controlled environment
The nurse manager is observing the performance of a nursing assistant. Which behavior by the nursing assistant toward a client reflects a boundary violation? 1-Offering advice to the client 2-Providing false reassurance 3-Accepting a gift from the client 4-Engaging in excessive probing
3- Accepting a gift from the client
A client at the women's health clinic tells the nurse that she has endometriosis. What factors associated with endometriosis does the nurse anticipate the client will report? Select all that apply. 1-Insomnia 2-Ecchymosis 3-Rectal pressure 4-Abdominal pain 5-Skipped periods 6-Pelvic infections
3- Rectal pressure 4- Abdominal pain
A client underwent a mastectomy 24 hours ago. Which information is most important for the nurse to include in the plan of care? 1-The drainage container will be kept level with the affected arm. 2-The affected arm will be abducted at the shoulder with the elbow extended. 3-The hand and elbow of the affected arm will be elevated above the shoulder. 4-The elbow and shoulder of the affected arm will be elevated, with the hand resting on the abdomen.
3- The hand and elbow of the affected arm will be elevated above the shoulder.
Which statement by the nurse is accurate and appropriate to the parents of a toddler-age client who has never been to the dentist? 1-"You should continue to work with your child regarding brushing and flossing habits." 2-"You should schedule an appointment for a thorough cleaning and a full set of x-rays." 3-"It is best that you wait until your child is more cooperative prior to making an appointment." 4-"It is a good idea to let your child go with you for a dental visit prior to scheduling one for your child."
4- "It is a good idea to let your child go with you for a dental visit prior to scheduling on for your child."
A 12-year-old child is to be bedridden at home for several weeks after orthopedic surgery. What activity should the nurse encourage the parents to plan? 1-Drawing pictures 2-Playing card games 3-Watching television 4-Continuing schoolwork
4- Continuing schoolwork
Which theory proposes that older adults experience a shift from a materialistic to cosmic view of the world? 1-Activity theory 2-Continuity theory 3-Disengagement theory 4-Gerotranscendence theory
4- Gerotranscendence theory
A client is admitted for chest pain and a myocardial infarction. The nurse caring for the client is preparing to apply nitroglycerin ointment. Before applying the ointment, what action will the nurse take? 1-Assess the client's pulse rate. 2-Prepare the site with an alcohol swab. 3-Shave the client's chest in the area for application. 4-Use the dose measuring application paper and spread the ointment in a thin layer to the prescribed amount.
4- Use the dose measuring application paper and speed the ointment in a thin layer to the prescribed amount.
A nurse places a client with severe burns on a circulating air bed. Which goal is the nurse trying to achieve? 1 Increasing mobility 2 Preventing contractures 3 Limiting orthostatic hypotension 4 Preventing pressure on peripheral blood vessels
4-Preventing pressure on peripheral blood vessels
