test 1 adult Practice Questions

A new nurse reports to the precepting nurse that a client requested pain medication, and when the nurse brought it, the client was sound asleep. The nurse states the client cannot possibly sleep with the severe pain the client described. What response by the experienced nurse is best? a. "Being able to sleep doesn't mean pain doesn't exist." b. "Have you ever experienced any type of pain?" c. "The client should be assessed for drug addiction." d. "You're right; I would put the medication back."

a. "Being able to sleep doesn't mean pain doesn't exist."

The nurse receives a hand-off report. One client is described as a drug seeker who is obsessed with even tiny changes in physical condition and is "on the light constantly" asking for more pain medication. When assessing this client's pain, what statement or question by the nurse is most appropriate? a. "Help me understand how pain is affecting you right now." b. "I wish I could do more; is there anything I can get for you?" c. "You cannot have more pain medication for 3 hours." d. "Why do you think the medication is not helping your pain?"

a. "Help me understand how pain is affecting you right now."

A nurse is assessing coping in older women in a support group for recent widows. Which statement by a participant best indicates potential for successful coping? a. "I have had the same best friend for decades." b. "I think I am coping very well on my own." c. "My kids come to see me every weekend." d. "Oh, I have lots of friends at the senior center."

a. "I have had the same best friend for decades."

A nurse assesses a client who is admitted with hip problems. The client asks, "Why are you asking about my bowels and bladder?" How should the nurse respond? a. "To plan your care based on your normal elimination routine." b. "So we can help prevent side effects of your medications." c. "We need to evaluate your ability to function independently." d. "To schedule your activities around your elimination pattern."

a. "To plan your care based on your normal elimination routine."

A nurse researcher is evaluating clinical questions. Which is a quantitative question? a. "What are the effects of hourly rounding on client fall rates?" b. "How do middle-aged men respond to premature balding?" c. "What are the lived experiences of postoperative clients with pain?" d. "What is the experience of having breast cancer like for young women?"

a. "What are the effects of hourly rounding on client fall rates?"

A postoperative client is reluctant to participate in physical therapy. What action by the nurse is best? a. Ask the client about pain goals and if they are being met. b. Ask the client why he or she is being uncooperative with therapy. c. Increase the dose of analgesia given prior to therapy sessions. d. Tell the client that physical therapy is required to regain function.

a. Ask the client about pain goals and if they are being met.

6. Which action by the nurse working with a client best demonstrates respect for autonomy? a. Asks if the client has questions before signing a consent b. Gives the client accurate information when questioned c. Keeps the promises made to the client and family d. Treats the client fairly compared to other clients

a. Asks if the client has questions before signing a consent

A nurse uses the Checklist of Nonverbal Pain Indicators to assess pain in a nonverbal client with advanced dementia. The client scores a zero. What action by the nurse is best? a. Assess physiologic indicators and vital signs. b. Do not give pain medication as no pain is indicated. c. Document the findings and continue to monitor. d. Try a small dose of analgesic medication for pain.

a. Assess physiologic indicators and vital signs.

4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse best demonstrates this concept? a. Assesses for cultural influences affecting health care b. Ensures that all the clients' basic needs are met c. Tells the client and family about all upcoming tests d. Thoroughly orients the client and family to the room

a. Assesses for cultural influences affecting health care

5. A client is going to be admitted for a scheduled surgical procedure. Which action does the nurse explain is the most important thing the client can do to protect against errors? a. Bring a list of all medications and what they are for. b. Keep the doctor's phone number by the telephone. c. Make sure all providers wash hands before entering the room. d. Write down the name of each caregiver who comes in the room.

a. Bring a list of all medications and what they are for.

A home health care nurse is planning an exercise program with an older client who lives at home independently but whose mobility issues prevent much activity outside the home. Which exercise regimen would be most beneficial to this adult? a. Building strength and flexibility b. Improving exercise endurance c. Increasing aerobic capacity d. Providing personal training

a. Building strength and flexibility

3. A nurse is caring for a postoperative client on the surgical unit. The client's blood pressure was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action by the nurse is best? a. Call the Rapid Response Team. b. Document and continue to monitor. c. Notify the primary care provider. d. Repeat blood pressure measurement in 15 minutes.

a. Call the Rapid Response Team.

A health care provider prescribes genetic testing for a client who has a family history of colorectal cancer. Which action should the nurse take before scheduling the client for the procedure? a. Confirm that informed consent was obtained and placed on the client's chart. b. Provide genetic counseling to the client and the client's family members. c. Assess if the client is prepared for the risk of psychological side effects. d. Respect the client's right not to share the results of the genetic test.

a. Confirm that informed consent was obtained and placed on the client's chart.

A nurse who wants to incorporate evidence-based practices into client care on a medical unit is meeting resistance. Which barrier does the nurse identify as preventing nurses from engaging in evidence-based practices? a. Difficulty accessing research materials b. Lack of value for client preferences c. Trouble understanding client needs d. Inadequate nurse-client ratios

a. Difficulty accessing research materials

2. A nurse is orienting a new client and family to the inpatient unit. What information does the nurse provide to help the client promote his or her own safety? a. Encourage the client and family to be active partners. b. Have the client monitor hand hygiene in caregivers. c. Offer the family the opportunity to stay with the client. d. Tell the client to always wear his or her armband.

a. Encourage the client and family to be active partners.

2. A nurse working with older adults in the community plans programming to improve morale and emotional health in this population. What activity would best meet this goal? a. Exercise program to improve physical function b. Financial planning seminar series for older adults c. Social events such as dances and group dinners d. Workshop on prevention from becoming an abuse victim

a. Exercise program to improve physical function

An older adult client is in the hospital. The client is ambulatory and independent. What intervention by the nurse would be most helpful in preventing falls in this client? a. Keep the light on in the bathroom at night. b. Order a bedside commode for the client. c. Put the client on a toileting schedule. d. Use siderails to keep the client in bed.

a. Keep the light on in the bathroom at night.

An emergency department (ED) manager wishes to start offering clients nonpharmacologic pain control methodologies as an adjunct to medication. Which strategy would be most successful with this client population? a. Listening to music on a headset b. Participating in biofeedback c. Playing video games d. Using guided imagery

a. Listening to music on a headset

A nurse obtains health histories when admitting clients to a medical-surgical unit. With which client should the nurse discuss predisposition genetic testing? a. Middle-aged woman whose mother died at age 48 of breast cancer b. Young man who has all the symptoms of rheumatoid arthritis c. Pregnant woman whose father has sickle cell disease d. Middle-aged man of Eastern European Jewish ancestry

a. Middle-aged woman whose mother died at age 48 of breast cancer

A nurse plans care for a client who is bedridden. Which assessment should the nurse complete to ensure to prevent pressure ulcer formation? a. Nutritional intake and serum albumin levels b. Pressure ulcer diameter and depth c. Wound drainage, including color, odor, and consistency d. Dressing site and antibiotic ointment application

a. Nutritional intake and serum albumin levels

A nurse cares for a pregnant client who has a family history of sickle cell disease. The client is unsure if she wants to participate in genetic testing. What action should the nurse take? a. Provide information about the risks and benefits of genetic testing. b. Empathize with the client and share a personal story about a hereditary disorder. c. Teach the client that early detection can minimize transmission to the fetus. d. Advocate for the client and her baby by encouraging genetic testing.

a. Provide information about the risks and benefits of genetic testing.

A nurse assesses a client recovering from coronary artery bypass graft surgery. Which assessment should the nurse complete to evaluate the client's activity tolerance? a. Vital signs before, during, and after activity b. Body image and self-care abilities c. Ability to use assistive or adaptive devices d. Client's electrocardiography readings

a. Vital signs before, during, and after activity

A nurse is looking for the best interventions for postoperative pain control. When are the facility's policies and procedures an appropriate source of evidence? a. When policies are based on high-quality clinical practice guidelines b. When evidence is derived from a valid and reliable quantitative research study c. When procedures originated from opinions of the facility's chief surgeon d. When evidence is founded on recommendations from experienced nurses

a. When policies are based on high-quality clinical practice guidelines

1. A nurse cares for a dying client. Which manifestation of dying should the nurse treat first? a. Anorexia b. Pain c. Nausea d. Hair loss

b pain

A client is being discharged from the hospital after surgery on hydrocodone and acetaminophen (Lorcet). What discharge instruction is most important for this client? a. "Call the doctor if the Lorcet does not relieve your pain." b. "Check any over-the-counter medications for acetaminophen." c. "Eat more fiber and drink more water to prevent constipation." d. "Keep your follow-up appointment with the surgeon as scheduled."

b. "Check any over-the-counter medications for acetaminophen."

The nurse in the surgery clinic is discussing an upcoming surgical procedure with a client. What information provided by the nurse is most appropriate for the client's long-term outcome? a. "At least you know that the pain after surgery will diminish quickly." b. "Discuss acceptable pain control after your operation with the surgeon." c. "Opioids often cause nausea but you won't have to take them for long." d. "The nursing staff will give you pain medication when you ask them for it."

b. "Discuss acceptable pain control after your operation with the surgeon."

10. A newly graduated nurse in the hospital states that, since she is so new, she cannot participate in quality improvement (QI) projects. What response by the precepting nurse is best? a. "All staff nurses are required to participate in quality improvement here." b. "Even being new, you can implement activities designed to improve care." c. "It's easy to identify what indicators should be used to measure quality." d. "You should ask to be assigned to the research and quality committee."

b. "Even being new, you can implement activities designed to improve care."

. A nurse consults a genetic counselor for a client whose mother has Huntington disease and is considering genetic testing. The client states, "I know I want this test. Why do I need to see a counselor?" How should the nurse respond? a. "The advanced practice nurse will advise you on whether you should have children or adopt." b. "Genetic testing can be a stressful experience. Counseling can provide support and education throughout the process." c. "There is no cure for this disease. The counselor will determine if there is any benefit to genetic testing." d. "Genetic testing is expensive. The counselor will advocate for you and help you obtain financial support."

b. "Genetic testing can be a stressful experience. Counseling can provide support and education throughout the process."

A research nurse meets with the nurse manager to discuss plans for the development of evidence-based practice (EBP) guidelines using the Reavy and Tavernier model. Which statement should the nurse include in the discussion? a. "Our efforts should focus on forming a team to develop an EBP initiative." b. "I will assist staff nurses with literature reviews and the synthesis of evidence." c. "You should identify barriers to evidence-based implementation." d. "I will develop a PICOT question and share it with the staff nurses."

b. "I will assist staff nurses with literature reviews and the synthesis of evidence."

A nurse teaches a client with a past history of angina who has had a total knee replacement. Which statement should the nurse include in this client's teaching prior to beginning rehabilitation activities? a. "Use analgesics before and after activity, even if you are not experiencing pain." b. "Let me know if you start to experience shortness of breath, chest pain, or fatigue." c. "Do not take your prescribed beta blocker until after you exercise with physical therapy." d. "If you experience knee pain, ask the physical therapist to reschedule your therapy."

b. "Let me know if you start to experience shortness of breath, chest pain, or fatigue."

A nurse assists a client with left-sided weakness to walk with a cane. What is the correct order of steps for gait training with a cane? 1. Apply a transfer belt around the client's waist. 2. Move the cane and left leg forward at the same time. 3. Guide the client to a standing position. 4. Move the right leg one step forward. 5. Place the cane in the client's right hand. 6. Check balance and repeat the sequence. a. 3, 1, 5, 4, 2, 6 b. 1, 3, 5, 2, 4, 6 c. 5, 3, 1, 2, 4, 6 d. 3, 5, 1, 4, 2, 6

b. 1, 3, 5, 2, 4, 6

A rehabilitation nurse cares for a client who has generalized weakness and needs assistance with activities of daily living. Which exercise should the nurse implement? a. Passive range of motion b. Active range of motion c. Resistive range of motion d. Aerobic exercise

b. Active range of motion

A client has received an opioid analgesic for pain. The nurse assesses that the client has a Pasero Scale score of 3 and a respiratory rate of 7 shallow breaths/min. The client's oxygen saturation is 87%. What action should the nurse perform first? a. Apply oxygen at 4 L/min. b. Attempt to arouse the client. c. Give naloxone (Narcan). d. Notify the Rapid Response Team.

b. Attempt to arouse the client.

8. A nurse is calling the on-call physician about a client who had a hysterectomy 2 days ago and has pain that is unrelieved by the prescribed narcotic pain medication. Which statement is part of the SBAR format for communication? a. A: "I would like you to order a different pain medication." b. B: "This client has allergies to morphine and codeine." c. R: "Dr. Smith doesn't like nonsteroidal anti-inflammatory meds." d. S: "This client had a vaginal hysterectomy 2 days ago."

b. B: "This client has allergies to morphine and codeine.

A nurse on the medical-surgical unit has received a hand-off report. Which client should the nurse see first? a. Client being discharged later on a complicated analgesia regimen b. Client with new-onset abdominal pain, rated as an 8 on a 0-to-10 scale c. Postoperative client who received oral opioid analgesia 45 minutes ago d. Client who has returned from physical therapy and is resting in the recliner

b. Client with new-onset abdominal pain, rated as an 8 on a 0-to-10 scale

An older adult is brought to the emergency department because of sudden onset of confusion. After the client is stabilized and comfortable, what assessment by the nurse is most important? a. Assess for orthostatic hypotension. b. Determine if there are new medications. c. Evaluate the client for gait abnormalities. d. Perform a delirium screening test.

b. Determine if there are new medications.

A nurse caring for an older client in the hospital is concerned the client is not competent to give consent for upcoming surgery. What action by the nurse is best? a. Call Adult Protective Services. b. Discuss concerns with the health care team. c. Do not allow the client to sign the consent. d. Have the client's family sign the consent.

b. Discuss concerns with the health care team.

7. A student nurse asks the faculty to explain best practices when communicating with a person from the lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) community. What answer by the faculty is most accurate? a. Avoid embarrassing the client by asking questions. b. Don't make assumptions about their health needs. c. Most LGBTQ people do not want to share information. d. No differences exist in communicating with this population.

b. Don't make assumptions about their health needs.

A client is put on twice-daily acetaminophen (Tylenol) for osteoarthritis. What finding in the client's health history would lead the nurse to consult with the provider over the choice of medication? a. 25-pack-year smoking history b. Drinking 3 to 5 beers a day c. Previous peptic ulcer d. Taking warfarin (Coumadin)

b. Drinking 3 to 5 beers a day

An older adult has diabetic neuropathy and often reports unbearable foot pain. About which medication would the nurse plan to educate the client? a. Desipramine (Norpramin) b. Duloxetine (Cymbalta) c. Morphine sulfate d. Nortriptyline (Pamelor)

b. Duloxetine (Cymbalta)

1. A new nurse is working with a preceptor on an inpatient medical-surgical unit. The preceptor advises the student that which is the priority when working as a professional nurse? a. Attending to holistic client needs b. Ensuring client safety c. Not making medication errors d. Providing client-focused care

b. Ensuring client safety

A nurse is caring for a client on an epidural patient-controlled analgesia (PCA) pump. What action by the nurse is most important to ensure client safety? a. Assess and record vital signs every 2 hours. b. Have another nurse double-check the pump settings. c. Instruct the client to report any unrelieved pain. d. Monitor for numbness and tingling in the legs.

b. Have another nurse double-check the pump settings.

A rehabilitation nurse cares for a client who is wheelchair bound. Which intervention should the nurse implement to prevent skin breakdown? a. Place pillows under the client's heels. b. Have the client do wheelchair push-ups. c. Perform wound care as prescribed. d. Massage the client's calves and feet with lotion.

b. Have the client do wheelchair push-ups.

A hospitalized client has a history of depression for which sertraline (Zoloft) is prescribed. The client also has a morphine allergy and a history of alcoholism. After surgery, several opioid analgesics are prescribed. Which one would the nurse choose? a. Hydrocodone and acetaminophen (Lorcet) b. Hydromorphone (Dilaudid) c. Meperidine (Demerol) d. Tramadol (Ultram)

b. Hydromorphone (Dilaudid)

An older client had hip replacement surgery and the surgeon prescribed morphine sulfate for pain. The client is allergic to morphine and reports pain and muscle spasms. When the nurse calls the surgeon, which medication should he or she suggest in place of the morphine? a. Cyclobenzaprine (Flexeril) b. Hydromorphone hydrochloride (Dilaudid) c. Ketorolac (Toradol) d. Meperidine (Demerol)

b. Hydromorphone hydrochloride (Dilaudid)

A home health care nurse has conducted a home safety assessment for an older adult. There are five concrete steps leading out from the front door. Which intervention would be most helpful in keeping the older adult safe on the steps? a. Have the client use a walker or cane on the steps. b. Install contrasting color strips at the edge of each step. c. Instruct the client to use the garage door instead. d. Tell the client to use a two-footed gait on the steps.

b. Install contrasting color strips at the edge of each step.

A nurse cares for a client with decreased mobility. Which intervention should the nurse implement to decrease this client's risk of fracture? a. Apply shoes to improve foot support. b. Perform weight-bearing activities. c. Increase calcium-rich foods in the diet. d. Use pressure-relieving devices.

b. Perform weight-bearing activities.

A nurse wants to explore why clients who receive patient-controlled analgesia (PCA) after abdominal surgery ambulate sooner than clients who receive nurse-administered pain medications. Which action should the nurse take first? a. Contact the medical center's clinical pharmacist. b. Search the medical library for the best evidence. c. Recommend PCA for all clients. d. Appraise data obtained through client chart audits.

b. Search the medical library for the best evidence.

A nurse teaches a client who has a flaccid bladder. Which bladder training technique should the nurse teach? a. Stroking the medial aspect of the thigh b. Valsalva maneuver c. Self-catheterization d. Frequent toileting

b. Valsalva maneuver

A nurse manager educates staff nurses in the use of clinical practice guidelines. Which statement should the nurse include in this teaching? a. "Clinical practice guidelines are implemented by The Joint Commission." b. "Practice guidelines are based on hospital management staff's expertise." c. "Clinical practice guidelines are official recommendations based on evidence." d. "Practice guidelines allow for greater reimbursement from insurance companies."

c. "Clinical practice guidelines are official recommendations based on evidence."

A nurse is working with an older client admitted with mild dehydration. What teaching does the nurse provide to best address this issue? a. "Cut some sodium out of your diet." b. "Dehydration can cause incontinence." c. "Have something to drink every 1 to 2 hours." d. "Take your diuretic in the morning."

c. "Have something to drink every 1 to 2 hours."

A nurse identifies clinical practice problems on a cardiac unit. Which question is a background question? a. "How should a client experiencing chest pain be prioritized?" b. "What is the experience of a cardiac catheterization like for middle-aged men?" c. "How are a client's vital signs affected by anxiety?" d. "What is the best treatment for a myocardial infarction?"

c. "How are a client's vital signs affected by anxiety?"

A client is typed and crossmatched for a unit of blood. Which statement by the nurse indicates a need for further genetic education? a. "Blood type is formed from three gene alleles: A, B, and O." b. "Each blood type allele is inherited from the mother or the father." c. "If the client's blood type is AB, then the client is homozygous for that trait." d. "If the client has a dominant and a recessive blood type allele, only the dominant will be expressed."

c. "If the client's blood type is AB, then the client is homozygous for that trait."

A nurse cares for a client who has a genetic mutation that increases the risk for colon cancer. The client states that he does not want any family to know about this result. How should the nurse respond? a. "It is required by law that you inform your siblings and children about this result so that they also can be tested and monitored for colon cancer." b. "It is not necessary to tell your siblings because they are adults, but you should tell your children so that they can be tested before they decide to have children of their own." c. "It is not required that you tell anyone about this result. However, your siblings and children may also be at risk for colon cancer and this information might help them." d. "It is your decision to determine with whom, if anyone, you discuss this test result. However, you may be held liable if you withhold this information and a family member gets colon cancer."

c. "It is not required that you tell anyone about this result. However, your siblings and children may also be at risk for colon cancer and this information might help them."

A student nurse asks why several clients are getting more than one type of pain medication instead of very high doses of one medication. What response by the registered nurse is best? a. "A multimodal approach is the preferred method of control." b. "Doctors are much more liberal with pain medications now." c. "Pain is so complex it takes different approaches to control it." d. "Clients are consumers and they demand lots of pain medicine."

c. "Pain is so complex it takes different approaches to control it."

A medical-surgical nurse asks the nurse researcher, "What is the difference between qualitative and quantitative questions?" How should the nurse researcher respond? a. "Quantitative questions analyze the content of what a person says or does." b. "Qualitative questions utilize a strict statistical analysis of information." c. "Quantitative questions identify relationships between measurable concepts." d. "Qualitative questions ask about associations among defined phenomena."

c. "Quantitative questions identify relationships between measurable concepts."

A nurse delegates the ambulation of an older adult client to an unlicensed nursing assistant (UAP). Which statement should the nurse include when delegating this task? a. "The client has skid-proof socks, so there is no need to use your gait belt." b. "Teach the client how to use the walker while you are ambulating up the hall." c. "Sit the client on the edge of the bed with legs dangling before ambulating." d. "Ask the client if pain medication is needed before you walk the client in the hall."

c. "Sit the client on the edge of the bed with legs dangling before ambulating."

A nurse is educating a client about genetic screening. The client asks why red-green color blindness, an X-linked recessive disorder noted in some of her family members, is expressed more frequently in males than females. How should the nurse respond? a. "Females have a decreased penetrance rate for this gene mutation and are therefore less likely to express the trait." b. "Females have two X chromosomes and one is always inactive. This inactivity decreases the effect of the gene." c. "The incidence of X-linked recessive disorders is higher in males because they do not have a second X chromosome to balance expression of the gene." d. "Males have only one X chromosome, which allows the X-linked recessive disorder to be transmitted from father to son."

c. "The incidence of X-linked recessive disorders is higher in males because they do not have a second X chromosome to balance expression of the gene."

A nurse cares for a client who recently completed genetic testing and received a negative result. The client states, "I feel guilty because so many of my family members are carriers of this disease and I am not." How should the nurse respond? a. "You are not genetically predisposed for this disease but you could still become ill. Let's discuss a plan for prevention." b. "Since many of your family members are carriers, you should undergo further testing to verify the results are accurate." c. "We usually encourage clients to participate in counseling after receiving test results. Can I arrange this for you?" d. "It is normal to feel this way. I think you should share this news with your family so that they can support you."

c. "We usually encourage clients to participate in counseling after receiving test results. Can I arrange this for you?"

A cardiac nurse wants to know about the best practices to prevent pneumonia after open-heart surgery. In what order do the steps of the evidence-based practice (EBP) process take place? 1. Asking "burning" clinical questions 2. Making recommendations for practice improvement 3. Implementing accepted recommendations 4. Finding the very best evidence to try to answer those questions 5. Evaluating outcomes 6. Critically appraising and synthesizing the relevant evidence a. 5, 1, 4, 6, 3, 2 b. 1, 5, 4, 3, 2, 6 c. 1, 4, 6, 2, 3, 5 d. 5, 2, 1, 4, 6, 3

c. 1, 4, 6, 2, 3, 5

A nurse cares for a client who has a specific mutation in the a1AT (alpha1-antitrypsin) gene. Which action should the nurse take? a. Teach the client to perform monthly breast self-examinations and schedule an annual mammogram. b. Support the client when she shares test results and encourages family members to be screened for cancer. c. Advise the client to limit exposure to secondhand smoke and other respiratory irritants. d. Obtain a complete health history to identify other genetic problems associated with this gene mutation.

c. Advise the client to limit exposure to secondhand smoke and other respiratory irritants.

A nurse is caring for four clients receiving pain medication. After the hand-off report, which client should the nurse see first? a. Client who is crying and agitated b. Client with a heart rate of 104 beats/min c. Client with a Pasero Scale score of 4 d. Client with a verbal pain report of 9

c. Client with a Pasero Scale score of 4

A nurse assesses this PICOT question: "In the adult hospitalized client, does a COX-2 inhibitor decrease the risk of gastrointestinal bleeding compared with other NSAIDs?" What is the outcome component in this question? a. Adult hospitalized client b. Cyclooxygenase-2 (COX-2) inhibitor c. Decreased risk of gastrointestinal bleeding d. Other nonsteroidal anti-inflammatory drugs (NSAIDs)

c. Decreased risk of gastrointestinal bleeding

A nurse is assessing pain on a confused older client who has difficulty with verbal expression. What pain assessment tool would the nurse choose for this assessment? a. Numeric rating scale b. Verbal Descriptor Scale c. FACES Pain Scale-Revised d. Wong-Baker FACES Pain Scale

c. FACES Pain Scale-Revised

11. A nurse is talking with a client who is moving to a new state and needs to find a new doctor and hospital there. What advice by the nurse is best? a. Ask the hospitals there about standard nurse-client ratios. b. Choose the hospital that has the newest technology. c. Find a hospital that is accredited by The Joint Commission. d. Use a facility affiliated with a medical or nursing school.

c. Find a hospital that is accredited by The Joint Commission.

1. A nursing faculty member working with students explains that the fastest growing subset of the older population is which group? a. Elite old b. Middle old c. Old old d. Young old

c. Old old

3. A nurse caring for an older client on a medical-surgical unit notices the client reports frequent constipation and only wants to eat softer foods such as rice, bread, and puddings. What assessment should the nurse perform first? a. Auscultate bowel sounds. b. Check skin turgor. c. Perform an oral assessment. d. Weigh the client.

c. Perform an oral assessment.

A registered nurse (RN) and nursing student are caring for a client who is receiving pain medication via patient-controlled analgesia (PCA). What action by the student requires the RN to intervene? a. Assesses the client's pain level per agency policy b. Monitors the client's respiratory rate and sedation c. Presses the button when the client cannot reach it d. Reinforces client teaching about using the PCA pump

c. Presses the button when the client cannot reach it

9. A nurse working on a cardiac unit delegated taking vital signs to an experienced unlicensed assistive personnel (UAP). Four hours later, the nurse notes the client's blood pressure is much higher than previous readings, and the client's mental status has changed. What action by the nurse would most likely have prevented this negative outcome? a. Determining if the UAP knew how to take blood pressure b. Double-checking the UAP by taking another blood pressure c. Providing more appropriate supervision of the UAP d. Taking the blood pressure instead of delegating the task

c. Providing more appropriate supervision of the UAP

An older adult client takes medication three times a day and becomes confused about which medication should be taken at which time. The client refuses to use a pill sorter with slots for different times, saying "Those are for old people." What action by the nurse would be most helpful? a. Arrange medications by time in a drawer. b. Encourage the client to use easy-open tops. c. Put color-coded stickers on the bottle caps. d. Write a list of when to take each medication.

c. Put color-coded stickers on the bottle caps.

An older adult recently retired and reports "being depressed and lonely." What information should the nurse assess as a priority? a. History of previous depression b. Previous stressful events c. Role of work in the adult's life d. Usual leisure time activities

c. Role of work in the adult's life

A nurse is caring for a client who has a spinal cord injury at level T3. Which intervention should the nurse implement to assist with bladder dysfunction? a. Insert an indwelling urinary catheter. b. Stroke the medial aspect of the thigh. c. Use the Credé maneuver every 3 hours. d. Apply a Texas catheter with a leg bag.

c. Use the Credé maneuver every 3 hours.

A rehabilitation nurse prepares to move a client who has new bilateral leg amputations. Which is the best approach? a. Use the bear-hug method to transfer the client safely. b. Ask several members of the health care team to carry the client. c. Utilize the facility's mechanical lift to move the client. d. Consult physical therapy before performing all transfers.

c. Utilize the facility's mechanical lift to move the client.

A nurse caring for an older adult has provided education on high-fiber foods. Which menu selection by the client demonstrates a need for further review? a. Barley soup b. Black beans c. White rice d. Whole wheat bread

c. White rice

A nurse cares for a client of Asian descent who is prescribed warfarin (Coumadin). What action should the nurse perform first? a. Schedule an international normalized ratio (INR) test to be completed each day. b. Initiate fall precautions and strict activity limitations. c. Teach the client about bleeding precautions, including frequent checks for any bruising. d. Confirm the prescription starts warfarin at a lower-than-normal dose.

d Confirm the prescription starts warfarin at a lower-than-normal dose.

A client who tests positive for a mutation in the BRCA1 gene allele asks a nurse to be present when she discloses this information to her adult daughter. How should the nurse respond? a. "I will request a genetic counselor who is more qualified to be present for this conversation." b. "The test results can be confusing; I will help you interpret them for your daughter." c. "Are you sure you want to share this information with your daughter, who may not test positive for this gene mutation?" d. "This conversation may be difficult for both of you; I will be there to provide support."

d. "This conversation may be difficult for both of you; I will be there to provide support."

The nurse is assessing a client's pain and has elicited information on the location, quality, intensity, effect on functioning, aggravating and relieving factors, and onset and duration. What question by the nurse would be best to ask the client for completing a comprehensive pain assessment? a. "Are you worried about addiction to pain pills?" b. "Do you attach any spiritual meaning to pain?" c. "How high would you say your pain tolerance is?" d. "What pain rating would be acceptable to you?"

d. "What pain rating would be acceptable to you?"

A nurse teaches a client about performing intermittent self-catheterization. The client states, "I am not sure if I will be able to afford these catheters." How should the nurse respond? a. "I will try to find out whether you qualify for money to purchase these necessary supplies." b. "Even though it is expensive, the cost of taking care of urinary tract infections would be even higher." c. "Instead of purchasing new catheters, you can boil the catheters and reuse them up to 10 times each." d. "You can reuse the catheters at home. Clean technique, rather than sterile technique, is acceptable."

d. "You can reuse the catheters at home. Clean technique, rather than sterile technique, is acceptable."

A health care facility is implementing a new evidence-based nursing protocol. Which action is necessary to ensure successful implementation? a. Develop evaluation processes to validate the protocol. b. Ask for recommendations from senior nursing administration. c. Assess cost-effectiveness of the evidence-based protocol. d. Attain support from nurses who are implementing the protocol.

d. Attain support from nurses who are implementing the protocol.

A nurse on the postoperative inpatient unit receives a hand-off report on four clients using patient-controlled analgesia (PCA) pumps. Which client should the nurse see first? a. Client who appears to be sleeping soundly b. Client with no bolus request in 6 hours c. Client who is pressing the button every 10 minutes d. Client with a respiratory rate of 8 breaths/min

d. Client with a respiratory rate of 8 breaths/min

A student asks the nurse what is the best way to assess a client's pain. Which response by the nurse is best? a. Numeric pain scale b. Behavioral assessment c. Objective observation d. Client's self-report

d. Client's self-report

A nurse performs passive range-of-motion exercises on a semiconscious client and meets resistance while attempting to extend the right elbow more than 45 degrees. Which action should the nurse take next? a. Splint the joint and continue passive range of motion to the shoulder only. b. Progressively increase joint motion 5 degrees beyond resistance each day. c. Apply weights to the right distal extremity before initiating any joint exercise. d. Continue to move the joint only to the point at which resistance is met.

d. Continue to move the joint only to the point at which resistance is met.

A nurse cares for an adult client who has received genetic testing. The client's mother asks to receive the results of her daughter's genetic tests. Which action should the nurse take? a. Obtain a signed consent from the client allowing test results to be released to the mother. b. Invite the mother and other family members to participate in genetic counseling with the client. c. Encourage the mother to undergo genetic testing to determine if she has the same risks as her child. d. Direct the mother to speak with the client and support the client's decision to share or not share the results.

d. Direct the mother to speak with the client and support the client's decision to share or not share the results.

A nurse is searching for evidence related to a qualitative PICOT question. Which type of evidence should the nurse search first? a. Meta-analyses with credible synthesized findings b. Systematic reviews c. Multi-site randomized clinical trials d. Meta-syntheses

d. Meta-syntheses

A hospitalized client uses a transdermal fentanyl (Duragesic) patch for chronic pain. What action by the nurse is most important for client safety? a. Assess and record the client's pain every 4 hours. b. Ensure the client is eating a high-fiber diet. c. Monitor the client's bowel function every shift. d. Remove the old patch when applying the new one.

d. Remove the old patch when applying the new one.

A nurse admits an older client from a home environment where she lives with her adult son and daughter-in-law. The client has urine burns on her skin, no dentures, and several pressure ulcers. What action by the nurse is most appropriate? a. Ask the family how these problems occurred. b. Call the police department and file a report. c. Notify Adult Protective Services. d. Report the findings as per agency policy.

d. Report the findings as per agency policy.

An older client who lives alone is being discharged on opioid analgesics. What action by the nurse is most important? a. Discuss the need for home health care. b. Give the client follow-up information. c. Provide written discharge instructions. d. Request a home safety assessment.

d. Request a home safety assessment.

A client who had surgery has extreme postoperative pain that is worsened when trying to participate in physical therapy. What intervention for pain management does the nurse include in the client's care plan? a. As-needed pain medication after therapy b. Client-controlled analgesia with a basal rate c. Pain medications prior to therapy only d. Round-the-clock analgesia with PRN analgesics

d. Round-the-clock analgesia with PRN analgesics

A nurse is assessing pain in an older adult. What action by the nurse is best? a. Ask only "yes-or-no" questions so the client doesn't get too tired. b. Give the client a picture of the pain scale and come back later. c. Question the client about new pain only, not normal pain from aging. d. Sit down, ask one question at a time, and allow the client to answer.

d. Sit down, ask one question at a time, and allow the client to answer.

A nurse is preparing to give a client ketorolac (Toradol) intravenously for pain. Which assessment findings would lead the nurse to consult with the provider? a. Bilateral lung crackles b. Hypoactive bowel sounds c. Self-reported pain of 3/10 d. Urine output of 20 mL/2 hr

d. Urine output of 20 mL/2 hr