NRS 2024: Exam #1 Review Practice Questions

The nurse is caring for a client with tuberculosis. Which precautions will the nurse select for this client? a. standard b. airborne c. droplet d. contact

b

Clients demonstrating apnea have what? a. a temporary cessation of breathing b. decreased rate and depth of respirations c. increased rate and depth of respirations d. normal respiratory rate of 20

a

The nurse is caring for an older adult with a recurrent wound infection. Which precautions will the nurse begin? a. droplet b. contact c. none d. airborne

b

The nurse is caring for an older adult with streptococcal pneumonia. Which precautions will the nurse begin? a. airborne b. droplet c. contact d. none

b

The nurse has admitted a client on airborne precautions onto the medical-surgical unit. When the client asks, "When will these airborne precautions be removed?" what is the appropriate nursing response?

"When your sputum culture is negative."

A nurse is documenting client care using the SOAP format. Place the statements listed below in the order that the nurse would record them. a. "I don't feel well. I've been urinating often, and it burns when I urinate." b. Abdomen soft non-tender. Urine dark yellow and cloudy. Temperature 100.8 degrees F. Indwelling urinary catheter removed 2 days ago. c. Fever, possible urinary tract infection. d. Notify Dr. Phillips of fever and client complaints. Encourage fluids, continue to monitor temperature.

1. a 2. b 3. c 4. d

The nurse has received a medication order over the telephone from a provider. What is the next appropriate nursing action?

Repeat or read back the order

The nurse is assessing an adult who has a pulse rate of 180 beats/min. Which condition would the nurse document?

Tachycardia

A nurse is preparing to file a safety event report after a client experienced a fall. Which statement is correct regarding the filing of a safety event report?

The nurse should record the incident in the client's medical record and fill out a safety event report separately.

Infection occurs when the host is exposed to pathogens. What type of pathogen uses the cell's metabolism, and replicates itself while destroying the cell or changing the cell's genetic makeup?

Virus

A nursing student is caring for a client with dentures. Which action by the nursing student would require intervention by the nurse? a. using ungloved hands to remove an unconscious client's dentures b. cleaning dentures with tepid water from the sink c. encouraging the client to leave the dentures in their mouth overnight d. holding dentures over a plastic basin or towel when cleaning them

a

A client comes to the emergency department reporting becoming very ill after consuming shrimp and lobster. How will the nurse document this condition? a. noncommunicable disease b. communicable disease c. infectious disease d. contagious disease

a

A client has sought care because of a knee wound that appears to have become infected. Which process is a component of the cellular stage of inflammation that occurred earlier in his body's response to infection? a. Migration of leukocytes to the area of the wound b. Constriction of the small blood vessels near the wound c.Release of histamine d. Production of antibodies

a

A client in a long-term care facility has become increasingly unsteady. The nurses are worried that the client will climb out of bed and fall. Which measure would be a priority recommendation for this client? a. Placing the client in a bed with a bed alarm b. Providing a bed that is elevated from the floor c. Raising all the side rails of the bed d. Using restraints on the client to prevent a fall

a

A client monitoring his BP at home notices that his BP is higher in one arm than the other. He calls his health care provider for guidance. What is the most appropriate information for the nurse to give this client? a. It has been found that most people have differences in BP between arms and that he should use the arm that gives him the highest reading for accurate results. b. It has been found that most people have differences in BP between arms and that he should use the arm that gives him the lowest reading for accurate results. c. This has no impact on BP readings and he should continue doing what he has been doing. d. This is unusual and he should be seen by the health care provider as soon as possible.

a

A client suffers from bloody diarrhea after eating contaminated food at a local restaurant. The client has been infected with a(an): a. bacteria. b. virus. c. fungi. d. protozoa.

a

A client tests positive for the human immunodeficiency virus (HIV) antibody but has no symptoms. This client is considered a carrier. What component of the infection cycle does the client illustrate? a. a reservoir b. an infectious agent c. a portal of exit d. a portal of entry

a

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 clean surfaces d. make contact between two contaminated surfaces

a

A nurse accidentally gives a double dose of blood pressure medication. After ensuring the safety of the client, the nurse would record the error in which documents? a. Client's record and occurrence report b. Occurrence report and clinical pathway c. Critical pathway and care plan d. Care plan and client's record

a

A nurse is admitting a client to a geriatric medicine unit. Which nursing action would the nurse perform to reduce the client's risk for a fall? a. Orient the client to the room and environment upon admission. b. Provide the client with a bedpan to reduce ambulating to the restroom. c. Administer pain medications sparingly in order to minimize any cognitive side effects. d. Place the client in a shared room with a client who is stable and oriented.

a

A nurse is assisting an older, continent client with dry skin who is hospitalized. Which approach to hygiene should the nurse take with this client? a. Alternate between a full bed bath on one day and use of skin lotion or bath oil on the next. b. Provide a tub bath with bath oil every day. c. Use skin lotion daily and avoid giving bed baths. d. Provide a full bed bath with soap and water every day

a

A nurse is filling out an incident report after an older adult client fell while attempting to transfer from her bed to a commode. Which health problem should the nurse consider when client falls occur? a. orthostatic hypotension b. dyspnea c. primary hypertension d. secondary hypertension

a

A nurse is preparing to document client care in the electronic medical record using the SOAP format. The client had abdominal surgery 2 days ago. How would the nurse document the "S" information? a. Client states, "I have more pain in my belly today than I did yesterday. My pain is about a 7 out of 10." b. Client states expecting some pain, but it is more severe than anticipated. c. Abdomen soft, slightly tender on palpation. Incision clean, dry and intact. Positive bowel sounds all four quadrants. d. Client is requesting pain medications, is grimacing, and is diaphoretic.

a

A nurse manager is discussing a nurse's social media post about an interesting client situation. The nurse states, "I didn't violate client privacy because I didn't use the client's name." What response by the nurse manager is most appropriate? a. "Any information that can identify a person is considered a breach of client privacy." b. "You may continue to post about a client, as long as you do not use the client's name." c. "All aspects of clinical practice are confidential and should not be discussed." d. "The information being posted on social media is inappropriate. Make sure to discuss information about clients privately with friends and family."

a

A parent of a 9-year-old child states to the nurse, "I have not noticed any fever yet but my child describes feeling achy and not well." Which phase of the fever does the nurse identify the child may be experiencing? a. prodromal b. invasion c. stationary d. resolution

a

The charge nurse is reviewing SOAP format documentation with a newly hired nurse. What information should the charge nurse discuss? a. Subjective data should be included when documenting. b. Objective data are what the client states about the problem c. The plan includes interventions, evaluation, and response d. Abnormal laboratory values are common items that are documented.

a

The nurse assists the client to the bathroom sink to perform morning care. The nurse observes the client wash his face, arms, abdomen, and legs. The nurse washes the client's back and rectal area and applies soap to the back. The client brushes his teeth and ambulates to a chair in his room with assistance. How will the nurse describe the morning care on the client's chart? a. partial care b. as-needed care c. self-care d. complete care

a

The nurse is caring for a 76-year-old client who has an unsteady gait. Which method is most appropriate to assist in transferring? a. transfer belt b. transfer boards c. mechanical lift d. roller sheet

a

The nurse is caring for a client that has multiple dental caries and wants to understand the cause. Which statement by the client indicates that additional teaching is warranted? a. "I will brush once every day and floss every other day." b. "I will rinse my mouth with water, if I am unable to brush." c. "I will not chew ice cubes or crushed ice." d. "I will get a dental checkup every 6 months."

a

The nurse is caring for a client who has smoked for more than 20 years and is now experiencing labored respirations. The nurse documents the client is experiencing: a. dyspnea. b. fremitus. c. stridor. d. wheezing.

a

The nurse is caring for a client with a surgical wound. Which action by the nurse best reduces the reservoir of infection? a. changing the soiled dressing b. wearing clean unsterile gloves when changing the dressing c. isolating the client's belongings d. applying a face mask with shield

a

The nurse is caring for a college student with meningococcal meningitis. Which precautions will the nurse begin? a. droplet b. none c. airborne d. contact

a

The nurse is documenting a variance that has occurred during the shift. This report will be used for quality improvement to identify high-risk patterns and, potentially, to initiate in-service programs. This is an example of which type of report? a. Incident report b. Nurse's shift report c. Transfer report d. Telemedicine report

a

The nurse is preparing discharge instructions for a family member who will be caring for a client with an abdominal incision. Which concept should be the priority in the teaching plan? a. hand washing b. sterile technique c. putting on gloves d. signs of healing

a

The nurse is teaching the caregiver of an infant about safety. Which teaching will the nurse include? a. Supervise your child on the changing table. b. Place all household cleaners out of reach. c. Buy protective sporting equipment. d. Peer pressure causes children of this age to take risks.

a

The nurse manager is developing a plan to decrease the transmission of health care associated infections. What would be the best to implement? a. staff education on utilizing hand hygiene b. having any visitor with a cough or cold wear a mask c. restricting visitors to those older than 12 years of age d. providing alcohol-based hand sanitizer to all clients

a

The nurse notices multiple caries upon inspecting a client's mouth. When asked if the client has dental pain, the client responds, "No, my teeth and gums never hurt." Which structural damage does the nurse anticipate? a. nerve b. enamel c. root d. gingiva

a

The nurse places a client experiencing labored breathing in an upright position. The nurse notes that the client is able to breathe more easily in this upright position and documents this condition on the chart as: a. orthopnea b. bradypnea c. apnea d. tachypnea

a

The nurse working with the hospital's infection control team is attempting to decrease the transmission of healthcare-associated pathogens. Which intervention will be most effective? a. Incentivizing health care workers to utilize hand hygiene b. Revising the facility's infection control protocols c. Encouraging visitors to adhere to isolation precautions d. Limiting visitors to family members over the age of 18

a

When caring for a client with dentures, what should the nurse teach the client? a. Keeping dentures out for long periods of time permits the gum line to change, affecting denture fit. b. Dentures should be wrapped in tissue or a disposable wipe when out of the mouth and stored in a disposable cup. c. Dentures should never be stored in water because the plastic material may warp. d. A brush and nonabrasive powder should be used to clean the dentures, and hot water should be used to rinse them.

a

When maintaining health care records for a client, the nurse knows that a health care record also serves as a legal document of evidence. What should the nurse do to ensure legally defensible charting? a. Ensure that the client's name appears on all pages. b. Leave spaces between entries and signature. c. Use abbreviations wherever possible. d. Record all facts and subjective interpretations.

a

When providing oral care, what does the nurse recognize as the most important component of the oral care process? a. a thorough, mechanical cleaning b. application of moisturizing ointment to the lips c. selection of toothpaste d. use of a mouthwash or breath freshener

a

Which documentation note regarding an assessment of eroding tooth enamel is most appropriate? a. The client is at risk for caries due to eroding tooth enamel. b. The client is at risk for tartar due to eroding tooth enamel. c. The client is at risk for gingivitis due to eroding tooth enamel. d. The client is at risk for periodontal disease due to eroding tooth enamel.

a

Which is the primary purpose of client records? a. Communication b. Reimbursement c. Legal protection d. Performance improvement

a

The nurse documents a progress note in the wrong client's electronic medical record (EMR). Which action would the nurse take once realizing the error? a. Immediately delete the incorrect documentation. b. Create an addendum with a correction. c. Contact information technology (IT) staff to make the correction. d. Contact the health care provider.

b

Which note includes all elements of a SOAP note? a. Client reports nausea, including one episode of nausea yesterday. Also with diarrhea. Mucous membranes are moist, good turgor. Blood pressure of 130/85 mm Hg, heart rate of 92 beats/min. Nausea and vomiting of unknown etiology. Will give an antiemetic and reassess within 1 hour for effectiveness. b. Client reports nausea, vomiting, and diarrhea x 3 days. Denies any sick contacts or recent travel. Mucous membranes moist, blood pressure of 130/85 mm Hg, heart rate of 92 beats/min. c. Client reports nausea and vomiting x 3 days. Vital signs stable. Most likely due to gastroenteritis. d. Client with nausea, vomiting, diarrhea, most likely secondary to gastroenteritis. Will give an antiemetic and reassess.

a

Which nursing action is a component of medical asepsis? a. handwashing after removing gloves b. insertion of an indwelling urinary catheter c. insertion of an intravenous catheter d. drawing blood from a central line

a

While receiving a report, the nurse learns that a client has paraplegia. The nurse will plan care for this client based upon the understanding that the client has: a. paralysis of the legs. b. weakness affecting one-half of the body. c. paralysis affecting one-half of the body. d. paralysis of the legs and arms.

a

he client is an employee on the medical unit at the local children's hospital. The nurse is an occupational health nurse educating the client on various routes of exposure. The nurse knows that as a hospital employee, the client is most susceptible to infection by what mode of transmission? a. contact b. vehicle c. droplet d. airborne

a

The nurse is in the process of reporting to the health care provider the changes in the client's status. Which are appropriate ways for the nurse to communicate information about the client to the health care provider? Select all that apply. a. Showing the provider the trends from baseline to present in blood pressure b. Informing the provider of the client's present heart rate of 116 beats/min c. Faxing the results of blood chemistry levels to the provider's office d. Writing the hemoccult result on a piece of paper and leaving it at the desk e. Placing a note on the computer terminal with the client's name and information

a, b, c

Which are the names of the transmission-based precautions defined by the Centers for Disease Control and Prevention (CDC)? Select all that apply. a. airborne precautions b. droplet precautions c. contact precautions d. respiratory precautions e. microbial precautions body fluid precautions

a, b, c

The nurse is caring for a client who has had multiple dental caries. Which food will the nurse encourage the client to avoid that is on the dietary tray? a. vegetable soup with cheese b. jelly to go on the toast c. coffee with sugar substitute d. salad with full-fat dressing

b

The nurse is caring for a client on a mechanical ventilator who has developed periodontitis. Which intervention(s) would the nurse include in the nursing care plan? Select all that apply. a. Monitor for bleeding gums and other signs of infection b. Administer local antimicrobial agents as prescribed c. Use foam sticks to moisten the oral mucous membranes, clean out debris, and swab out the mouth d. Lightly brush all surfaces of the teeth, gums, and tongue with a soft-bristled nylon or foam brush e. Rinse the oral mucosa with hydrogen peroxide to remove exudate

a, b, c, d

The nurse is performing an assessment on an older adult. From which data does the nurse deduce that the client is at high risk for falls in the home? Select all that apply. a. Takes furosemide daily b. Admits to drinking wine through the evening c. Shares a one floor living space with a spouse d. Has history of diabetic neuropathy e. Participates in a walking club

a, b, d

The nurse provides care to clients of all age groups and is developing an education pamphlet warning about falls. Which age groups would the nurse identify as at risk for falls? Select all that apply. a. newborns b. toddlers c. adolescents d. adults e. older adults

a, b, e

The nurse is caring for a client whose spouse wishes to see the electronic health record. What is the appropriate nursing response? a. "Let me get that for you." b. "Only authorized persons are allowed to access client records." c. "The provider will need to give permission for you to review." d. "I am sorry I can't access that information."

b

The nurse is caring for a client with diabetes who has thick toenails. What is the appropriate nursing intervention? a. Clip the toenails with large clippers. b. File, rather than cut the nails. c. Use a handheld electric rotary file to reduce the length of the toenails. d. Clean under the toenails with a wooden orange stick.

b

During an interaction with a client who is HIV-positive, the nurse learns that the client has nonspecific symptoms such as nausea, fever, general weakness, and aches and pains. The nurse interprets these findings as reflecting which stage of the communicable period? a. Incubation period b. Prodromal period c. Acute phase of illness d. Convalescent period

b

A nurse is applying the principles of Standard and Contact Precautions in the care of a hospital client. Which action violates these principles? a. The nurse performs hand hygiene after touching the client's surroundings. b. The nurse removes her gown and then removes her gloves. c. The nurse performs hand hygiene before putting on gloves. d. The nurse applies nonmedicated hand cream after performing hand hygiene.

b

A nurse is following a clinical pathway that guides the care of a client after knee surgery. When the nurse observes the client vomiting, it creates a deviation from the clinical pathway. What should the nurse identify this event as? a. A never event b. A variance c. An audit d. A sentinel event

b

A nurse is providing nail care for feet to clients admitted to a health care facility. What should the nurse look for while performing nail care for a client with a long history of diabetes? a. A bony bump on the joint at the base of the big toe b. Breaks in skin integrity and fungal nail infection c. Cold feet d. Redness and swelling in the joint of the big toe with reports of pain

b

After taking vital signs of an older adult, the nurse writes down findings as T = 98.9/37.2 oral, P = 104, R = 18, BP = 120/82. Based on the collected data, which step would the nurse take next? a. Recheck BP level to ensure accuracy b. Take pulse again to assess for tachycardia c. Wait 20 minutes and recheck oral temperature. d. Talk with client to allow them to relax before retaking vital signs.

b

An older adult client is admitted into the hospital due to tuberculosis. In addition to standard precautions, which transmission-based precautions should the nurse initiate? a. Fomite b. Airborne c. Droplet d. Contact

b

The nurse is caring for a client with tuberculosis. The prior shift's nurse has placed the client in droplet precautions. Which is the appropriate nursing action? a. change to contact precautions b. change to airborne precautions c. change to standard precautions d. continue with droplet precautions

b

When recording data regarding the client's health record, the nurse mentions the analysis of the subjective and objective data, in addition to detailing the plan for care of the client. Which of the following styles of documentation is the nurse implementing? a. FOCUS charting b. SOAP charting c. PIE charting d. narrative charting

b

Which client would the nurse consider the most infectious? a. A client who is in the incubation period b. A client who is in the prodromal stage c. A client who is in the full stage of illness d. A client who is in the convalescent period

b

Which client's blood pressure best describes the condition called hypotension? a. The systolic reading is above 110 and diastolic reading is above 80. b. The systolic reading is below 100 and diastolic reading is below 60. c. The systolic reading is above 102 and diastolic reading is above 60. d. The systolic reading is below 120 and the diastolic reading is below 80.

b

Why is it important for the nurse to teach and role model proper body mechanics? a. to ensure knowledgeable client care b. to promote health and prevent illness c. to prevent unnecessary insurance claims d. to demonstrate knowledge and skills

b

Which actions should the nurse perform to limit casual access to the identity of clients? Select all that apply. a. Posting information linking a client with diagnosis, treatment, and procedure on whiteboards b. Obscuring identifiable names of clients and private information about clients on clipboards c. Placing fax machines, filing cabinets, and medical records in areas that are off-limits to the public d. Keeping record of people who have access to clients' records e. Making the names of clients on charts visible to the public

b, c, d

A nurse is examining an adult client with inflammation of the gums. The nurse observes bleeding gums. What additional information should the nurse acquire to help determine next steps? a. How many cavities the client has had b. How often the client sees the dentist for oral care c. How often the client brushes and flosses the teeth d. The client's history of oral surgery

c

A client went missing from a long-term care facility and an emergency code was called. After a search of 1 hour, the client was discovered in a utility room that should have been inaccessible. When responding to this event, staff should: a. complete an incident report to determine who was primarily responsible for the event. b. document strategies in the client's health record for preventing future incidents. c. fill out an incident report, with the goal of preventing a similar event in the future. d. hold a facility-wide meeting to identify strategies for making improvements to the safety of residents.

c

A nurse documents the following data in the client record according to the SOAP format: Client reports unrelieved pain; client is seen clutching the side and grimacing; client pain medication does not appear to be effective; Call in to primary care provider to increase dosage of pain medication or change prescription. This is an example of what charting method? a. Source-oriented method b. PIE charting method c. Problem-oriented method d. Focus charting method

c

A nurse is completing an intake assessment. The nurse notes that an older adult male client appears to have bruises in varying stages of healing. Which action by the nurse indicates an understanding of her responsibilities? a. The nurse should notify the primary care provider about the bruises. b. The nurse should contact the facility's social services department. c. The nurse should question the client about the source of the bruises. d. The nurse should request permission from the client to photograph the bruises.

c

A nurse was injured when a client with Alzheimer disease struck the nurse on the side of the head during a transfer. The nurse has completed an incident report. Which statement about an incident report is most accurate? a. The report becomes a confidential part of the client's health record once it is reviewed by hospital administration. b. The incident report is reviewed by state agencies and the Occupational Safety and Health Administration rather than by hospital administration. c. The report provides a detailed and objective account of the circumstances before, during, and after the event. d. The client and the client's family will be required to sign the report, acknowledging that they read it before it was filed.

c

A nursing student is making notes that include client data on a clipboard. Which statement by the nursing instructor is most appropriate? a. "Be sure to write down specific information for your clinical paperwork." b. "You can get an electronic printout of client lab data to take with you." c. "Clipboards with client data should not leave the unit." d. "Be sure to put the client's name and room number on all paperwork."

c

For which client would the use of standard precautions alone be appropriate? a. a child with chickenpox who is treated in the emergency room b. a client with diphtheria who needs p.m. care c. an incontinent client in a nursing home who has diarrhea d. a client with TB who needs medications administered

c

Several family members are visiting a client with an antibiotic-resistant infection who has been placed on contact precautions. When the nurse teaches the visitors about wearing gloves and gowns, a family member states, "I don't want to wear those. I can't catch anything just by holding my loved one's hand." What is the best response to educate the family about infection transmission? a. "I understand; wearing these items is not pleasant but it really isn't optional." b. "If you don't come into contact with anything with your body, you may wear gloves only, as long as you wash your hands after removing the gloves." c. "These barriers help prevent the transmission of infection to you or other people." d. "Wearing the gloves and gown prevents sharing additional microorganisms with the client."

c

The nurse is assisting a client with a history of vancomycin resistant enterococcus (VRE). What precaution should the nurse implement? a. standard precautions b. droplet precautions c. contact precautions d. airborne precautions

c

The nurse is preparing a SOAP note. Which assessment findings are consistent with objective client data? a. pain rating of 4 on a scale of 0-10 b. describes wound as itchy c. urine output 100 ml d. concerned with feeling tired

c

The nurse is providing perineal care for clients in a hospital setting. What is an appropriate nursing action when providing this type of care? a. Always proceed from the most contaminated area to the least contaminated area. b. Do not retract the foreskin in an uncircumcised male. c. Dry the cleaned areas and apply an emollient as indicated. d. Powder the area to prevent the growth of bacteria.

c

Using proper body mechanics, which motions would the nurse make to move an object? a. The nurse balances the head over the shoulders, leans forward, and relaxes the stomach muscles when moving an object. b. The nurse uses the muscles of the back to help provide the power needed in strenuous activities. c. The nurse uses the internal girdle and a long midriff to stabilize the pelvis and to protect the abdominal viscera when stooping, reaching, lifting, or pulling. d. The nurse directly lifts an object rather than sliding, rolling, pushing, or pulling it, thus reducing the energy needed to lift the weight against the pull of gravity.

c

What is the primary role of the nurse in the care of clients who experience domestic violence? a. Calling the police b. Identifying health education and counseling measures for the family c. Providing prompt recognition of the potential or actual threat to safety d. Serving as a witness in court

c

When assisting a client from the bed into a wheelchair, the nurse assesses the client for signs of dizziness. For what adverse condition is the nurse assessing in the client? a. deep vein thrombosis b. circulatory alterations c. orthostatic hypotension d. hypertension

c

Which action by the nurse is compliant with the Health Insurance Portability and Accountability Act (HIPAA)? a. Disclosing client health information for research purposes after obtaining permission from the client's health care provider b. Releasing the client's entire health record when only portions of the information are needed c. Submitting a written notice to all clients identifying the uses and disclosures of their health information d. Obtaining only the client's verbal acknowledgement of having been informed of the disclosure of information

c

Which is not a purpose of the client care record? a. To serve as a legal document. b. To facilitate reimbursement c. To serve as a contract with the client. d. To assist with care planning.

c

Which statement by the nurse would indicate to the charge nurse that there is need for further teaching on the purposes of medical records? a. "The clients' medical records provide data for legal evidence." b. "I can share the clients' medical records with the health care team." c. "The clients' medical records are an obstruction to research and education." d. "The clients' health records should be used to promote reimbursement from insurance companies"

c

Which are appropriate actions for protecting clients' identities? Select all that apply. a. Orient computer screens toward the public view. b. Ensure that clients' names on charts are visible to the public. c. Document all personnel who have accessed a client's record. d. Place light boxes for examining X-rays with the client's name in private areas. e. Have conversations about clients in private places where they cannot be overheard.

c, d, e

A client is very anxious and states, "I am so stressed." What is the reason stress affects the client's safety? a. Stress increases retention of information. b. Stress affects interpersonal relationships. c. Stress increases concern about hazards. d. Stress tends to narrow the attention span.

d

A client who has been lying prone reports shortness of breath and a sensation of choking. Into which position will the nurse place the client? a. supine b. prone c. Sims' d. Fowler's

d

A nurse is educating a client on how to care for dentures. What is a recommended teaching guideline? a. Remove dentures whenever possible to rest the gums. b. Wrap dentures in a napkin when not using them. c. Keep dentures near you in the bed for easy access. d. Store dentures in cold water when not in use.

d

A nurse is filing a safety event report for an older adult client who tripped and fell when getting out of bed. Which action exemplifies an accurate step of this process? a. The nurse adds the information in the safety event report to the client health record. b. The nurse calls the primary health care provider to fill out and sign the safety event report. c. The nurse provides an opinion of the physical and mental condition of the client that may have precipitated the incident. d. The nurse details the client's response and the examination and treatment of the client after the incident.

d

The nurse adjusts a client's bed to a comfortable working height in order to turn the client. What would be the nurse's next action? a. push the client to the opposite side of the bed b. push the client to the edge of the bed to which the client will be turning c. pull the client to the edge of the bed to which the client will be turning d. move the client to edge of the bed opposite the side that client will be turning

d

The nurse documents that a client does not have pain prior to the administration of pain medication. The client, however, requested medication for increasing postsurgical pain. What is the appropriate action to correct the pain assessment documented in the client's paper medical record? a. Scribble through the entry. b. Obtain white-out to cover the entry. c. Write over the entry in another color pen. d. Place one line through the entry and initial it.

d

The nurse is admitting a client who has a draining wound that is contaminated with Staphylococcus aureus. What type of precautions should the nurse initiate for this client? a. droplet precautions b. airborne precautions c. neutropenic precautions d. contact precautions

d

The nurse is assisting a client from the bed into a wheelchair. What is a recommended guideline for this procedure? a. Make sure the bed brakes are unlocked. b. Put the chair at the foot of the bed. c. Place the bed in the highest position. d. Raise the head of the bed to a sitting position.

d

The nurse is teaching a nursing student about caring for a client with dentures. Which education will the nurse provide? a. "Use your ungloved hands to remove an unconscious client's dentures." b. "Clean dentures with hot water to eliminate bacteria." c. "Store dentures in a peroxide solution if not worn continuously." d. "Hold dentures over a plastic basin or towel when cleaning them."

d

Two nurses are moving a client up in bed. What motion would the nurses use to counteract the client's weight? a. Shift their weight back and forth from the legs to the back muscles. b. Rock the client back and forth to raise the client up in bed. c. Turn the client from side to side while pushing upward. d. Shift their weight back and forth, from back leg to front leg.

d

Which practice is a correct application of infection control practices? a. A nurse uses an alcohol-based hand rub each time that the nurse's hands are visibly soiled. b. A nurse rinses hands thoroughly after the application of an alcohol-based hand rub. c. A nurse dons a pair of gloves prior to any client contact. d. A nurse performs hand washing each time the nurse removes a pair of gloves.

d

A client has smoked most of his life and has labored respirations. He is experiencing:

dyspnea

A nurse who is taking the vital signs of a client with acute diarrhea is ordered to attend to another client. What is the priority nursing action the nurse must perform before leaving the client's room?

thorough handwashing