NURS 202 Modules 6-7

3

The nurse is working with a client to develop an expected outcome for the nursing diagnosis Disturbed Sleep Pattern, difficulty staying asleep related to anxiety secondary to multiple life stressors. Which expected outcome would be most applicable to this clients situation? 1. The client will sleep at least 8 hours each night. 2. The client will list three positive coping mechanisms for anxiety relief. 3. The client will report getting sufficient sleep to provide energy for daily activities. 4. The client will manifest less anxiety after taking prescribed medications.

feels connected to her reality

The nurse is working with a client who, during her interview, expresses feelings of groundedness. The nurse interprets this to mean that the client 1. is full of energy. 2. feels connected to her reality. 3. is focused on her center of energy. 4. feels down in the dumps.

4 hours

The nurse provides an oral opiate to a client with pain. In how many hours should the nurse expect the client to need another dose of the medication? 1. 2 hours 2. 4 hours 3. 6 hours 4. 8 hours

1, 2, 3, 5

The nurse suspects that an adult is not getting an adequate amount of nightly sleep. What information caused the nurse to have this suspicion? Select all that apply. 1. Enrolled in online classes 2. Raising two children ages 4 and 8 3. Experiences chronic pain from sciatica 4. Attends religious services every Sunday and Wednesday 5. Works one job steady night turn and another part-time late afternoon

3

A 5-year-old client has recurrent night terrors. What nursing intervention should the nurse use to help alleviate this problem? 1. Have the child walk around in the room when night terrors occur. 2. The next morning, ask the child to describe the event. 3. Have the child empty the bladder prior to going to bed. 4. Use an additional pillow behind the childs head at night.

3, 4, 5

A client asks the nurse about chiropractic medicine. What should the nurse explain as being among the goals of this type of health intervention? Select all that apply. 1. Improvement of blood and lymph flow through the body 2. Stimulation of specific points to help with pain relief, cures certain illnesses, and promote wellness 3. Reduce or eliminate pain 4. Correct spinal dysfunction 5. Preventive maintenance

2

A client comes to the clinic with a chief complaint of feeling dirty inside and asks the nurse how colonics would work to improve the clients overall well-being. What should the nurse respond to this client? 1. Colonics is a dangerous and not useful technique that no one should try. 2. There is much controversy about colonics. What do you know about it? 3. This is a good way to get rid of toxins in your system. 4. Youd better ask your doctor about this.

Milk thistle

A client comes to the family planning clinic for follow-up and is currently taking an oral contraceptive. During the interview assessment, the client states she has been using some natural medicines. Which herbal preparation should alert the nurse to a possible interaction with oral contraceptives? 1. Valerian 2. Echinacea 3. Garlic 4. Milk thistle

1

A client complains of not being able to stay awake during the day even after sleeping throughout the night. What should the nurse suggestion to this client? 1. Go to your physician for a physical examination. 2. Go to a mental health professional for evaluation of possible depression. 3. Purchase an over-the-counter sleep aid to deepen nighttime sleep. 4. Drink more caffeinated beverages in the daytime to stay awake.

Garlic

A client diagnosed with hypertension has had well-controlled follow-up of her blood pressure for the past 6 months. At todays clinic appointment, the clients blood pressure is 98/58. The client insists she has been taking her prescribed antihypertensive medication as prescribed, but also added an herbal tablet because she heard it was supposed to be good for her. Which is most likely interfering with the clients antihypertensive? 1. Valerian 2. Milk thistle 3. Ginseng 4. Garlic

2

A client experiencing chronic pain is not getting relief with pain medication. What should the nurse do to help this client? 1. Ask the physician to change the prescribed pain medication. 2. Reassess the pain and consider another pain relief measure. 3. Limit interaction with the client. 4. Stop using alternative pain relief measures, if not effective.

1,2,5

A client experiencing pain has been prescribed a coanalgesic. The nurse should prepare to administer what medications to the client? Select all that apply. 1. Nortriptyline 2. Amitriptyline 3. Tramadol 4. Meloxicam 5. Gabapentin

Guided imagery

A client has been diagnosed with post-traumatic stress syndrome and has difficulty sleeping because of recurrent nightmares. In working with this client to overcome the problem, what should the nurse implement as part of therapy? 1. Guided imagery 2. Hypnotherapy 3. Yoga 4. Meditation

Addiction

A client has been taking medication for back pain for several months, and has seen several different health care providers in efforts to receive pain medication. The nurse is concerned that the client is exhibiting 1. tolerance. 2. addiction. 3. physical dependence. 4. pseudoaddiction.

Hypnotherapy

A client has been undergoing therapy as a victim of severe emotional abuse. The goal of the clients therapy is to gain self-control of the situation, improve self-esteem, and become self-sufficient. Which application should the nurse suggest become a part of the clients therapy sessions? 1. Yoga 2. Meditation 3. Hypnotherapy 4. Guided imagery

1, 2, 3, 4

A client has not had uninterrupted sleep for several nights, and is irritable. What other assessment findings should the nurse associate with the clients lack of REM sleep? Select all that apply. 1. Depression 2. Confusion 3. Disorientation 4. Impaired memory 5. Muscle weakness

Perception

A client is complaining of having the same type of pain that he experienced prior to being diagnosed with cancer. The nurse realizes that which process will influence this clients perception of pain? 1. Transmission 2. Modulation 3. Perception 4. Transduction

Topical

A client is diagnosed with chronic low back pain syndrome. The nurse realizes that which analgesic delivery route might be beneficial for this client? 1. Topical 2. Rectal 3. Transmucosal 4. Transdermal

Somatic pain

A client is experiencing pain after spraining an ankle. The nurse realizes that the client is most likely experiencing which type of pain? 1. Mild pain 2. Severe pain 3. Somatic pain 4. Visceral pain

3,4

A client is prescribed a medication that is a blend of an opioid analgesic with an NSAID. The nurse realizes that this medication will have which effects on the client? Select all that apply. 1. Encourage the development of tolerance. 2. Encourage the development of addiction. 3. Maximize pain control while minimizing toxicity. 4. Maximize pain control while minimizing side effects. 5. Reduce the onset of pseudoaddiction.

Referred pain

A client is surprised to learn of the diagnosis of a heart attack when there was no chest pain experienced but only some left shoulder pain. The nurse should explain that the client experienced which type of pain? 1. Phantom pain 2. Referred pain 3. Visceral pain 4. Chronic pain

4

A client is working two jobs, caring for aged parents, and maintaining a household for the family. The nurse realizes that this emotional stress will have what impact on the clients sleep? 1. More REM sleep 2. Less Stage 1 and Stage II NREM sleep 3. More NREM sleep 4. Less deep sleep and more awakenings during the night

Animal-assisted therapy

A client living in a long-term care center has been withdrawn and subdued, and does not eat in the dining room because of embarrassment about her physical decline. What might the nurse suggest that provides opportunities for unconditional love, achievement of trust, responsibility, and empathy toward others? 1. Chelation therapy 2. Animal-assisted therapy 3. Meditation 4. Pilates

2

A client questions why a medication that is used to treat Parkinsons disease has been prescribed for the diagnosis of periodic limb movement disorder (PLMD). What should the nurse do? 1. Contact the physician. 2. Assure the client that medications used to treat Parkinsons disease are also used to treat PLMD. 3. Tell the client not to take the medication because there is most likely an error. 4. Check with the pharmacy to make sure the correct medication has been provided to the client

3

A client recovering from back surgery is refusing pain medication for fear of becoming addicted. What should the nurse say to the client? 1. I understand. 2. There are ways to treat addictions to pain medications. 3. If the medication is taken to treat pain, you will not become addicted to it. 4. All pain medication causes addiction. There is nothing that can be done to prevent it.

2

A client recovering from hip surgery is reluctant to ambulate because of the amount of pain that occurred with walking prior to the surgery. What can the nurse do to help this client with pain control? 1. Provide pain medication before every ambulation session. 2. Address the clients fear of pain with walking. 3. Tell the client that the pain is now gone. 4. Explain that the client is confusing postoperative pain with the pain before the surgery.

pseudoaddiction

A client repeatedly asks the nurse How much longer until I can get more pain medication? Once the medication is provided, the client stops asking for it. The nurse identifies the clients behavior as being 1. addiction. 2. tolerance. 3. pseudoaddiction. 4. physical dependence.

Energy-field disturbance

A client reports feelings of spiritual anguish and depression as a result of experiencing numerous somatic complaints that make the client feel like everything is out of order. Which nursing diagnosis should the nurse identify for this client? 1. Energy-field disturbance 2. Powerlessness 3. Hopelessness 4. Anxiety

1,2,3

A client reports pain as being a 2 on a scale from 0 to 10. Which pain medications should the nurse consider for the client at this time? Select all that apply. 1. Acetaminophen (Tylenol) 2. Ibuprofen (Motrin) 3. Naproxen (Naprosyn) 4. Hydrocodone (Vicodin) 5. Methadone (Dolophine)

Illness

A client reports the need to urinate during the night and then not being able to fall back asleep. The nurse should document this assessment finding as which factor that influences sleep? 1. Illness 2. Stimulant 3. Diet 4. Lifestyle

Acute pain

A client states that a cramping pain started 2 hours ago and is not accompanied by any nausea or vomiting. Which type of pain is this client most likely experiencing? 1. Chronic pain 2. Phantom pain 3. Visceral pain 4. Acute pain

1, 2, 3, 5

A client tells the nurse about having problems falling and staying asleep. What should the nurse ask the client to gain more information about this client problem? Select all that apply. 1. How often does this happen? 2. How much coffee do you drink each day? 3. How do you feel when you wake up in the morning? 4. When do you eat your evening meal? 5. What have you done to deal with this sleeping problem?

The gate control theory of pain

A client tells the nurse that an ice pack works well to reduce the intensity of back pain. The nurse realizes that the client is implementing 1. a placebo. 2. distraction. 3. guided imagery. 4. the gate control theory of pain.

Social interactions

A client tells the nurse that at home, the dog helps distract the client from chronic hip pain. The nurse realizes that the client is utilizing which form of nonpharmacologic pain control? 1. Body 2. Mind 3. Social interactions 4. Spirit

Acupressure and reflexology

A client visits a clinic that integrates Western medicine with complementary therapies. Which therapies might the client utilize and believe to keep the flow of qi at a therapeutic level? 1. Acupressure and reflexology 2. Therapeutic touch and Reiki 3. Aromatherapy and naturopathic remedies 4. Chiropractic and massage therapy

Animal-assisted therapy

A client was in a motor vehicle crash where he sustained injury to his spinal cord that has resulted in difficulty with balance and holding his posture. Which should the nurse suggest the client consider? 1. Animal-assisted therapy 2. Hypnotherapy 3. Chelation therapy 4. Detoxification

Pulse rate

A client who has a long-standing history of depression has been on a prescribed antidepressant for several months and states that he has also been trying St. Johns wort. Which vital sign should the nurse assess for possible effects? 1. Temperature 2. Respiratory Rate 3. Oxygen saturation 4. Pulse rate

The registered nurse

A client who is on postoperative day 1 after abdominal surgery is requesting a back rub. The nurse realizes this care should be provided by 1. the registered nurse. 2. unlicensed assistive personnel. 3. no one, because the client cannot assume the prone position. 4. the physician.

Help satisfy the need for caring and nurturing touch

A client who resides in a long-term care facility has no family or visitors. Her only social contacts are with the staff. The client is confined to bed and is not able to communicate verbally. As part of the clients care plan, the nurses provide massage therapy three times a week. What is the main benefit of this intervention for this client? 1. Stretch and loosen the muscles 2. Speed the removal of metabolic waste products 3. Help satisfy the need for caring and nurturing touch 4. Relieve pain

2

A client who smokes cigarettes tells the nurse that sleep is light, and that he awakens easily. What should the nurse suggest to help this client with sleep? 1. Smoke no cigarettes 1 hour before sleep. 2. Smoke no cigarettes after the evening meal. 3. Limit the number of cigarettes smoked during the day. 4. Adjust to the lack of sleep, because those who smoke do not get sufficient sleep.

1

A client with diabetes asks the nurse why his blood glucose level is higher on days when he sleeps less. What should the nurse explain to the client? 1. During sleep, the hormone cortisol is inhibited. If sleep is interrupted, cortisol levels will remain elevated, impacting blood glucose. 2. Because the client is awake more, it is likely the client is eating more, which is impacting the blood glucose level. 3. There is no relationship between sleep and blood glucose levels. 4. The body needs cortisol for the extra energy created by the lack of sleep.

Anxiety

A client with pain has had previous episodes of uncontrolled pain in the past and is worried about the current pain pattern. Which diagnosis would be appropriate for the nurse to include for this client? 1. Anxiety 2. Ineffective Coping 3. Deficient Knowledge 4. Hopelessness

4

A clients pain level is assessed as being severe. Which intervention would be the most applicable for the client at this time? 1. Provide NSAID medication as prescribed. 2. Coach the client with guided imagery. 3. Suggest the client read or watch television until the pain subsides. 4. Provide opioid analgesic as prescribed.

spiritual distress

A home health nurse is working with a client who has had to quit his job after a serious injury and whose future employability is uncertain. The client states that his life has no meaning or purpose anymore and that he feels lonely and abandoned. What is an appropriate nursing diagnosis for this client? 1. Body Image Disturbance 2. Health-Seeking Behavior 3. Altered Family Processes 4. Spiritual Distress

3

A hospitalized client is being woken up every hour during the night for care and procedures. The nurse realizes that the lack of NREM sleep can have which physiological effect? 1. Decrease urine output 2. Increase thirst 3. Increase susceptibility to infection 4. Decrease heart rate

mental

A nurse is helping a hospice client who has had difficulty with making end-of-life decisions. The nurse has encouraged the client to focus on her self-worth, her accomplishments, and having positive self-esteem in order to process through some of these decisions. The nurse is helping the client to achieve balance in which component? 1. Environmental 2. Physical 3. Mental 4. Spiritual

Qigong

A nurse who works in a busy neonatal intensive care unit has been having difficulty with concentration after a long days work. Which therapy should the nurse consider doing to help with this problem? 1. Guided imagery 2. Hypnotherapy 3. Qigong 4. Aromatherapy

Music therapy

A nurse working on an Alzheimers unit notes that just before the supper hour, many of the residents become more anxious and confusedexhibiting typical sundowners syndromemaking the evening meal an unpleasant ordeal. As a method to try to decrease their turmoil during this time, which therapy should the nurse introduce into the daily routine? 1. Biofeedback 2. Music therapy 3. Pilates 4. Spiritual therapy

Challenge the belief that others always come first

After having a difficult time saying no when asked to work yet another overtime shift, the nurse begins to feel overwhelmed and irritable. As a method to most effectively promote self-healing, what should this nurse do? 1. Clarify values and beliefs. 2. Set realistic goals. 3. Learn to manage stress. 4. Challenge the belief that others always come first.

3

After receiving medication for mild pain, the client states that the pain is getting worse. What should the nurse plan to do for this client? 1. Administer another dose of a nonopioid medication. 2. Administer an opioid for severe pain. 3. Administer an opioid for moderate pain. 4. Administer two doses of an opioid for moderate pain.

1

The client scheduled to undergo minor surgery states, The physician will not give me pain medication after surgery because my surgery is only minor. What is the best response by the nurse? 1. You can experience pain after minor surgery, so you can have pain medication. 2. You are correct. The physician will not order any pain medication. 3. You are correct. I will need to teach you nonpharmacologic pain relief measures. 4. You can only have about half the dose because your surgery is minor.

1,2,3,4

The nurse is preparing to conduct a pain assessment. What should the nurse include in this assessment? Select all that apply. 1. Duration 2. Location 3. Intensity 4. Etiology 5. Neurology

1,2,4,5

The nurse is preparing to instruct a client on nonpharmacologic interventions that target the body for pain control. What should the nurse include in these instructions? Select all that apply. 1. Massage 2. Acupressure 3. Self-hypnosis 4. Exercise 5. Nutritional supplements

2,5,4,6,1,3

The nurse is preparing to massage a clients back. Place in order the steps the nurse will follow, after conducting hand hygiene and preparing the client, to perform the back massage. Click and drag the options below to move them up or down. Choice 1. Move the hands down the sides of the back. Choice 2. Pour lotion into the palms of the hands to warm the lotion. Choice 3. Massage the areas over the right and left iliac crests. Choice 4. Move the hands up the center of the back. Choice 5. With the palms, massage the sacral area with smooth, circular strokes. Choice 6. Move the hands to the scapulae and massage this region using circular strokes.

2

The nurse is providing discharge instructions to a client prescribed an opioid medication. What should the nurse suggest to decrease the risk of constipation with this medication? 1. Take an antihistamine three times per day. 2. Drink 6 to 8 glasses of water per day. 3. Assess respiratory rate before taking medication. 4. Assess heart rate before taking medication.

Rectal

The nurse is to administer acetaminophen (Tylenol) prn to a client for a headache; however, the client has been vomiting all day. Which route should the nurse use to administer the medication? 1. Oral 2. Vaginal 3. Rectal 4. Intravenous

2, 3

The nurse is working on a hospital committee tasked with reducing environmental distractions to sleep within the hospital. Which recommendations by the committee would be helpful? Select all that apply. 1. Turn off all overhead lights on the unit and use night-lights and flashlights. 2. Establish a time at which radios and televisions should be turned off or down. 3. Discontinue use of the paging system after 2100. 4. Conduct nursing reports in the hallway. 5. Open curtains between beds in semiprivate rooms.

1,3,5

The nurse wants to assign back rubs to unlicensed assistive personnel (UAP). Before doing so, the nurse should first determine whether Select all that apply. 1. unlicensed assistive personnel know how to perform a back rub. 2. there any clients who have intravenous fluids infusing. 3. there any clients who should not have a back rub performed. 4. there any clients who are prescribed to take nothing by mouth. 5. there any clients who do not want a back rub done by unlicensed assistive personnel.

I

The nurse, seeing a client asleep, turns off the television in the room. The client opens her eyes and says I was watching that. I wasnt sleeping. The nurse realizes that the client was demonstrating which stage of NREM sleep? 1. IV 2. III 3. II 4. I

2

The parent of a preschool-age child asks the nurse what can be done to reduce the number of nightmares the child experiences. What should the nurse suggest to this parent? 1. Provide hot chocolate prior to bedtime. 2. Limit or eliminate television. 3. Engage in a physical activity before bedtime. 4. Play a computer game before bedtime.

1

The parents of a 6-month-old tell the nurse that they are exhausted because their baby wakes up several times every night. What advice should the nurse give these parents? 1. Be certain that the baby is truly awake before picking him up for feeding. 2. Let the baby cry it out for a few nights until he can sleep through the night. 3. Continue to respond to the baby whenever he is restless during the night. 4. Bring the baby in for a possible sleep study to check for sleeping disorders.

Respiratory rate

Which of the following objective assessment data will the nurse obtain before administering a prescribed opioid medication to a client? 1. Pain level as stated by client 2. Any nausea the client may be feeling 3. Respiratory rate 4. Color of skin

3,4,5

From an assessment, the nurse learns that the client is having difficulty sleeping because of pain in the hips and knees due to arthritis. The client is weak and fatigued. Which diagnoses would be applicable to the client at this time? Select all that apply. 1. Anxiety 2. Hopelessness 3. Ineffective Health Maintenance 4. Insomnia 5. Impaired Physical Mobility

1

The client reports difficulty sleeping and awakening several times during the night. What intervention should the nurse recommend for the client when unable to sleep? 1. Get out of bed, go into another room, and pursue some relaxing activity until drowsy. 2. Get out of bed, go into another room, and exercise until tired before trying to go back to sleep. 3. Sit in bed and watch the bedroom television until drowsy. 4. Stay in bed with eyes closed and do some mental arithmetic until sleepy.

3

The client reports difficulty sleeping. Which environmental intervention should the nurse recommend? 1. Play soft music throughout the night. 2. Keep a television on in the bedroom. 3. Provide white noise with a fan. 4. Play a talk radio station.

1

A client experiencing pain after surgery says Something must be wrong because the pain is so severe. What is the best response for the nurse to make to the client? 1. The amount of tissue disrupted from the surgery is not related to the degree of pain you feel. 2. That could be so. 3. Taking pain medication for many years has made the medication ineffective now. 4. Are you sure the pain is as bad as you are saying it is?

Transduction

A client experiencing pain has been prescribed aspirin. The nurse realizes that this medication will affect which pain process? 1. Transduction 2. Transmission 3. Perception 4. Modulation

Severe pain

A client rates pain as being 7 on a scale from 0 to 10. What should the nurse document as this clients pain intensity? 1. Mild pain 2. Moderate pain 3. Severe pain 4. Physiological pain

Phantom limb pain

A client recovering from a left below-the-knee amputation is experiencing left foot pain. The nurse realizes the client is experiencing which type of pain? 1. Phantom limb pain 2. Acute pain 3. Chronic pain 4. Narcotic-induced pain

2

A client tells the nurse that because of work and life responsibilities, sleep has become optional. What is the best response the nurse should make to this client? 1. Be sure to get extra sleep when you can. 2. A lack of sleep can affect hormone levels and bodily functions. 3. Everyone has different needs for sleep to in order to function. 4. You must be very productive.

Meditation

A client undergoing chemotherapy becomes very anxious and stressed just before the treatments. Which would be an appropriate therapy for this person to learn? 1. Meditation 2. Aromatherapy 3. Homeopathy 4. Yoga

Chamomile

A client with degenerative joint disease comes to the clinic and states that he has been reading a lot about essential oils that are helpful for stomach problems. The nurse should offer the client information about the use of which oil? 1. Chamomile 2. Eucalyptus 3. Lavender 4. Tea tree

1, 2, 4, 5

After an assessment, the nurse is concerned that an older client is experiencing changes in sleep. What findings did the nurse use to make this clinical decision? `Select all that apply. 1. Is wide awake around 3 am 2. Takes a nap after lunch every day 3. Returns to sleep after using the bathroom 4. Goes to sleep before 9 pm most evenings 5. Wakes up and looks at the clock every hour

2,3,5

An older client who refuses medication for pain is irritable and unable to sleep. What should the nurse explain to the client to encourage the use of pain medication? Select all that apply. 1. There are high-dose medications that will eradicate the pain. 2. The lack of pain control is causing the inability to sleep. 3. The lack of pain control is causing irritability. 4. The risks of taking pain medication are low in the older population. 5. The lack of pain control will affect mobility and activity tolerance.

3

The client who has obstructive sleep apnea is being treated with a nasal continuous positive airway pressure (CPAP) device, but has just been prescribed modafinil (Provigil). What client statement indicates that teaching about these therapies has been effective? 1. I am so glad that I wont have to sleep in this machine anymore. 2. Once I get regulated on the Provigil, I will wean myself off the CPAP. 3. I will continue using my CPAP machine at night. 4. I can turn down the pressure on my CPAP machine in about 1 week.

4

The client who has sleep apnea reports falling asleep while driving, almost being involved in an accident, and frequent episodes of sleepwalking. What nursing diagnosis should be a priority for this client? 1. Disturbed Sleep Pattern related to difficulty staying asleep 2. Risk for Impaired Gas Exchange related to sleep apnea 3. Disturbed Thought Processes related to chronic insomnia 4. Risk for Injury related to somnambulism

Gastrointestinal (GI) distress

The nurse is preparing to discharge a client home with a prescription for ibuprofen (Motrin). What should the nurse instruct as a common side effect of this medication? 1. Gastrointestinal (GI) distress 2. Shakiness 3. Tremors 4. Rash

Ginseng

During a clinic appointment, a client prescribed medication for glaucoma reports vision problems. When taking a medication history, which herbal preparation should the nurse identify as being problematic for this client? 1. Ginseng 2. Echinacea 3. Valerian 4. St. Johns wort

1

During an interview assessment, the client states a belief in nutritional lifestyle counseling and that the bodys vital energy circulates through the body, which can be manipulated through specific anatomical points. Which type of healing practice should the nurse identify that this patient is following? 1. Traditional Chinese medicine 2. Native American healing 3. Ayurveda 4. Curanderismo

3

The 70-year-old client tells the nurse, I can go to sleep without a problem, but then I wake up in a couple of hours and cant go back to sleep. What nursing action would help promote rest and sleep in this client? 1. Have the client develop a bedtime ritual of quiet music and a glass of wine. 2. Encourage the client to avoid taking pain medication prior to sleep. 3. Evaluate if the client perceives sleeplessness to be a serious problem. 4. Have the client perform moderate exercises before bedtime.

Are there specific ones you're wondering about?

The client asks whether herbal medicines are a good idea. What should the nurse respond? 1. Things found in nature are always healthy. 2. If your doctor didnt prescribe it, dont take it. 3. Are there specific ones youre wondering about? 4. Everything is good in moderation.

1

The client has been prescribed zolpidem (Ambien) for the short-term management of insomnia. What information should the nurse include when teaching the client about this medication? 1. For best results, take the medication just prior to bedtime. 2. Take the medication at dinnertime to avoid gastric upset. 3. Do not take the medication with any liquid that contains calcium. 4. Drink an entire glass of water with the dose to avoid kidney stones.

3

The client has complained of stiffness and muscle tension in his back. The nurse suggests a back rub, but the client declines the offer. What action should the nurse take? 1. Encourage the client to accept the back rub, saying how much it will relax the back muscles. 2. Document that the client is noncompliant with the nursing plan of care. 3. Accept the declination but tell the client to call if he changes his mind. 4. Instruct the UAP to rub the clients back while assisting him to change into a clean gown.

4

The client is being treated with a nasal continuous positive airway pressure device (CPAP) for sleep apnea. What finding indicates that this treatment has been helpful to the client? 1. The client has lost 7 pounds since treatment began. 2. The client sleeps so soundly that he snores. 3. The clients diabetes is now under control. 4. The client reports a decrease in morning headache.

Diphenhydramine hydrochloride (Benadryl)

The client is taking meperidine (Demerol) and experiencing pruritus. Which medication should the nurse expect the physician to order? 1. Naloxone hydrochloride (Narcan) 2. Acetaminophen (Tylenol) 3. Diphenhydramine hydrochloride (Benadryl) 4. Normal saline

Cereal with milk

The hospitalized client requests a bedtime snack. Which food should the nurse offer this client? 1. Hot chocolate 2. Tea and crackers 3. Cereal with milk 4. Chips and salsa

2

The mother of a newborn tells the nurse, I am concerned about my baby. When she first goes to sleep, her eyes dart around under her eyelids, she doesnt breathe regularly, and she sometimes twitches. What advice should the nurse give this mother? 1. Please bring your baby in immediately for a checkup. 2. These are common behaviors in newborns and are normal. 3. You should ask the physician about these symptoms at your next checkup. 4. If your baby does this again, take her to the emergency department.

3

The nurse is admitting a client to the emergency department with complaints of severe abdominal pain. What is the nurses first action? 1. Administer IV pain medication as ordered. 2. Start an IV line of lactated Ringers. 3. Assess pain using a scale of 1 to 10. 4. Place a Foley catheter to bedside drainage.

1

The nurse is admitting a critically ill client to the intensive care unit. What question should the nurse ask regarding this clients sleep history? 1. No questions should be asked. 2. When do you usually go to sleep? 3. Do you have any problems with sleeping? 4. What are your bedtime rituals?

4, 5

The nurse is assessing a client in the intensive care unit who is asleep. What physiological changes will the nurse observe in this client? Select all that apply. 1. Lower respiratory rate 2. Increased muscle tension 3. Increased lower extremity edema 4. Lower blood pressure 5. Lower heart rate

Naloxone hydrochloride (Narcan)

The nurse is caring for a client who is using morphine through patient-controlled analgesia (PCA). What medication should the nurse have readily available? 1. Naloxone hydrochloride (Narcan) 2. Acetaminophen (Tylenol) 3. Diphenhydramine hydrochloride (Benadryl) 4. Normal saline

Respiratory rate: 8

The nurse is caring for a postpartum client receiving pain medication through an epidural catheter. Which assessment finding should the nurse report immediately to the physician? 1. Pulse rate: 80 2. Respiratory rate: 8 3. Blood pressure: 120/80 4. Pain rating of 4 on scale of 1 to 10

FLACC scale

The nurse is caring for an 8-month-old infant. What is the best tool the nurse should use for evaluating pain in this infant? 1. FLACC scale 2. Wong-Baker FACES 3. Visual analog scale 4. Numeric rating scale

1,2,3,4

The nurse is caring for an adolescent client who is experiencing postoperative pain. What interventions should the nurse use to help this client? Select all that apply. 1. Talk with the client about pain. 2. Provide privacy. 3. Present choices for dealing with pain. 4. Encourage distraction with music or television. 5. Allay fears and anxiety.

1, 2, 3

The nurse is completing the admission assessment on a client who has obstructive sleep apnea. Which findings should the nurse expect when assessing this client? Select all that apply. 1. Reddened uvula 2. Large soft palate 3. Obesity 4. Short neck 5. Deviated septum

2

The nurse is developing a plan of care for a client diagnosed with narcolepsy. Which intervention should the nurse include in this plan of care? 1. Encourage the client to take an over-the-counter medication to improve nighttime sleep. 2. Be certain the client has the prescription for modafinil (Provigil) filled. 3. Have the client purchase sodium oxybate (Xyrem) over the counter to prevent daytime drowsiness. 4. Be certain the client obtains antihistamines to control nasal stuffiness.

1

The nurse is performing discharge teaching for a client taking an NSAID. The client states he has heard that taking an antacid with this medication will help decrease the incidence of upset stomach. What is the nurses best response? 1. Antacids reduce the absorption and therefore the effectiveness of the NSAID. 2. Antacids help to reduce the incidence of gastric bleeding that could occur with the use of NSAIDs. 3. Antacids should never be taken with an NSAID. 4. Antacids help to reduce the incidence of pain.

1

The nurse is planning interventions for a client who has difficulty falling asleep. Which intervention regarding sleep times would be most helpful? 1. Maintain a regular bedtime and wake-up time for all days of the week. 2. If bedtime is delayed on one night, go to bed that much earlier the next night. 3. If daytime drowsiness occurs, go to bed earlier that night. 4. Sleep at least 1 hour later on mornings you dont have to go to work.

4,5

The nurse is preparing a client for a back massage. Which positions would be the best for the client to receive this massage? Select all that apply. 1. Supine 2. Fowlers 3. Trendelenburg 4. Prone 5. Side-lying

Asthma

The nurse is preparing to assess a group of assigned clients with chronic illnesses who use essential oils. For which health problem should the nurse particularly assess the clients? 1. Hypertension 2. Cardiac problems 3. Asthma 4. Cancer