NCLEX Test #2 Full Exam

Question 1 of 265

The nurse is providing teaching to a client that is using crutches to go up the stairs. What action by the client indicates the teaching was effective?

1. Moving the unaffected leg onto the step first
2. Supporting the unaffected leg with both crutches
3. Moving the injured leg and crutch on that side to the stair first
4. Starting with crutches on the floor and the injured leg on the first step

Question 2 of 265

What food should a client with stress incontinence avoid?

1. Tea
2. Pretzels
3. Alcohol
4. Asparagus

Question 3 of 265

The nurse is teaching a client with stress incontinence after a vaginal birth. What should be included in the plan of care? Select all that apply.

1. Increase fluid intake
2. Increase sodium intake
3. Avoid vitamin C intake
4. Avoid caffeinated beverages
5. Perform Kegel exercises several times daily

Question 4 of 265

What is identified as a priority to include in the plan of care when assisting a client with bowel elimination?

1. Using an elevated commode
2. Encouraging a low-fiber diet
3. Ambulating the client as soon as possible
4. Turning and positioning the client every 4 to 6 hours

Question 5 of 265

An older adult client is being evaluated for urinary incontinence. What statement by the nurse indicates a need for further teaching?

1. “Urinary incontinence is a normal sign of aging."
2. "Sometimes excessive drying can lead to incontinence."
3. "Are you having any difficulty getting to the bathroom?"
4. "We should probably check for a urinary tract infection."

Question 6 of 265

The nurse has provided teaching to a client that requires maximum support when using a cane. What action by the client indicates the teaching was effective?

1. Advancing unaffected side first
2. Moving the cane before moving the legs
3. Bring the affected leg forward with the cane
4. Keeping the cane at affected side when taking step

Question 7 of 265

A client that had surgery to reduce a compound open tibia/fibula fracture of the left leg has progressed to using a walker. What action by the client demonstrates the proper use of the walker?

1. Moving left leg with walker
2. Moving walker than the left leg
3. Moving right leg then the walker
4. Moving walker than moving the right leg

Question 8 of 265

The nurse is caring for several patients that are reporting pain. What client should not receive cutaneous stimulation for pain relief?

1. A client diagnosed with arthritis
2. A client with shingles (herpes zoster)
3. A client diagnosed with breast cancer
4. A client diagnosed with lupus erythematosus

Question 9 of 265

What pain relief is indicated for a client who sustained a low back injury three days ago? Select all that apply.

1. Ice bath
2. Ice massage
3. Heating pad
4. Hot compress
5. Warm sitz bath

Question 10 of 265

The nurse is planning to use distraction to treat pain in a hospitalized 8-year-old boy. What type of distractions is most appropriate?

1. Massage
2. Guided imagery
3. Play video games
4. Crossword puzzles

Question 11 of 265

The nurse is providing nutritional counseling for a client with a BMI of 32.5. What foods should be encouraged frequently in the nutritional plan?

1. Popcorn, pretzels, and peanuts
2. Whole milk, yogurt, and chicken
3. Frozen entrees and protein shakes
4. Fresh vegetables, fresh fruits, and whole grains

Question 12 of 265

What vitamin should be included in the teaching for a woman that is planning to conceive in order to reduce the risk for neural tube defects?

1. Iron
2. Calcium
3. Folic Acid
4. Magnesium

Question 13 of 265

A preschool child is admitted to the hospital. What nutritional assessments are priority? Select all that apply.

1. Eating habits
2. Access to food
3. Food preferences
4. Body mass index
5. Age started on solid food

Question 14 of 265

The nurse has provided information to a client about dietary guidelines. What statement by the client indicates a need for further teaching?

1. “I should eat more grains than protein.”
2. “I should eat more vegetables than fruit.”
3. “I should eat more dairy than vegetables.”
4. “I should eat about the same amount of fruit and protein.”

Question 15 of 265

The nurse is providing personal care to a client diagnosed with dementia. What action by the nurse demonstrates a need for further teaching?

1. Singing to the client while bathing them
2. Patting the client dry rather than rubbing them
3. Asking the client how they prefer to be bathed
4. Set a designated time for bathing or showering

Question 16 of 265

What action by the nurse providing personal care demonstrates a need for further teaching?

1. Wiping a female client from front to back
2. Washing a client from dirtiest to cleanest area
3. Cleansing the urinary meatus of a male patient in a circular motion from center towards the glans
4. Using a clean wipe for each stroke while cleaning the perineal area of a female who is menstruating

Question 17 of 265

The nurse is performing oral care for an unconscious client. What actions by the nurse are appropriate? Select all that apply.

1. Turn client on to side
2. Elevate head of the bed
3. Place a towel under the chin
4. Keep suction on and in mouth
5. Apply water soluble lip moisturizer

Question 18 of 265

An adult obese man is being evaluated for fatigue and snoring with difficulty sleeping. The nurse should assess the client for what common diagnosis?

1. Depression
2. Acute tonsillitis
3. Obstructive sleep apnea
4. Chronic obstructive pulmonary disease (COPD)

Question 19 of 265

A school nurse is expected to maintain competency in what areas? Select all that apply.

1. Current health practices
2. State health regulations
3. Current reimbursement
4. Community billing codes
5. Necessary immunizations

Question 20 of 265

The nurse is caring for a client who is on hospice and has a do not resuscitate order in place. The client has appointed a power of attorney who has an advance care directive with them. The client’s family member is questioning the do not resuscitate order and requesting that the client be changed to a full code. What action by the nurse is most appropriate?

1. Request an ethical consult
2. Change the client to a full code
3. Restrict the family member from visiting
4. Refer the family member to speak to the appointed power of attorney

Question 21 of 265

Of the following options, who has the greatest authority to make decisions on behalf of a client who is unable to make their own decisions?

1. A family member
2. Healthcare provider
3. A power of attorney
4. The hospital administration

Question 22 of 265

A client that is 14 weeks pregnant following a rape has made the decision to terminate the pregnancy. The mother of the client is arguing with the client and trying to get her to agree to have the child and place the child up for adoption. What action is appropriate for the nurse to take when advocating for the client?

1. Ask the mother to leave the room
2. Inform the mother it is not her decision to make
3. Encourage the client and mother to discuss their feelings
4. Consult psychiatry to speak with the mother and daughter

Question 23 of 265

An older adult client has a non-healing wound on their lower extremity. The surgeon has informed the client that they will need to have an amputation or will likely develop a life-threatening infection. After receiving all of the information the client has decided they do not want to have the surgery performed. The surgeon does not agree with the client’s decision and has proceeded to tell the client they’re making the wrong decision. What action is appropriate by the nurse and advocating for the client?

1. Report the surgeon to the medical board.
2. Encourage the client to share why they have made this decision.
3. Take the surgeon out of the room to discuss the client’s situation.
4. Tell the surgeon it is not their place to make these decisions for the client.

Question 24 of 265

What client should be assigned to a new graduate registered nurse?

1. A client that is eight hours post thyroidectomy.
2. A client that has had incidences of ventricular tachycardia today.
3. A client diagnosed with a spontaneous pneumothorax who is waiting to have a chest tube placed.
4. A client diagnosed with chronic obstructive pulmonary disease that is receiving IV Methylprednisolone daily.

Question 25 of 265

Which client should be assigned to the most experienced registered nurse?

1. A client with a 3rd° heart block waiting to see the care provider.
2. A client diagnosed with bradycardia that is being externally paced.
3. A client diagnosed with supraventricular tachycardia that had a cardioversion today.
4. A client that is in a medically induced hypothermia after being found in cardiac arrest.

Question 26 of 265

Which client should the registered nurse delegate to a license vocational nurse?

1. A client diagnosed with diabetes who has a blood sugar of 45.
2. A client with type two diabetes who has a hemoglobin A-1 C level of 7.5.
3. A client with diabetic ketoacidosis (DKA) on an insulin drip at four units per hour.
4. The client with hyperosmolar hyperglycemic non-ketotic syndrome (HHNS) that has just been admitted.

Question 27 of 265

What intervention should be delegated to the licensed vocational nurse (LVN)?

1. Assessing a client who has just been medicated for hypoglycemia
2. Administering subcutaneous insulin to a client with type one diabetes
3. Providing teaching to a client that is newly diagnosed with type two diabetes
4. Hanging IV insulin for a client with hyperosmolar hyperglycemic non-ketotic syndrome (HHNS)

Question 28 of 265

Which intervention should be assigned to an unlicensed assistive personnel?

1. Silencing an intravenous pump
2. Administering a soapsuds enema
3. Irrigating an indwelling urinary catheter
4. Walking a client with an assistive device

Question 29 of 265

What client should the charge nurse assign to the most experienced registered nurse?

1. A client with a deep vein thrombosis and a history of cerebrovascular accident
2. A client diagnosed with infective endocarditis awaiting surgery that has an audible murmur
3. A client diagnosed with congestive heart failure that has pitting edema in the lower extremities
4. A client with chronic obstructive pulmonary disease who has an oxygen saturation of 88% on 2 L of oxygen via nasal cannula

Question 30 of 265

Which of the following four patients should the nurse delegate to the licensed practical nurse?

1. A client that is one-day post-operative for a cholecystectomy
2. A client with acute pancreatitis that is receiving IV push morphine
3. A client diagnosed with chronic pancreatitis that is awaiting a paracentesis
4. A client diagnosed with acute appendicitis waiting to go to the operating room

Question 31 of 265

The nurse delegates care of a client to a licensed vocational nurse (LVN). The LVN incorrectly performs the delegated role that is within their scope of practice. Who is legally responsible for the error that occurred?

1. The RN
2. The LVN
3. The institution
4. Both the RN and LVN

Question 32 of 265

What client is most appropriate to delegate to a licensed vocational nurse?

1. A client with pancreatitis awaiting a paracentesis.
2. A postoperative client that needs IV push morphine every hour.
3. A client diagnosed with metastatic cancer receiving buccal pain medication.
4. A client diagnosed with chronic obstructive pulmonary disease with a pH of 7.29.

Question 33 of 265

What client is appropriate for delegation to a licensed vocational nurse?

1. The client diagnosed with hyperparathyroidism with a serum calcium level of 11 mg/dL.
2. A client diagnosed with ulcerative colitis who is experiencing large loose bowel movements.
3. The client admitted for difficulty breathing who has begun coughing up a pink frothy sputum.
4. A client diagnosed with a left sided pneumothorax who has a new right-sided tracheal deviation.

Question 34 of 265

The registered nurse and licensed vocational nurse (LVN) are caring for the following group of clients. What task is appropriate to assigned to the LVN?

1. A pressure ulcer
2. Providing IV push morphine
3. Administering IV fluids through a central venous catheter
4. Administering medications through a gastrointestinal tube

Question 35 of 265

Which of the following tasks are appropriate to delegate to an unlicensed assistive personnel? Select all that apply.

1. Evaluating pain
2. Postmortem care
3. Performing simple dressing changes
4. Giving advice to a client over the phone
5. Performing cardiopulmonary resuscitation

Question 36 of 265

What delegation of care from a registered nurse to an unlicensed assistive personnel should be questioned?

1. Having an unlicensed assistive personnel walk the client utilizing a walker.
2. Instructing an unlicensed assistive personnel to do a simple dressing change on a skin tear.
3. Asking an unlicensed assistive personnel to do a standing weight on a client before assessing the client.
4. Requesting an unlicensed assistive personnel to provide postmortem care and a newly deceased client.

Question 37 of 265

A client that has undergone a total knee replacement is scheduled for discharge in the morning. The family members of the clients are concerned that the client is not making adequate progress to go home. What action by the nurse is most appropriate?

1. Notify physical therapy
2. Contact the case manager
3. Consult with occupational therapy
4. Document the concern in the chart

Question 38 of 265

Who has the responsibility of assessing clients and their homes as well as coordinating client care?

1. Case management
2. Healthcare provider
3. Occupational therapy
4. The assigned registered nurse

Question 39 of 265

The nursing case manager is evaluating an older adult client that is four days post hip replacement surgery. The case manager notices the client has not been making progress in physical therapy and has not been weaned off of IV narcotics. What type of treatment plan should a case manager anticipate?

1. Long-term care
2. Inpatient rehabilitation
3. Outpatient physical therapy
4. Home health medication administration.

Question 40 of 265

What point in the client’s care would the nursing case manager first become involved?

1. Preadmission
2. Admission to the facility
3. After discharge from the facility
4. Prior to discharge from the facility

Question 41 of 265

After agreeing to be involved in a research study of a new medication, the client has learned that they will need to have blood work and additional studies done every week. This information was not given to the client by a healthcare provider. What client right has been violated?

1. The right to privacy
2. The right to full disclosure
3. The right not to be harmed
4. The right to self-determination

Question 42 of 265

The nurse is preparing to administer a subcutaneous heparin injection. The client pulled up their gown to expose the abdomen. What type of consent has the client given the nurse?

1. Implied consent
2. Express consent
3. Voluntary consent
4. Diagnostic consent

Question 43 of 265

A pediatric client has been admitted to the emergency department with a foreign body protruding from their abdomen after sustaining a fall. The nurse accompanies the physician to speak to the family of the child while the child is being prepared for the operating room. The mother of the child verbally consents to the surgery. What action by the nurse is priority?

1. Document the oral consent
2. Request the physician fill out a written consent
3. Notify nursing supervisor the consent has not been signed
4. Inform the mother that the surgery cannot be completed until paperwork is done

Question 44 of 265

Collaboration amongst healthcare professionals can lead to what positive outcomes? Select all that apply.

1. Optimal health care for clients
2. Increased satisfaction of clients
3. Elimination of medication errors
4. The ability to perform each other’s roles
5. Understanding of each other's scope of practice

Question 45 of 265

Which example best demonstrates a collaborative practice model?

1. The nurse assisting the physician as they suture.
2. The physician providing a nurse with standing orders
3. The nurse and physician making rounds on the clients together
4. The nurse making a referral to a psychiatrist for a client with mental health concerns

Question 46 of 265

A client who has experienced a spinal cord injury is having difficulty with fine motor skills in their hands. What referral is most appropriate?

1. A surgeon
2. Physical therapy
3. Pain management
4. Occupational therapy

Question 47 of 265

The nurse manager on a medical surgical floor has allowed staff nurses to create vacation schedule and decide on how vacations will be taken. In addition the nurse manager has allowed them to create their own staffing and staffing policies. Many of the nurses’ report dissatisfaction in their positions. What type of leadership style is this manager demonstrating?

1. Autocratic
2. Democratic
3. Bureaucratic
4. Laissez-faire

Question 48 of 265

A weekly staff meeting is held by the nurse manager. At the meeting nurses are asked about their opinions and asked to vote on important decisions regarding the unit. What type of management style is this nurse manager exhibiting?

1. Autocratic
2. Democratic
3. Bureaucratic
4. Laissez-faire

Question 49 of 265

A nurse manager develops and implements a new system of scheduling. What type of management style does this represent?

1. Autocratic
2. Democratic
3. Laissez-faire
4. Shared governance

Question 50 of 265

What are the most important characteristics a nurse needs in order to be an effective manager?

1. The respect of all nurses.
2. An ability to direct people
3. Effective communication and leadership skills
4. Understanding of nursing care plan development

Question 51 of 265

A client admitted to the hospital for a hysterectomy following a diagnosis of uterine cancer is being prepared for surgery. While the client is in the bathroom a friend visiting asks the nurse if the client is going to need chemotherapy. What statement by the nurse is most appropriate?

1. "I don't think she will."
2. "I'm sorry I can't discuss her care with you."
3. "She didn't tell you about her chemotherapy?"
4. "That is something that they usually decide after the surgery."

Question 52 of 265

A client who does not speak English has been admitted to the emergency department for abdominal pain. The nurse is unable to communicate with the client. What action by the nurse is most appropriate?

1. Request an interpreter
2. Write down any messages for the client
3. Attempt to communicate with the client
4. Ask if any of the family members speak English

Question 53 of 265

The nurse is caring for a client with a T-tube inserted after cholecystectomy. The T-tube is not draining and the client has developed jaundice. What action by the nurse is appropriate?

1. Flushing the T-tube
2. Clamping the T-tube
3. Contacting the surgeon
4. Connecting the T-tube to low wall suction

Question 54 of 265

The nurse offers pain medication to a client who has returned from the operating room after a cholecystectomy. What ethical principle is the nurse demonstrating?

1. Justice
2. Veracity
3. Beneficence
4. Non-maleficence

Question 55 of 265

The nurse is caring for a client admitted to their unit for observation of chest pain. The client is an inmate at the local prison who is serving a life sentence for murder. The nurse realizes that they need to treat the client the same as any other client. What ethical principle does this demonstrate?

1. Justice
2. Veracity
3. Beneficence
4. Non-maleficence

Question 56 of 265

The nurse receives an order from the healthcare provider for 250 mg of metoprolol IV. The nurse contacts the physician regarding the order. What ethical principle does this demonstrate?

1. Justice
2. Veracity
3. Autonomy
4. Non-maleficence

Question 57 of 265

A client diagnosed with metastatic cancer has made the decision to stop treatment and begin palliative care. What ethical principle does this demonstrate?

1. Fidelity
2. Veracity
3. Autonomy
4. Parentalism

Question 58 of 265

A client that is on a liver transplant list offers the nurse money to help them move higher on the list for a liver transplant. The nurse informed the client that they are unable to take money or change the clients place on the recipient list. What ethical principle does this demonstrate?

1. Justice
2. Beneficence
3. Confidentiality
4. Non-maleficence

Question 59 of 265

A client diagnosed with end stage renal disease has decided not to have dialysis despite the family encouraging the client to fight. What ethical principle does this demonstrate?

1. Fidelity
2. Veracity
3. Autonomy
4. Parentalism

Question 60 of 265

A nurse is asked by an unlicensed nursing personnel (UAP) why a patient not in their care was admitted. The nurse informs the UAP that the client had a new diagnosis of breast cancer. What ethical principle has the nurse violated?

1. Justice
2. Beneficence
3. Confidentiality
4. Non-maleficence

Question 61 of 265

A client is scheduled for a colonoscopy. What is the role of the nurse in obtaining an informed consent?

1. Provide risks and benefits
2. Witness a client’s signature
3. Provide a clear explanation of the surgery
4. Provide additional information about the procedure

Question 62 of 265

Which client cannot sign an informed consent?

1. A lethargic, oriented client
2. A client given a mild sedative
3. The mother of a six-year-old child
4. A client meeting emergency surgery

Question 63 of 265

Prior to administering a psychoactive drug to a client having surgery what action by the nurse is priority?

1. Sign for the medication
2. Have a second nurse verify the dose
3. Check the client's past surgical records
4. Verify an informed consent was signed

Question 64 of 265

What procedures require informed consent? Select all that apply.

1. A biopsy
2. A chest x-ray
3. A paracentesis
4. Abdominal ultrasound
5. A CT scan with contrast

Question 65 of 265

A client is brought to the emergency room following a gunshot wound to the abdomen. What statement by the nurse regarding informed consent demonstrates a need for further teaching?

1. "The client can provide consent."
2. "A close friend can provide consent."
3. "Emergency surgery does not require consent."
4. "Consent by next of kin over the phone is acceptable."

Question 66 of 265

What advantages do virtual reality VR simulations have? Select all that apply.

1. Interactions with a real client
2. Ability to perform tasks on a manikin
3. The chance to identify misconceptions
4. A practice environment at their own pace
5. Freedom to practice before working with a client

Question 67 of 265

What term is the management and processing of information that can be applied to nursing practice, education and research?

1. Data
2. Informatics
3. Evidence-based practice
4. Electronic health records

Question 68 of 265

What benefits does automation have on healthcare documentation? Select all that apply.

1. Improves communication
2. Prevent HIPAA violations
3. Eliminates medication errors
4. Reduces errors in abbreviations
5. Makes information accessible at bedside

Question 69 of 265

What action by the nurse will protect their license? Select all that apply.

1. Renewing the license on time
2. Contact the board of nursing yearly
3. Only provide the original license to employers
4. If you lose your license take steps to obtain a duplicate
5. Practice according to the scope of practice in your state

Question 70 of 265

What are examples of intentional torts? Select all that apply.

1. Battery
2. Assault
3. Negligence
4. Malpractice
5. False imprisonment

Question 71 of 265

What are examples of unintentional tort? Select all that apply.

1. Battery
2. Assault
3. Negligence
4. Malpractice
5. False imprisonment

Question 72 of 265

The nurse is caring for a confused client. The nurse tells the client that they will restrain them if they do not sit down and stop getting up. The client is upset and attempts to get up when the nurse pushes them back in the chair and applies a chest restraint. What legal torts has the nurse violated? Select all that apply.

1. Battery
2. Assault
3. Negligence
4. False imprisonment
5. Defamation of character

Question 73 of 265

The nurse administers intramuscular morphine to an adult client in the dorsogluteal site. The client sustains damage to the sciatic nerve. Despite receiving education on the risks of administering injections in the site, the nurse still chose to give the medication in the dorsogluteal site. What legal action may the nurse face?

1. Assault
2. Defamation
3. Negligence
4. Malpractice

Question 74 of 265

A client presents to the emergency department with a severe infection. The physician orders ceftriaxone for a client with a severe penicillin allergy. The nurse questions the physician’s order and is instructed to administer the medication. Shortly after administering the medication the client develops an anaphylactic reaction, goes into cardiac arrest and dies. Who is legally liable?

1. The nurse alone
2. The physician alone
3. The nurse and physician
4. Neither, this medication is not contraindicated in clients with penicillin allergies.

Question 75 of 265

A client is admitted to the emergency department after being discharged following abdominal surgery. The client reports being lightheaded, dizzy and extremely tired. What medication should the nurse assess the client for?

1. Docusate
2. Ibuprofen
3. Enoxaparin
4. Hydrocodone

Question 76 of 265

An older adult client presents to the emergency department with a sudden onset of confusion, nausea and tremors. The client’s vital signs are blood pressure 104/60, heart rate 110, temperature 94.4°F. The nurse should assess the client for history of taking what medication?

1. Thyroxine
2. Salicylates
3. Amphetamines
4. Oral hypoglycemic

Question 77 of 265

A client that is prescribed digoxin has an apical pulse of 55 bpm. What action by the nurse is priority?

1. Hold the medication
2. Check the radial pulse
3. Document the findings
4. Contact healthcare provider

Question 78 of 265

A client that is currently taking digoxin has a potassium level of 3.2 mEq/L, a magnesium level of 1.4 mg/dL and a calcium level 11.0 mg/dL. What action by the nurse is priority?

1. Request repeat labs
2. Check the client’s digoxin level
3. Place the client on a calcium restriction
4. Get an order for potassium and magnesium supplements

Question 79 of 265

A client is prescribed clozapine. Which client symptom should the nurse report to the health care provider immediately?

1. Sore throat
2. Weight loss
3. Increased appetite
4. Increased urination

Question 80 of 265

A nurse has provided teaching to a client taking escitalopram. Which client statement indicates the teaching was effective?

1. “I should limit fluid intake.”
2. “I should not eat blue cheese.”
3. “I should expect to urinate often.”
4. “I should avoid caffeinated drinks.”

Question 81 of 265

A client taking lubiprostone for irritable bowel syndrome has received teaching about the medication. What statement by the client demonstrates a need for further teaching?

1. “The medicine may cause gas.”
2. “I should not take this with food”
3. “This medication should not make me tired.”
4. “This medication will help with my constipation.”

Question 82 of 265

A client has developed a hemolytic reaction after the initiation of a blood transfusion. What actions by the nurse are appropriate? Select all that apply.

1. Obtain a urine sample
2. Administer corticosteroids
3. Administer diphenhydramine
4. Send the tubing and bag to the blood bank
5. Run IV 0.9% sodium chloride through a new IV line

Question 83 of 265

A client who has had a previous blood transfusion begins to report chills and muscle stiffness. The client’s vital signs are: BP 138/88, Pulse 98, temperature 101.3. What interventions does the nurse anticipate being ordered? Select all that apply.

1. Epoetin
2. Chelation
3. Acetaminophen
4. Methylprednisolone
5. A leukocyte reduction filter

Question 84 of 265

What medications should be questioned in a client diagnosed with chronic obstructive pulmonary disease (COPD)? Select all that apply.

1. Timolol
2. Digoxin
3. Captopril
4. Cardizem
5. Carvedilol

Question 85 of 265

What is the most common cause of acute hemolytic transfusion reactions?

1. Previous blood transfusions
2. Clients unaware of blood type
3. Failure to verify a type and crossmatch
4. Improper labeling of blood components

Question 86 of 265

A client has just received the first 40 mLs of a blood transfusion. The client reports low back pain, nausea, chest tightness and dyspnea. The vital signs are blood pressure 92/48 pulse 108, temperature 100.8°F. What action by the nurse is priority?

1. Notify the provider
2. Stop the transfusion
3. Administer diphenhydramine
4. Prepare normal saline with new IV tubing.

Question 87 of 265

A client admitted with a lower GI bleed requires a blood transfusion. The client’s blood type is B positive. What type of blood can the client receive?

1. O positive
2. O negative
3. A positive
4. A negative
5. B negative

Question 88 of 265

The nurse is caring for a client that is receiving a blood transfusion. The client reports a headache and chills. What action by the nurse is priority?

1. Stop the infusion
2. Assess the client’s vital signs
3. Reduce the rate of the blood transfusion
4. Request an order for acetaminophen

Question 89 of 265

What intervention(s) are priority for a client suspected of having a hemolytic transfusion reaction? Select all that apply.

1. Obtain 2 blood samples
2. Test urine for hemoglobinuria
3. Administer diphenhydramine
4. Evaluate serum calcium levels
5. Discard the blood bag in a biohazard bag

Question 90 of 265

Two hours after the initiation of a blood transfusion the client begins to report shortness of breath. The client’s vital signs are blood pressure 80/48, pulse 98, oxygen saturation 86% on room air. And temperature is 101.8°F. What type of transfusion reaction does the nurse suspect?

1. Allergic reaction
2. Acute hemolytic reaction
3. Febrile nonhemolytic reaction
4. Transfusion related acute lung injury

Question 91 of 265

A client with a new central venous catheter placed begins to have a sudden onset of chest pain and shortness of breath. The nurse suspects the client is experiencing a pneumothorax. What actions by the nurse are priority? Select all that apply.

1. Monitor vital signs
2. Remove the catheter
3. Notify healthcare provider
4. Maintain the client supine
5. Prepare for chest tube insertion

Question 92 of 265

What action by a nurse caring for a client with a peripherally inserted central catheter (PICC) demonstrates a need for further teaching?

1. Flushing the line prior to administering medications
2. Drawing blood from a vessel above the insertion site
3. Informing the client that they may go home with this inserted
4. Checking the blood pressure on the leg of the side the wine is inserted

Question 93 of 265

What type of vascular access is recommended for a client who is going to need therapy for several months to several years?

1. A tunneled central catheter
2. A non-tunneled central catheter
3. A peripherally inserted central catheter
4. A peripherally inserted vascular access device

Question 94 of 265

What type of central venous access device requires a Huber tip needle to access for medication administration?

1. An implanted port
2. A tunneled central catheter
3. A non-tunneled central catheter
4. A peripherally inserted central catheter

Question 95 of 265

The order is to titrate dobutamine 250 mg in 250 mL of D5W at 4 mcg/kg/min. The client weighs 129.8 lbs. How many mL/hr should the nurse set the infusion pump? Round to the nearest tenth.

Question 96 of 265

A client has an order for naloxone 2 mg IV push. The nurse has a vial that reads 0.5 mg/mL. How many milliliters should the nurse administer?

Question 97 of 265

A client has azithromycin 500 mg PO ordered. The nurse has 250mg tablets. How many tables should the client receive?

Question 98 of 265

A newborn has just been circumcised. Acetaminophen 15 mg/kg has been ordered to be administered post circumcision. The newborn weighs 3500 grams. How many mg of acetaminophen should the newborn receive? ___________ mg

Question 99 of 265

What medications are anti-hyperlipidemic agents? Select all that apply.

1. Simvastatin
2. Atorvastatin
3. Nitroglycerin
4. Nicotinic acid
5. Acetylsalicylic acid

Question 100 of 265

A client is diagnosed with urge incontinence. What medication does the nurse anticipate administering for this client? Select all that apply.

1. Terazosin
2. Doxazosin
3. Tolterodine
4. Furosemide
5. Oxybutynin

Question 101 of 265

Which medications does the nurse anticipate the health care provider to prescribe to a client in alcohol withdrawal? Select all that apply.

1. Haloperidol (Haldol)
2. Lorazepam (Ativan)
3. Carbamazepine (Tegretol)
4. Chlordiazepoxide (Librium)
5. Diphenhydramine (Benadryl)

Question 102 of 265

As the nurse prepares to administer Vitamin K to the newborn, the parents ask why their baby needs a “shot” so soon after birth. What response by the nurse is appropriate?

1. “This is to prevent vitamin deficiency in your baby”
2. “This is to prevent a rare bleeding problem in newborns”
3. “This is the first immunization all babies get in the hospital”.
4. “It is a very small needle and will hurt less if you hold the baby while I administer it”

Question 103 of 265

A client diagnosed with end stage liver failure has received teaching about lactulose. What statement by the client indicates the teaching was effective?

1. “I am probably still going to be confused after this.”
2. “It is alright to mix the medication with fruit juices.”
3. “Watery diarrhea is normal while taking this medication.”
4. “More than one bowel movement a day is important to report.”

Question 104 of 265

What medications are bronchodilators that are used in the treatment of chronic obstructive pulmonary disease?

1. Imipenem
2. Salmeterol
3. Ipratropium
4. Methylprednisolone
5. Tiotropium bromide

Question 105 of 265

A client with pruritus from cirrhosis can be provided what PRN medication?

1. Lactulose
2. Diphenhydramine
3. Hydrochlorothiazide
4. Topical hydrocortisone 1%

Question 106 of 265

A client has an order for enoxaparin 70 mg subcutaneously. What site is appropriate for administration?

1. Deltoid
2. Forearm
3. Abdomen
4. Ventrogluteal

Question 107 of 265

A client with low back pain has a new order for a transdermal fentanyl patch. After providing education, what action by the client indicates a need for further teaching?

1. Placing a heating pad over the patch.
2. Cleaning and drying an area before placing a patch.
3. Removing the old patch before putting a new one on.
4. Verbalizing that it may be 12-18 hours before relief is felt the first time.

Question 108 of 265

A client with esophageal cancer is now receiving medications via a gastrointestinal tube. The client has an order for sublingual nitroglycerin PRN for chest pain. How would the nurse administer this medication?

1. Ask pharmacy for nitroglycerin IV
2. Contact the prescriber for a new order
3. Administered under the client’s tongue
4. Crush it dissolve in water and administer through the tube

Question 109 of 265

A nurse is preparing to administer medications through a gastrointestinal tube. What actions by the nurse are appropriate? Select all that apply.

1. Hold medications if residual is greater than 50 ML's
2. Dissolve medications together in 30 mL's of water
3. Provide 60 mL's of water in between each medication
4. Maintain the client's head of the bed greater than 30 degrees
5. Flush with 30 mL's of water before administering medication

Question 110 of 265

The nurse is caring for a client with a gastrointestinal tube that enters the small intestine through a surgically created opening in the abdominal wall. The nurse should document what type of tube?

1. Orogastric tube
2. Nasogastric tube
3. Gastrostomy tube
4. Jejunostomy tube

Question 111 of 265

A client who has begun enteral tube feedings has developed diarrhea. What action by the nurse is most appropriate?

1. Decrease the rate of the feeding
2. Administer the feeding via bolus
3. Assess fluid balance and electrolytes
4. Change the type of tube feeding formula

Question 112 of 265

A client who has been receiving enteral feeding begins coughing and has a drop in their oxygen saturation. What action by the nurse is priority?

1. Stop the feeding
2. Check tube placement
3. Turn the client on their side
4. Perform a respiratory assessment

Question 113 of 265

A client diagnosed with nephrolithiasis is administered toradol IV. What action by the nurse is priority?

1. Place the client on fall precautions.
2. Re-assess the client’s pain in 30 minutes.
3. Request a family member stay with the client.
4. Assess for symptoms of bleeding every 15 minutes.

Question 114 of 265

A client admitted for a fractured vertebra that reports pain of 9/10 should receive what pain medication?

1. Ibuprofen 600 mg for mild pain.
2. Morphine 4 mg IV for severe pain.
3. Toradol 50 mg IV for moderate pain.
4. Hydrocodone 7.5/325 for moderate pain.

Question 115 of 265

What action by the nurse is priority before administering parenteral nutrition?

1. Reassess the client’s ability to eat food
2. Inspect the solution for separation and precipitate
3. Report the client’s intake to the prescribing practitioner
4. Verify the parenteral nutrition received against the order with another nurse

Question 116 of 265

What action by the nurse demonstrates a need for further teaching when administering parenteral nutrition?

1. Utilizing a filter to administer the parenteral nutrition
2. Checking the parenteral solution against the original order
3. Changing the tubing every time the parenteral nutrition is hung
4. Administering parenteral nutrition with the dextrose concentration of 15% through a peripheral line

Question 117 of 265

What action by the nurse is priority when caring for a client that is receiving total parenteral nutrition (TPN) through a central venous access device?

1. Obtaining daily blood cultures
2. Assessing the client's peripheral IV site
3. Checking the client's capillary blood glucose levels
4. Maintaining the client on continuous electrocardiogram.

Question 118 of 265

The nurse is assessing a client who is receiving total parenteral nutrition. What finding indicates the client may need changes made to the TPN order?

1. A blood glucose level of 450
2. A calcium level of 9.8 mg/dL
3. A potassium level of 4.5 mEq per liter
4. A sodium concentration of 135 mEq per liter

Question 119 of 265

A pregnant woman exhibited an elevated blood pressure reading of 145/94 at her 30-week prenatal visit. She was sent to the antepartum unit for further evaluation and was found to have continued blood pressure readings of 150/92 and 148/96 over the next several hours. She does not have a history of hypertension, and a complete blood count, comprehensive metabolic panel, and urinalysis are normal. Which diagnosis does the nurse suspect?

1. Toxemia
2. Chronic Hypertension
3. Gestational Hypertension
4. Pregnancy Induced Hypertension

Question 120 of 265

A client is being evaluated for hypoxia. What diagnostic test is most appropriate?

1. Chest x-ray
2. Arterial blood gas
3. Hemoglobin level
4. Red blood cell count

Question 121 of 265

What’s components of an arterial blood gas should be evaluated by a nurse in determining an acid base balance? Select all that apply.

1. pH
2. HCO3
3. PaCO2
4. Sodium
5. Chloride
6. Potassium

Question 122 of 265

A client admitted being evaluated for an acute asthma exacerbation has a respiratory rate of 40, heart rate of 112 and a blood pressure of 158/92. ABGs indicate the pH is 7.49. What action by the nurse is most appropriate?

1. Administer high flow oxygen
2. Plan for immediate intubation
3. Administer IV sodium bicarbonate
4. Have client breathe into a paper bag

Question 123 of 265

What finding is consistent with a client diagnosed with respiratory acidosis? Select all that apply.

1. PaO2 of 95%
2. A pH of 7.28
3. A HCO3 of 21
4. A PaCO2 of 50
5. An anion gap of 14

Question 124 of 265

The nurse is caring for a client diagnosed with Guillain-Barré syndrome that has developed increased difficulty breathing. The clients ABGs demonstrate a pH of 7.23 and a PaCO2 of 58. The client oxygen saturation is 85% on a face mask. What action by the nurse is priority?

1. Increase the oxygen
2. Prepare for intubation
3. Switch the client to a nasal cannula
4. Encourage the client to slow their breathing

Question 125 of 265

What order should be questioned for a client diagnosed with congestive heart failure or that has a sodium concentration of 132 mEq/L, potassium of 3.6 mEq/L, in a magnesium of 1.2 mg/dL?

1. D5 normal saline at 75 mL/hr
2. Potassium 20 mEq/L PO for two doses
3. 2g magnesium sulfate IV over one hour
4. 0.45% sodium chloride IV at 150 mL/hr

Question 126 of 265

A client admitted being evaluated for an acute asthma exacerbation has a respiratory rate of 40, heart rate of 112 and a blood pressure of 158/92. ABGs indicate the pH is 7.49. What action by the nurse is most appropriate?

1. Administer high flow oxygen
2. Plan for immediate intubation
3. Administer IV sodium bicarbonate
4. Have client breathe into a paper bag

Question 127 of 265

What finding is consistent with a client diagnosed with metabolic alkalosis?

1. HCO3 of 32
2. A pH of 7.43
3. A PaCO2 of 45
4. A serum anion gap of 12mEq/L

Question 128 of 265

The nurse is caring for a client diagnosed with Guillain-Barre syndrome that has developed increased difficulty breathing. The clients ABGs demonstrate a pH of 7.23 and a PaCO2 of 58. The client oxygen saturation is 85% on a face mask. What action by the nurse is priority?

1. Increase the oxygen
2. Prepare for intubation
3. Switch the client to a nasal cannula
4. Encourage the client to slow their breathing

Question 129 of 265

A client is being evaluated for hypoxia. What diagnostic test is most appropriate?

1. X-ray
2. Arterial blood gas
3. Hemoglobin level
4. Red blood cell count

Question 130 of 265

A client that is admitted for a small bowel obstruction has had nasogastric suction for several days. The client has the following lab values: PH 7.50, PaCO2 35, HCO 31. K+ 3.0 mEq/L. Na + 149 mEq/L. What imbalances does the nurse recognize? Select all that apply.

1. Hypoxia
2. Hypokalemia
3. Hyponatremia
4. Metabolic alkalosis
5. Respiratory acidosis

Question 131 of 265

When evaluating a client diagnosed with metabolic acidosis which findings does the nurse anticipate?

1. pH 7.48, paCO2 34, HCO3 24
2. pH 7.50, PaCO2 of 35, HCO3 28
3. pH of 7.29, PaCO2 40, HCO3 19
4. pH of 7.29, PaCO2 50, HCO3 of 22

Question 132 of 265

When evaluating a client diagnosed with metabolic alkalosis which findings does the nurse anticipate?

1. pH 7.48, paCO2 34, HCO3 24
2. pH 7.50, PaCO2 of 35, HCO3 28
3. pH of 7.29, PaCO2 40, HCO3 19
4. pH of 7.29, PaCO2 50, HCO3 of 22

Question 133 of 265

When evaluating a client diagnosed with respiratory acidosis which findings does the nurse anticipate?

1. pH 7.48, paCO₂ 34, HCO₃ 24
2. pH of 7.29, PaCO₂ 40, HCO₃ 19
3. pH 7.50, PaCO₂ of 35, HCO₃ 28
4. pH of 7.29, PaCO₂ 50, HCO₃ of 22

Question 134 of 265

A client has been vomiting for several hours. ABG results indicate the client is in metabolic alkalosis. What action by the nurse is priority?

1. Administer PRN antiemetic
2. Administer sodium bicarbonate
3. Request an order for a nasogastric tube
4. Place a client on oxygen via nasal cannula

Question 135 of 265

What finding should be reported immediately in a client taking potassium sparing diuretics?

1. Sodium of 134 mEq/L
2. Calcium level of 11.2 mg/dL
3. Potassium level of 4.9 mEq/L
4. Magnesium level of 2.5 mg/dL

Question 136 of 265

What methods should the nurse use to monitor cardiovascular function in a client that has just undergone surgery? Select all that apply.

1. Measuring urinary output
2. Evaluating the blood pressure
3. Looking at the arterial blood gas
4. Reviewing the complete blood count
5. Assessing the client’s musculoskeletal system

Question 137 of 265

What finding related to cardiac hemodynamics should be reported to the healthcare provider immediately?

1. A pulse of 60
2. Cardiac output of 5 L a minute
3. A resting stroke volume of 70 ML's
4. Central venous pressure reading of 1 mmHg

Question 138 of 265

What is the amount of resistance to rejection of blood from the ventricle?

1. Preload
2. Afterload
3. Stroke volume
4. Ejection fraction

Question 139 of 265

Which of the following is the percentage of diastolic blood volume injected from the ventricle during each heartbeat?

1. Preload
2. Afterload
3. Stroke volume
4. Ejection fraction

Question 140 of 265

Which of the following is the amount of blood ejected from one of the ventricles with each heartbeat?

1. Preload
2. Afterload
3. Stroke volume
4. Ejection fraction

Question 141 of 265

What findings are consistent with changes to the cardiac system in aging? Select all that apply.

1. Decreased elasticity of the aorta
2. Thickening and rigidity of the AV valves
3. Decrease in the size of the heart chambers
4. Decrease in number of sinoatrial node cells
5. Increased response to beta adrenergic stimulation

Question 142 of 265

What finding is consistent with an abnormal increase in central venous pressure?

1. Jugular vein visible when a client is supine
2. Inability to see the jugular veins when the client is elevated 90°
3. Distended jugular veins when the head of the bed is elevated 45°
4. Palpable pulses in the right jugular vein when the client's Head of the bed is elevated 30°

Question 143 of 265

What type of blood pressure monitoring is most appropriate for a client who is undergoing a carotid endarterectomy?

1. Arterial line pressure monitoring
2. Pulmonary artery wedge pressures
3. Manual blood pressure monitoring
4. Central venous pressure monitoring

Question 144 of 265

What client is at increased risk for development of calculus cholecystitis?

1. Renal failure
2. Hypertension
3. Hypervolemia
4. Impaired gallbladder motility

Question 145 of 265

What finding is consistent with a diagnosis of chronic cholecystitis? Select all that apply.

1. Icterus
2. Jaundice
3. Halitosis
4. Flatulence
5. Negative Murphy’s sign

Question 146 of 265

A client diagnosed with adrenal insufficiency is placed on a low-potassium diet. What selections by the client indicate a need for further teaching? Select all that apply.

1. Apples
2. Raisins
3. Apricots
4. Cabbage
5. Green beans

Question 147 of 265

A client is admitted to the emergency department with an umbilical hernia, abdominal distention, vomiting, and pain. The client’s vital signs are: blood pressure 150/82, pulse 106, temperature 99.8°F. What action by the nurse is priority?

1. Place the client on NPO status.
2. Request an order for hydrocodone.
3. Attempt to push the hernia back in.
4. Administer oral acetaminophen for the fever.

Question 148 of 265

What signs and symptoms are consistent with a diagnosis of Raynaud’s disease? Select all that apply.

1. Pain
2. Weak pulse
3. Brittle nails
4. Cyanosis of the fingers
5. Intermittent claudication

Question 149 of 265

A 34-year-old Asian man with a history of smoking presents to the emergency department with pain in the legs at rest with intermittent claudication. The client’s feet are cold with decreased pulses. What diagnosis does the nurse suspect?

1. Thrombophlebitis
2. Buerger's disease
3. Raynaud's disease
4. Peripheral vascular disease

Question 150 of 265

Nursing care for a client diagnosed with heart failure should focus on what priority interventions?

1. Improving cardiac output
2. Maintaining oxygen levels
3. Decreasing the risk for falls
4. Increasing activity tolerance

Question 151 of 265

A client diagnosed with angina pectoris asks the nurse, “What causes this disorder?” What statement by the nurse is appropriate?

1. "It can be caused by reduced blood flow to the heart."
2. "It is cell death because of prolonged lack of oxygen to your heart."
3. "It occurs when scar tissue replaces muscle in the heart cannot pump correctly."
4. "It is the result of the heart having to pump against extremely high tension in the wall of your left ventricle."

Question 152 of 265

A client that has had a myocardial infarction has an increased pulmonary artery pressure due to impaired ventricular filling. What type of heart failure does the nurse suspect?

1. Left sided heart failure
2. Flash pulmonary edema
3. Right-sided heart failure
4. Pulmonary hypertension

Question 153 of 265

What signs and symptoms are consistent with left sided heart failure? Select all that apply.

1. Cough
2. Nausea
3. Peripheral Edema
4. Shortness of breath
5. Crackles on auscultation

Question 154 of 265

What signs and symptoms are consistent with right sided heart failure? Select all that apply.

1. Cough
2. Nausea
3. Sacral edema
4. Shortness of breath
5. Jugular vein distention

Question 155 of 265

A client undergoing cardiac monitoring has a regular sinus rhythm with a rate of 104 bpm. The nurse correctly documents what cardiac rhythm?

1. Atrial fibrillation
2. Sinus arrhythmia
3. Sinus tachycardia
4. Supraventricular tachycardia

Question 156 of 265

A client with a history of angina presents to the emergency department with sudden onset of chest pain. The nurse recognizes significant Q waves on the client’s electrocardiogram. What condition does the nurse suspect?

1. Angina
2. Ischemia
3. Infection
4. Infarction

Question 157 of 265

What findings are consistent with a diagnosis of a pneumothorax? Select all that apply.

1. Anxiety
2. Bradypnea
3. Subcutaneous emphysema
4. Sharp chest pain worse on inspiration
5. Increased breath sounds on the affected side

Question 158 of 265

The nurse is caring for a client that presented to the emergency department with tachypnea, tachycardia, petechiae and a sudden onset of dyspnea. Despite ventilatory effort the client’s oxygen saturation is 85% on 2 L of oxygen via nasal cannula. The client reports that they have recently had a cast removed for a fractured tibia. What diagnosis does the nurse suspect?

1. Pleurisy
2. Hemothorax
3. Pleural effusion
4. Pulmonary embolism

Question 159 of 265

A client diagnosed with a pulmonary embolus has been started on warfarin therapy. What lab value should be reported to the healthcare provider immediately?

1. Platelet count of 400,000
2. A hemoglobin level of 14 g/dL
3. A white blood cell count of 10,000
4. An international normalized ratio of 1

Question 160 of 265

A client that is diagnosed with COPD has been given teaching regarding the use of pursed lip breathing. What is the purpose of this type of breathing?

1. To expand the lungs
2. To maintain positive pressure
3. To encourage the client to focus on breathing
4. To reduce the amount of carbon dioxide inhaled

Question 161 of 265

What diagnosis is the result of an autosomal recessive disorder that leads to excessive production of mucus with chronic obstructive lung disease in early childhood?

1. Asthma
2. Bronchiectasis
3. Cystic Fibrosis
4. Chronic obstructive pulmonary disease COPD

Question 162 of 265

A client is admitted to the hospital with chronic obstructive pulmonary disease and is receiving oxygen via nasal cannula at 2 L per minute. The client’s oxygen saturation is 89%. The daughter of the client asks why her father is not given more oxygen. What statement by the nurse is most appropriate?

1. "What does your father normally have his oxygen set at?"
2. "I'll ask the doctor if they want to provide any other treatment."
3. "People with COPD breathe better with lower levels of oxygen."
4. "Let me turn it up a little bit and see if we can get him over 90%."

Question 163 of 265

What complication of parenteral nutrition administration are clients with pancreatitis at increased risk for?

1. Embolism
2. Pneumothorax
3. Fluid overload
4. Hyperglycemia

Question 164 of 265

The nurse is caring for a toddler that presented to the emergency department with a femur fracture. The child has multiple fractures at various stages of healing on an x-ray. What action by the nurse is priority?

1. Inform the healthcare provider
2. Ask the toddler about the fractures
3. Report suspected abuse to the national hotline
4. Provide education to the parents about safety interventions

Question 165 of 265

What medication should a nurse anticipate administering to a client who is being weaned off of opiates after long-term use?

1. Ibuprofen
2. Methadone
3. Hydrocodone
4. Acetaminophen

Question 166 of 265

What physiologic findings are consistent with stress? Select all that apply.

1. Flatulence
2. Bradycardia
3. Dilated pupils
4. Decreased blood glucose
5. Increased urinary frequency

Question 167 of 265

The client is being evaluated for increased stress. What action by the nurse is priority?

1. Determine future stress
2. Discuss possible medications
3. Encourage spiritual meditation
4. Assess the client's coping mechanisms

Question 168 of 265

A client’s home was destroyed by massive flooding. The nurse reports the client is experiencing debilitating anxiety and frequent panic attacks. Which type of crisis is the client experiencing?

1. Dispositional crisis
2. Traumatic stress crisis
3. Psychiatric emergency crisis
4. Maturational/developmental crisis

Question 169 of 265

The nurse is caring for a client that is admitted to the hospital after a recent diagnosis of pancreatic cancer. The nurse places her hand on the client’s shoulder and the client pulls away. What action by the nurse is most appropriate?

1. Request clergy to visit the client
2. Step back and allow the client space
3. Sit down next to the client in silence
4. Ask the client why they are uncomfortable being touched

Question 170 of 265

What findings are consistent with Asian culture? Select all that apply.

1. Avoiding hot liquids
2. Coining and cupping
3. Use of herbal remedies
4. Avoiding dairy products
5. Wrapping someone with a high fever in blankets

Question 171 of 265

What intervention by the nurse is appropriate when caring for a Buddhist client that is near death?

1. Do not enter the room
2. Provide a private room
3. Encourage the family to provide all care
4. Evaluate the pulse and blood pressure every four hours

Question 172 of 265

What are clinical manifestations of impending death? Select all that apply.

1. Tachycardia
2. Hypotension
3. Bowel incontinence
4. Increase smell and taste
5. Mottling of the extremities

Question 173 of 265

What type of family consists of a mother and children living in a home?

1. Extended family
2. A nuclear family
3. Bi-Nuclear family
4 Single-parent family

Question 174 of 265

The wife of an older adult male client is upset and crying after being given information that her spouse is terminal. She’s been reflecting on their life and sobbing through the day. What type of grief is she experiencing?

1. Unresolved grief
2. Anticipatory grief
3. Complicated grief
4. Disenfranchised grief

Question 175 of 265

A client is refusing their morning dose of quetiapine (Seroquel) due to weight gain. Which statement by the nurse is most appropriate?

1. “Why are you refusing the medication?”
2. “Weight gain is not listed as a side effect.”
3. “I will document you refused the medication.”
4. “Let’s talk about proper nutrition and exercise.”

Question 176 of 265

Which action by the nurse suggests a violation of client boundaries? Select all that apply.

1. The nurse informs a client of unit rules
2. The nurse agrees to keep a client's secret
3. The nurse refuses to purchase snacks for a client
4. The nurse discusses her marital issues with a client
5. The nurse requests to provide care for a specific client

Question 177 of 265

What food tray should be returned if brought to a Muslim client?

1. A vegetarian lasagna
2. Pork chop with corn and rice
3. hamburger with French-fries
4. Steak with potatoes and green beans

Question 178 of 265

A client tells the nurse that they are fearful of telling their spouse about a previous abortion. What statement by the nurse demonstrates the therapeutic communication technique of reflecting?

1. "Why are you fearful about telling your spouse?"
2. "I'm sorry that you feel this way if you need to talk I'm here."
3. "A lot of people have abortions, you should not be embarrassed."
4. "So, you're telling me that you're afraid to tell him about your abortion?"

Question 179 of 265

A client is admitted to the hospital with a diagnosis of heart failure. The client informs the nurse that she has recently lost her husband and begins to share her grief with the nurse. What actions by the nurse demonstrate she is visibly tuning in to the client? Select all that apply.

1. Facing the client.
2. Maintaining eye contact
3. Leaning towards the client
4. Maintaining hands on their hips
5. Standing up in front of the client

Question 180 of 265

While reviewing stress and coping, the nursing student correctly identifies which of the following as components of the general adaptation syndrome?

1. Crisis Stage
2. Alarm Reaction
3. Resistance Stage
4. Exhaustion Stage
5. Fight-or-flight stage

Question 181 of 265

A client asks the nurse what a living will is. What statement by the nurse is accurate?

1. “It specifies who will control and inherit your estate.”
2. “It identifies the person responsible for making your healthcare decisions.”
3. “It is a set of orders by a healthcare provider that list what you do and do not want done.”
4. “It is a list of healthcare provisions you do and do not want completed if unable to make decisions.”

Question 182 of 265

While caring for a client that has undergone a mastectomy, the nurse identifies the client is experiencing what type of loss?

1. Actual
2. Perceived
3. Anticipatory
4. Maturational

Question 183 of 265

What interactions occur during the termination phase of the nurse-client helping relationship? Select all that apply

1. Identify the client’s goals
2. Turning over responsibility for the clients care
3. Reviewing medical and nursing documentation
4. Reminisce about the relationship with the client
5. Encouraging the client to discuss feelings about their health

Question 184 of 265

The claim is being admitted to the hospital for surgery. The client has nail polish on all of their fingers. What intervention is most appropriate to obtain an accurate oxygen saturation?

1. Obtain a set of ABGs
2. Request and earlobe sensor for the client
3. Use the clients toe for the pulse oximetry
4. Remove nail polish from one finger for pulse oximetry

Question 185 of 265

What is the most appropriate method to evaluate oxygen for a client with carbon monoxide poisoning?

1. Pulse oximeter
2. Color of the skin
3. Arterial blood gas
4. Peripheral blood sample

Question 186 of 265

An unlicensed assistive personnel is attempting to get a pulse oximetry reading on an older adult client. They are unable to get a reading on the fingers or toes. What intervention should the registered nurse perform?

1. Use an earlobe sensor
2. Check an arterial blood gas
3. Perform massage on the hands
4. Encourage the older adult to move their hands more

Question 187 of 265

A client is being evaluated for orthostatic hypotension. After assessing the client’s blood pressure in the supine position what action should the nurse take?

1. Assist the client to a sitting position
2. Compare the finding to previous readings
3. Instruct the client to lay supine for 10 minutes
4. Subtract the diastolic from the systolic blood pressure

Question 188 of 265

The nurse is caring for a client with orthostatic hypotension. The client’s blood pressure while supine is 120/80. After assisting the client to a sitting position the blood pressure is 112/74. What action by the nurse is priority?

1. Document the findings
2. Notify the healthcare provider
3. Place the client on fall precautions.
4. Instruct the client not to change positions quickly

Question 189 of 265

What finding related to vital signs is consistent with aging?

1. Increase in pulse
2. Lower body temperature
3. Increase depth of respirations
4. Decreased diastolic blood pressure

Question 190 of 265

A client diagnosed with influenza has a wide range of temperature fluctuations over 24 hours. All temperature readings are over 99.5°F. What type of fever is the client experiencing?

1. Constant fever
2. Remittent fever
3. Relapsing fever
4. Intermittent fever

Question 191 of 265

The nurse is caring for a client who is having periods of fever followed by intervals of normal temperature. At times the client’s temperature is below normal. What type of fever is the client experiencing?

1. Constant fever
2. Remittent fever
3. Relapsing fever
4. Intermittent fever

Question 192 of 265

The nurse is caring for a client who has had short periods of fever with periods of normal temperature in between. What type of fever is this client experiencing?

1. Constant fever
2. Remittent fever
3. Relapsing fever
4. Intermittent fever

Question 193 of 265

An unlicensed assistive personnel UAP reports vital signs on a postoperative client. The vital signs are blood pressure 108/100, pulse 100 and temperature 98.6° F. What action by the nurse is priority?

1. Document the findings
2. Notify the healthcare provider
3. Reassess the client’s blood pressure
4. Ask the UAP to obtain an apical pulse

Question 194 of 265

What factors cause increases in body temperature? Select all that apply

1. Stress
2. Aging
3. Exercise
4. Hormones
5. Oral Hypoglycemic medications

Question 195 of 265

What findings are consistent with a client diagnosed with hypothermia? Select all that apply.

1. Shivering
2. Tachypnea
3. Tachycardia
4. Hypotension
5. Increased urinary output

Question 196 of 265

What intervention is appropriate for a client who presents with mild hypothermia?

1. Sedation
2. Warm IV fluid
3. A hyperthermia blanket
4. Applying warm blankets

Question 197 of 265

A newborn baby is being assessed. What vital sign should be reported to the healthcare provider immediately?

1. Pulse of 70
2. Respiratory rate of 40
3. Temperature of 99.1°F
4. Blood pressure of 90/60

Question 198 of 265

The nurse is assessing an apical – radial pulse. The apical pulse is 101 and the radial pulse is 85. What action by the nurse is priority?

1. Document the findings
2. Notify the healthcare provider
3. Request the client remain sitting above 45°
4. Assess the difference in the femoral and popliteal pulses

Question 199 of 265

The client is admitted to the emergency department with paleness dizziness and vomiting. The client was at a family function and had a syncopal episode. The client’s pulse is 104 and their temperature is 102°F. The family reports the client had not been drinking very much and had been out in the heat all day. What condition does the nurse suspect?

1. Heat stroke
2. Fever spike
3. Heat exhaustion
4. Intermittent fever

Question 200 of 265

A client has a temperature of 102.9°F. What interventions by the nurse are appropriate? Select all that apply.

1. Provide cold baths
2. Administer antipyretics
3. Reduce physical activity
4. Remove excess blankets
5. Decreased fluid intake to 1500 to 2000 ML's

Question 201 of 265

A client diagnosed with an abdominal ascites is scheduled for an abdominal paracentesis. What actions by the primary care provider are done to avoid hypovolemic shock? Select all that apply.

1. Obtaining a culture
2. Withdrawing the trocar
3. Draining the fluid slowly
4. Withdrawing less than 1500 ML's
5. Using a sterile bandage after procedure

Question 202 of 265

What positions are indicated for a client that is scheduled for thoracentesis? Select all that apply.

1. Prone with arms at the side
2. Low Fowlers with knees bent
3. Supine with arms over the head
4. Sitting up leaning forward over a pillow
5. Sitting leaned to the side with arm up to the front

Question 203 of 265

The nurse is preparing a client for a bone marrow biopsy. What bone is most frequently used for this procedure?

1. Tibia
2. Skull
3. Humorous
4. Posterior superior iliac crest

Question 204 of 265

How much bone marrow needs to be aspirated in order to assess it for malignancy?

1. 1 mL
2. 5 mL
3. 10 mL
4. 20 mL

Question 205 of 265

A child is scheduled for a lumbar puncture. What actions are appropriate?

1. Have the child's parents hold the child
2. Demonstrate the procedure on a stuffed animal
3. Avoid telling the child until the time of the procedure
4. Stay very quiet and avoid conversation during the procedure

Question 206 of 265

The client is scheduled for a lumbar puncture. What position should the nurse place the client when preparing for the procedure?

1. Prone with head to the left side
2. Laterally with head bent and knees flexed
3. On their side with legs straight end and arms in front of them
4. Sitting with arms crossed over the head leaning on a tray table

Question 207 of 265

A client suspected of having diverticulitis should be prepared for what diagnostic test?

1. Barium enema
2. Abdominal x-ray
3. Upper endoscopy
4. Abdominal ultrasound

Question 208 of 265

What diagnostic tests are used when evaluating a client for gastroesophageal reflux disease (GERD)? Select all that apply.

1. Endoscopy
2. Colonoscopy
3. Barium enema
4. Abdominal x-ray
5. Esophageal pH monitoring

Question 209 of 265

The client has a urinary output of 520 mL’s in 24 hours. What action by the nurse is priority?

1. Strain all urine
2. Evaluate the renal function
3. Compare the intake and output
4. Check the urine for Ketone bodies

Question 210 of 265

A client with diabetes has an elevated blood sugar and positive ketone bodies in their urine. What diagnosis does the nurse expect?

1. Infection
2. Hypoglycemia
3. Diabetic Ketoacidosis (DKA)
4. Hyperosmolar Hyperglycemic Nonketotic State (HHNS)

Question 211 of 265

What test is used in the diagnosis of cystic fibrosis?

1. Chest x-ray
2. Ploidy analysis
3. Chloride sweat test
4. Pulmonary function test

Question 212 of 265

A client with an elevated blood urea nitrogen BUN should be evaluated for what type of diet?

1. Low-fat
2. High calorie
3. High protein
4. Low carbohydrate

Question 213 of 265

What lab tests evaluate kidney function? Select all that apply.

1. Amylase
2. Aspartate
3. Creatinine
4. Blood urea nitrogen (BUN)
5. Alkaline aminotransferase (ALT)

Question 214 of 265

A woman presents to the prenatal clinic for a pregnancy test. The nurse asks the woman to collect a urine sample for testing. What hormone is detected by a urine pregnancy test?

1. Estrogen
2. Progesterone
3. Thyroid stimulating hormone
4. Human chorionic gonadotropin

Question 215 of 265

Which newborn is most at risk for hypoglycemia?

1. A 38 +5 gestational age newborn weighing 3980 grams
2. A 37+ 4 gestational age newborn weighing 2510 grams
3. A 36+ 4 gestational age newborn weighing 2200 grams
4. A 36 +5 gestational age newborn weighing 3000 grams

Question 216 of 265

A nurse is caring for a client post procedure electroconvulsive therapy (ECT). Which is the most important intervention by the nurse?

1. Administer oxygen
2. Reorientation of client
3. Assess return gag reflex
4. Offer acetaminophen (Tylenol)

Question 217 of 265

An infant born at 35 weeks gestation has an abundant, thick, white, cheesy substance on the skin. The nurse should document what finding?

1. Nevi
2. Vernix
3. Lanugo
4. Mongolian spots

Question 218 of 265

When creating a care plan for a client diagnosed with diabetic neuropathy, what expected outcome is the most important?

1. Client will remain free from injury
2. Client will discuss prescribed medications
3. Client will demonstrate glucose self-monitoring techniques
4. Client will list potential complications of peripheral neuropathy

Question 219 of 265

As part of an injury prevention assessment, an older adult client should be evaluated for what cognitive changes related to aging? Select all that apply.

1. Decreased visual acuity
2. Increased reaction time
3. Increased glare sensitivity
4. Decreased short-term memory
5. Decreased hearing of high frequency sounds

Question 220 of 265

A hospitalized client at risk for falls is being evaluated by the nurse. The client is unable to stand from a sitting position without using their arms for support and has noticeable unsteadiness when ambulating. What action by the nurse is priority?

1. Notify the healthcare provider
2. Initiate a physical therapy referral
3. Place the client on fall precautions
4. Discuss the use of assistive equipment

Question 221 of 265

The nurse is performing an admission assessment on a slightly confused older adult female client who is diagnosed with urosepsis. The client’s daughter informs the nurse that her mother got very confused, agitated and combative with staff during her last hospital admission. What actions by the nurse are appropriate? Select all that apply.

1. Discuss this concern with the client.
2. Reorient the client to the call bell every hour.
3. Keep the client in a room close to the nursing station.
4. Ask the daughter if a family member would like to stay with her.
5. Request an order for soft wrist restraints from the healthcare provider.

Question 222 of 265

Which client has the highest risk for falls?

1. An older adult client that has a colostomy bag that they empty themselves.
2. An older adult client with an indwelling urinary catheter receiving IV morphine for pain.
3. An older adult client that has an intravenous catheter receiving IV Lasix for heart failure.
4. An older adult client diagnosed with renal failure that receives hemodialysis every three days.

Question 223 of 265

A client at risk for falls is sitting in a chair. What item should the nurse utilize to prevent the client from falling out of the chair?

1. A bedside table
2. A vest restraint
3. A wedge cushion
4. Pillows and blankets

Question 224 of 265

During the initial home screening for an older adult client, the home health nurse provides teaching about injury prevention. What action by the client indicates the teaching was effective?

1. Moving electrical wires out of site
2. Placing throw rugs in high traffic areas
3. Using matches to light a propane heater
4. Asking people to smoke in different room

Question 225 of 265

After a client receives teaching about home fire prevention, what statement by the client indicates a need for further teaching?

1. “I won’t leave candles burning when I’m not home.”
2. “If a fire started in the oven, I would leave the door shut.”
3. “I make sure my gas is off on my grill and the hose is tight.”
4. “We change our batteries in the smoke detectors once a year.”

Question 226 of 265

A nurse is caring for a suicidal client. Which nursing action identifies the assessment phase of the nursing process?

1. Prioritizes the need for inpatient treatment
2. Identifies the nursing priority as risk for harm
3. Notes a family reports recent suicide attempt by client
4. Obtains a verbal agreement from the client to contract for safety

Question 227 of 265

The nurse is responding to an emergency that requires Level A protection. What personal protective equipment should be worn to shield the health care worker?

1. A typical work uniform.
2. Air-purified respirator, chemical coverall, chemical resistant gloves and boots.
3. Self-contained breathing apparatus and chemical resistant suit that is not vapor tight, gloves and boots.
4. Self-contained breathing apparatus and fully encapsulated, vapor-tight chemical resistant suit, gloves and boots.

Question 228 of 265

When moving a client up in bed that can assist the nurse with moving, what instructions should be provided to the client?

1. Keep neck straight
2. Place arms at sides
3. Push off with heels as nurse pulls up
4. Elevate the lower back and buttocks

Question 229 of 265

The nurse is assisting an unlicensed assistive personnel (UAP) to lie a client in bed. What action by the UAP indicates a need for further teaching?

1. Raising the bed to waist level
2. Lowering the head of bed flat
3. Placing clients arms at their side
4. Keeping legs 12 inches apart when lifting

Question 230 of 265

The nurse is administering total parenteral nutrition (TPN) to a client. What statement by the nurse indicates a need for further teaching?

1. “I will not need to use vented tubing.”
2. “I will change the filter every 72 hours.”
3. “TPN should be given through a central line.”
4. “The filter should be primed before hanging the TPN.”

Question 231 of 265

The nurse is preparing to hang acetaminophen IV, which comes in a glass bottle. What equipment is necessary to administer this medication?

1. An IV pump
2. An in line filter
3. Vented tubing
4. IV tubing that is 15 drops per mL

Question 232 of 265

When caring for a client with a triple lumen central venous catheter, which lumen is recommended for drawing blood?

1. Distal
2. Middle
3. Proximal
4. No lumen should be used for blood draws

Question 233 of 265

The nurse has administered an incorrect dose of a medication. What action by the nurse indicates a need for further teaching?

1. Listing any witnesses to the medication error
2. Placing the incident report in the client's record
3. Including the date and time of the medication error
4. Identifying the client by name and identification number

Question 234 of 265

A new nurse is preparing a sterile field to perform a sterile wet-to-dry dressing change on a client who is 2 days postoperative. What action indicates a need for further teaching?

1. Touching the outer 1 inch of the field
2. Pouring fluid into a sterile container on the field
3. Keeping the objects on the field above the waist
4. Opening the outer flap of the package towards the body

Question 235 of 265

The nurse is preparing to pack a wound using a sterile wet-to-dry dressing. What action demonstrates correct procedure has been followed?

1. The nurse opens the field towards her body
2. The nurse pours fluid onto sterile 2x2 dressing
3. The nurse places sterile gloves on before setting up field
4. The nurse only touches 1 inch around the perimeter of the field

Question 236 of 265

When emptying a suction canister, what type of precautions should be used?

1. Droplet
2. Contact
3. Standard
4. Airborne

Question 237 of 265

When disposing of a needle and syringe used to collect a blood specimen, where should they be discarded?

1. Garbage
2. Sharps container
3. Biohazard waste
4. Dirty utility room

Question 238 of 265

The nurse receives a report from the laboratory that a client is positive for Clostridium difficile. What type of precaution should the client be placed?

1. Contact
2. Droplet
3. Airborne
4. Standard

Question 239 of 265

Place the following personal protective equipment in the order that they should be removed after caring for a client.

1. Mask
2. Gown
3. Gloves
4. Goggles

Question 240 of 265

A college student is being admitted to the emergency department with suspicion of neisseria meningitis. What action by the nurse is priority?

1. Initiate droplet precautions
2. Notify the local health department
3. Perform a neurological assessment
4. Determine who else has been exposed

Question 241 of 265

The nurse is caring for an older adult client who had surgery to repair a femur fracture. The client is confused and combative and attempting to climb out of bed. The client received prescribed lorazepam and had an unlicensed assistive personnel with her. There has been no improvement in the client’s behavior. What action should the nurse take next?

1. Sit with the client
2. Request an order for restraints
3. Place the client in a stretcher in the hallway
4. Contact the family to come and sit with the client

Question 242 of 265

Which client would be appropriate for placement of restraints?

1. A client who removed their urinary catheter.
2. A client that is being monitored for suicidal ideations.
3. A client that is intubated attempting to pull out the endotracheal tube.
4. A client that has Alzheimer’s disease that wanders around the nursing unit.

Question 243 of 265

The nurse is caring for the following four clients. Which situation demonstrates a need for further teaching?

1. Transporting a client for surgery with two full side-rails.
2. Holding a client’s arm down while putting in an intravenous catheter.
3. Placing a tray in front of an older adult client that was climbing out of chair.
4. Applying soft wrist restraints to a client trying to pull out an endotracheal tube.

Question 244 of 265

An older adult client with hepatic encephalopathy exhibits confusion and despite reorientation, continues to try to get out of bed without assistance. What action by the nurse is priority?

1. Request an order for soft wrist restraints.
2. Sit with the client during periods of confusion.
3. Place the bed alarm on and reorient the client.
4. Put familiar music on and request the family bring pictures.

Question 245 of 265

An intoxicated client is brought to the emergency department by police after an altercation. The client has multiple wounds and is combative with officers and staff. An order was obtained to place the client in restraints. What action by the nurse is priority?

1. Avoid eye contact or speaking to the client.
2. Assess the skin integrity around the restraints.
3. Request a family member come and sit with the client.
4. Caution the client that continued behavior may result in ankle restraints.

Question 246 of 265

What intervention is not considered a restraint?

1. Holding a client down during a panic attack.
2. Padding the side rails of a client with epilepsy.
3. Securing a client into a wheelchair with a vest restraint.
4. Placing a tray table in front of a confused client not eating.

Question 247 of 265

The nurse receives a call from a client that believes she is in labor. The client reports contractions for the past two hours that have progressed to every four minutes. The client has not had her membranes rupture. What action should the nurse instruct the client to take?

1. Administer a cleansing enema.
2. Come in to the labor and delivery unit.
3. Go to the hospital when her membranes rupture.
4. Call back when the contractions are less than 2 minutes apart.

Question 248 of 265

What interventions are priority to include in the care of a 4-year-old child diagnosed with leukemia?

1. Provide time for the child to play
2. Explain what is going to be done to the child
3. Have parents hold the child during interventions
4. Perform any interventions in the child’s hospital room

Question 249 of 265

The nurse caring for a client who is postoperative cesarean section has a history of gastric bypass surgery. Which medication order should questioned?

1. Docusate
2. Ibuprofen
3. Ferrous Sulfate
4. Acetaminophen

Question 250 of 265

A client is being seen in the emergency department for sutures after removal of a piece of wood. What immunization is priority for the nurse update?

1. Tetanus
2. Pertussis
3. Hepatitis B
4. Meningococcal

Question 251 of 265

A 45-year-old male client asks the nurse what type of screening they should have yearly. What statement by the nurse is accurate?

1. Colonoscopy
2. Prostate examination
3. Visual glaucoma screening
4. Testicular self-examination

Question 252 of 265

What is the most appropriate action when auscultating lung sounds in an adult client?

1. Ask the client to breathe in and out through the nose
2. Hold the bell of the stethoscope lightly against the chest
3. Hold the diaphragm of the stethoscope firmly against the chest
4. Ask the client to take rapid, deep breaths with their mouth open wide

Question 253 of 265

When providing teaching to an older adult client about a new prescribed medication, what action by the nurse is most appropriate to ensure adherence?

1. Provide the directions in writing.
2. Ask the client questions about the teaching.
3. Determine the client’s past medication adherence.
4. Request a home health nurse to administer medications.

Question 254 of 265

A newborn was delivered four hours ago to an HIV-positive mother. Which intervention is most important for the nurse to do at this time?

1. Administer the Zidovudine
2. Educate mother on newborn care
3. Encourage bonding with the newborn
4. Assist the mom with formula feeding the newborn

Question 255 of 265

A nurse is performing a postpartum assessment. The nurse notices that the patient continues to have trickling despite the uterus being firm. What would the nurse suspect at this time?

1. The patient has to void
2. The patient has a hematoma
3. The patient has retained placental fragments
4. The patient has a laceration that was not repaired

Question 256 of 265

The nurse is providing teaching to the parents of a newborn baby. The parents expressed concern about the irregular shape of the baby’s head. What statement by the nurse is appropriate?

1. “The head regains normal shape in about a week.”
2. “Once your child has hair, you won’t notice the shape of the head.”
3. “The pediatrician will check to see if anything needs to be done at your first visit.”
4. “Once the posterior fontanel closes, in 9 months, the head will have a different shape.”

Question 257 of 265

A nurse working in occupational health should place priority on which role?

1. Injury prevention
2. Health education
3. Exercise promotion
4. Equipment inspection

Question 258 of 265

What method of teaching safe sex is most appropriate when providing education for a group of teenagers?

1. Demonstrating condom application.
2. Giving out pamphlets about safe sex.
3. Including their parents in the teaching.
4. Promoting abstinence amongst the group.

Question 259 of 265

The nurse is performing an abdominal assessment on a client suspected of having appendicitis. What position should the client be placed?

1. Prone
2. Supine
3. Low Fowler’s
4. Trendelenburg

Question 260 of 265

When performing a physical assessment and auscultating lung sounds it is noted that inspiratory and expiratory wheezing is present. What is the most appropriate action to take next?

1. Call a code and begin CPR
2. Assess the client’s oximetry
3. Administer IV corticosteroids as ordered
4. Administer high flow nebulizer treatment

Question 261 of 265

The nurse is performing a Weber test on a client that is suspected of having a sensorineural disturbance. Where should the nurse place the tuning fork?

1. Behind the ear
2. In front of the tragus
3. On the top of the head
4. In the center of the forehead

Question 262 of 265

What finding would indicate conductive hearing loss?

1. Vibration heard longer in front of the ear than behind the ear.
2. Vibration heard longer behind the ear than in front of the ear.
3. Sound heard equally in both ears when tuning fork placed on top of the head.
4. Sound heard more in one ear than another when tuning fork placed on top of the head.

Question 263 of 265

The nurse is assessing a client’s heart sounds. The nurse notices a “whooshing” sound at the second intercostal space at the sternal border on the client’s right side. What does the nurse suspect?

1. A snap
2. A friction rub
3. Mitral valve prolapse
4. An aortic valve murmur

Question 264 of 265

While auscultating a client’s heart sounds the nurse notices a grating sound. That is the most appropriate documentation for this finding?

1. A gallop
2. A split S2
3. A murmur
4. A friction rub

Question 265 of 265

What heart valve is best heard at the 4th to 5th intercostal space at the midclavicular line on the left side of the chest?

1. Mitral valve
2. Aortic valve
3. Pulmonic valve
4. Tricuspid valve

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