lead Flashcards
A school nurse is developing a teaching plan about testicular cancer for a group of adolescents. Whatwe info should the nurse include in the teaching?
A) Perform a testicular self-examination weekly.
B) Do not palpate the epididymis when performing a testicular self-examination.
C) Expect testicles to be uniform in consistency when performing a testicular self-examination.
D) Perform a testicular self-examination after a cool shower
C) Expect testicles to be uniform in consistency when performing a testicular self-examination.
A home health nurse is providing teaching to a family of a client who has seizure manifestations as a result of an inoperable brain tumor. What interventions should the nurse include in the teaching?
pad the side rails of the bed
A charge nurse is planning care for a group of patients on a med surg unit, what tasks should the nurse delegate to an assistive personnel?
A) Giving a glycerin suppository to a client for constipation
B) Evaluating the effectiveness of ibuprofen administered to a client who reported a headache
C) Discussing dietary changes with a client who has a prescription for a gluten-free diet
D) Measuring hourly urinary output for a client who is postoperative
D) Measuring hourly urinary output for a client who is postoperative
A newly licensed nurse tells a charge nurse he is unsure about accepting telephone med prescriptions. Which of the following providers should the charge nurse identify as having the legal ability to give telephone medication prescriptions?
A) Anesthesiologists
B) Physician assistants
C) Hospital pharmacists
D) Mental health technicians
E) Nurse practitioners
A) Anesthesiologists
B) Physician assistants
E) Nurse practitioners
A nurse working in a mobile health clinic is assessing a migrant farm worker, what finding should the nurse identify as a priority?
A) Report of back pain associated with twisting at the waist
B) Absence of a dental health provider
C) Lives in a home with 25 other migrant workers
D) Report of muscle twitching and skin rash
D) Report of muscle twitching and skin rash
A nurse enters the patient’s room and finds the client pulseless, the living will requests no resuscitation be performed, but the provider has not written the prescription. What actions should the nurse take?
A) Administer emergency medications without performing CPR.
B) Begin CPR.
C) Call the provider for a do-not-resuscitate (DNR) order.
D) Respect the client’s wishes, and do not attempt CPR
B) Begin CPR.
A nurse is planning care for a patient who follows the Mormon belief system. What modifications should the nurse include to meet Mormon dietary practices?
offer noncaffeinated beverage options
A nurse manager of a rural clinic is orienting a new employee on characteristics of residents in the area. What facts about rural health should the nurse manager include?
A) Lower maternal morbidity rates
B) Reduced incidence of death from motor-vehicle crashes
C) Increased rates of chronic illness
D) More frequent dental preventative care visits
C) Increased rates of chronic illness
During an initial visit, a home health nurse is assessing a patient who has different cultural beliefs than her own. What questions should the nurse ask to determine the patient’s beliefs about environmental control?
A) “Do you spend more time thinking about the past, present, or future?”
B) “Who makes most of the decisions in your family group?”
C) “What do you think you can do to affect your health status?”
D) “Can you list any diseases that your parents or siblings have had?”
C) “What do you think you can do to affect your health status?”
A nurse manager is discussing EMR with a new nurse. What should the nurse do to maintain client confidentiality? (SATA)
log off computer terminal before leaving
change computer access passwords on a regular basis
avoid accessing information about patients admitted to other units
shred computer-generated client worksheets after use
A nurse manager on the acute care unit is preparing a staff presentation about promoting cost-effective care. What strategies should the nurse plan to include in the presentation?
A) Change IV solution bags every 36 hr.
B) Avoid the delegation of hygiene care to assistive personnel (AP).
C) Wear sterile gloves when removing urinary retention catheters.
D)Educate staff about the correct use of personal protective equipment (PPE) for isolation precautions.
D)Educate staff about the correct use of personal protective equipment (PPE) for isolation precautions.
A home health nurse is teaching about CPT treatments with a patient who has COPD. What client statements should the nurse identify as an indication that the teaching has been understood?
A) “My coughing will decrease during CPT treatments.”
B) “CPT treatments will decrease my respiratory infections.”
C) “I will perform postural drainage after eating meals.”
D) “CPT treatments will help cure my COPD.”
B) “CPT treatments will decrease my respiratory infections.”
A case manager completes a history and physical assessment for a patient who has COPD. What actions should the case manager take next?
A) Identify the client’s current health needs.
B) Call the provider with a list of client concerns.
C) Compile a list of community resources for the client.
D) Refer the client to a COPD support group
A) Identify the client’s current health needs.
A nurse is discussing organ donation with a newly license nurse. What should the nurse include in the teaching?
a donor needs to use his signature to agree to the gift of donation upon admission to the hospital
it is required that all clients over 18 be questioned about organ donation documentation about giving permission or refusing to donate is placed in the EMR
A nurse manager is implementing a quality improvement project to to reduce the number of MRSA infections. What action should the nurse manager take first?
A) Develop a MRSA protocol for implementation.
B) Provide educational in-service for staff.
C) Evaluate outcomes resulting from interventions.
D) Conduct a chart review to evaluate precipitating factors of clients who develop MRSA
D) Conduct a chart review to evaluate precipitating factors of clients who develop MRSA
A forensic nurse is using the epidemiological triangle to explain factors that predispose an individual to violent behavior.
Which of the following factors should the nurse identify as an environmental factor in the epidemiological triangle?
A) Crowded living conditions
B) Traumatic brain injury
C) Alzheimer’s disease
D) Impaired coping abilities
A) Crowded living conditions
A nurse manager is teaching a class about proper body mechanics during a facility’s annual competency event. Which of the following statements by one staff member in attendance indicates the use of proper body mechanics?
I should bend my knees when lifting objects off the floor
A nurse is preparing to administer the initial dose of ceftriaxone to a patient who has endometritis. What statements by the patient should cause the nurse to hold the medication and consult the provider?
A) “I have a severe allergy to amoxicillin.”
B) “I get sick when I take diuretics.”
C) “I have a history of hearing problems.”
D) “I take prednisone for my asthma.”
A) “I have a severe allergy to amoxicillin.”
A nurse is planning discharge teaching for a patient who has multiple sclerosis. What action should the nurse plan to include?
teach the pt to avoid extremes in hot and cold temps
A nurse is caring for a patient who has an ethical conflict about the care she is receiving. What resources should the nurse consult about resolving the dilemma?
A) Hospital ethics committee
B) Quality improvement committee
C) Chaplain
D) Director of nursing
A) Hospital ethics committee
A parent of a child who is terminally ill tells a nurse that she wants to take her child home. What response should the nurse make?
tell me more about your desires
After signing an informed consent form, a client states, “I have changed my mind and do not want to have the procedure.” Which of the following actions should the nurse take?
A) Suggest that family members discuss the importance of the surgery with the client.
B) Notify the surgeon that the client wishes to withdraw informed consent for the procedure.
C) Document the risks of refusing the procedure in the client’s medical record.
D) Discuss the benefits of the procedure with the client
B) Notify the surgeon that the client wishes to withdraw informed consent for the procedure.
A nurse is receiving a change of shift report on a group of clients. Which of the following patients should the nurse assess first?
A) A client who has urolithiasis and reports severe ankle pain extending toward the abdomen
B) A client who has acute cholecystitis and reports abdominal pain radiating to the right shoulder
C) A client who has had a total knee arthroplasty, is 1 day postoperative, and reports a pain level of 8 on a 0 to 10 pain scale
D) A client who has a fractured femur and reports sudden sharp chest pain
D) A client who has a fractured femur and reports sudden sharp chest pain
A county public health nurse is developing a list of interventions to address the 3 core functions of public health. What interventions should the nurse include as a part of the assurance function?
A) Use surveillance to investigate outbreaks of food borne illness.
B) Monitor the incidence rates of varicella every 2 months.
C) Organize an immunization clinic for at-risk members of the community.
D) Educate the community about the health risks of alcohol use.
C) Organize an immunization clinic for at-risk members of the community.
A nurse in a clinic is caring for a patient who has a UTI. What prescription should the nurse verify with a provider?
A) Trimethoprim-sulfamethoxazole
B) Hyoscyamine
C) Oxybutynin
D) Phenazopyridin
C) Oxybutynin
A community nurse is instructing a group of high school students about the transmission of hepatitis A. What following modes of transmission should the nurse include in the teaching?
fecal oral
A nurse on a rehab unit is creating a plan of care for a newly admitted patient who has difficulty swallowing following a stroke. What interprofessional team members should the nurse anticipate consulting about the patient’s condition? (SATA)
A) Speech-language pathologist
B) Occupational therapist
C) Dietitian
D) Psychologist
E) Pharmacy technician
A) Speech-language pathologist
B) Occupational therapist
C) Dietitian
A nurse is caring for a patient and realizes she administered the wrong medication. What actions should the nurse take first?
A) Notify the provider.
B) Check the condition of the client.
C) Document the occurrence in the electronic medical record.
D) Complete an incident report
B) Check the condition of the client.
A nurse is caring for a newborn in the nursery following a circumcision. The newborn’s grandparent, who does not have an identification bracelet, requests to take the newborn to his mother’s room. What actions should the nurse take?
A) Check the newborn’s identication bracelet with the chart.
B) Obtain permission from the newborn’s mother.
C) Respectfully deny the grandparent’s request.
D) Review the newborn’s footprint record
C) Respectfully deny the grandparent’s request.
A community health nurse is reviewing primary prevention for West Nile virus with a group of patients in a rural health clinic. What instructions should the nurse include?
A) Avoid exposure to deer ticks.
B) Eliminate areas of standing water.
C) Use a respiratory mask when cleaning bird coops.
D) Plan outdoor activities after dusk
B) Eliminate areas of standing water.
A charge nurse on a med-surg unit is preparing to delegate tasks to a licensed practical nurse (LPN). What tasks should the charge nurse delegate to the LPN?
A) Administering an oral antibiotic to a client
B) Performing an admission assessment of a client
C) Creating new teaching for a guardian of a toddler
D) Administering IV conscious sedation to a client
A) Administering an oral antibiotic to a client
A nurse is caring for a patient who has been in a motor vehicle crash and has a minor TBI. What findings should the nurse recognize as a complication and report to the provider? (SATA)
bradycardia
vomiting
drainage from the ear
unequal pupils
A home health nurse is providing teaching to a patient who has a new diagnosis of a gastric ulcer and a new prescription for sucralfate oral suspension. What statements by the patient should the nurse identify as an understanding of the teaching?
I will take this medicine 1 hour before meals and at bedtime
A nurse is planning a staff education program to review nursing interventions for patients who have kidney failure. What sources should the nurse identify as the best sources for obtaining EBP info?
A) The advice of an expert nephrology nurse
B) Retrospective chart reviews
C) Facility critical pathway
D) A recent peer-reviewed nursing research article
D) A recent peer-reviewed nursing research article
A staff nurse is challenging a shift assignment with the charge nurse. What statement made by the charge nurse is an example of smoothing to resolve conflict?
A) “If you accept this assignment today, I will let you choose your assignment tomorrow.”
B) “If you don’t agree with the assignment, I will have to report your decision to the nursing supervisor.”
C) “Let’s just focus on giving our client medications on time.”
D) “You have a lot of experience, so I’m sure you’re capable of these tasks.”
D) “You have a lot of experience, so I’m sure you’re capable of these tasks.”
A charge nurse working in a mental health unit is concerned that a nurse is experiencing countertransference when caring for a patient. The charge nurse should identify which of the following behaviors as an indication of countertransference?
the nurse is inattentive when spending time with the pt
A newly licensed nurse is giving a change of shift report using SBAR to an oncoming nurse. Which of the following statements by the newly licensed nurse should be included in the intro portion of the report?
the pt is a 45 year old male admitted 8 hours ago
A nurse in an ED is preparing a change of shift report for an older adult patient transferring to the med-surg unit. Using the SBAR communication tool, what information should the nurse include in the report?
A) The client has a do-not-resuscitate order.
B) The client has a continuous IV of lactated Ringer’s.
C) The client was straight catheterized for 350 mL 2 hr ago.
D) The client has Medicare insurance.
E) The client lives in a one-story home
A) The client has a do-not-resuscitate order.
B) The client has a continuous IV of lactated Ringer’s.
C) The client was straight catheterized for 350 mL 2 hr ago.
A nurse is completing an assessment of a recently widowed older adult. He states he is unable to drive and is afraid to cook on the stove. The nurse should recommend which of the following community resources?
A) Hospice care
B) Meals on Wheels
C) Home health services
D) American Association of Retired Persons
B) Meals on Wheels
A pH nurse is developing guidelines for the management of a botulism outbreak. What info should thorge nurse include?
A) High-risk individuals should receive immunoglobulin E (IgE).
B) Implement airborne precautions for clients who have botulism.
C) Administer an aminoglycoside medication.
D) Rinse skin with soap and water following exposure to the botulism toxin.
D) Rinse skin with soap and water following exposure to the botulism toxin.
A nurse is reviewing the medical record of an older adult patient who has a new prescription for cimetidine. What lab findings should the nurse identify as the priority to report to the provider?
A) Sodium 140 mEq/L
B) WBC count 9,000/mm3
C) Aspartate aminotransferase (AST) 50 units/L
D) Fasting glucose 105 mg/dL
C) Aspartate aminotransferase (AST) 50 units/L
A nurse manager is preparing to complete staff performance appraisals. Which of the following principles should the nurse manager consider when completing the appraisals?
A) Performance appraisals should be written in measurable terms.
B) Appraisal objectives should be applicable to staff at every level.
C) Performance appraisals should be based on the nurse manager’s preferences.
D) Completed appraisals should be approved by a provider.
A) Performance appraisals should be written in measurable terms.
An occupational health nurse is preparing to teach a health promotion class for workers at a warehouse. Which of the following statements should the nurse include?
A) “Rub your hands together for at least 10 seconds when washing them.”
B) “Keep your abdominal muscles tightened when lifting objects.”
C) “Ensure that 20 percent or less of calories are from saturated fats.”
D) “Engage in aerobic exercise 2 to 4 days per week for 20 min.”
B) “Keep your abdominal muscles tightened when lifting objects.”
A nurse is preparing an in-service about family violence for a group of newly licensed nurses. Which of the following statements should the nurse include in the teaching?
A) “Perpetrators of family-directed violence recognize their behavior as abnormal.”
B) “Female clients who experience partner violence are at greater risk for acute diseases.”
C) “The victim’s risk for homicide is greatest when they decide to leave the relationship.”
D) “The level of violence of the events decreases over time.”
C) “The victim’s risk for homicide is greatest when they decide to leave the relationship.”
A school nurse is providing care for students in an elementary education facility. Which of the following interventions by the nurse addresses the primary level of prevention?
A) Design interventions for a student’s individual education plan (IEP).
B) Teach students about healthy food choices.
C) Perform first aid for minor injuries.
D) Perform scoliosis screenings for students.
B) Teach students about healthy food choices.
A nurse is conducting a home visit with an older adult client. Which of the following observations should the nurse address to promote a safe environment?
A) Loud volume of the television set
B) Wall-to-wall carpet in the living room
C) Low chairs without armrests
D) Use of indirect lighting
C) Low chairs without armrests
A nurse manager is implementing a quality improvement project to reduce the number of methicillin-resistant Staphylococcus aureus (MRSA) infections at the facility. Which of the following actions should the nurse manager take first?
Conduct a chart review to evaluate precipitating factors of clients who develop MRSA.
A nurse manager is teaching a group of employees about standards for Quality and Safety Education for Nurses (QSEN).
Which of the following statements by an employee should the nurse manager identify as an example of the QSEN concept of quality improvement?
A) “We should start tracking how soon clients are discharged after laparoscopic versus open surgery.”
B) “We should be sure to log out of the computers immediately following documentation.”
C) “We should involve our clients’ partners in care planning as much as possible.”
D) “We should provide change-of-shift report as a team, including the assistive personnel who assisted with care”
C) “We should involve our clients’ partners in care planning as much as possible.”
A hospice nurse is providing teaching to a client who has a new diagnosis of a terminal illness and her family. Which of the following statements should the nurse include in the teaching?
A) “Hospice care focuses on disease treatment and rehabilitation.”
B) “The provider will coordinate your health care needs while in hospice.”
C) “You must choose a family caregiver before being admitted into a hospice facility.”
D) “Hospice care continues to help families with grief after a death occurs.”
D) “Hospice care continues to help families with grief after a death occurs.”
A nurse manager is discussing electronic medical records with a newly licensed nurse. Which of the following actions should the nurse take to maintain client confidentiality? (Select all that apply.)
A) Log out of the computer terminal before leaving.
B) Share passwords for computer access with colleagues.
C) Change computer access passwords on a regular basis.
D) Avoid accessing information about clients admitted to other units.
E) Shred computer-generated client worksheets after use
A) Log out of the computer terminal before leaving.
C) Change computer access passwords on a regular basis.
D) Avoid accessing information about clients admitted to other units.
E)Shred computer-generated client worksheets after use.
A charge nurse is discussing HIPAA with a newly licensed nurse. Which of the following actions should the charge nurse include in the teaching as an example of a HIPAA violation?
A) Posting the name of the nurse providing care on a client’s communication board
B) Discussing the client’s new medication with a hospital pharmacist
C) Faxing requested medical information for a client who is transferring to another facility
D) Emailing the client’s positive hepatitis results from an unencrypted serve
D) Emailing the client’s positive hepatitis results from an unencrypted serve
A community nurse is instructing a group of newly licensed nurses about diseases that require airborne precautions. Which of the following diseases should the nurse include?
A) Rubella
B) Pertussis
C) Influenza
D) Varicella
D) Varicella
An occupational health nurse in a factory is planning interventions to reduce environmental stressors for employees. Which of the following interventions should the nurse use to affect physical agents in the environment? (Select all that apply.)
A) Teach workers to choose personal strategies to cope with work stress.
B) Limit the amount of time workers spend in temperatures over 43.3° C (110° F).
C) Provide ear plugs for use at workstations throughout the factory.
D) Obtain dosimeters for employees to wear when using new machinery that emits radiation.
E) Require more frequent disinfection of work surfaces during inuenza season
B) Limit the amount of time workers spend in temperatures over 43.3° C (110° F).
C) Provide ear plugs for use at workstations throughout the factory.
D) Obtain dosimeters for employees to wear when using new machinery that emits radiation.
A nurse is using the ecologic model for population health to develop interventions to address HIV in a community. Which of the following interventions should the nurse include to address financial factors affecting community health?
A) Have adolescents lead peer discussions in schools about safe sexual practices.
B) Distribute condoms through remote community clinics.
C) Create commercial advertisements describing the long-term effects of HIV.
D) Include information about perinatal HIV transmission at prenatal education classes.
B) Distribute condoms through remote community clinics.
A newly licensed nurse is giving a change-of-shift report using I-SBAR to an oncoming nurse. Which of the following statements by the newly licensed nurse should be included in the “Background” portion of the report?
A) “The client has a new prescription for incentive spirometry.”
B) “The client’s partner plans to return later today.”
C) “The client has no living family members.”
D) “I initiated a consultation by a nutritionist.”
C) “The client has no living family members.”
A nurse is discussing organ donation with a newly licensed nurse. Which of the following statements should the nurse include in the teaching? (Select all that apply.)
A) “To harvest a client’s organs, they must provide consent prior to death.”
B) “The donor client’s provider will harvest the organs for donation.”
C) “During admission, all clients over the age of 18 should be asked about their organ donor status.”
D) “The National Organ Transplant Act prohibits the sale and purchase of organs.”
E) “Documentation about the client’s organ donor preference is placed in the electronic medical
C) “During admission, all clients over the age of 18 should be asked about their organ donor status.”
D) “The National Organ Transplant Act prohibits the sale and purchase of organs.”
E) Documentation about the client’s organ donor preference is placed in the electronic medical record.”
A case manager at an assisted living facility is reviewing the use of complementary health practices by several clients. Which of the following actions should the case manager plan to take?
A) Plan to report a client’s use of echinacea to the provider as a contraindication to aspirin therapy.
B) Plan to schedule time for a new client to continue tai chi practice as a stress reduction technique.
C) Tell a client that yoga has not been proven effective to reduce manifestations of menopause.
D) Tell a client who drinks cranberry juice daily that it can help treat existing urinary tractinfections.
B) Plan to schedule time for a new client to continue tai-chi practice as a stress reduction technique.
A nurse manager is teaching a group of staff members about proper body mechanics. Which of the following statements by a staff member indicates an understanding of the teaching?
A) “I should get assistance when lifting more than 35 pounds.”
B) “I will twist at my waist when moving an object.”
C) “I should hold objects 1 ft away from my body when I walk.”
D) “I will roll my shoulders forward to reduce strain on my back.”
A) “I should get assistance when lifting more than 35 pounds.”
A nurse is caring for a client who is requesting to leave the facility against medical advice (AMA). The client states, “I am ready to go iimmediately.” Which of the following actions should the nurse take first?
A) Teach the client about the potential health risks of leaving early.
B) Ask the client to sign a document stating they are leaving AMA.
C) Document the client’s statement in direct quotes in the medical record.
D) Complete an incident report detailing the client scenario
A) Teach the client about the potential health risks of leaving early.
A nurse at a local health department is caring for a client who is newly diagnosed with listeriosis. Which of the following actions should the nurse plan to take?
A) Provide the Centers for Disease Control (CDC) and Prevention with the client’s information.
B) Inform the client that they are required to have health department staff directly observe their treatment.
C) Determine whether the condition is reportable under state requirements.
D) Find out whether the condition is endemic in the client’s neighborhood
C) Determine whether the condition is reportable under state requirements.
A parent of a child who is terminally ill tells a nurse that she wants to take her child home. Which of the following responses should the nurse make?
A) “Your provider will be here later today.”
B) “I can give you information on what that would involve.”
C) “I understand how you feel. I felt the same way when my sister was terminally ill.”
D) “I think you should speak with social services about your request.”
B) “I can give you information on what that would involve.”
A nurse manager is asked to select clients for early discharge from the unit following a mass casualty event. Which of the following clients should the nurse manager recommend?
A) A client awaiting a screening colonoscopy later that day
B) A client whose discharge was cancelled the prior day because they developed respiratory distress
C) A client who is 6 hr postoperative following an open cholecystectomy
D) A client who is prescribed gastric lavage treatments to treat acute aspirin toxicity
A) A client awaiting a screening colonoscopy later that day
A nurse is providing a report to an occupational therapist about a client who weighs 210 lb and has a prescription for one-third weight bearing on the right leg to prevent injury and falls. How many kg of weight should the client bear on the right leg? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
32 kg
A school nurse is providing care for students in an elementary education facility. Which of the following interventions by the nurse addresses the primary level of prevention?
Teach students about healthy food choices.
A charge nurse allows two nurses who are arguing about who gets to go to lunch first to go together. The charge nurse agrees to take care of both of the nurses’ clients while they are at lunch. The charge nurse is demonstrating which of the following types of conflict management?
Avoiding
Competing
Compromising
Cooperating
Cooperating
A nurse educator is discussing community mental health with a group of nursing students. Secondary prevention?
Day care center
Outpatient rehabilitation center
Community recreational center
Crisis center
Crisis center
A nurse is reviewing the guidelines for reporting nationally notifiable infectious diseases. Which of the following diseases should the nurse plan to report to the Centers for Disease Control and Prevention (CDC)?
Lyme disease
Cytomegalovirus
Streptococcus pharyngitis
Toxoplasmosis
Lyme disease
A nurse is teaching a class on torts. The nurse should include which of the following situations as an example of negligence?
A nurse identifies the absence of peripheral pulsation in a casted extremity in the early morning and reports it to the provider in the early afternoon.
A client who is competent refuses an antidepressant medication. The nurse dissolves the medication in food and administers it to her without her knowledge.
A client who is alert and oriented makes an informed decision to leave the hospital against medical advice. The nurse applies restraints to the client to prevent him from leaving.
A nurse finds a client who is on a low-sodium diet eating salted potato chips. The nurse tells the client that she will apply wrist restraints if he does not stop eating the potato chips.
A nurse identifies the absence of peripheral pulsation in a casted extremity in the early morning and reports it to the provider in the early afternoon.
A nurse in the emergency department is caring for a client who has extensive partial and full-thickness burns of the head, neck and chest. While planning the client’s care, the nurse should identify which of the following risks as the priority for assessment and intervention?
Airway obstruction
Infection
Fluid imbalance
Paralytic ileus
Airway obstruction
A nurse is among the first responders to a mass-casualty incident and does not know what type of personal protective equipment (PPE) is needed. Which of the following actions should the nurse take?
Wait until the type of equipment needed is known.
Decontaminate victims before intervening.
Choose the highest level of protection equipment available.
Use a dosimeter to measure the level of radiation in the area before intervening.
Choose the highest level of protection equipment available.
A community health nurse is reviewing the levels of disease prevention. Which of the following activities is an example of tertiary prevention?
Providing treatment for clients who have chronic obstructive pulmonary disease
Performing screening for sexually transmitted infections
Administering influenza immunizations at a local health fair
Testing new nurses for exposure to tuberculosis.
Providing treatment for clients who have chronic obstructive pulmonary disease
A nurse is teaching a newly licensed nurse about methods to reduce costs of client care. Which of the following statements by the newly licensed nurse indicates understanding of the teaching?
“I should wait to empty my client’s drainable colostomy until it is three-fourths full.”
“I should delegate providing closed irrigation to the assistive personnel (AP).”
“I should encourage clients to receive an annual flu immunization.”
“I should recommend that my clients who have an established tracheostomy use sterile technique at home to provide ostomy care.”
“I should encourage clients to receive an annual flu immunization.”
A nurse is planning care for a client who has hepatitis B. Which of the following interventions should the nurse include in the plan?
Administer antibiotics.
Provide a diet high in fat.
Restrict fluids.
Encourage short periods of ambulation.
Encourage short periods of ambulation.
A nurse overhears two assistive personnel (AP) from the medical-surgical unit discussing a hospitalized client while in the cafeteria. Which of the following is the priority nursing action?
Quietly tell the APs that this is not appropriate.
Ask the nurse manager to provide an inservice program about confidentiality to the staff on the unit.
Complete an incident report.
Document the occurrence in a personal log.
Quietly tell the APs that this is not appropriate.
A nurse is supervising a licensed practical nurse (PN) who is providing care to a client who is postoperative. Which of the following statements by the client requires the nurse to follow up with the PN?
“I do not know how to make the remote control work.”
“Do you know when I will be going home?”
“My dressing was changed earlier this morning.”
“I have not received any of my medications today.”
“I have not received any of my medications today.”
A charge nurse is preparing an educational session about addictive disorders for nursing staff. Which of the following should the nurse include as an etiological factor of addictive disorders? (select all that apply).
Being female
Low self-esteem
Family history of addiction
Personality disorders
Asian ethnicity
Low self-esteem
Family history of addiction
Personality disorders
A nurse is planning care for four clients and is assigning tasks to a licensed practical nurse (LPN) and an assistive personnel (AP). Which of the following should the nurse assign to the LPN?
Complete an admission assessment for a client who has COPD.
Measure I&O for a client who has an indwelling urinary catheter.
Reinforce teaching to a client to begin taking enoxaparin at home following a hip arthroplasty.
Develop a plan of care for a client who has cholecystitis.
Reinforce teaching to a client to begin taking enoxaparin at home following a hip arthroplasty.
A nurse on a pediatric unit is caring for a child and his family. His parents define family as a husband, wife, and child. This definition is which type of family form?
Extended family
Blended family
Nuclear family
Intergenerational family
Nuclear family
A charge nurse is working with an assistive personnel (AP) who provides excellent care to clients and is an effective team member. Which of the following actions should the nurse take first to recognize the AP’s contributions to client care?
Give positive feedback directly to the AP.
Tell other nurses what an effective team member the AP is.
Nominate the AP for the Employee of the Month award.
Detail the AP’s contributions to the nurse manager.
Give positive feedback directly to the AP.
A nurse is caring for four clients who are postoperative from surgery 24 hr ago. At 1200 the nurses assesses the clients. Which of the following clients is the nurse’s priority?
A client who has a prescription for insulin and his premeal capillary blood glucose was 110 mg/dL and his post-meal capillary blood glucose is now 160 mg/dL
A client whose wound drainage at 0800 was sanguineous and now it is serosanguineous
A client who reports pain as 4 on a scale of 1 to 10 at 0800 now reports pain as 6
A client whose blood pressure at 0800 was 138/86 mm Hg and at 1200 is 106/60 mm Hg
A client whose blood pressure at 0800 was 138/86 mm Hg and at 1200 is 106/60 mm Hg
A nurse is caring for a group of clients. Which of the following clients should the nurse refer to a social worker? (select all that apply.)
A client who requires placement in an assisted living facility.
A client who requests to secure an emergency notification system in the home.
A client who requests to get school assignments while hospitalized on a pediatric unit.
A client who requests to receive additional instructions on breastfeeding prior to discharge.
A client who requests to obtain information on the adverse effects of antidepressant medication therapy.
A client who requires placement in an assisted living facility.
A client who requests to secure an emergency notification system in the home.
A client who requests to get school assignments while hospitalized on a pediatric unit.
A nurse in a long-term care facility enters the day room and finds the window curtains on fire. Clients are panicking and the room is filling with smoke. Indicate the emergency actions the nurse must take (Move the steps into the box on the right, placing them in the order of performance. Use all the steps).
Activate the fire alarm.
Extinguish the fire.
Close the door.
Remove the clients from the room.
Remove the clients from the room.
Activate the fire alarm.
Close the door.
Extinguish the fire.
A nurse is caring for an older adult client who is disoriented and has a history of falls. Which of the following actions should the nurse take? (Select all that apply.)
Raise all side rails on the client’s bed.
Obtain a prescription to restrain the client PRN.
Check on the client hourly.
Instruct the client in the use of the call light.
Apply an ambulation alarm to the client’s leg.
Check on the client hourly.
Instruct the client in the use of the call light.
Apply an ambulation alarm to the client’s leg.
A nurse is providing instructions for a 52-year-old client who is schedule for a colonoscopy. The client reports that he has not had the procedure before and is very anxious about feeling pain during the procedure. Which of the following responses by the nurse is appropriate?
“Don’t worry; most clients dislike the prep more than the procedure itself.”
“Before the examination, your provider will give you a sedative that will make you sleepy.”
“I know you’re anxious, but this procedure is recommended for people your age.”
“After you have signed the consent form, we can talk more about this.”
“Before the examination, your provider will give you a sedative that will make you sleepy.”
A nurse is reinforcing teaching about self-care with a client who has pelvic inflammatory disease. The client does not speak English. Which of the following actions by the nurse is appropriate?
Ask an assistive personnel (AP) who speaks the client’s language to serve as an interpreter.
Ask the client’s English-speaking family member to translate.
Seek assistance from a facility-approved interpreter.
Use a translation dictionary to reinforce the teaching.
Seek assistance from a facility-approved interpreter.
A nurse is caring for four clients. After administering morning medications, she realizes that nifedipine prescribed for one client was inadvertently administered to another. Which of the following actions should the nurse take first?
Notify the client’s provider.
Check the client’s vital signs.
Fill out an occurrence form.
Administer the medication to the correct client.
Check the client’s vital signs.
A nurse is completing discharge teaching with a client. Of the following barriers to learning the nurse identifies with this client, which should the nurse interpret as a need to postpone the session?
Pain
Hearing loss
The client’s culture
Motor impairment
Pain
A nurse on a surgical unit is caring for a group of clients. Which of the following is the priority action of the nurse?
Taking a telephone prescription about a client who is to be transferred from PACU
Assessing a client who experiences unilateral calf pain when ambulating
Reinforcing a client’s dressing for the surgical site of an above-the-knee amputation
Reassuring the partner of a client who sustained a closed head injury
Assessing a client who experiences unilateral calf pain when ambulating
A nurse is planning a staff education session regarding biological weapons of mass destruction. Which of the following should he plan to include in the session? (Select all that apply).
Sarin
Smallpox
Anthrax
Hydrogen cyanide
Botulism
Smallpox
Anthrax
Botulism
An assistive personnel (AP) reports to the nurse that a client who is 3 days postoperative following an abdominal hysterectomy has a dressing that is saturated with blood. Which of the following tasks should the nurse delegate to the AP?
Change the abdominal dressing.
Obtain vital signs.
Palpate for possible bladder distention.
Observe the incision site.
Obtain vital signs.
A nurse is caring for a client whose family member requests to view the client’s medical record. Which of the following responses should the nurse make?
“I will ask the nursing supervisor to obtain the medical records for you.”
“The health care provider will share this information with you.”
“The ethics committee will need to approve this request for you.”
“The client must provide permission to share the records with you.”
“The client must provide permission to share the records with you.”
A community health nurse is reviewing information about infectious diseases with the nurses on her team. The nurse should remind the team that which of the following diseases are included in the list of nationally notifiable infectious diseases? (select all that apply).
Trichomonas vaginalis
Chlamydia
Gonorrhea
Chancroid
Candidiasis albicans
Chlamydia
Gonorrhea
Chancroid
A nurse is planning to discharge a client who has quadriplegia to his home. The nurse suggests that the family might needed respite care services. When a family member asks how respite care can help, which of the following responses should the nurse provide?
“Respite care allows the primary caregiver time away from day-to-day care responsibilities.”
“Respite care provides holistic support and care for a client who is terminally ill.”
“Respite care helps relieve pain and promote comfort.”
“Respite care is a continuation of psychological support after a family member dies.”
“Respite care allows the primary caregiver time away from day-to-day care responsibilities.”
A nurse is assigned a group of clients at the start of the shift. Which of the following clients should the nurse plan to care for first?
A client who needs assistance with a bath
A client requesting a referral for home health services
A client asking about his PCA pump that contains morphine
A client who has questions about his new prescription
A client asking about his PCA pump that contains morphine
A nurse is creating a plan of care for clients who are aged 65 years and older and at risk for experiencing frailty syndrome. Which of the following interventions should the nurse include?
Increase the number of individuals who reside in long-term care.
Decrease the amount of funds spent on education about chronic health issues.
Decrease the use of community-based programs for health services.
Increase the frequency of participation in social and civic activities.
Increase the frequency of participation in social and civic activities.
A nurse is performing a community assessment of a region of the county. Which of the following data should the nurse expect to gather during a windshield survey?
Details about how the county’s health relates to that of other local counties
A list of safety concerns identified by residents who live in the area
Numerical data about resident income and the economy within the region
Information about the conditions of the most commonly traveled roads
Information about the conditions of the most commonly traveled roads
A county health nurse is developing a program to address lead poisoning in infants and toddlers. Which of the following strategies should the nurse include as a secondary level of prevention?
Develop educational infographics for the parents of infants and toddlers about lead poisoning.
Conduct research into the frequency of lead poisoning among infants and toddlers in the county.
Work with landlords and homeowners to decrease the lead levels in the homes of children who have lead poisoning.
Perform blood lead level screening of infants and toddlers during well-child visits and early and periodic screenings.
Perform blood lead level screening of infants and toddlers during well-child visits and early and periodic screenings.
A nurse in a health department is taking part in a community group working to eliminate local health disparities. Which of the following strategies should the nurse suggest?
Decreasing the number of individuals who regularly visit a provider
Decreasing the use of preventive health care services
Increasing the time spent with individuals who have low health literacy levels
Increasing the proportion of individuals dependent on government assistance programs
Increasing the time spent with individuals who have low health literacy levels
A nurse is leading an interprofessional team to develop a clinical pathway for clients following coronary artery bypass grafting (CABG) surgery. Which of the following tasks should the nurse expect the case manager to complete?
Coordinating cost-effective services for clients scheduled for CABG surgery
Structuring a progressive activity program for clients following CABG surgery
Developing a medication formulary commonly used for clients having CABG surgery
Creating a pulmonary hygiene protocol for clients scheduled for CABG surgery
Coordinating cost-effective services for clients scheduled for CABG surgery
A nurse manager is reviewing changes that occurred on a unit during the prior year. Which of the following changes should the nurse identify as a planned change?
Syringes were purchased from a different company because the original syringes were no longer available.
Staff nurses adopted a new system for how to rotate assignments after a demonstration from a newly licensed nurse.
The case manager began calling clients 24 hr after discharge as part of a readmission prevention program.
The average census decreased over recent months when a new facility opened in a neighboring community.
The case manager began calling clients 24 hr after discharge as part of a readmission prevention program.
A nurse is receiving change of shift report on four clients. Which of the following clients should the nurse see first?
A client who has a patient-controlled analgesia (PCA) device that requires medication replacement
A client who was repositioned 3 hr ago
A client who has an increased uric acid level and reports toe pain
A client who is receiving tissue plasminogen activator (tPA) and reports bleeding from the IV site
A client who is receiving tissue plasminogen activator (tPA) and reports bleeding from the IV site
A charge nurse is meeting with a staff member who is suspected of chemical impairment. Which of the following findings should the nurse identify as an indication of chemical impairment?
Increased attention to meeting deadlines
Emotional lability
Asks others to administer controlled substances for them
Increased socialization
Emotional lability
A nurse is developing a continuous quality improvement program to reduce catheter-associated urinary tract infections (CAUTIS). Which of the following information should the nurse include as part of the structural aspect of the program?
The number of extra inpatient days required to treat a CAUTI
The number of clients who have an indwelling urinary catheter and develop a CAUTI
The facility’s procedural guide about how to insert an indwelling urinary catheter
The types of urinary catheter supplies available in the facility
The types of urinary catheter supplies available in the facility
A nurse is telephoning a provider to speak about a client who is experiencing opioid toxicity. When using the I-SBAR communication tool, which of the following information should the nurse include as part of the background information?
The nurse’s name and the name of the client
The client’s admitting date and medical diagnosis
The client’s most recent vital signs, including oxygen saturation
The nurse’s summary about the client’s condition
The client’s admitting date and medical diagnosis
A nurse is educating a group of newly licensed nurses about the core functions of public health. Which of the following interventions should the nurse include as part of the public health assurance?
Develop partnerships with agencies in the community.
Confirm adequate health care services are available in the community.
Investigate health problems and hazards for a specified community.
Educate community members about common health issues.
Confirm adequate health care services are available in the community.
A public health nurse is teaching an in-service about using partnerships to accomplish public health goals. Which of the following information should the nurse include?
The partnering groups should have shared power in decision making.
Partnerships do not have to involve specific goals to be successful.
Partnerships should be allowed to end naturally without closure.
The partnering groups do not receive individual benefit from interactions.
The partnering groups should have shared power in decision making.
A nurse is developing tertiary prevention measures related to physical disabilities. Which of the following interventions should the nurse include?
Media campaigns teaching pregnancy nutrition to promote healthy fetal development
Political legislation that requires folic acid supplements in grain products
School regulations that accommodate the use of assistive devices
Community screening event for arthritis or other musculoskeletal concerns
School regulations that accommodate the use of assistive devices
A nurse in a public health clinic is reviewing statistics from the previous year. Which of the following examples indicates a reduction in disease prevalence?
A decrease in the number of clients who have hepatitis C
A decrease in the number clients who were diagnosed with heart disease
A decrease in the case-fatality rate for septic shock
A decrease in the number of deaths from motor vehicle crashes
A decrease in the number of clients who have hepatitis C
An occupational health nurse is reviewing health outcomes for the previous year. Which of the following findings should the nurse identify as a positive patient outcome?
Increased insurance claims for exacerbations of chronic disease
Increased use of sick time
Decreased use of workers’ compensation funds
Decreased use of health screening services
Decreased use of workers’ compensation funds
A charge nurse is receiving report for a group of clients. For which of the following situations should the nurse plan to follow up?
A client who states they do not want resuscitation in an emergency, but does not have a DNR prescription on the medical record
A client who is unconscious, does not have a living will, and whose family consents for limb amputation surgery
An emancipated minor declined chemotherapy and the provider cancelled the prescription
A client designates their adult child to be the health care surrogate rather than their partner
A client who states they do not want resuscitation in an emergency, but does not have a DNR prescription on the medical record
A nurse is teaching a group of newly licensed nurses about delegating to assistive personnel (AP). The nurse should emphasize that which of the following criteria must be met prior to the delegation of the task?
The task involves a client experiencing an acute complication.
The task is performed infrequently on the assigned unit.
The task will lead to an obvious expected outcome.
The performance of the task varies depending on the client.
The task will lead to an obvious expected outcome.
A nurse manager is developing a plan for improving time management on the unit. Which of the following strategies should the nurse manager include?
Make time for phone calls at the beginning of the day.
Select certain tasks for delegation to other team members.
Make a list of tasks and perform them in that sequence.
Remain available to answer staff questions throughout the day.
Select certain tasks for delegation to other team members.
A nurse is assisting with the development of a community emergency response plan. Which of the following interventions should the nurse identify as a mitigation strategy?
Create storm shelters.
Train workers on debriefing techniques.
Perform client triage.
Administer tetanus toxoid to injured individuals
Create storm shelters.
A charge nurse is receiving change of shift report. Which of the following situations should the charge nurse identify as needing an incident report?
A constant passive movement (CPM) machine stops working while being used by a client following total knee replacement surgery.
A client whose living will requested no artificial life preservation dies within 4 hr following removal of mechanical ventilation.
A visitor trips exiting the facility door, but does not fall or experience an injury.
A client’s family member complains about visits from another family member.
A constant passive movement (CPM) machine stops working while being used by a client following total knee replacement surgery.
A nurse is working with risk management to create an in-service for facility staff. Which of the following situations should the nurse plan to include as an example of a sentinel event?
A nurse avoided administering an iron capsule to the wrong client by checking the medication at the client’s bedside.
A client’s screening mammogram had to be repeated because the technician could not locate the results of the first test.
Facility security had to remove two visitors from the lobby who were shouting and pushing each other.
A client required intensive care treatment after developing a hemolytic transfusion reaction from whole blood administration.
A client required intensive care treatment after developing a hemolytic transfusion reaction from whole blood administration.
A nurse is performing triage following a community disaster. Which of the following clients should the nurse categorize with a yellow tag?
A client who has a closed upper extremity fracture
A client who has full-thickness burns covering 30% of the body
A client who has a large abdominal laceration with minimal bleeding
A client who was exposed to radiation and is experiencing a seizure
A client who has a large abdominal laceration with minimal bleeding
A nurse preceptor is observing a newly licensed nurse who is caring for several clients. Which of the following actions by the newly licensed nurse demonstrates an understanding of infection control practices?
The nurse wears an N95 respirator mask when caring for a client who has pertussis.
The nurse cleans a client’s bedside table with chlorhexidine gluconate to remove a blood spill.
The nurse double bags a soiled dressing when the first bag becomes contaminated.
The nurse uses a foam hand sanitizer after caring for a client who has Clostridium difficile.
The nurse double bags a soiled dressing when the first bag becomes contaminated.
