Questions I got wrong

Question 1

A nurse is initiating seizure precautions for a client who has a seizure disorder. Which of the following pieces of equipment should the nurse have readily available at the client’s bedside?

Answer 1

Oxygen Equipment

Question 2

After assessing a client’s radial pulses, the nurse documents “radial pulses 4+ bilaterally.” The nurse should document this finding when a client’s pulses have which of the following qualities?

Answer 2

Bounding

Question 3

A client who reports shortness of breath requests the nurse’s help in changing positions. After repositioning the client, which of the following actions should the nurse take next?

Answer 3

Observe the rate, depth, and character of the client’s respirations.

Question 4

A nurse observes an assistive personnel (AP) preparing to obtain blood pressure with a regular-sized cuff for a client who is obese. Which of the following explanations should the nurse give the AP?

Answer 4

Using a cuff that is too small will result in an inaccurately high reading.

Question 5

A nurse is performing a neurological assessment for a client. Which of the following examinations should the nurse use to check the client’s balance?

Answer 5

Romberg test

Question 6

A nurse is admitting a client who has TB. In addition to standard precautions, which of the following transmission-based precautions should the nurse add to the client’s plan of care?

Answer 6

Airborne

Question 7

A nurse is explaining the use of written consent forms to a newly licensed nurse. The nurse should ensure that a written consent form has been signed by which of the following clients?

Answer 7

A client who has a prescription for a transfusion of packed red blood cells.

Question 8

Pain Status should be listed in which I-SBAR report?

Answer 8

Assessment

Question 9

A nurse is preparing to administer a med to a client. Which of the following admin schedules should the nurse identify as a prescription to administer the med once and as soon as possible?

Answer 9

STAT Prescription

Question 10

A nurse is caring for a client who has emphysema. The client has not stopped smoking cigarettes and states, “It’s too late for me to quit.” Which of the following actions should the nurse take?

Answer 10

Assist the client in finding local smoking cessation assistance programs.

Question 11

A nurse is preparing to administer oral phenytoin to a client who has a seizure disorder. Before administering the med, what action should the nurse take?

Answer 11

Check the med dose and the client’s identification.

Question 12

A nurse is teaching a client who is postoperative about the importance of turning, coughing, and breathing deeply. What statement should the nurse identify as an indication that the client understands the instruction?

Answer 12

If I do this often, I won’t get pneumonia.

Question 13

A nurse is performing a physical assessment of a client. What action should the nurse take to assess the client’s tissue perfusion?

Answer 13

Perform a blanch test.

Question 14

A nurse is teaching a group of older adults about expected age related changes. What statement by a group member indicates that the teaching has been effective?

Answer 14

I should expect my HR to take longer to return to normal after exercise as I get older.

Question 15

A nurse is caring for a client who has a hearing impairment. What intervention should the nurse use when speaking with the client?

Answer 15

Face the client when speaking

Question 16

A nurse is caring for a client who has the head of his bed elevated to a 45 degree angle with his knees slightly flexed. Which position is he in?

Answer 16

Fowler’s

Question 17

Nurse is preparing to administer meds to a client who is unconscious. The nurse should bring the MAR to the clients bedside and preform what verification procedure?

Answer 17

Compare the med record number and name on the MAR with the clients identification band.

Question 18

Nurse is teaching an AP about proper hand hygiene. What statement by the AP indicates an understanding of the teaching?

Answer 18

There are times I should use soap and eater rather than a alcohol based rub to clean my hands.

Question 19

Nurse is caring for a client who is receiving a blood transfusion. The client reports flank pain, and the nurse notes reddish-brown urine in the client’s urinary catheter bag. The nurse recognizes these manifestations as what type of transfusion reaction?

Answer 19

Hemolytic

Question 20

Nurse discovers that a client received the wrong meds. What action should the nurse take first?

Answer 20

Assess the client.