3. A nurse is reinforcing teaching with client who has prescriptionfor knee-high antiembolism stockings for home use. Which of the

  

3. A nurse is reinforcing teaching with client who has prescriptionfor knee-high antiembolism stockings for home use. Which of the following instructions by the client indicates an understanding of the teaching? I will use hot water weekly to disinfect my stockings in the washing machine I will take a walk around the house before wearing the stockings to ensure a proper fit I will fold the excess top of the stockings down the middle of my calf I will replace the stockings when they longer seem to stretch 4. A nurse is showing a newly licensed nurse how to use mechanical life. Which of the following statements by the newly licensed nurse indicates an understand of the assistive device? The sides of the sling are for the client to hold on to The type of the device is useful for a client who cannot assist The lower end of the sling goes below the client’s calves The device requires the client to use upper body strength 5. A nurse on medical-surgical unit is collecting data from a client who is postoperative following abdominal surgery. The client’s BP was 126/72 mm Hg 15 min ago. The nurse now finds that the client’s BP is 176/96 mm Hg. Which of the fowling actions should the night take? Deflate the cuff faster when repeating the BP measurement Request a prescription for an antihypertensive medication Use a narrower cuff to repeat the BP measurement Measure the client’s BP in the other arm6. A nurse is preparing to obtain capillary blood specimen from a client for blood glucose testing. Which of the following actions should the nurse take?Use the first drop of blood that appears for testing Select the pad of the fingertip as the puncture site Hold the finger above the level of the client’s heart prior to puncturing Squeeze the puncture site lightly until a blood droplet forms 7. A nurse is assisting with the care of a client who has a closed chest tube drainage system. Which of the following actions should the nurse take? Clamp the tubing when ambulating the client Make the client’s tubing every shift Loop excess tubing next to the client’s side Place the drainage system below the client’s chest level 8. A nurse is collecting data from a client who has an NG tube in place for gastric decompression which of the following findings should the nurse report to the provider? Orangish yellow drainage Report of hunger Gastric contents are present in the air vent Abdominal distention 9. A nurse is caring for a client who has experienced a cerebrovascular accident with resulting dysphagia. Which of the following therapists assists client to learn to eat with less risk of aspiration? Respiranxy Physical Speech Occupational 10. A nurse is caring for a client who is angry and states. “The doctor gave me the wrong information. I was lied to!” Which of the following responds by the nurse is appropriate? I am certain the doctor would not life to you You feel as if the doctor hasn’t been honest with you? Why do you think the doctor is lying? You doctor has an excellent reputation for being honest with clients 11. A nurse is preparing to reinforce discharge teaching with a client who has hearing loss. Which of the following communications techniques is appropriate? (Select all that apply)Rephrase for better understanding Speak in a high tone of voice Sit at the same level as the client Provide the client with written information Avoid using hand gestures 12. A nurse is preparing to administer a medication from an ampule. Which of the following an appropriate action for the nurse to take? Use a filter needle to aspirate the medication Inject air into the ampule prior to drawing medication into a syringe Add 0.5 mL of diluent to the medication Cleanse the trip of the ampule with an alcohol swab after opening 13. A nurse is caring for a client who has chronic constipation. Which of following actions should the nurse recommend to the client? Take a calcium supplement Bake with white flour Use a laxative every day Consume probiotic sources 14. A nurse is reinforcing teaching about advance directives with a client who has terminal colorectal cancer. Which of the following statements by the client indicates an understanding of the teaching? I’m glad to have the opportunity to choose what kind of care receive while I still can If I want life support, I’ll need to sign a separate consent for first Once I fill out my living will, there will be a 1-month delay before it is legally binding I can’t change my mind about the care I will receive once I sign my living will 15. A nurse is assisting with the care of four clients in a inpatient mental health facility. The nurse should recognize that which of the following client can give informed consent? A 30-year-old client who has postpartum depression A 45-year-old client who just received a dose of methadone A 17-year-old client who lives with friends A 20-year-old client who has a blood alcohol level of 0.08% 16. A nurse is reinforcing discharge teaching about fecal occult blood testing with a client. Which of the following instructions should the nurse include in the teaching? Urinate prior to collecting the stool specimen Place a thick layer of stool on the specimen card Refrain from consuming pork 7 days before the test Discontinue supplement containing vitamin C 24 hr before the test 17. A nurse in a provider’s office is reviewing data from a client’s medical record. Which of the following findings should the nurse identify as a risk factor for cardiovascular disease? MBI of 24 Orthostatic hypotension Family history of osteoporosis Type 1 diabetes melilites 18. A home health nurse is reinforcing teaching about dietary needs with the son of a client. The son states. “I don’t know what to do because his not eating” which of the following response should the nurse make? I’m sure it’s nothing serious and his appetite will return soon He may need a feeding tube Why do you think he’s not eating? Tell me more about what happens at mealtime 19. A nurse is reinforcing discharge instructions with a client who is walking with crutches. Which of the following statements by the client identification an understanding of the instructions? I should advance my crutches up the step ahead of my unaffected leg I will support my weight on the hand grips of the crutches When I’m walking around my house with my crutches, it’s okay to take my shoes off I should keep my elbows straight when I am walking with my crutches20. A nurse is caring for a client who has a hip fracture and plans to administer pain medication prior to turning the client. Which of the following ethical principles is the nurse implementing? Beneficence Fidelity Veracity Autonomy 21. A nurse is caring for an older adult client who has dementia. Which of the following findings places the client at risk for falls? The client’s wheelchair is locked There is a night light in the client’s bathroom The client’s bed in the low position The four side rails on the client’s bed are raised 22. A nurse is reinforcing teaching with a client who has crutches regarding the use of the three-point gait. Which of the following instructions should the nurse include? Keep the crutches at the level of the axillaeStand with the crutch tips against the feet Hold the arms straight when walking Bear weight on the unaffected leg 23. A nurse instructing an indwelling urinary catheter for a male client. After inserting the catheters 15 cm (6 in). The nurse feel reinforces, and no urine flows through the catheter. Which of the following actions should the nurse take? Apply lidocaine gel to the urethra Twist the catheter gently Lower the penis to a 45° angle Inflate the catheter’s balloon 24. A nurse is caring for a client who fell while walking to the bathroom. Which of the following actions should the nurse take when completing the incident report? Place a copy of the incident report in the client’s medical record Draw a conclusion regarding the cause of the incident Use direct quotes made by the client to describe the incident Make a notation in the client’s medical record that an incident report was completed 25. A charge nurse is reinforcing teaching with a newly licensed nurse about informed consent. Which of the following information should the nurse include? A minor who is pregnant is unable to give consent A family member should witness the client’s consent A client can withdraw consent at anytime A nurse is responsible for obtaining informed consent 26. A nurse is collecting data from a client who is malnourished due to inflammatory bowel diseases. Which of the following finding should the nurse expect? Bradycardia Brittle hair Yellow conjunctiva Clubbing of the fingernails 27. A nurse is caring for a client who is pulling on his NG tube. Which of the following actions should the nurse take? Administer a PRN sedative medication Apply a soft-wrist restraint Document the client’s behavior Determine the client’s level of comfort 28. A nurse is caring for a client who expresses concern about weight gain with age. The nurse should inform the client that weight gain with age can result from which of the following factors? Decrease in vitamin intake Decrease in muscle mass Increase in fluid requirements Increase in protein requirements 29. A nurse is reinforcing discharge teaching with a client who speaks a different language then the nurse. Which of the following actions should the nurse take? Ask a nurse from another unit who speaks the same language as the client to reinforce the discharge teachingUse nonverbal communication with gestures to reinforce discharge teaching with the client Reinforce discharge teaching with the client’s partner who speaks the languages of both the client and the nurse Reinforce discharge teaching with the client’s partner who speaks the languages of both the client and the nurse Request that a medical interpreter assist with translating the discharge teaching for the client 30. A nurse is replacing a dressing for a client who has an abdominal incision with a closed wound drain. Which of the following actions should the nurse take? Dry the incision with sterile gauze pads Clean around the drain site using horizontal strokes Lift the soiled dressing so that the underside faces the clientPush the skin down while gently removing the tape 31. A nurse is collecting date from a female client who has a body mass index of 32. The nurse should classify the client as which of the following? Underweight Normal weight Obesity class I Overweight 32. A nurse is caring for client who is 2 days postoperative following a below-the-knee amputation. Which of the following statements by the client should the nurse identify as indicating an acceptance of the limb loss? I need to learn how to perform a dressing change on my leg I stay awake at night because I keep thinking about my leg I know my family means well, but I don’t want visitors seeing my leg right now I am going o have to find someone who can take care of my leg at home 33. A nurse is caring for an older adult client who has a hearing aid. Which of the following actions should the nurse take when the client is reports hearing a whistling sound from the hearing aid? Clean the hearing aid with isopropyl alcohol Turn the hearing aid off for 5 min Soak the hearing aid in warm water Decrease the volume on the hearing aid 34. A nurse is collecting data from a client who has diabetes mellites. The nurse should ask which of the following s to determine the client’s ability to provide foot self-hygiene? Do you have any problems taking care of your feet? Do you go barefoot at home?Have you noticed any problems with foot swelling? Have you had a problem with ingrown toenails?  Health Science Science Nursing PRN 1032LL Share (0)