ATI: Practice Exam NG 2020 Study

Questions with Correct Answers Graded

A
A nurse is caring for a client who is in Buck's traction. Which of the following action
should the nurse take? - Allow the weights to hang freely

A nurse is caring for a client who takes prednisone daily for the treatment of chronic
asthma. The nurse should plan to monitor the client for which of the following
adverse effects? - Gastric ulcer formation

A nurse is receiving a change of shift report for a group of clients. The nurse should
plan to implement which of the following time management strategies? - Prepare a
priority list of client needs for the shift

A nurse is reinforcing teaching about home care for conjunctivitis with the parent of a
school age child. Which of the following information should the nurse include? -
Separate the child's used wash cloth from those of others

A nurse is caring for a client who has a prescription for famotidine 160 mg PO q 6hrs.
Available is famotidine oral suspension 40 mg/5 mL. How many ML should the nurse
administer per dose? (round the answer to the nearest whole number. Use the
leading zero if it applies. Do not use a trailing zero) - 20

A nurse is discussing alopecia with a client who is scheduled to begin

chemotherapy. Which of the following statements should the nurse make? - Your
oncologist, my prescribe, a cold cap to wear during treatment to reduce hair loss

A nurse on a medical surgical unit is delegating tasks to an assistive personnel.

Which of the following task should the nurse delegate to the AP? - Obtaining a clients
vital signs prior to discharge

A nurse is preparing to insert an indwelling urinary catheter for a female client.

Which of the following action should the nurse take? - Open the outer package flap
of the catheterization kit away from their body
A home health nurse is caring for an older adult client who just returned home
following a total knee arthroplasty. Which of the following action should the nurse
take first? - Determine the clients mobility status

A nurse is delegating the collection of a sputum specimen to an assistive personnel.

At which of the following time should the nurse instruct the AP to collect the
specimen? - As soon as the client awakens in the morning

A nurse on the medical surgical unit is assisting with the care of a patient who was
admitted from the emergency department. Complete the following sentence by
using the list of options... - A client is at risk for developing confusion due to sodium
level

A nurse is reviewing the laboratory results for a client who is at 29 weeks of gestation
period for which of the following results. Should the nurse notify the provider? -
Platelet count of 95,000 MM3

A nurse is collecting data from an older adult client during a routine physical exam.
Which of the following client statements should the nurse identify as possible
indication of Mal treatment? - My son took my wallet so he can keep track of what I'm
spending

A nurse is reviewing laboratory reports for a client who has an E. coli infection, and is
receiving Gentic myself. Which of the following results of the nurse report to the
provider before administering the next dose? - Creatinine 2.5 MG/DL.

A nurse in a pediatric clinic is collecting data from a school age child his injuries are
inconsistent with the parent stated cause. Which of the following action should the
nurse take? - Report the suspected abuse to the appropriate agency

A nurse is collecting data from a postpartum client who had a vaginal birth two days
ago. Which of the following findings is the nurses priority to report to the provider? -
Client reports burning with urination

A nurse is collecting data from a client who has hypokalemia. Which of the following
findings should the nurse expect? - Muscle weakness
A nurse is assisting in the care of a client who is postoperative following an
appendectomy. Which of the following for client findings should the nurse report to
the charge nurse? - Pain, level, oxygen saturation, nausea and heart rate

A nurse is reviewing a clients electronic medical record and finds that AP record of
the clients temperature as 35.3°C (95.5°F.) two hours earlier. Which of the following
action should the nurse take first? - Check the clients temperature

A nurse is reinforcing teaching with a female client, her request information about
how to lose weight. Which of the following statements should the nurse make? -
Keep fat intake to no more than 30% of your daily caloric intake

A nurse at a long-term care facility is part of a team preparing a report on the quality
of care at the facility. Which of the following information should the nurse
recommend including in the report to demonstrate improvement in care quality? -
The facility had 12% fewer urinary tract infections over the past six months

A nurse is speaking with a partner of a client who has Alzheimer's disease. The
partner states, "I love him, but caring for him is wearing me out. "Which of the
following responses should the nurse make? - Let's discuss how caring for your
partner is affecting your health.

A nurse is reinforcing, teaching with a client who has left-sided weakness, and his
learning how to ambulate with a cane. The nurse should identify that the client
understands the teaching when the client place is the cane in which of the following
positions when advancing forward? - B. On the stronger, right, side

A nurse is assisting with the care of a client. Select the two findings the nurse should
report to the provider - HR and Dressing

A nurse has administered medication's to a group of clients. For which of the

following clients situation should the nurse complete an incident report? - The nurse
administered insulin lispro to a client who has diabetes mellitus and is NPO

A nurse is reinforcing teaching with a client about the clients recent diagnosis of
multiple sclerosis. The client states "I am very upset and I want to be alone for a little
while." Which of the following responses should the nurse make? - I see that you're
feeling overwhelmed. I will come back when you're ready.

A nurse is caring for a patient in an outpatient setting. Complete the following

sentence by using the list of options... - The client is exhibiting manifestations of
heart failure as evidenced by the clients BNP level.

A nurse is contributing to the plan of care for a client following a transurethral

resection of the prostate (TURP). Which of the following intervention should the
nurse include? - Irritate the bladder using sterile technique

A nurse is preparing to administer insulin to a client who has type one diabetes
mellitus. After drying up the medication, the nurse accidentally purchased a needle
on the counter service. Which of the following action should the nurse take? -
Prepare a new dose of the insulin for injection

A nurse is performing vision testing for a client following a head injury. Which of the
following findings should the nurse identify as a problem with people
accommodation? - Lack of changing pupil size when the client looks from a far to a
near object

A nurse is preparing to administer medication to a client. The client states, "I'm sick
of all these medication's and I'm not taking anymore today! "Which of the following
action should the nurse take? - Inform the client of the possible consequences of the
medication refusal

A nurse in an urgent care setting is assisting with the care of a client. For each
finding, click to specify if the finding requires follow up, or does not require follow up.
- Follow up, needed for heart rate, BP, HbA1c and BMI

A nurse is reinforcing teaching with a client regarding prescribed asthma

medication's. The nurse should instruct the client to use which of the following
medication's for treatment of acute asthma attack? - Albuterol

A nurse is caring for a client who request information about advance directives.
Which of the following responses should the nurse make? - Advance directives are
written instructions regarding end of life care
A nurse is caring for a client who took an overdose of acetaminophen. Which of the
following medication should the nurse plan to administer to the client? -
Acetylcysteine

A nurse is receiving report on for a clients. Which of the following client should the
nurse plan to see first? - A client who has pneumonia, and a new onset of confusion

A nurse is assisting in the care of a client who is postoperative following

administration of general anesthesia. Complete the diagram by dragging from the
choices below, to specify what condition the client is most likely experiencing, two
actions the nurse should take to address that condition and the two parameters the
nurse should monitor to assess the clients progress. - O2 and dantrolene...Malignant
hyperthermia...Hypercapnia and muscle tension

A nurse is collecting data from a client who has Tourette's syndrome. The client
reports taking haloperidol, 0.5 mL orally three times a day at home. Which of the
following components of the prescription should the nurse question? - Dosage

A nurse is reinforcing teaching with a client about how to use an incentive

spirometer. Which of the following actions by the client indicates an understanding
of the teaching? - The client attempts to elevate the cylinder by inhaling deeply.

A nurse is assisting with the care of a client who is postoperative following coronary
artery bypass surgery (CABG). Complete the following sentence by using the list of
options. - The client is at greatest risk for developing dysrhythmias, as evidenced by
electrolyte imbalance

A nurse is caring for a client following a bronchoscopy. Which of the following action
should the nurse take first? - Check for gag reflex

A nurse is receiving change of shift report for four clients. Which of the following
client should the nurse see first? - A client whose urinary output was 100 mL for the
last 12 hours
A nurse is caring for a client who has expressive aphasia following a stroke. Which of
the following method should the nurse use when communicating with the client? -
Provide a picture board

A nurse is assisting in the care of a client who is one day postoperative following a
total thyroidectomy. Complete the following sentence by using a list of options. - The
client is at greatest risk for developing hypocalcemia, as evidenced by numbness
around the lips

A nurse is caring for a client who is scheduled for surgery in the morning. The nurse
learns that the client has decided not to have surgery even though they've already
signed the informed consent form. Which of the following action should the nurse
take? - Report the situation to the provider who obtained the informed consent

A nurse is assisting with an in-service about hepatitis A for a group of staff nurses.
The nurse should include that hepatitis A is transmitted through which of the
following methods? - Consumption of contaminated food

Community health nurse is helping to reinforce teaching about hepatitis A with a

group of employees adult child care facility. Which of the following characteristics of
the nurse identify as an external factor that can pee learning for the participants? -
Poor lighting in the learning setting

A nurse is contributing to the plan of care for an older adult client who has difficulty
sleeping. Which of the following intervention should the nurse include? - Establish a
regular exercise routine, two hours or more before bedtime

A nurse is caring for a client who is postoperative following a perennial

prostatectomy. For each potential postoperative complication below, click to
specify the nursing intervention with the nurse should implement. - Pain and
discomfort/or assist the client with a sitz bath... constipation/encourage the client to
drink, prune juice... deep vein thrombosis/and I instruct the client to perform calf
pump and foot circle exercises

A nurse is collecting data from a client who has multiple fractures following a motor
vehicle crash. For which of the following client statements, should the nurse
recommend a referral to an occupational therapist? - "I am so frustrated. I cannot
even open my milk carton for breakfast."

A nurse is caring for a client who is being discharged home following a

cerebrovascular accident. Which of the following documents should the nurse plan
to include with a discharge report? - List of potential complications to report

A nurse is assisting with a presentation at the community center about personal

disaster preparedness. Which of the following strategies should the nurse
recommend for preparing a Home disaster supply kit? - Have a supply of prescribed
medications.

The nurse is assisting with the care of a client who is admitted to the emergency
department. For each potential assessment, finding, click to specify of the findings,
consistent with schizophrenia or bipolar 1 disorder. Each finding may support more
than one disease process. - Dependency/schizophrenia and bipolar 1 disorder...
Pressured speech/bipolar 1 disorder... grandiose, delusions/schizophrenia, and
bipolar 1 disorder... social impairment/schizophrenia, and bipolar 1 disorder

A high school nurse is having a conversation with parents of an adolescent. The

nurse should identify which of the following situations as an ethical dilemma for the
parents? - We can't decide whether to try to homeschool our child or move them to a
private school

A nurse in a long-term care facility is contributing to the plan of care for a client who
has a new Ostomy. Which of the following intervention should the nurse include? -
Change the appliance two times each week

A nurse is assisting in the care of a client who's in the emergency department. For
each body system below, clip to specify the potential nursing intervention that would
be appropriate for the care of the client. Each party system is support more than one
potential nursing intervention. - Respiratory/Administer naloxone...
Cardiovascular/monitor the client for hypotension... Neurological/observe the client
for pinpoint pupils
A charge nurse in a long-term care facility notices in assistive personnel's repeated
failure to provide oral care for clients. Which of the following action should the
charge nurse take? - Discuss the behavior with the AP while reinforcing expectations

A nurse is preparing to administer an influenza virus an immunization to a client by

the intradermal route. Which of the following action should the nurse take? - Avoid
massaging the site after injecting the vaccine

A nurse is assisting with the care of a client who is postoperative period. Click to
highlight the findings that require immediate follow up. To deselect to finding click
on the finding again. - Blood tinged sputum, respiratory rate, client feeling anxious
and restless, BP & D dimer, 700 NG/ML

A nurse is contributing to an in-service for newly licensed nurse is about child

maltreatment. The nurse should include that which of the following characteristics
increases a child's risk for physical maltreatment? - The child was born at 34 weeks
of gestation

A charge nurse is observing a newly licensed nurse supply sterile gloves. Which of
the following actions by the newly licensed nurse demonstrate sterile technique? -
Putting a glove on the dominant hand first

A nurse is reinforcing, teaching with a client about taking warfarin to treat atrial
fibrillation. Which of the following statements by the client indicates an
understanding of the teaching? - I'll use a safety razor to shave each day

A nurse in the emergency department is assisting in the care of a client. Complete

the following sentence by using the list of options... - The nurse should suspect the
client is experiencing serotonin syndrome as evidenced by the client's altered
mental status

A nurse is assisting with the admission of a client who has major depressive
disorder. Which of the following communication technique should the nurse use to
establish a trusting relationship with the client? - Offering general leads
A nurse is preparing to discharge a client who is immuno compromised. Which of the
following vaccine should the nurse plan to administer? - PPSV/ pneumococcal
polysaccharide

A nurse on a mental health unit is caring for a client. For each nursing action, click to
specify the nursing action is anticipated or contraindicated for the client... -
Anticipated - initiate suicide, precautions, offer, high, calorie snacks frequently,
encourage the client to attend group therapy
Contraindicated - allow the client to sleep with their hands beneath the blankets

A nurse is reinforcing teaching with a client who has a prescription from nitroglycerin
sublingual tablets. Which of the following instruction should the nurse include in the
teaching? - Take up to three tablets during a single Angina episode

A nurse is preparing to administer a clients morning medication's. Which of the

following action should the nurse take to verify the clients identity? - Scan the clients
facility, identification band

A nurse is collecting data from a client who has type two diabetes mellitus and is
concerned about weight gain during pregnancy. Which of the following responses
should the nurse make? - Your weight gain should be the same as for someone
without diabetes

Nurse is reinforcing discharge instructions for the parent of an infant who has
rotavirus. Which of the following statements by the parent indicates an
understanding of the teaching? - I will apply diaper cream to my baby skin during
each diaper change

A nurse is caring for a client who has an altered mental status and has become
aggressive. Which of the following prescriptions should the nurse clarify with the
provider prior to administration? - Zolpidem

A nurse is assisting with the care of a client who has bulimia nervosa. Drag words
from the choices below to fill in each blank in the following sentence... - The client is
at risk for developing electrolyte in balance and cardiovascular abnormalities
A nurse is contributing to the plan of care for a client who is nearly diagnosed with
iron deficiency anemia. Which of the following foods should the nurse include in the
plan is having the highest amount of iron? - Boiled spinach

A nurse is reinforcing, teaching with a newborn's parents about umbilical cord care.
Which of the following statements by a parent indicates an understanding of the
instructions? - I will give her baby sponge baths until the cord falls off

A nurse is collecting data from a client who's in the diagnostic center and is
scheduled to undergo a colonoscopy. Based on the information provided in the
clients chart, which of the following cases of data places this client at risk for
colorectal cancer? - BMI

A nurse in a providers office is reinforcing, teaching with a client who has a new
prescription for Ferris sulfate elixir. Which of the following statements by the client
should indicate to the nurse an understanding of the teaching? - I will rinse my
mouth after taking this medication

A nurse is reinforcing teaching with a client who has acute diverticulitis. Which of the
following statements by the client indicates an understanding of the instructions? - I
will receive the nutrients I need through my IV fluid

Nurse is reinforcing teaching with a client who has fluid volume deficit about
selecting foods that have high water Contant. The nurse should indicate that which
of the following raw foods contains the highest amount of water per 1 cup serving? -
Cherry tomatoes

A nurse is reinforcing teaching with the adult children have a client who is dying.
Which of the following statements should the nurse make? - You can continue
talking to your parent until they are gone

A nurse is caring for an infant who is receiving IV fluids for dehydration. Which of the
following should the nurse recognize as a positive response to the therapy? - moist
mucous membranes

A nurse is caring for a school-age child. For each data collection, finding, click to
specify if the finding is consistent with attention deficit, hyperactivity disorder or
intellectual disability. Each finding may support more than one disease process... -
ADHD - losing things, interrupting others, social functioning, deficit hyperactivity to
sensory input
ID - impaired language skills, and social functioning deficit

A nurse is reinforcing teaching about stress management techniques with a client

who has moderate anxiety disorder. Which of the following responses by the client
indicates an understanding of the teaching? - I will imagine myself in a calm place,
when I can't concentrate

A nurse is working with an interpreter to assist the provider with explaining a

diagnostic procedure to a client who speaks a different language than the nurse.
Which of the following action should the nurse take? - Ensure the interpreter is
culturally compatible with the client

A nurse in a long-term care facility is serving on the ethics committee, which is a

dressing a client care dilemma. Which of the following strategies will facilitate
resolving the dilemma? - Determine the facts related to the dilemma, identify
possible solutions and consider the clients wishes

A nurse is reinforcing, teaching with a client who has hypothyroidism, and a

prescription for level thyroxine. Which of the following instruction should the nurse
include in the teaching? - You will need to take this medication for the rest of your life

A nurse is reinforcing home, safety instructions with the parent of a newborn. Which
of the following statements should the nurse include in the instructions? - Place your
babies crib away from heat vents

A nurse is reinforcing teaching with a client who has asthma and a new prescription
for and ipratropium inhaler. Which of the following statements by the client indicates
an understanding of the teaching? - I should wait one minute before taking a second
puff of the medication

A nurse is preparing to administer metoclopramide 10 mg IM. Available is

metoclopramide 5 mg/ML. How many ML should the nurse administer? Round the
answer to the nearest whole number. Use the leading zero if it applies. Do not use
trailing zero... - 2mL
A nurse is assisting with the admission of an adolescent who has bulimia nervosa.
Which of the following manifestations should the nurse expect? - Hematemesis

A nurse is observing an assistive personnel, caring for a client. Which of the following
actions by the AP should the nurse Intervine? - The AP reports client information to
the oncoming AP in the hallway

A nurse is assisting with the admission of a client who has a latex allergy. The nurse
should identify that which of the following supplies has the potential to contain
latex? - Indwelling urinary catheter

A nurse is collecting data from a client who has myasthenia gravis (MG). Which of
the following images should the nurse identify as an indication that the client is
experiencing ptosis? -

A nurse is reinforcing teaching with a client who is pregnant. Complete the following
sentence by using the list of options. - The client is at rest for experiencing metabolic
acidosis due to excessive weight loss

A nurse is reinforcing teaching with a client who has tuberculosis. Which of the
following statements by the client indicates an understanding of the teaching? - The
people I live with should be tested for TB

A nurse on an acute care unit is collecting data from a school age child who has
cystic fibrosis. Which of the following findings is the priority for the nurse to report to
the provider? - Reports lack of appetite

A nurse is assisting in the care for a client who is one hour postpartum. Select the six
actions. The nurse should take... - Firmly massage the uterine fundus, administer
methylergonovine, weigh the perennial pads, provide emotional support, insert
indwelling urinary catheter and administer oxygen at 12 L per minute via a non-
rebreather facemask

A nurse in a long-term care facility is transcribing new prescriptions for four clients.
Which of the following prescriptions is accurately transcribed by the nurse? -
Potassium chloride 20 mEq PO every morning
A nurse is contributing to the plan of care for a client who had a vaginal delivery for
hours ago and has a fourth-degree perennial laceration. Which of the following
intervention should the nurse recommend? - Instruct the client to use a sitz bath at
least twice a day

A nurse is caring for a client who has one day postoperative and is unable to
ambulate. Which of the following action should the nurse take to promote the clients
venous return? - Maintain a sequential compression device

A nurse in a long-term care facility is reviewing information about healthcare

associated infections with a newly licensed nurse. Which of the following
information should the nurse include? - Prolonged use of corticosteroids is a risk
factor for infections

A nurse is caring for a female client who just had an indwelling urinary catheter.
Which of the following action should the nurse take? - Wipe the drainage port, with
an antiseptic wipes after emptying urine from the bag

A nurse is reinforcing teaching with a client who has a new prosthesis for an above
the knee amputation of the right leg. Which of the following instruction should the
nurse include? - Apply the prosthesis immediately upon waking each day

A nurse is assisting with the care of a client who is 24 hour postoperative following a
cesarean birth. Complete the following sentence by using a list of options.... - The
client is at risk for developing seizures as evidenced by severe features of
preeclampsia

A nurse is reinforcing teaching with a client who has a new diagnosis of type two
diabetes mellitus and inquires about information concerning oral anti-diabetic
agents. In addition to the provider, where should the nursery for the client for
information? - A pharmacist, package inserts, and American diabetes association

A nurse is observing an assistive personnel, apply antiembolic stockings for a client.

Which of the following actions by the AP demonstrates an understanding of how to
perform the skill? - Applying the stockings before the client gets out of bed
A nurse is reinforcing, teaching about ways to reduce solid fat consumption with a
client who has an elevated cholesterol level. Which of the following instruction
should the nurse include? - Purchase beef that is loin cut

A nurse is collecting data from a male client who is scheduled for a left inguinal
nerniorrhapy. Which of the following findings is the priority for the nurse to report to
the provider? - Decreased bowel sounds

A nurse is reinforcing teaching with a mail. Client who is uncircumcised about

obtaining a clean catch midstream, urine specimen. Identify the sequence of
actions. The nurse will instruct the client to take after washing their hands... - -
expose the glans of the penis
-Cleanse the penis using an antiseptic swab
-Begin urination
-Pass the cup into the urine stream
-Move the cup out of the urine stream
-Replace the foreskin

A nurse is contributing to the plan of care for a client who has had a chest tube
connected to a close drainage system. Which of the following intervention should
the nurse include? - Maintain the drainage system below the level of the clients
chest

A nurse on the pediatric unit is collecting data from for newly admitted client. Which
of the following client should the nurse identify as being at risk for urinary retention?
- A school-age child who has allergic rhinitis and is taking diphenhydramine

A nurse is transferring a client from bed to a wheelchair. The client has right sided
weakness following a recent stroke. Which of the following action should the nurse
take? - Place the wheelchair on the clients left side

A nurse is caring for a client who has two days postoperative following abdominal
surgery and has a new prescription for a regular diet. For which of the following
findings should the nurse notify the provider? - The client has absent bowel sounds
A nurse is assisting with the admission of a client who is experiencing alcohol
withdrawal. Which of the following medication should the nurse expect the provider
to prescribe for the client? - Chlordiazepoxide/librium

A nurse manager is preparing to complete a performance analysis for a group of

assistant personnel. The manager asked the staff nurse for feedback on each APs
abilities. Which of the following action should the staff nurse take? - Discuss how
each APs actions measure against the job description

A nurse at a long-term care facility is caring for a client who requires oral suctioning
which of the following supplies. Should the nurse plan to use for this task? - A
Yankauer catheter

A nurse is assisting in the care of a client who is pregnant. The nurse is reinforcing
discharge teaching with a client. For each discharge instruction, click to specify if
each action is recommended or contraindicated for the client... - Recommened - Eat
every 2 to 3 hours, alternate eating solid foods and liquids, increase intake of high
protein foods and drink, warm Gingerale

A nurse is reinforcing teaching about food selection with a client who has a
moderate burn injury. Which of the following food should the nurse recommend as
being high in vitamin C? - Tomatoes

A nurse is collecting data from a client who is in severe pain. Which of the following
question should the nurse ask first? - Where is your pain located?

A nurse is reinforcing teaching with a parent of a preschooler who has lactose

intolerance. Which of the following statements by the parent indicates an
understanding of the teaching? - I should offer my child yogurt that has a probiotic as
a snack

A nurse in a long-term care facility is observing a newly licensed nurse who is

providing tracheostomy care for a client. The nurse identifies proper performance of
the procedure, when the newly licensed nurse selects, which of the following
solutions to clean the inner cannula? - Hydrogen peroxide
A nurse is assisting with monitoring a client who is in labor and has spontaneous
rupture of membranes following a vaginal examination. The provider reports the
client cervix is dilated to 1 cm with an engaged, presenting part. Which of the
following action should the nurse take? - Apply the external fetal heart rate monitor

A nurse is performing post Mortem care for a client prior to the arrival of the clients
family for viewing of the body. Which of the following action should the nurse take? -
Gently close the clients eyelids

A nurse is collecting data from a client who is experiencing a situational crisis

following the loss of a job. The client states "I don't think I can go through this again."
Which of the following actions is the nurses priority? - Determine if the client is
experiencing psychotic thinking

A nurse is reinforcing teaching with a client who has type two diabetes mellitus and
reports waking during the night with tremors and anxiety. Which of the following
information should the nurse include? - Eat a bedtime snack

A nurse is preparing to administer digoxin to a client who has heart failure. Which of
the following finding should indicate to the nurse that the medication has been
effective? - Cardiac work load decreases

A nurse is assisting with monitoring a client who is at 40 weeks of gestation and is in

active labor. The nurse recognizes late declarations on the fetal monitor tracing.
Which of the following action should the nurse take? - Please the client in a lateral
position

A nurse is preparing to administer purified protein derivative (PPD) to a client who

has suspected tuberculosis. Which of the following action should the nurse plan to
take? - Ensure the injection produces a wheal on the skin

A nurse assisting with a childbirth class is discussing non-pharmacological

strategies used during labor. Which of the following statements by a client indicates
an understanding of cutaneous stimulation? - I should use counter pressure for back
pain during labor
A nurse is contributing to the plan of care for a client who is at risk for developing
pressure injuries. Which of the following intervention should the nurse include? -
Place the client at a 30° lateral position

A nurse is reinforcing teaching with a client who is bottlefeeding their full term
newborn with formula. Which of the following instruction should the nurse include in
the teaching? - Feed the newborn at least every 3 to 4 hours

A nurse is contributing to the plan of care for a client who is receiving mechanical
ventilation. Which of the following intervention should the nurse recommend? -
Position the bed at a 30° angle

A nurse is collecting data from a client who has bipolar disorder and is experiencing
acute mania. Which of the following findings is the nurses priority? - Lack of sleep

A nurse is assisting with performing a non-stress test for a client who is at 39 weeks
of gestation period which of the following instruction should the nurse reinforce with
the client? - You should depress the button on the hand held marker when you feel
your baby move

A nurse is maintaining droplet precautions for a client who has meningitis. Which of
the following action should the nurse take? - Where is surgical mask within 3 feet of
the client

A nurse is reinforcing teaching with a client who has a new prescription for
prednisone for the treatment of Addison's disease. Which of the following instruction
should the nurse include in the teaching? - You should schedule a bone density test

A charge nurse on a long-term care unit is preparing to delegate task to a licensed,

practical nurse and an assistive personnel. Which of the following tasks should the
nurse delegate to the LPN? - Administering an initial NG tube, feeding to a client who
had a stroke

A nurse is administering lorazepam to a client who is scheduled for surgery within

one hour. Which of the following action should the nurse take after administering the
medication? - Instruct the client not to get out of bed
A nurse is preparing to administer a rectal suppository to a school age child. Which
of the following action should the nurse plan to take? - Use one finger to insert a
suppository past the anal sphincter's

A nurse is reinforcing, discharge teaching about car seat safety, with the guardian of
a newborn. Which of the following statements by the guardian indicates an
understanding of the teaching? - i will secure the car seat in the car by using the
seatbelt.

A nurse is preparing to administer medications to a client who is NPO and is

receiving enteral feedings through an NG tube. Which of the following prescription
should the nurse clarify with the provider? - Metoprolol ER 50 mg per NG tube BID

A nurse in a long-term care facility is assisting in an in-service for newly hired

assistive personnel about legal issues within the facility. Which of the following
should the nurse include as an example of assault? - Informing a client that the
nurse is going to administer an injection, even though the client refuses

A nurse in a long-term care facility is auscultating lung sounds of a client who reports
shortness of breath and increased fatigue. The nurse should report which of the
following to the provider after hearing this sound? - Fine crackles

A nurse notices in assistive personnel, taking a nap in the break room during meal
time. The nurse also notes that the AP is drowsy while performing routine tasks.
Which of the following action should the nurse take? - Report the observations about
the AP to the unit's nurse manager

A nurse manager is providing an in-service on hand hygiene to assistive personnel.

Which of the following information should the nurse manager include in the in-
service? - Remove rings when washing hands with soap and water

A nurse is assisting in the care of an adolescent. Select the for findings that require
follow up after the fall of a skateboard. - -capillary refill
-Pedial pulse
-Skin temperature
-Pain
A nurse is reviewing the clients medical record. Which of the following action should
the nurse take after the adolescent returns from surgery? - -elevate the adolescence
affected limb to chest level
-Monitor neurovascular status every hour
-Remove the indwelling urinary catheter when no longer indicated

The nurse is continuing to care for the adolescent... complete the following sentence
by using the list of options. - The client is at greatest risk for developing compartment
syndrome as evidenced by pain level

The nurse is continuing to care for the adolescent. For each potential providers
prescription, clip to specify of the potential prescription is anticipated or
contraindicated for the adolescent - Contraindicated - elevating the leg above heart
level and applying ice to the affected extremity.
Anticipated - prepare the adolescent for surgery and remove the splint

The nurse is assisting with preparing the adolescent for fasciotomy. Which of the
following findings should the nurse report to the provider prior to surgery? - The
adolescence parents have concerns regarding the surgery

The nurse is collecting data from the adolescent for hours following the fasciotomy.
Click to highlight the findings below that indicate an improvement in the
adolescence condition... - Highlight extremity pulse, capillary, refill, extremity, warm
to the touch, no numbness or tingling and a decrease in pain