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A 2-day postpartum mother who is breastfeeding asks, “Why do I feel this tingling in my breasts after the baby sucks for a few minutes?” Which information should the nurse provide?
The nurse is preparing to administer dalteparin subcutaneously to an immobile client who has been receiving the medication for 5 days. Which finding indicates that the nurse should hold the prescribed dose?
Two days after swallowing 30 tablets of alprazolam, a client with a history of depression is hemodynamically stable but wants to leave the hospital against medical advice. Which nursing action(s) is(are) most likely to maintain client safety? (Select all that apply.)
Which question is most relevant to ask the parents when obtaining the history of a 2-year-old child recently diagnosed with otitis externa?
The RN manager of a skilled nursing facility wants to assign a staff member to assess the nutritional needs of an emaciated client with pressure ulcers. Which of these team members is appropriate?
The health care provider prescribes 1000 mL of a D5W solution to infuse over 8 hours for a client who has had an appendectomy. The IV tubing being used delivers 15 gtt/mL. The nurse should set the flow rate at how many gtt/min? (If rounding is necessary, round to the nearest whole drop.)
The nurse is preparing a client for surgical stabilization of fractured lumbar vertebrae. Which indication(s) best supports the client’s need for insertion of an indwelling urinary catheter? (Select all that apply.)
The nurse is teaching a client who is diagnosed with gonorrhea. What does the nurse tell the client about the disease?
According to Erikson, which client should the nurse identify as having difficulty completing the developmental stage of older adults?
The nurse is conducting a medication assessment on an older adult client who is being admitted to a long-term care facility for rehabilitation following a hip replacement. With Beers Criteria used as a resource, which drug poses a potential risk for this client?
A client with acquired immunodeficiency syndrome (AIDS) is hospitalized after a recent discharge. Which nursing intervention is most important in reducing the client’s stress associated with repeated hospitalization?
Transcutaneous electrical nerve stimulation (TENS) is prescribed for a client with chronic back pain. Which action(s) should the nurse take when preparing the client for this type of pain relief? (Select all that apply.)
A client with human immunodeficiency virus (HIV) infection has white lesions in the oral cavity that resemble milk curds. Nystatin preparation is prescribed as a swish and swallow. Which information is most important for the nurse to provide the client?
When the administration at a large urban medical center decides to establish a unit to care for clients with infectious diseases, such as COVID-19 and the avian flu, several employees express fear related to caring for these clients. When choosing staff to work on this unit, which action is best for the nurse-manager to take?
Which nursing intervention(s) should be implemented when caring for a client with bipolar disorder in the manic phase? (Select all that apply.)
The nurse is evaluating a client’s response to antibiotic treatment for the pelvic inflammatory disease (PID). Which finding indicates that the treatment is effective?
The nurse would be correct in withholding a dose of digoxin in a client with congestive heart failure without specific instruction from the health care provider if which finding was documented?
Which client is best to assign to a graduate PN who is being oriented to a renal unit?
The RN at a skilled nursing facility is supervising a staff of LPN/LVNs and nursing assistants. Which of these nursing actions does the RN delegate to a nursing assistant?
The only RN on a surgical unit performs an admission assessment on a client scheduled for surgery in 2 hours. The UAP reports to the RN that an unresponsive male client with a continuous feeding tube has just vomited. Which action should the RN delegate to the UAP?
The nurse is assessing an older adult client’s alcohol use. Which client statement warrants a follow-up collection of more data?
A 70-year-old client whose spouse died the previous year says to the nurse, “Life is not fun anymore.” How does the nurse respond?
A client with small cell carcinoma of the lung has also developed a syndrome of inappropriate antidiuretic hormone (SIADH). Which outcome finding is the priority for this client?
A nurse is planning client care and wants to verify the steps for a specific client procedure. Which action should the nurse take?
The medication allopurinol is prescribed for a client newly diagnosed with gout. Which comment by the client warrants intervention by the nurse?
After administering a 0730 dose of Humalog 50/50 insulin to a client with diabetes mellitus, which nursing action has the highest priority?
The client with which fasting plasma glucose level needs the most immediate intervention by the nurse?
A child is having a generalized tonic-clonic seizure. Which action should the nurse take?
Which older adult client’s living situation typically presents the highest risk for abuse?
An older client who resides in a long-term care facility is hearing-impaired. How should the nurse modify interventions for this client?
Which pathophysiologic response supports the contraindication for opioids, such as morphine, in clients with increased intracranial pressure (ICP)?
The nurse formulates a nursing diagnosis of pain related to muscle spasms for a client with extreme lower back pain associated with acute lumbosacral strain. Which is the best intervention for the nurse to implement?
The RN is arriving for night duty at an acute care hospital. Which client does the RN assess first?
The health care provider prescribes 1000 mL of Ringer’s lactate solution with 30 units of oxytocin (Pitocin) to infuse over 4 hours for a client who has just delivered a 10-lb infant by cesarean section. The tubing has been changed to a 20 gtt/mL administration set. The nurse should set the flow rate at how many gtt/min?
A client with hemiparesis needs assistance transferring from the bed to the wheelchair. The nurse assists the client to a sitting position on the side of the bed. Which action should the nurse implement next?
The nurse is teaching a client newly diagnosed with diabetes mellitus about the subcutaneous administration of regular and NPH insulin. Which statement indicates that the client needs further instruction?
The nurse is assessing the nutritional status of an older adult client. Which statement made by the client needs to be explored further?
A client hospitalized for meningitis is demonstrating nuchal rigidity. Which symptom is this client likely to be exhibiting?
The charge nurse overhears a staff member asking for a doughnut from a client’s meal tray. Which action should the charge nurse implement?
Staff on a cardiac unit consists of an RN, two practical nurses (PNs), and one UAP. Team 1’s assignment includes two clients who are both 1 day postangioplasty and two clients with unstable angina. Team 2’s assignment includes all stable clients, but two clients are bedridden and incontinent. Which staffing plan represents the best use of available staff?
The charge nurse of a medical-surgical unit is alerted to an impending disaster requiring implementing the hospital’s disaster plan. Specific facts about the nature of this disaster are not yet known. Which instruction should the charge nurse give to the other staff members at this time?
A client on the outpatient surgical unit is preparing for discharge after a myringotomy with the placement of ventilating tubes. Which response by the client indicates that further teaching is necessary?
An older adult client who lives with her daughter is admitted to the hospital. During the admission assessment, the nurse notes strong body odor, several large pressure ulcers, and limb contractures. What does the nurse do first?
An older client is admitted to the hospital with abdominal pain and watery, incontinent diarrhea following a course of antibiotic therapy for pneumonia. Stool cultures reveal the presence of C. difficile. While planning care, which nursing goal should the nurse establish as the priority?
The nurse is teaching a class of older adults about ways to promote their cognitive health. Which collaborative interventions will be most helpful for them?
Select all that apply.
A client with hemiplegia on bed rest is turned to the supine position, and the nurse determines that the client’s hips are externally rotated. Which intervention is most important for the nurse to implement?
A 50-year-old man arrives at the clinic with complaints of pain on ejaculation. Which action should the nurse implement?
A client with schizophrenia tells the nurse, “The world is coming to an end. All the violence in the Middle East is soon going to destroy the entire world!” How should the nurse respond?
A male client with arterial peripheral vascular disease (PVD) complains of pain in his feet. Which instruction should the nurse give to the UAP to relieve the client’s pain quickly?
The nurse is talking to a group of active senior citizens about making healthy lifestyle choices. Which suggestion is most important in promoting health and safety?
The client is diagnosed by the emergency department health care provider (HCP) with an acute migraine. For which situation is it most important to have a discussion with the HCP before medication is prescribed?
Which client is at greatest risk for respiratory depression while receiving opioids for analgesia?
A client is crying and grimacing but denies pain and refuses pain medication because “my brother is a drug addict and has ruined our lives.” What is the priority intervention for this client?
Which drug prescription would the nurse be sure to question for a patient diagnosed with heart failure?
The RN is supervising a student nurse caring for a patient with hypertension. The health care provider prescribed enalapril 2.5 mg orally twice a day. The student tells the nurse that the patient has swelling around the eyes and lips. What does the nurse tell the student is the first best action?
Because she is a carrier of hemophilia, a new mother is worried about hemophilia A developing in her child. The nurse explains the meaning of sex-linked inheritance. Which statements are correct? (Select all that apply.)
A patient with atrial fibrillation on warfarin (Coumadin) asks why he has to take so much more medication than his neighbor, who has the same problem. Which response by the nurse is correct? (Select all that apply.)
The nurse is discussing the patient’s home medications. Which question will elicit the most information from the patient regarding the patient’s understanding of the diuretic?
What are the advantages to performing preoperative patient and family teaching about the recovery phase of surgery? (Select all that apply.)
A patient has been on a non-rebreathing mask at 10 L/min for 4 days and is complaining of a dry cough, a stuffy nose, and substernal chest pain (pain score 6 of 10) that increases with deep breathing. The chest radiograph shows no changes, and the 12-lead electrocardiography (ECG) findings are normal. The nurse suspects the patient is experiencing which disorder?
The physician orders rotation therapy for a patient experiencing acute lung injury. Which technique should be used for the therapy to be effective?
The nurse is suctioning a patient’s endotracheal tube and notices that the heart rate is dropping from 100 to 52 beats/min. What is the priority action?
Which of the following actions is an important part of oral care for an intubated patient? (Select all that apply.)
The nurse concludes that which behavior by the client is consistent with adherence to a 2-gram sodium-restricted diet?
The nurse is aware that the client who underwent gastric lavage for overdose of a prescribed medication will need careful assessment for treatment complications. Which assessment should be the nurse’s priority?
The nurse has emptied a Jackson Pratt wound drainage device and needs to reestablish suction to the tube. Which action should the nurse take to accomplish this objective?
The nurse determines that a hypertensive client understands the DASH diet (Dietary Approaches to Stop Hypertension) when the client chooses which items from a sample menu used in dietary teaching?
A client who underwent pelvic surgery the previous day has a Penrose drain placed in the lower abdomen. The nurse should take which action in the care of this wound drain?
The nurse is evaluating a client using a cane. Which assessment made by the nurse would indicate that the client is using the cane appropriately?
A client who is recovering from partial- and full-thickness burns has been advanced to a general diet. Which foods should the nurse encourage the client to eat most often?
A client with chronic obstructive pulmonary disease (COPD), who ingests more than 3,000 calories/day to gain weight, now reports increased breathing difficulty. The client states, “I thought that if I gained weight by eating more, I would feel better.” How should the nurse respond to the client’s concern?
A client is at risk for developing a pressure injury and is placed on a repositioning regimen. The client does not like to lie on his side and complains about the need to turn. Which explanations by the nurse may enhance compliance? Select all that apply.
Which client comment indicates to the nurse that more teaching is needed about measures to reduce dumping syndrome after gastric surgery?
The nurse is changing the abdominal dressing of a client who is 4 days postoperative. The nurse notes a moderate amount of serosanguineous drainage, wound edges not approximated, and puffy tissue protruding through the wound. What condition should the nurse suspect from theses manifestations?
Which statement would the nurse make during dietary teaching to a client who has renal calculi?