Predictive exam XII RN

The home health nurse discovers that an older adult client has been sharing his pain medication with his daughter. Despite the nurse’s warnings about the dangers of sharing, he states, “My daughter can’t afford to see a doctor or to buy medicine, so I must give her a few of my pain pills.” Which member of the health care team is the nurse most likely to consult first?

For a postoperative client, the health care provider (HCP) prescribed multimodal therapy, which includes acetaminophen, nonsteroidal anti-inflammatory drugs, as needed (PRN) opioids, and nonpharmaceutical interventions. The client continuously asks for the PRN opioid, and the nurse suspects that the client may have a drug abuse problem. Which action by the nurse is best?

An inexperienced graduate nurse is reviewing the medication administration record (MAR) for a client who has a patient-controlled analgesia (PCA) pump for pain management. The new nurse compares the MAR and the health care provider’s (HCP’s) prescription, and both indicate that larger doses are prescribed at night compared with doses throughout the day. Which member of the health care team should the new nurse consult first?

During a check-up at the health care provider’s (HCP’s) office, a male patient tells the nurse that he is having difficulty getting and keeping an erection. The HCP diagnoses the patient with erectile dysfunction (ED) and prescribes sildenafil 50 mg orally once daily 30 minutes to 1 hour before sexual activity. Which are key teaching points about this drug? Select all that apply.

The nurse wants to join a professional, multidisciplinary critical care association. Which organization would be the best choice?

The nurse is educating the patient on guided imagery. Which statement indicates the patient requires more education?

The nurse hesitates to report a critical laboratory value to a physician for fear of receiving an angry, inappropriate response. By waiting for the next shift, the nurse does not promote which of the following Healthy Work Environment Initiatives?

A nurse is preparing to present information to a women’s group about the cautions associated with aromatherapy. What information is appropriate to include for the audience? Select all that apply.

The female client tells the nurse that she is planning a pregnancy soon. In providing client education about the use of herbs during pregnancy, which statement by the nurse is most appropriate?

A child with nephrotic syndrome is receiving prednisone. Which choice of breakfast foods at a fast food restaurant indicates that the mother understands the dietary guidelines necessary for her child?

The nurse is preparing a presentation for staff about the effects of humor in nursing situations. What feedback would indicate to the nurse that the participants understand the role of humor in the healthcare setting?

The client presents to the healthcare clinic with an abrasion to the left knee from a fall. After cleaning the abrasion, the nurse might support the use of which client-chosen herb as adjunct therapy to treat the abrasion?

The nurse is evaluating the effectiveness of guided imagery for a client with preoperative anxiety. Which client statement should indicate to the nurse that the therapy has been successful?

A client scheduled for arthroscopic knee surgery has been taking ginger for relief of arthritic pain. The client asks the nurse about postoperative use of ginger for continued relief of pain and postoperative nausea. What essential information should the nurse provide?

The health care provider performs a bone marrow aspiration from the posterior iliac crest for a client with pancytopenia. Which action should the nurse implement first?

The nurse is using progressive relaxation on a client who is experiencing a great deal of stress. What nursing action is necessary in order to protect the client’s safety prior to the start of the session?

Which client is best to assign to a graduate PN who is being oriented to a renal unit?

A 50-year-old man arrives at the clinic with complaints of pain on ejaculation. Which action should the nurse implement?

The nurse is teaching the client’s partner how to perform a back massage on the client. Which observation by the nurse indicates that the partner understands how to perform the activity? Select all that apply.

A client is admitted with a diagnosis of leukemia. This condition is manifested by which of the following?

Which intervention is most important when caring for a client immediately after electroconvulsive therapy (ECT)?

The nurse is caring for a client with deep vein thrombosis who is on a continuous IV heparin infusion. The activated partial prothrombin time (aPTT) is 120 seconds. Which action should the nurse take?

A client comes to the obstetric clinic for her first prenatal visit and complains of feeling nauseated every morning. The client tells the nurse, “I’m having second thoughts about wanting to have this baby.” Which response is best for the nurse to make?

A client with bipolar disorder is seen in the mental health clinic for evaluation of a new medication regimen that includes risperidone. The nurse notes that the client has gained 30 lb in the past 3 months. Which assessment is most important for the nurse to obtain?

When caring for an 80-year-old client with pneumonia, which finding is of most concern to the nurse?

Which intervention should be included in the plan of care for a client admitted to the hospital with ulcerative colitis?

The nurse walks into the room and observes the client experiencing a tonic-clonic seizure. Which intervention should the nurse implement first?

When blood or blood products are administered, which task can be assigned to the licensed practical nurse (PN)?

The nurse prepares to administer digoxin, 0.125 mg IV, to an adult client with atrial fibrillation. Which client datum requires the nurse to withhold the medication?

The nurse is caring for a client with chronic renal failure (CRF) who is receiving dialysis therapy. Which nursing intervention has the greatest priority when planning this client’s care?

The nurse is assessing a client at 20 weeks’ gestation. Which measurement should be compared with the client’s current weight to obtain the most accurate data about her weight gain during pregnancy?

A client with type 2 diabetes has a plantar foot ulcer. When developing a teaching plan regarding foot care, what information should the nurse obtain first from the client?

The nurse hears a series of long-duration, discontinuous, low-pitched sounds on auscultation of a client’s lower lung fields. Which documentation of this finding is correct?

When caring for a client in labor, which finding is most important to report to the primary health care provider?

The nurse is correct in withholding an older adult client’s dose of nifedipine if which assessment finding is obtained?

Six hours following thoracic surgery, a client has the following arterial blood gas (ABG) findings: pH, 7.50; PaCO₂, 30 mm Hg; HCO₃, 25 mEq/L; PaO₂, 96 mm Hg. Which intervention should the nurse implement based on these results?

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 nurse who has recently completed orientation is beginning work in the labor and delivery unit for the first time. When making assignments, which client should the charge nurse assign to this new nurse?

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.)

The nurse is planning a community teaching program regarding the use of folic acid to prevent neural tube birth defects. Which community group is likely to benefit most from this program?

A client with hemiplegia who is 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?

When assisting a client who has undergone a right above-knee amputation with positioning in bed, which action should the nurse include?

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.)

Which physiologic finding in an older adult contributes to an adverse drug reaction?

The nurse meets resistance while flushing a central venous catheter (CVC) at the subclavian site. Which action should the nurse perform?

The nurse should encourage a laboring client to begin pushing at which point?

A male client is admitted for observation after being hit on the head with a baseball bat. Six hours after admission, the client attempts to crawl out of bed and asks the nurse why there are so many bugs in his bed. His vital signs are stable, and the pulse oximeter reading is 98% on room air. Which intervention should the nurse perform first?

When the nurse-manager posts a schedule for volunteers to be on call, one staff member immediately signs up for all available 7-to-3 day shifts. Other staff members complain to the charge nurse that they were not permitted the opportunity to be on call for the day shift. What action should the nurse-manager implement?

Because of census overload, the charge nurse of an acute care medical unit must select a client who can be transferred back to a residential facility. The client with which symptomology is the most stable?

The charge nurse of a medical-surgical unit is alerted to an impending disaster requiring implementation of 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?

Which assessment finding for a client with peritoneal dialysis requires immediate intervention by the nurse?

The charge nurse working in the surgical department is making shift assignments. The shift personnel include an RN with 12 years of nursing experience, an RN with 2 years of nursing experience, and an RN with 3 months of nursing experience. Which client should the charge nurse assign to the RN with 3 months of experience?

A client has been on a mechanical ventilator for several days. What should the nurse use to document and record this client’s respirations?

The only RN on a surgical unit is performing 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?

Which findings would suggest to the nurse that diagnosis of glomerulonephritis is correct?

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 charge nurse of a 16-bed medical unit is making 0700 to 1900 shift assignments. The team consists of two RNs, two PNs, and two UAP. Which assignment is the most effective use of the available team members?

A client tells the nurse that he is suffering from insomnia. Which information is most important for the nurse to obtain?

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?

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?

The nurse taught the client about meditation. Which statement by the client demonstrates a correct understanding of this activity?

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?

A registered nurse (RN) delivers telehealth services to clients via electronic communication. Which nursing action creates the greatest risk for professional liability and has the potential for a malpractice lawsuit?

The nurse is performing an imagery session with a group of clients. What instruction should the nurse give the clients?

Which assessment finding indicates that nystatin swish and swallow, prescribed for a client with oral candidiasis, has been effective?

A female client arrives for an annual well-woman checkup and cervical Pap test and tells the nurse that she has been using an over-the-counter (OTC) vaginal cream for the past 2 days to treat an infection. Which initial response should the nurse make?

When the administration at a large urban medical center decides to establish a unit to care for clients with infectious diseases, such as ebola 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?

The nurse recognizes which behaviors in a client as warning signs of an impending suicide attempt? (Select all that apply.)

Prior to administering an oral suspension, which intervention is most important for the nurse to implement?

A client with hepatic failure tells the nurse about recent use of acetaminophen. How should the nurse respond to this client’s statement?

The nurse is preparing a client for surgical stabilization of a fractured lumbar vertebrae. Which indication(s) best supports the client’s need for insertion of an indwelling urinary catheter? (Select all that apply.)

A client who is admitted with emphysema is having difficulty breathing. In which position should the nurse place the client?

The nurse plans to evaluate the effectiveness of a bronchodilator. Which assessment datum indicates that the desired effect of a bronchodilator has been achieved?

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?