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Maternal and Newborn Nursing Chapter Exam Questions - 2944 Verified Questions

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Maternal and Newborn Nursing Chapter

Exam Questions

Course Introduction

This course provides an in-depth examination of nursing care for mothers and newborns, emphasizing the physiological and psychological changes experienced during pregnancy, childbirth, and the postpartum period. Students will explore concepts related to prenatal care, labor and delivery, maternal and neonatal assessment, and common complications encountered in the perinatal setting. Evidence-based practices for promoting the health and well-being of both mother and infant are highlighted, along with family-centered care, patient education, cultural considerations, and interprofessional collaboration. Opportunities for critical thinking and clinical decision-making are integrated to prepare students for safe, compassionate, and competent practice in maternal and newborn nursing.

Recommended Textbook

Nursing A Concept Based Approach to Learning Volume I.II and III 1st Edition by Pearson Services

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Page 2

Chapter 1: Acid-Base Balance

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Sample Questions

Q1) The nurse is analyzing the client's arterial blood gas report, which reveals a pH of 6.58. The client has just suffered a cardiac arrest. Which consequences of this pH value does the nurse consider for this client?

A)Decreased cardiac output

B)Increase magnesium levels

C)Decreased free calcium in the ECT

D)Increased myocardial contractility

Answer: A

Q2) The nurse is providing care to an older adult client diagnosed with respiratory alkalosis. The nurse states to the client, "Look into my eyes and breathe with me so that we can slow down your breathing rate." The client continues to look down and refuses to make eye contact with the nurse. The client's daughter later asks you to teach her how to help her mother to control her breathing. When documenting this client's care, which statement is appropriate for the nurse to include?

A)"The client is noncompliant with suggested treatment plan."

B)"The client is unable to understand and follow directions."

C)"The client did not feel comfortable making eye contact during nursing care."

D)"The client's daughter may be abusive."

Answer: C

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Page 3

Chapter 2: Cellular Regulation

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Sample Questions

Q1) The nurse is caring for an adolescent client with a strong family history of breast cancer. What should the nurse instruct the client regarding cancer prevention? Select all that apply.

A)Encourage the client to learn more about the disease.

B)Talk to family members who have the disease.

C)Perform monthly breast self-examination.

D)Teach the side effects of cancer treatment.

E)Discuss cancer fears with the healthcare provider.

Answer: A, C

Q2) An adult client reports to the nurse an inability to tolerate usual exercise and the feeling of fatigue. The client states that these symptoms have been gradual over time. Which physical assessment findings, along with the client's verbal complaints, would indicate chronic lymphocytic leukemia (CLL)? Select all that apply.

A)Joint pain

B)Pallor

C)Splenomegaly

D)Abnormal bleeding

E)Edema

Answer: B, C, E

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4

Chapter 3: Comfort

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Sample Questions

Q1) A 15-year-old female client diagnosed with juvenile primary fibromyalgia syndrome asks the nurse whether the fibromyalgia can be cured so that she won't have to deal with it as an adult. Which of the following is the best response the nurse could make to this question?

A)The fibromyalgia likely can be cured with proper sleep hygiene, exercise, and pharmacologic management.

B)Fibromyalgia can be difficult to treat effectively, but the symptoms are unlikely to persist into adulthood.

C)It is likely that the fibromyalgia will persist into adulthood, and there is no cure, but the symptoms can be treated and the condition is not life-threatening.

D)The client will suffer from persistent fibromyalgia for the remainder of her life unless a cure can be found.

Answer: C

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Chapter 4: Digestion

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Sample Questions

Q1) The nurse has implemented a care plan for an adult client with gastroesophageal reflux disorder (GERD). On the next clinic visit, which statement by the client indicates adherence to the plan of care?

A)"I can wear snug spandex camisoles if I feel comfortable."

B)"I have switched from margaritas to wine."

C)"I've lost 6 pounds because I eat every 3 hours and never before bed."

D)"I take a Tums with the ranitidine to make it work better."

Q2) Which of the following statements best describes the role of gluten in celiac disease?

A)It acts as a toxin damaging the villi of the small intestine.

B)It acts as an immunological body to destroy pathogens.

C)It acts as a virus to cause disease.

D)It acts as a foreign substance that provokes an immune response.

Q3) What is most characteristic of acute pancreatitis?

A)The pancreas attacks its own tissue.

B)The pancreas becomes distended with fluid.

C)The pancreas ceases to produce enzymes.

D)The pancreas needs to be removed.

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Chapter 5: Elimination

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Sample Questions

Q1) The nurse is providing care to a client who is diagnosed with mild benign prostatic hyperplasia (BPH). Which lifestyle change is appropriate for this client?

A)Increasing caffeine intake

B)Increasing alcohol intake

C)Urinating at first urge

D)Using over-the-counter antihistamines

Q2) The nurse is providing care to a client who is diagnosed with benign prostatic hyperplasia (BPH). Which items in the client's health history indicate a risk factor for this diagnosis? Select all that apply.

A)Excessive exercise

B)Decreased fluid intake

C)Diet high in milk

D)70 years of age

E)African American ethnicity

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Chapter 6: Fluids and Electrolytes

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Sample Questions

Q1) The nurse is concerned that a client diagnosed with a fluid imbalance is at risk for an alteration in perfusion. Which assessment data should indicate to the nurse that the client is not currently experiencing an alteration in perfusion? Select all that apply.

A)Skin turgor 20 seconds

B)Peripheral pulses present and full

C)Capillary refill of nail beds 3 seconds

D)Oriented to person, place, and time

E)Bowel sounds sluggish in all four quadrants

Q2) A client diagnosed with recurrent urinary tract calculi would be at elevated risk for which of the following types of acute kidney injury (AKI)?

A)Prerenal AKI

B)Intrinsic AKI

C)Postrenal AKI

D)Intrarenal AKI

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8

Chapter 7: Health Wellness and Illness

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Sample Questions

Q1) The portion of the tooth that wears away, allowing dental decay, is the A)pulp cavity.

B)enamel.

C)gingiva.

D)root.

Q2) A school nurse is reviewing the physical activity for adolescent high school students. Which student has met the outcome for physical activity set by the Centers for Disease Control and Prevention (CDC)?

A)An 18-year-old who speed-walks 60 minutes once per week

B)A 16-year-old who lifts moderately heavy weights for 15 minutes 3 times per week

C)A 15-year-old who runs at a fast pace for 20 minutes 2 times per week

D)A 17-year-old who alternates aerobic activities for 60 minutes daily and lifts weights 2 times per week

Q3) A nurse is caring for a 50-year-old client performing aerobic exercise in the cardiac rehabilitation office. The nurse calculates the client's target heart rate as ________-________.

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Chapter 8: Immunity

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Sample Questions

Q1) The nurse is providing care to a client who is receiving nonsteroidal anti-inflammatory drugs (NSAIDs)in the treatment of rheumatoid arthritis. When providing care to this client, which actions by the nurse are appropriate? Select all that apply.

A)Monitoring for signs of allergic reaction

B)Assuring the client that NSAIDs are safe for clients with cardiovascular disease

C)Encouraging the client to take NSAIDs with a small snack to help avoid GI distress

D)Monitoring for signs of renal problems

E)Inquire about the use of herbal supplements such as feverfew, garlic, ginger, or ginkgo

Q2) The nurse is providing care to a client with a compromised immune system. Which independent nursing intervention is appropriate for the nurse to include in the client's plan of care?

A)Educating the client on the importance of a nutritious diet

B)Administering corticosteroids per order

C)Prescribing prophylactic antibiotic therapy

D)Recommending gene transfer therapy

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Chapter 9: Infection

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Sample Questions

Q1) Which client should the nurse anticipate will have the greatest psychosocial needs?

A)A client under standard precautions

B)A client taking antibiotics

C)A client under droplet precautions

D)A client in isolation

Q2) The infecting organism that causes tuberculosis is

A)Micrococcus tuberculosis.

B)Microbacterium tuberculosis.

C)Mycoplasma tuberculosis.

D)Mycobacterium tuberculosis.

Q3) The healthcare provider prescribes a client to have peak and trough blood levels drawn to evaluate the therapeutic effect of an IV antibiotic. When should the nurse schedule the blood samples to be drawn? Select all that apply.

A)Prior to the discontinuing the antibiotic

B)A few minutes before the next scheduled dose of medication

C)During the infusion of the antibiotic

D)30 minutes after the IV administration

E)1 to 2 hours after the oral administration of the medication

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11

Chapter 10: Inflammation

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Sample Questions

Q1) Why is laparotomy typically the surgery of choice for a perforated appendix?

A)Surgeons are better able to remove contaminants from the peritoneal cavity via laparotomy than via laparoscopy.

B)Laparotomy requires a smaller incision than laparoscopy and thus involves less blood loss.

C)Laparotomy involves a shorter period of postoperative hospitalization than laparoscopy.

D)Laparotomy allows for direct visualization of the damaged appendix, whereas laparoscopy does not.

Q2) The nurse is providing care to a client who experiences chronic inflammation due to arthritis. For which collaborative intervention should the nurse plan when providing care to this client?

A)Administering anti-inflammatory medications

B)Administering diuretics

C)Administering frequent doses of opioid medications

D)Administering antibiotics

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12

Chapter 11: Intracranial Regulation

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Sample Questions

Q1) The nurse is planning care for an older adult client with a head injury secondary to a motor vehicle crash. Which information should the nurse keep in mind when planning this client's care? Select all that apply.

A)Anxiety, illness, and pain can alter the ability to learn.

B)Baseline reflexes may be slower or diminished.

C)Impulse transmission and reactions to stimuli are slower.

D)Neurologic assessment should be completed in a single session.

E)Impairment in vision and hearing should be taken into consideration.

Q2) Hydrocephalus results from an imbalance between production and absorption of which of the following?

A)Blood

B)Cerebrospinal fluid

C)Oxygen

D)Water

Q3) Which lobe of the brain stores memory and interprets auditory stimuli?

A)Frontal

B)Occipital

C)Parietal

D)Temporal

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Chapter 12: Metabolism

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Sample Questions

Q1) The nurse is finalizing a plan of care for a school-age client newly diagnosed with type 1 diabetes mellitus. Which areas should the plan prioritize to achieve the maximum outcomes for this client? Select all that apply.

A)Ways to minimize the number of school days missed

B)Identification and referral to community resources

C)Physical activities that limit exposure to injuries

D)Self-management of glucose monitoring and medications

E)Signs and symptoms of hypoglycemia and actions to take

Q2) A client with liver cirrhosis begins to drain bright red blood through the nasogastric tube. Which should the nurse prepare to administer to this client?

A)Vitamin K

B)Ferrous sulfate

C)Platelets

D)Folic acid

Q3) Which change in bone structure contributes to osteoporosis?

A)The diaphysis of the bone becomes longer.

B)Trabeculae are increased in cancellous bone.

C)The outer cortex of the bone becomes thicker.

D)The diameter of the bone increases.

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Page 14

Chapter 13: Mobility

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Sample Questions

Q1) An adult client recently diagnosed with multiple sclerosis (MS)reports engaging in vigorous exercise on a regular basis. Which statements contain the correct information to give this client when answering specific questions about lifestyle? Select all that apply.

A)"Hyperbaric oxygen treatment is recommended prior to vigorous physical exercise."

B)"You will tolerate exercise better in an air-conditioned room."

C)"Acupuncture may benefit some of your symptoms."

D)"Drinking cold water is recommended during exercise."

E)"You will be able to maintain your current exercise schedule."

Q2) A client diagnosed with multiple sclerosis has an acute onset of visual changes, fatigue, and leg weakness. The client states that the last time this happened, she recovered in a few weeks. Which classification of multiple sclerosis is the client experiencing?

A)Progressive-relapsing

B)Secondary-progressive

C)Relapsing-remitting

D)Primary-progressive

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Chapter 14: Nutrition

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Sample Questions

Q1) Bariatric surgery is an option for which category of clients?

A)Overweight

B)Pregnant women

C)Adolescents

D)Morbidly obese

Q2) Which statements regarding upper body obesity are accurate? Select all that apply.

A)Upper body obesity is also called peripheral obesity.

B)Upper body obesity is when the waist-to-hip ratio in men is greater than 0.8 in men or greater than 1 in women.

C)Upper body obesity is associated with a greater risk of hypertension.

D)Young women tend to have more intra-abdominal fat than men.

E)Postmenopausal women tend to have upper body obesity.

Q3) The nurse is working with a morbidly obese client who is seeking help to lose weight at a bariatric clinic. When planning this client's care, which nursing diagnosis is the priority?

A)Activity Intolerance

B)Disturbed Body Image

C)Defensive Coping

D)Constipation

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Page 16

Chapter 15: Oxygenation

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Sample Questions

Q1) The nurse is providing care to a client diagnosed with chronic obstructive pulmonary disease (COPD). Which clinical manifestations are the direct result of altered perfusion? Select all that apply.

A)Bounding pulse

B)Pink nail beds

C)Cyanosis

D)Confusion

E)Wheezing

Q2) Which clinical manifestation does the nurse correctly attribute to hypoxia in a client with acute respiratory distress syndrome (ARDS)?

A)Fluid imbalance

B)Hypertension

C)Bradycardia

D)Dyspnea

Q3) The client with ARDS who is likely to have the poorest outcome is

A)a Hispanic male with pneumonia.

B)an African American male with sepsis.

C)a Caucasian female with sepsis.

D)an African American female with chest trauma.

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Page 17

Chapter 16: Perfusion

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Sample Questions

Q1) A nurse is caring for a client who was involved in a motor vehicle accident and has lost approximately 1,550 mL of blood. The nurse should recognize that the client's shock will be classified as:

A)Class I

B)Class II

C)Class III

D)Class IV

Q2) Which is believed to be the cause of preeclampsia?

A)Placental dysfunction

B)Liver disease

C)Anxiety

D)Low sodium intake

Q3) Which risk factor for hypertension is modifiable?

A)Age

B)Ethnicity

C)Family history

D)Tobacco use

Q4) A client's stroke volume (SV)is 85mL/beat and the heart rate (HR)is 71 beats per minute (bpm). What is the client's cardiac output (CO)rounded to the nearest liter?

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Chapter 17: Perioperative Care

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Sample Questions

Q1) Which of the following statements best describes the vital signs the nurse collects during the preoperative phase?

A)They are the only vital signs collected during the perioperative period.

B)When later vital signs are taken, they are compared against the preoperative set.

C)Generally preoperative vital signs are only relevant during the intraoperative process.

D)These are not essential and may be omitted for emergency surgeries.

Q2) The nurse is preparing an older adult client for surgery. On which topics should the nurse focus when preparing this client's preoperative teaching? Select all that apply.

A)Level of hearing

B)Amount of anesthesia needed during surgery

C)Teaching on deep breathing and coughing

D)Plans for discharge care

E)Actions to prevent pressure ulcers

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19

Chapter 18: Sensory Perception

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Sample Questions

Q1) The nurse is providing teaching to a client who was prescribed an ophthalmic beta blocker for glaucoma. The client is having difficulty understanding how to self-administer the medication. Which instruction by the nurse is best?

A)"Occlude your lacrimal duct."

B)"Close your eyes."

C)"Guard against systemic absorption."

D)"Use punctal occlusion."

Q2) A nurse is working with several clients who are experiencing hearing loss. Of these clients, which is the best candidate for a cochlear implant?

A)A client with a perforated tympanic membrane

B)A client with sensorineural hearing loss from long-term exposure to loud noise

C)A client with an obstruction of the external ear canal

D)A client with a tumor of the middle ear

Q3) Which of the following scenarios is consistent with secondary congenital glaucoma?

A)A newborn is diagnosed with glaucoma at birth.

B)An infant is diagnosed at 6 months with glaucoma.

C)A 1-year-old infant develops glaucoma following neurofibromatosis.

D)A 5-year-old child is diagnosed with glaucoma.

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Chapter 19: Sexuality

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Sample Questions

Q1) During a vaginal examination, a woman's cervix and vaginal fornices are found to have a bluish cast to them. This finding suggests that the client

A)is experiencing menopause.

B)may be pregnant.

C)has a pelvic infection.

D)is likely anemic.

Q2) The nurse is assessing a postmenopausal client. Which client statement indicates the need for further assessment by the nurse?

A)"I use water-soluble lubricant to treat my vaginal dryness."

B)"For some reason, I have more sexual desire than ever."

C)"Sex certainly takes longer than it used to, but I'm getting used to that."

D)"I am so glad that I don't need to worry about sex anymore."

Q3) The nurse is planning care to address pain in a client with genital herpes. Which intervention would most be appropriate for this plan of care?

A)Do not submerge lesions in water.

B)Clean lesions two or three times a day with warm water and soap.

C)Dry lesions with a hair dryer turned to the hot setting.

D)Wear tight cotton clothing.

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Chapter 20: Thermoregulation

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Sample Questions

Q1) The nurse is educating a family who is planning an ice fishing trip on ways to prevent hypothermia. Which recommendation by the nurse is appropriate?

A)All family members should wear skid-proof footwear.

B)If someone becomes hypothermic, sponge tepid water onto any exposed skin.

C)All family members should wear light rain jackets.

D)If someone becomes hypothermic, remove any wet clothing, wrap the person in blankets, and have the person drink a warm liquid.

Q2) A client is admitted with the diagnosis of fever of unknown origin. Which diagnostic test does the nurse anticipate for this client?

A)CT scan of the abdomen

B)Bone scan

C)Glucose tolerance test

D)Complete blood count

Q3) What is the primary means of assessing the severity of hyperthermia?

A)Core temperature measurement

B)Skin temperature measurement

C)Clinical presentation of the client

D)Client history related to current condition

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Chapter 21: Tissue Integrity

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Q1) A middle-age adult client states to the nurse, "I do not want to have brown spots on my skin like my parents did as they got older." Which instruction by the nurse is appropriate?

A)Spend at least 15 minutes each day in the sun.

B)Increase the intake of calcium.

C)Increase the intake of dietary fat.

D)Avoid the sun or use a sunscreen to reduce skin damage.

Q2) A client has an excoriated skin area with purulent drainage. Which diagnostic test does the nurse anticipate being ordered?

A)Skin biopsy

B)Culture

C)Wood's lamp

D)Patch test

Q3) A client is admitted to the hospital with a gunshot wound to the leg. Which nursing diagnosis is a priority?

A)Situational Low Self-Esteem

B)Risk for Infection

C)Anxiety

D)Ineffective Coping

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Chapter 22: Addiction

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Q1) A nurse is caring for a client with congestive heart failure (CHF)who currently smokes cigarettes and has a 50 pack-year smoking history. When providing smoking cessation education to this client, which statements regarding the pathophysiology of nicotine use are appropriate? Select all that apply.

A)"In low doses, nicotine stimulates nicotinic receptors in the brain to release dopamine."

B)"In high doses, nicotine stimulates the parasympathetic system to release epinephrine, causing vasoconstriction."

C)"Initially, nicotine increases mental alertness and cognitive ability."

D)"Nicotine is a nonpsychoactive substance found in tobacco."

E)"Gradual reduction of nicotine intake appears to be the best method of cessation."

Q2) A client who is attending a Narcotics Anonymous (NA)program asks the nurse what the most important initial goal of attending the meetings is. How should the nurse respond?

A)"The most important initial goal is to admit that you have a problem."

B)"The most important initial goal is to learn problem-solving skills."

C)"The most important initial goal is to take a personal moral inventory."

D)"The most important initial goal is to make amends to people you have hurt."

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Chapter 23: Cognition

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Q1) A 7-year-old child presents to the primary care office for a routine physical. Which question should the nurse include during the interview to identify the need for education related to preventing potential cognitive disorders?

A)"Do you wear a helmet when you ride a bicycle or skateboard?"

B)"How many times per day do you brush your teeth?"

C)"How are your grades in school?"

D)"How many hours per day do you watch television?"

Q2) A nurse is preparing an educational program for clients in a long-term care facility regarding protective factors for Alzheimer disease (AD). Which information should the nurse include? Select all that apply.

A)Becoming involved in activities such as reading that keep the mind active

B)Incorporate a high-calorie, high-carbohydrate diet to decrease formation of amyloid plaques

C)Remain socially active

D)Including modest exercise into daily regimen

E)Begin drinking a glass of wine each night before bed

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Chapter 24: Culture and Diversity

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Q1) The client is admitted to the hospital following a miscarriage, and she is septic. The healthcare provider orders antibiotics, which the client refuses, stating, "I don't deserve them. I lost my baby because I had sex outside of marriage." Which is the appropriate response by the nurse?

A)"I'll notify your healthcare provider about your decision."

B)"Do you think you should be punished because you had a miscarriage?"

C)"I think you need to do what is best for you."

D)"You have a serious infection and really need the medication."

Q2) A nurse is working with a number of clients at a free clinic. Which client population is at the highest risk for low levels of healthcare?

A)Undocumented immigrants

B)Men who have protected sex with men

C)Men who have sex with women

D)Teenagers

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Chapter 25: Development

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Q1) A nurse is caring for a child who has been diagnosed with attention-deficit/hyperactivity disorder (ADHD). The client's healthcare provider has prescribed amphetamine-dextroamphetamine (Adderall)to treat the child's disorder.

Which of the following statements regarding the use of this medication is appropriate for the nurse to include in the medication teaching?

A)"Your child's liver function should be monitored with this medication."

B)"Your child's growth will need to be monitored on this medication."

C)"This medication may increase the risk of psychosis."

D)"This medication has less abuse tendency because it is not a stimulant."

Q2) A nurse is teaching a mother of an infant who has been diagnosed with failure to thrive (FTT)about the treatment for the condition. Which statement by the nurse is appropriate?

A)"Appetite stimulant medications will be prescribed to help your child gain weight."

B)"If your child is breastfeeding, you must stop and feed your child formula."

C)"A home care nurse will be visiting to see how your child eats."

D)"A home care nurse will be visiting to insert a nasogastric feeding tube in your child."

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Chapter 26: Family

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Q1) The community nurse identifies that a family new to the community needs assistance with family dynamics and material resources. Which of the following should the nurse consider offering to the parents of this family to support their needs? Select all that apply.

A)A list of free counseling services to assist with parental stress

B)Hours of the local health clinic

C)Location of the community library

D)Location of the community co-op food bank

E)Hours when the park is open

Q2) The nurse is observing a family counseling session that is focusing on the family members' communication patterns. Which observation indicates that there are existing or potential problems with family communication?

A)All members are participating in the discussion equally.

B)A few of the members just sit and listen.

C)Disagreements are ignored by the family leader.

D)The verbal communication is congruent with the nonverbal messages.

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Chapter 27: Grief and Loss

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Q1) The staff nurse is planning for a client who is grieving the loss of a spouse. Which should the nurse identify as an appropriate independent nursing intervention?

A)Teach the client about the grieving process

B)Select an appropriate antidepressant

C)Conduct complicated grief therapy (CGT)

D)Provide chaplain services

Q2) A client is hospitalized for suicidal ideations as a response to complicated grief. Which collaborative interventions can the nurse anticipate including in this client's care? Select all that apply.

A)Social service consult

B)Bereavement group

C)Antidepressant medication

D)Sleep medication

E)Psychotherapy

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Chapter 28: Mood and Effect

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Q1) A nurse is caring for a client who displays symptoms associated with seasonal affective disorder (SAD). Which treatment would the nurse question as inappropriate for this client?

A)Cognitive-behavioral therapy

B)Light therapy

C)Bupropion extended-release

D)Selective serotonin reuptake inhibitor (SSRI)

Q2) Which data should suggest to the home health nurse that the client experiencing postpartum depression is improving?

A)Client wearing clean clothes, holding baby while rocking in a chair

B)Spouse making dinner, client in bed asleep, baby in rocker in the kitchen

C)Dirty dishes in the sink, beds unmade, and client wearing clothing for sleep

D)Client watching television in the living room while the baby is in the crib crying

Q3) What is the greatest risk for a woman diagnosed with postpartum psychosis?

A)Infanticide

B)Hallucinations

C)Insomnia

D)Poor judgment

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Chapter 29: Self

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39 Verified Questions

39 Flashcards

Source URL: https://quizplus.com/quiz/45860

Sample Questions

Q1) Which of the following personality disorders is characterized by an inability to trust others; a rigid worldview that often conspiratorial in nature; and the belief that other people's actions are based on ulterior motives?

A)Obsessive-compulsive personality disorder

B)Paranoid personality disorder

C)Schizoid personality disorder

D)Schizotypal personality disorder

Q2) Which of the following questions would best help the nurse assess a client's global self-esteem?

A)"What do you consider your greatest personal strength?"

B)"What do you like least about yourself?"

C)"How satisfied are you with yourself and your life so far?"

D)"Do you consider yourself a hard-working person?"

Q3) Which of the following manifestations would the nurse least likely observe in a client with a Cluster B personality disorder?

A)Dramatic behavior

B)Erratic behavior

C)Extreme fearfulness

D)Extremely emotionality

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31

Chapter 30: Spirituality

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29 Flashcards

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Sample Questions

Q1) A client was recently diagnosed with alcoholic liver cirrhosis. During a regular checkup, the client tells the nurse, "This is God's punishment for all those parties I went to when I was younger." The nurse should recognize that this religious view could have a negative effect on what other nursing concept?

A)Addiction

B)Legal Issues

C)Stress and Coping

D)Digestion

Q2) The nurse is caring for an older adult client with advanced dementia. The family often mentions that the client was very spiritual earlier in life and loved to sing. What could the nurse suggest to the family to help support the client's religious needs?

A)They should help the client reminisce about spiritual events early in life.

B)They should encourage the client to compose lyrics or write music to a new spiritual song.

C)They should sing some of their favorite songs to the client.

D)They should bring in a recording of some of the client's favorite spiritual songs for him to listen to.

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Page 32

Chapter 31: Stress and Coping

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Sample Questions

Q1) For a client with obsessive-compulsive disorder with contamination obsessions, what nursing assessment is essential to development of an effective client care plan?

A)Assessment for skin integrity

B)Assessment for sexual activity

C)Assessment for tics

D)Assessment for religious beliefs

Q2) The nurse is providing care to a client who is diagnosed with obsessive-compulsive disorder. Which nursing intervention is most appropriate when providing care to this client?

A)Confront the client and ask what purpose the behavior serves.

B)Tell the client that the behavior is unacceptable and must end.

C)Interrupt the ritualistic behavior when observed.

D)Discuss the need to incorporate the behavior with other hospital routines.

Q3) A client with what level of anxiety would be most receptive to learning tools that would help the client recognize triggers?

A)Mild

B)Moderate

C)Severe

D)Panic

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Chapter 32: Trauma

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Sample Questions

Q1) The nurse is caring for a client who is the victim of domestic violence and is visited by the spouse in the hospital. The client has indicated that she plans to return to her spouse when she leaves the hospital. Which action by the nurse supports the client when the spouse is present?

A)Call the police to have the spouse arrested for assault.

B)Refuse to permit the spouse to visit with the client.

C)Call security to have the spouse removed.

D)Ask the client if there is anything that is needed at this time.

Q2) A nurse is developing a plan of care for a client diagnosed with posttraumatic stress disorder (PTSD)who was admitted to the hospital for suicidal ideations and sleep disturbance due to frequent nightmares. Which is the priority nursing diagnosis for this client?

A)Disturbed Sleep Pattern

B)Post-Trauma Syndrome

C)Risk for Other-Directed Violence

D)Risk for Self-Directed Violence

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Chapter 33: The Concept of Reproduction

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Q1) The nurse is providing discharge instructions for a first-time mother and her baby. Which statement is appropriate for the nurse to include in the teaching session?

A)"Your baby's stools will change to a dark green color when your milk comes in."

B)"Your baby may spit up frequently for the first few weeks."

C)"Compress the bulb syringe before placing it in your baby's nose or mouth."

D)"You can wipe away any green drainage that might form around the umbilical cord."

Q2) The nurse is providing discharge instructions for a healthy 37-year-old first-time mother and her newborn. What should the nurse include in her instructions for this mother and her spouse?

A)Information related to contraception and sexually transmitted infections (STIs).

B)A reminder that addition of a newborn will alter established routines.

C)A referral to a group class that provides information on newborn care.

D)A referral for follow-up care with healthcare providers other than the obstetrician.

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Chapter 34: Assessment

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Sample Questions

Q1) A nurse educator is providing information to a group of nursing students regarding appropriate assessment techniques that can be applied across the life span. Which statements should the educator include in the teaching session? Select all that apply.

A)"Auscultate the chest while the client is sleeping to obtain the most accurate assessment of the heart."

B)"Use standard precautions during the history and physical examination process."

C)"Perform invasive procedures like pharyngeal and otic exams at the end of the assessment."

D)"Use age-appropriate terminology for explaining procedures and actions."

E)"Use the assessment process to teach about exam procedures and findings."

Q2) What is one possible conclusion the nurse could draw after assessing a client with the Braden Scale?

A)The client is at risk for falls.

B)The client is at risk for pressure ulcers.

C)The client is at risk for malnutrition.

D)The client may be unable to complete activities of daily living.

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Chapter 35: Caring Interventions

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Sample Questions

Q1) A nurse in a rural community is employed in a facility that has had a shortage of nurses for several years. As a result, several nurses have left the institution citing burnout. To avoid risking burnout, the nurse regularly works out, practices yoga, socializes with friends once or twice a week, and participates in at least one annual national or state nursing conference. This approach to work-life balance reflects which concept within the framework of Caring Interventions?

A)Self-compassion

B)Self-care

C)Self-control

D)Self-actualizing

Q2) During a performance appraisal, a unit manager praises a staff nurse on the ability to use presencing when caring for terminally ill clients. What did the nurse demonstrate that would exemplify this caring behavior? Select all that apply.

A)Face-to-face discussions with clients

B)Instructing clients on how they should perform certain functions

C)Sitting quietly with clients

D)Validating the client's experience through active listening

E)Guaranteeing quality and safety in care

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Chapter 36: Clinical Decision Making

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40 Flashcards

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Sample Questions

Q1) A construction worker admitted to the unit with a chest injury and broken ribs from a fall from a ladder has nursing diagnoses of "Disturbed Sleep Pattern," "Ineffective Breathing Pattern," and "Risk for Infection." The client states, "I've never been sick a day in my life and am really worried about how I can support my family while I'm out of work."

When evaluating the client's plan of care during the shift, the nurse adds the nursing diagnosis "Anxiety" to the plan of care. Which diagnosis would be the priority for nursing interventions?

A)Risk for Infection

B)Ineffective Breathing Pattern

C)Disturbed Sleep Pattern

D)Anxiety

Q2) The nurse is preparing to provide care to a group of clients. On which specific areas should the nurse focus in order to prioritize the clients' care needs? Select all that apply.

A)Asking if any clients have complex issues

B)Noting number of licensed staff assigned for the shift

C)Noting time when the attending physicians make rounds

D)Identifying clients with specific medication times

E)Noting which clients have particular safety needs

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Page 38

Chapter 37: Collaboration

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Sample Questions

Q1) The nurse is caring for a client with rheumatoid arthritis who expresses the desire to remain active as long as possible. In order for the client to meet this goal, what should the nurse prepare to do?

A)Teach the client about nutrition and joint exercises.

B)Ask the client about the reasons for this goal.

C)Tell the client that activity limitations are inevitable with rheumatoid arthritis.

D)Provide referrals to other professionals who can help the client meet this goal.

Q2) In arranging community services for a client who is diagnosed with schizophrenia, the nurse case manager discusses options with the assertive community treatment (ACT)team. Which team disciplines should the nurse expect will be part of the client's ACT interdisciplinary team?

A)Psychiatrists, nurses, social workers, employment counselors

B)Speech pathologists, occupational therapists, nurses, physicians

C)Teachers, school administrators, psychiatrists, nurses

D)Transportation providers, nurses, physicians, social workers

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Chapter 38: Communication

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Sample Questions

Q1) A novice nurse is working with a client who is admitted to a medical-surgical unit. The nurse is establishing a therapeutic relationship with the client by conveying empathy. Which statement by the nurse best exemplifies empathy?

A)"I wouldn't be afraid if I were you."

B)"You shouldn't have done it that way."

C)"You seem to be frightened by the procedure. Tell me how you are feeling."

D)"I know just how you feel, because my mother has the same illness."

Q2) A nurse educator in a medical-surgical unit is demonstrating the use of new equipment to the rest of the nurses on the unit. After initial efforts at having the class gather closely around the models were met with discomfort and inattention, the nurse educator sets up the models in the front of the classroom. Which level of proxemics would be ideal for this situation?

A)4 to 12 feet

B)1 1/2 to 4 feet

C)12 to 15 feet

D)Less than 1 1/2 feet

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Chapter 39: Managing Care

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Sample Questions

Q1) A nurse is applying for a job as a case manager for a managed care insurance organization. Which responsibility is associated with this role?

A)Providing home visits to clients

B)Independent treatment planning

C)Coordinating client care over time

D)Approving treatment decisions

Q2) An older adult client tells the nurse, "I am worried about how I will pay for my hospital bill." The client is being discharged, is being referred to home healthcare, and the new plan of care involves extremely expensive drugs. Which response by the nurse is appropriate?

A)"You need to focus on recovering and not worry about finances."

B)"I'll have someone from the business office come and set up your payment plan."

C)"Don't worry. I'm sure everything will work out okay."

D)"Much of your care will be covered by Medicare."

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Chapter 40: Professional Behaviors

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Sample Questions

Q1) A charge nurse is making assignments for the shift and notes that a client from a different culture was recently admitted and will require a thorough admission assessment during the upcoming shift. Which generation of nurse is likely to be the most culturally sensitive and thus the best choice for this client assignment?

A)The Millennial nurse

B)The Generation X nurse

C)The veteran nurse

D)The baby boomer nurse

Q2) Which action by a student nurse is most consistent with commitment to the nursing profession?

A)The student calls in sick for clinicals in order to study for a class exam.

B)The student declines to observe a new procedure for giving a necessary bath.

C)The student misses class to attend a political rally.

D)The student calls in sick for clinicals because of a respiratory infection.

Q3) An individual's work ethic reflects his or her

A)belief in the importance and moral worth of work.

B)desire to advance in a chosen profession.

C)level of affective commitment to a profession.

D)degree of optimism with regard to the work environment.

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Page 42

Chapter 41: Teaching and Learning

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Sample Questions

Q1) A nurse is caring for a child who is hospitalized for an exacerbation of asthma. The nurse is preparing discharge teaching, as the client will be going home on nebulizer treatments and an inhaler. The client and her family members, who are recent immigrants to the United States, speak little English. In addition to enlisting an interpreter to help with the language barrier, what should be a priority for the nurse in developing a teaching plan?

A)Provide written instructions before discharge.

B)Make sure the parents can set up the treatments for their child.

C)Make sure the child comes back for the follow-up appointment.

D)Address any healing beliefs the family has.

Q2) The nurse is caring for a client who has been diagnosed with diabetes mellitus. The client must learn how to independently perform fingerstick blood sugar analysis as part of the plan of care. The client says, "I already know what you are attempting to teach because I looked everything up on the internet." Which is the best action by the nurse based on the client's statement?

A)Document that the client understands teaching.

B)Teach the client's support system how to perform the procedure.

C)Give the client printed learning materials.

D)Watch the client perform a return demonstration of the skill.

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Page 43

Chapter 42: Accountability

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Sample Questions

Q1) One of the roles of the community health nurse is to educate individuals about health promotion and wellness. Which activity would the nurse dismiss as irrelevant to health promotion and wellness?

A)Holding classes for teenagers regarding prevention of sexually transmitted infections

B)Teaching a class about smoking cessation

C)Initiating infant care classes for new parents

D)Implementing an exercise class for clients who have had a heart attack

Q2) A nurse educator is conducting a continuing education in-service for the nurses in a pediatric intensive care unit. Why is it so important for the professional nurse to attend these in-services?

A)Most states require it to maintain licensure.

B)It is a good way to receive overtime pay.

C)Research and new technology demand that nurses stay current.

D)New diseases are discovered every day.

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Chapter 43: Advocacy

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Sample Questions

Q1) Which of the following advocacy interventions might nurses provide that are within their role and scope of practice? Select all that apply.

A)Educating clients and their families about their legal rights regarding informed decision-making

B)Ensuring that clients have the necessary information to make an informed decision or give informed consent

C)Evaluating organizational policies and procedures to ensure protection of client rights

D)Supporting medical authority even when this goes against the client's wishes

E)Declaring clients incompetent so family members can make medical decisions for them

Q2) A nurse suspects another healthcare provider is under the influence of alcohol at work. Which actions by the nurse are correct? Select all that apply.

A)Assume that healthcare provider is handling any problem.

B)Immediately report it to a supervisor.

C)Respect the privacy of the healthcare provider.

D)Assist the provider while care is provided to clients.

E)Follow the state board guidelines.

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Chapter 44: Ethics

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Sample Questions

Q1) Staff at the hospital have decided to strike in order to try to improve working conditions. Which are some of the ethical issues that a nurse working in the hospital will have to consider when deciding whether or not to honor the picket line? Select all that apply.

A)The need to support coworkers in their efforts to improve working conditions

B)The need to ensure that clients receive care and are not abandoned

C)The desire to take some time off

D)Loyalty to the nurse's employer

E)The need for higher pay

Q2) A nurse educator is explaining the idea of healthcare as a partnership between provider and client. Which are client responsibilities that some hospitals have included in their client bill of rights? Select all that apply.

A)Involving your family in your healthcare decisions

B)Reporting accurate and complete information about your health to your healthcare team

C)Answering questions asked by your healthcare team

D)Immediately paying all expenses not covered by insurance

E)Accepting the consequences if you fail to comply with instructions given to you

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Chapter 45: Evidence-Based Practice

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Sample Questions

Q1) A client in the clinic is being asked to participate in a research study. The client asks why a nursing research study is necessary given that research on this subject has already been published by the American Medical Association (AMA). Which of the following responses should the nurse offer in reply to the client's question?

A)"This study is useful because it supports the medical profession."

B)"This study is useful because it validates nursing through medical research."

C)"This study is useful because it supports products used in nursing care."

D)"This study is useful because it validates nursing care, not medical care."

Q2) The nurse is caring for a client who requires extensive wound care. The client has consented to participate in a nursing research study regarding the wound care. Which client statement indicates understanding of the research goal?

A)"This research will not influence my care."

B)"Nursing care is based solely on research."

C)"I will be paid to participate in the research project."

D)"I will be helping to validate nursing care."

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Chapter 46: Healthcare Systems

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Sample

Questions

Q1) The nurse is caring for a client who sustained multiple injuries in an automobile accident. As a part of secondary prevention for this client, which does the nurse include in the plan of care?

A)Promote wellness.

B)Detect early disease.

C)Restore the client to previous functioning.

D)Prevent the progression of more symptoms.

Q2) The nurse is participating on a local council as an advisor regarding community needs during an emergency. Which recommendation regarding community needs during an emergency that the nurse might include when advising the council would be involved in the emergency response phase?

A)A coordinated emergency preparedness plan

B)Assembling disaster kits

C)Programs to restore the community

D)The identification of potential hazards to the community

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Chapter 47: Health Policy

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Sample Questions

Q1) Which regulatory agency ensures the health and safety of Americans in the workplace?

A)Department of Health and Human Services (DHHS)

B)National Institutes of Health (NIH)

C)Occupational Safety and Health Administration (OSHA)

D)Centers for Medicare and Medicaid Services (CMS)

Q2) An older adult client experiences an extended hospitalization due to a chronic illness. The client states to the nurse, "I don't know how I can pay for this hospital stay and afford all of the new medication that I have been prescribed." Which response by the nurse is the most appropriate?

A)"I'll have someone from the business office come and talk to you about your bill."

B)"You need to focus on recovering and stop worrying about money."

C)"Much of your care will be covered by Medicare."

D)"Don't worry. I'm sure everything will work out okay."

Q3) Which organization promotes excellence in all levels of nursing education?

A)National League for Nursing (NLN)

B)National Student Nurses Association (NSNA)

C)American Nurses Association (ANA)

D)American Association of Colleges of Nursing (AACN)

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Page 49

Chapter 48: Informatics

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Sample Questions

Q1) The nurse is caring for a client who has a condition that is not responding to standard interventions. How could accessing the clinical decision support system (CDSS)help with this client's care?

A)Provides evidence-based recommendations for care

B)Decreases the need to use critical thinking skills

C)Tells the nurse what the next step should be

D)Supports the nurse's "gut" instinct when providing care

Q2) Which administrative function related to medical records management may be made easier by the use of informatics?

A)Tracking client outcomes

B)Making sure charts are coded correctly

C)Ordering materials and supplies

D)Assigning a client to a hospital room

Q3) Which organization specifically focuses on improving healthcare quality, safety, and outcomes through improving the use of information technology (IT)and systems?

A)Healthcare Information and Management Systems Society (HIMSS)

B)American Medical Informatics Association (AMIA)

C)Alliance for Nursing Informatics (ANI)

D)Technology Informatics Guiding Educational Reform (TIGER)

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Page 50

Chapter 49: Legal Issues

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Sample Questions

Q1) A nurse working on a medical-surgical unit wants to ensure care is provided within the standard of nursing care. Which actions by the nurse are appropriate? Select all that apply.

A)Analyze the position description.

B)Review and become familiar with the policy and procedure manual.

C)Question the value of collaborating with other disciplines.

D)Review applicable state nurse practice act and administrative rules.

E)Adhere to national standards of practice and care.

Q2) During an assessment of a child in the urgent care clinic, the nurse notes that the child has a swollen and split lip. When asking the parent how the child's lip injury occurred, the parent responds, "We are here for my child's ear not my child's lip." Which is the rationale for reporting this incident?

A)The child reports that a parent caused the injury.

B)The lip injury is unrelated to the ear infection.

C)The nurse can be sued if there is no abuse.

D)Suspected abuse must be reported.

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Chapter 50: Quality Improvement

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Sample Questions

Q1) The nurse is administering medications to a client. Which action is most likely to lead to an adverse event?

A)The nurse verifies tube placement prior to administering the medications.

B)The nurse checks for known allergies prior to administering the medications.

C)The nurse combines medications with the same active ingredient.

D)The nurse has a second nurse check the medication order.

Q2) The nurse is working in a healthcare setting that has implemented Lean Six Sigma. Which of the following should the nurse anticipate with regard to this model?

A)Shorter breaks

B)Ordering extra supplies

C)Replacing licensed with unlicensed personnel

D)Decreasing staff when the census is low

Q3) Which statement regarding standards of care in the hospital setting is inaccurate?

A)"Standards of care are based on models of high-quality performance."

B)"Process standards focus on the steps used to lead to a particular outcome."

C)"Process standards focus on human resources, and general organizational structure."

D)"Outcome standards focus on the performance of a process."

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52

Chapter 51: Safety

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Sample Questions

Q1) A client who is living independently but needs skilled nursing services may take advantage of what type of healthcare?

A)Long-term care

B)Home healthcare

C)Telehealth

D)Assisted living

Q2) An experienced nurse has accepted a new position in the mental health unit after working in the medical-surgical floor for the past 4 years. What training would be beneficial for the nurse to refresh before starting her new position?

A)How to properly use respirators

B)How to prevent needlestick injuries

C)How to manage aggressive behaviors

D)How to safely lift and move clients

Q3) Reducing the risk of functional decline in older adults can help prevent which complication?

A)Pressure ulcers

B)Macular degeneration

C)Hyperglycemia

D)Hearing loss

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Page 53

Chapter 52: Assessment

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Sample Questions

Q1) The nurse is completing an assessment on a client who just received morphine. Which is the nurse's highest priority?

A)Pain level

B)Respirations

C)Temperature

D)Blood pressure

Q2) The nurse is observing the UAP taking the temperature of an unconscious client. Which route will the nurse question the UAP using?

A)Oral

B)Rectal

C)Scanner

D)Tympanic

Q3) Based on the information provided, which client should the nurse see first?

A)Infant respirations 38/min

B)2-year-old pulse 112/min

C)6-year-old axillary temperature 97.5°F

D)10-year-old blood pressure 138/88

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54

Chapter 53: Caring Interventions

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Sample Questions

Q1) A nurse cares for a client who receives new hearing aids for the first time. Which statements will the nurse include when teaching the client about the hearing aids? Select all that apply.

A)"Push the earmold slightly backward and pull out to remove it."

B)"Rotate the earmold slightly forward and pull out to remove it."

C)"If the hearing aid is not used for several days, be sure to turn the device off."

D)"If the earmold is detachable, soak it in isopropyl alcohol weekly to disinfect it."

E)"Blow any excess moisture through the opening of the earpiece when cleaning it."

Q2) Prior to delegating hearing aid care to a UAP, what is the nurse's priority?

A)Determine the UAP's knowledge of the procedure.

B)Inform the UAP of what to report back to the nurse.

C)Discuss relevant client health information necessary for the task.

D)Provide the UAP with guidance on where to find supplies necessary for the task.

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55

Chapter 54: Comfort

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Sample Questions

Q1) The nurse cares for a client who wants to try biofeedback for relief of chronic pain. What advantages to this therapy does the nurse recognize? Select all that apply.

A)Increases circulation and endorphins.

B)Completely controlled by the client.

C)Rapid pain relief.

D)Redirects energy flow through pressure on meridian points.

E)Promotes stress reduction as well as pain relief.

Q2) The nurse is caring for a client with acute pain and uses the FLACC pain assessment. Which clinical scenario does the nurse recognize as least appropriate for use of the FLACC pain assessment?

A)Situations where clients self-report pain.

B)Situations requiring rapid pain assessment.

C)Clients who are asleep.

D)Clients who are children.

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Chapter 55: Elimination

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Sample Questions

Q1) A nurse performs a sterile urine specimen collection from an ileal conduit. Which action by the nurse is incorrect and may lead to inaccurate results?

A)Removing the collection pouch prior to obtaining the sample.

B)Inserting the tip of the catheter into the stoma approximately 4 cm (1.5 inches).

C)Obtaining the sample from the collection pouch.

D)Placing towels around the stoma.

Q2) The home care nurse cares for a client who requires continuous ambulatory peritoneal dialysis (CAPD)at home. Place the steps in correct order for infusing the dialysate.

A)Warm the dialysate.

B)Add medications to the dialysate as ordered.

C)Connect tubing to dialysate bag.

D)Perform hand hygiene and don gloves.

E)Hang the dialysate bag above the client's shoulder and open the clamp.

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Chapter 56: Fluids and Electrolytes

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Sample Questions

Q1) The nurse cares for a client with a triple lumen central line who develops a fever, which the nurse suspects is from the central line. Which nursing actions are appropriate? Select all that apply.

A)Replace the infusing TPN with normal saline.

B)Change the IV tubing.

C)Remove the IV using sterile technique.

D)Change the IV dressing.

E)Culture the insertion site using sterile technique.

Q2) The nurse needs to obtain blood samples from the client's central line for blood analysis. Place the steps of the procedure in correct order.

A)Withdraw 10 mL of blood and discard.

B)Flush with 5 mL normal saline.

C)Inject 5mL heparin.

D)Draw up the required blood and transfer to the appropriate containers.

E)Clean the infusion access port according to policy for 10 seconds.

F)Clean the infusion access port according to policy for 30 seconds

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Chapter 57: Infection

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Sample Questions

Q1) The nurse is removing gloves after performing client care activities. Place the steps in correct order for removing gloves.

A)Pull off one glove by touching the outside of the glove at the cuff.

B)Slip one finger of ungloved hand under glove cuff of other hand.

C)Pull down and off so both gloves are removed as one.

D)Roll up glove and place in gloved hand.

Q2) A novice nurse works with a nurse preceptor on a busy medical surgical unit. Which action by the novice nurse requires intervention by the nurse preceptor when observing the novice nurse performing hand hygiene?

A)Washing hands with warm soapy water for 15 seconds.

B)Using a waterless foam sanitizer before entering the room of a client.

C)Cleaning under the fingernails with an orangewood stick.

D)Drying hands thoroughly with fingers pointing up.

Q3) The nurse is removing gloves after performing client care activities. Place the steps in correct order for removing gloves.

A)Pull off one glove by touching the outside of the glove at the cuff.

B)Slip one finger of ungloved hand under glove cuff of other hand.

C)Pull down and off so both gloves are removed as one.

D)Roll up glove and place in gloved hand.

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Page 59

Chapter 58: Intracranial Regulation

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Sample Questions

Q1) The nurse enters a client's room with a suspected head injury in preparation for completing a neurological assessment that includes a Glasgow Coma Score (GCS). Upon entering the room and turning on a light, the nurse notes that the client doesn't open his eyes immediately. Which is the nurse's next action?

A)Complete the client's vital signs and recheck the client in 30 minutes.

B)Gently touch the client's arm to see if the client spontaneously awakens.

C)Turn the light off, leave the room, and document that the client is sleeping.

D)Vigorously rub the client's sternum to determine if the client responds to painful stimuli.

Q2) The nurse is caring for a client with a diagnosed closed head injury that requires intracranial pressure monitoring. Which signs/symptoms indicate that the client's intracranial pressure is rising? Select all that apply.

A)The nurse notes "Doll's eyes" when assessing the client's pupils.

B)The nurse documents eupnea in respect to respiratory effort.

C)The nurse finds that all extremities are flaccid.

D)The nurse notes that blood pressure is stable.

E)The nurse documents that the client is in a comatose state.

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Chapter 59: Metabolism

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Q1) Place in correct order the steps for obtaining capillary blood glucose sampling.

A)Cleanse the side of the client's finger.

B)Apply the blood to the test strip.

C)Pierce the skin with a lancet.

D)Calibrate the blood glucose meter.

E)Apply clean gloves.

F)Wipe away the first drop of blood.

Q2) The client tells the nurse that he doesn't check his blood sugar as often as he should because his fingers are so sore from pricking them. How can the nurse assist this client to be more compliant with his blood sugar monitoring?

A)Push the injector as far into the finger as possible to ensure that an adequate drop is obtained with the first prick.

B)Hang the hand to be used below the waist for a minute to make sure the site that is chosen will have adequate blood supply for the test.

C)For best results, choose the pad of the finger for the test.

D)Allow two or three drops of blood to fall, wipe them away, and then place the next drop of blood on the test strip.

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Page 61

Chapter 60: Mobility

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Q1) The nurse is preparing to do pin site care for a client in skeletal traction. It is noted that the site appears red and feels warm to the touch. What actions will the nurse perform in taking care of this situation? Select all that apply.

A)Notify the healthcare provider.

B)Refrain from disturbing the crusts around the pin until the healthcare provider can observe it.

C)Expect to obtain a culture and sensitivity specimen from the pin site.

D)Remove the client's traction weights until the healthcare provider sees the client.

E)Check the client's vital signs.

Q2) The nurse and the UAP are preparing to logroll a client who has a spinal injury. The nurse will ask the UAP to obtain what assistive device prior to beginning the procedure?

A)Trochanter roll

B)Hydraulic lift

C)Friction-reducing device

D)Foot board

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Chapter 61: Nutrition

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Sample Questions

Q1) The nurse knows that which setting would be most effective in assisting teenagers to eat a more nutritious diet?

A)In a small group of their peers

B)At the hospital cafeteria

C)At a table with parents

D)Served to each teenager privately

Q2) The nurse is teaching a group of toddler parents about snack foods that are safe for this age group and should include which food in this teaching?

A)Grapes

B)Popcorn

C)Corn chips

D)Applesauce

Q3) The nurse is completing an anthropometric measurement of an individual and should use which instruments to complete this assessment?

A)Yard stick and scale

B)Yard stick and tape measure

C)Tape measure and ruler

D)Tape measure and skinfold caliper

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63

Chapter 62: Oxygenation

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Sample Questions

Q1) The nurse is preparing to perform tracheostomy care on an alert, cooperative adult client and should request an assistant prior to which step?

A)An assistant is not required when performing tracheostomy care in a cooperative, alert adult client.

B)The assistant is required prior to pouring liquids into the sterile container.

C)The assistant is required prior to removing the inner cannula.

D)The assistant is required prior to removing and placing new tracheostomy ties.

Q2) The nurse is caring for a client with pneumonia and should be most concerned about which assessment?

A)The client cannot remember which day it is.

B)The client's heart rate has risen from 72 to 78 bpm.

C)The client's pulse oximetry has decreased from 99% to 97%.

D)The client respiratory rate has risen from 16 to 20 breaths per minute.

Q3) The nurse should encourage the client to use incentive spirometry prior to which procedure?

A)Ambulating the client

B)Preparing the client for a rest period

C)Removing the client's meal tray

D)Obtaining a sputum specimen

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Page 64

Chapter 63: Perfusion

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Sample Questions

Q1) How should the nurse calculate the heart rate from a rhythm strip?

A)Count the number of R waves in 30 large blocks and multiply by 10.

B)Count the number of small squares in a 3-second period and multiply by 0.20.

C)Count the number of large squares and multiply by 3.

D)Count the number of P waves in a 0.04 second and multiply by 5.

Q2) The nurse is placing electrodes on a client. Which is the correct placement of a 3-lead telemetry?

A)RA (white)-below right clavicle; LA (black)-below left clavicle; LL (red)-left lowest rib cage area

B)RA (white)-right wrist; LA (black)-left wrist; LL (red)-left leg

C)RA (green)-right lowest rib cage; LA (brown)-midaxillary line; LL (red)left lowest rib cage

D)RA (green)-below right clavicle; LA (black)-below left clavicle; LL (red)-left leg

Q3) The nurse observes an irregular chaotic rhythm. Which arrhythmia should the nurse document?

A)Ventricular tachycardia

B)Ventricular fibrillation

C)Atrial flutter

D)Atrial fibrillation

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Page 65

Chapter 64: Perioperative Care

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Q1) The nurse is preparing a client for surgery and asks the client to remove his dentures and place them in the specified cup at the bedside. The client states, "Why are you asking me to do this? The last time I had surgery I got to keep my dentures in my mouth." Which is the nurse's best response to this client statement?

A)"You may have thought you kept them in. I'm guessing your dentures were removed after you went to sleep and were returned to your mouth before you were completely awake."

B)"Some anesthesiologists allow a client to keep a full set of dentures in the mouth if a specific type of anesthesia is given."

C)"I've never heard of anyone keeping their dentures in for surgery. You must remove them."

D)"I'm sorry that you don't want to do this. You must take them out or your surgery will be canceled."

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Chapter 65: Reproduction

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Sample Questions

Q1) A 16-year-old client comes to the prenatal clinic and is very concerned about a black line that has appeared on her abdomen. Which statement by the nurse will be most helpful to this client concerning this issue?

A)"This line occurs depending upon the sex of your baby. I don't want to tell you which one in case you don't know the gender of your baby yet."

B)"This line indicates that you are getting too much iron in your diet. You need to reduce the amount of red meat you are eating."

C)"This line is called the linea nigra and is related to the increase in your hormones during pregnancy."

D)"Please don't be worried about this. It is normal and it will go away after you have your baby."

Q2) The nurse is admitting a client to the labor and delivery unit and is preparing to apply the tocodynamometer (toco). Which must the nurse do first to properly apply this equipment?

A)Apply ultrasound gel to the client's abdomen before applying the toco.

B)Determine the fetal position.

C)Locate the uterine fundus.

D)Ensure that the client's membranes have ruptured.

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67

Chapter 66: Safety

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Sample Questions

Q1) The nurse has completed an assessment of an older adult client who lives with her son and his wife. The nurse observed some bruising on the client but no other signs of abuse. Which question by the nurse to the client would be most helpful in determining if abuse is occurring?

A)"Who manages your money?"

B)"How did the bruises I noted on your wrists occur?"

C)"Are you happy with where you live?"

D)"How often do you see the doctor?"

Q2) The nurse is assessing an older adult client who has come to the emergency department with a possible urinary tract infection. Which would alert the nurse that this client has been abused?

A)The right knee has a large bruise.

B)The underwear smells of urine.

C)There are bilateral contusions above the elbows.

D)There are small lacerations on the forehead.

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Chapter 67: Tissue Integrity

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Sample Questions

Q1) The nurse is caring for a client who is receiving negative-pressure wound therapy for an infected leg wound and is aware that the dressing on this wound must be changed how often?

A)Once a week

B)Every 48 hours

C)Every 24 hours

D)Every 4 hours

Q2) The healthcare provider has ordered an elastic bandage to be applied to a wound on a client's femur. The nurse will begin to apply the bandage at which point on the client's leg?

A)The groin

B)The wound itself

C)The knee

D)The hip

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