An adult who had been abused as a child is discussing the group therapy program. Which statement indicates that the client has gained insight?
How is the information documented on incident reports used?
A nurse assesses a 83 year-old female’s venous ulcer for the second time that is located near the right medial malleolus. The wound is exhibiting purulent drainage and the patient has limited mobility in her home. Which of the options is the best course of action?
A nurse is caring for a patient in the step down unit. The patient has signs of increased intracranial pressure. Which of the following is not a sign of increased intracranial pressure?
A 93 year-old female with a history of Alzheimer’s Disease gets admitted to an Alzheimer’s unit. The patient has exhibited signs of increased confusion and limited stability with gait. Moreover, the patient is refusing to use a w/c. Which of the following is the most appropriate course of action for the nurse?
When planning care of a client who has a been diagnosed with Amphetamine Abuse, the nurse should use the knowledge that:
A central venous pressure reading of 11cm/H(2)0 of an IV of normal saline is determined by the nurse caring for the patient. The patient has a diagnosis of pericarditis. Which of the following is the most applicable:
A 32-year-old female frequently comes to her primary care provider with vague complaints of headache, abdominal pain, and trouble sleeping. In the past, the physician has dutifully prescribed medication, but little else. Which of the following comments by the nurse to the physician is appropriate?
An infection in a central venous access device is not eliminated by giving antibiotics through the catheter. How might bacterial glycocalyx contribute to this?
The home health nurse has made a visit to an 85-year-old female client’s home who has recently had surgery to replace her left knee. The client has been discharged from a rehab facility and has been able to walk on her own. The nurse assesses the need for teaching related to fall prevention. What should the nurse include in this teaching plan?
A nurse is covering a pediatric unit and is responsible for a 15 year-old male patient on the floor. The mother of the child states, “I think my son is sexually interested in girls.” The most appropriate course of action of the nurse is to respond by stating:
A nurse has been assigned a patient who has recently been diagnosed with Guillain-Barre’ Syndrome. Which of the following statements is the most applicable when discussing the impairments with Guillain-Barre’ Syndrome with the patient?
In hanging a parenteral IV fluid that is to be infused by gravity, rather than with an infusion pump, the nurse notes that the IV tubing is available in different drop factors. Which tubing is a microdrop set?
A 28 year-old male has a diagnosis of AIDS. The patient has had a two year history of AIDS. The most likely cognitive deficits include which of the following?
A patient has experienced a severe third degree burn to the trunk in the last 36 hours. Which phase of burn management is the patient in?
Why is it often necessary to draw a complete blood count and differential (CBC/differential) when a client is being treated with an antiepileptic drug (AED)?
During a well-baby check of a 6-month-old infant, the nurse notes abrasions and petechaie of the palate. The nurse should:
A client was involved in a motor vehicle accident in which the seat belt was not worn. The client is exhibiting crepitus, decreased breath sounds on the left, complains of shortness of breath, and has a respiratory rate of 34/min. Which of the following assessment findings should concern the nurse the most?
A young boy is recently diagnosed with a seizure disorder. Which of the following statements by the boy’s mother indicates a need for further teaching by the nurse?
The goals of palliative care include all of the following except:
A teenage client is admitted to the hospital because of acetaminophen (Tylenol) overdose. Overdoses of acetaminophen can precipitate life-threatening abnormalities in which of the following organs?
Nurses caring for clients who have cancer and are taking opioids need to assess for all of the following except:
Which of the following neurological disorders is characterized by writhing, twisting movements of the face and limbs?
A health care worker is concerned about a new mother being overwhelmed by caring for her infant. The health care worker should:
The nurse is assessing the dental status of an 18-month-old child. How many teeth should the nurse expect to examine?
Which of the following lab values is associated with a decreased risk of cardiovascular disease?
For a client with suspected appendicitis, the nurse should expect to find abdominal tenderness in which quadrant?
A 20-year-old obese female client is preparing to have gastric bypass surgery for weight loss. She says to the nurse, “I need this surgery because nothing else I have done has helped me to lose weight.” Which response by the nurse is most appropriate?
A client is taking hydrocodone (Vicodin) for chronic back pain. The client has required an increase in the dose and asks whether this means he is addicted to Vicodin. The nurse should base her reply on the knowledge that:
Which sign might the nurse see in a client with a high ammonia level?
Which of the following terms refers to soft-tissue injury caused by blunt force?
Which of the following conditions is mammography used to detect?
To remove a client’s gown when she has an intravenous line, the nurse should:
Which of the following injuries, if demonstrated by a client entering the Emergency Department, is the highest priority?
The nurse teaching about preventable diseases should emphasize the importance of getting the following vaccines:
A client has been diagnosed with Disseminated Intravascular Coagulation (DIC) and transferred to the medical intensive care unit (ICU) subsequent to an acute bleeding episode. In the ICU, continuous Heparin drip therapy is initiated. Which of the following assessment findings indicates a positive response to Heparin therapy?
Nonpharmacological pain management involves all of the following except:
When assessing a client in the Emergency Department whose membranes have ruptured, the nurse notes that the fluid is a greenish color. What is the cause of this greenish coloration?
For which condition might a client’s antidiuretic hormone (ADH) level be increased?
Which of the following diseases places a client at risk for developing cirrhosis?
The teaching plan for a postpartum client who is about to be discharged should include which of the following instructions?
One of the major functions of the kidneys in maintaining normal fluid balance is:
As part of the teaching plan for a client with type I diabetes mellitus, the nurse should include that carbohydrate needs might increase when:
When a client wishes to improve her appearance by removing excess skin from her face and neck, the nurse should provide teaching regarding which of the following procedures?
Neural tube defects in the fetus have been primarily associated with which deficiency in the mother?
Increased cortisol levels might be found in a client with which condition?
A standard walker is used when clients:
During the work phase of the nurse-client relationship, the client says to her primary nurse, “You think that I could walk if I wanted to, don’t you?” What is the best response by the nurse?
Which of the following actions should a nurse take first for a client who has just vomited 300 cc of bright red blood?
All of the following clients are in need of an emergency assessment except:
Which of the following represents a normal serum potassium level?
A nurse is caring for a client with an elevated cortisol level. The nurse can expect the client to exhibit symptoms of:
What does client and family communication and education concerning restraints do?
Padding on a restraint helps:
Health promotion activities are designed to help clients:
A nurse observes a client sitting alone and talking. When asked, the client reports that he is “talking to the voices.” The nurse’s next action should be:
A client states, “I eat a well-balanced diet. I do not smoke. I exercise regularly, and I have a yearly checkup with my physician. What else can I do to help prevent cancer?” The nurse should respond with which of the following statements?
A client is given an opiate drug for pain relief following general anesthesia. The client becomes extremely somnolent with respiratory depression. The physician is likely to order the administration of:
The focus of a nurse case manager is:
The family carries out its health care functions in which of the following ways?
A 65-year-old female client is experiencing postmenopausal bleeding. Which type of physician should this client be encouraged to see?
The death of a beloved spouse places the surviving partner in which type of crisis?
A corporate executive works 60–80 hours a week. The client is experiencing some physical signs of stress. The nurse teaches the client biofeedback techniques. This is an example of which of the following health-promotion interventions?
Ethical and moral issues concerning restraints include all of the following except:
Using clichés in therapeutic communication leads the client toward:
According to the ANA Code of Ethics for Nurses, professional nurses have an ethical obligation to:
Following the change of shift report, the nurse should analyze the information and set priorities accordingly. When the plan has been formulated, at what point during the shift can or should the nurse’s plan be altered or modified?
A 4-year-old client is unable to go to sleep at night in the hospital. Which nursing intervention best promotes sleep for the child?
The greatest time savers when planning client care include all of the following except:
The nurse is teaching a client about erythema infectiosum. Which of the following factors are not correct?
A client recently lost a child due to poisoning. The client tells the nurse, “I don’t want to make any new friends right now.” This is an example of which of the following indicators of stress?
When teaching a client about anti-retroviral therapy for human immunodeficiency virus (HIV), the PN should emphasize:
Incidences of child abuse apperar to be higher in the African-American community and might be explained by:
A client who is newly diagnosed with Parkinson’s disease and beginning medication therapy asks the nurse, “How soon will I see improvement ?” The nurse’s best response is:
Which of the following is the most appropriate diet for a client who is unable to swallow?
Pulling is easier than pushing. So pulling a client rather than pushing him or her has which of the following advantages?
The best lab test to diagnose disseminated intravascular coagulation (DIC) is:
Which of the following allergies might be a contraindication for a client to receive contrast enhancement for intracranial computed tomography?
When discussing the patterns of use of alcohol and other drugs, the nurse should include which piece of information?
The nurse is caring for a postpartum woman who has relinquished her baby for adoption. The care plan for the client should include which of the following priority strategies?
In managing nausea related to Morphine epidural analgesia, the nurse should administer:
A client with sickle cell disease is worried about passing the disease on to children. Which of the following statements by the PN is most appropriate for this client?
Which of the following isoenzymes is elevated in a client who has had a myocardial infarction?
Which of the following should not be included in the teaching for clients who take oral iron preparations?
The nurse has completed client teaching about introducing solid foods to an infant. To evaluate teaching, the nurse asks the mother to identify an appropriate first solid food. Which of the following is an appropriate response?
Which of the following statements is correct regarding rape?
The method of splinting is always dictated by:
A client with Parkinson’s disease has difficulty performing voluntary movements. This is known as:
Which of the following client groups should the nurse recognize as the fastest-growing segment of the homeless population?
Acute hyphema is associated with what type of injury?
One day postoperative, the client complains of dyspnea, and his respiratory rate (RR) is 35, slightly labored, and there are no breath sounds in the lower-right base. The nurse should suspect:
American families are having difficulty adequately performing their vital health care function. What are the basic reasons for this difficulty?
Local anesthetics block the conduction of pain impulses to the spinal cord. Their duration of action:
A client asks the nurse what risk factors increase the changes of getting skin cancer. The risk factors include all except:
Who should receive the hepatitis A vaccine?
A female having her first child is experiencing which type of crisis event?
A client with a diagnosis of Schizophrenia has been released from an acute care setting. The client had a prolonged recovery from relapse. One of the parents says to the discharge nurse, “I do not understand what is going on. The hospital said she was better, but all she does is sit around all day and smoke. We cannot get her to go to the vocational training you arranged.” The nurse recognizes that more teaching is needed about:
The three major sequential maturational crises for females include:
A serious complication of a total hip replacement is displacement of the prosthesis. What is the primary sign of displacement?
The nurse can best communicate to a client that he or she has been listening by:
When caring for a Native-American family, the nurse needs to consider which of the following?
When questioning an elder about suspected abuse, the nurse should keep the questions:
A visitor accidentally knocks over a plastic pleural drainage system connected to a client, and it cracks. What should the nurse do first?
A client has just returned from surgery where a femoral-popliteal bypass was performed. The nurse has assessed the client and is unable to feel a pulse at either the dorsalis pedis or the posterior tibial sites of the left foot. The foot feels warm and the color is pink. What action should the nurse perform next to prevent ischemia?
A community health nurse is asked to organize a health promotion project that plans to provide glucose screening. This activity is most beneficial within what realm?
There are many types of torts that can be committed against clients. They include all of the following except:
The nurse is teaching a client about sleep and gives background information on normal sleep patterns. Which of the following substances promotes sleep?