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    Exam Review

    1. A nurse is admitting a client who has hepatitis C. Which of the following precautions should the nurse implement?
      A)Airborne
      B)Droplet
      C)Contact
      D)Standard
    2. The nurse is notifying the HCP of the client's change in status using the SBAR format. In which order should the nurse place the statements? 1. "I suggest that the client be transferred to the critical care unit, and I would like you to come evaluate the client." 2. "The client is deteriorating, and I'm afraid the client is going to arrest." 3. "I am calling about (client name and location). Vital signs are BP=100/50, P=120, RR=30, T=100.4°F (38°C)." 4. "The client is becoming confused and agitated. The skin is pale, mottled, and diaphoretic. The client is very dyspneic with an oxygen saturation of 85% despite placing a nonrebreather mask."
      A)2,4,3,1
      B)3.4.2.1
      C)4.3.2.1
      D)3.4.1.2
    3. A nurse is caring for a client who is prescribed bedrest. The plan of care indicates that the client should perform isometric exercises every 2 hr. Which of the following actions should the nurse take as directed by the plan of care?
      A)Move the client's limbs through their complete range of motion.
      B)Have the client move each limb independently through its complete range of motion.
      C)Ask the client to move her arms and legs while applying slight resistance.
      D)Instruct the client to tighten muscle groups for a short period, and then relax.
    4. A nurse is caring for a client who has active pulmonary tuberculosis (TB). The client requires airborne precautions and is receiving multidrug therapy. Which of the following precautions should the nurse take to transport the client safely to the radiology department for a chest x-ray?
      A)Have the client wear a mask.
      B)Wear a filtration mask and gloves during transport.
      C)Notify the x-ray department that the client requires airborne precautions.
      D)Ask the x-ray technician to come to the client's room to obtain a portable x-ray.
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    Exam Review

    1. Which of the following is a benefit of negative pressure wound therapy (NPWT) for skin wounds?
      A)Prevents scarring by minimizing collagen production
      B)Relieves pain by numbing the wound area
      C)Promotes wound healing by increasing blood flow to the wound
      D)Reduces the risk of infection by creating a sterile environment
    2. In a clinical setting, a patient with a chronic wound is scheduled for debridement. Which of the following is the primary purpose of wound debridement?
      A)To increase blood flow to the wound site
      B)To remove necrotic tissue to promote healing
      C)To apply antibiotics directly to the wound
      D)To prevent scar formation
    3. A nurse is teaching a new group of assistive personnel (AP) about the importance of hand hygiene. Which of the following statements should the nurse include?
      A)"If you wear gloves, you do not have to wash your hands."
      B)"Rub all surfaces of your hands with an alcohol rub for 20 to 30 seconds."
      C)"Use an alcohol rub when your hands are visibly soiled."
      D)"If you don't have an infection, your hands won't infect others."
    4. A nurse is assessing a client who is experiencing complications due to immobility. Which of the following findings should the nurse expect? (Select all that apply)(SATA)
      A)Diarrhea
      B)Contractures of the extremities
      C)Polyuria
      D)Pressure ulcers
      E)Crackles in the lungs
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    Exam Review

    1. A nurse is caring for a group of clients. The nurse demonstrates adherence to the ethical principle of fidelity by doing which of the following?
      A)Allowing a new mother to hold her stillborn infant
      B)Refusing to disclose information about a client to the media
      C)Confirming that a client going for surgery has signed a consent form
      D)Keeping an appointment with a client
    2. A nurse is assisting with transferring a client from the bed to a wheelchair. Which of the following actions should the nurse take?
      A)Elevate the bed to a position of comfort for the nurse.
      B)Lock the wheels of the bed and the wheelchair.
      C)Place the wheelchair at a 90° angle to the bed.
      D)Acquire the help of several people to lift the client.
    3. A nurse is reviewing the laboratory results of a client who has a pressure ulcer. The nurse should identify an elevation in which of the following laboratory values as an indication that the client has developed an infection?
      A)Potassium
      B)WBC count
      C)BUN
      D)RBC count
    4. When preparing to move a patient in bed with the help of an assistant, which posture will both caregivers use to ensure their own safety?
      A)Stand with the knees locked.
      B)Flex the hips and knees.
      C)Shift the body weight from the front leg to the back leg.
      D)Stand with the feet together.
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    Exam Review

    1. A nurse is performing a home safety assessment for a client who has experienced a stroke. Which of the following findings are a safety hazards for the client? (Select All that Apply.)(SATA)
      A)The hot water heater is set at 54°C (130° F).
      B)Grab bars are installed in the bathroom.
      C)Area rugs are placed in the living room.
      D)Medications are stored in a clear bag.
      E)Dim lighting installed throughout the house.
    2. A nurse in reviewing the laboratory data on a client who has a new prescription for heparin for treatment of a pulmonary embolism. Which of the following data should the nurse report to the provider?
      A)Partial thromboplastin time (PTT) 65 seconds
      B)Hematocrit 45%
      C)White blood cell count 8.000/mm3
      D)Platelets
    3. A nurse is caring for a client who has an infection. The nurse should use which of the following strategies to prevent the transmission of the client's infection?
      A)Encouraging the client to consume a high-protein diet
      B)Placing the client in a room with positive-pressure airflow
      C)Changing the client's bed linens each day
      D)Performing hand hygiene before, during, and after direct contact with the client
    4. A 65-year-old post-operative patient presents with a sudden opening of their surgical abdominal wound. What is the most appropriate immediate nursing action to take for this patient experiencing wound dehiscence?
      A)Instruct the patient to cough and deep breathe to prevent atelectasis.
      B)Apply a sterile saline dressing and notify the surgeon immediately.
      C)Increase the patient's oral fluid intake to promote healing.
      D)Apply pressure to the wound to stop any bleeding.
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    Exam Review

    1. A nurse caring for a client who has an infected wound removes a dressing saturated with blood and purulent drainage. How should the nurse dispose of the dressing material?
      A)Discard the dressing in the bedside trash receptacle.
      B)Enclose the dressing in a single clear plastic bag and discard in the bedside trash receptacle.
      C)Double-bag the dressing in clear bags and label it "biohazard".
      D)Dispose of the dressing in a biohazardous waste container.
    2. The nurse is teaching a client who is preparing for surgery. Which teaching about a Jackson-Pratt drain will the nurse include?
      A)"The bulb-like system will stay in place permanently after your surgery."
      B)"You will receive medication through this device."
      C)"This drain minimizes the chance for bacteria to enter the surgical site."
      D)"It provides a way to remove drainage and blood from the surgical wound."
    3. A nurse is admitting an older adult from Mumbai, India who is visiting family members in the US. Which of the following would be most appropriate for the nurse to say?
      A)"Your roommate is Catholic and her priest comes to see her, is that a problem for you?"
      B)"Can I call the Hindu hospital chaplain to make a visit with you today?"
      C)"Can you tell me how your culture will impact the care I will give?"
      D)“I will be sure to get a menu for you without any beef and beef related foods."
    4. A nurse is teaching a client who has strained her back muscles while preparing to move to a new apartment. Which of the following instructions should the nurse include?
      A)Twist at the waist when she moves an object to one side.
      B)Bend at the knees when picking up an object.
      C)Hold an object away from her body as she lifts it.
      D)Relax her abdominal muscles when she lifts an object.
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