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    Exam Review

    1. A client with a prescription for morphine sulfate 2 mg IV every 4 hours PRN for pain reports the pain is a 10 on a 0 to 10 scale one hour after receiving the last administration. Which intervention should the nurse implement?
      A)Contact the healthcare provider about the frequency of pain medication.
      B)Administer an additional dose of morphine sulfate 2 mg IV.
      C)Review the medical record for additional pain medication prescriptions.
      D)Encourage the client to allow more time for the medication to work.
    2. The nurse is caring for a client with hypertension, gastroesophageal reflux, and osteoarthritis. While performing a bedside assessment the nurse observes the client is alert and oriented to person, place, time, and situation, but is exhibiting signs of jaundice. The nurse should notify the healthcare provider (HCP) about which scheduled medication?
      A)Prednisone.
      B)Omeprazole.
      C)Captopril.
      D)Acetaminophen.
    3. The nurse orients a client with depression to a new room on the mental health unit. The client states, "It seems strange that I don't have a television (TV) in my room." Which statement is best for the nurse to provide?
      A)Sometimes clients feel like the TV is sending them messages.
      B)Watching TV is a passive activity and we want you to be active.
      C)It's important to be out of your room and talking to others.
      D)You can watch TV as much as you want outside of your room.
    4. A client who weighs 176 pounds receives a prescription for filgrastim 5 mcg/kg/daily subcutaneously for 14 days. The medication is available in a 300 mcg/mL vial. How many mL should the nurse administer? (Enter numerical value only. If rounding is required, round to the nearest tenth.)
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    Exam Review

    1. A client presents to the emergency department with muscle aches, headache, fever, and describes a recent loss of taste and smell. The nurse obtains a nasal swab for COVID-19 testing. Which action is most important for the nurse to take?
      A)Report the COVID-19 result to the local health department according to CDC guidelines.
      B)Don an N95 respirator mask, face shield, gown, gloves, and shoe coverings prior to returning to the room.
      C)Explain to the client to inform others that they may have been potentially exposed in the last 14 days.
      D)Teach the client to wear a mask, hand wash, and social distance to prevent spreading the virus.
    2. The nurse is caring for a school-age child with sickle cell anemia presenting with an upper respiratory infection and fever. Which action should the nurse take first to minimize vaso-occlusive crisis?
      A)Initiate prescribed intravenous fluids.
      B)Apply oxygen via nasal cannula.
      C)Administer pain medication.
      D)Determine tolerance of activity.
    3. A client is newly diagnosed with type 2 diabetes mellitus. The nurse is educating the client about self-monitoring blood glucose (SMBG) and hemoglobin A1C (HbA1C). Which statement by the client indicates teaching has been effective?
      A)"I will inform the healthcare provider (HCP) of my average HbA1C results weekly."
      B)"I will use a lancing device on the center of my finger pad for a drop of blood."
      C)"I will document my HbA1C results from the SMBG monitor every morning."
      D)"I will wash my hands with warm soapy water before sticking my finger."
    4. The nurse leading a care team on a medical-surgical unit is assigning client care to a practical nurse (PN) and an unlicensed assistive personnel (UAP). Which activity should the nurse assign to the PN?
      A)Administer medications by piggyback infusion.
      B)Determine the need for urinary catheterizations.
      C)Initiate teaching for client care after discharge.
      D)Complete comprehensive assessments.
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    Exam Review

    1. The nurse is preparing to feed a newly admitted older adult client who is debilitated, but is able to respond to most commands. Before starting to feed the client, which information is most important for the nurse to obtain?
      A)Client's ability to chew and swallow.
      B)The client's respiratory rate and lung sounds.
      C)The consistency of the prescribed diet.
      D)Review of current medications.
    2. A male client has been receiving the antibiotic gentamicin sulfate, IV piggyback, every 12 hours for several days. Which observation by the nurse indicates that the client may be experiencing an adverse effect of gentamicin? Reference Range: White Blood Cell [5,000 to 10,000/mm³ (5 to 10 × 10⁹/L)]
      A)Hearing has decreased.
      B)Decreased blood urea nitrogen.
      C)Reports of photophobia.
      D)White blood cell count of 6,000/mm³ (6 × 10⁹/L).
    3. A client experiences residual effects following an acute attack of Meniere's disease and receives a new prescription for an antihistamine. Which assessment finding indicates that the medication is effective?
      A)Ambulates easily without vertigo.
      B)Blood pressure of 120/80 mm Hg.
      C)Headache pain rated 0 on a 0 to 10 scale.
      D)Oxygen saturation level of 99% on room air.
    4. The nurse is conducting an admission assessment of an 11-month-old infant with heart failure who is scheduled for repair of restenosis of coarctation of the aorta that was repaired 4 days after birth. Findings include blood pressure higher in the arms than the lower extremities, pounding brachial pulses, and slightly palpable femoral pulses. Which pathophysiologic mechanism supports these findings?
      A)The aortic semilunar valve obstructs blood flow into the systemic circulation.
      B)The pulmonic valve prevents adequate blood volume into the pulmonary circulation.
      C)An opening in the atrial septum causes a murmur due to a turbulent left to right shunt.
      D)The lumen of the aorta reduces the volume of blood flow to the lower extremities.
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    Exam Review

    1. A client is hospitalized with heart failure (HF). Which intervention should the nurse implement to improve ventilation and reduce venous return?
      A)Administer oxygen per nasal cannula.
      B)Increase the client's activity level.
      C)Perform passive range of motion exercises.
      D)Place the client in high Fowler position.
    2. An older adult male client tells the nurse of losing sleep because of having to get up several times at night to go to the bathroom. The client also reports having trouble starting his urinary stream, and he does not feel like his bladder is ever completely empty. Which intervention should the nurse implement?
      A)Palpate the bladder above the symphysis pubis.
      B)Review the client's fluid intake prior to bedtime.
      C)Collect a urine specimen for culture analysis.
      D)Obtain a fingerstick blood glucose level.
    3. A client arrives to the emergent care clinic describing pain, tenderness, and swelling of the right knee and an inability to bear weight on the leg. The nurse obtains a history from the client that a popping sound was suddenly heard in the right knee while playing tennis. Based on the history and assessment, which injury should the nurse expect has occurred?
      A)Tendonitis.
      B)Fracture of the patella.
      C)Rotator cuff tear.
      D)Ligament sprain.
    4. In planning the turning schedule for a bedfast client, it is most important for the nurse to consider which assessment finding?
      A)A Braden risk assessment scale rating score of ten.
      B)4+ pitting edema of both lower extremities.
      C)Warm, dry skin with a fever of 100.0° F (37.8° C).
      D)Hypoactive bowel sounds with infrequent bowel movements.
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    Exam Review

    1. The nurse is caring for a client who is taking warfarin and is scheduled for a cholecystectomy. Which laboratory result should the nurse report to the healthcare provider (HCP)? Reference Ranges: Hemoglobin (Hgb) [14 to 18 g/dL (140 to 180 g/L)] White Blood Cell (WBC) [5,000 to 10,000/mm³ (5 to 10 × 10⁹/L)] International normalized ratio (INR) [0.8 to 1.1] Potassium [3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)]
      A)Potassium of 4.9 mEq/L (4.9 mmol/L).
      B)Hemoglobin 14 g/dL (140 g/L).
      C)International normalized ratio of 1.6.
      D)White blood cells 10,000/mm³ (10 × 10⁹/L).
    2. A client who suffered an electrical injury with the entrance site on the left hand and the exit site on the left foot is admitted to the burn unit. Which intervention is most important for the nurse to include in this client’s plan of care (POC)?
      A)Evaluate level of consciousness.
      B)Perform passive range of motion.
      C)Continuous cardiac monitoring.
      D)Assess lung sounds every 4 hours.
    3. An adult client is admitted with AIDS and oral candidiasis manifested by several painful mouth ulcers. The nurse delegates oral care to the unlicensed assistive personnel (UAP) and discusses how to assist the client. Which instruction should the nurse provide the UAP?
      A)Provide a soft bristled toothbrush for the client to use during oral care.
      B)Wear sterile gloves when cleansing any areas of infected mucosa.
      C)Offer the client mouthwash for thorough cleansing after brushing teeth.
      D)Assist with personal care, but leave oral care for the nurse to complete.
    4. The RN charge nurse of a 24-bed medical unit is making shift assignments for 2 experienced registered nurses (RN), 1 graduate registered nurse, 1 practical nurse (PN), and 2 unlicensed assistive personnel (UAP). Which client should the nurse assign to the most experienced RN?
      A)The 72-year-old admitted with urosepsis who is being transferred to a skilled unit today.
      B)The 48-year-old with advanced cancer who has requested not to be resuscitated.
      C)The 28-year-old who is being prepared for a laparoscopic cholecystectomy this morning.
      D)The 36-year-old admitted with angina who has a history of coronary artery disease.
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