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A nurse is planning medication teaching for a client who has ED. Which of the following
medications should the nurse plan to include in the teaching?
A. Hydrochlorothiazide
B.Finasteride
C.Sildenafil
D.Carbidopa/levodopa
A. Hydrochlorothiazide
Hydrochlorothiazide is a thiazide diuretic prescribed to treat hypertension.
B.Finasteride
Finasteride is a 5-alpha reductase inhibitor medication, which is prescribed to treat benign
prostatic hypertrophy, as well as alopecia.
C.Sildenafil (CORRECT)
The nurse should identify that sildenafil is a PDE5 inhibitor, which is prescribed as an oral firstline treatment for erectile dysfunction.
D.Carbidopa/levodopa
Carbidopa/levodopa is a dopaminergic medication, which is prescribed to treat Parkinson's
disease.
Set
confidence
level:
5
2
A nurse is caring for a client who has gestational hypertension and is experiencing postpartum
hemorrhage. Which of the following medications should the nurse anticipate?
A.Dinoprostone
B.Misoprostol
C.Methylergonovine
D.Carboprost
A.Dinoprostone
This medication is contraindicated for clients who have hypertension.
B.Misoprostol (CORRECT)
The nurse should anticipate administering misoprostol or oxytocin to the client who has
gestational hypertension and is experiencing a postpartum hemorrhage.
C.Methylergonovine
This medication is contraindicated for clients who have hypertension.
D.Carboprost
This medication is contraindicated for clients who have hypertension.
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2
3
A nurse is assessing a 7 month old infant who is experiencing developmental delays. Which of
the following findings should the nurse expect?
A.Makes eye contact with staff members
B.Plays with blocks in the crib
C.Restricts attention to large objects
D.Momentarily sits erect
A.Makes eye contact with staff members
The nurse should expect a 7-month-old infant to make eye contact with staff members. However,
a 7-month-old infant who is experiencing developmental delays will not display this socialization
skills.
B.Plays with blocks in the crib
The nurse should expect a 7-month-old infant to play with blocks in the crib. However, a 7month-old infant who is experiencing developmental delays will not display this fine motor skill.
C.Restricts attention to large objects (CORRECT)
The nurse should expect a 7-month-old infant to begin to focus on very small objects. However,
a 7-month-old infant who restricts attention to large objects is displaying a sensory
developmental delay.
D.Momentarily sits erect
The nurse should expect a 7-month-old infant to momentarily sit erect. However, a 7-month-old
infant who is experiencing developmental delays will not display this gross motor skill.
3
4
A nurse is caring for a client who is being seen for infertility and has a new prescription for
clomiphene citrate. Which of the following manifestations should the nurse include in the
teaching as a common adverse effect of the medication?
A."You might have chills while taking the medication."
B."You might experience drooling while taking the medication."
C."You might have breast tenderness while taking the medication."
D."You might experience an increase in urination while taking the medication."
A."You might have chills while taking the medication."
The client might experience hot flashes while taking clomiphene citrate.
B."You might experience drooling while taking the medication."
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The client might have a dry mouth while taking clomiphene citrate.
C."You might have breast tenderness while taking the medication." (CORRECT)
Breast tenderness is a common adverse effect of the medication.
D."You might experience an increase in urination while taking the medication."
Increased urine output is an adverse effect of furosemide, rather than clomiphene citrate.
3
5
A nurse is discussing palliative care with the family of a client who is terminally ill. Which of the
following information should the nurse include?
A.Palliative care begins once life-saving treatments have been stopped.
B.Palliative care includes a variety of therapies.
C.Palliative care requires the client to sign a DNR.
D.Palliative care must be provided in the home setting.
A.Palliative care begins once life-saving treatments have been stopped.
A client is eligible to participate in hospice care when curative or life-saving treatments, such as
chemotherapy, have been stopped. Palliative care is available to a client throughout her illness,
regardless of the treatment regimen.
B.Palliative care includes a variety of therapies. (CORRECT)
Along with medical treatments, palliative care includes a holistic approach using a variety of
therapies to improve the client's level of comfort. Therapies such as yoga, meditation, and pet
therapy enhance the client's quality of life.
C.Palliative care requires the client to sign a DNR.
Palliative care does not require a client to sign a DNR. Curative treatments can continue
simultaneously with palliative care.
D.Palliative care must be provided in the home setting.
Palliative care is offered in both home and inpatient settings.
-6
A nurse is caring for a client who is experiencing hypovolemic shock due to postpartum
hemorrhage. After notifying the provider, which of the following actions should the nurse take
next?
A.Massage the client's fundus.
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B.Insert an indwelling urinary catheter.
C.Elevate the client's right hip on a pillow.
D.Administer oxygen via nonrebreather face mask at 10 L/min.
A.Massage the client's fundus. (CORRECT)
The greatest risk to the client is hemorrhage. Therefore, the next action the nurse should take is
to massage the client's fundus to expel clots and promote contractions.
B.Insert an indwelling urinary catheter.
The nurse should insert an indwelling urinary catheter to monitor perfusion of the kidneys.
However, this is not the next action the nurse should take.
C.Elevate the client's right hip on a pillow.
The nurse should elevate the client's right hip to enhance perfusion. However, this is not the next
action the nurse should take.
D.Administer oxygen via nonrebreather face mask at 10 L/min.
The nurse should administer oxygen at 10 L/min to enhance perfusion. However, this is not the
next action the nurse should take.
-7
A nurse in a provider’s office is performing office a skin assessment on a client who reports
concern about lesions on her back. Which of the following images should the nurse identify as
having the characteristics of melanoma?
A.The nurse should identify this image as having the characteristics of melanoma. This form of
skin cancer is characterized by an irregularly shaped lesion that contains a combination of colors
such as red, black, blue-black, and brown. The nurse should perform a complete skin assessment
because melanoma can occur anywhere on the client's body, especially where the client has nevi
or birthmarks.
B.The nurse should identify this image as having the characteristics of squamous cell carcinoma.
This form of skin cancer is characterized by a nodular lesion that is firm to palpation. The lesion
has an ulcerated center and is covered by a crust. Squamous cell carcinoma is most commonly
found on sun-exposed areas of the skin.
C.The nurse should identify this image as having the characteristics of basal cell carcinoma. This
form of skin cancer is characterized by a papular lesion that has rolled borders and a crater in the
center. Basal cell carcinoma is most commonly found on sun-exposed areas of the skin.
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D.The nurse should identify this image as having the characteristics of psoriasis. This
autoimmune disorder is not cancerous and is characterized by thick reddened areas covered with
scales that have a silver-white color. Psoriasis is commonly found on the elbows, knees, and
scalp.
(CORRECT)
A.The nurse should identify this image as having the characteristics of melanoma. This form of
skin cancer is characterized by an irregularly shaped lesion that contains a combination of colors
such as red, black, blue-black, and brown. The nurse should perform a complete skin assessment
because melanoma can occur anywhere on the client's body, especially where the client has nevi
or birthmarks.
B.The nurse should identify this image as having the characteristics of squamous cell carcinoma.
This form of skin cancer is characterized by a nodular lesion that is firm to palpation. The lesion
has an ulcerated center and is covered by a crust. Squamous cell carcinoma is most commonly
found on sun-exposed areas of the skin.
C.The nurse should identify this image as having the characteristics of basal cell carcinoma. This
form of skin cancer is characterized by a papular lesion that has rolled borders and a crater in the
center. Basal cell carcinoma is most commonly found on sun-exposed areas of the skin.
D.The nurse should identify this image as having the characteristics of psoriasis. This
autoimmune disorder is not cancerous and is characterized by thick reddened areas covered with
scales that have a silver-white color. Psoriasis is commonly found on the elbows, knees, and
scalp.
-8
A nurse is assessing a client who is at 24 weeks of gestation. Which of the following findings
should the nurse identify as an indication of gestational hypertension?
A.Protein in the urine
B.Visual disturbances
C.Systolic blood pressure 132 mm Hg
D.Diastolic blood pressure 98 mm Hg
A.Protein in the urine
Protein in the urine is a manifestation of preeclampsia. Preeclampsia is a complication that can
follow uncontrolled gestational hypertension.
B.Visual disturbances
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Visual disturbances are a manifestation of preeclampsia. Preeclampsia is a complication that can
follow uncontrolled gestational hypertension.
C.Systolic blood pressure 132 mm Hg
For a client who has gestational hypertension, the nurse should expect a systolic blood pressure
greater than 140 mm Hg.
D.Diastolic blood pressure 98 mm Hg (CORRECT)
Gestational hypertension is characterized by a systolic blood pressure greater than 140 mm Hg or
a diastolic blood pressure greater than 90 mm Hg in a client who is at or past 20 weeks of
gestation. To diagnose gestational hypertension, the nurse should record the increased levels on
two occasions that are 4 hr apart.
-9
A nurse in a mental health facility is caring for a client who has anorexia nervosa. Which of the
following actions should the nurse take to help the client manage this eating disorder? (select all
that apply)
Have the client establish a weight gain goal of 1.81 kg (4 lb) per week
Offer the client fried foods to increase caloric intake
Limit the client's intake of caffeine
Suggest high-fiber food choices to the client
Use increments of 100 calories when advancing the client's dietary intake
Have the client establish a weight gain goal of 1.81 kg (4 lb) per week is incorrect. The nurse
should help the client establish a reasonable weight gain goal, such as 0.45 to 1.36 kg (1 to 3 lb)
per week.
Offer the client fried foods to increase caloric intake is incorrect. The client should avoid eating
fried foods because they can lead to gastrointestinal intolerance.
Limit the client's intake of caffeine is correct. The nurse should limit the client's intake of
caffeine because it works as a diuretic and can cause excess stimulation.
Suggest high-fiber food choices to the client is correct. The client should consume high-fiber
foods to decrease the risk of constipation.
Use increments of 100 calories when advancing the client's dietary intake is correct. The client's
dietary intake should be increased gradually to avoid overwhelming the client. Increasing the
client's dietary intake by increments of 100 to 200 calories is a reasonable strategy
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10
A school nurse is observing a preschooler who has autism spectrum disorder. Which of the
following behavioral characteristics should the nurse expect the child to exhibit?
A.Imaginative
B.Extroverted
C.Ritualistic
D.Adaptable
A.Imaginative
A child who has ASD has difficulty with imaginative activities. The child is likely to demonstrate
reduced initiation of interactions with others and repetitive, rigid play.
B.Extroverted
A child who has mild ASD has difficulty with social relationships. A child who has severe ASD
is likely to show no interest in peers and might lack the ability to communicate with others.
C.Ritualistic (CORRECT)
The nurse should expect a child who has ASD to demonstrate compulsive ritualistic or repetitive
movements, such as hand-clapping or, in some cases, self-mutilation movements such as banging
or hitting his head.
D.Adaptable
A child who has ASD demonstrates rigid behaviors, insists on repetition, and is inflexible
regarding routines.
-11
A nurse is caring for a newborn who has a congenital heart defect and is postoperative following
a cardiac catheterization. Which of the following actions should the nurse take?
A.Administer an IV of lactated Ringer's.
B.Assess vital signs once every 30 min.
C.Remove the pressure dressing 2 hr after the procedure.
D.Monitor the color of the affected extremity.
A.Administer an IV of lactated Ringer's.
The nurse should administer an IV fluid containing dextrose because newborns are at an
increased risk for hypoglycemia.
B.Assess vital signs once every 30 min.
The nurse should assess the newborn's vital signs as frequently as every 15 min. The nurse
should focus on the heart rate and ensure it is auscultated for 1 full min to detect bradycardia or
dysrhythmias.
C.Remove the pressure dressing 2 hr after the procedure.
The nurse should remove the pressure dressing the day after the catheterization.
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D.Monitor the color of the affected extremity. (CORRECT)
The nurse should assess the color and temperature of the affected extremity because blanching or
coolness can indicate an arterial obstruction. Additionally, the nurse should palpate the pulses
with special attention to pulses below the catheterization site. The nurse should palpate for
symmetry and equality
-12
A nurse is discussing family planning with a client who wants to use a diaphragm for conception.
Which of the following statements should the nurse include in the teaching?
A."You should be refitted for your diaphragm after a 20 percent weight fluctuation."
B."You should inspect your diaphragm once each month.
C."You should get an exam by your provider every 2 years to check the fit of your diaphragm."
D."You do not have to use a spermicide with the diaphragm."
A."You should be refitted for your diaphragm after a 20 percent weight fluctuation."
(CORRECT)
The nurse should instruct the client to be refitted for a diaphragm after a 20% weight fluctuation,
after a pregnancy, and after abdominal or pelvic surgery.
B."You should inspect your diaphragm once each month.
The nurse should instruct the client to inspect the diaphragm prior to each use.
C."You should get an exam by your provider every 2 years to check the fit of your diaphragm."
The nurse should instruct the client to get an annual examination by a provider to check the fit of
the diaphragm.
D."You do not have to use a spermicide with the diaphragm."
The nurse should instruct the client to use a spermicide with the diaphragm to increase the
effectiveness of pregnancy prevention.
-13
A nurse is assessing a client who is at 34 weeks of gestation and is experiencing severe uterine
pain. Which of the following findings should the nurse report to the provider?
A.Increased fundal height since admission (CORRECT)
An increased fundal height since admission indicates placental abruption with concealed
bleeding. Therefore, the nurse should report this finding to the provider.
B.Biophysical profile score of 8
This is an expected finding that indicates the fetus is at low risk for asphyxia.
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C.Client reports eight fetal movements in 1 hr
This is an expected finding at 34 weeks of gestation. A count of less than three movements in 1
hr requires further evaluation and a nonstress test.
D.Client's cervical length is 30 mm
A cervical length of 30 mm is an expected finding. A length of less than 25 mm is an indication
of cervical insufficiency and should be reported to the provider.
-14
A nurse is providing teaching to a client who has epilepsy and is starting to take carbamazepine.
The nurse should instruct the client to monitor for which of the following manifestations as an
adverse effect of this medication?
A.Increased fundal height since admission
B.Biophysical profile score of 8
C.Client reports eight fetal movements in 1 hr
D.Client's cervical length is 30 mm
A.Weight loss
The nurse should instruct the client to monitor for the adverse effect of weight gain while taking
carbamazepine.
B.Urinary frequency
The nurse should instruct the client to monitor for the adverse effect of urinary hesitancy or
retention while taking carbamazepine.
C.Blurred vision (CORRECT)
The nurse should instruct the client to monitor for the adverse effect of blurred vision or double
vision while taking carbamazepine and report the occurrence of these findings to the provider.
D.Insomnia
The nurse should instruct the client to monitor for the adverse effect of drowsiness or sedation
while taking carbamazepine.
-15
A nurse is an acute care mental health unit is caring for a newly admitted client who has OCD.
The client is repeatedly washing her hands. Which of the following actions should the nurse
take?
A.Physically prevent the client from repeating compulsive acts.
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B.Teach the client to use thought-stopping techniques.
C.Allow the client to choose from a list of alternative activities.
D.Administer diphenhydramine IV to the client.
A.Physically prevent the client from repeating compulsive acts.
The nurse should not physically prevent the client from repeating compulsive acts, because this
could greatly increase anxiety. At the beginning of treatment, the nurse should allow the client
time for compulsive acts and should gradually limit that time as therapy continues by replacing
rituals with other behaviors.
B.Teach the client to use thought-stopping techniques. (CORRECT)
Thought stopping, where the client is taught to stop herself from performing compulsions, can
interrupt impulsive actions. Other activities that accomplish this include physical activity and
relaxation techniques.
C.Allow the client to choose from a list of alternative activities.
The nurse should provide the client with a structured schedule of activities to prevent increasing
anxiety.
D.Administer diphenhydramine IV to the client.
Diphenhydramine is an anticholinergic medication given for allergy symptoms and itching.
Medications used for a client who has obsessive-compulsive disorder include anxiolytics and
SSRI antidepressants
-16
A nurse is assessing a client who has acute pyelonephritis. The nurse should identify which of the
following findings as an indication of inflammation?
A.Increased BUN
B.Redness on the right flank
C.Decreased C-reactive protein
D.Urinary retention
A.Increased BUN
An increased BUN can indicate dehydration and renal failure, but it is not an indication of
inflammation.
B.Redness on the right flank (CORRECT)
The nurse should assess the client's flanks and gently palpate the costovertebral angle. Findings
including redness, enlargement, asymmetry, or edema can indicate inflammation.
C.Decreased C-reactive protein
An increase in the C-reactive protein would indicate inflammation. The nurse should also
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monitor the client's erythrocyte sedimentation rate to note the presence of inflammation.
D.Urinary retention
Urinary retention is a manifestation of an enlarged prostate or an obstruction in the urinary tract.
Urinary frequency, urgency, or burning with urination are manifestations of acute pyelonephritis
-17
A nurse is assessing a 12 month old infant who has down syndrome. Which of the following
manifestations should the nurse expect?
A.Long, thin neck
B.Decreased muscle tone
C.Large ears with thick cartilage
D.Early tooth eruptions
A.Long, thin neck
The nurse should expect an infant who has Down syndrome to exhibit a short, broad neck.
B.Decreased muscle tone (CORRECT)
Decreased muscle tone is an expected assessment finding in a 12-month-old infant who has
Down syndrome. The nurse should expect the infant to exhibit hypotonia as well as
hyperflexibility.
C.Large ears with thick cartilage
The nurse should expect an infant who has Down syndrome to exhibit small ears and a short
pinna.
D.Early tooth eruptions
The nurse should expect an infant who has Down syndrome to experience delayed eruption of
teeth.
-18
A nurse is caring for a newly admitted client who is at 37 weeks of gestation and is experiencing
moderate placental abruption. Which of the following actions should the nurse take?
A.Place a strainer device on the client's bedside toilet to monitor for clots.
B.Assess the fetal condition once hourly.
C.Insert a large-bore IV catheter.
D.Perform vaginal exams for the client to determine the presence of bleeding.
A.Place a strainer device on the client's bedside toilet to monitor for clots.
The nurse should insert an indwelling urinary catheter for the client who is experiencing
moderate placental abruption because continual urinary output assessment is a secondary method
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of measuring maternal organ perfusion.
B.Assess the fetal condition once hourly.
The nurse should closely and constantly monitor the mother and fetus because this is a lifethreatening condition. Therefore, continuous electronic fetal monitoring is mandatory and the
nurse should document and report any change in the fetal or maternal condition to the provider
immediately.
C.Insert a large-bore IV catheter. (CORRECT)
The nurse should insert a 16- to 18-gauge IV catheter into the client's brachial artery because
fluid volume and blood replacement might be necessary to correct defects in coagulation.
D.Perform vaginal exams for the client to determine the presence of bleeding.
The nurse should not perform any vaginal examinations and the client should be placed on pelvic
rest. The amount of bleeding is assessed by checking perineal pads and bed pads. Also, the nurse
should assess the client's laboratory values for decreased hemoglobin and hematocrit levels.
-19
A nurse is caring for a client who has schizophrenia. Which of the following statements made by
the client indicates delusions of reference?
A."Someone is trying to get a message to me through this newspaper."
B."I am possessed by the evil one and will destroy the world."
C."I know these nurses are watching my every move."
D."The dentist put a radio transmitter in my tooth to control me."
A."Someone is trying to get a message to me through this newspaper." (CORRECT)
The nurse should recognize that delusions of reference occur when events are interpreted as
directed at the client. The client's belief that someone would send messages through the
newspaper is an example of this.
B."I am possessed by the evil one and will destroy the world."
The client's belief of exaggerated power or identity demonstrates the client is experiencing
delusions of grandeur. Delusions of grandeur occur when the client has a heightened sense of
importance and ability.
C."I know these nurses are watching my every move."
The client's belief that the nurses are watching every move he makes demonstrates paranoia.
Paranoia occurs when the client becomes suspicious of the actions and intentions of others.
D."The dentist put a radio transmitter in my tooth to control me."
The client's belief that the dentist is using a radio transmitter demonstrates the client is
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experiencing delusions of control. Delusions of control occur when the client believes an
external force has the ability to control his thoughts or actions
-20
A nurse is assessing a client who has inflammatory bowel disease and is 1 day postoperative
following a permanent ileostomy placement. Which of the following findings should the nurse
report to the provider?
A.The ostomy output is loose and dark green.
B.The stoma is cherry red in color.
C.The ostomy output contains streaks of blood.
D.The stoma is retracted into the abdominal wall.
A.The ostomy output is loose and dark green.
The nurse should expect the ostomy output to be loose and dark green in the immediate
postoperative period. Therefore, the nurse does not need to report this finding to the provider.
B.The stoma is cherry red in color.
The nurse should expect the stoma to be pinkish to cherry red in color to ensure an adequate
blood supply in the immediate postoperative period. Therefore, the nurse does not need to report
this finding to the provider.
C.The ostomy output contains streaks of blood.
The nurse should expect the ostomy output to contain small amounts of blood. Therefore, the
nurse does not need to report this to the provider.
D.The stoma is retracted into the abdominal wall. (CORRECT)
The nurse should frequently assess the stoma. It should not be prolapsed or retracted into the
abdominal wall. The nurse should report these findings to the provider as well as a change in the
appearance of the stoma color to pale, bluish, or dark in color.
-21
A staff nurse tells the nurse manager that he consistently receives work assignments with a
heavier workload than the other nurses on the shift. Which of the following actions should the
nurse manager take to address the staff nurses report is bullying? Who is the person song
bowling.
A.Check work assignments to validate the staff nurse's claim.
B.Complete an employee performance evaluation on the staff nurse.
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C.Intervene if there is no change in the staff nurse's report after 2 weeks.
D.Determine what the staff nurse did to offend the nurse who makes the assignments.
A.Check work assignments to validate the staff nurse's claim. (CORRECT)
The nurse manager should recognize that a nurse consistently receiving heavier work
assignments than the other nurses is a form of bullying. The manager should verify work
assignments to validate the staff nurse's claim and then immediately address the problem.
B.Complete an employee performance evaluation on the staff nurse.
The nurse manager does not need to complete an employee performance evaluation on the staff
nurse at this time. The manager should acknowledge that bullying is about control and the staff
nurse is the victim in this situation.
C.Intervene if there is no change in the staff nurse's report after 2 weeks.
The nurse manager should assess the situation and intervene immediately. Bullying can have
negative physical and psychological effects on the victim and can ultimately compromise patient
safety.
D.Determine what the staff nurse did to offend the nurse who makes the assignments.
The nurse manager should recognize that the victim of bullying is in no way the source of the
problem. Under no circumstances should bullying be an acceptable behavior.
-22
A nurse is assessing a group of clients who have personality disorders. Which of the following
clients should the nurse identify as having characteristics of schizoid personality disorder?
A.A client who suspects that others are attacking his reputation
B.A client who is uncomfortable when she is not the center of attention
C.A client who demonstrates frequent self-mutilating
D.A client who dislikes having close relationships with other people
A.A client who suspects that others are attacking his reputation
A client who has paranoid personality disorder is suspicious and feels that others are attacking
his reputation.
B.A client who is uncomfortable when she is not the center of attention
A client who has histrionic personality disorder wants to be the center of attention and is
uncomfortable when this is not possible.
C.A client who demonstrates frequent self-mutilating behavior
A client who has borderline personality disorder demonstrates frequent self-mutilating behavior
and is at risk for suicidal behavior.
D.A client who dislikes having close relationships with other people (CORRECT)
A client who has schizoid personality disorder desires solitude and dislikes having close
relationships with others.
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-23
A nurse is providing teaching to a family member of a client who had delirium. Which of the
following information should the nurse include?
A.A client usually develops delirium slowly over several weeks.
B.A client who has delirium often has a flat affect.
C.Delirium is not a reversible condition.
D.Delirium can be brought on by the stress of an illness.
A.A client usually develops delirium slowly over several weeks.
The nurse should tell the family member that delirium develops quickly over the course of
several hours or days.
B.A client who has delirium often has a flat affect.
The nurse should tell the family member that a client who has delirium displays a wide range of
emotions.
C.Delirium is not a reversible condition.
The nurse should tell the family member that delirium can be reversed by treating the underlying
cause.
D.Delirium can be brought on by the stress of an illness. (CORRECT)
The nurse should tell the family member that delirium can be caused by the stress of an illness or
an underlying factor, such as infection or dehydration
-24
A nurse is caring for a client who is receiving chemotherapeutic for non Hodgkin lymphoma.
Which of the following actions should the nurse take?
A.Obtain the client's temperature once per day.
B.Advise the client not to bathe on days of chemotherapy treatment.
C.Instruct the client to wash drinking glasses after each use.
D.Ensure the client washes his hands with a mild soap before meals.
A.Obtain the client's temperature once per day.
The nurse should obtain the client's temperature at least twice per day to detect if the client is
febrile, which might indicate infection.
B.Advise the client not to bathe on days of chemotherapy treatment.
Bacteria can be harmful to a client who is immunocompromised. Therefore, the nurse should
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instruct the client to bathe daily to remove the bacteria that accumulates on the skin during
treatment.
C.Instruct the client to wash drinking glasses after each use. (CORRECT)
The nurse should instruct the client to wash drinking glasses after each use to remove bacteria,
which can be harmful to a client who is immunocompromised.
D.Ensure the client washes his hands with a mild soap before meals.
Bacteria can be harmful to a client who is immunocompromised. Therefore, the nurse should
ensure that the client washes his hands with an antimicrobial soap prior to eating.
-25
A nurse is assessing a client who has RA and has been taking methotrexate for 4 months. Which
statements by the client indicates to the nurse that the medication is effective?
A."I have been able to go outside for walks lately."
B."My temperature has been normal for the past month."
C."I have gained 5 pounds over the past 4 months."
D."My headaches are less frequent now."
A."I have been able to go outside for walks lately." (CORRECT)
The client's report of going out for walks is an indication that the medication is effective.
Methotrexate is a disease-modifying antirheumatic drug, which is given to clients who have
rheumatoid arthritis to slow the progression of the disease. The desired effects of this medication
include a decrease in joint pain and swelling and improved mobility for clients.
B."My temperature has been normal for the past month."
Low-grade fever can be a manifestation of RA. The client's report of having a normal
temperature for the last month indicates that the client's overall comfort is improving. However,
methotrexate does not act to decrease body temperature, so a lack of fever does not indicate the
medication is effective. The desired effects of this medication include a decrease in joint pain and
swelling as well as improved mobility for clients.
C."I have gained 5 pounds over the past 4 months."
Anorexia and weight loss can be manifestations of RA. The client's report of weight gain
indicates that the client's overall health status is improving. However, methotrexate does not act
to improve the client's anorexia, so a weight gain does not indicate the medication is effective.
The desired effects of this medication include a decrease in joint pain and swelling as well as
improved mobility for clients.
D."My headaches are less frequent now."
Headaches can be a manifestation of RA due to vasculitis. The client's report of fewer headaches
indicates that the client's overall comfort is improving. However, methotrexate does not act to
decrease the frequency of headaches, so a decrease in headache frequency does not indicate that
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the medication is effective. The desired effects of this medication include a decrease in joint pain
and swelling as well as improved mobility for clients.
-26
A nurse is providing discharge teaching about home management strategies to a client who has
MS. Which of the following client statements indicates an understanding of the teaching?
A."I will soak in a hot tub to ease muscle tremors and spasticity."
B."I will limit social activities due to the personality changes I might have."
C."I should schedule rest breaks between activities."
D."I will limit my fluid intake to 1 liter of fluid each day."
A."I will soak in a hot tub to ease muscle tremors and spasticity."
Increased body temperature can cause an exacerbation of MS manifestations, such as increased
weakness and fatigue. This is referred to as the Uhthoff phenomenon. Therefore, the nurse
should instruct the client to avoid the use of hot tubs and performing vigorous exercise.
B."I will limit social activities due to the personality changes I might have."
Personality changes can occur in a client who has MS. It is important for the client to engage in
social activities when they feel well enough physically to do so. The nurse should also teach the
client's partner, family members, or friends strategies to enable the client to participate in social
activities.
C."I should schedule rest breaks between activities." (CORRECT)
The nurse should instruct the client to schedule rest breaks between activities and use strategies
to help conserve energy. A client who has MS can experience muscle weakness and fatigue. The
nurse should encourage the client to use assistive devices as needed and to modify their
environment to reduce fatigue during ADLs.
D."I will limit my fluid intake to 1 liter of fluid each day."
The client who has MS often experiences constipation. The nurse should encourage the client to
drink 1.5 to 2 L of fluids daily and increase dietary fiber intake to 25 to 35 g daily to prevent
constipation.
-27
A nurse is assessing a client who has acute glomerulonephritis. Which of the following findings
should the nurse expect?
A.Weight loss
B.Rust-colored urine
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C.Tachypnea
D.Nocturia
A.Weight loss
The nurse should expect the client who has glomerulonephritis to have weight gain. This disease
process is a result of damage to the glomeruli. The client will retain sodium and fluid, resulting
in increased weight, fluid overload, and circulatory congestion.
B.Rust-colored urine (CORRECT)
The nurse should expect the client who has glomerulonephritis to have color changes in the
urine, such as reddish brown, rust-colored, or cola-colored. This disease process is a result of
damage to the glomeruli, and the client will develop hematuria as a result of the microscopic
blood in the urine. The red blood cells in the urine will cause the color of the urine to change.
C.Tachypnea
The nurse should expect the client who has acute pyelonephritis to have tachypnea. Acute
pyelonephritis is a bacterial infection in the renal pelvis and kidneys.
D.Nocturia
The nurse should expect the client who has acute pyelonephritis to experience nocturia. Acute
pyelonephritis is a bacterial infection in the renal pelvis and kidneys.
-28
A nurse in an emergency department is creating a plan of care for a client who reports a recent
sexual assault. Which of the following interventions should the nurse plan to include?
A.Rotate staff members collecting assessment data.
B.Explain to the client the reason each procedure is conducted.
C.Discourage the client from giving an immediate account of the assault.
D.Avoid discussing criminal charges during the initial assessment.
A.Rotate staff members collecting assessment data.
A client who reports a recent sexual assault is extremely vulnerable in the immediate postcrisis
period. Therefore, additional staff members increase the client's anxiety and feelings of
vulnerability.
B.Explain to the client the reason each procedure is conducted. (CORRECT)
The nurse should explain the reason each assessment procedure is conducted and why because a
client who reports a recent sexual assault is extremely vulnerable in the immediate postcrisis
period. Explaining the purpose for each procedure will decrease the client's anxiety and fear and
increase feelings of trust.
C.Discourage the client from giving an immediate account of the assault.
The nurse should encourage the client to provide an immediate account of the details of the
assault. Nonjudgmental listening provides the client with an avenue to vent, which begins the
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healing process. Also, a detailed account is required for evidence collection.
D.Avoid discussing criminal charges during the initial assessment.
During the initial assessment, the nurse should encourage the client to discuss the assault,
determine if the client wishes to press criminal charges, and determine if the client has a safe
place to go. Client safety is the nurse's priority.
-29
A nurse is caring for a client who has diverticulitis. Which of the following medications should
the nurse expect to administer?
A.Metronidazole
B.Balsalazide
C.Mesalamine
D.Sulfasalazine
A.Metronidazole (CORRECT)
The nurse should expect to administer metronidazole to a client who has diverticulitis. This is a
broad-spectrum antimicrobial drug and is administered in combination with other antibiotics,
such as trimethoprim/sulfamethoxazole or ciprofloxacin.
B.Balsalazide
The nurse should expect to administer balsalazide for the treatment of a client who has Crohn's
disease or ulcerative colitis.
C.Mesalamine
The nurse should expect to administer mesalamine for treatment of a client who has Crohn's
disease or ulcerative colitis.
D.Sulfasalazine
The nurse should expect to administer sulfasalazine for the treatment of a client who has Crohn's
disease or ulcerative colitis.
-30
A nurse is teaching a client about family planning and the proper use of an intrauterine device.
Which of the following client responses indicates an understanding of the teaching?
A."I will need to get this device replaced in 2 years."
B."I might not be able to get pregnant for 6 months after the device is removed."
C."I might experience pain during intercourse for up to 1 year."
D."I will need to check that the two strings of this device are the same length once per month."
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A."I will need to get this device replaced in 2 years."
The nurse should instruct the client that the length of protection from pregnancy varies with each
device. Available devices offer protection from 3 to 10 years.
B."I might not be able to get pregnant for 6 months after the device is removed."
The nurse should instruct the client that fertility returns as soon as the device is removed.
C."I might experience pain during intercourse for up to 1 year."
The nurse should instruct the client that pain with intercourse is an indication of a potential
complication and the provider should be notified.
D."I will need to check that the two strings of this device are the same length once per month."
(CORRECT)
The nurse should instruct the client to check for the two strings preferably after menses each
month to ensure the device is in place.
-31
A nurse is reviewing the laboratory report of an adolescent client who had hemophilia A. Which
of the following laboratory results should the nurse expect?
A.aPTT 110 seconds
B.Coagulating factor VIII 50%
C.Coagulating factor IX 75%
D.PT 14 seconds
A.aPTT 110 seconds
An aPTT of 110 seconds is within the expected reference range. The nurse should expect to find
a prolonged aPTT value for an adolescent who has hemophilia A.
B.Coagulating factor VIII 50% (CORRECT)
The nurse should expect to find a coagulating factor VIII value of 50%, which is below the
expected reference range, when reviewing the laboratory results of an adolescent who has
hemophilia A. This type of hemophilia reflects a deficiency of factor VIII, a protein in the body
that helps the blood to clot.
C.Coagulating factor IX 75%
A coagulating factor IX value of 75% is within the expected reference range. The nurse should
expect to find a deficiency of coagulating factor IX in an adolescent who has hemophilia B.
D.PT 14 seconds
A PT value of 14 seconds is within the expected reference range for an adolescent client who has
a vitamin K deficiency. The nurse should expect to find a PT within the expected reference range
for an adolescent who has hemophilia A.
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-32
A nurse in an infertility clinic is providing teaching to a client about her upcoming hyper
salpingography. Which is the following statements should the nurse take?
A."You might feel pain in your shoulder after the procedure."
B."You will schedule the exam 3 to 5 days before your period is due."
C."The procedure is performed under general anesthesia."
D."The procedure checks for fibroids that hinder implantation."
A."You might feel pain in your shoulder after the procedure." (CORRECT)
The nurse should inform the client that she might experience referred shoulder pain during or
after the procedure. This pain indicates irritation from the contrast when it is spilled out of the
uterine tubes that are patent. The nurse should instruct the client to manage this pain with mild
analgesics and position changes
B."You will schedule the exam 3 to 5 days before your period is due."
The hysterosalpingography is scheduled 2 to 5 days after the client's menstrual period, rather
than before it is due.
C."The procedure is performed under general anesthesia."
Hysterosalpingography is an x-ray examination. Therefore, it does not require general anesthesia.
D."The procedure checks for fibroids that hinder implantation."
Hysteroscopy uses a scope through the cervix to visualize the client's uterine cavity. This method
is used for evaluating fibroids that could impair implantation. This procedure is a last resort
because it is the most expensive and invasive test to determine the degree of infertility.
-33
A nurse is caring for a client who has a major depressive disorder. Which of the following client
responses should the nurse identify as an overt statements indicating the potential for suicide?
A."I want to give my favorite quilt to my daughter."
B."I'm not happy and probably never will be."
C."I just can't go on living like this any longer."
D."Things just never seem to go my way anymore."
A."I want to give my favorite quilt to my daughter."
The nurse should recognize this as an indirect or covert statement indicating that the client feels
she no longer needs her favorite or meaningful belongings and might be considering suicide.
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B."I'm not happy and probably never will be."
The nurse should recognize this as an indirect or covert statement indicating that the client is
feeling hopeless and might be considering suicide.
C."I just can't go on living like this any longer."
The nurse should recognize this as a direct or overt statement indicating that the client wishes to
end her life.
D."Things just never seem to go my way anymore."
The nurse should recognize this as an indirect or covert statement indicating that the client is
feeling hopeless and might be considering suicide.
-34
A nurse in a provider's office is caring for a client who is 9 weeks of gestation and is having her
first prenatal exam. The client asks the nurse why she is being tested for sexually transmitted
infections. Which of the following responses should the nurse make?
A."The provider will answer your questions for you when she completes your examination."
B."Why wouldn't you want to be tested for these types of infections? It could save your baby's
life."
C."Aren't you worried that you might have contracted an infection from one of your previous
sexual partners?"
D."Most sexually transmitted infections are hard for you to detect. We screen all clients at their
initial appointment."
A."The provider will answer your questions for you when she completes your examination."
This response by the nurse is the nontherapeutic technique of rejection. This can cause the client
to feel the nurse is not interested in her questions, which indicates rejection.
B."Why wouldn't you want to be tested for these types of infections? It could save your baby's
life."
This response by the nurse is the nontherapeutic technique of asking a "why" question. This can
cause the client to become defensive, which decreases further attempts at communication.
C."Aren't you worried that you might have contracted an infection from one of your previous
sexual partners?"
This response by the nurse is nontherapeutic because it makes an assumption about the client's
sexual history and her feelings about it. This can cause the client to become defensive, which
decreases further attempts at communication.
D."Most sexually transmitted infections are hard for you to detect. We screen all clients at their
initial appointment." (CORRECT)
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This response by the nurse is therapeutic. It offers recognition and acceptance to the client, which
decreases the client's anxiety level and creates an atmosphere of trust between the client and the
nurse.
-35
A nurse is caring for a client who has a terminal illness and is approaching death. Which of the
following actions should the nurse take?
A.Position the client in a supine position.
B.Encourage the client to stay awake during daylight hours.
C.Keep the client's curtains open to provide light in the room.
D.Apply a thin coating of lip balm to the client's lips.
A.Position the client in a supine position.
Clients who are dying often manifest ineffective breathing patterns. The nurse should position
the client with the head of the bed elevated to ease the breathing process. If the client is
experiencing congestion or nausea, the nurse should position the client on his side.
B.Encourage the client to stay awake during daylight hours.
A client who is dying has a decreased metabolism, which results in increased sleeping. The nurse
should allow the client to rest and not force the client to stay awake.
C.Keep the client's curtains open to provide light in the room.
A client who is dying is often restless due to slowed circulation to the brain. The nurse should
keep the room dimly lit, reduce the number of people in the room, and keep the noise level to a
minimum.
D.Apply a thin coating of lip balm to the client's lips. (CORRECT)
A client who is dying can experience dehydration, causing the lips to become dry or chapped.
The nurse should apply a thin coat of lip balm to the client's lips to promote comfort.
-36
A nurse is providing teaching about combined oral contraceptives to a client who is 6 weeks
postpartum. Which of the following instructions should the nurse include?
A."Oral contraceptives increase your risk of developing ovarian cysts."
B."Some herbal supplements can alter the effectiveness of your oral contraceptives."
C."Remain abstinent for 1 week if you miss a dose of your oral contraceptive."
D."A pelvic exam is required before you start your oral contraceptives."
A."Oral contraceptives increase your risk of developing ovarian cysts."
Oral contraceptive use decreases the risk of developing ovarian cysts.
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B."Some herbal supplements can alter the effectiveness of your oral contraceptives."
(CORRECT)
The nurse should inquire about herbal supplement use prior to the client being considered for
combined oral contraceptive use. Some of these supplements can decrease the effectiveness of
contraceptives.
C."Remain abstinent for 1 week if you miss a dose of your oral contraceptive."
Abstinence or another form of contraception is required if more than one pill is missed.
D."A pelvic exam is required before you start your oral contraceptives."
A pelvic exam or a Papanicolaou (Pap) test are not requirements before starting oral
contraceptives
-37
A nurse is caring for a client following a stroke. Which of the following actions should the nurse
take?
A.Report the client's BP to the provider.
B.Recommend a referral to the speech language pathologist (SLP).
C.Request an additional dose of digoxin from the client's provider.
D.Initiate oxygen at 2 L/min via nasal cannula for the client.
A.Report the client's BP to the provider.
The nurse should immediately report a systolic blood pressure greater than 180 mm Hg to the
provider. The provider might prescribe IV antihypertensive medication at this time.
B.Recommend a referral to the speech language pathologist (SLP). (CORRECT)
A client who is having difficulty swallowing following a stroke requires a referral to an SLP.
Aspiration can be a complication for a client who is experiencing dysphagia. The SLP can
establish care guidelines including thickened liquids and head positioning to prevent aspiration.
C.Request an additional dose of digoxin from the client's provider.
Digoxin is an antidysrhythmic medication given for the client's irregular heart rate. Due to the
narrow therapeutic range and the cardiovascular adverse effects of the medication, the nurse
should not request an additional dose from the provider unless the client's heart rate is over
100/min.
D.Initiate oxygen at 2 L/min via nasal cannula for the client.
Following a stroke, the nurse should initiate oxygen therapy to prevent hypoxia for a client who
has an oxygen saturation less than 93%
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38
A nurse is caring for a client who was recently diagnosed with a terminal illness and is
experiencing an intrapersonal crisis. Which of the following silent statements indicates the use of
rationalization?
A."I can beat this illness if I take my prescribed medication."
B."I'll have hospice set up at home to decrease the burden on my family."
C."I'll wait until after my nephew's wedding to think about my diagnosis."
D."I think this disease happened to me to test my belief system."
A."I can beat this illness if I take my prescribed medication."
This statement is an example of denial, in which the client refuses to acknowledge the truth of a
situation.
B."I'll have hospice set up at home to decrease the burden on my family."
This statement is an example of intellectualization, in which a client uses intellectual processes
to prevent needing to talk about emotions.
C."I'll wait until after my nephew's wedding to think about my diagnosis."
This statement is an example of suppression, in which the client voluntarily blocks thoughts
about reality to decrease stress.
D."I think this disease happened to me to test my belief system." (CORRECT)
This statement is an example of rationalization, in which a client attempts to justify the presence
of her illness by giving an illogical explanation.
-39
A nurse is caring for a client who is pregnant and states that the first day of her last menstrual
period was September 2nd. Using nagales rule which of the following is the clients estimated
date of delivery?
The nurse should use Nägele's rule to calculate the client's estimated date of delivery. The nurse
should first determine the client's first day of the last menstrual period (LMP), subtract 3
calendar months, and add 7 days. The client's last LMP was September 2nd. Therefore,
subtracting 3 calendar months equals June for the month, and adding 7 days equals the 9th for
the day.
-40
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A nurse is teaching a client who has tobacco use disorder about the use of nicotine patches as an
aid in smoking cessation. Which of the following statements indicates the client understands the
teaching?
A."I should leave each nicotine patch on for 12 hours before replacing."
B."I should expect to have heartburn while using a nicotine patch."
C."I should adjust the dosage of the nicotine patch if I crave a cigarette."
D."I should gradually decrease the dose of the nicotine patch over several weeks."
A."I should leave each nicotine patch on for 12 hours before replacing."
The nurse should inform the client that each nicotine patch should be left in place for 16 to 24 hr,
depending on the brand that is used. After the prescribed amount of time has elapsed, the client
should remove the patch. The client should avoid applying a patch to the same site for at least 1
week.
B."I should expect to have heartburn while using a nicotine patch."
The nurse should inform the client that dyspepsia is a common adverse effect of nicotine gum or
lozenges. Common adverse effects of a nicotine patch include localized itching, redness, and
burning.
C."I should adjust the dosage of the nicotine patch if I crave a cigarette."
The nurse should inform the client that the dosage of a nicotine patch is not adjustable, as it
releases the nicotine at a slow and steady rate. If the client experiences intolerable cravings for
cigarettes while using the nicotine patch, the client should discuss other possible treatment
options with the provider.
D."I should gradually decrease the dose of the nicotine patch over several weeks." (CORRECT)
The nurse should identify that this statement indicates understanding of use of a nicotine patch
system. The prescribed dosage of the nicotine patch is gradually decreased over a period of 8 to
10 weeks depending on the brand that is used. This gradual decrease enables the client to
physically adjust to lower blood levels of nicotine. When a nicotine patch system is used
correctly, it doubles the client's chance to successfully quit smoking.
-41
A nurse is providing teaching to a client who has numerous severe food allergies on how to use
an epi pen. Which of the following instructions should the nurse include?
The nurse should instruct the client to first remove the activation cap from the epinephrine
injector. The client should then forcefully insert the injector into the outer aspect of the thigh and
hold the epinephrine injector in place for 10 seconds. Following the removal of the injector, the
client should massage the injection site for 10 seconds. Finally, the client should ensure that the
needle is projecting through the tip of the device. This indicates the medication was injected.
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Following examination of the pen, the client should seek immediate medical attention, because
the therapeutic effects of the epinephrine injector begin to subside within 10 to 20 min.
-42
A nurse is teaching a client about obesity management. Which of the following information
should the nurse include?
A."You should follow a clear liquid diet 2 weeks each month."
B."You should walk 5 days a week for 30 minutes."
C."You should avoid drinking water during your meal."
D."You should reward yourself with dessert for losing 10 pounds."
A."You should follow a clear liquid diet 2 weeks each month."
The nurse should teach the client to eat a nutritionally balanced diet of 1,200 calories per day.
Liquid diet programs are usually not successful and there is an increased risk of medical
conditions, such as ketosis, which require close medical supervision.
B."You should walk 5 days a week for 30 minutes."
To increase energy and prevent discouragement with exercise, the nurse should encourage the
client to engage in a low-intensity, short-duration program such as walking 30 to 40 min at least
5 days each week.
C."You should avoid drinking water during your meal."
The nurse should encourage the client to drink water while eating meals. This will increase
feelings of satiety and decrease the amount of food the client eats.
D."You should reward yourself with dessert for losing 10 pounds."
The nurse should encourage the client to reward meeting weight loss goals with nonfood
rewards, such as a new article of clothing or going to a movie.
-43
A nurse in a mental health facility is assessing a client who has schizophrenia. Which of the
following findings should the nurse identify as a cognitive symptom of schizophrenia?
A.Periods of mood instability
B.Difficulty in decision making
C.Demonstration of social withdrawal
D.Use of concrete thinking
A.Periods of mood instability
The nurse should identify periods of mood instability as an affective symptom of schizophrenia.
Affective symptoms involve the client's expression of emotions.
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B.Difficulty in decision making (CORRECT)
The nurse should identify difficulty in decision making as a cognitive symptom of schizophrenia.
Cognitive symptoms involve the client's executive functioning.
C.Demonstration of social withdrawal
The nurse should identify demonstration of social withdrawal as a negative symptom of
schizophrenia. Negative symptoms involve the absence of expected abilities or behaviors.
D.Use of concrete thinking
The nurse should identify the use of concrete thinking as a positive symptom of schizophrenia.
Positive symptoms involve the presence of behaviors that are not expected.
-44
A nurse in an acute care mental health facility is planning care for a client who has major
depressive disorder and who verbalized feelings of hopelessness. Which of the following actions
is the nurse's priority?
A.Supervise the client closely during medication administration
B.Urge the client to participate in physical activities on the unit.
C.Provide positive feedback when the client makes independent decisions.
D.Assist client in identifying areas of his life that he can control.
A.Supervise the client closely during medication administration. (CORRECT)
The greatest risk to this client is self-injury because of feelings of hopelessness. Therefore, the
nurse's priority is to supervise the client closely during medication administration to prevent the
client from saving medication to attempt suicide. The nurse should also remove potentially
dangerous material, such as belts or glass, from the client's environment and should supervise the
client during meals.
B.Urge the client to participate in physical activities on the unit.
The nurse should plan to urge the client to participate in physical activities, which can be an
outlet for feelings of anger. However, another action should be the nurse's priority.
C.Provide positive feedback when the client makes independent decisions.
The nurse should plan to provide positive feedback for any independent decisions made by the
client, because the client who has major depressive disorder is indecisive and passive. However,
another action should be the nurse's priority.
D.Assist client in identifying areas of his life that he can control.
The nurse should plan to assist the client in identifying areas of his life he can control, since a
lack of control can foster feelings of hopelessness and worthlessness. However, another action
should be the nurse's priority.
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-45
A nurse is caring for a client who is active labor and has a history of STIs. Upon examination.
The nurse noted a large, cauliflower like cluster of lesions near the vagina. Which of the
following actions should the nurse take?
A.Prepare the client for a cesarean section to prevent newborn contact with the lesions.
B.Initiate contact precautions for the client.
C.Monitor the client for progressive fetal descent.
D.Administer penicillin G to the client intravenously to decrease the size of the lesions.
A.Prepare the client for a cesarean section to prevent newborn contact with the lesions.
Cesarean birth is not recommended to prevent the newborn from contracting human
papillomavirus (HPV). The likelihood of this outcome is not known, and a cesarean birth is more
dangerous for the client as well as the newborn.
B.Initiate contact precautions for the client.
HPV does not require contact precautions or isolation. The provider will discuss options for
removal of the warts and lesions with the client.
C.Monitor the client for progressive fetal descent. (CORRECT)
The nurse should monitor the client closely who has HPV lesions for fetal descent. These lesions
can become large enough to obstruct the birth canal and impair fetal descent.
D.Administer penicillin G to the client intravenously to decrease the size of the lesions.
Penicillin G is not indicated to decrease the size of the client's HPV lesions. Cryotherapy is
recommended to remove warts and lesions, and there are several ointments and creams the
provider can prescribe to place on the areas to increase the client's comfort level.
-46
A nurse is assessing a newly admitted client who has borderline personality disorder. Which of
the following manifestations should the nurse expect?
A.The client needs others to be responsible for decisions about his life.
B.The client has a sense of self-importance and requires admiration.
C.The client exhibits a pattern of unstable interpersonal relationships.
A client who has obsessive-compulsive personality disorder is preoccupied with rules and being
organized.
A.The client needs others to be responsible for decisions about his life.
A client who has dependent personality disorder needs others to be responsible for his life and
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decisions. The client who has BPD uses splitting to alternatively admire others and reject them.
B.The client has a sense of self-importance and requires admiration.
A client who has narcissistic personality disorder has an inflated sense of self-importance and
requires admiration. A client who has BPD is frequently depressed and has a disturbed selfimage.
C.The client exhibits a pattern of unstable interpersonal relationships.
A client who has BPD has great difficulty being alone and requires companionship, even though
his friendships are unstable and the client often displays anger and anxiety around others.
D.The client is preoccupied with following rules and being organized.
A client who has obsessive-compulsive personality disorder is preoccupied with rules and being
organized. A client who has BPD is impulsive and acts without thinking of consequences.
-47
A nurse is teaching a client who has gestational hypertension about the condition. Which of the
following statements made by the client indicates an understanding of the teaching?
A."I will need to remain on strict bed rest until after my baby is delivered."
B."I will receive a medication in my IV during labor to prevent seizures."
C."I know my blood pressure should return to normal a few weeks after delivery."
D."I need to take a vitamin C supplement so I don't get preeclampsia."
A."I will need to remain on strict bed rest until after my baby is delivered."
Clients who have gestational hypertension are not required to be on bedrest.
B."I will receive a medication in my IV during labor to prevent seizures."
Clients who have gestational hypertension do not require magnesium sulfate during labor for the
prevention of seizures.
C."I know my blood pressure should return to normal a few weeks after delivery." (CORRECT)
Clients who have gestational hypertension typically experience blood pressures within the
expected reference range the week following birth.
D."I need to take a vitamin C supplement so I don't get preeclampsia."
Clients who have gestational hypertension are not at a greater risk for developing preeclampsia,
and therefore do not require the use of supplements.
-48
A nurse in a provider's office is assessing a 2 month old infant. Which of the following findings
indicates the infant has a congenital heart defect?
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A.Bounding femoral pulses
B.Parent reports frequent nosebleeds
C.Parent reports respiratory distress while eating
D.Sunken anterior fontanel
A.Bounding femoral pulses
An infant who has a congenital heart defect will experience weak pulses.
B.Parent reports frequent nosebleeds
Epistaxis is a manifestation of hemophilia.
C.Parent reports respiratory distress while eating (CORRECT)
Manifestations of a congenital heart defect include feeding difficulties and tachypnea.
D.Sunken anterior fontanel
A sunken anterior fontanel is a manifestation of acute dehydration.
-49
A nurse is caring for a client who has HELLP syndrome. The nurse should monitor the client for
which of the following manifestations?
A.Hypernatremia
B.Hyperglycemia
C.Deep-vein thrombosis
D.Stroke
A.Hypernatremia
Hyponatremia is a complication of HELLP syndrome.
B.Hyperglycemia
Hypoglycemia is a complication of HELLP syndrome.
C.Deep-vein thrombosis
Deep-vein thrombosis is not a complication of HELLP syndrome. Clients who have HELLP
syndrome have low platelet counts and are at an increased risk for bleeding.
D.Stroke (CORRECT)
Stroke is a manifestation of HELLP syndrome because of the low platelet counts and an
increased risk for bleeding.
-50
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A nurse in a pediatric unit is assessing a preschooler who has autism disorder. Which of the
following findings should the nurse expect?
A.Spends long periods of time staring at spinning objects
B.Becomes easily upset when the parent leaves the room
C.Primarily plays with imaginary friends
D.Enjoys being held and cuddled by strangers
A.Spends long periods of time staring at spinning objects (CORRECT)
The nurse should expect a preschooler who has ASD to display unusual stereotypes and
repetitive behavior patterns such as spending extended time periods staring at spinning objects,
rocking, flapping hands, and head nodding.
B.Becomes easily upset when the parent leaves the room
Children who have ASD become upset and exhibit behavioral outbursts when they are the sole
focus of the parents' attention. The parent should bring some of the child's favorite possessions
from home in order to decrease the anxiety of hospitalization.
C.Primarily plays with imaginary friends
Children who have ASD do not typically have imaginary friends. They are more focused on
solitary activities and excel in areas such as mathematics, art, music, and puzzle-building.
D.Enjoys being held and cuddled by strangers
Children who have ASD require decreased stimulation, and physical contact often upsets them.
They might exhibit behavioral outbursts if they experience too much eye contact or physical
contact.
-51
A nurse in a provider’s office is preparing immunizations for a 12 month old infant who is
immunocompromised. Which of the following immunizations should the nurse plan to
administer at this time?
A.Varicella (VAR)
B.Measles-Mumps-Rubella (MMR)
C.Hepatitis B (HepB)
D.Human Papillomavirus (HPV4)
A.Varicella (VAR)
The VAR vaccine contains a live virus and should not be administered to clients who are
immunocompromised.
B.Measles-Mumps-Rubella (MMR)
The MMR vaccine contains a live virus and should not be administered to clients who are
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immunocompromised.
C.Hepatitis B (HepB) (CORRECT)
The nurse should plan to administer the HepB vaccine to a 12-month-old infant who is
immunocompromised because this vaccine does not contain a live virus.
D.Human Papillomavirus (HPV4)
The HPV4 vaccine should not be administered to children who are less than 9 years of age.
-52
A nurse is assessing a client who is at 28 weeks of gestation and is receiving magnesium sulfate
for preterm labor. Which of the following findings is the priority for the nurse to report to the
provider?
A.Increased muscle weakness
B.Decreased blood pressure
C.New onset of diarrhea
D.Decreased respiratory rate
A.Increased muscle weakness
Muscle weakness is an expected adverse effect of magnesium sulfate. The nurse should report
increased muscle weakness to the provider. However, another finding is the priority.
B.Decreased blood pressure
The nurse should report hypotension to the provider. However, another finding is the priority.
C.New onset of diarrhea
The nurse should report new onset of diarrhea to the provider. However, another finding is the
priority.
D.Decreased respiratory rate (CORRECT)
When using the airway, breathing, circulation approach to client care, the nurse should determine
that the priority finding to report to the provider is a deceased respiratory rate.
-53
An intensive care nurse is providing education about organ and tissue donation to the parent of
an adolescent who has died following a mVC. Which of the following responses by the parent
indicates an understatement of the teaching?
A."We will not be able to donate organs or tissue until an autopsy is performed."
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B."I am not sure we can afford to pay for the expenses associated with organ donation."
C."I will need to contact our family attorney to complete the
D."No one will notice the organs were donated if we have an open casket at the funeral."
A."We will not be able to donate organs or tissue until an autopsy is performed."
The nurse should inform the parent that performance of an autopsy does not preclude organ and
tissue donation. Some nonvital tissue, such as corneas, can be taken at the time of death, but vital
organs are required to remain on life support to provide blood and oxygen before transplantation.
B."I am not sure we can afford to pay for the expenses associated with organ donation."
The nurse should inform the parent that there are no costs incurred by the donor family.
C."I will need to contact our family attorney to complete the organ donation paperwork."
The nurse should inform the parent that organ donation does not require an attorney. A client can
express the desire to donate organs by making a provision in a will or signing a form. If the client
has not designated his wishes in advance, the family will be asked about consenting to organ and
tissue donation, and the nurse can serve as a witness.
D."No one will notice the organs were donated if we have an open casket at the funeral."
The nurse should reassure the parent that organ transplantation does not change the appearance
of the body. Therefore, if the family wishes to have an open casket at the funeral, there will be no
noticeable disfigurement to the adolescent.
-54
A nurse is teaching a client has genital herpes and a new prescription for acyclovir. Which of the
following information should the nurse include regarding the expected outcome of the
medication?
A."Acyclovir is given to cure genital herpes."
B."Acyclovir is given as a topical anesthetic to decrease the pain of genital herpes."
C."Acyclovir is given to prevent the transmission of genital herpes."
D."Acyclovir is given to promote healing of genital herpes."
A."Acyclovir is given to cure genital herpes."
Acyclovir is an antiviral medication administered to decrease the severity of genital herpes, as
well as the frequency of recurrent outbreaks. It reduces the healing time of the lesions; however,
it will not cure genital herpes.
B."Acyclovir is given as a topical anesthetic to decrease the pain of genital herpes."
Acyclovir is an antiviral medication administered to decrease the severity of genital herpes, as
well as the frequency of recurrent outbreaks. It is does not have anesthetic properties.
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C."Acyclovir is given to prevent the transmission of genital herpes."
Acyclovir is an antiviral medication administered to decrease the severity of genital herpes, as
well as the frequency of recurrent outbreaks. It can reduce viral shedding; however, it will not
prevent the transmission of genital herpes.
D."Acyclovir is given to promote healing of genital herpes."
Acyclovir is an antiviral medication administered to decrease the severity of genital herpes, as
well as the frequency of recurrent outbreaks. It also reduces the healing time of the lesions.
-55
A nurse is speaking with the family of a terminally ill client about organ donation. Which of the
following statements by one of the clients sons indicates an understanding of the organ donation
process?
A."After we donate his organs, our father must be cremated."
B."Only our father can make the decision about donating his own organs."
C."Our father will remain on life support until after the organs are removed."
D."We could face legal actions if the donated organ fails to work for the recipient."
A."After we donate his organs, our father must be cremated."
The nurse should inform the family that cremation is not required for clients who donate their
organs. These clients have autonomy and can choose any method of preparing the remains of
their loved one.
B."Only our father can make the decision about donating his own organs."
The nurse should inform the family that they can make the decision to donate their father's
organs in the event that he is unable to make the decision for himself.
C."Our father will remain on life support until after the organs are removed." (CORRECT)
The nurse should inform the family that even though the client is legally declared dead, he will
need to remain on life support to provide blood and oxygen to the vital organs so they will be
viable for procurement.
D."We could face legal actions if the donated organ fails to work for the recipient."
The nurse should inform the family that The National Organ Transplant Act protects the donor's
estate from liability for any damage or injury that occurs as a result of the use of the donated
organs.
-56
A nurse in an emergency department is speaking with the parent of a school aged child who has
conduct disorder. Which of the following parent characteristics places the child at risk for
malnutrition?
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A.The parent's manner indicates she has high self-esteem.
B.The parent is aware of expected child development characteristics.
C.The parent has a new diagnosis of diabetes mellitus.
D.The parent makes most decisions on impulse.
A.The parent's manner indicates she has high self-esteem.
A parent having low self-esteem puts the child at risk for maltreatment.
B.The parent is aware of expected child development characteristics.
A parent's lack of knowledge about expected child development puts the child at risk for
maltreatment.
C.The parent has a new diagnosis of diabetes mellitus.
A parent who has a diagnosis of a chronic condition does not place the child at risk for
maltreatment. However, children who have chronic illnesses are at an increased risk for child
maltreatment.
D.The parent makes most decisions on impulse. (CORRECT)
A parent who has poor impulse control puts the child at risk for child maltreatment.
-57
A nurse is reviewing the lab report of a client who is at 34 weeks of gestation and preeclampsia.
Which of the following results should the nurse recognize as an indication that the client could
be developing HELLP syndrome?
A.Alanine aminotransferase 41 units/L
B.Platelets 150,000/mm3
C.Hemoglobin 16 g/dL
D.Creatinine clearance 105 mL/min
A.Alanine aminotransferase 41 units/L (CORRECT)
The nurse should recognize this finding is above the expected reference range and indicates the
client could be developing HELLP syndrome. HELLP syndrome is characterized as severe
preeclampsia that involves liver dysfunction.
B.Platelets 150,000/mm3
This is an expected laboratory finding for a client who is pregnant.
C.Hemoglobin 16 g/dL
This is an expected laboratory finding for a client who is pregnant.
D.Creatinine clearance 105 mL/min
This is an expected laboratory finding for a client who is pregnant
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58
A nurse is assessing a client who has epilepsy. The nurse should identify that which of the
following client statements indicates the preictal phase of seizure?
A."I open my eyes and cannot remember what happened."
B."My entire body goes stiff."
C."I suddenly smell a foul odor."
D."Only one side of my body is affected."
A."I open my eyes and cannot remember what happened."
The nurse should identify this statement as referring to the postictal phase of a complex partial
seizure. In the timeframe following the seizure, the client has amnesia and cannot remember
what occurred.
B."My entire body goes stiff."
The nurse should identify this statement as referring to the tonic phase of a tonic-clonic seizure.
During this phase, the client has stiffening or rigidity of the muscles occurring in the arms and
legs. Following this, the client becomes unconscious.
C."I suddenly smell a foul odor." (CORRECT)
The nurse should identify this statement as referring to the preictal phase of a simple partial
seizure. The client often reports an aura or an unusual sensation, such as the perception of an
offensive smell or a déjà vu experience of having already seen what is happening.
D."Only one side of my body is affected."
The nurse should identify this statement as referring to the occurrence of a simple partial seizure.
During the seizure, the client might experience one-sided movement of an extremity, or
experience autonomic changes such as a change in heart rate or flushing of the skin.
-59
A nurse is assessing a client for alcohol use disorder. Which of the following assessment scales
should the nurse use?
A.Body Attitude Test
B.Brief Patient Health Questionnaire
C.Addiction Severity Index
D.Mini-Mental State Examination
A.Body Attitude Test
The nurse should use the Body Attitude Test to assess a client for an eating disorder.
B.Brief Patient Health Questionnaire
The nurse should use the Brief Patient Health Questionnaire to assess a client for anxiety.
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C.Addiction Severity Index (CORRECT)
The nurse should use the Addiction Severity Index to assess a client for a substance use disorder.
Other scales the nurse can use include the Brief Drug Abuse Screen Test and the Recovery
Attitude and Treatment Evaluator.
D.Mini-Mental State Examination
The nurse should use the Mini-Mental State Examination to assess a client's cognitive function.
-60
A nurse on an acute care unit is caring for a newly admitted client who has bipolar disorder.
Which of the following actions should the nurse take?
A.Place the client on a fluid restriction.
B.Prepare the client for hemodialysis.
C.Administer the next scheduled dose of lithium.
D.Escort the client to a group therapy session.
A.Place the client on a fluid restriction.
The nurse should encourage fluid intake for clients who take lithium. Adequate fluid intake
promotes fluid and electrolyte balance, which decreases the risk for lithium toxicity.
B.Prepare the client for hemodialysis. (CORRECT)
The client's recent vomiting and diarrhea caused sodium loss, which places the client at risk for
lithium toxicity. The nurse should identify that the client's current lithium level indicates severe
toxicity, which places the client at risk for death. Hemodialysis promotes removal of lithium and
is indicated as a treatment for lithium toxicity for lithium levels greater than 2.5 mEq/L.
C.Administer the next scheduled dose of lithium.
The nurse should identify that the client's lithium level indicates severe toxicity. Therefore, the
nurse should withhold the client's scheduled lithium and implement interventions to address the
toxicity.
D.Escort the client to a group therapy session.
The nurse should promote the client's attendance in group therapy sessions after acute treatment
of mania. During periods of mania the nurse should promote a quiet, low-stimulation
environment.
-61
A nurse is assessing a client who has lung cancer. Which of the following manifestations should
the nurse expect?
A.Clear sputum
B.Flank pain
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C.Weight gain
D.Persistent cough
A.Clear sputum
The nurse should expect a client who has lung cancer to have blood-streaked or rust-colored
sputum.
B.Flank pain
The nurse should expect a client who has lung cancer to have shoulder, arm, or chest pain.
C.Weight gain
The nurse should expect a client who has lung cancer to have weight loss.
D.Persistent cough(CORRECT)
The nurse should expect a client who has lung cancer to have a persistent cough or any change in
the pattern of coughing, such as increased frequency, longer duration, or producing more sputum.
-62
A nurse is caring for a client who is experiencing preterm labor and is receiving betamethasone.
Which of the following actions should the nurse take?
A.Assess the client's deep tendon reflexes.
B.Monitor the client's heart rate.
C.Monitor the client's blood glucose level.
D.Assess the client for signs of pulmonary edema.
A.Assess the client's deep tendon reflexes.
The nurse should assess the deep tendon reflexes of a client who is receiving magnesium sulfate.
B.Monitor the client's heart rate.
The nurse should monitor the heart rate of a client who is receiving a beta-adrenergic agonist.
C.Monitor the client's blood glucose level.
The nurse should monitor the blood glucose level of a client who is receiving betamethasone
because it can cause hyperglycemia. The nurse should also monitor the client's WBC count and
the body movements of the fetus.
D.Assess the client for signs of pulmonary edema.
The nurse should assess for indications of pulmonary edema in a client who is receiving a betaadrenergic agonist.
-63
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A nurse is caring for a newborn who was born prematurely. Which of the following is the priority
for the nurse to investigate further?
A.Poor weight gain
B.Grunting on expiration
C.Temperature instability
D.Fluctuating blood glucose level
A.Poor weight gain
The nurse should further investigate poor weight gain because it might indicate anemia.
However, another finding is the priority for the nurse to investigate further.
B.Grunting on expiration (CORRECT)
When using the airway, breathing, circulation approach to client care, the nurse should determine
the priority finding to investigate further is expiratory grunting. This finding indicates respiratory
distress, which can be life-threatening for the preterm newborn.
C.Temperature instability
The nurse should further investigate temperature instability in the newborn to prevent
hypothermia. However, another finding is the priority for the nurse to investigate further.
D.Fluctuating blood glucose level
The nurse should further investigate a fluctuating or unstable blood glucose level because it
might indicate a gastrointestinal infection. However, another finding is the priority for the nurse
to investigate further.
-64
A nurse is providing nutritional teaching to a client who has leukemia and is experiencing
neutropenia. Which of the following instructions should the nurse include?
Refrigerate foods within 2 hr of purchase from the grocery store
Discard leftovers after 5 days
Thaw frozen foods in the refrigerator is correct.
Avoid buffet-style restaurants
Refrigerate leftovers within 3 hr
Refrigerate foods within 2 hr of purchase from the grocery store is incorrect. The nurse should
instruct the client to refrigerate foods immediately after purchase from the grocery store to
prevent the risk of exposing the food to bacteria, potentially causing bacterial growth.
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Discard leftovers after 5 days is incorrect. The nurse should instruct the client to discard leftovers
after a maximum of 4 days to prevent the risk of consuming foods which have been exposed to
bacteria, potentially causing bacterial growth.
Thaw frozen foods in the refrigerator is correct. The nurse should instruct the client to thaw
frozen foods in the refrigerator rather than at room temperature. Thawing food at room
temperature can increase the risk of exposure to bacteria, potentially causing environmental
bacterial growth.
Avoid buffet-style restaurants is correct. The nurse should instruct the client to avoid buffets and
salad bars as the food is open to human contamination, potentially causing bacterial growth.
Refrigerate leftovers within 3 hr is incorrect. The nurse should instruct the client to refrigerate
food immediately after eating to prevent foodborne contamination from occurring. The client
should also reheat the food throughout and thoroughly prior to eating it again. This process will
eliminate any potential bacterial growth
-65
A nurse is creating a plan of care for a toddler who has cerebral palsy. Which of the following
interventions should the nurse include?
A.Position the child upright for feedings
B.Avoid using jaw control during feedings.
C.Perform stretching exercises 30 min after administering oral pain medication to the child.
D.Use the COMFORT scale to determine the child's pain level.
A.Position the child upright for feedings. (CORRECT)
The nurse should place the child in an upright position for feedings to promote the movement of
food and fluids through the esophagus and minimize the risk of aspiration.
B.Avoid using jaw control during feedings.
The nurse should use jaw control during the child's feedings to promote eating.
C.Perform stretching exercises 30 min after administering oral pain medication to the child.
The nurse should wait at least 60 min following administration of oral pain medication to
perform stretching exercises for the child. This will ensure adequate pain relief has been
received.
D.Use the COMFORT scale to determine the child's pain level.
The COMFORT scale is predominantly used in the critical care setting with unconscious or
ventilated infants to determine their pain level. The scale has eight indicators that are all based on
behaviors
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-66
A nurse in an inpatient psychiatric facility is assessing a client who has schizoaffective disorder.
Which of the following client statements indicates flight of ideas?
A."I have no heart. The world doesn't exist. I know who I am."
B."My foot hurts. It's time to eat lunch. I like movies."
C."It's time to eat. It's time to eat. Eat. Eat."
D."I am the president. You should salute me."
A."I have no heart. The world doesn't exist. I know who I am."
This statement illustrates nihilistic delusion in which the client has a false idea that the world is
nonexistent.
B."My foot hurts. It's time to eat lunch. I like movies." (CORRECT)
This statement illustrates flight of ideas in which the client's speech jumps from one thought to
the next without pausing.
C."It's time to eat. It's time to eat. Eat. Eat."
This statement illustrates echolalia in which the client repeats words or sentences he hears.
D."I am the president. You should salute me."
This statement illustrates a grandiose delusion in which the client believes he is very important.
-67
A nurse is preparing to administer immunizations to a 2 month old infant at a well child visit.
Which of the following immunizations should the nurse plan to administer?
A.Varicella (VAR)
B.Measles-Mumps-Rubella (MMR)
C.Haemophilus influenzae type b (Hib)
D.Influenza
A.Varicella (VAR)
The VAR immunization is administered in a series of two doses starting at 12 months of age.
B.Measles-Mumps-Rubella (MMR)
The MMR immunization is administered in a series of two doses starting at 12 months of age.
C.Haemophilus influenzae type b (Hib) (CORRECT)
The nurse should plan to administer the Hib immunization. This vaccine is administered in a
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series of three to four doses starting at 2 months of age.
D.Influenza
The influenza immunization is administered annually starting at 6 months of age.
-68
A nurse is assessing a client who is in early stages of alzheimer's disease. Which of the following
should the nurse expect?
A.The client cannot recall the year.
B.The client exhibits a more aggressive personality.
C.The client misplaces familiar objects.
D.The client is unable to manage personal finances.
A.The client cannot recall the year.
The nurse should expect the client to have difficulty recalling the date or year in the later stages
of Alzheimer's disease.
B.The client exhibits a more aggressive personality.
The nurse should expect the client to have personality changes, such as aggression and agitation,
in the later stages of Alzheimer's disease.
C.The client misplaces familiar objects. (CORRECT)
The nurse should expect the client to display forgetfulness and forget the location of familiar
objects in the earlier stages of Alzheimer's disease.
D.The client is unable to manage personal finances.
The nurse should expect the client to have difficulty managing personal finances in the later
stages of Alzheimer's disease.
-69
A nurse is caring for a client who has preeclampsia and is receiving a 30 min bolus infusion of
magnesium sulfate
A.Discontinue the infusion.
B.Administer calcium gluconate every 8 hr.
C.Reassure the client these are expected findings.
D.Assess the client's deep tendon reflexes every 30 min.
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A.Discontinue the infusion.
The nurse should not discontinue the infusion, because these are expected findings during the
initial bolus of the medication and do not require intervention.
B.Administer calcium gluconate every 8 hr.
The nurse should have calcium gluconate readily available in case the client develops
magnesium toxicity. However, this should not be administered at this time because these are
expected findings during the initial bolus of the medication and do not require intervention.
C.Reassure the client these are expected findings. (CORRECT)
The nurse should reassure the client that her reported reactions are expected findings during the
initial bolus of the medication.
D.Assess the client's deep tendon reflexes every 30 min.
The nurse should assess the client's deep tendon reflexes prior to administration and during
treatment. However, the reported reactions are expected findings during the initial bolus of the
medication and do not require intervention
-70
A nurse is providing discharge teaching to a client who is receiving radiation therapy for
Hodgkin’s lymphoma. Which of the following client statements indicates an understanding of the
teaching?
A."I will floss my teeth after each meal."
B."I can take aspirin if I get a headache."
C."I can use a suppository if I experience constipation."
D."I will apply ice to the area if I get a bruise."
A."I will floss my teeth after each meal."
The client should avoid flossing her teeth and use a soft-bristle toothbrush to prevent bleeding.
B."I can take aspirin if I get a headache."
The client should take acetaminophen for a headache because aspirin can increase the risk of
bleeding.
C."I can use a suppository if I experience constipation."
The client should avoid using rectal suppositories and enemas to prevent the risk of bleeding.
D."I will apply ice to the area if I get a bruise." (CORRECT)
The nurse should recognize that the teaching is effective when the client makes this statement.
The nurse should instruct the client to apply ice for at least 1 hr to any bruised or bumped area on
the skin. This decreases the risk of bleeding underneath the skin and prevents further injury
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-71
A nurse is caring for a client who has eclampsia and has just experienced a tonic clonic seizure.
Which of the following actions should the nurse take?
A.Apply oxygen via nonrebreather at 10 L/min.
B.Administer calcium gluconate.
C.Administer a 500 mL bolus of IV fluids.
D.Place the client in reverse Trendelenburg position.
A.Apply oxygen via nonrebreather at 10 L/min. (CORRECT)
The nurse should administer oxygen at 10L/min via nonrebreather face mask following a seizure.
Also, the nurse should use suction as needed, apply a pulse oximetry monitor, initiate
intravenous fluids, administer magnesium sulfate, insert an indwelling urinary catheter, and
monitor vital signs.
B.Administer calcium gluconate.
The nurse should not administer calcium gluconate. This medication is indicated for magnesium
toxicity.
C.Administer a 500 mL bolus of IV fluids.
The nurse should not administer a bolus of IV fluids and should carefully monitor the client for
fluid overload.
D.Place the client in reverse Trendelenburg position.
The nurse should not place the client in reverse Trendelenburg position. The nurse should place
the client in a lateral side-lying position.
-72
A nurse is providing teaching about expected manifestations of the disease to the partner of a
client who has parkinson’s disease. Which of the following statements by the clients partner
indicates an understanding of the teaching?
A."She might have trouble swallowing, so I will offer her milkshakes to drink."
B."She will develop a shuffling gait, so I should encourage her to focus on her feet when she
walks."
C."She will probably gain weight since she can't exercise much anymore."
D."She will start sleeping longer hours at night, so I will have to adjust her breakfast time."
A."She might have trouble swallowing, so I will offer her milkshakes to drink." (CORRECT)
The nurse should teach the partner that the client might develop difficulty swallowing. The
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partner should offer a soft diet and thick, cold fluids, such as milkshakes, because these are likely
to be better tolerated by the client.
B."She will develop a shuffling gait, so I should encourage her to focus on her feet when she
walks."
The nurse should teach the partner to encourage the client to participate in active and passive
range-of-motion exercises to keep her flexible and retain mobility. The partner should not
encourage the client to focus on her feet when walking, because this increases her risk of falling.
C."She will probably gain weight since she can't exercise much anymore."
The nurse should teach the partner that the client will lose weight due to her inability to eat a
balanced diet and increased calorie burning from muscle rigidity. The nurse should instruct the
partner to weigh the client weekly so her diet can be adjusted as needed.
D."She will start sleeping longer hours at night, so I will have to adjust her breakfast time."
The nurse should teach the partner that the client will have the tendency to sleep less at night due
to the disease itself as well as the medications she might be taking. The nurse should instruct the
partner to monitor the client's sleeping patterns and ensure the client is safe to perform high-risk
tasks safely
-73
A nurse is reviewing the lab report for a client who has acute pancreatitis. Which of the
following lab results should expect?
A.Amylase 200 units/L
B.Lipase 150 units/L
C.Fasting blood glucose 100 mg/dL
D.WBC count 21,000/mm3
A.Amylase 200 units/L
The nurse should expect to find an increased serum amylase level in a client who has acute
pancreatitis due to pancreatic cell injury. An amylase level of 200 units/L is within the expected
reference range.
B.Lipase 150 units/L
The nurse should expect to find an elevated serum lipase level in a client who has acute
pancreatitis due to pancreatic cell injury. A lipase level of 150 units/L is within the expected
reference range.
C.Fasting blood glucose 100 mg/dL
The nurse should expect to find an elevated serum blood glucose level in a client who has acute
pancreatitis due to pancreatic cell injury, which results in impaired carbohydrate metabolism and
a decrease in insulin resistance. A fasting blood glucose level of 100 mg/dL is within the
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expected reference range.
D.WBC count 21,000/mm3 (CORRECT)
The nurse should expect to find an elevated WBC (leukocyte) count in a client who has acute
pancreatitis due to acute inflammation. A WBC count of 21,000/mm3 is an expected finding of a
client who has acute pancreatitis.
-74
A nurse is teaching an adolescent who has a severe allergy to bee stings about how to use an
automatic epi injector. Which of the following statements by the client indicated an
understanding of the teaching?
A."I will store the injector device in the refrigerator until I need it."
B."I will lie down and rest for 1 hour after using the injector device."
C."I will inject the medication into my upper thigh at a 90 degree angle."
D."I will obtain a replacement injector device if the medication appears clear in color."
A."I will store the injector device in the refrigerator until I need it."
The nurse should instruct the client that any extremes in temperature, such as storing the device
in the refrigerator, can impair the injection mechanism and make the medication less effective.
B."I will lie down and rest for 1 hour after using the injector device."
The nurse should instruct the client to report to the nearest emergency facility or call 911
immediately following use of the device. The client requires monitoring for 4 to 6 hr following
exposure to an antigen.
C."I will inject the medication into my upper thigh at a 90 degree angle."
The nurse should instruct the client to inject the medication into the top of the outer thigh. The
device should be held so that the needle enters the skin at a 90° angle. The injector button should
be held for 10 seconds. After injection, the client should massage the site for 10 seconds.
D."I will obtain a replacement injector device if the medication appears clear in color."
The nurse should instruct the client that a replacement device should be obtained if the
medication is discolored.
-75
A nurse is providing palliative care to a client who is scheduled for surgery the following day.
The client's family is questioning the nurse about the necessity of the surgery. Which of the
following responses should the nurse make?
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A."Palliative surgery will restore some of your mother's lost functionality."
B."Palliative surgery will remove a diseased body part from your mother."
C."Palliative surgery will relieve some of the pain your mother is experiencing."
D."Palliative surgery will confirm your mother's diagnosis."
A."Palliative surgery will restore some of your mother's lost functionality."
The nurse should inform the family that constructive surgery can restore lost or reduced function
for a client.
B."Palliative surgery will remove a diseased body part from your mother."
The nurse should inform the family that ablative surgery can remove a diseased body part from a
client.
C."Palliative surgery will relieve some of the pain your mother is experiencing." (CORRECT)
The nurse should inform the family that palliative surgery can relieve or reduce pain or disease
manifestations, but does not involve any curative procedures.
D."Palliative surgery will confirm your mother's diagnosis."
The nurse should inform the family that diagnostic surgery can establish or confirm a client's
diagnosis.
-76
BLAHHHHHHH
???
-77
A community health nurse is assessing an older adult client. Which of the following situations
should the nurse identify as a possible indication of undue influence?
A.The client stays with her son one night each week.
B.The client's niece moves into her home to provide care.
C.The client rarely signs legal documents regarding her medical care.
D.The client has increased her attendance at family gatherings.
A.The client stays with her son one night each week.
A client who is exhibiting indications of undue influence is not allowed to be left alone or to
function independently. An abuser who is using undue influence over a victim maintains
psychological control over the victim's decisions at all times.
B.The client's niece moves into her home to provide care. (CORRECT)
The nurse should identify that this client is at risk for undue influence. Undue influence can
occur when an older adult moves into someone's home, or when someone moves into her home,
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under the pretense of providing better care for the client. This allows the abuser to have access
and control to the client at all times, and makes it easier for the abuser to influence the client's
decisions about medical care, property, and finances.
C.The client rarely signs legal documents regarding her medical care.
A client who is exhibiting indications of undue influence suddenly begins to sign legal
documents frequently regarding medical care, property, and finances.
D.The client has increased her attendance at family gatherings.
A client who is exhibiting indications of undue influence becomes suspicious of friends and
family members due to the abuser's influence and begins to avoid family gatherings.
-78
A nurse is caring for a client following a hemorrhagic stroke. Which of the following routine
prescriptions should the nurse clarify?
A.Perform neurologic checks hourly.
B.Maintain the head of the bed at 20°.
C.Initiate alteplase infusion.
D.Implement seizure precautions.
A.Perform neurologic checks hourly.
Neurologic deterioration can occur following a hemorrhagic stroke. Manifestations include a
decreased level of consciousness, alterations in motor function, and pupillary response. The
nurse should monitor the client's neurologic status hourly.
B.Maintain the head of the bed at 20°.
A head elevation of 20° decreases intracranial pressure and promotes venous blood flow.
C.Initiate alteplase infusion. (CORRECT)
The nurse should clarify a provider's prescription for an alteplase infusion because this will
increase the bleeding within the brain. Alteplase is indicated for treatment of acute ischemic
stroke.
D.Implement seizure precautions.
Complications following a hemorrhagic stroke include seizures. The nurse should initiate seizure
precautions and provide prescribed medications if a seizure occurs.
-79
A nurse is planning care for a client who has benign chondroma of the tibia. Which of the
following interventions should the nurse plan to include?
A.Remind the client of non-weight-bearing status of the affected extremity.
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B.Palpate for changes in the muscle of the affected extremity.
C.Prepare the client for a needle biopsy.
D.Teach the client about pain management with radiation therapy.
A.Remind the client of non-weight-bearing status of the affected extremity.
Non-weight-bearing status is required for a client who undergoes bone grafting for treatment of
primary, cancerous tumors of the lower extremities.
B.Palpate for changes in the muscle of the affected extremity. (CORRECT)
The nurse should palpate the muscle of the affected extremity to monitor for changes such as
muscle spasm, atrophy, or swelling. These manifestations indicate enlargement of the tumor.
C.Prepare the client for a needle biopsy.
A needle biopsy can be performed to stage bone cancer and determine the size and potential
metastasis of a cancerous tumor. This client has a benign tumor and does not require staging.
D.Teach the client about pain management with radiation therapy.
Pain management with radiation therapy is required for a client who has a malignant tumor.
Benign tumors are managed with analgesics as well as heat and cold therapy
-80
A charge nurse is leading an educational session about intimate partner violence for a group of
newly licenced nurses. Which of the following statements by a newly licenced nurse indicates an
understanding of the teaching?
A."Physical intimate partner violence is often passed on to future generations."
B."Intimate partner violence is likely to decrease during pregnancy."
C."Rates of abuse are directly correlated with socioeconomic status."
D."Victims of intimate partner violence can leave the relationship whenever they want to."
A."Physical intimate partner violence is often passed on to future generations." (CORRECT)
Family coping patterns tend to be passed on from generation to generation. Physical intimate
partner violence is no different in that regard.
B."Intimate partner violence is likely to decrease during pregnancy."
Intimate partner violence is likely to begin or increase during pregnancy.
C."Rates of abuse are directly correlated with socioeconomic status."
Intimate partner violence occurs regardless of socioeconomic and educational background.
D."Victims of intimate partner violence can leave the relationship whenever they want to."
Nurses should understand that it can be very difficult for a victim of intimate partner violence to
leave a relationship. Factors which prevent leaving include financial dependence, worries about
children, fear of increased abuse, or death
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81
A nurse is teaching a client who is experiencing preterm labor about receiving betamethasone.
Which of the following outcomes should the nurse include in the teaching regarding
betamethasone?
A.Enhances fetal lung maturity
B.Decreases uterine contraction
C.Increases fetal weight
D.Prevents infection
A.Enhances fetal lung maturity (CORRECT)
The nurse should instruct the client that betamethasone is given to enhance fetal lung maturity
should the fetus be born prior to the expected due date
.
B.Decreases uterine contraction
Betamethasone does not decrease uterine contractions. Terbutaline and magnesium sulfate are
given to clients who experience preterm labor to decrease uterine contractions.
C.Increases fetal weight
Betamethasone does not increase fetal weight.
D.Prevents infection
Betamethasone does not prevent infection. A client who experiences preterm labor might be
given IV antibiotics to prevent chorioamnionitis.
-82
A nurse in an acute care mental health facility is planning care for a client who has bipolar
disorder and who is experiencing acute mania. Which of the following actions should the nurse
plan to take?
A.Encourage the client to take part in daily group meetings.
B.Allow the client to pick from a variety of activities on the unit.
C.Assign the client to a semiprivate room.
D.Provide the client with finger foods to eat.
A.Encourage the client to take part in daily group meetings.
The client who is experiencing acute mania should have one-to-one activities with a member of
the nursing staff to prevent the overstimulation of being around groups of people.
B.Allow the client to pick from a variety of activities on the unit.
The nurse should provide a schedule of activities that includes scheduled meals and rest periods
for the client who is experiencing mania. A structured schedule will help to decrease stimulation
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for the client.
C.Assign the client to a semiprivate room.
The nurse should reduce environmental stimuli for the client and should assign the client to a
private room with reduced noise and lighting to decrease stimuli and promote rest.
D.Provide the client with finger foods to eat. (CORRECT)
A client who is experiencing mania is often unable to sit and eat and can become dehydrated and
lose weight. Providing the client finger foods, such as sandwiches, allows the client to eat while
standing or walking and allows her to obtain nutrition even though she cannot sit down for a
meal.
-83
A client is caring for a client who is in active labor. The nurse notices an abnormal pattern in the
fetal heart monitor. Which of the following actions should the nurse take for late deceleration?
A.Elevate the head of the client's bed to 90°.
B.Request a prescription to decrease the primary IV infusion rate.
C.Administer oxygen by nonrebreather facemask at 10 L/min.
D.Prepare the client for an amnioinfusion.
A.Elevate the head of the client's bed to 90°.
The nurse should assist the client into a side-lying position to increase perfusion of oxygen to the
fetus.
B.Request a prescription to decrease the primary IV infusion rate.
The nurse should increase, rather than decrease, the client's IV infusion rate.
C.Administer oxygen by nonrebreather facemask at 10 L/min. (CORRECT)
The nurse should administer oxygen by nonrebreather facemask at 10 L/min. Late decelerations
are primarily caused by impaired oxygenation to the placenta.
D.Prepare the client for an amnioinfusion.
An amnioinfusion is an infusion of isotonic fluid into the uterine cavity if the amniotic fluid level
is low. This procedure is not effective for late decelerations.
-84
A nurse is providing teaching to a client who has Parkinson’s disease and has a new prescription
for levodopa-carbidopa. Which is the following instructions should the nurse include?
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A."Do not eat within 2 hours of taking this medication."
B."Change from a lying or sitting position slowly."
C."Notify the provider of any change in color of urine."
D."Take the medication every 4 hours day and night."
A."Do not eat within 2 hours of taking this medication."
The nurse should instruct the client that levodopa-carbidopa can cause gastric irritation, which
can be alleviated by eating shortly after taking the medication. However, the client should avoid
foods that are high in protein because they can impair the effects of levodopa.
B."Change from a lying or sitting position slowly." (CORRECT)
The nurse should instruct the client that levodopa-carbidopa can cause orthostatic or postural
hypotension. To minimize the effects of this adverse effect, the nurse should instruct the client to
slowly change from a lying or sitting position to a standing position.
C."Notify the provider of any change in color of urine."
The nurse should instruct the client he might experience a harmless darkening of the urine,
saliva, or sweat. This expected finding does not need to be reported to the provider.
D."Take the medication every 4 hours day and night."
The nurse should instruct the client to take levodopa-carbidopa on a regular schedule during
waking hours. This will improve sleep and minimize the adverse effects of the medication.
-85
A nurse is providing teaching to a client who has RA and a new prescription for methotrexate.
Which of the following information should the nurse include?
A.Limit alcohol intake to 360 mL (12 oz) each week.
B.Avoid large crowds of people when possible.
C.Take low-dose aspirin for general pain.
D.Expect to experience increased fatigue.
A.Limit alcohol intake to 360 mL (12 oz) each week.
The nurse should instruct the client to avoid alcohol intake while taking methotrexate due to the
adverse effect of hepatotoxicity.
B.Avoid large crowds of people when possible. (CORRECT)
Clients taking methotrexate are at an increased risk of infection due to the adverse effect of
leukopenia. The nurse should instruct the client to avoid crowds and people who are sick to
minimize their exposure to infectious organisms.
C.Take low-dose aspirin for general pain.
The nurse should instruct the client to avoid the use of aspirin or NSAIDs while taking
methotrexate due to the adverse effect of thrombocytopenia. The combination of these
medications can precipitate gastric bleeding.
D.Expect to experience increased fatigue.
The nurse should instruct the client to notify his provider immediately for increased fatigue,
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which is a manifestation of an infection or bleeding. Methotrexate can cause leukopenia or
thrombocytopenia.
-86
A nurse is providing discharge instructions to a client following gastric bypass surgery for
management of obesity. Which of the following client statements indicates an understanding of
the teaching?
A."I will apply moisturizing lotion between skin folds."
B."I will remain in a reclining position for 30 minutes after I eat."
C."I will return to my normal diet in 3 weeks."
D."I will need to take digestive enzymes daily."
A."I will apply moisturizing lotion between skin folds."
The nurse should teach the client that the area between skin folds should be kept clean and dry.
Applying a moisturizing lotion can cause breakdown of the skin.
B."I will remain in a reclining position for 30 minutes after I eat." (CORRECT)
Following gastric bypass surgery, clients are at risk for dumping syndrome. The nurse should
teach the client that this can be avoided by reclining for 30 min following meals. Remaining in a
reclining position slows gastric emptying and minimizes the risk of dumping syndrome.
C."I will return to my normal diet in 3 weeks."
The nurse should teach the client that his diet will consist of pureed foods and liquids for a
minimum of 6 weeks following surgery. After this period of time, the client can gradually return
to a solid diet.
D."I will need to take digestive enzymes daily."
The nurse should teach the client that gastric bypass surgery results in a loss of intrinsic factor,
which is a protein secreted by the stomach that is necessary for absorption of vitamin B12, and
therefore requires monthly injections of vitamin B12 and iron. Digestive enzymes are not
required.
-87
A nurse is caring for a client who has an alcohol use disorder and recently completed
detoxification. Which of the following medications should the nurse plan to administer to assist
the client in maintaining abstinence from alcohol?
A.Varenicline
B.Clonidine
C.Chlordiazepoxide
D.Disulfiram
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A.Varenicline
The nurse should plan to administer varenicline to a client who has a tobacco use disorder.
Varenicline decreases the craving for nicotine and reduces manifestations of withdrawal.
B.Clonidine
The nurse should plan to administer clonidine to a client who has an opiate use disorder and is
experiencing hypertension.
C.Chlordiazepoxide
The nurse should plan to administer chlordiazepoxide to a client who is experiencing
manifestations of alcohol withdrawal. Chlordiazepoxide reduces the risk for seizures and
agitation during withdrawal.
D.Disulfiram (CORRECT)
The nurse should plan to administer disulfiram to a client who has completed alcohol
detoxification. Disulfiram will cause a toxic reaction in a client who ingests alcohol.
-88
A nurse is providing teaching to the parent of a school aged child who has sickle cell anemia.
Which of the following statements should the nurse include?
A."You should report to the provider if your child has a severe headache."
B."You should apply cold compresses to your child's affected joints."
C."You should restrict your child's intake of fluids."
D."You should administer a stool softener to your child each day."
A."You should report to the provider if your child has a severe headache." (CORRECT)
The nurse should instruct the parent to report a severe headache to the child's provider because it
can be an indication of a stroke.
B."You should apply cold compresses to your child's affected joints."
The nurse should instruct the parent to apply warm compresses to the affected joints to prevent
vasoconstriction.
C."You should restrict your child's intake of fluids."
The nurse should instruct the parent to encourage the child to increase fluid intake to maintain
hydration.
D."You should administer a stool softener to your child each day."
The nurse should not instruct the parent to administer a stool softener because constipation is not
a manifestation of sickle cell anemia.
-89
A nurse is assessing a client who has PTSD. Which of the following manifestations should the
nurse expect?
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A.Unable to dream at night since the event
B.Regularly spending time where the event occurred
C.Memory loss related to the event
D.Passive behavior since the event
A.Unable to dream at night since the event
A client who has PTSD has distressing dreams related to the traumatic event that reoccur on a
regular basis.
B.Regularly spending time where the event occurred
A client who has PTSD avoids places that bring back memories of the traumatic event.
C.Memory loss related to the event (CORRECT)
A client who has PTSD has recurrent distressing memories of the traumatic event, but is often
unable to remember details associated with the event, also known as dissociative amnesia.
D.Passive behavior since the event
A client who has PTSD will commonly exhibit irritability and aggression toward others.
-90
A nurse is assessing a young client for behaviors that indicate addiction. Which of the following
characteristics should the nurse recognize as potentially indicating addictive behavior?
A.The client exhibits histrionic personality traits.
B.The client has a decreased self-image.
C.The client has a proactive attitude toward life.
D.The client exhibits manic behavior.
A.The client exhibits histrionic personality traits.
Antisocial personality traits are associated with the development of addictive behaviors.
B.The client has a decreased self-image. (CORRECT)
A poor self-image is a common characteristic found in clients who develop addictive behaviors.
C.The client has a proactive attitude toward life.
A passive attitude toward life is a common characteristic found in clients who develop addictive
behaviors.
D.The client exhibits manic behavior.
Anxiety, depression, or a history of depressive episodes are commonly found in clients who
develop addictive disorders.
-91
A nurse manager is teaching a group of newly license nurses about obesity management for
overweight clients. Which of the following information should the nurse manager include?
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A.Decrease intake by 500 calories per day to lose 0.45 kg (1 lb) per week.
B.Limit daily exercise until 13.61 kg (30 lb) of weight loss has been achieved.
C.Initiate a short-term fasting program.
D.Provide information about a clear liquid diet.
A.Decrease intake by 500 calories per day to lose 0.45 kg (1 lb) per week. (CORRECT)
The nurse manager should recommend a decrease in calorie intake of 500 to 1,000 calories each
day to see a loss of 0.45 to 0.91 kg (1 to 2 lb) each week. This recommendation is based on the
metabolism of each individual, assuming that 0.45 kg (1 lb) of fat is equal to 3,500 calories.
B.Limit daily exercise until 13.61 kg (30 lb) of weight loss has been achieved.
The nurse manager should encourage daily exercise, which assists in burning calories and weight
loss.
C.Initiate a short-term fasting program.
The nurse manager should include that short-term fasting has not been successful and does not
produce permanent weight loss.
D.Provide information about a clear liquid diet.
The nurse manager should discourage the use of novelty diets, such as a clear liquid diet. These
diets are nutritionally inadequate and concentrate on certain foods or liquids to promote weight
loss.
-92
A nurse is assessing a client who has acute glomerulonephritis. Which of the following
manifestations should the nurse expect?
Edema
Hematuria
Hypotension i
Polyuria
Fatigue
Edema is correct. The nurse should expect the client who has acute glomerulonephritis to
manifest edema as a result of fluid and sodium retention and decreasing kidney function.
Hematuria is correct. The nurse should expect the client who has acute glomerulonephritis to
have urine that is reddish brown or rusty. Urinalysis will indicate red blood cells in the urine.
Fatigue is correct. The nurse should expect the client who has acute glomerulonephritis to report
fatigue as the kidneys fail to filter waste products in the blood. Anemia might also be present.
-93
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A nurse in an ER is assessing a client who was in a MVC. The client has a blood alcohol
concentration of 0.18% and states “i would never drink and drive”. The nurse should identify that
the client is demonstrating use of which of the following defense mechanisms?
A.Intellectualization
B.Denial
C.Rationalization
D.Projection
A.Intellectualization
Intellectualization occurs when a client uses reasoning or logic to prevent thinking about
emotional aspects of a situation.
B.Denial (CORRECT)
Denial occurs when a client refuses to acknowledge the reality of a situation.
C.Rationalization
Rationalization occurs when a client tries to use logical arguments to excuse unacceptable
behavior.
D.Projection
Projection occurs when a client attributes his feelings as the feelings of another person.
-94
A nurse manager is conducting an in service about medications for substance use disorders with
a group of staff nurses. Which of the following medications should the nurse manager include as
an opioid agonist used in withdrawal therapy?
A.Methadone
B.Diazepam
C.Morphine
D.Doxepin
A.Methadone (CORRECT)
The nurse should include in the in-service that methadone is an opioid agonist used for
withdrawal therapy for clients addicted to opioids. The client can use methadone in place of an
illegal substance to prevent withdrawal as part of maintenance therapy or to build tolerance to
opioids through suppressive therapy.
B.Diazepam
Diazepam is a benzodiazepine medication that is used to treat anxiety, insomnia, and seizure
disorders.
C.Morphine
Morphine is a pure opioid agonist given to relieve moderate to severe pain.
D.Doxepin
Doxepin is a tricyclic antidepressant that is given to treat depression. It is also used to treat
insomnia due to the strong sedative action of the medication.
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-95
A nurse is planning care for a client who has adenocarcinoma and associated thrombocytopenia.
Which of the following actions should the nurse plan to take?
A.Apply pressure to the client's venipuncture sites for a total of 5 min.
B.Use a firm-bristled toothbrush to remove bacteria from the client's teeth.
C.Initiate fall precautions for the client.
D.Check the client's IV site for bleeding every 8 hr.
A.Apply pressure to the client's venipuncture sites for a total of 5 min.
The nurse should plan to apply firm pressure to the client's venipuncture sites for a minimum of
10 min to encourage blood coagulation, which is impaired due to thrombocytopenia.
B.Use a firm-bristled toothbrush to remove bacteria from the client's teeth.
The nurse should plan to use an extra soft- or soft-bristled toothbrush or sponges to clean the
client's teeth. This will help to prevent bleeding or irritation of the client's gums.
C.Initiate fall precautions for the client. (CORRECT)
The nurse should plan to initiate fall precautions for the client who has thrombocytopenia to
prevent injury.
D.Check the client's IV site for bleeding every 8 hr.
The nurse should plan to check the client's IV site for bleeding every 4 hr rather than every 8 hr.
-96
A nurse is teaching a client who has gential herpes simplex virus. Which of the following
statements should the nurse include in the teaching about this STI?
A."A 14-day course of acyclovir will eradicate the infection."
B."The law requires you to contact all sexual partners so they can be treated."
C."Avoid taking over-the-counter medications that contain aspirin while you have lesions."
D."You should cleanse the lesions with a saline solution twice each day."
A."A 14-day course of acyclovir will eradicate the infection."
The nurse should teach the client that there is no cure for genital herpes. Antiviral medication
like acyclovir can reduce the symptoms during active infections.
B."The law requires you to contact all sexual partners so they can be treated."
The nurse should teach the client that there is no cure for genital herpes. As a courtesy, the client
should contact all sexual partners so they can receive treatment; however, the law does not
require prior sexual partners to be contacted.
C."Avoid taking over-the-counter medications that contain aspirin while you have lesions."
The nurse should teach the client to take over-the-counter analgesics such as acetaminophen,
ibuprofen, or aspirin to control pain associated with the infection.
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D."You should cleanse the lesions with a saline solution twice each day." (CORRECT)
The nurse should teach the client to cleanse the lesions twice each day with a saline solution to
prevent secondary bacterial infections.
-97
A nurse is screening a female client for alcohol use disorder. Which of the following client
statements should the nurse identify as a possible indicator of alcohol use disorder?
A."I enjoy drinking alcohol."
B."I drink alcohol socially with friends."
C."I have two drinks that contain alcohol each day."
D."I know my partner wants me to drink less alcohol."
A."I enjoy drinking alcohol."
A client's enjoyment of alcohol consumption is not an indicator of alcohol use disorder. When
screening the client for alcohol use disorder, the nurse should focus on factors related to the
amount of alcohol consumption and its effect on the client's life and relationships.
B."I drink alcohol socially with friends."
Social drinking is not an indicator of alcohol use disorder. When screening the client for alcohol
use disorder, the nurse should focus on factors related to the amount of alcohol consumption and
its effect on the client’s life and relationships.
C."I have two drinks that contain alcohol each day."
Drinking two alcohol drinks each day is not considered excessive for a female client. Four or
more is considered an indicator of alcohol use disorder for a male client and three or more is an
indicator for a female client.
D."I know my partner wants me to drink less alcohol." (CORRECT)
The nurse should ask the client about whether her partner, relatives, friends, or others have
expressed concern about her alcohol consumption. This concern or suggestions to decrease
drinking of alcohol are possible indicators of alcohol use disorder. The nurse should continue to
ask further screening questions about alcohol consumption and its effect on the client's life.
-98
A school nurse is evaluating a school aged child who has ADHD. Which of the following
behavioral characteristics should the nurse expect the child to exhibit?
A.Aggression
B.Intrusiveness
C.Organization
D.Submissiveness
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A.Aggression
Aggression is a manifestation of conduct disorder.
B.Intrusiveness (CORRECT)
The nurse should expect a school-age child who has ADHD to exhibit a decreased attention span,
talkativeness, decreased ability to follow directions, inability to complete tasks, poor social
skills, poor impulse control, and intrusive behaviors.
C.Organization
RChildren who have ADHD exhibit extreme disorganization and are easily distracted.
D.Submissiveness
Submissiveness is a manifestation of dependent personality disorder
-99
A nurse in a provider's office is assessing a client who is 3 weeks postpartum. The nurse should
recognize that which of the following manifestations is associated with postpartum depression?
A.Increased appetite
B.Emotionless affect
C.Manipulative behavior
D.Excessive clinginess
A.Increased appetite
Clients who have postpartum depression experience a lack of appetite.
B.Emotionless affect (CORRECT)
The nurse should recognize that clients who have postpartum depression exhibit a flat affect,
feelings of guilt, crying, irritability, persistent sadness, mood swings, feelings of loss, and
rejection of the newborn.
C.Manipulative behavior
Manipulative behavior is a manifestation of borderline personality disorder.
D.Excessive clinginess
A client who is excessively clingy is displaying a manifestation of borderline personality
disorder.
-100
A nurse is providing discharge teaching about newborn care to a client who is 2 days postpartum.
Which of the following client responses indicates an understanding of the teaching?
A."I should give my baby three larger bottles of formula daily when she has a cold."
B."I should place soft bumper pads inside my baby's crib to protect her from the crib slats."
C."It can take up to 3 weeks for my baby's umbilical cord to fall off."
D."I will swaddle my baby tightly with her legs extended."
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A."I should give my baby three larger bottles of formula daily when she has a cold."
The nurse should instruct the mother to feed the baby who has a cold or an upper respiratory
infection smaller amounts of formula more often to avoid fatigue.
B."I should place soft bumper pads inside my baby's crib to protect her from the crib slats."
The nurse should instruct the mother to avoid placing bumper pads, pillows, quilts, or stuffed
animals inside the infant's crib because these objects can increase the risk of suffocation.
C."It can take up to 3 weeks for my baby's umbilical cord to fall off." (CORRECT)
The nurse should inform the mother that the average time for cord separation is 14 days,
although it can take up to 3 weeks.
D."I will swaddle my baby tightly with her legs extended."
The nurse should instruct the mother to swaddle her baby loosely with the hips flexed and
abducted to prevent hip dislocation. Wrapping the blanket too tightly can cause respiratory
distress.
-101
A nurse in a provider's office is caring for a client who is being evaluated for Alzheimer’s
disease. Which of the following behaviors should the nurse identify as the earliest possible
indication of Alzheimer’s disease?
A.The client becomes lost while driving.
B.The client forgets material he has just read.
C.The client needs help handling details of toileting.
D.The client is aware of his memory lapses.
A.The client becomes lost while driving.
A client who becomes lost while driving is displaying behavior associated with mild cognitive
decline of Alzheimer's disease.
B.The client forgets material he has just read.
A client who forgets material he has just read is displaying behavior associated with mild
cognitive decline of Alzheimer's disease.
C.The client needs help handling details of toileting.
A client who needs help handling details of toileting is displaying behavior associated with an
advanced stage of Alzheimer's disease.
D.The client is aware of his memory lapses. (CORRECT)
A client who is aware of his memory lapses is displaying behavior associated with the earliest
stages of Alzheimer's disease.
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A nurse is developing a plan of cate a newly admitted client who has bulimia nervosa. Which of
the following actions should the nurse plan to take?
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A.Weigh the client weekly for the first month.
B.Tell the client that privileges are based on treatment compliance.
C.Stay with the client for 15 min following each meal.
D.Allow the client to be responsible for scheduling mealtimes throughout the week.
A.Weigh the client weekly for the first month.
The newly admitted client who has an eating disorder should be weighed daily for the first week.
After that time, the client should be weighed three times weekly or as prescribed.
B.Tell the client that privileges are based on treatment compliance. (CORRECT)
The nurse should not argue or bargain with the client, but should explain to the client privileges
will be based on compliance with treatment, such as weight gain or absence of purging
behaviors.
C.Stay with the client for 15 min following each meal.
The nurse should stay with the client for 1 hr following meals to prevent purging.
D.Allow the client to be responsible for scheduling mealtimes throughout the week.
The nurse should schedule strict mealtimes, lasting approximately 30 min, for the client who has
an eating disorder. The client often feels less anxious with a structured daily schedule.
-103
A nurse is assisting the provider in performing a mental status examination for neurocognitive
disorder on a client who has dementia. Which of the following tasks should the nurse use to test
the client’s constitutional ability?
A.Ask the client to name similarities between cars and airplanes.
B.Ask the client to explain the phrase, "Don't cry over spilled milk."
C.Ask the client to name four objects in the room as you point to them.
D.Ask the client to draw a clock that displays the time as 2:30.
A.Ask the client to name similarities between cars and airplanes.
The nurse should ask the client to compare two objects to test his concept of relationships.
B.Ask the client to explain the phrase, "Don't cry over spilled milk."
The nurse should ask the client to explain familiar sayings to test his ability of interpretation.
C.Ask the client to name four objects in the room as you point to them.
The nurse should ask the client to name common objects to test his word-finding ability.
D.Ask the client to draw a clock that displays the time as 2:30. (CORRECT)
The nurse should ask the client to create a drawing of a clock displaying the time on the hands as
2:30 to test his constructional ability.
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A nurse is assessing the fluid balance of a school aged child who has acute poststreptococcal
glomerulonephritis if experiencing inflammation. Which of the following actions is the nurse’s
priority?
A.Monitor the child's BUN and creatinine levels regularly.
B.Keep a precise daily account of the child's intake and output.
C.Measure the child's BP manually every 4 hr.
D.Maintain a strict record of the child's daily weight.
A.Monitor the child's BUN and creatinine levels regularly.
The nurse should monitor the child's BUN and creatinine levels regularly. However, there is
another action that is the nurse's priority in detecting inflammation as it relates to the child's fluid
balance.
B.Keep a precise daily account of the child's intake and output.
The nurse should keep a precise daily account of the child's intake and output. However, there is
another action that is the nurse's priority in detecting inflammation as it relates to the child's fluid
balance.
C.Measure the child's BP manually every 4 hr.
The nurse should measure the child's BP every 4 to 6 hr to identify acute hypertension as early as
possible. However, there is another action that is the nurse's priority in detecting inflammation as
it relates to the child's fluid balance.
D.Maintain a strict record of the child's daily weight. (CORRECT)
When using the urgent vs. nonurgent approach to client care, the nurse should determine that
maintaining a strict record of the child's daily weight is the priority to determine fluid balance
and inflammation level for a child who has acute glomerulonephritis.
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A nurse is assessing a 2 day old newborn who was delivered at 32 weeks of gestation. Which of
the following findings is the priority for the nurse to report to the provider?
A.Temperature of 36.5° C (97.7° F)
B.Central cyanosis
C.Poor muscle tone
D.Weight loss 10% of birth weight
A.Temperature of 36.5° C (97.7° F)
The nurse should report this temperature to the provider. However, there is another finding that is
the priority.
B.Central cyanosis (CORRECT)
When using the urgent vs. nonurgent approach to client care, the priority finding for the nurse to
report to the provider is central cyanosis. This type of cyanosis is caused by an excessive
concentration of decreased hemoglobin in the blood, leading to deoxygenation. This causes the
newborn to have a blue discoloration around the core, lips, and tongue. Central cyanosis often
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indicates impaired cardiovascular function and should be immediately reported to the provider.
C.Poor muscle tone
The nurse should report poor muscle tone to the provider. However, there is another finding that
is the priority.
D.Weight loss 10% of birth weight
The nurse should report this amount of weight loss to the provider. However, there is another
finding that is the priority.
-106
A nurse is assessing a client who has acute pancreatitis. Which of the following findings should
the nurse expect?
A.Hypertension
B.Hyperactive bowel sounds
C.Peripheral edema
D.Periumbilical discoloration
A.Hypertension
The nurse should expect the client to have hypotension, rather than hypertension.
B.Hyperactive bowel sounds
The nurse should expect the client to have hypoactive bowel sounds, rather than hyperactive
bowel sounds.
C.Peripheral edema
The nurse should expect the client to have abdominal ascites, rather than peripheral edema.
D.Periumbilical discoloration (CORRECT)
The nurse should expect a client who has pancreatitis to have a greyish-blue bruised appearance
around the navel and flanks.
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A nurse is caring for an infant who has tetralogy of falling. The nurse bits that the infant exhibits
a sudden onset of cyanosis and is hyperpneic. Which of the following actions should the nurse
take?
A.Initiate oxygen via nasal cannula at 2 L/min.
B.Administer epinephrine IV.
C.Place the infant in a knee-chest position.
D.Discontinue the infusion of IV fluids.
A.Initiate oxygen via nasal cannula at 2 L/min.
The nurse should administer 100% oxygen via facemask to the infant during hypercyanotic
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episodes.
B.Administer epinephrine IV.
The nurse should administer morphine subcutaneously or through an existing IV line during
hypercyanotic episodes.
C.Place the infant in a knee-chest position. (CORRECT)
The nurse should place the infant in a knee-chest position to maximize the oxygenation status of
the infant during hypercyanotic episodes.
D.Discontinue the infusion of IV fluids.
The nurse should initiate or increase the rate of IV fluids to the infant during hypercyanotic
episodes.
-108
A nurse is creating a plan of fate for a newborn who has myelomeningocele. Which of the
following interventions should the nurse include?
A.Place the newborn in a prone-kneeling position.
B.Cover the meningeal sac with a dry nonadherent dressing.
C.Wear latex gloves when caring for the newborn.
D.Clean the meningeal sac daily with 0.9% sodium chloride-soaked gauze.
A.Place the newborn in a prone-kneeling position. (CORRECT)
The nurse should place the newborn in a prone-kneeling position to protect the protruding
meningeal sac from injury.
B.Cover the meningeal sac with a dry nonadherent dressing.
The nurse should cover the meningeal sac with a sterile, moist nonadherent dressing.
C.Wear latex gloves when caring for the newborn.
The nurse should avoid the use of latex gloves or latex products because a newborn who has a
myelomeningocele is at an increased risk for developing a latex sensitivity.
D.Clean the meningeal sac daily with 0.9% sodium chloride-soaked gauze.
The nurse should avoid contact with the meningeal sac because it can rupture, releasing
cerebrospinal fluid and providing entry for infectious agents.
-109
A nurse is teaching a client about ways to prevent melanoma. Which of the following
instructions should the nurse include in the teaching?
A.Limit exposure in tanning beds to 15 min per session.
B.Avoid sun exposure after 1500.
C.Keep a body map of skin abnormalities.
D.Inspect the entire body once every 3 months for lesions.
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A.Limit exposure in tanning beds to 15 min per session.
The nurse should instruct the client to avoid tanning beds. There is no safe amount of time for
exposure in a tanning bed.
B.Avoid sun exposure after 1500.
The nurse should instruct the client to avoid the outdoors and sun exposure between the hours of
1100 and 1500. This is when the sun's rays are the strongest and the most damaging to skin.
C.Keep a body map of skin abnormalities. (CORRECT)
The nurse should instruct the client to keep a body map of skin abnormalities, including scars,
spots, and lesions, to detect any changes that occur that could be precancerous.
D.Inspect the entire body once every 3 months for lesions.
The nurse should instruct the client to inspect the body every month to note any lesions or
changes in the skin's appearance. Some types of skin cancers grow rapidly. Therefore, once every
3 months is not frequent enough to detect a lesion in the precancerous stage.
-110
A nurse is assessing an adolescent who has sickle cell anemia and is experiencing a vaso
occlusive crisis. Which of the following manifestations should the nurse expect?
A.Hematuria
B.Pallor
C.Tinnitus
D.Tingling of the hands
A.Hematuria (CORRECT)
Hematuria is a manifestation of vaso-occlusive crisis resulting from ischemia to the kidneys.
B.Pallor
Pallor is not a manifestation of vaso-occlusive crisis. Adolescents who are experiencing a vasoocclusive crisis can experience obstructive jaundice resulting in yellow-colored skin.
C.Tinnitus
Tinnitus is not a manifestation of a vaso-occlusive crisis.
D.Tingling of the hands
Tingling of the hands is not a manifestation of a vaso-occlusive crisis. Adolescents who are
experiencing a vaso-occlusive crisis have painful swelling of the hands and feet and painful
joints.
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