1. A nurse is planning care for a group of clients. Which of the following tasks should the
nurse delegate to an assistive personnel?
A. Changing the dressing for a client who has a stage 3 pressure injury
B. Determining a client's response to a diuretic
C. Comparing radial pulses for a client who is postoperative
D. Providing postmortem care to a client Postmortem care serves several purposes,
including: preparing the patient for viewing by family. ensuring proper identification of the
patient prior to transportation to the morgue or funeral home. providing appropriate
disposition of patient's belongings. maintaining vital organs, if donation is planned.)
2. A nurse is conducting a health assessment for a client who takes herbal supplements. Which
of the following statements by the client indicates an understanding of the use of the
supplements?
A. I take ginkgo biloba for a headache
B. I take echinacea to control my cholesterol
C. I use ginger when I get car sick
D. I use garlic for my menopausal symptoms
3. A nurse is caring for a client who has influenza and isolation precautions in place. Which
of the following actions should the nurse take to prevent the spread of infection?
A. Wear a mask when working within 3 feet of the client
B. Administer metronidazole
C. Don protective eyewear before entering the room.
D. Place the client in a negative airflow room.
4. A nurse obtains a prescription for wrist restraints for a client who is trying to pull out his
NG tube. Which of the following actions should the nurse take?
A. Attach the restraints securely to the side rails of the client's bed.
B. Apply the restraints to allow as little movement as possible
C. Allow room for two fingers to fit between the clients skin and the restraints
D. Remove the restraints every 4 hr.
5. A nurse is admitting a client who has tuberculosis. Which of the following types
of transmission precautions should the nurse plan to initiate?
A. Droplet
B. Airbornes
C. Protective environment
D. Contact
6. A nurse in a well-child clinic receives a telephone call from a parent who states that their
child accidentally swallowed paint thinner. The child is awake and alert. Which of the following
responses should the nurse make?
A. Have your child drink one large glass of water.
B. Hang up and call a poison control center hotline.
A. Oral temperature slightly elevated at 0800
B. Administered pain medication
C. Incision without redness or drainage
D. Drank adequate amounts of fluid with meals.
8. A nurse is providing oral care for a client who is unconscious. Which of the following
actions should the nurse take?
A. Place the client in a side-lying position.
B. Brush the clients teeth daily
C. Apply mineral oil to the client’s lips
D. Rinse the client’s mouth with an alcohol-based mouthwash
9. A nurse is collaborating with a risk management team about potential legal issues
involving client care. The nurse should identify which of the following situations is an
example of negligence?
A. A nurse administers a medication without first identifying the client.
B. An assistive personnel discusses client care in the facility cafeteria with
visitors present.
C. A nurse begins a blood transfusion without obtaining consent.
D. An assistive personnel prevents a client from leaving the facility.
10. A nurse is collecting a sputum specimen for culture from a client who has a
respiratory infection. Which of the following actions should the nurse take?
A. Wear sterile gloves when collecting the specimen.
B. Offer the client oral hygiene after the collection
C. Collect the specimen in the
evening. D Collect 1 ml of sputum.
11. A nurse is assessing an older client. Which of the following findings should the nurse expect?
Decreased sense of balanced
Increased nighttime sleeping
Heightened sense of pain
Nighttime urinary incontinence
12. A nurse is completing discharge teaching about ostomy care with a client who has a new
stoma. Which of the following instructions should the nurse include in the teaching? (select
all that apply)
“Cut the opening of the pouch ⅛ of an inch larger than the stoma “
“Place a piece a gauze over the stoma while changing the pouch”
“Use povidone-iodine to clean around the stoma”
“Empty the ostomy pouch when it becomes one-third full of contents”
“Expect the stoma to turn a purple-blue color as its heals”
13. A nurse is preparing to obtain informed consent from a client who speaks a different
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