2024 Advanced medsurg proctored
Version A& B WITH 100% CORRECTANSWERS A+ graded
A charge nurse is observing a newly licensed nurse care for a client who is at risk for
falls. Which of the following findings should the nurse identify as a risk factor for falls?
a) Instructs the client to wear...
2024 Advanced medsurg proctored
Version A& B WITH 100% CORRECT-
ANSWERS A+ graded
A charge nurse is observing a newly licensed nurse care for a client who is at risk for
falls. Which of the following findings should the nurse identify as a risk factor for falls?
a) Instructs the client to wear their own socks to
the bathroom
b) Keeps the client's bed in the low position
c) Positions the bedside table close to the client
d) Attaches the call light to the side rail of the
client's bed - CORRECT ANSWERA. Instructs the client to wear their own socks to the
bathroom
A nurse in a long-term care facility is providing care for a client who has Alzheimer's
disease and is
agitated. Which of the following interventions should the nurse implement?
a) Encourage the client to ambulate with a staff member.
b) Isolate the client in their room.
c) Apply bilateral wrist restraints to the client.
d) Administer a prescribed oral dose of trazodone to the client. - CORRECT
ANSWERA. Encourage the client to ambulate with a staff
member.
A nurse is reinforcing teaching with a client who is to begin taking lansoprazole. Which
of the following statements by the client indicates an understanding of the teaching?
a) "I should chew the capsule thoroughly."
b) "I should report episodes of diarrhea."
c) "I should take the medication following a meal."
d) "I should expect the medication to cause indigestion." - CORRECT ANSWERB. "I
should report episodes of diarrhea."
An occupational health nurse is interpreting the results of a tuberculin skin test for a
group of clients
who received the test 48 hr ago. Which of the following clients should the nurse identify
as having a positive test result?
a) A client whose injection site has an elevated area measuring 15 mm (0.6 in)
b) A client who injection site is scabbed
c) A client whose injection site is firm and measures 3 mm (0.1 in)
d) A client whose injection site is ecchymotic - CORRECT ANSWERA. A client whose
injection site has an elevated area
,measuring 15 mm (0.6 in)
A nurse is performing tracheostomy care for a client who has a chronic tracheostomy.
Which of the following actions should the nurse take?
a) Suction the client for 20 seconds with each pass.
b) Apply suction pressure while inserting the catheter into the trachea.
c) Sanitize around the stoma with
povidone-iodine.
A nurse is caring for a client who is taking lithium
and reports persistent nausea and vomiting for 2
days. Which of the following laboratory values should
the nurse report to the provider?
a) Potassium 4.0 mEq/L
b) Lithium 0.9 mEq/L
c) BUN 12 mg/dL
d) Sodium 132 mEq/L - CORRECT ANSWERD. Sodium 132 mEq/L
A nurse is caring for a client who has cancer and has
a WBC count of 4,000/mm3. Which of the following
actions should the nurse take?
a) Cleanse the client's toothbrush with hydrogen
peroxide.
b) Instruct the client to use a disposable razor to
shave.
c) Decrease the client's protein intake.
d) Encourage the client to eat unpasteurized
dairy products. - CORRECT ANSWERA. Cleanse the client's toothbrush with hydrogen
peroxide.
A nurse enters a client's room and sees smoke coming from the bathroom. Which of the
following
actions should the nurse take first?
a) Activate the fire alarm system.
b) Use a fire extinguisher at the source of the
smoke.
c) Assist the client to a nearby common area.
d) Close the doors to the room and to the
bathroom. - CORRECT ANSWERC. Assist the client to a nearby common area.
A nurse is contributing to the plan of care for a client who reports difficulty eating due to
chronic arthritis.
Which of the following interventions should the nurse include in the plan?
a) Apply foam handles to the client's eating
utensils.
b) Obtain a referral for physical therapy.
c) Have an assistive personnel feed the client.
, d) Ask the provider for a prescription for a
pureed diet. - CORRECT ANSWERA. Apply foam handles to the client's eating utensils.
A nurse is obtaining a medication history from a client who is to start taking nitroglycerin
for chest discomfort with activity. Which of the following medications should the nurse
instruct the client to avoid taking within 24 hr of using nitroglycerin?
a) Atorvastatin
b) Metformin
c) Sildenafil
d) Omeprazole - CORRECT ANSWERC. Sildenafil
A nurse is preparing to obtain a postprandial blood glucose level from a client who has
diabetes mellitus. Which of the following actions should the nurse take?
a) Apply the first drop of blood to the test strip.
b) Clean the client's finger with
hexachlorophene.
c) Prick the central tip of the client's finger.
d) Hold the client's finger in a dependent
position. - CORRECT ANSWERD. Hold the client's finger in a dependent
position.
A nurse is reinforcing teaching with a client about breast self-examinations. Which of the
following statements by the client indicates an understanding of the teaching?
a) "It is common for one breast to be larger than
the other."
b) "It is common for the skin on my breasts to
dimple."
c) "I will perform breast exams the day my
period begins."
d) "I will perform breast exams every other
month." - CORRECT ANSWERA. "It is common for one breast to be larger than
the other."
A nurse is reinforcing teaching with a client who has a new ileostomy. Which of the
following statements by the client indicates an understanding of the teaching?
a) "I will need to empty the bag every 4 to 6
hours."
b) "I will use moisturizing soap to clean around
the stoma before applying the bag."
c) "I will use a skin sealant before I apply the
bag."
d) "I will cut the wafer opening one-fourth of an
inch larger than the stoma." - CORRECT ANSWERC. "I will use a skin sealant before I
apply the
bag."
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