10/23/24, 6:08 AM RN CONCEPT-BASED ASSESSMENT LEVEL 2 EXAM 2024-2025 QUESTIONS AND CORRECT ANSWERS WITH RATIONALE…
RN CONCEPT-BASED ASSESSMENT LEVEL 2
EXAM 2024-2025 QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES
Terms in this set (110)
A nurse is caring for a Observe the client perform incentive spirometry
client who has pneumonia.
Which of the following When using the airway, breathing, and circulation
actions is the priority for framework, the priority action the nurse should take is
the nurse to take? to observe the client perform incentive spirometry.
-Monitor intake and Incentive spirometry improves gas exchange and
output oxygenation and stimulates coughing, which assists in
-Provide teaching about clearing secretions.
antibiotic therapy
-Administer the influenza
vaccine
-Observe the client
perform incentive
spirometry
,10/23/24, 6:08 AM RN CONCEPT-BASED ASSESSMENT LEVEL 2 EXAM 2024-2025 QUESTIONS AND CORRECT ANSWERS WITH RATIONALE…
A nurse is assessing a The client reports sleeping longer during the night
client who has
hyperthyroidism and has The nurse should recognize that insomnia is a
been taking methimazole manifestation of hyperthyroidism. The client's ability to
for 6 months. Which of the sleep longer during the night indicates a therapeutic
following findings response to the medication.
indicates a therapeutic
response to the
medication
-The client's skin is warm
and moist
-The client reports
sleeping longer during the
night
-The client is experiencing
increased bowel
movements
-The client's weight is 1.4
kg (3.1 lb) less than
baseline
A nurse is planning Monitor the site daily for drainage
discharge teaching for the
guardian of a child who The nurse should instruct the guardian to monitor the
had a cardiac site daily for manifestations of infection, such as
catheterization. Which of drainage, redness, and swelling. The guardian should
the following instructions report these findings to the provider.
should the nurse include?
-Monitor the site daily for
drainage
-Leave the pressure
dressing on the 48 hr
-Administer aspirin if the
child reports pain
-Resume tub baths in 24hr
,10/23/24, 6:08 AM RN CONCEPT-BASED ASSESSMENT LEVEL 2 EXAM 2024-2025 QUESTIONS AND CORRECT ANSWERS WITH RATIONALE…
A nurse is reviewing the 1 kg (2.2 lb) weight gain over the past 2 days
medical record of a client
who is receiving total Total parenteral nutrition is administered to clients
parenteral nutrition for a who have inflammatory bowel disorders and are
malabsorption disorder. unable to tolerate enteral nutrition. A weight gain of
Which of the following 0.5 kg (1.1 lb) daily is an indication that the client is
findings should the nurse responding to the parenteral nutrition.
identify as an indication
that the client's nutritional
status is improving?
-Intake of fluid is less than
output of urine over the
past 2 days
-1kg (2.2 lb) weight gain
over the past 2 days
-Blood glucose 206
mg/dL
-Prealbumin 13 mg/dL
Right upper quadrant
A nurse is performing a
focused assessment on a
The nurse should assess the gallbladder for the
client who has
presence of pain or discomfort as a result of biliary
cholelithiasis and reports
colic, which is caused by a gallbladder stone
pain. Which of the
obstructing the bile duct. The pain can radiate from
following areas should the
the right upper quadrant of the client's abdomen to
nurse assess?
the client's right shoulder.
, 10/23/24, 6:08 AM RN CONCEPT-BASED ASSESSMENT LEVEL 2 EXAM 2024-2025 QUESTIONS AND CORRECT ANSWERS WITH RATIONALE…
The nurse is providing "Consume a clear liquid diet until symptoms resolve"
discharge teaching to a
client about managing The nurse should recommend the client consume a
diverticulitis. Which of the clear liquid diet until manifestations such as abdominal
following statements pain, nausea, and vomiting have resolved. A clear
should the nurse include liquid diet is low in fiber and does not stimulate
in the teaching? intestinal motility.
-"Use bisacodyl
suppositories to stimulate
a bowel movement"
-"Avoid lifting objects
greater than 50 pounds"
-"Consume a clear liquid
diet until symptoms
resolve"
-"Take a probiotic 15
minutes after taking a
prescribed antibiotic to
prevent antibiotic-related
diarrhea"
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