• A young adult female client with recurrent pelvic pain for 3 year returns to the clinic for relief of severe
dysmenorrhea. The nurse reviews her medical record which indicates that the client has endometriosis. Based on
this finding, what information should the nurse provide this client?
A) Oral contraceptives increase the symptoms of endometriosis. B) The symptoms of endometriosis can increase
with menopause.
C) An option to diagnose disease extent and provide therapeutic treatment is laparoscopy. D) Infertile is
successfully treated with removal of intra-abdominal endometrial lesions.
• A 75-year-old female client is admitted to the orthopedic unit following an open reduction and internal fixation of
a hip fracture. On the second postoperative day, the client becomes confused and repeatedly asks the nurse she
is. What information for the nurse to obtain?
A. Use of sleeping medications. B. History of alcohol use,
C. Use of antianxiety medications, D. History of this behavior.
• The nurse is assessing and elderly bedridden client. Which finding indicates that the turning and
positioning schedule is effective in protecting the client’s skin?
A. Reddened skin areas disappear within 15 minutes of being turned and positioned. B. No complaints of pressure or pain
are verbalized by the client after being turned C. Only small areas of redness remain longer than 30 min after the client is
turned. D. The client verbalizes feeling better after being turned and positioned
• A client with a liver abscess develops septic shock. A sepsis resuscitation bundle protocol is initiated and
the client receives a bolus of IV fluids. Which parameter should the nurse monitor to assess effectiveness
of the fluid bolus?
• A 17-year –old male is brought to the emergency department by his parents because he has been coughing
and running a fever with flu-like symptoms for the past 24 hours. Which intervention should the nurse
implement first?
A. Obtain a chest X-ray per protocol. B. Place a mask on the client’s face.
C. Assess the client’s temperature.
D. Determine the client’s blood pressure
• An older client is admitted for repair of a broken hip. To reduce the risk for infection in the postoperative
period, which nursing care interventions should the nurse include in the client’s plan of care? (Select all
that apply)
A. Teach client to use incentive spirometer q2 hours while awake.
B. Remove urinary catheter as soon as possible and encourage voiding.
C. Maintain sequential compression devices while in bed.
D. Administer low molecular weight heparin as prescribed
E. Assess pain level and medicate PRN as prescribed.
• A client is scheduled to receive an IW dose of ondansetron (Zofran) eight hours after receiving
chemotherapy. The client has saline lock and is sleeping quietly without any restlessness. The nurse caring
for the client is not certified in chemotherapy administration. What action should the nurse take?
Ask a chemotherapy-certified nurse to administer the Zofran
Administer the ondasentron (Zofran) after flushing the saline lock with saline Hold the scheduled dose of Zofran until the
client awakens
Awaken the client to assess the need for administration of the Zofran.
• The nurse note a visible prolapse of the umbilical cord after a client experiences spontaneous rupture of the
membranes during labor. What intervention should the nurse implement immediately?
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