Which of the following interventions, regarding personal hygiene for a client who is unconscious, performed by ancillary personnel requires immediate follow-up by the RN? 1. Storing the damaged dentures in the client’s bedside stand 2. Shaving the client’s mustache to facilitate the nasogastric tube 3. Postponing the daily bath until the client’s temperature has stabilized […]
The nurse is visiting the day care center for routine assessment of the children. After spending time with the children in one of the playrooms, the nurse suspects that a child has a visual deficit as a result of observing: 1. Poor balance and gait 2. An increase in weight 3. Sitting and rocking back […]
A 46-year-old client has had kidney disease for the past 10 years. His kidneys are no longer functioning. The nurse knows that which of the following offers the client the potential for res-toration of normal kidney function? 1. Lasix therapy 2. Hemodialysis 3. Peritoneal dialysis 4. Kidney transplant ANSWER ANS: 4 Unlike the other […]
The client has an enlarged thyroid gland and is currently admitted to a medical nursing unit. Which of the following is accurate regarding the procedure for a thyroid assessment for this cli-ent? 1. Deep palpation should be used anterior and posterior. 2. Swallowing sips of water causes the isthmus of the thyroid gland to rise. […]
To avoid legal risks and possible lack of confidentiality associated with computerized documen-tation, many programs currently have: 1. Periodic changes in staff passwords 2. Thumbprint identification restrictions 3. All nursing staff uses the same access code 4. Only centralized medical records use the client data ANSWER ANS: 1 A good system of computerized documentation […]
The nurse is checking the client’s overall oxygenation. In assessment of the presence of central cyanosis, the nurse will inspect the client’s: 1. Palms and soles of the feet 2. Nail beds 3. Earlobes 4. Tongue ANSWER ANS: 4 Central cyanosis is observed in the tongue, soft palate, and conjunctiva of the eye, where […]
Levels of prevention are used by the nurse to provide a framework or guide for nursing interven-tions. Focus is based on the client’s needs and the care or service that is provided. An example of a true health promotion service is a(n): 1. Aerobic dance class 2. Immunization clinic 3. Diabetic support group 4. Smoking […]
Which nursing intervention is appropriate when caring for a client with a retention catheter? 1. Don sterile gloves. 2. Gently retract the labia majora away from the urinary meatus. 3. Observe urine in the drainage bag. 4. Retape the catheter to the thigh. ANSWER Correct Answer: 4 Rationale 1: Gloves are to be worn […]
An active 25-year-old female client shared with the nurse that ever since she had gone on a high-protein low-carbohydrate diet she had suffered from constipation. The client states that the diet is working for her in terms of weight loss and would like to stay on it. The best response from the nurse is that […]
A nurse educator assigned students an activity to implement Socratic questioning in their daily lives. Which of the following is a question about reason using this technique? 1. “What makes you think cramming for a test is an ineffective way to study?” 2. “What other ways of studying could you implement?” 3. “If you didn’t […]
