The mother of a 25-month-old is discussing her concerns regarding her daughter’s eating habits with the nurse. The most therapeutic response to the mother’s statement, “She is such a fussy eater; it seems that she will only eat dry cereal and cheese” is: 1. “As long as she is eating a little from all the […]
Acupuncture is contraindicated for which of the following clients? 1. A 72-year-old asthmatic 2. A 10-year-old hemophiliac 3. A 23-year-old with Crohn’s disease 4. A 40-year-old who is clinically depressed ANSWER ANS: 2 This treatment is contraindicated in persons who have bleeding disorders, thrombocytopenia, or skin infections or who have a fear of needles. […]
The nurse is going to perform the admission history for a newly admitted client on the medical unit. The optimum time for completion of the history is planned for: 1. Coordination with the physician’s visit 2. The time when the client’s family are visiting 3. Immediately before the client’s scheduled MRI testing 4. After the […]
At an accident scene a nurse stopped and began to provide emergency care for the victims. Her actions are best labeled ethically as: 1. Triage 2. Beneficence 3. Nonmaleficence 4. Respect for persons ANSWER ANS: 2 Beneficence refers to taking positive actions to help others, as in providing emergency care at an accident scene. […]
The appropriate site for taking the pulse of a 2-year-old is: 1. Radial 2. Apical 3. Femoral 4. Pedal ANSWER ANS: 2 The brachial or apical pulse is the best site for assessing an infant’s or young child’s pulse because other peripheral pulses are deep and difficult to palpate accurately. The radial pulse is […]
A nurse forgets to put the call light within the client’s reach and then leaves the room. The client reaches for it and falls out of bed. The nurse could be charged with which of the following? 1. Assault 2. Battery 3. Negligence 4. Criminal intent ANSWER Correct Answer: 3 Rationale 1: Assault is […]
The nurse notes that the tube-fed client has shallow breathing and dusky color. The feeding is running at the prescribed rate. What should the nurse do first? 1. Place the client in high Fowler’s position. 2. Turn off the tube feeding. 3. Assess the client’s lung sounds. 4. Assess the client’s bowel sounds. ANSWER […]
Which of the following is the best example of an intermediate prioritized client need for a client diagnosed with risk of injury related to poor skin integrity? 1. Applying adequate clothing to ensure the client’s warmth 2. Providing sufficient quantities of an aloe-based skin lotion 3. Helping the client select her favorite foods from the […]
The nurse is assessing the pressure ulcer of a 68-year-old female client. Which of the following would indicate to the nurse that healing is taking place? 1. Eschar 2. Slough 3. Granulation tissue 4. Exudate ANSWER ANS: 3 Granulation tissue is red moist tissue composed of new blood vessels, the presence of which in-dicates […]
The nurse needs to obtain a sputum specimen from a client. What should the nurse have the client do? 1. Apply sterile gloves. 2. Clear the throat. 3. Cough to bring up secretions. 4. Rinse the mouth with mouthwash prior to the collection. ANSWER Correct Answer: 3 Rationale 1: The client does not need […]