The nurse has completed nasopharyngeal suctioning of a client. What should the nurse document about this procedure? 1. Amount, consistency, color, and odor of sputum 2. Amount of sterile solution used to flush the catheter 3. Lung sounds before the procedure 4. Lung sounds after the procedure 5. Oxygen saturation after the procedure ANSWER […]
The nurse has assigned the vital signs of the elderly clients residing in the facility’s assisted living unit to the nursing assistant. Which of the following statements made by the ancillary personnel requires immediate correction by the RN? 1. “As you age your blood pressure may go up, but it doesn’t have to if your […]
A client seeking care for stress tells the nurse that he is interested in seeking holistic care that in-corporates body, mind, and spirit. The nurse knows that which of the following CAM therapies may be beneficial to him? 1. Chiropractic medicine 2. Chinese medicine 3. European phytomedicine 4. Allopathic medicine ANSWER ANS: 2 Includes […]
Which of the following statements made by a nursing student concerning the use of critical thinking and client care requires follow-up by the nursing instructor? 1. “I feel it’s good practice to always have alternative interventions in mind.” 2. “I trust my feelings about a client’s needs since I work hard at knowing my cli-ent.” […]
The newly enacted Health Insurance Portability and Accountability Act (HIPAA) of 2003 re-quires: 1. Insurance coverage for all clients 2. Policies on how to report communicable diseases 3. Limits on information and damages awarded in court cases 4. Safeguards to protect written and verbal information about clients ANSWER ANS: 4 The Health Insurance Portability […]
The nurse sits on a chair alongside a client’s bed to discuss the postoperative nursing care the cli-ent will receive. The therapeutic outcome of sitting beside the client is that: 1. The nurse-client relationship will be strengthened 2. The client will feel less threatened by the nurse’s presence 3. The nurse can appear more relaxed […]
During the physical examination, the nurse should assess the client’s glands by using the: 1. Dorsum of the hand 2. Pads of the fingers 3. Palmar surface of the hand 4. Fingertip grasp of the tissue ANSWER ANS: 2 To assess the client’s glands, the nurse should use the pads of the fingers and […]
A client reports following the “food pyramid” to guide nutritional intake. How should the nurse evaluate this information? 1. Because this food pyramid is produced by the U.S. Department of Agriculture, the client is likely consuming necessary levels of all essential nutrients. 2. The food pyramid is most useful when applied to the nutritional intake […]
Which of the following statements, made by the daughter of an older adult client concerning bring her mother home to live with her family, presents the greatest concern for the nurse? 1. “If this doesn’t work out, she can always go to live with my sister.” 2. “I don’t think she will react very well […]
The nurse best displays an understanding of the role the skin plays in monitoring the body sys-tems and their ability to function properly when documenting which of the following regarding a 70-year-old client? 1. Skin appears generally jaundiced. 2. Dryness noted on heels and elbows bilaterally. 3. Skin tears present on upper left and right […]
