The nurse is concerned that atelectasis may develop as a postoperative complication. Which of the following is an appropriate diagnostic label for this problem, should it occur? 1. Impaired gas exchange 2. Decreased cardiac output 3. Ineffective airway clearance 4. Impaired spontaneous ventilation ANSWER ANS: 1 A potential etiology for impaired gas exchange may […]
A home safety measure specific for a client with diminished olfaction is the use of: 1. Smoke detectors on all levels 2. Extra lighting in hallways 3. Amplified telephone receivers 4. Mild water heater temperatures ANSWER ANS: 1 A reduced sensitivity to odors means that the client may be unable to smell a smoldering […]
A nurse has worked in the trauma critical care area for several years. Which of the following noises may become indiscriminate for this particular nurse? 1. A client with audible breathing 2. Moaning of a client in pain 3. Whirring of ventilators 4. Co-workers discussing their clients’ conditions ANSWER Correct Answer: 3 Rationale: Nurses […]
A nurse is planning interventions for the clients of a homeless shelter. Which of the activities represents a primary level intervention regarding sexually transmitted diseases? 1. HIV screening for all residents 2. Sex education for teenage residents 3. Treatment for residents diagnosed with AIDS 4. Gynecological referrals for female residences ANSWER ANS: 2 Primary […]
The nurse is to administer several medications to the client via the N/G tube. The nurse’s first ac-tion is to: 1. Add the medication to the tube feeding being given 2. Crush all tablets and capsules before administration 3. Administer all of the medications mixed together 4. Check for placement of the nasogastric tube […]
The nurse is caring for a client receiving pain medication through an epidural catheter. What should the nurse include to ensure safety when caring for this client? 1. Secure all tubing connections with gauze. 2. Apply tape over all injection ports on the tubing. 3. Cleanse the insertion site with alcohol swabs once a day. […]
A nursing instructor is researching the implementation of assigning study guides for homework points and the effect this has on the students’ test grades. The instructor reports group data for published research. This is an example of which of the rights in research? 1. Right of full disclosure 2. Right of confidentiality 3. Right of […]
A client just had a baby following a long labor and difficult delivery. Which of the following nursing diagnoses is formulated correctly? 1. Constipation, due to tissue trauma, manifested by no bowel movement for 2 days 2. Risk for infection, because of new incision, related to episiotomy 3. Ineffective breast-feeding, related to lack of motivation, […]
A home health client is having difficulty with the medication regimen that is prescribed by the physician. The nurse helps with this situation by consulting the pharmacist for ideas on how to improve the situation. This is an example of which of the following? 1. Hands-on care 2. Direct care 3. Advocacy 4. Indirect care […]
With advancing age, which of the following normal physiological changes in sensory function occurs? 1. Decreased sensitivity to glare 2. Increased number of taste buds 3. Difficulty discriminating vowel sounds 4. Decreased sensitivity to pain ANSWER ANS: 4 Older adults experience tactile changes, including declining sensitivity to pain, pressure, and temperature. Older adults have […]
