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Ch. 55: A nurse educator is reviewing the wound healing process with a group of nurses. The nurse educator should include in the information which of the following alterations for wound healing by secondary intention? (Select all that apply.) A. Stage 3 pressure ulcer B. Sutured surgical incision C. Casted bone fracture D. Laceration sealed with adhesive E. Open burn area - CORRECT ANSWER- - A, E Ch 50 (#2) A nurse is teaching a client who has a new prescription for oxybutynin about managing the medication's anticholinergic effects. Which of the following instructions should the nurse include? A. Take sips of water frequently. B. Wear sunglasses when outdoors in sunlight. C. Use a soft toothbrush when brushing teeth. D. Take the medication with an antacid. E. Urinate prior to taking the medication. - CORRECT ANSWER- - A, B, E Ch 50 (#3) A nurse is reviewing a client's medications. They include cimetidine and imipramine. Knowing that cimetidine decreases the metabolism of imipramine, the nurse should identify that this combination is likely to result in which of the following effects?

A. Decreases therapeutic effects of cimetidine. B. Increased risk of imipramine toxicity. C. Decreased risk of adverse effects of cimetidine. D. Increased therapeutic effects of imipramine - CORRECT ANSWER- - Answer: B Ch 50 (#4): A nurse in an outpatient clinic is caring for a client who has a new prescription for an antihypertensive medication. Which of the following instructions should the nurse give to the client? A. "Get up and change positions slowly." B. "Avoid eating aged cheese and smoked meat" C. "Report any unusual bruising and bleeding to the doctor immediately." D. "Eat the same amount of foods that contain vitamin K every day." - CORRECT ANSWER- A Ch 50 (#5): A nurse in an outpatient medical center is admitting a client for a laparoscopic procedure. The client has a prescription for preoperative diazepam. Prior to administering this medication, which of the following actions is the nurse's priority? A. Teaching the client about the purpose of this medication. B. Giving the medication at the administration time the provider prescribed. C. Identifying the clients medication allergies. D. Documenting the clients anxiety level. - CORRECT ANSWER- - C Ch 49 (#3): During a new employee orientation, a nurse is explaining how to prevent IV infections. Which of the following statements by an orientee indicates understanding of the preventative strategies? A. "I will leave the IV catheter in place after the client completes the coarse of IV antibiotics."

Ch 51 (#1): To promote adherence to medication self-administration, a nurse is making recommendations for an older adult client. Which of the following instructions should the nurse include? (Select all that apply) A. Adjust dosages according to daily weight. B. Place pills in daily pill holders. C. Ask for liquid form of the client has difficulty swallowing pills. D. Ask a relative to assist periodically. E. Request child-resistant caps on medication containers. - CORRECT ANSWER- - B, C, D Ch 51 (#2): A client in a providers office tells the nurse that "I fast for several days each week to control my weight." The client takes several medications for various chronic issues. The nurse should explain to the client that which of the following mechanisms that results from fasting puts her at risk for medication toxicity? A. Increasing the metabolism of the medication over time. B. Increasing the protein-binding response. C. Increasing the medications' transit time through the intestines. D. Decreasing the excretion of the medications. - CORRECT ANSWER- - B Ch 51 (#3): A nurse is preparing medications for a preschooler. Which of the following factors should the nurse identify as altering how a medication affects children? (Select all that apply) A. Increased gastric acid production B. Immature liver C. Higher body water content D. Increased absorption of topical medications

E. Increased gastric emptying time - CORRECT ANSWER- - B, C, D Ch 51 (#4): A nurse is teaching a client who is lactating about taking medications. Which of the following actions should the nurse recommend to minimize in the entry of medication into breast milk? A. Drink 8 oz of milk with each dose of medication. B. Use medications that have an extended half-life. C. Take each dose right after breastfeeding. D. Pump breast milk and freeze it prior to feeding the newborn. - CORRECT ANSWER- - C Ch 51 (#5): A nurse in an outpatient clinic is teaching a client who is in the first trimester of pregnancy. Which of the following statements should the nurse make? A. "You will need to get a rubella immunization if you haven't had one prior to pregnancy." B. "You can safely take OTC medications." C. "You should avoid any vitamin preparations containing iron." D. "Your provider can prescribe a medication for nausea if you need it." - CORRECT ANSWER- - D Ch. 55: A client who had abdominal surgery 24 hr ago suddenly reports a pulling sensation and pain in their surgical incision. The nurse checks the surgical wound and finds it separated with viscera protruding. Which of the following action should the nurse take? (Select all that apply.) A. Cover the area with saline-soaked sterile dressings B. Apply an abdominal binder snugly around the abdomen C. Use sterile gauze to apply gentle pressure to the exposed tissues D. Position the client supine with the hips and knees bent E. Offer the client a warm beverage (herbal tea) - CORRECT ANSWER- - A, D

D. Recommend a screening test for family members - CORRECT ANSWER- - A Ch. 56: A charge nurse is teaching a newly licensed nurse about the care of a client who has methicillin-resistant Staphylococcus aureus (MRSA). Which of the following statements should the charge nurse identify as an indication that the newly licensed nurse understands the teaching? A. "I should obtain a specimen for culture and sensitivity after the first dose of an antimicrobial." B. "MRSA is usually resistant to vancomycin, so another antimicrobial will be prescribed." C. "I will protect others from exposure when I transport the client outside the room." D. "To decrease resistance, antimicrobial therapy is discontinued when the client is no longer febrile." - CORRECT ANSWER- - C Ch. 57: A nurse is performing an admission assessment on a client who has hypovolemia due to vomiting and diarrhea. The nurse should expect which of the following findings? (Select all that apply.) A. Distended neck veins B. Hyperthermia C. Tachycardia D. Syncope E. Decreased skin turgor - CORRECT ANSWER- - C, D, E Ch. 57: A nurse on a medical-surgical unit is caring for a group of clients. The nurse should identify that which of the following clients is at risk for hypovolemia? A. A client who has nasogastric suctioning

B. A client who has chronic constipation C. A client who has syndrome of inappropriate antidiuretic hormone D. A client who took a toxic dose of sodium bicarbonate antacids - CORRECT ANSWER- - A Ch. 21

A nurse is talking with the caregivers of a 10-year-old who is concerned that their child is becoming secretive, including closing the door when showering and dressing. Which of the following responses should the nurse make? A. "Perhaps you should try to find out what is happening behind those closed doors." B. "Suggest that the door be left ajar for safety reasons." C. "At this age, children tend to become modest and value their privacy." D. "You should establish a disciplinary plan to stop this behavior." - CORRECT ANSWER- - C School-age children develop a need for privacy. It is important for the caregivers to show trust in the child and respect the child's need for privacy. Ch. 56: A nurse in a primary care clinic is assessing a client who has a history of herpes zoster. Which of the following findings suggests that the client has postherpetic neuralgia. A. Linear clusters of vesicles on the right shoulder B. Purulent drainage from both eyes C. Decreased white blood cell count D. Report of continued pain following resolution of the rash - CORRECT ANSWER- - D

Ch 48 (#5): A nurse is preparing to administer ketorolac 0.5 mg/kg IV bolus every 6 hr to a school-age child who weighs 66 lb. The amount available is ketorolac injection 30 mg/dL. How many mL should the nurse administer per dose? (Round answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) - CORRECT ANSWER- - Answer: 0.5 mL Ch. 21

A nurse is planning diversionary activities for school-age children on an inpatient pediatric unit. Which of the following activities should the nurse include? (Select all that apply) A. Building models B. Playing video games C. Reading books D. Using toy carpentry tools E. Playing board games - CORRECT ANSWER- - A, B, C, E Ch 48 (#6): A nurse is preparing to administer dextrose 5% in water (D5W) 1,000 mL IV to infuse over 10 hr. The nurse should set the IV infusion pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do nose use a trailing zero.) - CORRECT ANSWER- - Answer: 100 mL/hr Ch 48 (#7): A nurse is preparing to administer acetaminophen 320 mg PO every 4 hr PRN for pain. The amount available is acetaminophen liquid 160 mg/5 mL. How many mL should the nurse administer per dose? (Round answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) - CORRECT ANSWER- - Answer: 10 mL Ch 48 (#8): A nurse is preparing to administer dextrose 5% in lactated Ringer's (D5LR) 1,000 mL to infuse over 6 hr. The drop factor of he manual IV tubing is 15 gtt/mL. The nurse should adjust

the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Do nose use a trailing zero.) - CORRECT ANSWER- - Answer: 42 gtt/min Ch. 7) A nurse is discussing the nursing process with a newly licensed nurse. Which of the following statements by the newly licensed nurse should the nurse identify as appropriate for the planning step of the nursing process? A. "I will determine the most important client problems that we should address." B. " I will review the past medical history on the client's record to get more information." C. "I will carryout new prescriptions form the provider." D. "I will ask the client if their nausea has resolved." - CORRECT ANSWER- - A Rationale: prioritize the clients problems during the planning step of the nursing process Ch. 54: A nurse is delivering an enteral feeding to a client who has an NG tube in place for intermittent feedings. When the nurse pours water into the syringe after the formula drains from the syringe, the client asks the nurse why the water is necessary. Which of the following responses should the nurse make? A. "Water helps clear the tube so it doesn't get clogged." B. "Flushing helps make sure the tube stays in place." C. "This will help you get enough fluids." D. "Adding water makes the formula less concentrated." - CORRECT ANSWER- - A Ch. 7) A charge nurse is talking with a newly licensed nurse and is reviewing nursing interventions that do not require a provider's prescription. Which of the following interventions should the charge nurse include? (SATA) A. Writing a prescription for morphine sulfate as needed for pain

E. The assistive personnel reports that the client walked with a limp - CORRECT ANSWER- A, D, E Rationale: Objective data includes information the nurse measures (vital signs), the nurse observes (skin appearance), and observations of others (family and staff) Ch.

A nurse is talking with caregiver of a 12-year-old child. Which of the following issues verbalized by the caregivers should the nurse identify as the priority? A. "We just don't understand why our child can't keep up with the other kids in simple activities like running and jumping." B. "Our child keeps trying to find ways around our household rules. They always want to make deals with us." C. "We think our child is trying too hard to excel in math just to get the top grades in the class." D. "Our child likes to sing and worries it will make the other kids want to laugh." - CORRECT ANSWER- - A When using the urgent vs. nonurgent approach to client care, the priority issue is the delay in motor skills, which could indicate an illness and requires further investigation. Ch. 53: A nurse is preparing to perform endotracheal suctioning for a client. The nurse should follow which of the following guidelines? (Select all that apply.) A. Apply suction while withdrawing the catheter B. Perform suctioning on a routine basis every 2 to 3 hr C. Maintain medical asepsis during suctioning D. Use a new catheter for each suctioning attempt

E. Apply suction for 10 to 15 seconds - CORRECT ANSWER- - A, D, E Ch 47 (#5): A nurse reviewing a client's health record notes a new prescription for lisinopril 10 mg PO once every day. The nurse should identify this as which of the following types of prescriptions? A. Single B. Stat C. Routine D. Now - CORRECT ANSWER- - C. Routine Rationale: A routine or standing prescription identifies medications to give on a regular schedule with or without a termination date or a specific number of doses. Administer this medication every day until the provider discontinues it. Ch 47 (#4): A nurse educator is teaching newly licensed nurses about safe medication administration. Which of the following statements indicates understanding? (Select all that apply) A. "I will observe for adverse effects." B. "I will monitor for therapeutic effects." C. "I will prescribe the appropriate dose." D. "I will change the dose if adverse effects occur." E. "I will refuse to give a medication if I believe it is unsafe." - CORRECT ANSWER- - A, B, E Ch 47 (#3): A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands the process?

B. Select a site on the client's abdomen C. Use the Z-track technique to displace the skin on the injection site. D. Observe for bleb formation to confirm proper placement. - CORRECT ANSWER- - B. Select a site on the client's abdomen (FYI I saw this as a question on one of the practice exams) Ch 47 (#1): A nurse prepares an injection of morphine to administer to a client who reports pain, then asks a second nurse to give the injection because another assigned client needs to use a bedpan. Which of the following actions should the second nurse take? A. Offer to assist the client who needs the bedpan. B. Administer the injection the other nurse prepared. C. Prepare another syringe and administer the injection. D. Tell the client who needs the bedpan to wait while the nurse gives someone else medication.

• CORRECT ANSWER- - A. Ch 46 (#5): A nurse is teaching an adult client how to administer ear drops. Which of the following statements should the nurse identify as an indication that the client understands? A. "I will straighten my ear canal by pulling my ear down and back." B. "I will gently apply pressure with my finger to the front part of my ear (tragus) after putting in the drops." C. "I will insert the nozzle of the ear drop bottle snug into my ear before squeezing the drops in." D. "After the drops are in, I will place a cotton ball all the way into my ear canal." - CORRECT ANSWER- - B.

(Also saw this exact question on the practice exam but the answers were worded a little differently) Ch 49 (#5): A nurse is caring for a client receiving dextrose 5% in 0.9% NaCl IV at 120 mL/hr. Which of the following statements by the client should alert the nurse to suspect fluid overload? (Select all that apply.) A. "I feel lightheaded" B. "I feel as though my heart is racing" C. "I feel a little short of breath" D. "The nurse technician told me that my blood pressure was 150/90" E. "I think my ankles are less swollen" - CORRECT ANSWER- - B, C, D Ch 50 (#1) A nurse is collecting data from a client who takes haloperidol to treat schizophrenia. Which of the following findings should the nurse document as extrapyramidal symptoms (EPSs)? (Select all that apply) A. Orthostatic hypotension B. Tremors C. Acute dystonia D. Decreased level of consciousness E. Restlessness - CORRECT ANSWER- - B, C, E Ch. 57: A nurse on a medical-surgical unit is caring for a group of clients. For which of the following clients should the nurse expect a prescription for fluid restriction? A. A client who has a new diagnosis of adrenal insufficiency

D. Hyperthyroidism - CORRECT ANSWER- - A Ch. 58: A nurse receives a laboratory report for a client indicating a potassium level of 5. mEq/L. When notifying the provider, the nurse should expect which of the following actions? A. Starting an IV infusion of 0.9% sodium chloride B. Consulting with dietitian to increase intake of potassium C. Initiating continuous cardiac monitoring D. Preparing the client for gastric lavage - CORRECT ANSWER- - C Ch. 58: A nurse is collecting data from a client who has hypercalcemia as a result of longterm use of glucocorticoids. Which of the following findings should the nurse expect? (Select all that apply.) A. Hyperreflexia B. Confusion C. Positive Chvostek's sign D. Bone pain E. Nausea and vomiting - CORRECT ANSWER- - B, D, E Ch. 58: A nurse is providing education for a client who has severe hypomagnesemia and is prescribed oral magnesium sulfate. Which of the following information should the nurse include in the teaching? A. "Avoid green, leafy vegetables while taking this medication." B. "You should receive a prescription for a thiazide diuretic to take with the magnesium." C. "You should eliminate whole grains from your diet until your magnesium level increases."

D. "Report diarrhea while taking this medication." - CORRECT ANSWER- - D Ch. 21

A nurse is planning a health promotions and primary prevention class for the caregivers of school-age children. Which of the following actions should the nurse plan to take? (Select all that apply.) A. Provide information about the risk of childhood obesity. B. Discuss the danger of substance use disorders. C. Promote discussion about sexual issues. D. Recommend the school-age child sit in the front seat of the car. E. Reinforce stranger awareness. - CORRECT ANSWER- - A, B, C, E Ch. 57: A nurse is reviewing the laboratory test results for a client who has an elevated temperature. The nurse should identify which of the following findings as a manifestation of dehydration? (Select all that apply.) A. Hct 55% B. Blood osmolarity 260 mOsm/kg C. Blood sodium 150 mEq/L D. Urine specific gravity 1. E. Blood creatinine 0.6 mg/dL - CORRECT ANSWER- - A, C, D ch11)A nurse is caring for a client who has severe acute respiratory syndrome (SARS). the nurse knows that health care professionals are required to report communicable and infectious diseases. Which of the following illustrate the rationale for reporting? Select all that apply.