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1.A nurse is reinforcing with a client who has oral candidiasis and is to begin therapy with nystatin oral suspension. The nurse should tell the client to take which of the following actions? 1. Gargle with a commercial mouthwash before administering the medication. 2. Scrape off white patches on the tongue using a swab prior to medication administration. 3. Retain the medication in the mouth before swallowing. 4. Take the medication 1 hr before meals. 2.A nurse is caring for a client who has arthritis and reports he does not exercise because it is too painful. Which of the following actions should the nurse suggest? 1. Repeat the same number of exercises regardless of pain level. 2. Exercising in water will help with pain. 3. Think of something pleasant while exercising to reduce pain. 4. Soak affected joints in water that is 48.9 degrees( 120 degrees Fahrenheit) to ease pain. 3.A nurse is reinforcing teaching with a female client who has a history of urinary tract infections. Which of the following instructions should the nurse include? 1. Urinate before and after sexual intercourse. 2. Increase milk consumption to make the urine more alkaline. 3. Empty the bladder at least every 6 hr. 4. A nurse is caring for a client who has undergone hemodialysis. Which of the following findings should the nurse report to the provider? 1. Vibration at fistula site 2. Decrease in weight 3. Headache 4. Fatigue 5. A nurse working in a provider’s office is caring for a client who received penicillin 15 min ago to treat strep throat. Which of the following is the priority finding the nurse should report to the provider? 1. Hypertension 2. Nausea 3. Arthralgia 4. Abdomen pain 6. A nurse is caring for a client who is 1 day postoperative following an appendectomy. Which of the following should the nurse report? 1. Serosanguineous drainage at the incision site 2. Hypoactive bowel sounds in all four quadrants 3. Temperature 37.2 degrees(99 degrees Fahrenheit) 4. Red streaks along the incision 7. A nurse is caring for a client who has a prescription for a cerebrahanglogram. Which of the following actions should the nurse take? 1. Maintain the client NPO for 2 to 3 hr. 2. Instruct the client to limit activity for 48 hr following the procedure. 3. Inform the client she will receive sedation to prevent claustrophobia. 4. Determine if the client has an allergy to shellfish. 8. A nurse is caring for an older adult client immediately following a bronchoscopy with biopsy. Which of the following is the priority actions the nurse should take? 1. Instruct the client to gargle with warm saline. 2. Check for a gag reflex. 3. Document sputum color and consistency. 4. Differ ice chips 9. A nurse is reinforcing teaching with a client about increasing her intake of fiber. Which of the following foods should the nurse encourage the client to eat? 1. Fears 2. Cheese 3. Eggs 4. Yogurt 10. A nurse is caring for a client who has a tracheostomy tube. Upon data collection, the nurse observes the client is restless and hears crackles in the lungs. Which of the following interventions should the nurse take? 1. Check the cuff pressure. 2. Increase the humidification. 3. Perform suctioning. 4. Instill saline into the tubing. 11. A nurse is reinforcing teaching with a client who has a new ileostomy. Which of the following statements by the client indicates an understanding of the teaching? 1. ´´I will use a skin sealant before I apply the bag.´´ 2. ´´I will cut the wafer opening one-fourth of an inch larger than the stoma.´´ 3. ´´I will use moisturizing soap to clean around the stoma before applying the bag.´´ 4. ´´I will need to empty the bag every 4 to 6 hours.´´ 13. A nurse is monitoring a client who is undergoing a blood transfusion of packed RBCs. The nurse should recognize that which of the following findings indicates fluid overload? 1. Bradycardia 2. Pruritus 3. Fever 4. Dyspnea 14. A nurse is caring for a client who has a new prescription for nitroglycerin. The nurse should monitor for which of the following adverse effects of the medication? 1. Fever 2. Nocturia 3. Flushing 4. Increased saliva production 15. A nurse is collecting data from a client who is taking metoprolol. Which of the following findings should the nurse expect? 1. Decreased heart rate 2. Increased blood glucose level 3. Increased blood pressure 4. Decreased bronchospasms 16. A nurse is reinforcing teaching with a client who has gastroesophageal reflux disease. Which of the following dietary instructions should the nurse include? 1. Drink carbonated beverages with meals. 2. Use a straw when drinking liquids. 3. Limit meals to three per day with no snacking in between. 4. Chew food thoroughly. 17. A nurse is reinforcing teaching with a client who has diabetes mellitus about reducing the risk for a stroke. Which of the following statements by the client indicates an understanding of the teaching? 1. ´´My risk for a stroke increases if my HDA1c level is 6 percent or less.´´ 2. ´´Having a total cholesterol level below 200 mg/dL increases my risk for a stroke.´´ 3. ´´My provider might prescribe a glucocorticoid regimen to decrease my risk for a stroke.´´ 4. ´´I can decrease my risk for a stroke by losing excess weight.´´ 18. A nurse is reinforcing teaching with a client who has celiac disease. Which of the following statements by the client indicates an understanding of the teaching? 1.´´I eat rice cakes instead of toast.´´ 2. ´´I no longer eat corn or nuts.´´ 3. ´´I cook soups with barley instead of egg noodles.´´ 4. ´´Í have switched to non dairy coffee creamer.´´ 19. A nurse is caring for a client who has a closed head injury. In which of the following positions should the nurse place the client? 1. Semi-Fowler´s 2. Sims’ 3. Modified Trendelenburg 4. Prone 20. A nurse is assisting in teaching a group of nurses about pain management for older clients. Which of the following information should the nurse include in the teaching? 1. Reassess the effectiveness of the pain relief measures every 3 hr. 2. Use nonpharmacological measures as a substitute for pain medication. 3. Recognize that a cognitive impaired older adult client can identify the intensity of pain. 4. Withhold pain medication until the client reports a pain level of 6 or higher on a scale from 0 to 10. 21. A nurse is preparing to enter the room of a client who has tuberculosis. Which of the following personal protective equipment should the nurse wear? 1. Surgical mask 2. Nonrebreather mask 3. Respirator mask 4. Venturi mask 22. A nurse is caring for a client who is postoperative following a right total knee arthroplasty. Which of the following actions should the nurse take ? 1. Apply the CPM device over the knee immobilizer. 2. Elevate the head of the bed 30 degrees before starting the CPM device. 3. Ensure the knee joint is positioned over the CPM device frame joint. 4. Ensure the hip is in full abduction when applying the CPM device. 23. A nurse is caring for a client who is receiving an IV bolus and whose site has infiltrated, identify the sequence in which the nurse should remove the IV catheter. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.) 1. Clamp the IV tubing. 2. Hold the client’s arm above the level of the heart. 3. Remove the dressing and tape from the venipuncture site. 4. Withdraw the catheter from the client’s vein 24. A nurse is caring for a client who has stomatitis due to chemotherapy. Which of the following is an appropriate food choice for the nurse to offer? 1. Milk shake 2. Fresh fruit 3. Tomato soup 4. Dry toast 25. A nurse is reinforcing teaching about foods containing potassium with a client who has a new prescription for hydrochlorothiazide. Which of the following foods should the nurse recommend as the best source of potassium? 1. ½ cup cucumber slices 2. ½ cup okra 3. 1 cup apricot slices 4. 1 cup pineapple chunks 26. A nurse is reviewing the ABG value of a client who has pneumonia. Which of the following indicates the client is developing respiratory acidosis? 1. Pa02 85 mm Hg 2. pH 7.47 3. HC02 25 mm Hg 4. PaCO2 55 mm Hg 27. A nurse is assisting with the administration assessment of a client who has late-stage emphysema. The nurse should recognize which of the following as an expected finding? 1. Chubbing of the fingernails 2. Elevated body mass index 3. Slow, deep respiration 4. Flushed facial skin 29. A nurse is reinforcing dietary teaching with a client who has neutropenia. Which of the following foods should the nurse encourage the client to consume? 1. Fresh fruit 2. Broiled chicken 3. Raw vegetables 4. Soft-boiled eggs 30. A nurse is reinforcing teaching with a client who is prescribed levothyroxine for a thyroid disorder. Which of the following information should the nurse include in the teaching? 1. Take the medication with an aluminum-containing antacid. 2. Expect to discontinue the medication after 1 month. 3. Notify the provider if resting pulse is less than 80/min. 4. Administer the medication 1 hr before breakfast. 31. A nurse is reinforcing discharge teaching with a client who had an abdominal hysterectomy 2 days ago. Which of the following instructions should the nurse include in the teaching? 1. ´´Expect bright red vaginal bleeding for 1 week following surgery.´´ 2. Douche with warm water to remove vaginal discharge.´´ 3. ´´Avoid climbing stairs for 8 weeks.´´ 4. ´´Take a shower rather than a tub bath.´´ 32. A nurse is caring for a client who has deep-vein thrombosis. Which of the following interventions should the nurse plan to take? 1. Place the client’s bed in reverse Trendelenburg position. 2. Measure the calf of the affected extremity each shift. 3. Massage the affected extremity every 4 hr. 4. Apply cold compresses to the affected extremity. 33. A nurse is caring for a client who has diabetes mellitus. Which of the following laboratory findings indicates the client has maintained control of his blood glucose levels for the past 3 months? 1. Fasting blood glucose 100 mg/dL 2. HbA1c 12.5% 3. Fasting blood glucose 70 mg/dL 4. HbA1c 6.5% 34. A nurse is monitoring a client who is receiving intravenous fluids. Which of the following findings indicates a fluid volume excess? SATA 1. Hypertension 2. Flat neck veins 3. Weight gain 4. Bradycardia 5. Dyspnea 35. A nurse is reinforcing teaching about ways to promote health with an older adult client. Which of the following statements by the client indicates the teaching was effective? 1. ´´I will limit my dietary fat to 40% of my total calories.´´ 2. ´´I will exercise for 30 minutes five times per week.´´ 3. ´´I will socialize with my friends on a regular basis.´´ 4. ´´I will apply sunscreen on cloudy days when going outside.´´ 5. ´´I will get an influenza vaccination every 2 years.´´ 36. A nurse is reinforcing teaching with a client who is being discharged following a prostatectomy. Which of the following statements should the nurse include in the teaching? 1. ´´You might see blood in your urine after coughing.´´ 2. ´´You may take aspirin for mild pain.´´ 3. ´´You should shower instead of taking a tub bath.´´ 4. ´´You may resume sexual intercourse after 2 weeks.´´ 5. ´´You should avoid lifting objects that weigh more than 8 pounds.´´ 37. A nurse in a long-term care unit is assisting in the care of a client who has Alzheimer’s disease. Which of the following actions should the nurse take? 1. Participate in reminiscence therapy with the client. 2. Alternate the client´s daily routine. 3. Keep the lights dimmed. 4. Raise the four side rails on the client’s bed. 38. A nurse is contributing to the plan of care for a client who has disuse syndrome following cast removal from a lower extremity. Which of the following referrals should the nurse include in the plan of care? 1. Social worker 2. Dietitian 3. Occupational therapist 4. Herbalist 39. A nurse is caring for a client who has hypocalcemia. For which of the following findings should the nurse monitor? 1. Decreased bowel sounds 2. Increased blood pressure 3. Tetany 4. Lethargy 40. A nurse is reinforcing health promotion education at a community health fair. Which of the following statements by attendees indicates understanding of the teaching? 1. ´´I will examine my breasts a week after each menstrual period.´´ 2. ´´I should get a hepatitis B vaccine on a yearly basis.´´ 3. ´´I do my testicular self-exam every 6 months without fail´´ 4. ´´The flu shot I received last year will last me for 2 years.´´ 41. A nurse is reinforcing urinary bladder training for a client who has urge incontinence. Which of the following instructions should the nurse include? 1. Drink citrus juice with breakfast. 2. Keep a voiding diary for 3 days. 3. Void as soon as the urge occurs. 4. Restrict fluids to meal time. 42. A nurse is reinforcing teaching about a heart-healthy diet with a client. Which of the following statements by the client indicates that the teaching was effective? 1. ´´I will eat chicken as my source of fiber.´´ 2. ´´I will increase my intake of lean red meat.´´ 3. ´´I will increase my servings of canned vegetables.´´ 4. ´´I will use skim milk as my source of diary.´´ 43. A nurse is reinforcing teaching about the use of an insulin pen with a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching? 1. ´´I will hold the pen upside-down to select the appropriate dose.´´ 2. ´´I will shake the pen before injecting the insulin.´´ 3. ´´I will aspirate before injecting the insulin.´´ 4. ´´I will apply a disposable needle on the cartridge.´´ 44. A nurse is reinforcing teaching with a client who will undergo a colonoscopy the following week. Which of the following instructions should the nurse include? 1. Restrict the diet to clear liquids for 1 to 3 days before the procedure. 2. Administer enemas 2 days before the procedure. 3. Do not eat or drink anything except water for 12 hr before the procedure. 4. Expect the provider to schedule another procedure to remove any polyps. 45. A nurse in a provider’s office is reviewing the medical record of a client. Based on the information provided in the medical record, which of the following findings places the client at risk for breast cancer? 1. BRCA1 result 2. Obstetric history 3. Biopsy result 4. Race 46. A nurse is prioritizing care for four clients following change-of-shift report. Which of the following clients should the nurse attend to first? 1. A client who has Alzheimer’s disease and requires assistance to the bathroom 2. A client who has diverticulitis and a temperature of 38.3 degrees( 100.9 degrees Fahrenheit). 3. A client who has a prescription for a sputum specimen to be obtained before breakfast. 4. A client who sustained a head injury 2 days ago and has a decreased level of consciousness. 47. A nurse is assisting with the admission of a client who has multiple sclerosis. Which of the following sections is the priority for the nurse to take? 1. Determine the client’s ability to see the buttons on the call light. 2. Encourage the client to verbalize her feelings. 3. Discuss the possible changes in family roles. 4. Assist the client and family locating a community support group. 48. A nurse working the night shift is caring for an older adult client who has dementia and is at risk for falls. Which of the following actions should the nurse take? 1. Raise all four side rails while the client is in bed. 2. Move the overbed table away from the bed. 3. Leave the television on in the client’s room. 4. Apply a motion sensor mat to the client’s bed. 49. A nurse is reinforcing teaching about meal planning with a client who has hypertension. Which of the following statements by the client indicates an understanding of the teaching? 1. ´´I can have a bologna sandwich.´´ 2. ´´I can have canned soup.´´ 3. ´´I can season food with ketchup.´´ 4. ´´I can season food with vinegar.´´ 50. A nurse is transporting a client who has pneumonia and is on droplet precautions to radiology. Which of the following safety measures should the nurse take while transporting the client? 1. The client should wear a gown during transport. 2. The nurse should wear a gown during transport. 3. The client should wear a mask during transport. 4. The nurse should wear a mask during transport.

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