The nurse notes that a client has an elevated cholesterol level. Which health problem is
this client at risk for developing?
1. Osteoarthritis
2. Ischemic stroke
3. Hemorrhagic stroke
4. Traumatic brain injury
Before beginning a surgical procedure the safety checklist is reviewed. Which
information is necessary prior to starting this client’s case?
1. Date of birth
2. Known allergies
3. Last urine output
4. Family members’ names
The nurse is preparing a client for a liver biopsy. In which position should the client be
placed?
1. Sims position
2. Seated in a chair
3. Leaning forward
4. Right arm raised and extended over the left shoulder
While working on the orthopedic unit, the nurse finds an assigned client pulseless and
not breathing. When the code team responds, which action by the nurse is appropriate?
1. Leaving the room and calling the family members to notify them of the sudden
change in the client’s condition
2. Getting the crash cart and emergency supplies that will be needed by the code team
3. Participating in the code in whatever role is necessary
4. Standing at the bedside and answering questions as they arise
The nurse positions the client on the sling, wheels the lift into position, and connects the
sling to the lift. Which are priority safety measures prior to lifting the client?
Standard Text: Select all that apply.
1. Locking the wheels of the lift
2. Opening the base to the widest position
3. Lowering the side rails
4. Checking that the hooks are correctly placed and that matching chains are of equal
length
5. Facing the hooks toward the client
The nurse receives this order: “Administer Ativan (lorazepam) 0.1 mg IV whenever
seizure occurs.” The nurse recognizes this as which type of medication order?
1. Stat order
2. Single order
3. Routine order
4. PRN order
The nurse notes that an older client is withdrawn and has lost weight over the last few
weeks. What should the nurse suggest to help this client?
1. Setting firm limits
2. Maintaining a calm quiet approach
3. Talking about feelings of depression
4. Attending the bingo game in the dining room
A comatose client is being positioned supine. What should be done to maintain the
functional alignment of this client’s hands?
1. Externally rotate the arms
2. Cross the arms over the chest
3. Elevate the upper arms on pillows
4. Place a rolled washcloth in each hand
The nurse is inserting a small-bore nasogastric tube. Which action by the nurse is
appropriate when completing this procedure?
1. Removing the stylet prior to inserting the tube into the client’s nose
2. Measuring from the tip of the client’s nose to the xiphoid process to determine length
of tube to be inserted
3. Checking the nares for patency prior to passing the catheter
4. Applying sterile gloves before beginning the procedure
The nurse is completing the preoperative checklist on the night shift in preparation for
the client’s surgery, scheduled for 0800. Which tasks could the nurse complete at this
time?
1. Documenting the time of last voiding
2. Checking the medical record for the history, physical, and signed informed consent
3. Administering preoperative medication
4. Removing the prosthesis
The nurse is assisting the health care provider insert a chest tube into a client with a
hemothorax following a motor vehicle crash. Which should the nurse don in order to
assist with this procedure?
Standard Text: Select all that apply.
1. Sterile gown
2. Sterile gloves
3. Mask with eye shield
4. Mask
5. Clean gown
The nurse is assigned to care for a newly admitted client. Which approach should be
used to address the client’s responses to the illness?
1. Best practices
2. Nursing process
3. Critical thinking
4. Evidence-based practice
The nurse is caring for a client who developed an infection after admission to the
hospital. Which term should the nurse use when documenting this infection?
1. Idiopathic infection
2. Bacterial infection
3. Health care-associated infection
4. Therapeutic infection
Which task could be safely delegated by the nurse to the unlicensed assistive personnel
(UAP)?
1. Caring of the client with the newly placed cast
2. Explaining to the client how to respond to itching under the cast
3. Caring of the insertion site for Crutchfield tongs
4. Caring of the client with a stable cast
The nurse is caring for a client who feels like something is crawling through the hair.
The client also has small, white dandruff-like particles along the hairline. Which term
should the nurse use when documenting this client’s health problem?
1. Alopecia
2. Hirsutism
3. Pediculosis
4. Scabies
The nurse is initiating IV therapy for an adult client who requires IV fluid infusion for
2″3 days and might require blood administration. What should the nurse choose as the
best option for IV catheterization?
1. Butterfly
2. Huber needle
3. Angiocatheter
4. Implantable venous access device
The nurse is concerned that a home care client is experiencing abuse. What information
did the nurse use to make this clinical determination?
1. New bruises on various body parts
2. Client states oldest daughter moved home
3. Next door neighbor brought homemade soup
4. Bank phoned because social security check will be delayed one day