All practice questions

A clinical educator at a skilled nursing facility is reviewing the admission assessments completed by newly hired nurses. Which of the following documented findings for a 77-year-old client should the educator identify as expected physiological adaptations of the normal aging process? Select all that apply.

A nurse is caring for a client in the final stages of terminal lung cancer. The client is unresponsive and exhibiting a Cheyne-Stokes respiratory pattern. The client's spouse is crying at the bedside and asks the nurse, "I know he is dying, but I just want him to wake up and talk to me one last time. Should I try to wake him?" Which of the following is the most appropriate response by the nurse?

During a routine health maintenance visit, a clinic nurse evaluates a toddler who just turned two years old. Based on standard pediatric growth and development guidelines, which assessment findings indicate the client is achieving age-appropriate milestones? Select all that apply.

A community health nurse is conducting a health screening for a 25-year-old client who discloses the regular use of injectable anabolic-androgenic steroids for competitive bodybuilding. Which statements by the nurse are appropriate to promote harm reduction and health maintenance? Select all that apply.

A client with a documented history of severe chronic obstructive pulmonary disease (COPD) is brought to the emergency department by a caregiver. The caregiver reports that the client has become increasingly lethargic and confused over the past four hours. The healthcare provider orders an arterial blood gas (ABG) analysis on room air. Which of the following ABG results indicates an acute loss of compensatory mechanisms requiring immediate airway management?

A client with severe decompensated heart failure is admitted to the intensive care unit with a double-lumen peripherally inserted central catheter (PICC) in place. Lumen 1 is infusing continuous dobutamine, and Lumen 2 is infusing continuous $0.9\%$ sodium chloride. The healthcare provider prescribes stat intravenous (IV) furosemide, a continuous IV heparin infusion, and a scheduled dose of IV potassium chloride. Which actions by the nurse are appropriate? Select all that apply.

A public health nurse is designing a competency assessment for newly hired registered nurses regarding the epidemiological framework of disease prevention. Which of the following interventions should be identified as secondary prevention strategies? (Select all that apply.)

A neonate born at 32 weeks gestation had a birth weight of $1800\text{ g}$. On day 3 of life, the neonate's current weight is $1650\text{ g}$. The healthcare provider prescribes a total daily fluid intake of $120\text{ mL/kg/day}$ based on the neonate's current weight. The neonate is receiving the following therapies:

- Enteral formula feedings of $13\text{ mL}$ every 3 hours via orogastric tube.
- Intravenous (IV) ampicillin every 12 hours. Each antibiotic dose is diluted in $5\text{ mL}$ of normal saline.

The remaining fluid requirement will be administered as a continuous IV infusion of 10% dextrose in water (D10W). The antibiotic volume is included in the total daily fluid intake. What is the required infusion rate for the continuous D10W, in $\text{mL/hr}$, to ensure the neonate receives exactly the prescribed total daily fluid intake? Record your answer using one decimal place.

A client on a telemetry unit requires strict bed rest after undergoing a percutaneous coronary intervention via the right femoral artery. During the immediate post-procedure period, the client reports a mild lower back ache and needs personal hygiene care. Which nursing interventions are appropriate for this client? (Select all that apply.)

A nurse is preparing to hang an intravenous infusion of cyclophosphamide when the bag accidentally drops, spilling the liquid antineoplastic medication onto the floor. Arrange the following nursing actions in the correct sequence to safely manage this incident.

A nurse is caring for a 68-year-old client with symptomatic anemia (hemoglobin 6.8 g/dL) who is prescribed a packed red blood cell (PRBC) transfusion. To reduce the risk of adverse reactions and ensure safe administration, place the following steps in the correct chronological order.

A nursing care coordinator at a primary care clinic is auditing client charts to ensure adherence to national health maintenance guidelines. Which of the following planned actions indicates that the coordinator correctly applies evidence-based screening principles?

A nurse is observing staff members handle various hazardous and infectious materials on a medical-surgical unit. Which observed actions indicate appropriate infection control and safety practices? Select all that apply.

A nurse in the intensive care unit is caring for a client who weighs $187\text{ lbs}$ and is receiving a continuous intravenous infusion of norepinephrine for septic shock. The medication is supplied as $4\text{ mg}$ of norepinephrine in $250\text{ mL}$ of $5\%$ dextrose in water ($D_5W$). The infusion is currently running at $17\text{ mL/hr}$.

The client's current vital signs include a heart rate of $112\text{ bpm}$ and a blood pressure of $82/46\text{ mmHg}$ (mean arterial pressure [MAP] $58\text{ mmHg}$).

The provider's prescribed titration parameters state: "Titrate norepinephrine infusion by $0.02\text{ mcg/kg/min}$ every 5 minutes to maintain a MAP $\geq 65\text{ mmHg}$."

Based on the client's current MAP, the nurse performs one titration increase. What should the nurse set the new infusion pump rate to in $\text{mL/hr}$? (Record answer to the nearest tenth.)

A nurse provides care for a client hospitalized with a severe respiratory infection. During the shift, the client repeatedly activates the call bell for minor demands, attempts to touch the nurse's arm, and makes sexually explicit remarks regarding the nurse's appearance. Which of the following is the priority behavioral intervention for the nurse to implement?

A nurse is preparing to transfer a client who is 2 days postoperative following a right total hip arthroplasty (posterior approach) from the bed to a bedside chair. In what order should the nurse perform the following actions? (Arrange the steps in the correct sequential order)

A nurse is caring for a client with community-acquired pneumonia who has a continuous primary intravenous (IV) infusion of 0.9% sodium chloride running at 75 mL/hr. The healthcare provider prescribes an intermittent dose of IV ceftriaxone to infuse over 30 minutes. Arrange the following steps in the correct order for safely setting up and initiating the secondary infusion using a gravity drip system.

A client on a busy cardiovascular step-down unit becomes increasingly agitated. The client's room is brightly lit, and multiple monitor alarms are continuously sounding. The client points frantically at the electrocardiogram (ECG) lead wires on their chest and shouts, 'Get these worms off of me!' Which of the following nursing interventions should the nurse implement to manage this perceptual alteration? Select all that apply.

A nurse is preparing to administer an intermittent intravenous (IV) secondary medication (piggyback) to a client who has a continuous primary IV infusion of $0.9\%$ sodium chloride. Which of the following actions should the nurse take to ensure safe administration? Select all that apply.

A nurse is developing a plan of care to maintain skin integrity and provide comfort for an older adult client who is immobile. Which of the following interventions is the most appropriate for the nurse to include?