All practice questions

A nurse on a medical-surgical unit is developing a plan of care for a newly admitted adult client who practices Islam. Which nursing interventions demonstrate cultural awareness and sensitivity? Select all that apply.

A preceptor is evaluating a newly licensed nurse on the implementation of clinical safety protocols in a medical-surgical unit. Which of the following actions by the newly licensed nurse demonstrate correct adherence to safety guidelines? (Select all that apply.)

A home health nurse is conducting a visit for a 72-year-old client whose adult child died unexpectedly in a motor vehicle collision two days ago. Upon the nurse's arrival, the client is pacing rapidly, clutching their chest, and crying, 'I cannot breathe, my heart is breaking, make it stop!' The client's 14-year-old grandchild is sitting silently in the corner of the room. Which of the following nursing actions are appropriate? Select all that apply.

A nurse is administering a prescribed intravenous medication to a client via an electronic infusion pump. Shortly after the medication is initiated, the client suddenly reports a severe headache, a tight feeling in the chest, and dizziness. The nurse observes intense facial flushing and notes a rapid, irregular pulse. Recognizing these manifestations as speed shock, in what chronological order should the nurse perform the following interventions? Arrange the actions from first to last.

A registered nurse (RN) is caring for a 75-year-old client experiencing acute delirium secondary to a severe infection. The client is restless, repeatedly attempts to pull out a continuous intravenous (IV) catheter, and tries to climb over the bed rails. The client's visiting adult child becomes frustrated and demands that the nurse physically restrain the client to prevent injury. Which legally sound nursing action should the RN implement first?

A nurse is receiving shift report for a client with severe Crohn's disease who is malnourished and has just been started on continuous total parenteral nutrition (TPN) via a newly placed peripherally inserted central catheter (PICC). Which of the following nursing interventions should the nurse include in the client's daily plan of care? (Select all that apply.)

A home healthcare RN is evaluating an older adult client who lives independently. During the medication reconciliation, the client reports consuming half a bottle of whiskey daily along with a prescribed dose of lorazepam for anxiety. Which of the following nursing interventions should the RN include in the client's plan of care? (Select all that apply.)

A nurse is preparing to witness a client's signature on an informed consent document for a scheduled lumbar laminectomy. The nurse places the document on the bedside table and hands the client a pen. The client hesitates and states, "The doctor said this will fix my back, but I am terrified of being paralyzed. Maybe I should just try physical therapy instead." Arrange the following nursing actions in the correct chronological sequence.

A 55-year-old client is admitted to the telemetry unit with acute chest pain and is scheduled for a cardiac catheterization. The client suddenly removes their telemetry monitor, puts on their street clothes, and states, "I am leaving right now. I don't want any more tests." Which of the following actions by the nurse represent legally sound practice? Select all that apply.

Following a traumatic motor vehicle collision, a young adult client is recovering from an emergent above-the-knee amputation. The client's spouse visits the surgical unit briefly each evening but remains near the doorway, deliberately avoids looking at the residual limb, and states, "I just cannot handle seeing medical things." The client tearfully tells the nurse, "My spouse is disgusted by me and won't be able to help me at home." Which action should the nurse take first to address this support system concern?

A nurse is caring for a client who is 15 minutes into a packed red blood cell (PRBC) transfusion. The client suddenly reports acute lower back pain, severe shortness of breath, and a feeling of impending doom. Arrange the following nursing interventions in the correct prioritized sequence. (Place the first action at the top and the final action at the bottom).

A client is scheduled for an elective partial thyroidectomy. The surgeon has discussed the procedure with the client and left the surgical unit. Before signing the consent document, the client asks the registered nurse, "What exactly did the doctor mean when she said I might have trouble speaking normally after this is done?" Which of the following is the most appropriate action by the nurse?

A nurse is caring for a 32-year-old client admitted to the burn unit with severe facial burns following a workplace accident. While the nurse is preparing for a dressing change, the client turns away from the mirror and states, 'I do not even want my spouse or children to visit me. I look like a monster. They will not be able to stand looking at my face.' Which of the following responses by the nurse demonstrate effective therapeutic communication? Select all that apply.

A client with severe cardiogenic shock is receiving a continuous intravenous (IV) infusion of milrinone via a single $22\text{-gauge}$ peripheral catheter. The client rapidly develops severe dyspnea, diffuse pulmonary crackles, and an oxygen saturation of $82\%$. The healthcare provider prescribes a stat dose of IV bumetanide. Upon consulting the pharmacological reference, the nurse notes that bumetanide and milrinone are physically incompatible. Which of the following is the most appropriate nursing action?

A nurse in an outpatient primary care clinic is conducting health screenings and wellness assessments for several clients. Which action by the nurse demonstrates the correct application of evidence-based health screening guidelines and assessment principles?

An oncology nurse is providing palliative care to a client with terminal pancreatic cancer who identifies as a devout Buddhist. The client is currently reporting severe abdominal discomfort. When the nurse prepares to administer a scheduled intravenous opioid analgesic, the client refuses the medication, stating, "I must keep my consciousness completely clear for my transition. My state of mind at death will determine my next incarnation." Which action is the most appropriate for the nurse to take?

A nurse is assuming care for a client with severe Crohn's disease who is receiving continuous total parenteral nutrition (TPN) via a double-lumen central venous catheter. The client is currently resting comfortably. Which of the following nursing interventions are appropriate for managing this client's parenteral therapy? Select all that apply.

A home healthcare psychiatric nurse evaluates a client with severe major depressive disorder who began taking a selective serotonin reuptake inhibitor (SSRI) three weeks ago. During previous visits, the client exhibited severe psychomotor retardation, flat affect, and hygiene deficits. Today, the client is meticulously dressed, speaks with elevated energy, and hands the nurse a highly prized vintage watch, stating, "I want you to have this because I finally feel completely at peace." Which of the following is the priority action for the nurse?

A client is scheduled for a below-the-knee amputation due to severe and progressive peripheral arterial disease. The client signed the informed consent document the previous day. Today, as the nurse approaches to administer the prescribed preoperative intravenous midazolam, the client withdraws their arm and states, "I cannot go through with this. I would rather die with my leg attached." Arrange the following nursing actions in the correct order of priority from first to last.

The charge nurse on a medical-surgical unit is coordinating room assignments for four newly admitted clients. Which client must be placed in a private room with monitored negative-pressure airflow?