ATI 2019 Fundamentals Proctored Exam final

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1. A nurse is planning care for a group of clients. Which of the fol-
d. Providing postmortem care to a client
lowing tasks should the nurse delegate to an assistive personnel?
2. A nurse is conducting a health assessment for a client who
takes herbal supplements. Which of the following statements by
C. I use ginger when I get car sick
the client indicates an understanding of the use of the supple-
ments?
3. A nurse is caring for a client who has influenza and isolation
precautions in place. Which of the following actions should the A. Wear a mask when working within 3 feet of the client
nurse take to prevent the spread of infection?
4. A nurse obtains a prescription for wrist restraints for a client who
C. Allow room for two fingers to fit between the clients skin and the
is trying to pull out his NG tube. Which of the following actions
restraints
should the nurse take?
5. A nurse is admitting a client who has tuberculosis. Which of the
following types of transmission precautions should the nurse plan A. Droplet
to initiate?
6. A nurse in a well-child clinic receives a telephone call from
a parent who states that their child accidentally swallowed paint
A. Have your child drink one large glass of water.
thinner. The child is awake and alert. Which of the following re-
sponses should the nurse make?
7. A nurse is documenting a client's medical record. Which of the
B. Administered pain medication
following entries should the nurse record.
8. A nurse is providing oral care for a client who is unconscious.
A. Place the client in a side-lying position.
Which of the following actions should the nurse take?
9. A nurse is collaborating with a risk management team about
potential legal issues involving client care. The nurse should iden- C. A nurse begins a blood transfusion without obtaining consent.
tify which of the following situations is an example of negligence?
10. A nurse is collecting a sputum specimen for culture from
a client who has a respiratory infection. Which of the following B. Offer the client oral hygiene after the collection
actions should the nurse take?
11. A nurse is assessing an older client. Which of the following
a. Decreased sense of balanced
findings should the nurse expect?
a. "Cut the opening of the pouch 1D8 of an inch larger than the
stoma " YES
12. A nurse is completing discharge teaching about ostomy care b. "Place a piece a gauze over the stoma while changing the
with a client who has a new stoma. Which of the following in- pouch" YES
structions should the nurse include in the teaching? (select all that c. "Use povidone-iodine to clean around the stoma" YES
apply) d. "Empty the ostomy pouch when it becomes one-third full of
contents" YES
e. expect the stoma to turn a purple-blue color as its heals" NOPE
13. A nurse is preparing to obtain informed consent from a client
who speaks a different language than the nurse. Which of the c. "Offer written information in the client's language"
following actions should the nurse take?
14. A nurse is teaching a client about home care equipment.
Which of the following information should the nurse include in the a. "Avoid using wool blankets when receiving oxygen"
teaching? (select all that apply) b. check the O2 delivery rate at least once a day
d. "Keep the oxygen delivery system 0.6 m (2 feet) from any heat c. align the middle of the ball in the flow meter with the line of the
source" Nope prescribed flow rate
e. "Lay the oxygen tank flat when storing" Nope
15. A nurse is planning care for a client who reports insomnia.
Which of the following actions should the nurse perform shortly a. Provide a late supper.
before bedtime?
16. A nurse on a medical-surgical unit is receiving a
c. A client who has new onset of dyspnea 24hr after a total hip
change-of-shift report for four clients. Which of the following
arthroplasty •
clients should the nurse see first?
17. A nurse is reviewing a client's intake and output and notes
the following: 0.9% sodium chloride 600mL IV infusion, cefazolin
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250 mg in dextrose 5% in water 100mL intermittent IV bolus,
200mL emesis, 40mL voided urine, and 20mL urine from straight
catheterization. The nurse should record the client's net fluid
700 mL
intake as how many mL? (Round the answer to the nearest whole
number. Use a leading zero if it applies. Do not use a trailing zero.)
DOSAGE CALCULATION
18. A nurse is discussing incident reports with a group of newly
licensed nurses. The nurse should include that which if the fol- a. A client's prescribed laboratory testing was not obtained
lowing requires the completion of an incident report?
19. A nurse is caring for a client who has a new prescription
for negative-pressure therapy for a chronic wound. The nurse is
d. The policy and procedure manual
unfamiliar with the procedure. Which of the following resources
should the nurse consult to learn more about the intervention.
20. A nurse is performing postural drainage with percussion and
vibration for a client who has cystic fibrosis. Which of the following d. Perform percussion over the lower back
actions should the nurse take?
21. A nurse is preparing to administer diphenhydramine 20 mg
orally to a 6-year-old child who has difficulty swallowing pills.
Available is diphenhydramine 12.5mg/5ml oral syrup. Which of the
8ml
following images indicates the correct number of mL the nurse
should administer? (round answer to the nearest whole number.)
DOSAGE CALCULATION
22. A nurse is admitting a client who is malnourished. The client
states, "My wedding ring is loose and I'm worried I will lose it if it
d. I can put it in a locked storage unit for you
falls off."Which of the following is an appropriate response by the
nurse?
23. A charge nurse is teaching a group of newly licensed nurses
about the use of restraints. In which of the following clinical situ- d. When the client poses a threat to self
ations should the nurse apply restraints?
24. To ensure client safety, a nurse manager is planning to ob-
serve a newly licensed nurse perform a straight catheterization
d. Client advocate
on a client. In which of the following roles is the nurse manager
functioning?
25. A charge nurse in a long-term care facility is preparing an
educational program about delirium for newly hired nurses. Which c. "Delirium has an abrupt onset."
of the following statements should the nurse plan to include?
26. A nurse is speaking with a client who has recently received a
diagnosis of a chronic illness. The client states, " The doctor must
be wrong. I can't be that sick". The nurse should inform the client b. Denial
that their reaction is an example of which of the following expected
responses to grief?
27. A Nurse on a medical-surgical unit is providing care for four
d. the family of a client who has a terminal illness asks the provider
clients. The nurse should identify which of the following situations
not to tell the client the diagnosis
as an ethical dilemma?
28. A nurse is teaching a client about performing breast self-ex-
d. "I should make circular motions with my fingertips under my
aminations. Which of the following statements by the clients indi-
arms."
cates an understanding of the teaching?
29. A nurse is preparing to transfer a client who is partially weight
bearing from the bed to the chair. Which of the following actions d. Have the client bear weight on her stronger leg
should the nurse take?
30. A nurse is caring for a client following a laparoscopic cholecys-
1. perform hand hygiene
tectomy. The client has a prescription for ondansetron 4mg IV bo-
2. select the injection port of the IV tubing closest to the client
lus every 6hr PRN for nausea and vomiting. Identify the sequence
3. cleanse the injection port with an antiseptic swab
of steps the nurse should follow to administer the medication. (
4. aspirate for blood return
Move the steps into the box on the right, placing them in the order
5. inject the medication
of performance. Use all the steps.)

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31. A nurse is teaching a client who has diabetes mellitus about
d. I should roll the vial of NPH insulin between my hands before
mixing regular and NPH insulin. Which of the following statements
drawing it up
made by the client indicates an understanding of the teaching
32. A nurse is assessing the body temperature of an adult client
a. Slide the probe across the clients forehead
using a temporal artery thermometer. Which of the following ac-
c. Hold the client's hair aside while performing the procedure
tions should the nurse take? (Select all that apply)
33. A nurse is preparing to insert a peripheral IV catheter into the
client's arm. Which of the following actions should the nurse take b. Dangle the client's arm over the edge of the bed
to help dilate the vein?
34. A nurse is preparing to suction a client's tracheostomy tube.
a. Apply intermittent suction during catheter insertion
Which of the following actions should the nurse plan to take?
35. A nurse is assessing a client who received morphine for
severe pain 30 mins ago. Which of the following finding is the d. Respiratory rate 7/min
nurse's priority?
36. A nurse is caring for a client who has been treated multiple
times for STIs. Which of the following responses should the nurse c. "Let's explore why this might be re-occuring"
take?
37. A nurse enters the room of a client who has a seizure disorder.
The client is sitting in a chair and begins to experience a seizure. c. Help the client lie on the floor
Which of the following actions should the nurse take first?
38. A nurse is testing a client for conduction deafness by perform-
c. Place the base of a vibrating tuning fork on the top of the client's
ing Weber's test. Which of the following actions should the nurse
head
take when performing this test?
39. A nurse is obtaining the medication history of a client who
asks about taking ginkgo biloba. The nurse should identify which
a. Warfarin
of the following medications can interact adversely with this sup-
plement?
40. A nurse is obtaining informed consent from a client who is
scheduled for surgery. The client states, "I don't want to go through
d. Document the client's decision in the medical record
with the procedure." Which of the following actions should the
nurse take?
41. A nurse is caring for a client who is postoperative and has a
new prescription to advance her diet to full to full liquids. Which of
d. Plain Yogurt
the following foods should the nurse offer the client as a part of a
full liquid diet?
42. A nurse is providing teaching to a client about reducing the
adverse effects of immobility. Which of the following statements d." I will perform ankle and knee exercises every hour."
by the client indicates an understanding of the teaching?
43. A nurse is preparing a client who has terminal cancer for
discharge. Which of the following questions should the nurse ask d. " What Techniques do you use to cope with stress?"
when assessing the client's psychosocial history?
44. A nurse is performing a skin assessment on an older adult
c. Reduced sweat production
client. Which of the following findings should the nurse expect?
45. A nurse is caring for a client who begins to cry after receiving
a diagnosis of cancer. Which of the following responses should c " it must be difficult for you to receive this kind of news."
the nurse make?
46. A nurse is preparing to obtain a health history from a client.
b. Tell the client the purpose for collecting the information.
Which of the following actions should the nurse take?
47. A nurse is caring for a client who has brain cancer and is
transferring to hospice care. The client's son tells the nurse, " I
a. " Let's talk more about your dad's condition."
don't know what to tell my dad if he asks how he is going to die."
Which of the following is an appropriate response by the nurse?
48. A Nurse is preparing to administer several medications to a
client. Which of the following data should the nurse plan to use to d. The client's telephone number
confirm the client's identity?

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49. A nurse is caring for a client who is prescribed a special diet.
The client is concerned that he does not have the resources to
purchase the food he needs to adhere to the diet at home. The a. Social worker
nurse should notify which of the following members of the health
care team.
50. A nurse is teaching a newly licensed nurse about the care
of a client who has a methicillin resistant Staphylococcus aureus
a. " I will place the client in a Private room."
(MRSA) infection. Which of the following statements by newly
licensed nurse indicates an understanding of the teaching?
51. A nurse is planning care for a client who reports having a
latex allergy. Which of the following interventions should the nurse a. Cover the blood pressure cuff with a stockinette.
include in the plan?
52. A nurse is caring for a client who is scheduled for surgery.
While the nurse is witnessing the client's signature, the client
states, " I trust my doctor, but I don't understand what is meant b. Notify the Provider.
by resecting my intestines." Which of the following actions should
the nurse take?
53. A nurse is documenting client care. Which of the following
c. "BRP" for bathroom privileges
abbreviations should the nurse use?
54. A nurse is preparing to bathe a client who has dementia. Which
c. Use distractions when bathing the client.
of the following actions should the nurse take?
55. A hospice nurse is caring for a client who has end stage
cancer. Which of the following interventions should the nurse b. Refrain from discussing the client's prognosis
include to promote the client's dignity?
56. A nurse is caring for a client who has a closed wound drainage
d. Press straight down on the container to create vacuum.
system. Which of the following actions should the nurse take?
57. A nurse receives a telephone prescription from a provider for a
client who is experiencing pain. Which of the following responses a. " Will you please spell the name of that medication for me?"
should the nurse make?
58. During change of shift report, a nurse discovers she over-
looked a prescription for a type and cross-match of a client who is a. Inform the provider of the delay in obtaining the type and
to have surgery the next day. Which of the following actions should cross-match.
the nurse take first?
59. A Nurse is caring for client who has pneumonia. The nurse
should recognize which of the following should be discarded in a a. An emesis basin filled with blood from severe coughing
biohazard bag?
60. A nurse is caring for a client who is receiving enteral feedings
via NG tube. Which following actions should the nurse take prior a. Check for gastric residual volume
to administering the formula?
61. A nurse is caring for a client immediately following the insertion
of an NG tube. Which of the following should indicate to the nurse b. The client is coughing
that the tube is placed incorrectly?
62. A nurse is inserting an NG tube for a client who requires gastric
decompression. Which of the following actions should the nurse b. Measure the pH of the gastric
take to verify proper placement of the tube?
63. A nurse is caring for a client who reports a pain level of 5 on
a scale from 0-10. The client informs the nurse that pain meds
a. Would you like to get you a back massage?
are not an option for managing pain. Which of the following is an
appropriate response by the nurse?
64. a nurse is caring for a client who has an extracellular fluid
volume deficit. Which of the following findings should the nurse b. Postural hypotension
expect?
65. A nurse is caring for a client who is immunocompromised b. Cleanse hands with an alcohol based hand rub before client
which of the following actions should the nurse take? contact
b. The cephalic vein in the left distal forearm

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66. Which of the following veins should the nurse select when
initiating iv therapy?
67. What interventions should the nurse take to prevent skin
d. Apply a moisture barrier ointment after perineal hygiene
breakdown?
68. client tells the nurse" I am looking forward to seeing my
grandchildren grow up." the nurse should identify the client is d. Denial
experiencing which of the following stages of grief?
69. A nurse is teaching a client about the care and use of hearing
aids. Which of the following instructions should the nurse include b. Turn the hearing aid off and the volume down before insertion
in the teaching?
70. A nurse is teaching a client about the care and use of hearing c. Check the client's pupil reaction when focusing on distant and
aids. Which of the following should the nurse take? nearby objects
71. A nurse is teaching the assistive personnel about upper body
mechanics to prevent injury. Which of the following actions by the a. holding the object close to the body
AP demonstrate an understanding of the teaching?
72. A nurse is assessing a client who is immobile and notices a
red area over the client's coccyx. Which of the following actions c. Assess the red area for blanching
should the nurse take?
73. A nurse is planning care to prevent skin breakdown for a
client who is immobile and has urinary incontinence. Which of the a. request a prescription for an indwelling urinary cath
following actions should the nurse include in the plan of care.
74. A nurse is teaching a client who had an enucleation about care
of an artificial eye. Which of the
following information should be included in the teaching? (select c. Apply pressure just below artificial eye to break the suction
all that apply) d. Clear the artificial eye with hydrogen peroxide before storing
a. Store the artificial eye in the label container filled with 0.9% e. Retract the upper and lower lids to reinsert the artificial eye
sodium chloride irrigation
b. Remove from the artificial eye by retracting the upper eyelid
75. A nurse is caring for a client who is 2 days postoperative
following bowel resection and reports sudden severe abdominal b. Expose the client's abdomen to look for changes in appearance
pain. Which of the following actions should the nurse take first?
76. A nurse is providing care for a client who is to undergo a total
laryngectomy. Which of the following interventions is the nurses d. For the client explain the techniques of esophageal speech
priority?
77. A home care nurse is teaching a client about home safety.
Which of the following statements by the client indicates an un- a. I will use the bars when getting in and out of the bath tub
derstanding of the teaching? (select all that apply) b. I need to check my medications for expiration dates
d. I will apply tape over frayed areas of electrical cords c. I need to have a fire escape plan with my family
e. I need to set my hot water heater to 140 degrees Fahrenheit
78. A nurse in an emergency department is assessing a client who
reports a right lower quadrant pain, nausea and vomiting for the
c.Auscultate bowel sounds
past 48 hours? Which of the following actions should the nurse
take first?
79. A nurse is caring for a client who recently received a diagnosis
of terminal cancer. Which of the following statement by the client a. I don't know of if I will be able to meet his physical needs.
partner indicates maladaptive coping?
80. A nurse is planning care for a client who has a stage 1
pressure ulcer on the right heel. The nurse should anticipate b. Transparent
application of which of the following dressings?
81. A nurse is caring for a client who has brain cancer and is
transferring to hospice care. The client's son tells the nurse "I don't a. "lets discuss your concerns about your father," or anything along
know what to tell my dad if he asks how he is going to die". Which those lines that is therapeutic.
of the following is an appropriate response from the nurse?
82. a nurse is teaching an older adult client who has type 2 a. I can apply lotion to soften the calluses as long as I don't put
diabetes mellitus about how to care for corns and calluses toes. lotion between my toes

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Which of the following statements by the client indicates under-
standing of the teaching?
83. A nurse is caring for a client who has wrists restraints after an
episode of violent behavior. Which of the following actions should c. Remove one restraint at a time
the nurse take?
84. A nurse is admitting a client who has a clostridium difficile
infection. Which of the following actions should the nurse take? b. wear a gown and gloves when providing client care
Select all that apply c. assign the client to a private room with positive air flow
a. Use an N95 respirator while providing client care d. wash hands with soap and water after contact with the client
e. Ensure the client does not receive fresh fruits
85. A nurse is planning care for a client who has latex allergy
and is scheduled for surgery. Which of the following actions is
appropriate to include in the clients plan of care?
a. Schedule the client as the first surgical procedure of the day
a. Schedule the client as the first surgical procedure of the day
b. Cleanse the stoppers with primidone iodine for withdrawing
medication
c. Remove the stop stocks from iv tubing
d.Ensure the gloves in the surgical suite are powdered gloves
86. A nurse is providing discharge teaching to a client who does
not speak the same language as the nurse. Which of the following a. direct verbal discharge instruction to the interpreter
action should the nurse take?
87. A nurse is teaching a client how to self-administer daily low
dose heparin injections. Which of the following factors is most a. The client's belief that his needs will be met through education
likely to increase the clients motivation to learn?
88. A nurse is caring for a client who is receiving continuous en-
d. Aspirate residual volume every 4 hours (Every 4-8 hours is
teral feedings through gastrostomy tubes. Which of the following
correct)
actions should the nurse take?
89. A nurse is caring for a client who has an incisional wound
and a prescription for wound care. Which of the following answers a. use a different sterile swab for each stroke
indicates the proper method of cleaning a wound site?
90. A nurse is teaching a client who requires maximum support
c. The client stands with her elbows slightly flexed while holding
about how to use a two wheeled walker. Which of the following
the walker
actions by the client indicates an understanding of teaching?
91. A nurse is caring for a client who refuses to follow the providers
prescription for bed rest. The nurse over hears the assistive per-
sonnel tell the client that if she does not remain in bed he will c. Assault
place her in restraints. The nurse should identify that the AP is
committing which of the following torts?
92. A nurse is preparing to insert an IV catheter for an older adult
client who has fragile skin. Which of the following actions should b. Engorge the vein by placing the arm in the dependent position
the nurse take?
93. A nurse is planning care for a client who has a new prescription
for parental nutrition in 20% dextrose and fat emulsion. Which of
a. Prepare the client for a central venous line
the following is the appropriate action to indicate in the plan of
care?
94. A nurse is caring for a client who is agitated and threatening
to harm others. The nurse places the client in restraints but does
a. False imprisonment
not notify the provider or obtain a prescription for the restraints.
The situation respects which of the following torts?
95. A nurse is conducting a Webber test on a client. Which of the
a. Place an activated tuning fork in the middle of the client's head
following is an appropriate action for the nurse to take?
96. A nurse on a medical unit is caring for a group of clients. For
a. Changing the brief of an older client who has Clostridium difficile
which of the following tasks should the nurse wear a face shield.
97. An adult client tells a nurse about recent lack of sleep due to
changing to a night shift job. Which of the following interventions b. Listen to soft music before lying down
should the nurse suggest?

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98. A nurse is caring for a client who has a new diagnosis of
fibromyalgia. The client tells the nurse that she wants to use
a. You should ask the provider if she recommend traditional Chi-
traditional Chinese medicine for treatment instead of the med-
nese medicine.
ication prescribed by her provider. Which of the following is an
appropriate response by the nurse?
99. A nurse is caring for a client who reports that she has in-
somnia. Which of the following interventions is appropriate for the a. Eat a light carbohydrate snack before bedtime
nurse to recommend?
100. A nurse is teaching a group of newly licensed nurses about
the Braden scale. Which of the following responses by a newly d. The scale measures six elements
licensed nurse indicates understanding in the teaching?
101. A nurse is planning care for client who is scheduled for an
intravenous pyelogram. Which of the following actions is appro- a. Ensure the client is free of metal objects
priate for the nurse to include?
102. A staff nurse is teaching a newly hired nurse about alterna-
tives to the use of restraints on clients who are confused. Which a.Use full length side rales on the client's bed
of the following instructions should the staff nurse include
103. A nurse is planning to obtain a blood sample from a client for
capillary blood glucose posttest. b. The lateral aspect of the finger
Which of the following should the nurse take to obtain the sample?
104. A nurse is planning to discharge a client who has diabetes
c. Determine whether the client can afford the insulin administra-
and a new prescription for insulin which of the following actions
tion supplies
should the nurse plan to complete first?
106. A nurse is delegating client's care to the assistive personnel. a. obtain input & output for the patient that was stable, ADLs,
Which of the following tasks should the nurse delegate to the AP? specimen collection, I&O, vital signs if stable
107. A nurse is teaching about home safety with. Which of the a. Use electrical tape to secure extension cords next to base
following instructions should the nurse include? boards on the floor
108. A nurse is caring for a client who has restraints to each
extremity. Which of the following assessment should the nurse c. Peripheral pulses
perform first?
109. A nurse in a long-term care facility is assessing a client.
Which of the following findings should the nurse recognize as an a. Seepage of liquid stool
indication of fecal impaction?
110. A nurse is caring for a client who has a tracheostomy which d. Secure the tracheostomy ties to allow one finger to fit snuggly
of the following actions should the nurse take? underneath
111. A nurse is caring for a client who has a drainage evacuator.
Collapse the device of air after emptying.
Which of the following is an appropriate action by the nurse?
112. A nurse is preparing to transfer a client who is partially weight
bearing from the bed to a chair. Which of the following action a. Have the client bear weight on her stronger leg
should the nurse take?
113. A nurse in an acute care facility is preparing to transfer a
client to a long-term facility. Which of
the following information should be nurse include in the hand off a
report?
a. Effectiveness of the last dose of pain medication
114. A nurse is providing teaching to a client who is self-administer
an ophthalmic solution. Which of the following statements by the
client indicates understanding of the teaching?
a. I will keep my eyes closed for 5 mins after inserting drops
c
b. I will insert the drops in the center of the eye
c. I will press the inner corner of my eye after insert
drops
d. I will raise my eye lid up while looking down and insert drops
115. A nurse in a long-term care facility is planning care for
4 clients. Which of the following client's is at greatest risk of
developing a pressure ulcer?
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a. A client who is incontinent of urine 1 to 2 times a day
b. A client who is receiving enteral tube feedings
d
c. Client who requires assistance to transfer from the bed to a
chair d. Client who is unresponsive to pain stimuli
116. A nurse is assessing a client's personal hygiene. Which of
the following findings indicates that the client might have difficulty
with routinely bruising their teeth?
A. Theclientsmucosaismoist b
B. The client gums feel spongy
C. The client has a missing tooth
D. The Client's tongue is a dull red color
118. A community health nurse is teaching a group of clients
about kegel exercises to prevent urinary incontinence. Which of A. Contract your pelvic muscle when performing the exercises
the following instructions should the nurse include?
119. A nurse is assessing the skin of a client who has worked
outdoors for the past 20 years. Which of the following findings is B. A change in appearance of a mole on the shoulder
the nurse's priority?
120. A nurse is caring for a client who has a high fever. Which of
C apply a bath blanket between the client and a cooling blanket
the following actions should the nurse take?
121. A nurse is caring for an infant who is to undergo surgery. The
nurse should identify which of the following individuals should sign
the consent form?
A. The infants 17 year old mother a
B. The infants provider
C. The infants grandmother
D. The mother's 21 year old sibling
122. A nurse is assisting in the use of a fracture bedpan for a
D. Place the shallow end of the fracture pan under the clients
client who is immobile due to a cast. Which of the following actions
buttocks.
should the nurse use?
123. A nurse is reviewing the medical record of a client who asks
about the use of a
magnet therapy for pain relief. The nurse should identify which of
the following findings is a contraindication for receiving this type
of therapy? d
A. The client is allergic to penicillin B. The client has a prescription
for metoprolol
C. The client has a history of alcohol use disorder
D. The client has an implanted defibrillator
124. A nurse is caring for a client who requires airborne precau-
tions. The nurse is preparing to leave the clients room following
a dressing change. Which of the following pieces of personal
protective equipment should the nurse remove first?
a
A. Gloves
B. Eyewear
C. Gown
D. Mask
125. A nurse is teaching a newly licensed nurse about the care of
a client who has
methicillin resistant staphylococcus aureus (MRSA) infection.
Which of the following statements by the newly licensed nurse
indicates an understanding of the teaching?
a. I will wear an N95 respirator mask when caring for the client c
b. I will tell the clients visitors to wear a mask when they are within
3 feet of the client.
c. I will place the client in a private room
d. I will remove my gown before my gloves after providing client
care.
127. A nurse is preparing to insert an IV catheter for an adult client.
Which of the following actions should the nurse take?
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A.choose the most proximal site on the extremity selected
B. apply a cool compress for several minutes before insertion of
the IV catheter d
C. place the tourniquet below the proposed insertion site
D. place the extremity in a dependent position
128. A nurse is teaching a client who is about to undergo a
bowel resection about advance directives. Which of the following
instructions should the nurse include in the teaching?
A.Your partner must be present when you sign the advance direc-
tives b
B. You will receive written information about advance directives
prior to signing
C. You are required to sign advance directives prior to surgery
D. Your provider must sign the advance directives before surgery
129. A nurse is caring for a client who has wrist restraints after an
episode of violent behavior. Which of the following actions should
a
the nurse take?
a. Remove one restraint at a time
130. A nurse is preparing to administer several medications via
NG tube to a client who is receiving a continuous tube feeding.
Which of the following actions should the nurse take?
A. Dilute each crushed medication with sterile water
c
B. Mix the medication together in a single syringe
C. Flush the NG tube with 5mL of sterile water prior to adminis-
tration D. Combine the medication with the formula in the feeding
bag
131. A nurse is planning care for a client who has urinary in-
continence. Which of the following interventions should the nurse
include in the client's plan of care?
a. Toilet the client every 4hr while the client is awake
b
b. Apply a moisture barrier in a thick layer to vulnerable skin areas
c. Cleanse the skin with antibacterial soap and hot water after
each incontinence episode
d. Reduce the clients daily fluid intake
132. A nurse is caring for a client who has a prescription for a 250
mL IV fluid bolus. The nurse administers a 500 mL IV bolus. Which
of the following actions should the nurse take first?
A. Complete an incident report b
B. Obtain the client's vital signs
C. Document the fluid infusion in the client's chart
D. Report the incident in to the unit manager
133. A home health nurse is teaching a client about home safety.
Which of the following statements by the client indicates an un-
derstanding of the teaching? (SATA)
a, b, c
- I need to check my medications for expiration dates
- I will use the grab bars when getting in and out of the bathtub
- I need to have a fire escape plan with my family
134. A nurse is discussing the stages of general adaptation syn-
drome with a newly
licensed nurse. The nurse should identify that which of the follow-
ing manifestations occurs during the alarm reaction stage?
a
A. Dilated pupils
B. Physical exhaustion
C. Bradycardia
D. Depression
135. A nurse is preparing to administer IV fluids to a client. The
nurse notes sparks when plugging in the IV pump. Which of the
a
following actions should the nurse take first?
A. Unplug the pump

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B. obtain a replacement pump
C. Notify the biomedical department to fix the pump
D. Label the pump with a defective equipment sticker
136. A nurse is caring for a client who is receiving a warm,
moist compress to relieve lower back pain. Which of the following
findings should indicate to the nurse that the compress has been
effective?
c
A. The client's skin on the lower back is intact without redness
B. The client's laughing at a television show
C. The client states that he is able to concentrate while eating D.
The clients's vital signs are within the expected reference range
137. A nurse is preparing a sterile field to assist with suturing a
clients laceration. Which of the following actions should the nurse
plan to take?
A. Pour the sterile solution with the bottle 20cm(8in) above the
sterile bowl
b
B. Hold the bottle of sterile solution so that the label is facing the
palm of the hand
C. Place the lid of the sterile solution bottle face down on the sterile
drape
D. Apply sterile gloves before opening the bottle of sterile solution
138. A nurse is caring for a client who is scheduled to have his
alanine amino transferase (ALT) level checked. The client asks
the nurse to explain the laboratory test. Which of the following is
an appropriate response by the nurse?
d
A. This test will determine if your heart is performing properly
B. This test will indicate if you are at risk for developing blood clots
C. This test is used to check how your kidneys are working
D. This test will provide information about the function of your liver
139. A nurse receives a new prescription over the telephone from
a client's provider. Which of the following actions should the nurse
take first?
A. Ensure that the provider signs the prescription
c
B. Write down the complete prescription
C. Read back the prescription to the dr
d. Document the prescription as a telephone prescription in the
medical record
140. A nurse is caring for a client who is on bed rest following
abdominal surgery. Which of the following findings indicates the
need to increase the frequency of position changes?
A. Petechiae on the client's right anterior thigh d
B. Flat rash on the client's ankle
C. non-palpable macule on the client's left shoulder
D. Non Blanching darkened area over the client's trochanter
141. A nurse is providing teaching to a client who has a newly
prescribed hearing aid. Which of the following statements by the
client indicates an understanding of the teaching?
A. After insert the hearing aid, i will turn it up as high as it will go
d
B. I should leave the battery in the hearing aid when i take it out
to sleep
C. I will need to get a new hearing aide every year
D. I should gradually increase the time that i wear the hearing aid
142. A nurse is preparing to collect a specimen from a client.
Which of the following actions should the nurse take? a
a. Collect the sputum specimen in the morning
143. A nurse is assessing a client who has diabetes mellitus prior
to performing a blood glucose test. Which of the following findings
a
should indicate to the nurse that the client has hyperglycemia?
A. Thirst

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B. Confusion
C. Coolskin
D. Shakiness
144. A nurse is assessing an older adult client. Which of the
following findings should the nurse expect? a
a. Decreased sense of balance
145. A nurse is preparing to administer a controlled substance to a
client for pain management. Which of the following actions should
the nurse take?
A. Report any discrepancy in the court total of the controlled
substance after administration
B. Place the assisted portion of the controlled substance in the a
sharps container
C. Verify the count total of the controlled substance after removing
the amount needed
D. Ask a second nurse to report her signature when wasting any
unused portion of the controlled substance
146. A nurse is caring for a client who has colon cancer and is
scheduled for a colon resection with a possible colostomy. Before
the procedure, the client tells the nurse, i'm
worried about the bag. Which of the following is an appropriate
response by the nurse?
a
A. You are worried about having to wear a colostomy bag?
B. Have you ever known someone who has a colostomy
C. Let's wait until after the surgery to discuss your concerns about
your colostomy
D. The surgeon will only place the colostomy if it is necessary
147. A nurse is preparing to administer medication to a client.
Which of the following should the nurse use as a client identifier?
A. Age
a
B. Room number
C. Photograph
D. Bed number
148. A nurse is preparing to administer an injection to a client.
Which of the following actions should the nurse plan to take after
administering the injection?
A. Discard the needle in a puncture proof container a
B. Place the needle on the bedside table
C. Remove the needle from the syringe
D. Recap the needle before disposal
149. A nurse is planning care for a client who is concerned about
her tobacco smoking habits and is in the contemplation stage of
health behavior change. Which of the following actions should the
nurse plan to take during this stage?
A. Assist the client in setting goals to make the change
c
B. Develop a plan for the client to integrate the change into her
lifestyle
C. Present information about the benefits of quitting smoking
D. Recommend small changes for the client to make to change
her behavior overtime
150. A nurse is providing teaching to a client who is at risk for
thrombus formation. Which of the following statements made by
the client indicates an understanding of the teaching?
A. I will keep my legs crossed while sitting d
B. I will perform exercises once every 4 hours while i am awake
C. I should massage my legs when they hurt
D. I should limit the time that i spend sitting in a chair
C. Move the computer to a secure place

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152. A nurse who is documenting information in a clients electron-
ic medical record is asked to assist with an emergency. Which of
the following actions should the nurse take?
153. A nurse is caring for a client who is receiving continuous en-
teral feeding via NG tube. Which of the following is an unexpected A. Diarrhea one time in a 24 hour period
finding?'
154. A nurse is planning care for a female client who has an
indwelling urinary catheter.Which of the following actions should
the nurse include in the plan?
A. Tape the catheter to the lower abdomen c
B. Attach the drainage bag to the side rails of the bed
C. Keep the drainage bag below the level of the bladder
D. Empty the drainage bag when it is three quarters full
155. A nurse is reviewing the medical record for a newly admitted
client. Which of thefollowing laboratory values should the nurse
report to the provider?
A. Sodium 140 b
B. Potassium 1.8
C. Magnesium 1.9
D. Calcium 6.5
156. A nurse is preparing to administer gentamicin 2 mg/kg IV
to a client who weighs 220Ib. How many mg should the nurse
administer? (Round to the nearest whole number.Use a leading 200 mg
zero if it applies. Do not use trailing zero).
DOSAGE CALCULATION
157. A nurse is caring for a client who tells the nurse, since I
retired, I have a lot of time on my hands and nothing to do. I guess
nobody needs me. Which of the following responses should the
nurse make?
d
A. If i were you, i would volunteer my time
B. Do you have family members you can visit
C. You need to realize that you have valuable skills to offer others
D. Tell me about some hobbies you enjoy
158. A nurse is caring for a client who has an NG tube and has
repeatedly pulled it out.
The nurse should identify that which of the following findings
indicates a need for restraints?
d
A. The client's family is unable to stay with the client
B. The client becomes confused at night
C. The client gets out of bed to use the bathroom frequently
D. The client is assigned a room near the nurses station
159. A nurse is documenting a dressing change for a client who
has a pressure injury. Which of the following entries by the nurse
demonstrate correct documentation?
A. No changes noted to the wound from previous nursing notes
b
B. Client pre-medicated with MSO4 sunq prior to dressing change
C. The wound seems clean and does not appear to be infected
D. New dressing applied as prescribed, no drainage on old dress-
ing
!60. A nurse is preparing to reposition a client who has a lower
back injury. Which of the following actions should the nurse take?
A. Place the clients arms at their sides
B. Flex the client's knees d
C. Place the client at the side of the bed nearest the direction they
will be turned
D. Roll the client as one unit in a smooth continuous motion.
161. A nurse is caring for a client who has TB. which of the
a
following precautions should the nurse plan to implement when

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working with the client?
a. airborne
162. A nurse is implementing seizure precautions for a client who
has a seizure disorder. Which of the following equipment should
a
the nurse place at the client's bedside?
a. Oral suction equipment and oral airway.
163. A nurse is providing teaching to the family of a client who is at
the end stage of life. Which of the following client manifestations
should the nurse instruct the family to expect?
A. Increased periods of wakefulness b
B. Altered breathing patterns
C. Increased salivation
D. Warm and dry extremities
164. A nurse is preparing to obtain informed consent from a client
who speaks a different language than the nurse and is scheduled
a
for surgery. Which of the following actions should the nurse take?
a. recommend an interpreter who is the same gender as the client.
165. A nurse is caring for a client who is receiving continuous en-
teral feedings through a gastrostomy tube. Which of the following
a
actions should the nurse take?
a. Aspirate residual volume every 4 hr
166. A nurse is preparing to insert an IV catheter for a client
following a right mastectomy. Which of the following veins should
a
the nurse select when initiating IV therapy?
a. The cephalic vein in the left distal forearm
167. A nurse is caring for a client who is postoperative and has a
new prescription to advance her diet to full liquids. Which of the
following foods should the nurse offer the client as a part of a full a
liquid diet?
a. Plain yogurt
168. A nurse is planning care for a client who has a latex allergy
and is scheduled for surgery. Which of the following actions is
a
appropriate to include in the client's plan of care?
a. Schedule the client as the first procedure
169. Type 2 diabetes mellitus patient with corns and calluses.
a. I can apply lotion to soften calluses as long as i don't put lotion a
between my toes
170. A nurse is caring for a male client who has a prescription for
intermittent catheterization with a coude catheter. Which of the
a
following images show the type of catheter the nurse should use?
a. The picture with the curled end of the catheter
171. A nurse is caring for a client following a bilateral mastectomy.
The client is often tearful and avoids looking at her dressings.
Which of the following actions should the nurse take first?
A. Provide the client with a mirror to look at her mastectomy
c
incisions B. refer the client to a breast cancer support group
C. identify the impact of the mastectomy on the client's body
image
D. encourage the client to assist with her dressing change
172. A nurse is preparing to perform a physical assessment of a
client's abdomen. Identify the sequence in which the nurse should
perform the following steps. (Place them in order of performance.
Use all steps)
- 1. Provide adequate lighting to inspect the abdomen 3, 1, 4, 2, 5
- 2. Listen to the abdomen arteries using the bell of a stethoscope
- 3. Percuss all four quadrants of the abdomen to measure sound
quality
- 4 Locate liver and spleen borders by pressing hands 2.5 to 7.5

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cm ( 1 to 3 in) into
the abdomen
- 5. Check for areas of tenderness by pressing fingers 1.3 cm (0.5
in) into the abdomen
173. a nurse working on a medical surgical unit is making client
a. assisting with ambulation for a client who has a pulmonary
assignments for an upcoming shift. Which of the following tasks
infection.
should the nurse assign to an assistive personnel?
174. A nurse is mixing a short acting insulin and an intermediate
insulin in the same syringe for a client who has diabetes mellitus. a. Inject air into the short acting insulin vial.
Which of the following actions should the nurse take first?
175. A nurse is caring for a client who has a new diagnosis
of terminal cancer. Which of the following interventions is the a. Develop a list of goals
priority?

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