Fundamentals CMS EXAM
Weight-bearing exercises Weight bearing exercises are essential for maintaining bone mass, which helps to prevent osteoporosis. - answer A nurse is teaching an older adult client who is at risk
for osteoporosis about beginning a program of regular physical activity. Which of the following types of activity should the nurse recommend?
Walking briskly
Riding a bicycle Performing isometric exercises
Engaging in high-impact aerobics
Ambulating a client who is postoperative Ambulating a client is within the range of function of an AP. The nurse can delegate tasks to the AP that do not require special skills, assessment, or teaching. - answer A nurse is preparing to delegate client care tasks to an assistive personnel (AP). Which of the following tasks should the nurse delegate?
Ambulating a client who is postoperative
Inserting an indwelling urinary catheter for a client
Demonstrating the use of an incentive spirometer to a client
Confirming that a client's pain has decreased after receiving an analgesic
8mL/hr - answer A nurse is preparing a heparin infusion for a client who was admitted to the facility with deep-vein thrombosis. The prescription reads: 25,000 units of heparin in 0.9% sodium chloride 250 mL to infuse at 800 units/hr. At what rate should
the nurse set the infusion pump? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
A client who smokes one pack of cigarettes each day A client who smokes one pack of cigarettes each day is at an increased risk for hypertension. - answer A community health nurse is checking blood pressures for a group of clients at a community health screening. Which of the following clients is at an increased risk for hypertension?
A client who is 52 years old
A client who smokes one pack of cigarettes each day
A client who walks for 30 min every day A client who drinks one glass of wine three times per week
Medication dose In the prescription, the medication dose is not complete. The number 0.25 should be followed by a unit of measurement, such as mg, to clarify the amount the nurse should administer. - answer A nurse is reviewing a client's medication prescription that reads, "digoxin 0.25 by mouth every day." Which of the following components of the prescription should the nurse verify with the provider?
Medication name
Route of administration
Medication dose
Frequency of administration
Select a suction catheter that is half the size of the lumen. The nurse should select a suction catheter that is half the size of the lumen to prevent hypoxemia and trauma to the mucosa. - answer A nurse is reviewing protocol in preparation for suctioning secretions from a client who has a new tracheostomy. Which of the following actions should the nurse plan to take?
Use a resuscitation bag with 80% oxygen prior to the procedure.
Select a suction catheter that is half the size of the lumen.
Place the end of the suction catheter in water-soluble lubricant.
Adjust the wall suction apparatus to a pressure of 170 mm Hg.
A client who is unaware of her recent cancer diagnosis asks the nurse if she has cancer, and the nurse responds affirmatively. Following the ethical principle of veracity, the nurse must tell the truth at all times and never deceive others. - answer A nurse is caring for a group of clients on a medical-
surgical unit. In which of the following situations does the nurse demonstrate the ethical principle of veracity?
A client who is unaware of her recent cancer diagnosis asks the nurse if she has cancer, and the nurse responds affirmatively.
A client who has a prescription for a nasogastric tube refuses it, and the nurse complies with the client's wishes.
A client who has a do-not-resuscitate (DNR) order has a cardiac arrest, and the nurse does not perform CPR despite requests from the client's family.
A client who is about to undergo a painful procedure receives pain medication 30 min before the procedure that the nurse previously promised to administer. Assist the client to a left side-lying position with the right knee flexed is correct. The nurse should place the client in a left side-lying position with the right knee flexed prior to administering an enema. Because the provider prescribed a cleansing enema for the client, the nurse should prepare the client for the procedure.
Prepare the client for a chest x-ray is incorrect. A chest x-ray is typically performed for a
client who has an impairment of the upper thorax or lungs, not the abdomen. The client has already received an abdominal x-ray; therefore, a chest x-ray is not necessary.
Administer a cleansing enema is correct. The nurse should administer a cleansing enema for the client as a result of the provider's prescription. A cleansing enema is intended to assist with bowel elimination and remove any impacted fecal matter indicated by the abdominal x-ray.
Auscultate the client's bowel sounds is correct. The nurse should auscultate the client's bowel sounds to determine the status of the client's peristalsis. This is a necessary part of determining the presence of bowel sounds, which are an indication of the status of the client's gastrointestinal tract.
Perform a manual digital examination of the client's rectum is correct. The nurse should perform a manual digital examination of the client's rectum to determine if impacted stool is present. This is a part of the necessary evaluation of the status of the client's gastrointestinal tract.
Administer oxycodone extended-release tablets is incorrect. Although the client has a prescription for oxycodone to treat pain related to pancreatic cancer, opioid medications
can cause the adverse effect of constipation. Because the client reports not having experienced a bowel movement for an extended period of time, the nurse should withhold further opioids until the cause of the client's constipation is determined.
Prepare the client for NG tube placement is incorrect. The nurse should not prepare the client for placement of an NG tube because there is no indication or prescription to do so. Placement of an NG tube is required when there is an obstruction of the gastrointestinal tract and peristalsis is absent. - answer A nurse in the emergency department (ED) is caring for a client who reports abdominal pain.
Based on the client's clinical findings, which of the following actions should the nurse take?
Select all that apply.
Assist the client to a left side lying position with the right knee flexed
Prepare the client for chest xray
Administer a cleansing enema Auscultate the clients bowel sounds
Perform a manual digital examination of the clients rectum is correct
Administer oxycodone ER tablet Prepare the client for NG tube replacement
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