Practice Exam One ANSWERS

1. The nurse has taught a client who is receiving prescribed alendronate. Which of the following statements by the client would indicate a correct understanding of the teaching? Select all that apply. a. "I will take alendronate 1/2 hour before I eat breakfast. b. "I should avoid weight-bearing exercises while taking alendronate." c. "I should discontinue alendronate if I experience nausea or vomiting." d. "I will need to remain in an upright position for 30 minutes after I take alendronate. e. "I should notify my primary health care provider if I experience difficulty swallowing while taking alendronate." 2. The nurse has taught a client who is prescribed a low-sodium diet about appropriate food choices. Which of the following statements by the client would indicate a correct understanding of the teaching? a. "I will eat steamed, fresh broccoli with herbs and spices for an evening meal. b. "I will add cottage cheese and other dairy products to my daily diet. c. "I am glad I can still enjoy eating cereals, such as bran flakes with raisins." d. "I am glad I can eat lean meats daily because I eat ham sandwiches for an afternoon meal." 3. The nurse has observed a staff member tell a client with bipolar disorder that there will be consequences for making negative comments about conditions in the facility. When the nurse meets privately with the staff member, which of the following statements would be most appropriate for the nurse to make to the staff member? a. "Threatening a client can result in the immediate dismissal of a staff member." b. "Staff members who have difficulty with control issues often seek power over clients." c. "Clients have a right to complain about services without fear of punishment." d. "Staff should set limits with clients in a non-judgmental manner." 4. The nurse is preparing to insert a peripheral venous access device (VAD) for a client. Which of the following actions should the nurse take? a. Ask the client to open and close the fist multiple times. b. Tap the client's vein multiple times to promote dilation. c. Apply the tourniquet 9 to 10 in (22.5 to 25 cm) above the venipuncture site. d. Palpate for a vein after cleansing the selected site. 5. The nurse is caring for assigned clients. Which of the following clients would be at increased risk for the skin wound shown below? Select all that apply. a. a 65-year-old client who has a beefy, red tongue b. a 60-year-old client who is receiving a low-fiber diet c. a 55-year-old client who is exhibiting cognitive impairment d. a 70-year-old client who has a body mass index (BMI) of 24 e. a 65-year-old client who has a blood glucose level of 96 mg/dL (5.3 mmol/L) 6. The nurse is screening clients for those at increased risk for developing cancer. At highest risk for developing leukemia is the client who a. received more than 3 blood transfusions b. has a magnetic resonance imaging (MRI) scan annually c. has polycythemia vera and requires phlebotomy treatments d. had colon cancer and received prescribed chemotherapy treatments 7. The nurse is preparing to insert a peripheral venous access device (VAD) for a client who requires prescribed antibiotics intravenously. Which of the following actions by the nurse will increase the likelihood of success in initiating the VAD? Select all that apply. a. Select a vein that is visible but not palpable. b. Massage the arm distal to the selected venipuncture site. c. Apply a tourniquet tightly enough to suppress the radial pulse. d. Apply a warm compress to the client's arm for 10 to 15 minutes. e. Use the nondominant hand to hold the skin taut against the selected vein. 8. The nurse is preparing a staff education conference about total parenteral nutrition (TPN). Which of the following information should the nurse include? Select all that apply. a. "The TPN intravenous tubing should be changed once a week." b. "TPN can be administered through a peripherally inserted central catheter (PICC)." c. "Clients receiving TPN should be weighed daily." d. "An infusion pump is used to deliver TPN." e. "Blood glucose levels should be monitored in clients receiving TPN." 9. The nurse is preparing to administer a prescribed unit of packed red blood cells (PRBCs) to a client. Which of the following actions should the nurse take? a. Assess the client's recent urine output. b. Prime a Y-tubing blood administration set with lactated Ringer's solution. c. Ensure that the client has a peripheral venous access device (VAD) that is 24-gauge or larger. d. Verify with another nurse that the client's room number is on both the blood product label and the client's identification band. 10.The nurse has become aware of the following client situations. The nurse should first assess the client a. who had a right pneumonectomy 24 hours ago and is in the high-Fowler's position while lying on the right side b. with chronic obstructive pulmonary disease (COPD) who is using pursed-lip breathing and reporting hemoptysis c. who had a wedge resection of the left lung 24 hours ago and is sitting in the high-Fowler's position d. with heart failure who has a productive cough and is restless