A nurse is caring for a client who requires a 24-hr urine collection. Which of the
following statements by the client indicates an understanding of the teaching?
ANSWER : "I flushed what I urinated at 7:00 a.m. and have saved all urine since."
A nurse is assessing a client who has been on bed ...
NR 324 ATI FUNDAMENTALS
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A nurse is caring for a client who requires a 24-hr urine collection. Which of the
following statements by the client indicates an understanding of the teaching?
ANSWER : "I flushed what I urinated at 7:00 a.m. and have saved all urine since."
A nurse is assessing a client who has been on bed rest for the past month. Which of the
following findings should the nurse identify as an indication that the client has developed
thrombophlebitis?
ANSWER : Calf swelling
A nurse manager is overseeing the care on a unit. Which of the following situations
should the nurse manager identify as a violation of HIPAA guidelines?
ANSWER : A nurse asks a nurse from another unit to assist with her
documentation.
A nurse is caring for a client who requires bed rest and has a prescription for
antiembolic stockings. Which of the following actions should the nurse take?
ANSWER : Remove the stockings at least once per shift.
, Deeagles - Stuvia US
A nurse is administering IV fluid to an older adult client. The nurse should perform which
priority assessment to monitor for adverse effects?
ANSWER : Auscultate lung sounds
A nurse is assessing a client's readiness to learn about insulin administration. Which of
the following statements should the nurse identify as an indication that the client is
ready to learn?
ANSWER : "I can concentrate best in the morning."
A nurse is performing a Romberg's test during the physical assessment of a client.
Which of the following techniques should the nurse use?
ANSWER : Have the client stand with her arms at her side and her feet together.
A nurse is planning an deduction session for an older adult client who has just learned
that she has type 2 diabetes mellitus. Which of the following strategies should the nurse
plan to use with this client?
ANSWER : Allow extra time for the client to respond to questions
A nurse is teaching an older 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?
ANSWER : Walking briskly
, Deeagles - Stuvia US
A nurse is assessing an adult client who has been immobile for the past 3 weeks. The
nurse should identify that which of the following findings requires further intervention?
ANSWER : Erythema on pressure points
A nurse is preparing to administer 0.5 mL of oral single-dose liquid medication to a
client. Which of the following actions should the nurse take?
ANSWER : Gently shake the container of medication prior to administration.
A nurse is responding to a call light and finds a client lying on the bathroom floor. Which
of the following actions should the nurse take first?
ANSWER : Check the client for injuries
A nurse is caring for a client who is expressing anger over his diagnosis of colorectal
cancer. Which of the following actions should the nurse take?
ANSWER : Reassure the client that this is an expected response to grief.
A nurse in a clinic is caring for a middle adult client who states, "The doctor says that,
since I am at an average risk for colon cancer, I should have routine screening. What
does that involve?" Which of the following responses should the nurse make?
ANSWER : "You should have a fecal occult blood test every year."
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