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Exam 2025: Exam Format, Question Breakdown,
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Question 1: A nurse is completing discharge teaching about ostomy care with a client who has a new stoma. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) A. "Cut the opening of the pouch 1/8 of an inch larger than the stoma." B. "Place a piece of gauze over the stoma while changing the pouch." C. "Use povidone-iodine to clean around the stoma." D. "Empty the ostomy pouch when it becomes one-third full of contents." E. "Expect the stoma to turn a purple-blue color as it heals." Rationale: The correct answers are A, B, and D.
- A: Cutting the pouch opening slightly larger than the stoma prevents pressure and potential injury to the stoma.
- B: Placing gauze over the stoma helps to absorb any drainage during pouch changes and protects the skin.
- D: Emptying the pouch when it is one-third full prevents the weight of the contents from pulling on the appliance and potentially causing leaks.
- C: Povidone-iodine is generally not recommended for routine stoma cleaning as it can be irritating to the skin. Mild soap and water are usually preferred.
- E: A purple-blue stoma indicates compromised circulation and is a serious complication that should be reported immediately, not an expected finding during healing. Question 2: A nurse is preparing to obtain informed consent from a client who speaks a different language than the nurse. Which of the following actions should the nurse take? A. "Request that an assistive personnel interpret the information for the client."
B. "Use proper medical terms when giving information to the client." C. "Offer written information in the client's language." D. "Avoid using gestures when speaking to the client." Rationale: The correct answer is C. Providing written information in the client's language can help them understand the details of the procedure or treatment. However, this should ideally be supplemented by a qualified interpreter to ensure full comprehension and address any questions. Using an assistive personnel as an interpreter (A) is inappropriate as they may not have the necessary medical terminology knowledge or be qualified to provide accurate interpretation for informed consent. Using complex medical terms (B) will likely hinder understanding. Avoiding gestures (D) can also impede communication, especially when language barriers exist. Question 3: A nurse is teaching a client about home care equipment. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. "Avoid using wool blankets when receiving oxygen." B. "Check the O2 delivery rate at least once a day." C. "Align the middle of the ball in the flow meter with the line of the prescribed flow rate." D. "Keep the oxygen delivery system 0.6 m (2 feet) from any heat source." E. "Lay the oxygen tank flat when storing." Rationale: The correct answers are A, B, and C.
- A: Wool and synthetic fabrics can create static electricity, which poses a fire hazard in the presence of oxygen.
- B: Regularly checking the oxygen delivery rate ensures the client is receiving the prescribed amount.
- C: Proper alignment of the flow meter ensures accurate oxygen delivery.
- D: Oxygen supports combustion, so it should be kept at least 10 feet away from heat sources to prevent fires.
- E: Oxygen tanks should be stored upright and secured to prevent them from falling and causing injury. Question 4: A nurse is planning care for a client who reports insomnia. Which of the following actions should the nurse perform shortly before bedtime? A. Provide a late supper.
- 0.9% sodium chloride IV infusion: 600 mL
- Cefazolin in dextrose 5% in water IV bolus: 100 mL Total Intake = 600 mL + 100 mL = 700 mL Total Output:
- Emesis: 200 mL
- Voided urine: 40 mL
- Urine from straight catheterization: 20 mL Total Output = 200 mL + 40 mL + 20 mL = 260 mL Net Fluid Intake:
- Net Intake = Total Intake - Total Output Net Intake = 700 mL - 260 mL = 440 mL Question 7: A nurse is discussing incident reports with a group of newly licensed nurses. The nurse should include that which of the following requires the completion of an incident report? A. A client's prescribed laboratory testing was not obtained. B A client withdrew consent for a procedure. C An oncoming nurse arrived to work late. D A nurse transfused a unit of packed RBCs in 2 hr. Rationale: The correct answer is A. An incident report should be completed for any unexpected event or deviation from standard care that could potentially cause harm or has caused harm to a client. Failure to obtain prescribed laboratory testing can delay diagnosis and treatment, potentially impacting client outcomes. A client withdrawing consent (B) is a client right and not an incident, although it should be documented. An oncoming nurse arriving late (C) is an administrative issue. Transfusing blood in 2 hours (D) may or may not be an incident depending on the prescribed rate and the client's condition, but if it deviates significantly from policy or provider orders, it would warrant an incident report. Question 8: A nurse is caring for a client who has a new prescription for negative-pressure wound therapy for a chronic wound. The nurse is unfamiliar with the procedure. Which of the following resources should the nurse consult to learn more about the intervention? A. The client's plan of care. B. The nurse practice act. C. The material safety data sheet.
D. The policy and procedure manual. Rationale: The correct answer is D. The policy and procedure manual of the healthcare facility provides specific guidelines and protocols for various procedures, including negative-pressure wound therapy. It will outline the steps involved, necessary equipment, and potential complications. The client's plan of care (A) may mention the therapy but likely won't provide detailed instructions on how to perform it. The nurse practice act (B) defines the scope of nursing practice but does not provide specific procedural details. Material safety data sheets (C) provide information about the safe handling of chemical substances. A nurse is planning care for a group of clients. Which of the following tasks should the nurse delegate to an assistive personnel? a. Changing the dressing for a client who has a stage 3 pressure injury b. Determining a client's response to a diuretic c. Comparing radial pulses for a client who is postoperative d.Providing postmortem care to a client - correct ans- - d A nurse is conducting a health assessment for a client who takes herbal supplements. Which of the following statements by the client indicates an understanding of the use of the supplements? A. I take ginkgo biloba for a headache B. I take echinacea to control my cholesterol C. I use ginger when I get car sick D. I use garlic for my menopausal symptoms - - correct ans- - c A nurse is caring for a client who has influenza and isolation precautions in place. Which of the following actions should the nurse take to prevent the spread of infection? A. Wear a mask when working within 3 feet of the client B. Administer metronidazole C. Don protective eyewear before entering the room. D. Place the client in a negative airflow room. - - correct ans- - a
C. Incision without redness or drainage D. Drank adequate amounts of fluid with meals. - - correct ans- - b A nurse is providing oral care for a client who is unconscious. Which of the following actions should the nurse take? A. Place the client in a side-lying position. B. Brush the clients teeth daily C. Apply mineral oil to the client's lips D. Rinse the client's mouth with an alcohol-based mouthwash - - correct ans- - a A nurse is collaborating with a risk management team about potential legal issues involving client care. The nurse should identify which of the following situations is an example of negligence? A. A nurse administers a medication without first identifying the client. B. An assistive personnel discusses client care in the facility cafeteria with visitors present. C. A nurse begins a blood transfusion without obtaining consent. D. An assistive personnel prevents a client from leaving the facility. - - correct ans- - c A nurse is collecting a sputum specimen for culture from a client who has a respiratory infection. Which of the following actions should the nurse take? A. Wear sterile gloves when collecting the specimen. B. Offer the client oral hygiene after the collection C. Collect the specimen in the evening. D Collect 1 ml of sputum. - - correct ans- - b A nurse is assessing an older client. Which of the following findings should the nurse expect? a. Decreased sense of balanced
b. Increased nighttime sleeping c. Heightened sense of pain d. Nighttime urinary incontinence - - correct ans- - a A nurse is performing postural drainage with percussion and vibration for a client who has cystic fibrosis. Which of the following actions should the nurse take? a. Cover the area of percussion with a towel. b. Instruct the client to exhale quickly during vibration c. Schedule postural drainage after meals d. Perform percussion over the lower back - - correct ans- - d 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 following images indicates the correct number of mL the nurse should administer? (round answer to the nearest whole number.) DOSAGE CALCULATION - - correct ans- - 8ml 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 falls off."Which of the following is an appropriate response by the nurse? a. " I will place it in your drawer so it won't get lost." b. I can pin it to your hospital gown so you won't lose it." c. "I will hold onto it until a family member can take it home." d. I can put it in a locked storage unit for you - - correct ans- - d
d. Depression - - correct ans- - b A Nurse on a medical-surgical unit is providing care for four clients. The nurse should identify which of the following situations as an ethical dilemma? a. A surgeon who removed the wrong kidney during a surgical procedure refuses to take responsibility for her actions b. A client who has Crohn's disease reports that his prescription drug plan will not pay for his medications. c. A client who has a new colostomy refuses to take instructions from the ostomy therapist because she "doesn't like him." d. the family of a client who has a terminal illness asks the provider not to tell the client the diagnosis - correct ans- - d A nurse is teaching a client about performing breast self-examinations. Which of the following statements by the clients indicates an understanding of the teaching? a. "I should perform my self-exam the week that my period starts" b. "I should make different patterns on each breast when I do my self-exam." c. "I should use the palm of my hand to apply pressure to each breast." d. "I should make circular motions with my fingertips under my arms." - - correct ans- - d A nurse is preparing to transfer a client who is partially weight bearing from the bed to the chair. Which of the following actions should the nurse take? a. Keep his knees straight when moving the client b. Position the chair next to the bed as a 90 degree angle c. Stand with his feet together when lifting the client d. Have the client bear weight on her stronger leg - - correct ans- - d
A nurse is caring for a client following a laparoscopic cholecystectomy. The client has a prescription for ondansetron 4mg IV bolus every 6hr PRN for nausea and vomiting. Identify the sequence of steps the nurse should follow to administer the medication. ( Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)
- Select the injection port of the IV tubing closest to the client.
- Cleanse the injection port with an antiseptic swab.
- Aspirate for blood return.
- Inject the medication.
- perform hand hygiene - - correct ans- - 1. perform hand hygiene
- select the injection port of the IV tubing closest to the client
- cleanse the injection port with an antiseptic swab
- aspirate for blood return
- inject the medication A nurse is teaching a client who has diabetes mellitus about mixing regular and NPH insulin. Which of the following statements but the client indicates an understanding of the teaching a. I should wait 3 minutes after mixing the insulin to inject it b. I should draw up the NPH insulin before regular insulin c. I should inject air into the vial of regular insulin first d. I should roll the vial of NPH insulin between my hands before drawing it up - - correct ans- - d A nurse is assessing the body temperature of an adult client using a temporal artery thermometer. Which of the following actions should the nurse take? (Select all that apply) a. Slide the probe across the clients forehead b. Pull the clients pinna up & back c. Hold the client's hair aside while performing the procedure
a. "You must have too many sexual partners" b. "Why do you keep letting this happen?" c. "Let's explore why this might be re-occuring" d. "Don't you have access to condoms?" - - correct ans- - c 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. Which of the following actions should the nurse take first? a. Move items in the room away from the client b. Turn the client onto their side c. Help the client lie on the floor d. Loosen the client's clothing - - correct ans- - c A nurse is testing a client for conduction deafness by performing Weber's test. Which of the following actions should the nurse take when performing this test? a. Move a vibrating tuning form in front of the client's ear canals one after the other b. Place the base of a vibrating tuning fork on the client's mastoid process c. Place the base of a vibrating tuning fork on the top of the client's head d. Count how many seconds a client can hear a tuning fork after it has been struck - - correct ans-
- c A nurse is obtaining the medication history of a client who asks about taking ginkgo biloba. The nurse should identify which of the following medications can interact adversely with this supplement? a. Warfarin b. Albuterol c. Levothyroxine d. Atorvastatin - - correct ans- - a
A nurse is obtaining informed consent from a client who is scheduled for surgery. The client states, "I don't want to go through with the procedure." Which of the following actions should the nurse take? a. Discuss alternative treatments with the client b. Explain to the client the risks involved with not having the procedure c. Express approval of the client's decision to not have the procedure d. Document the client's decision in the medical record - - correct ans- - d A nurse is providing teaching to a client about reducing the adverse effects of immobility. Which of the following statements by the client indicates an understanding of the teaching? a. " I will have my partner help me change position every 4 hours" b. " I will remove my antiembolic stockings while I am in bed" c." I will hold my breath when rising from a sitting position" d." I will perform ankle and knee exercises every hour." - - correct ans- - d 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 the following foods should the nurse offer the client as a part of a full liquid diet? a. Oatmeal b. Applesauce c. Scrambled eggs d. Plain Yogurt - - correct ans- - d A nurse is preparing a client who has terminal cancer for discharge. Which of the following questions should the nurse ask when assessing the client's psychosocial history? a. " What medications are you currently taking?" b." Are you experiencing any Pain?"
a. " Let's talk more about your dad's condition." b. "The social worker will help you answer those questions." c. " Try to help your dad enjoy this time as much as he can." d. " I think that you should discuss this with the hospice nurse." - - correct ans- - a A Nurse is preparing to administer several medications to a client. Which of the following data should the nurse plan to use to confirm the client's identity? a. The client's room number b. The client's admitting diagnosis c. The name of the client's next of kind. d. The client's telephone number - - correct ans- - d 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 nurse should notify which of the following members of the health care team. a. Social worker b. Occupational therapist c. Registered Dietician d. Primary care provider - - correct ans- - a A nurse is teaching a newly licensed nurse about the care of a client who has a methicillin resistant Staphylococcus aureus (MRSA) infection. Which of the following statements by newly licensed nurse indicates an understanding of the teaching? a. " I will place the client in a Private room." b. " I will remove my gown before my gloves after providing client care." c. " I will wear an N95 respirator mask when caring for the client."
d. " I will tell the client's visitors to wear a mask when they are within 3 feet of the client." - - correct ans- - a A nurse is planning care for a client who reports having a latex allergy. Which of the following interventions should the nurse include in the plan? a. Cover the blood pressure cuff with a stockinette. b. Wear powdered gloves when providing care to the client. c. Apply adhesive tape when securing an IV insertion site. d. Use plastic syringes for medication administration. - - correct ans- - a 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 by resecting my intestines." Which of the following actions should the nurse take? a. Describe the surgery to the client. b. Notify the Provider. c. Complete an incident report d. Provide brochures about the procedure. - - correct ans- - b A nurse is documenting client care. Which of the following abbreviations should the nurse use? a. " SQ" for subcutaneous b. "SS" for sliding scale c. "BRP" for bathroom privileges d. "OJ" for orange juice - - correct ans- - c A nurse is preparing to bathe a client who has dementia. Which of the following actions should the nurse take? a. Give detailed instructions for the client to follow.
During change of shift report, a nurse discovers she overlooked a prescription for a type and crossmatch of a client who is to have surgery the next day. Which of the following actions should the nurse take first? a. Inform the provider of the delay in obtaining the type and cross-match. b. Obtain the client's type and cross-match. c. Prepare an incident report for risk management. d. Document the incident in the client's medical record. - - correct ans- - a A Nurse is caring for client who has pneumonia. The nurse should recognize which of the following should be discarded in a biohazard bag? a. An emesis basin filled with blood from severe coughing b. A bedpan containing diarrhea from a client who was receiving antibiotics c. A disposable tissue containing expectorated sputum d. A calibrated toilet insert filled with urine. - - correct ans- - a A nurse is caring for a client who is receiving enteral feedings via NG tube. Which following actions should the nurse take prior to administering the formula? a. Check for gastric residual volume b. Encourage the client to breathe deeply and cough. c. Flush the tube with sterile 0.9% sodium chloride irrigation. d. Encourage the client to take sips of water. - - correct ans- - a A nurse is caring for a client immediately following the insertion of an NG tube. Which of the following should indicate to the nurse that the tube is placed incorrectly? a. The client has a dry mouth b. The client is coughing c. The client has active bowel sounds
d. The client is hiccuping - - correct ans- - b A nurse is inserting an NG tube for a client who requires gastric decompression. Which of the following actions should the nurse take to verify proper placement of the tube? a. Assess the client for a gag reflex b. Measure the pH of the gastric c. Place the end of the NG tube in the water to observe for bubbling d. Asculatate 2.5 cm above the umbilicus while injecting 15 ml of water - - correct ans- - b 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 are not an option for managing pain. Which of the following is an appropriate response by the nurse? a. Would you like to get you a back massage? b. Why do you think pain med is not going to help you? c. You may take any herbal remedies you bring from home d. I'm sure it will work if you just give it a chance - - correct ans- - a a nurse is caring for a client who has an extracellular fluid volume deficit. Which of the following findings should the nurse expect? a. Bradycardia b. Postural hypotension c. Distended neck vein d. Dependent edema - - correct ans- - b A nurse is caring for a client who is immunocompromised which of the following actions should the nurse take? a. Use sterile gloves to provide perineal care
