1-While cleaning a client’s postoperative wound that is healing by granulation, the nurse observes a 3 cm area of eschar. What information should the nurse tell the client about the wound? 

a) Wound healing will begin once the drainage is stopped 

b) Bleeding areas interfere with tissues regrowth 

c) The sealed wound surface indicated healing 

d) Removal of the leathery tissue promotes wound healing 

2-The nursing staff in the emergency department are creating a continuous quality improvement project on social media that addressed prevention and early detection of cerebral vascular accident (CVA). Which action should the nurse implement to project client privacy? 

A) Ensure adherence with all state and federal privacy laws. 

B) Challenge inaccurate material that staff encounter online. 

C) Respect all copyright laws when adding website content 

D) Exclude form or misleading claims about client treatment. 

3-The nurse determines that a client whit acute renal failure (ARF) has a 24-hour urinary output of 400 mL. Which prescription should the nurse question? 

A) Weigh daily. 

B) 1,000 mL D5/normal saline with 20 mEg KCL. 

C) Low protein diet 

D) Restrict fluid intake to 400 mL per 24 hours. 

4-The nurse implements a secondary prevention program for a cardiometabolic disease in a rural health clinic. What outcome indicates that the program was effective ? 

a- There was only 30% client relapse in 5 year community- wide anti- smoking campaign 

b- A referral system for clients who develop complication was stablished 

c- Meals on Wheels delivered food to the clients unable to cook for themselves 

d- More than 50 % of at risk clients were diagnosed early in the disease process 

5-A male client with chronic kidney disease (CKD) has not had hemodialysis tor five days. The nurse notices that the client is confused and has an abnormal gait. Which action is most Important for the nurse to implement? 

a. Weigh the client and assess for signs of third spacing 

b. Confirm that the client is scheduled for hemodialysis today 

c. Reduce fluid intake for weight gain over 2 pounds 09 Ka) 

d. Call a family member to remain with the client 

6-the nurse is planning to assist a client with pneumonia from the bed to a chair for the first time after 4 days of bedrest. The nurse determines that the client ability to help during the transfer is limited. Which is the priority nursing action? 

A) Request assistant. 

B) Position chair at 45 degree 

C) provide non-slip footwear 

D) Use a gait belt 

7-In conducting a screening program for pulmonary tuberculosis (TB) the nurse should refer a client with which symptoms for further follow up ? 

a- Low grade fever , fatigue ,and night sweats 

b- Unusual behavior and altered mental status 

c- Dyspnea, barrel chest and hypoxemia 

d- Cyanosis ,prostration and pleural pain 

8-The nurse is assisting a client select food on a menu. Which meal selection is best for a client on a pre-surgical fiber-restricted diet? 

a. Chicken Cesar salad with tomatoes and cucumbers. 

b. Ham sandwich on white bread with soft cheese and yogurt. 

c. Fried chicken, baked yams, and broccoli. 

d. Coconut shrimp and fig pudding 

9-The nurse is developing a plan of care for a client who reports intermittent claudication and who us newly diagnostic with peripheral vascular disease .Which outcome should the nurse include in the plan of care for this client? 

a- The nurse will show the client how to perform stress management techniques 

b- The nurse will monitor the clients skin condition for color changes 

c- The nurse will instruct the client family members about the prescribed diet 

d- The client `s skin on the lower legs will be intact at the next clinic visit 

10-The mother of a 9-month-old infant tells the nurse that her healthy, “chubby baby is irritable and not very active. After obtaining a dietary history, the nurse determines that the infant refuses to eat any infant cereals Which finding is most important to report to the healthcare provider? 

A) Ingests 6 ten-ounce bottles of cow’s milk daily 

B) Breast feeds 10 minutes at night to go to sleep 

C) Has porcelain-like skin and a tripled birth weight. 

D) Does not take an infant vitamin supplement 

11-Which technique should the nurse include when applying an elastic bandage to a chant’s extremity? 

A) Leave the end of the limb exposed for circulation checks. 

B) Apply the bandage with the joint in extension to avoid strain. 

C) Secure the bandage over the injured area to mark the point of injury. 

D) Work from proximal to distal to promote blood flow. 

12-A young adult female client arrives at the emergency department with severe lower abdominal pain, vaginal bleeding, and right shoulder pain. The healthcare provider suspects an ectopic pregnancy and prescribes an abdominal ultrasound. Which additional diagnostic test results should the nurse report to the healthcare provider?

White blood cell count (WBC) 8,000/mm(8×10/L (SI units).

Positive human chorionic gonadotropin blood test.

Hemoglobin 12 grams/dl (120 mmol/L).

Urinalysis with white blood cells, too many to count.

13-During the assessment of a preschool-aged girl who is reporting that her hair hurts, the school nurse finds that the child’s hair has been arranged to cover several ecchymotic, baid areas. Which intervention should the nurse implement? 

a. Report the findings to the child’s parents 

b. Notify the department of child protective services 

c. Refer the child to her healthcare provider 

d. Document the findings in the child’s school health file 

14-A postpartum client asks the nurse about different contraceptives that are available for use after delivery. How should the nurse respond? ” 

a. Oral contraceptives are often used by woman under 30 years of age.” 

b. “The condom is probably the easiest and safest for you to use.” 

c. “Ovulation does not occur while breastfeeding so a contraceptive is not needed.” 

d. “I can discuss various methods so you can decide what is best for you.”

15-The nurse assesses a full-term infant whose mother has type 1 diabetes mellitus The infants blood glucose level at one hour of age is 45 mg/dL( 2.5 monk/L) and at two hours of age it is 25 mg/dL (1.4 mmol/L) What is the cause of the change in blood glucose? 

a. A reaction to the stress of labor and the period of increased activity following delivery 

b. An increase in urine production that results when the kidneys are ridding the body of excess glucose 

c. An interruption in the source of glucose and continued high insulin production by the infant 

d. A normal, physical response of the body that occurs during transition from intrauterine to extrauterine life 

16-A client intravenous (IV) catheter located in the cephalic vein of the right arm is 2 days old, edematous, and reddened. What additional data should the nurse use to determine that the iv catheter must be removed? 

A) Drainage from insertion site. 

B) Complaints of left arm pain 

C) Elevation in blood pressure 

D) tenderness over radial vein. 

17-The nurse on the post anesthesia care unit observes a colleague sharing credentials with another colleague who forgot access code to the electronic health records (EHR). Which action should the nurse implement? 

A) File an incident report with the facility’s ethics committee. 

B) Discuss the action with peers at the next staff meeting. 

C) Remind the colleague of information security principles. 

D) Ask the colleague why the action is being performed. 

18-Which complaints of a client with postpartum depression requires immediate intervention? (Select all that appl) 

A) Thoughts about harming the baby 

B) Feelings that she can no longer go on 

C) Difficulty going back to sleep after awaking 

D) Afterpains during breast feeding 

E) Inability to eat a full meal 

19-The nurse is educating a client with chronic kidney disease (CKD) about dietary changes. Which finding indicates to the nurse that the client needs additional teaching?

Restricts iron rich foods and iron supplements

Uses antacids that are phosphorus binder

Avoids potassium rich foods, such as avocados.

Maintains a sodiumrestrict diet

20-A client with anxiety does not want to communicate with friends, worries excessively, and reports not being able to deal with life. Which coping strategy should the nurse include in the plan of care? 

A) Concentrate on and ventilated emotions when distressed 

B) Focus on small achievable tasks, not taking problems 

C) Relax and reduce the amount of effort to solve the problem 

D) Practice switching thoughts to happy events in the past. 

21-The home health nurse supervises an unlicensed assistive personal (UPA) In providing home care for a client who is awaiting a liver transplant .The UPA reports that the client is often angry .Which instruction should the nurse emphasize with the UPA ? 

a- Schedule activities as early in the day as possible 

b- Provide consistency in schedule care activities 

c- Leave the premises when the client becomes angry 

d- Provide the client with choices about personal care 

22-when entering the emergency department , a male client tells the nurse that he is” having a heart attack “ what action should the nurse complete first? 

a) Determinate his BP 

b) Assess his level of anxiety 

c) Auscultate breath sounds 

d) Obtain a medication History 

23-Several days after returning from a mission trip to South Africa, a client presents with fever, chills, and mild confusion. The family reports that the client had cold-like symptoms with productive cough upon returning home. Which action is most important for the nurse to implement? 

a. Obtain detailed travel history 

b. Obtain full set of vital signs. 

c. Initiate airborne isolation precautions 

d. Insert two large bore IV catheters 

24-A client who is taking warfarin sodium for a deep vein thrombosis (DVT) has an INR (International Normalized Ratio) level of 2. What intervention should the nurse implement? 

a. Withhold the next dose of warfarin. 

b. Continue to administer the medication as scheduled. 

c. Administer PRN dose of vitamin K. 

d. Resume warfarin when INR is in therapeutic range. 

25-The nurse is preparing a young adult for discharge from the emergency department. The client was admitted 3 hrs ago with a fractured right ankle and a temporary spirt was applied. Which action is most important for the nurse to take prior to the client’s discharge. 

A) reassess the client’s pain level 

B) Assess right distal peripheral pulse 

C) Provide orthopedic follow up information 

D) Teach client how to use crutches 

26-The nurse is caring for a client who is in renal failure. In reviewing the client’s laboratory data, which result must be reported immediately to the healthcare provider? 

A) Serum sodium 140 mEq/L (140 mmol/L) 

B) Increased blood urea nitrogen level. 

C) Hematocrit 30% (0.30), hemoglobin 10 g/dl (100 g/L SI). 

D) Serum potassium 7 mEq/L (7 mmol/L).