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发布时间:2023-10-20 17:57:25

[单项选择]A nurse is caring for a client with a history of GI bleeding, sickle cell disease, and a platelet count of 22,000/μL. The client is dehydrated and receiving dextrose 5% in half-normal saline solution at 150mL/hr. He reports severe bone pain and is scheduled to receive a dose of morphine sulfate. In administering the medication, the nurse should avoid which route()
A. Oral.
B. IV.
C. IM.
D. Subcutaneous (SC).

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[单项选择]The nurse is caring for a client who has a history of alcohol abuse. Why would the client act as if he didn’t have a problem()
A. The client has never taken the CAGE questionnaire.
B. Denial is a defense mechanism commonly used by alcoholics.
C. Thought processes are distorted.
D. Alcohol is expensive.
[单项选择]The nurse is caring a client in an acute care mental health program. The client refuses his morning dose of an oral antipsychotic medication and believes he’s being poisoned. What should the nurse do( )
A. Crushing the medication and putting it in his food.
B. Consulting with the physician about a plan of care.
C. Administering the medication by injection.
D. Omitting the dose and trying again the next day.
[单项选择]The nurse is caring for a client with otosclerosis scheduled to undergo a stapedectomy. The client asks the nurse when her hearing will improve. Which response by the nurse is most appropriate()
A. Your hearing may not improve but you’ll no longer be bothered by tinnitus.
B. Your hearing may be dramatically improved right after surgery.
C. You may notice improved hearing within 1 to 2 weeks.
D. Your hearing may improve 3 to 6 weeks after surgery.
[单项选择]The nurse is caring for a client with cholelithiasis. Which sign indicates obstructive jaundice()
A. Straw-colored urine.
B. Reduced hematocrit.
C. Clay-colored stools.
D. Elevated urobilinogen in the urine.
[单项选择]The nurse is caring for a client with diabetes mellitus. When teaching the client about foot care, which instruction should the nurse provide()
A. Examine feet once per week for redness, blisters, and abrasions.
B. Apply lotion to dry feet, especially between the toes.
C. Avoid hot-water bottles and heating pads.
D. Dry feet vigorously after each bath.
[单项选择]The nurse is caring for a client infected with methicillin-resistant Staphylococcus aureus (MRSA). What’s the major infection control measure to reduce MRSA and other nosocomial pathogens in a health care setting()
A. Using antibacterial soap when bathing clients with MRSA.
B. Conducting culture surveys periodically.
C. Ensuring that personnel wash their hands before and after contact with every client.
D. Using specific housekeeping practices for environmental cleaning.
[单项选择]The nurse is caring for a client during the fourth stage of labor. Which of the following nursing interventions would be LEAST appropriate()
A. Catheterization to protect the bladder from trauma.
B. Perineal assessments for swelling and bleeding.
C. Vital signs and fundal checks every 15 minutes.
D. Time with the neonate to initiate breast-feeding.
[单项选择]The nurse is caring for a client who exhibits signs of somatization. Which of the following statements is most relevant()
A. Clients with somatization are cognitively impaired.
B. Anxiety rarely coexists with somatization.
C. Somatization exists when medical evidence supports the symptoms.
D. Clients with somatization often have lengthy medical records.
[单项选择]The nurse is caring for a client who recently underwent a tracheostomy. The first priority when caring for a client with a tracheostomy is()
A. helping him communicate.
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[单项选择]The nurse is caring for a client who exhibits magical thinking. Which of the following best describes magical thinking()
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[单项选择]The nurse is caring for a client undergoing IV antibiotic therapy with gentamicin sulfate. Which of the following interventions is most important()
A. Infuse the medication quickly to minimize its irritating effect on the walls of blood vessels.
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C. Assess for pulmonary and peripheral edema.
D. Obtain an order for an antiemetic to counteract the common adverse effect of nausea.
[单项选择]The nurse is caring for a client who has hemoconcentration after fluid loss. Which IV fluids would be the most appropriate fluid replacement therapy for this client()
A. Distilled water.
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[单项选择]The nurse is caring for a client who required chest tube insertion for a pneumothorax. To assess a client for pneumothorax resolution, the nurse can anticipate that he’ll require()
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C. chest auscultation.
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[单项选择]The nurse is caring for a client who complains of chronic pain. Given this complaint, why would the nurse simultaneously evaluate both general physical and psychosocial problems()
A. Depression is commonly characterized by pain disorders and somatic complaints.
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[单项选择]The nurse is caring for a client with mild active bleeding from placenta previa. Which of the following observations indicates that an emergency cesarean section may be necessary()
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[单项选择]The nurse is caring for a client with an exacerbation of ulcerative colitis. Which of the following nursing measures should be included in the plan of care()
A. Encourage regular use of antidiarrheal medications.
B. Incorporate frequent rest periods into the client’s schedule.
C. Have the client maintain a high-fiber diet.
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[单项选择]The nurse is caring for a client who is experiencing auditory hallucinations. What would be most critical for the nurse to assess()
A. Possible hearing impairment.
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C. Content of the hallucinations.
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