Question: What is the priority nursing action for a client experiencing an anaphylactic reaction?
Answer Choices:\n\nAdminister diphenhydramine Start a second IV line Assess airway and administer epinephrine Place the client in a supine position
Answer:\nAssess airway and administer epinephrine
Question: Which of the following is a sign of hypoglycemia?
Answer Choices:\n\nFlushed skin and dry mouth Fruity breath and confusion Tremors and diaphoresis Deep rapid breathing
Answer:\nTremors and diaphoresis
Question: Which client should the nurse assess first?
Answer Choices:\n\nA client with a stage 2 pressure ulcer requesting pain medication A client post-laparoscopy complaining of shoulder pain A client with asthma reporting shortness of breath A client scheduled for discharge later today
Answer:\nA client with asthma reporting shortness of breath
Question: Which type of isolation is required for a client with C. difficile infection?
Answer Choices:\n\nDroplet Contact Airborne Standard
Answer:\nContact
Question: Which diet is appropriate for a patient with celiac disease?
Answer Choices:\n\nWheat toast, oatmeal, and fruit Rice, grilled chicken, and steamed broccoli Barley soup, crackers, and tea Pasta, green beans, and cheese
Answer:\nRice, grilled chicken, and steamed broccoli
Question: What is the best way to prevent medication errors when administering medications?
Answer Choices:\n\nRely on memory when identifying the patient Use two identifiers and check against the MAR Ask the client what medication they take Administer quickly if you’re running behind
Answer:\nUse two identifiers and check against the MAR
Question: A client is receiving TPN. Which complication should the nurse monitor for?
Answer Choices:\n\nHyperglycemia Hypotension Dehydration Constipation
Answer:\nHyperglycemia
Question: Which of the following indicates that a patient understands how to use a metered-dose inhaler (MDI)?
Answer Choices:\n\n”I’ll breathe out quickly before I inhale the medicine.” “I should hold my breath for 10 seconds after inhaling.” “I’ll use the inhaler only when I feel short of breath.” “I don’t need to rinse my mouth afterward.”
Answer:\nI should hold my breath for 10 seconds after inhaling
Question: A client with hypothyroidism is receiving levothyroxine. Which statement indicates the medication is effective?
Answer Choices:\n\n“I feel cold all the time.” “My energy level is better now.” “My hair is falling out more.” “I’ve been gaining more weight.”
Answer:\nMy energy level is better now
Question: A client with a history of tuberculosis is admitted with night sweats and weight loss. What is the priority nursing action?
Answer Choices:\n\nBegin airborne isolation precautions Obtain a sputum culture Notify the provider Administer isoniazid
Answer:\nBegin airborne isolation precautions
Question: Which of the following indicates proper NG tube placement?
Answer Choices:\n\nAbdominal X-ray confirmation Air bolus auscultation Client’s ability to speak Gastric pH of 7.0
Answer:\nAbdominal X-ray confirmation
Question: A client is prescribed phenytoin (Dilantin). Which finding should the nurse report to the provider?
Answer Choices:\n\nGingival hyperplasia Acne Lethargy Rash
Answer:\nRash
Question: What is the correct action by the nurse when a medication error is discovered?
Answer Choices:\n\nDocument the error in the patient’s chart and move on Notify the healthcare provider and complete an incident report Inform the family and ask them what to do Keep it to yourself unless the patient has a reaction
Answer:\nNotify the healthcare provider and complete an incident report
Question: A nurse is assessing a child with suspected epiglottitis. What is the priority action?
Answer Choices:\n\nObtain a throat culture Have the child lie down and rest Notify the provider and prepare for airway management Administer cough syrup
Answer:\nNotify the provider and prepare for airway management
Question: A client with a chest tube has continuous bubbling in the water seal chamber. What should the nurse do?
Answer Choices:\n\nDocument as a normal finding Check for an air leak Increase suction Clamp the chest tube
Answer:\nCheck for an air leak
Question: What is the priority nursing action for a client with a potassium level of 2.8 mEq/L?
Answer Choices:\n\nPlace the client on cardiac monitoring Administer potassium chloride IV push Encourage fluids Prepare for dialysis
Answer:\nPlace the client on cardiac monitoring
Question: A client receiving blood reports back pain and chills. What should the nurse do first?
Answer Choices:\n\nSlow the infusion rate Notify the provider Stop the transfusion Reassess vital signs
Answer:\nStop the transfusion