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Nursing Comprehensive Exam 3

50 Questions  I  By Allfornursing
NURSING COMPREHENSIVE EXAM 3

  
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1.  A client’s vital signs have noticeably deteriorated over the past four hours following surgery.  A nurse does not recognize the significance of these changes in vital signs and keep no action.  The client later requires emergency surgery.  The nurse could be prosecuted for inaction according to the definition of which of these?
A.
B.
C.
D.
2.  A nurse calls the physician of a client scheduled for a cardiac catherization because the client has numerous questions regarding the procedures and has requested to speak to the physician.  The physician is very much upset and arrives at the unit to visit the client after prompting by the nurse.  The nurse is outside of the client’s room and hears the physician tell the client in derogatory manner that the nurse “doesn’t know everything”.  Which legal tort has the physician violated?     
A.
B.
C.
D.
3.  A nurse enters a client’s room and finds the client sitting on the floor.  The nurse performs a thorough assessment and assists the client back to bed.  The nurse completes an incident report and notifies the physician of the incident.  Which of the following is the next appropriate nursing action regarding the incident?           
A.
B.
C.
D.
4.  A client had a colon resection. A Levin tube is placed when a regular diet was brought to the client’s room. The client didn’t want to eat the solid food and ask the physician to be called.  The nurse insisted that the solid food was the correct diet.  The client ate and subsequently had additional surgery because of complications.  The determination of negligence is based on:
A.
B.
C.
D.
5.  A new nursing graduate is attending an agency orientation regarding the nursing model of practice implemented in the facility.  The nurse is told that the nursing model is the primary nursing approach.  The nurse understands which of the following is a characteristic of this type of nursing model of practice?             
A.
B.
C.
D.
6.  A client asks the nurse how to become an organ donor.  Which of the following would not be a component of the nurse’s response?      
A.
B.
C.
D.
7.  A registered nurse (RN) is providing instructions to a licensed practical nurse (LPN) who is preparing to care for a deceased client.  The RN notes on the client’s record that his/her eye will be donated.  The nurse avoids telling the LPN to do which of the following?   
A.
B.
C.
D.
8.  A clinical nurse manager is planning an in-service educational session for the staff nurses.  The topic of the discussion is case management.  Which of the following is not a characteristic of case management and would not be included in the discussion?  
A.
B.
C.
D.
9.  A registered nurse is delegating activities to the nursing staff. Which activity is least appropriate for the nursing assistant?        
A.
B.
C.
D.
10.  A clinical nurse manager is reviewing the critical paths of the clients on the nursing unit. The nurse manager collaborates with each nurse assigned to the clients and performs variance analysis.  Which of the following would indicate the need for further action and analysis
A.
B.
C.
D.
11.  A nurse manager is conducting a conference with the nursing staff regarding concerns and proposals for actions related to the nursing unit.  The nurse manager presents his or her own analysis of the problem and proposals for actions to members of the team, and invites the team members to comment and provide input. Which style of leadership is the nurse manager specifically employing?       
A.
B.
C.
D.
12.  A client with a right pleural effusion noted on a chest x-ray film is being prepared for thoracentesis.  The client experiences severe dizziness when sitting upright.  The nurse assists the client to which of the following positions for the procedure?
A.
B.
C.
D.
13.  A physician’s order reads: theophylline timed-release capsule (Slo-bid), 100mg PO every 6 hours.  The medication label reads: 50 mg /capsules.  The nurse prepares how many capsule(s) to administer one dose?
A.
B.
C.
D.
14.  A physician has written an order for a vest restraint to be applied on a client from 10:00 PM to 7:00 AM because the client becomes disoriented during the night and is at risk for fall. At 6:30 AM, the nurse manager takes rounds on all the clients in the  unit. When assessing the client with vest restraint, which observation would indicate that the nurse who cared for this client performed unsafe care in the use of the restrain?          
A.
B.
C.
D.
15.  The nurse is providing an educational session to a group of students who are enrolled in a certified nursing assistant program.  The nurse prepares an instructional list for the students regarding the correct procedure for hand washing.  Which instructions does the nurse include on the list?
A.
B.
C.
D.
16.  A nurse is preparing to suction a client through a tracheostomy tube.  Which of the following protective items would the nurse wear to perform this procedure?  
A.
B.
C.
D.
17.  A nurse is instructing a client on how to safely use crutches for ambulating at home.  Which measure would the nurse recommend to minimize the risk of falls while ambulating with crutches? 
A.
B.
C.
D.
18.  An 85-year-old client is on postoperative day 2 following repair of a fractured hip.  The nurse has observed that the client has episodes of extreme agitation.  Which of the following nursing interventions would be most appropriate for the nurse to implement to  avoid these episodes of agitation?
A.
B.
C.
D.
19.  A nurse has administered an injection to a client.  After the injection, the nurse accidentally drops the syringe on the floor.  Which nursing action is the most appropriate in this situation? 
A.
B.
C.
D.
20.  A nurse is observing a client using a walker.  The nurse determines that the client is using the walker correctly if the client is:     
A.
B.
C.
D.
21.  A client is fitted for crutches and the nurse observes the client to evaluate for the correct height of the crutches.  The nurse expects to note which of the following?
A.
B.
C.
D.
22.  A client has a risk for infection following radical vulvectomy.  The nurse avoids which of the following when giving perineal care to this client?            
A.
B.
C.
D.
23.  A nurse prepares to assist a postoperative client to progress from a lying to a sitting position to prepare for ambulation.  Which nursing action is most appropriate to maintain safety of the client? 
A.
B.
C.
D.
24.  A nurse is inserting an indwelling urinary catheter into a male client.  As the catheter is inserted to the urethra, urine begins to flow into the tubing.  At this point, the nurse:
A.
B.
C.
D.
25.  A nurse has just collected a sputum specimen by expectoration for a culture on a  client who has a productive cough.  The nurse plans to implement all of the following interventions.  Which of the following nursing action does the nurse identify as the priority?
A.
B.
C.
D.
26.  A male client who is admitted to the hospital for an unrelated medical problem is diagnosed with urethritis resulting from chlamydial infection.  The nursing assistant assigned to the client asks the nurse what measures are necessary to prevent contraction of the infection during care.  The nurse tells the assistant that:    
A.
B.
C.
D.
27.  A client is scheduled for gallbladder surgery is mentally impaired and is unable to communicate.  In regard to obtaining permission for the surgical procedure, which nursing intervention would be most appropriate?
A.
B.
C.
D.
28.  A client diagnosed with tuberculosis (TB) is scheduled to go to the radiology department for a chest x-ray evaluation.  Which nursing intervention would be appropriate when preparing to transport the client?  
A.
B.
C.
D.
29.  A nurse is taking care of a client on contact isolation.  After the nursing care has been performed, before leaving the room, which protective item worn during client care would the nurse remove first?
A.
B.
C.
D.
30.  A client requests pain medication and the nurse administers an intramuscular (IM) injection.  After  administration of the injection, the nurse does which of the following first?      
A.
B.
C.
D.
31.  A nurse is in the process of giving a client a bed bath.  In the middle of the procedure, the unit secretary calls the nurse on the intercom to tell the nurse that there is an emergency phone call.  The most appropriate nursing action is to:
A.
B.
C.
D.
32.  A nursing manager is reviewing the purpose for applying restraints with the nursing staff.  The nurse manager tells the staff that which of the following is not an indication for the use of restraint?      
A.
B.
C.
D.
33.  A nurse has an order to obtain a urinalysis from a client with an indwelling urinary catheter.  The nurse avoids which of the following that may contaminate the specimen?
A.
B.
C.
D.
34.  A nursing assistant is caring for an elderly client with cystitis who has an indwelling urinary catheter.  The registered nurse provides directions regarding care and ensures that the nursing assistant:   
A.
B.
C.
D.
35.  A nurse is caring for an elderly client who had a hip pinned for a fractured hip.  In planning  nursing care, the nurse avoids which of the following to minimize the chance for further injury?
A.
B.
C.
D.
36.  Following initial assessment, the nurse determines the need to place a vest restraint on a client. The client tells the nurse that he does not want the vest restraint applied. The best nursing action is to:
A.
B.
C.
D.
37.  A client is being discharged will receive oxygen therapy at home.  The nurse is teaching the client and family about oxygen safety measures.  Which of the following statements by the client indicates the need for further teaching?   
A.
B.
C.
D.
38.  A home health nurse  visits a client who is to receive intravenous (IV) therapy via an IV pump.  The nurse notes that the electrical plug on the wall to be used for the IV pump has only two prongs.  Which of the following is the most appropriate action?
A.
B.
C.
D.
39.  On an initial home health care visits, the health home care nurse’s assesses the client’s environment for potential hazards.  Which observation is an indication that the client needs instruction about safety?      
A.
B.
C.
D.
40.  A hospitalized client with a history of alcohol abuse tells the nurse, "I am leaving now, I have to go. I don’t want any more treatment.  I have things that I have to do right away."  The client has not been discharged.  In fact, the client is scheduled for an important diagnostic test to be performed in 1 hour.  After discussing the client’s concerns, the client dresses and begins to walk out of the hospital room.  The most appropriate nursing action is to:       
A.
B.
C.
D.
41.  Two nurses are in the cafeteria having lunch in a quiet secluded area.  A physical therapist from P.T. department joins the nurses.  During lunch, the nurses discuss a client who was physically abused.  After lunch, the physical therapist provides therapy as prescribed to this physically abused client and asks the client questions about the physical abuse.  The client discovers that the nurses told the therapist about the abuse situation and is emotionally harmed.  The ramifications associated with the nurses' discussion about the client are most appropriately associated with which of the following?
A.
B.
C.
D.
42.  A nurse arrives at work and is told that the intensive care unit (ICU) is in need of assistance.  The nurse is told by the supervisor that the assignment today is to work in the ICU.  The nurse has never worked in the ICU and shares concerns with the supervisor regarding unfamiliarity with technological equipment used in the unit.  The nurse is again told to report to the ICU.  The most appropriate action by the nurse is to:          
A.
B.
C.
D.
43.  A registered nurse (RN) asks a licensed practical nurse (LPN) to change the colostomy bag on a client.  The LPN tells the RN that although attendance at the hospital in-service was complete regarding this procedure, the procedure has never been performed on a client.  The most appropriate action by the RN is:        
A.
B.
C.
D.
44.  A nurse administers the morning dose of digoxin (Lanoxin) to the client.  When the nurse charts the medication, the nurse discovers that a dose of 0.25 mg is administered rather than prescribed dose of 0.125 mg.  Which nursing action is most appropriate?
A.
B.
C.
D.
45.  A nurse is preparing to transfer an average sized client with right-sided hemiplegia from the bed to the wheelchair. The client is able to support weight on the unaffected side. The nurse plans to use the hemiplegic transfer technique. The client is dangling on the side of the bed. For the safest transfer, the wheelchair should be positioned:        
A.
B.
C.
D.
46.  A nurse is caring for a client with a grave clinical condition who is a potential organ donor. Before approaching the family to discuss organ donation, the nurse reviews the client's medical record for contraindications to organ donation, which would include:    
A.
B.
C.
D.
47.  A nurse is monitoring the ongoing care given to the potential organ donor who has been diagnosed with brain death. The nurse evaluates that the standard of care had been maintained if which of the following data is observed?           
A.
B.
C.
D.
48.  A client who suffered a severe head injury had a vigorous treatment to control cerebral edema. Brain death has now been determined. The nurse prepares to carry out which of the following that will maintain viability of the kidneys before organ donation?
A.
B.
C.
D.
49.  A nurse is working in the emergency room of a small local hospital when a client with multiple gunshot wounds arrives by ambulance. Which of the following actions by the nurse is contraindicated in the proper care of handling legal evidence?
A.
B.
C.
D.
50.  A nurse working on a medical nursing unit during an external disaster is called to assist with care for clients coming into the emergency room. Using principles of triage, the nurse initiates immediate care for a client with which of the following injuries?
A.
B.
C.
D.
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