Nursing Assistant Certification Prep Quiz

1. The nurse is planning activities for a client diag- nosed with bipolar disorder with aggressive social behavior. Which activity would be most appropri- ate for this client?

Chess.

Writing.

Ping pong.

Basketball.

Solitary activities that require a short attention span with mild physical exertion are the most appropriate activities for a client who is exhibiting aggressive behavior. Writing (journaling), walks with staff, and finger painting are activities that minimize stimuli and provide a constructive release for tension. The remaining options have a competitive element to them and should be avoided because they can stimulate aggression and increase psychomotor activity.

Explanation

Solitary activities that require a short attention span with mild physical exertion are the most appropriate activities for a client who is exhibiting aggressive behavior. Writing (journaling), walks with staff, and finger painting are activities that minimize stimuli and provide a constructive release for tension. The remaining options have a competitive element to them and should be avoided because they can stimulate aggression and increase psychomotor activity.

2. The nurse is preparing a plan of care for a client, and is asking the client about religious preferences. The nurse considers the client's religious preferences as being characteristic of a Jehovah's Witness if which client statement is made?

“I cannot have surgery.”

“I cannot have any medicine.”

“I believe the soul lives on after death.”

“I cannot have any food containing or prepared with blood.”

Among Jehovah’s Witnesses, surgery is not prohib- ited, but the administration of blood and blood products is for- bidden. For a Jehovah’s Witness, administration of medication is an acceptable practice except if the medication is derived from blood products. This religious group believes that the soul cannot live after death. Jehovah’s Witnesses avoid foods prepared with or containing blood.

Explanation

Among Jehovah’s Witnesses, surgery is not prohib- ited, but the administration of blood and blood products is for- bidden. For a Jehovah’s Witness, administration of medication is an acceptable practice except if the medication is derived from blood products. This religious group believes that the soul cannot live after death. Jehovah’s Witnesses avoid foods prepared with or containing blood.

3. The registered nurse is planning the client assign- ments for the day. Which is the most appropriate assignment for an unlicensed assistive personnel (UAP)?

A client requiring a colostomy irrigation.

A client receiving continuous tube feedings.

A client who requires urine specimen collections.

A client with difficulty swallowing food and  fluids.

The nurse must determine the most appropriate assignment based on the skills of the staff member and the needs of the client. In this case, the most appropriate assign- ment for the UAP would be to care for the client who requires urine specimen collections. The UAP is skilled in this proce- dure. Colostomy irrigations and tube feedings are not per- formed by UAPs because these are invasive procedures. The client with difficulty swallowing food and fluids is at risk for aspiration.

Explanation

The nurse must determine the most appropriate assignment based on the skills of the staff member and the needs of the client. In this case, the most appropriate assign- ment for the UAP would be to care for the client who requires urine specimen collections. The UAP is skilled in this proce- dure. Colostomy irrigations and tube feedings are not per- formed by UAPs because these are invasive procedures. The client with difficulty swallowing food and fluids is at risk for aspiration.

4. Which meal tray should the nurse deliver to a client of Orthodox Judaism faith who follows a kosher diet? (Judaism = Jewish people)

Pork roast, rice, vegetables, mixed fruit, milk.

Crab salad on a croissant, vegetables with dip, potato salad, milk.

Sweet and sour chicken with rice and vegetables, mixed fruit, juice.

Noodles and cream sauce with shrimp and vegeta- bles, salad, mixed fruit, iced tea

Members of Orthodox Judaism adhere to dietary kosher laws. In this religion, the dairy-meat combination is unacceptable. Only fish that have scales and fins are allowed; meats that are allowed include animals that are vegetable eaters, cloven hoofed, and ritually slaughtered.

Explanation

Members of Orthodox Judaism adhere to dietary kosher laws. In this religion, the dairy-meat combination is unacceptable. Only fish that have scales and fins are allowed; meats that are allowed include animals that are vegetable eaters, cloven hoofed, and ritually slaughtered.

5. Which is the best nursing intervention regarding complementary and alternative medicine?

Advising the client about “good” versus “bad”  therapies.

Discouraging the client from using any alterna-  tive therapies.

Educating the client about therapies that he or  she is using or is interested in using.

Identifying herbal remedies that the client should request from the health care provider.

Complementary and alternative therapies include a wide variety of treatment modalities that are used in addition to conventional therapy to treat a disease or illness. Educating the client about therapies that he or she uses or is interested in using is the nurse’s role. Options 1, 2, and 4 are inappropriate actions for the nurse to take because they provide advice to the client.

Explanation

Complementary and alternative therapies include a wide variety of treatment modalities that are used in addition to conventional therapy to treat a disease or illness. Educating the client about therapies that he or she uses or is interested in using is the nurse’s role. Options 1, 2, and 4 are inappropriate actions for the nurse to take because they provide advice to the client.

6. The nurse manager has implemented a change in the method of the nursing delivery system from func- tional to team nursing. An unlicensed assistive per- sonnel (UAP) is resistant to the change and is not taking an active part in facilitating the process of change. Which is the best approach in dealing with the UAP?

Ignore the resistance.

Exert coercion on the UAP.

Provide a positive reward system for the UAP.

Confront the UAP to encourage verbalization of  feelings regarding the change.

Confrontation is an important strategy to meet resistance head-on. Face-to-face meetings to confront the issue at hand will allow verbalization of feelings, identification of problems and issues,and development of strategies to solve the problem. Option 1 will not address the problem. Option 2 may produce additional resistance. Option 3 may provide a tempo- rary solution to the resistance, but will not address the concern sp ecifica lly.

Explanation

Confrontation is an important strategy to meet resistance head-on. Face-to-face meetings to confront the issue at hand will allow verbalization of feelings, identification of problems and issues,and development of strategies to solve the problem. Option 1 will not address the problem. Option 2 may produce additional resistance. Option 3 may provide a tempo- rary solution to the resistance, but will not address the concern sp ecifica lly.

7. An Asian American client is experiencing a fever.The nurse plans care so that the client can self-treat the disorder using which method?

Prayer.

Magnetic therapy.

Foods considered to be yin.

Foods considered to be yang.

In the Asian American culture, health is believed to be a state of physical and spiritual harmony with nature and a balance between positive and negative energy forces (yin and yang). Yin foods are cold and yang foods are hot. Cold foods are eaten when one has a hot illness (fever), and hot foods are eaten when one has a cold illness. Options 1 and 2 are not health practices specifically associated with the Asian American culture or the yin and yang theory. 

Explanation

In the Asian American culture, health is believed to be a state of physical and spiritual harmony with nature and a balance between positive and negative energy forces (yin and yang). Yin foods are cold and yang foods are hot. Cold foods are eaten when one has a hot illness (fever), and hot foods are eaten when one has a cold illness. Options 1 and 2 are not health practices specifically associated with the Asian American culture or the yin and yang theory. 

8. A client with a diagnosis of anorexia nervosa, who is in a state of starvation, is in a 2-bed room. A newly admitted client will be assigned to this cli- ent's room. Which client would be the best choice as a roommate for the client with anorexia nervosa?

A client with pneumonia.

A client undergoing diagnostic tests.

A client who thrives on managing others.

A client who could benefit from the client’s  assistance at mealtime.  

The client undergoing diagnostic tests is an accept- able roommate. The client with anorexia nervosa is most likely experiencing hematological complications, such as leukope- nia. Having a roommate with pneumonia would place the cli- ent with anorexia nervosa at risk for infection. The client with anorexia nervosa should not be put in a situation in which the client can focus on the nutritional needs of others or be man- aged by others because this may contribute to sublimation and suppression of personal hunger.

Explanation

The client undergoing diagnostic tests is an accept- able roommate. The client with anorexia nervosa is most likely experiencing hematological complications, such as leukope- nia. Having a roommate with pneumonia would place the cli- ent with anorexia nervosa at risk for infection. The client with anorexia nervosa should not be put in a situation in which the client can focus on the nutritional needs of others or be man- aged by others because this may contribute to sublimation and suppression of personal hunger.

9. Which clients have a high risk of obesity and diabetes mellitus? Select all that apply. (4 correct answers)

Latino American man  .

Native American man.

Asian American woman.

Hispanic American man.

African American woman.

1,2,4,5 ✔️Because of their health and dietary practices, Latino Americans, Native Americans, Hispanic Americans, and Afri- can Americans have a high risk of obesity and diabetes melli- tus. Owing to dietary practices, Asian Americans have a lower risk for obesity and diabetes mellitus.

Explanation

1,2,4,5 ✔️Because of their health and dietary practices, Latino Americans, Native Americans, Hispanic Americans, and Afri- can Americans have a high risk of obesity and diabetes melli- tus. Owing to dietary practices, Asian Americans have a lower risk for obesity and diabetes mellitus.

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10. The nurse manager is discussing the facility protocol in the event of a tornado with the staff. Which instructions should the nurse manager include in the discussion? Select all that apply.(3 correct answers)

Open doors to client rooms.

Move beds away from windows.

Close window shades and curtains.

Place blankets over clients who are confined  to bed.

Relocate ambulatory clients from the hall-  ways back into their rooms.

2,3,4 ✔️ In this weather event, the appropriate nursing actions focus on protecting clients from flying debris or glass. The nurse should close doors to each client’s room and move beds away from windows, and close window shades and cur- tains to protect clients, visitors, and staff from shattering glass and flying debris. Blankets should be placed over clients con- fined to bed. Ambulatory clients should be moved into the hallways from their rooms, away from windows.

Explanation

2,3,4 ✔️ In this weather event, the appropriate nursing actions focus on protecting clients from flying debris or glass. The nurse should close doors to each client’s room and move beds away from windows, and close window shades and cur- tains to protect clients, visitors, and staff from shattering glass and flying debris. Blankets should be placed over clients con- fined to bed. Ambulatory clients should be moved into the hallways from their rooms, away from windows.

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