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    Exam Review

    1. The nurse has become aware of the following client situations. The nurse should first assess the client

      A)
      with chronic obstructive pulmonary disease (COPD), who is using pursed-lip breathing and reporting a productive cough.
      B)
      who had a laparoscopic cholecystectomy three hours ago and is reporting right shoulder pain and abdominal cramping.
      C)
      with ulcerative colitis, who had three bloody stools in the past two hours and reporting abdominal cramping.
      D)
      two hours postoperative following a tonsillectomy and is reporting throat pain while vomiting.

    2. The nurse is teaching a client about a vegan diet. Which of the following foods should the nurse recommend for this diet? Select all that apply. 

      (SATA)
      A)
      Legumes
      B)
      Tofu
      C)
      Almonds
      D)
      Prunes
      E)
      Baked fish
      F)
      Grapefruit

    3. The nurse is reinforcing medication teaching to a client prescribed sucralfate. Which of the following statements, if made by the client, would require further teaching? Select all that apply.

      (SATA)
      A)
      “I should take this medication one hour after meals.”
      B)
      “I will remain upright for 30 minutes after taking this medicine.”
      C)
      “This medication will help with my peptic ulcer disease.”
      D)
      "I know this medication works when my nausea and vomiting are gone."
      E)
      “I may dissolve this medication in warm water.”

    4. The nurse is developing a plan of care for a client admitted to the mental health unit with significant paranoia. Which of the following should the nurse include in the client's plan of care?

      Select all that apply. 

      (SATA)
      A)
      Plan competitive activities with other clients.
      B)
      Maintain consistent caregivers.
      C)
      Establish a rapport using therapeutic touch.
      D)
      Involve the client in decision-making.
      E)
      Develop a plan of care that is unstructured.
      F)
      Immediately enroll the client in group therapy.
    Page 1 of 38

    Exam Review

    1. The nurse cares for a client with a sodium 130 mEq/L (mmol/L)[135-145 mEq/L, mmol/L]. Which of the following medications may cause this abnormality? Select all that apply.

      (SATA)
      A)
      Spironolactone
      B)
      Hydrochlorothiazide
      C)
      Prednisone
      D)
      Sodium polystyrene
      E)
      Tolvaptan

    2. The nurse is observing infection control practices in the nursing unit. Which of the following findings require follow-up? A client with

      Select all that apply.

      (SATA)
      A)
      H. pylori, placed on standard precautions.
      B)
      rotavirus provided a disposable blood pressure cuff.
      C)
      rubella and their door is kept closed.
      D)
      influenza ambulating in the hall with a surgical mask.
      E)
      Legionnaires’ disease placed on contact precautions.

    3. The nurse is assisting a client with food choices appropriate for Celiac disease. Which food items would be appropriate to select?

      Select all that apply.

      (SATA)
      A)
      Grilled chicken
      B)
      Wheat pasta
      C)
      Scrambled eggs
      D)
      Oatmeal
      E)
      Beef patties

    4. The licensed practical/vocational nurse (LPN/VN) assists a registered nurse (RN) in preparing to transfuse platelets to a client. Which actions would be appropriate for the LPN/VN to take? Select all that apply.

      (SATA)
      A)
      Obtain the client's weight
      B)
      Ensure ABO type compatibility
      C)
      Infuse the platelets within 15-30 minutes
      D)
      Verify completed consent for platelet transfusion
      E)
      Obtain pre-transfusion vital signs
    Page 2 of 38

    Exam Review

    1. Which of the following are important points about fever in children that the LPN should review with a family who is being discharged home today?

      Select all that apply.

      (SATA)
      A)
      When to seek medical attention for a fever above a certain temperature
      B)
      Appropriate methods for managing a child's fever at home
      C)
      Signs and symptoms that may indicate a serious underlying condition
      D)
      Importance of monitoring the child's hydration status
      E)
      Administration of antibiotics to treat the fever

    2. The nurse is reinforcing education regarding HIPAA. Which of these scenarios would the nurse use as an example of a violation of HIPAA laws?

      Select all that apply.

      A)
      Sharing client information with colleagues without obtaining consent.
      B)
      Safeguarding client information and refraining from sharing it on social media.
      C)
      Having private conversations about client care in appropriate settings with appropriate professionals.
      D)
      Storing client files securely and ensuring they are not accessible to unauthorized individuals.
      E)
      Respecting client confidentiality and only discussing client information with authorized individuals involved in the client's care.

    3. The perinatal nurse is caring for a client experiencing suspected placental abruption. Which of the following signs and symptoms would be expected assessment findings for this client?

      Select all that apply.

      A)
      Painless bleeding.
      B)
      Dark red bleeding.
      C)
      Hypotension.
      D)
      Rigid abdomen.
      E)
      Fetal tachycardia.

    4. Which of the following medications is contraindicated for a pregnant client?

      Select all that apply.

      A)
      Warfarin
      B)
      Finasteride
      C)
      Celecoxib
      D)
      Clonidine
      E)
      Transdermal Nicotine
      F)
      Clofazimine
    Page 3 of 38

    Exam Review

    1. Which of the following is an example of a nurse-initiated nursing action? Select all that apply.

      A)
      The nurse administers 1000 mg of Cipro to a patient with pneumonia.
      B)
      The nurse consults with a psychiatrist for a patient who is abusing prescription pain medications.
      C)
      The nurse checks the skin of bedridden patients for break down.
      D)
      A nurse orders a kosher meal for an orthodox Jewish patient.
      E)
      The nurse records the Intake & Output of a patient as prescribed by her physician.
      F)
      The nurse prepares a client for minor surgery according to facility protocol.

    2. A nurse is caring for a client with bipolar disorder who is experiencing a manic episode. The client's behavior is disruptive and interfering with the unit's therapeutic environment. Which action should the nurse take to promote a therapeutic milieu?

      A)
      Assign a staff member to stay with the client at all times
      B)
      Isolate the client in a separate room until the manic episode subsides
      C)
      Develop a structured daily schedule with clear expectations and goals
      D)
      Encourage the client to engage in group therapy sessions with peers

    3. The nurse is providing care to a postpartum client who delivered a healthy newborn. Which of the following interventions should the nurse include in the plan of care to promote thermoregulation? Select all that apply.

      A)
      Encourage skin-to-skin contact
      B)
      Keep the room warm
      C)
      Swaddle the newborn
      D)
      Place an electric heating pad on the mother
      E)
      Use an incubator when needed, for a newborn that isn't clothed

    4. The nurse is caring for a client with diverticulosis who reports difficulty getting enough dietary fiber. The nurse should anticipate the physician will prescribe

      A)
      psyllium.
      B)
      oil-retention enema.
      C)
      codeine.
      D)
      bisacodyl.
    Page 4 of 38

    Exam Review

    1. The nurse reviews the vital signs of a client admitted to the medical-surgical unit. The unlicensed assistive personnel (UAP) obtained the client's blood pressure from the client's leg. The nurse should expect which change in blood pressure?

      A)
      Systolic pressure in the legs is usually higher by 10 to 40 mm Hg
      B)
      Systolic pressure in the legs is decreased by 10 to 40 mm Hg
      C)
      Diastolic pressure is the decreased by 10 to 40 mm Hg
      D)
      Diastolic pressure is higher by 10 to 40 mm Hg

    2. The community health nurse has been notified of several incidents. Which situation requires immediate follow-up? A client with

      A)
      pulmonary tuberculosis (TB) is still testing positive despite 2 months of treatment.
      B)
      hepatitis A who works as a cook at a local healthcare facility.
      C)
      human immunodeficiency virus (HIV) with an undetectable viral load (VL) and reports having recent unprotected sexual intercourse.
      D)
      Lyme disease and is refusing further treatment with intravenous antibiotics because of nausea and vomiting.

    3. The nurse is caring for a pregnant client in her third trimester who reports experiencing severe back pain. Which intervention should the nurse recommend?

      A)
      Prescribe a muscle relaxant.
      B)
      Suggest daily use of a heating pad.
      C)
      Encourage regular back exercises.
      D)
      Advise bed rest for the remainder of the pregnancy.

    4. The nurse is caring for a client with placenta previa. Which of the following orders by the primary healthcare provider (PHCP) should the nurse question?

      A)
      Manual cervical exam
      B)
      Transabdominal ultrasound
      C)
      Nonstress test
      D)
      Transvaginal ultrasound
    Page 5 of 38

    Exam Review

    1. The licensed practical/vocational nurse (LPN/VN) is caring for a teenager with cystic fibrosis and is upset about missing so many days of school. The teenager appears to be withdrawn and reluctant to participate in the plan of care.

      ➢ Which nursing interventions would be most appropriate for this client?

      A)
      Arrange for another teenager with cystic fibrosis to video conference with the client.
      B)
      Obtain a prescription for antidepressant medication.
      C)
      Modify future assignments to arrange for a consistent nursing team.
      D)
      Have an older adult come and talk to the teenager about living with cystic fibrosis.

    2. The nurse is caring for a client experiencing an acute episode of severe anxiety. The nurse should plan to take which appropriate action? Select all that apply. 

      A)
      Discuss previous coping skills
      B)
      Stay and observe the client
      C)
      Maintain an environment with low stimuli
      D)
      Plan to ambulate with the client in the hallway
      E)
      Instruct the client to identify what triggered the event
      F)
      Evaluate the client for possible hypoventilation
      G)
      Obtain a prescription for haloperidol

    3. The nurse is collecting data on a client with Antisocial Personality Disorder (ASPD). Which of the following would be an expected finding?

      Select all that apply.

      A)
      Lack of empathy
      B)
      Grandiosity
      C)
      Preoccupation with orderliness
      D)
      Excessive attention-seeking
      E)
      Disregard for the rights of others

    4. The licensed practical/vocational nurse (LPN/VN) is suctioning a client who has a tracheostomy.

      ➢ Which of the following actions by the nurse would indicate correct technique?

      A)
      Using a size 16 Fr catheter to suction the client.
      B)
      Withdrawing the suction catheter 1 to 2 cm before applying suction.
      C)
      Using 160 mm Hg of pressure when suctioning the client.
      D)
      Applying suction to the catheter for 25 seconds during withdrawal.
    Page 6 of 38