RN Fundamentals online Practice 2019 A with NGN

A nurse is caring for a client who has pharyngeal diphtheria. Which of the following types of transmission
precautions should the nurse initiate?
1. Contact
2. Droplet
3. Airborne
4. Protective

A nurse is talking with an older adult client who is contemplating retirement. The client states, "I keep thinking
about how much I enjoy my job. Im not sure I want to retire." Which of the following responses should the nurse
make?
1. "You would have so much more time to spend with your family."
2. "You should consider getting a part-time job or doing volunteer work."
3. "Let's talk about how the change in your job status will affect you."
4."Why wouldn't you want to retire and relax?"

A nurse is caring for a client who has herpes zoster and asks the nurse about the use of complementary and
alternative therapies for pain control. The nurse should in form the client that this condition is a contraindication
for which of the following therapies?
1. Biofeedback
2. Aloe
3. Feverfew
4. Acupuncture

A nurse is assessing an older adult client's risk for falls. which of the following assessments should the nurse
use to identify the clients safety needs?
1. Lacrimal apparatus
2. Pupil clarity
3. Appearance of bulbar conjunctivae
4. Visual fields
5. Visual acuity

A nurse is caring for a child who has a prescription for a blood transfusion. The child's parents have refused the
treatment due to their religious beliefs. Which of the following actions should the nurse take?
1. Examine personal values about the issue.
2. Tell the parents that this is a necessary procedure.
3. Inform the parents that the staff does not require their consent.
4. Contact a spiritual support person to explain the importance of the procedure.

A nurse caring for a client who is postoperative following a knee arthroplasty and requires the use of thigh-
length sequential compression sleeves. Which of the following actions should the nurse take?
1. Assist the client into a prone position.
2. Place a sleeve over the top of each leg with the opening at the knee.
3. Make sure two fingers can fit under the sleeves.
4. Set the ankle pressure at 65 mm Hg.
A nurse is reviewing evidence based practice principles about administration of oxygen therapy with a newly
licensed nurse. Which of the following actions should the nurse include?
1. Regulate the flow rate by aligning the rate with the top of the ball inside the flow meter.
2. Regulate oxygen via nasal cannula at a flow rate of no more than 6 L/min.
3. Make sure the reservoir bag of a partial rebreathing mask remains deflated.
4. Use petroleum jelly to lubricate the client's nares, face, and lips.

A nurse is caring for a client who has a history of substance use disorder and was involuntarily admitted to a
mental health facility. When the nurse attempts to administer oral lorazepam, the client refuses to take the
medication and becomes physically aggressive. Which of the following actions should the nurse take?
Do not administer the lorazepam
Request a prescription for IV lorazepam
Request the another nurse attempt to administer the lorazepam
Place the lorazepam in the client’s food

A nurse is planning care for a client who has depression and has made frequent suicide attempts. Which of the
following statements indicates the client has a decreased risk for suicide?
a. “I’m relieved now that my financial affairs are in order.” (depression verbalize getting their affair in order, they are at an increased
risk for suicide)
b. “It is easier to talk about my feelings now.”(client express their feelings, positive treatment outcome)
c. “Suddenly I have enough energy to do anything I want.”(depression suddenly have more energy, they are at an increased risk for
suicide)
d. “Thank you for always taking such good care of me.”(depression often show an appreciation for loved ones when they are
comtemplating suicide)

A nurse is caring for a client whose child has a terminal illness. the client requests information about how to deal with
upcoming loss. Which of the following statements should the nurse make?
"It will be better for you to keep busy to avoid thinking about your child's death."
"You will complete the grieving process about a year after your child's death."
"The grief process will start once your child actually dies."
"It is not uncommon to feel angry toward yourself or others."

During a client's initial interview in a mental health inpatient setting, the nurse identifies that the client is maintaining eye
contact and leaning forward. Which of the following assumptions should the nurse make based on the client's nonverbal
behavior?
The client is interested in what the nurse is saying.
The client is attempting to manipulate the nurse.
The client is physically attracted to the nurse.
The client needs to feel accepted by the nurse.

A nurse is reviewing the electronic medical record of a client who has schizophrenia and is taking clozapine. Which of the
following is the priority for the nurse to notify the provider?
The client's chart indicates a 1.36-kg (3-lb) weight gain in 1 month.
The client reports an inability to breathe easily.
The client's laboratory results indicate a fasting blood glucose level of 130 mg/dL.
The client reports having recently started smoking cigarettes.
A nurse is establishing a therapeutic relationship with a client who has antisocial personality disorder. Which of the
following strategies should the nurse use when communicating with this client?
Behave in a friendly manner toward the client.
Set realistic limits on the client's behavior.
Show respect for the client's need for isolation.
Act as a role model for assertiveness.

A nurse is reviewing routine laboratory values for several clients who are taking lithium carbonate. Which of the following
clients should the nurse assess further for finding indicating lithium toxicity?
A) A client who has a fasting blood glucose of 80 mg/dL
B) A client who has a sodium level of 128 mEq/L
C) A client who has a BUN of 18 mg/dL
D) A client who has potassium level of 3.6 mEq/L

A nurse in a provider’s office is collecting a health history from the guardian of a school-age child who has been taking
atomoxetine. Which of the following adverse effects reported by the guardian is the priority for the nurse to report to the
provider?
Reduced appetite
Fatigue
Dark urine
Sweating

A nurse is caring for a group of client’s. For which of the following situations should the nurse complete an incident report?

A client refuses electroconvulsive therapy after signing the consent form.

A client who was voluntarily admitted left the unit against medical advice.
A client was administered one-half of the prescribed dose of medication.
A client was placed in restraints after attempts to de-escalate aggressive behaviors failed.

A nurse is admitting a client who has schizophrenia to an acute care setting. When the nurse questions the client regarding
their admission, the client states, “I’m red, in the head, and I’m going to bed!” The nurse should document the client’s
speech pattern as which of the following?
Clang association
Word salad
Neologism
Echolalia

A nurse is communicating with a client in an inpatient mental health facility. Which of the following actions by the nurse
demonstrates the use of active listening?
Offering self
Use of silence
Attention to body language
Reflection of feelings

A home health nurse is assessing an older adult client whose sibling is the primary caregiver. Which of the following
findings should the nurse identify as a possible indicator of neglect?
Increased confusion
Sleep disturbances
Cluttered environment
Inappropriate dress
A nurse is admitting a female client who has anorexia nervosa. Which of the following manifestations should the nuse
expect during the admission assessment?
Diarrhea
Heavy menstrual bleeding
Tachycardia
Orthostatic hypotension

A nurse is caring for a client who has antisocial personality disorder and is receiving behavioral therapy through operant
conditioning. Which of the following client behaviors indicates effectiveness of the therapy?
Controls anger outbursts to avoid being placed in seclusion
No longer exhibits a fear of social or public situations
Refrains from manipulating others to earn dining room privileges
Imitates the therapist's use of a relaxation technique

A nurse is caring for a client who has impaired cognition/

Nurse notes
Day 1 0800:
Client is able to assist with self-care
Client is easily startled by sudden changes and loud noises.
Day 3 0830
Client has wandered into other client’s room and is more restless at night.
Client has increased anxiety and confusion today: does not wan to stay seated in the medical recliner.
A nurse is updating the client’s plan of care. For each of the following potential nursing interventions, click to
specify if the potential intervention is anticipated, non essential, or contraindicated for the client.
Exhibit 2
Progress Report

0230:
Prior medical record obtained and reviewed.

Client has a history of major depressive disorder and has had two prior suicide attempts.

Currently lives at a half-way house in town.

Last hospitalization was 3 months ago for phenelzine toxicity.
Client was changed to selegiline transdermal prior to discharge.
Weight at time of discharge was 83.5 kg (184 lb).

Exhibit 3
Vital Signs

Day 1 0800:
Temperature 36.9° C (98.4° F)
Heart rate 92/min
Respiratory rate 26/min
Blood pressure 132/80 mm Hg

Day 3 0830:

Temperature 37.3° C (99.1° F)

Heart rate 106/min
Respiratory rate 32/min
Blood pressure 144/86 mm Hg
 Exhibit 4
Medical History
Day 1 0800:
History of urinary tract infection 8 months ago.
Day 3 0830:
Client fell out of bed to go to the bathroom last night. Client sustained bruise to the left knee; no further injuries noted.

Exhibit 5
Provider Prescriptions

Obtain blood alcohol concentration (BAC)

Obtain blood glucose level
Obtain WBC count

0415:
Initiate IV access and infuse dextrose 5% in 0.9% sodium chloride (D5W 0.9% NaCl) at 100 mL/hr
Diazepam 10 mg IV bolus now, can repeat in 3 hr PRN
Repeat blood glucose level.
Acetaminophen 1,000 mg IV every 6 hr PRN fever.
Initiate suicide precautions.
Transfer client to the inpatient psychiatric unit.

Potential Intervention Anticipated

Nonessential Contraindicated

Give directions to the client slowly and in y

a moderate tone of voice.

Keep the lights off in the client's y

bedroom and bathroom at night.

y
Decrease sensory stimulation.

Use a vest restraint to keep the client in y

a medical recliner.

y
Assign the client to a room near the
nurses' station.

Ensure the bed is kept at a working y

height for the nurse.

Provide the client with high-calorie y

protein drinks hourly.

When addressing the client, approach y

them from the front when possible.
A nurse is planning care for a 7-year-old child who has ADHD. Which of the following interventions should the nurse identify
as the priority?
Decrease distractions during meal times.
Provide positive feedback when the child completes a task.
Clearly identify consequences for unacceptable behavior.
Remove unnecessary equipment from the child's surroundings.

A client who has paranoid schizophrenia is attending a treatment planning conference with a family member. During the
discussion of the medication adherence portion of the plan, a nurse notices that the family member seems distracted. Which
of the following actions should the nurse take?
Call the family member to the side to inquire if they have questions or concerns about the treatment plan.
Advise the family member that this treatment plan has been developed specifically for the client to follow.
Ask the family member if they have any thoughts or questions about the treatment plan.
Document that the family member does not support the medication treatment plan.

A nurse is preparing to administer chlorpromazine 0.55 mg/kg PO to an adolescent who wights 110 lb. Available is
chlorpromazine syrup 10 mg/5 mL. How many mL should the nurse administer? (Round the answer to the nearest whole
number. Use a leading zero if it applies. Do not use a trailing zero?)
14 ml

A nurse is delegating client care tasks to a licensed practical nurse (LPN) and an assistive personnel. Which of the following
tasks should the nurse assign to the LPN?
Obtain the weight of a client who has bipolar disorder and is experiencing mania.
Assess the nutritional intake of a client who has anorexia nervosa and has refused to eat for the past 2 days.
Monitor the cardiovascular status of a client who is experiencing serotonin syndrome.
Change the dressings of a client who has borderline personality disorder and superficial self-inflicted wounds.

A nurse is caring for a group of clients. Which of the following findings should the nurse report?
A client who is taking clozapine and has a WBC count of 7,500/mm3
A client who is taking lamotrigine and has developed a rash
A client who is taking valproate and has a platelet count of 150,000/mm3
A client who is taking lithium and has a lithium level of 1.2 mEq/L

A client who has a diagnosis of depression is attending group therapy. During the group meeting, the nurse asks each
member to identify one goal for the day. When is it the client’s turn, they do not respond. Which of the following actions
should the nurse take before repeating the request to the client?
Allow the client time to formulate an answer.
Prompt the client to give a response.
Move on to the next client.
Offer the client a suggestion for a goal.

A nurse is caring for a client who has a recent diagnosis of mild Alzheimer’s disease. The client’s partner
asks the nurse about expected manifestations. The nurse should teach the partner to expect which of the
following manifestations to occur first?
Inability to recognize family members
Chooses clothing that is inappropriate for the weather
Exhibits a change in personality
Frequently misplaces objects
A nurse is planning care for a client who has schizophrenia and reports auditory hallucinations. Which of the following
interventions should the nurse include in the plan?
Promote the use of music to compete with the client's auditory hallucinations.
Inform the client that the auditory hallucinations are not real.
Avoid asking the client if they are experiencing auditory hallucinations.
Instruct the client on the use of voice recognition regarding the auditory hallucinations.

A nurse is assessing a client who has borderline personality disorder. Which of the following finding should the nurse
expect?
Emotional lability
Self-sacrificing
Suspicious of others
Grandiosity

A charge nurse is preparing an educational session for a group of newly licensed nurses to review client under the law.
Which of the following statements should the nurse make?
"Information regarding clients should remain confidential until after their death."
"Failure to report suspected maltreatment or neglect of a disabled adult is a felony in all states."
"As long as client identity is disguised, their health information can be shared between professionals on the
internet."
"In the event a client threatens harm to others, medications can be administered without consent."

A nurse on a mental health unit is caring for a recently admitted client.

Exhibit 1
Vital Signs
0800:
Blood pressure 110/78 mm Hg
Heart rate 76/min
Respiratory rate 18/min
Temperature 37° C (98.6° F)
1200:
Blood pressure 116/80 mm Hg
Heart rate 88/min
Respiratory rate 20/min
Temperature 38° C (100.4° F)
Exhibit 2
Medical History
22-year-old client admitted following episodes of hallucinations and delusions. Outpatient treatment has been
ineffective. Client has been unable to maintain a job and friends have said the client has been acting different than
usual. Family members have noticed that the client no longer maintains a clean and neat appearance.
 Assessment Findings Positive Symptoms
Negative Symptoms

Catatonia

Delusions of grandeur

Clang associations

Absence of intonation in speech

Alogia

Withdrawal from social activities

A nurse is planning care for an adolescent who is being admitted to an acute care unit following a suicide attempt. Which of
the following interventions should the nurse identify as the priority?
Arrange one-to-one observation of the client.
Encourage interaction with the client's peers.
Administer medication for depressive disorder.
Encourage the client to attend a support group.

A nurse is obtaining a mental health history from an older adult client. Which of the following actions should the nurse plan
to take?
Raise the pitch of the voice when speaking to the client.
Begin the interview by explaining the plan of care.
Interview the client in a private setting.
Ask the client to complete a detailed questionnaire.

A nurse in an outpatient mental health setting is collecting a health history from a client who is taking paroxetine for
depression. The client reports to the nurse that he also take herbal supplements. The nurse should advise the client which of
the following supplements interacts adversely with paroxetine?
St. John's wort
Saw palmetto
Echinacea
Ginkgo

A community health nurse is planning an education program about depressive disorders. Which of the following factors
should the nurse include as increasing the risk for depression?
Male gender
Hyperthyroidism
Substance use disorder
Being married
A nurse is assessing a client who has schizophrenia. Which of the following finding should the nurse document as a
negative symptoms of this disorder?
Delusions
Neologisms
Anhedonia
Echopraxia

A nurse is planning discharge for a client who has bipolar disorder and has a prescription for lithium. Which of the following
statements indicates understanding of the teaching about the medications?
"I should eat a regular diet with normal amounts of salt and fluids."
"I should discontinue the lithium when I begin to feel better."
"I need to be careful to avoid becoming addicted to the lithium."
"I can skip a dose of medication if my stomach is upset."

A nurse is discussing the home care of a client who has advanced Alzheimer’s disease with the client’s partner, who is
planning to go out of town for several days. Which of the following resources should the nurse recommend to the caregiver?
Respite care
Partial hospitalization
Adult day care program
Geropsychiatric unit

A nurse on a mental health unit is admitting a client who is anxious and tells the nurse, “I hear voices telling me what to do.“
Which of the following actions should the nurse take?
Tell the client that the voices do not really exist.
Touch the client to help reduce feelings of anxiety.
Instruct the client to go to a quiet room when the voices start talking.
Ask the client what the voices are saying.

A nurse in a community health center is counseling a family of two parents and two children. Which of the following
statements by a family member indicates manipulative behaviors?
"If you do my homework for me, I won't bother you for the rest of the day."
"Mom is always upset."
"It's not the children's fault. It's mine."
"It's your fault that we're having problems as a family."
A nurse in the emergency department (ED) is admitting a client who was dropped off at the front door.
Exhibit 1
Nurses' Notes
0200:
Client is difficult to arouse, is unable to report on recent events, and is unaware of arrival to ED.
Evidence of emesis on clothing. Client reports nausea and has vomited two times since arrival.
Odor of alcohol on breath and clothing.
Client connected to cardiopulmonary monitoring. Alarms set.
0210:
Provider updated and prescriptions received

Exhibit 2
Graphic Record
0200:
Temperature 35.6° C (96° F)
Heart rate 62/min
Respiratory rate 11/min
Blood pressure 90/56 mm Hg
Oxygen saturation 95% on room air
Weight 74.8 kg (165 lb)
Glasgow coma scale (GCS) 13 (3 to 15)
Exhibit 3
Diagnostic Results

0230:
Blood alcohol concentration (BAC) 340 mg/dL (0 to 50 mg/dL)
Blood glucose level 82 mg/dL (74 to 106 mg/dL)
WBC count 7,400/mm3 (5,000 to 10,000/mm3)

Exhibit 4
Provider's Prescriptions
Obtain blood alcohol concentration (BAC).
Obtain blood glucose level.
Obtain WBC count.

Exhibit 5
Progress Report
0230:
Prior medical record obtained and reviewed.
Client has a history of major depressive disorder and has had two prior suicide attempts.
Currently lives at a halfway house in town.
Last hospitalization was 3 months ago for phenelzine toxicity.
Client was changed to selegiline transdermal prior to discharge.
Weight at time of discharge was 83.5 kg (184 lb).
The nurse is assessing the client.
Select the 5 finding the require follow up:

Oxygen saturation
Blood glucose level
Temperature
Nausea and vomiting
GSC score
Respiratory rate
WBC count
Level of consciousness (LOC)
BAC

A nurse in the emergency department (ED)a is caring for a client who has alcohol toxicity?
Exhitbit 1
Nurses' Notes
0200:
Client is difficult to arouse, is unable to report on recent events, and is unaware of arrival to ED.
Evidence of emesis on clothing. Client reports nausea and has vomited two times since arrival.
Odor of alcohol on breath and clothing.
Client connected to cardiopulmonary monitoring. Alarms set.
0210:
Provider updated and prescriptions received.
0330:
Client has had no further emesis.
Client woke up and is becoming very agitated, irritable, and anxious.
Client requests water to drink.
Client is still unable to remember recent events or how they arrived at the ED, resulting in fearful behavior.
Hand tremors noted.

Exhibit 2
Graphic Record
0200:
Temperature 35.6° C (96° F)
Heart rate 62/min
Respiratory rate 11/min
Blood pressure 90/56 mm Hg
Oxygen saturation 95% on room air
Weight 74.8 kg (165 lb)
Glasgow coma scale (GCS) 13 (3 to 15)
0330:
Temperature 37.7° C (99.9° F)
Heart rate 90/min
Respiratory rate 20/min
Blood pressure 100/64 mm Hg
Oxygen saturation 96% on room air

Exhibit 3
Diagnostic Results
0230:
Blood alcohol concentration (BAC) 340 mg/dL (0 to 50 mg/dL)
Blood glucose level 82 mg/dL (74 to 106 mg/dL)
WBC count 7,400/mm3 (5,000 to 10,000/mm3)
EProvider's Prescriptions
Obtain blood alcohol concentration (BAC).
Obtain blood glucose level.
Obtain WBC count.xhibit 4
Exhibit 5

Progress Report
0230:
Prior medical record obtained and reviewed.
Client has a history of major depressive disorder and has had two prior suicide attempts.
Currently lives at a halfway house in town.
Last hospitalization was 3 months ago for phenelzine toxicity.
Client was changed to selegiline transdermal prior to discharge.
Weight at time of discharge was 83.5 kg (184 lb).

Complete the following sentence by choosing from the lists of options.

The client is at risk for developing __alcohol withdrawal syndrome_________ as evidenced by the client’s mental status

A nurse in the emergency department (ED) is caring fro a client who has alcohol toxicity?

A nurse is admitting a client who has anorexia nervosa and is at 60% of ideal body weight. Which of the following
interventions should the nurse include in the plan of care?
Encourage the client to drink 125 mL of fluid each hour while awake.
Allow the client to eat independently in their room.
Weigh the client twice weekly.
Measure the client's vital signs once each day.

A nurse is caring for a group of clients. Which of the following finding is the nurse required to report?
A client who has bipolar disorder and tested positive for genital herpes simplex virus reports having multiple sexual
partners.
A client who has depression reports having a lack of interest in assisting their partner in the care of their children.
A client who has borderline personality disorder threatened to harm their roommate.
An adolescent client who has anorexia nervosa has a BMI of 17.

A nurse is assessing a school-age child who has conduct disorder. Which of the following characteristics
should the nurse expect the child to demonstrate?
Feelings of remorse
Extended periods of depression
Deficits in intellectual functioning
Aggression toward animals

A nurse is providing teaching to a client who is to begin undergoing light therapy at home. Which of the
following information should the nurse include in the teaching?
Ensure a family member can be present during treatment.
Increase fluid intake for 24 hr before the treatment starts.
Change position slowly when the treatment is complete.
Avoid looking directly at the light during treatment.
A nurse is caring for a client who has borderline personality disorder. Which of the following goals is the
priority when planning care for this client?
The client will take prescribed medications as scheduled.
The client will express feelings of frustration.
The client will refrain from self-mutilation.
The client will participate in group therapy.

A nurse in a mental health clinic is planning care for a client who has a new prescription for olanzapine.
Which of the following interventions should the nurse identify as the priority?
Advise the client to take frequent sips of water.
Instruct the client to avoid driving during initial therapy.
Consult a dietitian for a calorie-controlled diet plan.
Recommend that the client exercise regularly.