Nursing - Medical Surgical Health Assessment Critical Care

Free

The nurse reviewing a client's 1 hour GTT notes that the results are 155 mg/dl. Which should the nurse interpret the findings to indicate?

2

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The nurse reviewing records notes that a client has a positive Brudzinski's sign. Which clinical manifestation should the nurse recognize validates the assessment finding?

3

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The nurse is reviewing overall cultural beliefs in relation to health and illness. Which should the nurse recognize is the basis for belief that centers around the cause of illness?

4

Free

The intensive care unit nurse is preparing to assess the level of consciousness of a client who is intubated and has both hands restrained to prevent the client from pulling out the endotracheal tube. The client's injury occurred due to a stabbing incident that ultimately caused the client to fall and hit his head. Which item related to the client will cause the nurse to report an incomplete Glasgow Coma Score (GCS)?

5

Free

A client is diagnosed with Group B Streptococcus at 37 weeks' gestation. Which prescribed treatment should the nurse be prepared to discuss?

6

A client with a self-reported history of type 2 diabetes mellitus and an ulcer wound on the left foot states to the nurse, "I am healthy, I don't know why I have to be here to get a check-up." Which statement by the nurse is the most appropriate?

7

The nurse cares for a client who needs a PCA pump for control of postoperative pain. Which task can the nurse delegate to the unlicensed assistive personnel (UAP)?

8

The educator is reviewing the nursing staff's spiritual care competence. Which statement made by a nurse should the educator be concerned with?

9

The nurse assesses the fundus of a client who delivered 6 hours ago and notes that it is 2 centimeters above the umbilicus and is displaced to the right. Which is the nurse's best action at this time?

10

The nurse has just begun a new enteral feeding on a client using a closed system of formula. The nurse labels the bag with the time and date it was begun (1300 hours on 12/6) knowing that this will mean the feeding tubing set will need to be changed at which time and date?

11

A newly pregnant client tells the nurse she takes daily herbal supplements. Which initial action should the nurse take?

12

A client at 33 weeks' gestation calls the healthcare provider's office and reports she was attempting to nap when she became dizzy and felt faint. Which assessment data is the priority in this situation?

13

The nurse is assisting the healthcare provider during a vaginal examination. The healthcare provider notes that the cervix has a bluish-purple change in coloration. Based on this data, which will the nurse document in the medical record?

14

The nurse is assessing a client that is a new refugee in the country. Which should the nurse assist the client with to help them overcome a barrier unrelated to the healthcare system?

15

The nurse is caring for a client who is using a TENS unit for pain management. Which statements will the nurse use when teaching the client about this therapy? Select all that apply.

16

A pregnant client with hepatitis B asks the nurse if their baby will be born with the virus. Which information should the nurse include in the discussion?

17

The nurse is preparing to interview a client with osteoporosis. Which question related to symptoms should the nurse include?

18

A client's mother is distraught over her child's recent leukemic relapse and states, "What did I do wrong? Why does he deserve this? Why can't it be me?" Which should the nurse recognize the statements are associated with?

19

While auscultating a client's lungs, the nurse identifies more than one sound. Which action by the nurse is the most appropriate?

20

A nurse assesses a client who is experiencing acute pain. Which aspects of the pain assessment are gathered first before the detailed assessment? Select all that apply.

21

The nurse is preparing to obtain an obstetrical history from a client. Which question should the nurse include?

22

The nurse is assessing a client that experienced a head injury using the Glasgow Coma Scale. Which findings reflect the motor response portion of the scale? Select all that apply.

23

The nurse educator is teaching a group of students about cultural differences to consider when conducting an ear, nose, and throat assessment. Which statement by a nursing student indicates appropriate understanding of the information presented?

24

The nurses have requested a documentation system that will reduce the time spent writing out routine tasks but will still allow for documentation of exceptions. Which type of documentation should the nurse manager consider implementing in the healthcare organization?

25

The nurse is caring for a client in acute pain. When assessing the client's quality of pain, which statement will the nurse use?

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Nursing - Medical Surgical Health Assessment Critical Care

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