NUR-1040

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Sample questions from NUR-1040

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a medical-surgical unit, a 68-year-old client with heart failure has an oxygen saturation of 89% on room air, new crackles, and increased work of breathing. Which action should the nurse take first?

   • A.Document the findings and reassess the client in 30 minutes.
   • B.Call the client's family to ask about the usual breathing pattern.
   • C.Ask the unlicensed assistive personnel to obtain the client's daily weight.
   • D.Raise the head of the bed and apply oxygen according to protocol.

   Rationale: Raising the head of the bed and supporting oxygenation address the immediate breathing problem. Obtaining a weight and gathering family information may be useful later but do not stabilize the client. Waiting to reassess delays care for a client with signs of respiratory compromise; address an immediate threat before routine tasks.

2. 2.In a community clinic, a 15-year-old reports feeling unsafe at home and asks to speak privately; the parent is in the waiting room. Which actions should the nurse take? Select all that apply.

   • A.Assess for immediate danger, abuse, and thoughts of self-harm.
   • B.Ask the parent to answer the safety questions on the adolescent's behalf.
   • C.Explain the limits of confidentiality before asking sensitive questions.
   • D.Promise that nothing the adolescent says will be shared with anyone.
   • E.Interview the adolescent privately using open-ended questions.

   Rationale: Explaining confidentiality limits supports trust while being honest about required safety disclosures, and a private interview encourages accurate communication. Assessment for immediate danger, abuse, and self-harm identifies urgent risks that require follow-up. Promising absolute secrecy is inappropriate, and relying on the parent to answer can prevent disclosure or compromise safety.

3. 3.During a home visit, a 79-year-old client with limited mobility has a new prescription for an anticoagulant and says, "I take all my pills from the same bottle because the labels are hard to read." Which action is the nurse's priority?

   • A.Recommend that the client purchase a weekly pill organizer.
   • B.Contact the prescriber or pharmacist to reconcile the medications and arrange a safe labeling plan.
   • C.Tell the client to stop the anticoagulant until the next appointment.
   • D.Ask the client to demonstrate how the medications are currently taken.

   Rationale: The nurse should first clarify the medication regimen and collaborate on a safe system, because mixing medications creates a serious error risk, especially with an anticoagulant. A demonstration helps assess the problem, and an organizer may eventually help, but neither replaces medication reconciliation and accessible labeling. The nurse should not independently discontinue a prescribed medication.

4. 4.In a long-term care facility, a 90-year-old resident with dementia is found on the floor beside the bed after an unwitnessed fall; the resident is awake and has a small scalp bruise. What should the nurse do first?

   • A.Notify the resident's family of the fall.
   • B.Complete the facility incident report.
   • C.Assess the resident for injury and obtain vital signs.
   • D.Move the resident back to bed using a mechanical lift.

   Answer and rationale are in the full material.

5. 5.A provider prescribes a medication for a 46-year-old client who has a documented severe allergy to that medication in the electronic record. The client is stable, and the medication is due now. What is the nurse's best action?

   • A.Hold the medication and clarify the prescription with the prescriber.
   • B.Administer the medication and observe the client closely.
   • C.Remove the allergy entry because the prescription is current.
   • D.Ask another nurse to verify the prescription before administering it.

   Answer and rationale are in the full material.