NRS572

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Sample questions from NRS572

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

1. 1.Refer to the client's chart. Which actions should the charge nurse take in response to the change in the client's condition? Select all that apply.

   • A.Reassess the client's airway and work of breathing.
   • B.Wait for the next scheduled assessment before contacting the provider.
   • C.Notify the rapid response team.
   • D.Place the client supine and leave to obtain a complete set of vital signs.
   • E.Apply oxygen according to emergency protocol.

   Rationale: The falling oxygen saturation, increasing respiratory rate, and new confusion require an immediate airway and breathing assessment and escalation to the rapid response team. Applying oxygen per emergency protocol supports oxygenation while help is mobilized. Lying the client supine may worsen breathing, and waiting for the next assessment delays treatment.

2. 2.At change of shift on a medical unit, the charge nurse receives report on four clients. Which client should the nurse assess first?

   • A.A client with diabetes whose premeal glucose is 248 mg/dL and who requests insulin.
   • B.A client 4 hours after thyroidectomy who is restless and has noisy respirations.
   • C.A client with heart failure who has bilateral ankle edema unchanged from yesterday.
   • D.A client with a fractured wrist reporting pain of 7 on a 0-to-10 scale.

   Rationale: Noisy respirations after thyroid surgery may indicate airway obstruction from edema or a neck hematoma and require immediate assessment. Hyperglycemia and pain need timely care but are not the most immediate threat. Stable, unchanged edema is a lower priority.

3. 3.On a rehabilitation unit, an RN is assigning care to assistive personnel (AP). Which task is appropriate to delegate to the AP for a stable client?

   • A.Assess a new report of dizziness during ambulation.
   • B.Evaluate whether a pain medication relieved pain.
   • C.Teach use of a newly prescribed walker.
   • D.Obtain routine morning weight and report the result.

   Rationale: Obtaining a routine weight is a predictable task that can be delegated to trained AP, with the RN interpreting the result. Assessment, teaching, and evaluation require nursing judgment and remain the RN's responsibility. The RN should specify parameters for promptly reporting an unexpected weight.

4. 4.A provider prescribes IV potassium chloride for a hospitalized client with a potassium level of 2.9 mEq/L. Which action should the nurse take?

   • A.Give the medication through an infiltrated peripheral IV to avoid delay.
   • B.Hold the medication until the potassium level is above 3.5 mEq/L.
   • C.Verify the prescribed dilution and infusion rate before administration.
   • D.Administer the medication by IV push over 5 minutes.

   Answer and rationale are in the full material.

5. 5.During a home visit, a client with limited mobility says transportation problems have caused missed wound-care appointments. Which nursing action is best?

   • A.Ask about barriers and collaborate on transportation and home-care resources.
   • B.Document that the client is nonadherent.
   • C.Schedule appointments without discussing the client's preferences.
   • D.Tell the client that appointments are required to prevent complications.

   Answer and rationale are in the full material.