NUR-1030

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Sample questions from NUR-1030

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, the charge nurse receives report on four clients. Which client should the nurse assess first?

   • A.A 77-year-old with diabetes whose premeal blood glucose is 198 mg/dL and who is waiting for lunch
   • B.A 41-year-old awaiting discharge who needs clarification about a new prescription
   • C.A 54-year-old with pneumonia whose SpO2 has decreased from 95% to 88% on 2 L/min nasal cannula
   • D.A 68-year-old who is 1 day postoperative and reports incisional pain of 7/10, with stable vital signs

   Rationale: The client with pneumonia has a new decline in oxygenation despite supplemental oxygen, which may indicate worsening respiratory status and requires prompt assessment. The postoperative client's pain needs timely treatment, but stable vital signs make it less urgent. Discharge teaching and a moderately elevated premeal glucose are important but do not take priority over a possible airway or breathing problem. Prioritize acute changes using airway, breathing, and circulation.

2. 2.In a long-term care facility, a 4-year-old visiting a resident is found with a soiled diaper while the resident's certified nursing assistant is preparing to assist another resident with a meal. Which tasks may the registered nurse delegate to the certified nursing assistant? Select all that apply.

   • A.Teach the resident how to use a newly prescribed inhaler
   • B.Assess the resident's skin for a new pressure injury
   • C.Report to the registered nurse that the resident ate less than half of the meal
   • D.Obtain and record the resident's routine temperature and pulse
   • E.Assist the resident with eating after the registered nurse confirms the prescribed diet and swallowing precautions

   Rationale: A trained nursing assistant may obtain routine vital signs and assist with feeding when the registered nurse has established the diet and swallowing precautions. The assistant should report the resident's intake so the registered nurse can evaluate it. Skin assessment and inhaler teaching require nursing assessment or education and cannot be delegated to unlicensed assistive personnel. Delegation assigns predictable tasks while the registered nurse retains responsibility for assessment, teaching, and evaluation.

3. 3.A client states, 'I do not want the blood transfusion,' after signing the consent form in the hospital. The client is alert, understands the explanation, and has a hemoglobin level of 6.8 g/dL. Which action should the nurse take?

   • A.Notify the provider that the client has withdrawn consent and document the client's decision
   • B.Explain that the client must accept the transfusion because the hemoglobin is critically low
   • C.Ask the client's adult child to persuade the client to accept the transfusion
   • D.Begin the transfusion because the client previously signed the consent form

   Rationale: A client with decision-making capacity may withdraw consent at any time, including after signing the consent form. The nurse should promptly notify the provider and document the client's decision and relevant communication. A family member cannot override the decision of a capable adult, and the prior signature does not authorize treatment after consent is withdrawn. Respecting informed refusal is a core component of client autonomy.

4. 4.During a home visit, a public health nurse finds a 72-year-old client with heart failure sitting upright and stating, 'I cannot catch my breath.' The client has new bilateral crackles, RR 30/min, BP 168/92 mm Hg, and SpO2 86% on room air. Which action should the nurse take first?

   • A.Call the client's family to arrange transportation to the clinic later today
   • B.Call emergency medical services and remain with the client while providing immediate supportive care
   • C.Ask the client to weigh themself and record the result in the home log
   • D.Review the client's sodium intake and reinforce the low-sodium diet

   Answer and rationale are in the full material.

5. 5.The provider prescribes a medication dose that is substantially higher than the usual dose for a 2-month-old infant in the pediatric clinic. The infant's weight is documented in kilograms, and the medication is due now. What should the nurse do?

   • A.Reduce the dose to the usual range and document the adjustment
   • B.Administer the prescribed dose because the provider is responsible for the order
   • C.Ask the infant's parent to confirm the dose from a previous prescription
   • D.Hold the medication and clarify the dose with the provider before administration

   Answer and rationale are in the full material.