Ns 250

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Sample questions from Ns 250

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

1. 1.A 68-year-old client is admitted to a medical unit with pneumonia. The nurse has four clients to assess. Which client should the nurse see first?

   • A.A client with pneumonia whose oxygen saturation has fallen from 94% to 86% on 2 L/min nasal cannula
   • B.A client with diabetes whose premeal glucose is 248 mg/dL
   • C.A client 1 day after surgery who rates incisional pain as 7 out of 10
   • D.A client with a urinary tract infection who reports burning with urination

   Rationale: The falling oxygen saturation signals worsening oxygenation and requires immediate assessment and intervention. Hyperglycemia, dysuria, and postoperative pain need timely care, but none indicates a more immediate threat to airway or breathing. The exam takeaway is to prioritize acute changes in oxygenation over stable, expected problems.

2. 2.A 72-year-old client with heart failure is being discharged from a medical unit. The client has new prescriptions for a diuretic and an ACE inhibitor and says, "I cannot remember which pills I take in the morning." Which action should the nurse take before discharge?

   • A.Tell the client to take all medications together at bedtime
   • B.Reconcile the medication list with the client and use teach-back with a written schedule
   • C.Have the client sign the discharge papers before reviewing the medications
   • D.Ask the client to rely on memory and call the clinic if a dose is missed

   Rationale: Medication reconciliation followed by teach-back and a clear written schedule helps identify discrepancies and confirm understanding. Relying on memory does not resolve the client's stated difficulty, and changing administration times without an order may be unsafe. Signing paperwork is not a substitute for medication education.

3. 3.A 78-year-old client with heart failure is admitted to a medical unit with increasing dyspnea. The client is restless, has crackles bilaterally, oxygen saturation of 88% on room air, and blood pressure of 168/92 mm Hg. Which actions should the nurse take initially? Select all that apply.

   • A.Notify the provider or rapid response team based on the client's condition
   • B.Encourage the client to drink a large glass of water
   • C.Raise the head of the bed to improve ventilation
   • D.Apply oxygen as prescribed or per emergency protocol
   • E.Place the client flat to conserve energy

   Rationale: Upright positioning and oxygen support address impaired breathing, while prompt escalation is appropriate for acute hypoxemia and pulmonary congestion. Encouraging a large fluid intake can worsen volume overload. Lying flat can increase venous return and make dyspnea worse.

4. 4.A 74-year-old client with a new stroke is admitted to a neurologic unit. The client has right-sided weakness, slurred speech, and an order for oral medications. The client coughs after a sip of water. What should the nurse do?

   • A.Place the client supine and repeat the water test
   • B.Crush the medications in applesauce and administer them
   • C.Offer a straw to help the client control the liquid
   • D.Hold oral intake and request a swallowing evaluation before giving anything by mouth

   Answer and rationale are in the full material.

5. 5.A 67-year-old client is scheduled for elective surgery at an ambulatory surgical center. The client has signed the consent form but tells the nurse, "I still do not understand the major risks." Vital signs are stable. What should the nurse do?

   • A.Explain the surgical risks in detail and ask the client to proceed
   • B.Ask a family member to explain the risks and witness the consent
   • C.Pause the preparation and notify the surgeon that the client needs further explanation
   • D.Administer the preoperative sedative so the client can relax

   Answer and rationale are in the full material.