NUR290 Final

Free preview · Original latest version

Sample questions from NUR290 Final

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, report identifies four clients. Which client should the nurse assess first?

   • A.A 45-year-old with diabetes whose premeal glucose is 240 mg/dL and who is requesting insulin
   • B.A 72-year-old with pneumonia whose temperature is 38.2 C and who is due for acetaminophen
   • C.A 54-year-old 2 hours after thyroidectomy who is restless and making high-pitched inspiratory sounds
   • D.A 68-year-old with chronic heart failure who has bilateral ankle edema and SpO2 95% on room air

   Rationale: Restlessness and stridor after thyroidectomy suggest airway obstruction from edema or bleeding and require immediate assessment and intervention. The other findings require follow-up but do not indicate an immediate airway threat. Use airway, breathing, circulation priorities when selecting which client to see first.

2. 2.In a pediatric clinic, a 6-year-old has a temperature of 39.1 C, a dry cough, and a positive influenza test. Which actions are appropriate when assigning care to the team? Select all that apply.

   • A.Ask the nursing assistant to obtain routine vital signs after the RN establishes a plan
   • B.Ask the LPN to perform the initial assessment of a child with increasing work of breathing
   • C.Ask the experienced RN to assess the child's respiratory status and overall condition
   • D.Ask the LPN to administer a prescribed oral antipyretic to the stable child
   • E.Delegate interpretation of the influenza test and teaching to the nursing assistant

   Rationale: The RN retains initial assessment, interpretation, and teaching responsibilities, so the RN should assess the child. An LPN may administer a prescribed medication to a stable client, and a nursing assistant may collect routine data after the RN determines the plan. Test interpretation and assessment of deterioration cannot be delegated to unlicensed staff or assigned as an initial LPN assessment.

3. 3.A provider prescribes a medication dose that appears ten times higher than the usual dose for a 9-year-old. The child is stable, and the medication is due now. What should the nurse do first?

   • A.Hold the medication and clarify the prescription with the prescriber
   • B.Give one tenth of the prescribed dose and document the change
   • C.Ask another nurse to verify the dose, then administer it
   • D.Administer the dose and monitor for adverse effects

   Rationale: A potentially unsafe prescription must be clarified before administration. Independent verification does not make an implausible dose safe, and the nurse cannot independently alter the prescribed dose. The nurse is accountable for questioning orders that may harm the client.

4. 4.During a home visit, a 77-year-old client with heart failure reports gaining 2.3 kg (5 lb) in 3 days and needing two extra pillows to sleep. Which action should the nurse take first?

   • A.Review the client's sodium intake at the next scheduled visit
   • B.Notify the health care provider of the weight gain and worsening orthopnea
   • C.Ask the client to record weight again in one week
   • D.Recommend that the client stop taking the prescribed diuretic

   Answer and rationale are in the full material.

5. 5.At 1400, a 63-year-old client with a new colostomy is scheduled for discharge, but the client cannot demonstrate pouch emptying and says, "I am afraid to do this alone." Which action is most appropriate?

   • A.Document that the client declined teaching
   • B.Proceed with discharge because written instructions are available
   • C.Ask the client's family to complete the pouch care at home
   • D.Delay discharge and arrange further teaching and return demonstration

   Answer and rationale are in the full material.