1. The nurse has just completed discharge teaching about sublingual nitroglycerin NTG tablets to a client

PREBOARD 15 A

1.) The nurse has just completed discharge teaching about sublingual nitroglycerin (NTG) tablets to a client with stable angina. Which statement by the client indicates the need for further teaching?

• “I will call 911 if my chest pain isn’t relieved by NTG.”
• “If I have chest pain, I can take up to 3 pills 5 minutes apart.”
• “I’ll call my doctor if I start having chest pain at night.”
• “I’ll keep one bottle in the house and one in the car.”

2.) Ann is pregnant now and has had 1 miscarriage at 12 weeks, son born at 36 weeks, daughter born at 39 weeks, and a son born at 25 weeks that died shortly after delivery.

1. 41202

2. 41212

3. 51202

4. 51212

3.) The LPN is authorized to do the following with intravenous Piggy Back (IVPB). Select all that apply:

• Saline flush
• Total Parental Nutrition
• Heparin flush
• IVPB set up
• IV medications

4.) The following are true about cold therapy. Select all that apply:

• Decrease pain
• Slow/Stop bleeding
• Slows bacterial activity
• Decrease muscle tension
• Applied for 20-30 minutes then reapplied after an hour

5.) The nurse on a postpartum nursing unit is receiving report about a client who had a normal spontaneous vaginal delivery the night before. The client has been passing golf ball-sized clots on her peri-pad for the last few hours. The client's most recent blood pressure is 88/56 mm Hg, and her heart rate is 118 bpm. The nurse enters the client's room and notices blood oozing from her intravenous insertion site. Which action should the nurse take first?

• Perform peri-care and change the client's peri-pad.
• Notify the client's health care provider.
• Palpate and massage the client's uterus.
• Encourage breastfeeding to promote uterine contractions.

6.) The nurse in the primary care office is speaking with a client who has contact dermatitis on both hands. The client wants to know how to manage the condition. Which interventions should the nurse recommend to the client? Select all that apply.

• Applying a cold pack to the area can help
• Corticosteroid cream is acceptable to use
• Using soap without fragrance is recommended
• Avoid heat that can exacerbate symptoms
• Rubbing the area can alleviate symptoms
• Frequent handwashing is important

7.) A client is evaluated in the emergency department for an ankle sprain. Which discharge instructions should the nurse provide? Select all that apply.

• "It is important to avoid standing or walking without crutches until after your follow-up visit."
• "You should apply an ice pack to your ankle for 20 to 30 minutes at a time, 3 to 4 times a day."
• "Rest your foot and ankle tonight, but start strengthening exercises tomorrow morning."
• "To help decrease swelling, it is important to keep your ankle elevated when you are resting."
• "Wrap your foot and ankle tightly with the elastic wrap and leave on overnight."

8.) A community health clinic nurse is interviewing a client who is experiencing lightheadedness. The client reports a history of arthritis and is taking ibuprofen for the pain. The client is pale with a blood pressure of 88/40 mmHg. The client’s pulse is 114 bpm, the respiratory rate is 22 breaths per minute, and the oral temperature is 98.2°F (36.7°C). Which additional information should the nurse solicit from the client? Select all that apply.

• Color of bowel movements
• Presence of photophobia
• Presence of tingling or numbness in the extremities
• Presence of bruises
• Frequency and amount of ibuprofen used

9.) The nurse is providing discharge education to a client hospitalized for an acute exacerbation of rheumatoid arthritis. The nurse includes information focusing on conserving energy. Which statements by the client demonstrate the teaching has been effective? Select all that apply.

• "I will set priorities and complete the important tasks first."
• "If possible, I will delegate some things to my friends or family."
• "I will schedule activities throughout the day instead of trying to complete everything in the morning."
• "I will sit on a tall kitchen stool instead of standing when I am preparing meals."
• "On days of increased pain, I will stay in bed and relax instead of being active."

10.) The nurse is admitting a client through the emergency department who is 28-weeks pregnant and has a tentative diagnosis of placenta abruption. Which of the following actions should the nurse take first?

• Administer oxygen by mask at 100%
• Check fetal heart rate every 15 minutes
• Insert urethral catheter and monitor urine output hourly
• Start a second IV with an 18 gauge cannula

11.) The nurse is caring for a 68-year-old client who had a total hip replacement three days ago. Which client statement requires the nurse's immediate attention?

• "It seems that the pain medication is not working as well today."
• "I have to use the bedpan to pass my water at least every hour."
• "I have bad muscle spasms in my lower leg, below the incision."
• "I seem to have trouble breathing when I am resting in bed."

12.) Beth is pregnant and has two sons: one born at 40 weeks and the other at 39 weeks. She also has one daughter born at 34 weeks.

1. 42103

2. 32103

3. 43104

4. 42113

13.) A 16-year-old adolescent is admitted for Ewing's sarcoma of the tibia. In discussing the care with the parents, the nurse should understand that the initial treatment for this diagnosis usually includes which approach?

• Bone marrow graft in the affected leg
• Amputation of the affected leg
• Chemotherapy with adjunctive radiation
• Surgical excision of the mass

14.) The nurse is eating in the hospital cafeteria when a toddler at a nearby table begins to choke on a piece of food and turns slightly blue. What initial action should the nurse take?

• Give the child water to help with swallowing
• Perform abdominal thrusts
• Begin mouth to mouth resuscitation
• Call for the emergency response team

15.) The nurse in a public health clinic is caring for a female client diagnosed with genital herpes who reports dysuria, dyspareunia, leukorrhea, and lesions of the labia and perianal skin. Which interventions should the nurse include in the discharge instructions? Select all that apply.

• Soak in a tub of hot water
• Apply a wrapped ice pack to the sores
• Use lubrication during sexual intercourse
• Increase fluids to dilute urine
• Apply petroleum jelly to blistered areas
• Avoid any tight clothing

16.) The nurse in the urgent care center is caring for a 20-year-old client who sustained a sprained ankle while playing sports. Which instructions should the nurse give the client to prevent a future sprain injury? Select all that apply.

• Take ibuprofen 30 minutes before starting any sports activity.
• Wear snug, well-fitting shoes that go up to the ankle.
• Warm up for several minutes before starting the activity.
• Use appropriate protective equipment with the activity.
• Encourage stretching before and after any sports activity.

17.) The home health nurse is discussing safety concerns with a client who has osteoporosis. Which interventions should the nurse recommend to the client? Select all that apply.

• Request a referral for physical therapy.
• Increase intake of dairy products.
• Provide assistive devices, if needed.
• Go for a jog or run several times a week.
• Enroll in a smoking cessation program.

18.) The nurse is developing a plan of care for an older adult client who will be undergoing a total hip arthroplasty. To improve the client’s postoperative recovery, which interventions should the nurse include? Select all that apply.

• The use of assistive devices for ambulation
• Administration of subcutaneous warfarin
• Preoperative pain control with naproxen
• Application of sequential compression device
• Instruction on plantar and dorsiflexion exercises

19.) The nurse is admitting a 73-year-old client who has a fractured right hip. Which interventions should the nurse include in the client’s plan of care? Select all that apply.

• Place the client on continuous pulse oximetry.
• Palpate the client’s bilateral pedal pulses every four hours.
• Perform daily circulation, motion and sensation checks on the client’s right leg.
• Ask about the client’s pain level with every set of vital signs.
• Reposition the client every hour to prevent skin breakdown.

20.) The nurse is admitting a 73-year-old client who has a fractured right hip. Which interventions should the nurse include in the client’s plan of care? Select all that apply.

• Place the client on continuous pulse oximetry.
• Palpate the client’s bilateral pedal pulses every four hours.
• Perform daily circulation, motion and sensation checks on the client’s right leg.
• Ask about the client’s pain level with every set of vital signs.
• Reposition the client every hour to prevent skin breakdown.

21.) A client who has been newly diagnosed with carpal tunnel syndrome asks the nurse why they are having pain and tingling in their fingers. Which is the best response from the nurse?

• "The pain and tingling is caused by uric acid crystals collecting in the small joints of your fingers."
• "The pain and tingling is caused by compression of the median nerve in your wrist."
• "The pain and tingling is due to sclerotic plaques along the nerves in your hand."
• "The pain and tingling is caused by the fluid build-up in the soft tissue of your fingers."

22.) The nurse is caring for a client with a femur fracture. Which assessment findings require the nurse's immediate action? Select all that apply.

• Absent pulse in affected extremity
• Allergy to penicillin
• Blood pressure of 88/54 mm Hg
• Palpable hard mass near fracture site
• Shortness of breath
• Pain level of 5 (0 to 10 scale)
• History of deep vein thrombosis

23.) The nurse is developing a plan of care for a client with acute rheumatoid arthritis.Which priority interventions should the nurse include? Select all that apply.

• Managing stress
• Establishing a weight loss goal
• Preserving joint function
• Relieving pain
• Preventing joint deformity

24.) A client has received education from the nurse about their new diagnosis of systemic lupus erythematosus. Which statement by the client indicates that additional teaching is needed?

• "I will avoid foods that contain high levels of vitamin K."
• "I may feel more tired and fatigued than I used to."
• "I will monitor my body temperature carefully."
• "I will protect my skin from the sun when I'm outside."

25.) The nurse is reviewing the medical record of a client who has been diagnosed with osteoporosis. The nurse identifies which risk factors for this condition? Select all that apply.

• The client weighs 200 lbs. (90.7 kg) with a height of 5 feet 2 inches (157 cm).
• The client has a 30 pack per year smoking history.
• The client takes 10 mg of prednisone daily.
• The client is a 75-year-old Caucasian female.
• The client performs weight-bearing exercises six days a week.

26.) The nurse is reviewing the medical record of a client with recurring, nonhealing venous stasis ulcers to the lower extremities. Which findings are most likely contributing to the nonhealing of the client's wounds? Select all that apply.

• The client is 74-years-old.
• The client's body mass index (BMI) is 16.5.
• The client has a history of seasonal allergies.
• The client's ethnicity is Asian American.
• The client has a history of benign prostatic hyperplasia.
• The client smokes one pack of cigarettes per day.

27.) A client presents with a small, elevated, and ulcerated skin lesion on the upper back. The lesion has irregular edges that vary in color. The nurse knows that this finding could be associated with which type of skin cancer?

• Actinic keratosis
• Basal cell carcinoma
• Melanoma
• Squamous cell carcinoma