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Exit A_Alt O Time Remaining: 00:16:34 89 of 100 Calculator The nurse is planning care for a client following thoracic surgery. One nursing diagnosis is acute discomfort related to the incision. Which client goal is best for this diagnosis? 01. Client will state pain relief by day of discharge. O2. Pain will be measured on a scale of 1 to 10 O3. Client will ask for pain medication when needed. O 4. Pain medication will be given when prescribed. Exit A_Alt Time Remaining: Calculator A client demonstrates no facial expressiveness. The nurse uses which term to describe the client’s facial appearance? 01. Broad affect O2. Labile affect O 3. Flat affect O 4 Euphoric affect Exit A_Alt Time Remaining: 00:18:09 87 of 100 Calculator A client sustained a spinal cord injury at the C6 level. The client wears a halo vest to stabilize the vertebrae following surgery. Which is the most important nursing action for this client? O 1. Maintaining adequate fluid volume O2. Maintaining adequate respirations, 3. Facilitating adequate bowel function. O 4. Facilitating bladder management. Time Remaining: 00:11:22 95 of 100 Exit A_Alt o Calculator A new parent asks the nurse why the baby needs an injection so soon after birth. The baby was born vaginally with no trauma or problems. The Apgar scores were 9 and 9. Which information does the nurse give to the parent? O 1. This injection will help the baby gain weight better. O2. This injection will help prevent bleeding in the baby O 3. This injection will help the baby eat better and sooner. O 4. This injection will help prevent infections in the baby Exit A_Alt Calculator Time Remaining: 00:12:43 94 of 100 A client with a history of chronic stable angina reports the pain is different this time.” Three doses of nitroglycerin have been taken with no relief. What does the emergency department nurse do next? 01. Gives a double dose of nitroglycerin sublingually O2. Explains how the prescribed clopidogrel will prevent recurrences. O 3. Discusses smoking cessation with the client, O 4. Initiates obtaining an electrocardiogram Exit A_Alt O Time Remaining: 00:07:32 99 of 100 o Calculator A client has Cushing syndrome caused by taking large amounts of prednisone. The nurse plans care and identifies these nursing diagnoses for the care plan. Place the diagnoses in order of priority starting with the highest priority diagnosis. All options must be used. Unordered Options Ordered Response Imbalanced Nutrition: More than body requirements related to increased appetite. Body image changes related to alterations in body conformation and weight gain, Risk for infection related to suppressed immune system Risk for ineffective coping related to changes in body image and self-esteem Risk for impaired skin integrity related to increased skin fragility Exit A_Alt Time Remaining: 00:08:46 98 of 100 o Calculator A school-age client diagnosed with cystic fibrosis returns to school following a hospitalization. Which nursing diagnosis is appropriate for this client? (Select all that apply.) 1. Risk for delayed development related to disease process. O2. Decreased cardiac output related to disease process and activity level 03. Risk for impaired gas exchange related to pulmonary changes. U 4. Risk for activity intolerance related to decreased air exchange 5. Imbalanced nutrition: More than body requirements related to school food 06. Noncompliance related to desire not to take medication at school Next >
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