A nurse is teaching a client who has a new prescription for metformin extended release tablets. Which of the following statements by the client indicates an understanding of the teaching? ⦁ I will avoid crushing this medication A nurse is assessing a client who is receiving enteral feeding via an NG tube. The client has developed hyperosmolar dehydration. Which of the following actions should the nurse take when administering the client’s findings? ⦁ Switch to a lactose-free formula. A nurse is providing discharge teaching to a client who has a new ostomy. Which of the following instructions should the nurse include? ⦁ Empty your ostomy pouch when it is half full A nurse is teaching the parents of a school-age child who has sickle cell anemia about managing the disease at home which of the following instructions should the nurse include? ⦁ Apply cold compresses too painful areas A nurse is teaching about Safe Handling of formula to a client who is postpartum and chooses to bottle feed her newborn. Which of the following statements by the client indicates an understanding of the teaching? ⦁ I should boil tap water for 2 minutes and call it before I mix it with powdered formula A nurse is assessing a child who is post-operative following a tonsillectomy. Which of the following findings should the nurse identify as the priority? ⦁ Frequent swallowing A nurse is teaching a client who is pregnant about non-stress testing. Which of the following statements by the client indicates an understanding of the teaching? ⦁ During this test, I will punch a button if the baby moves A nurse is monitoring a client who is receiving a transfusion of packed RBC's. The client reports chills, headaches, low back pain, and a feeling of tightness in his chest. The nurse should identify that the client has developed which of the following types of transfusion reactions? ⦁ Acute hemolytic A nurse is caring for a client who is in the latent phase of Labor and reports severe back pain. The vaginal examination reveals that the cervix is dilated two centimeters, 25% effaced and -2 station. Which of the following interventions should the nurse implement? ⦁ Request the provider prescribe a pudendal nerve block A nurse is teaching about how to suppress lactation with a client who is postpartum and bottle feeding her newborn. Which of the following instructions should the nurse include in the teaching? ⦁ You should wear a snug fitting bra continuously for 72 hours A nurse is preparing to administer medication to a client. What are the following identifiers should the nurse use to identify the client? ⦁ Room number A nurse is caring for a client who is taking antihypertensive medication and is moving from a supine to a seated position. Which of the following findings should indicate to the nurse that the client is experiencing orthostatic hypotension? The clients systolic blood pressure decreases by 25 mmHg While a nurse is caring for a client who is receiving mechanical ventilation via an endotracheal tube, the high-pressure alarm of the ventilator sounds. Which of the following actions should the nurse take? ⦁ Look for a leak in the tubes cuff A nurse is preparing to insert an indwelling urinary catheter for a client. Which of the following actions should the nurse take first? ⦁ Position the sterile drape leaving the perineum exposed A nurse is planning to administer packed RBC's to an older adult client who has a low hemoglobin level. Which of the following actions should the nurse plan to take? ⦁ Monitor Vital Signs every hour throughout the transfusion A new nurse in an acute mental health facility is teaching a client about potential adverse effects of transcranial magnetic stimulation. The nurse tells the client that he might not feel light-headed but that it should not affect his memory. The nurse is demonstrating which of the following ethical principles? ⦁ Beneficence A nurse is teaching a class about providing care within the legal scope of practice to a group of nurses. The nurse should include that which of the following procedures is outside the legal scope of practice for an RN? ⦁ Irrigation of the external ear canal A nurse in an acute care facility is caring for a client who has anorexia nervosa. During the first week of care, which of the following actions should the nurse take? ⦁ Observe the client for 1 hour after meals A nurse is planning care for a client who has sciatica and a prescription for a transcutaneous electrical nerve stimulation (TENS) unit. Which of the following referral should the nurse anticipate for the client? ⦁ Physical therapist A nurse is teaching a client who has generalized anxiety disorder about ways to help manage stress. Which of the following instructions should the nurse give the client about using Progressive relaxation? ⦁ Tighten the muscle group, then release tension and move to the next one A nurse is assessing a client who is at 37 weeks of gestation and reports sudden, severe abdominal pain with moderate vaginal bleeding and persistent uterine contraction. The client's blood pressure is 88 over 50 mmhg and her abdomen is rigid. The nurse should identify these findings as indicating which of the following complications? ⦁ Placenta abruption A home health nurse is planning care for an older adult client who has a vision loss and takes medication throughout the day. Which of the following actions should the nurse include in the plan? ⦁ Use container Lids of different shapes to indicate times of Administration A nurse is planning care for a client who has a history of urinary tract infections UTIs and requires placement of an indwelling catheter. Which of the following actions should the nurse take to help minimize the client's risk of acquiring a UTI? ⦁ Whoop the tubing so that is lower than the collection bag ⦁ keep urine a bag at bladder level when ambulating ⦁ secure the catheter to the client’s thigh ⦁ obtain urinary samples by disconnecting the tubing connections A nurse at an acute care facility is teaching a client about fall risk prevention strategies for use during their stay at the facility. Which of the following statements by the client indicates an understanding of the teaching? I will wear a yellow wristband, so everyone knows I'm at risk for falling A nurse is caring for a client who is taking disulfiram for alcohol-use disorder and reports ingestion of alcohol. For which of the following adverse effects should the nurse monitor? ⦁ Headache A nurse at the health department is providing anticipatory guidance to a parent of a one month or a year-old infant. The nurse should inform the parent that the infant should receive which of the following immunizations at the age of two months? ⦁ Rotavirus A Nurse is assisting in the selection of foods for a client who has dysphagia caused by a stroke. Which of the following foods should the nurse recommend? ⦁ Scrambled eggs A community health nurse is providing education to a group of older adults about immunizations. Which of the following immunizations should the nurse recommend? ⦁ Tdap A nurse is caring for a client who is postoperative following a mitral balloon valvuloplasty. Which of the following areas should the nurse auscultate to assess for mitral areas of the heart? (you will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.) A nurse is planning care for a client who is experiencing benzodiazepine toxicity. The nurse should plan to administer which of the following medications? ⦁ Flumazenil A nurse is admitting a client to the medical-surgical unit. The patient self-determination act requires the nurse to perform which of the following actions during the admission process? Document in the client's medical record is a client has advance directives A nurse is assessing a client who is postoperative following orthopedic surgery. Which of the following findings should the nurse identify as an indication of paralytic Ileus? ⦁ Abdominal distension A nurse is performing an administered admission assessment of a school-age child who has spina bifida. the parents state that a child is allergic to latex. The nurse should assess further for cross sensitivity to which of the following Foods? ⦁ Bananas A nurse is planning care for a client who is at 32 weeks of gestation and has severe pre- eclampsia. Which of the following actions should the nurse plan to take? ⦁ Ensure that the side rails are up on the client's bed A nurse is documenting admission data for a client in an acute care facility. Which of the following actions should the nurse take? ⦁ Note whether the client has a living will A client on an acute mental health unit states to a nurse, tie a bow. Row the boat. Now I know. Whoa! I see you, you the nurse should document that the client is exhibiting which of the following speech alterations? Clang Association A nurse is caring for a client who has Crohn's disease. The nurse calculates that the client BMI is 17.2. The nurse should document that the clients wait status is being within which of the following categories? ⦁ Underweight A nurse is planning post-operative care for a client who is scheduled for a thoracotomy with chest tube placement. Which of the following pieces of equipment should the nurse plan to have at the client's bedside? ⦁ Tracheostomy tray A nurse is providing discharge teaching to a client who has Gerd. Which of the following information should the nurse include? ⦁ Avoid consuming foods containing chocolate A nurse is part of a task force planning to audit a facilities nursing unit concerning adherence to hand hygiene protocols. Which of the following steps should the task force take first? ⦁ Determine the accepted standards for hand hygiene A nurse is planning educational materials for a client who has a new pacemaker. Which of the following information should a nurse include? ⦁ Keep mobile phones 4 inches from the pacemaker generator A nurse is providing discharge teaching to a client who is 1-day postoperative following a right modified radical mastectomy. Which of the following instructions should the nurse include in the teaching? ⦁ Avoid using the affected arm for eating A nurse is planning care for a client prior to an amniocentesis. Which of the following actions should the nurse include in the plan of care? ⦁ Monitor the fetal heart rate throughout the procedure A nurse is assessing a 24-month-old toddler at a well-child checkup. Which of the following findings indicates to the nurse that the toddler has a developmental delay? ⦁ Runs with a wide stance