Review RN FUNDAMENTALS 2023

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RN FUNDAMENTALS 2023

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Total Questions : 54

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Question 1:

A nurse is planning care for a client who has acute pain as a result of a pressure injury to the sacrum. Which of the following nonpharmacological Interventions should the nurse include in the plan?

A. Loosen the client's bed linens. B. Provide bright lights in the client's room. C. Massage the client's sacrum. D. Offer to play music in the client's room.

Answer and Explanation

Choice A:

Loosen the client's bed linens:This option is not directly related to addressing acute pain from a pressure injury. While keeping the client comfortable is important, loosening bed linens may not specifically address the pain from the sacral pressure injury.

Choice B:

Provide bright lights in the client's room:Bright lights may not be directly relevant to managing acute pain from a pressure injury. In fact, some clients may prefer a dimly lit environment when experiencing pain. Therefore, this option is not the most appropriate for pain management in this case.

Choice C:

Massaging the client's sacrum is not recommended when there is a pressure injury, as this could further damage the tissue and exacerbate the injury.

Choice D:

Offer to play music in the client's room:Music therapy is a recognized nonpharmacological intervention for pain management. It can help distract the client and promote relaxation, thereby reducing the perception of pain.

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Question 2:

A nurse is caring for a client who has a terminal illness. The client states, "I am not giving up. I want as much treatment as possible." Which of the following responses should the nurse make?

A. "You need to understand that you have very little time left." B. "I will contact your provider to discuss your options." C. "Enjoy the time you have and do the things you want to do." D. "Hospice care is the best thing for you at this time."

Answer and Explanation

Choice A:

"You need to understand that you have very little time left":This response is blunt and may be emotionally distressing for the client. It is essential to communicate with sensitivity and respect the client's autonomy. This option does not explore the available treatment options, which is important in this situation.

Choice B:

"I will contact your provider to discuss your options":This is the correct answer. It demonstrates the nurse's commitment to the client's wishes by taking proactive steps to explore treatment options. Involving the healthcare provider in the discussion allows for a more informed decision-making process and ensures that the client's preferences are considered in the overall care plan

Choice C:

"Enjoy the time you have and do the things you want to do":This response may come across as dismissive and does not directly address the client's expressed desire for more treatment. It is important to acknowledge the client's wishes and explore available options before discussing end-of-life activities.

Choice D:

"Hospice care is the best thing for you at this time":While hospice care is an important consideration for individuals with terminal illnesses, it may not align with the client's current preference for more treatment. Introducing hospice care at this point without discussing treatment options may be premature.

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Question 3:

A nurse is assessing a client who received an IM antibiotic injection 15 min ago. Which of the following findings should the nurse identify as an indication of a possible anaphylactic reaction to the medication?

A. A feeling of swelling in the feet B. Pain at the injection site C. A sudden decrease in heart rate D. A sharp decrease in blood pressure

Answer and Explanation

Choice A:

A feeling of swelling in the feet:Swelling in the feet is not a typical sign of an anaphylactic reaction to an IM antibiotic injection. Anaphylaxis usually involves more rapid and widespread symptoms that can affect various body systems.

Choice B:

Pain at the injection site:Pain at the injection site is a common side effect of intramuscular (IM) injections and is not typically indicative of an anaphylactic reaction. Anaphylactic reactions are characterized by more systemic and severe symptoms.

Choice C:

A sudden decrease in heart rate:An anaphylactic reaction typically involves an increase in heart rate rather than a decrease. The body's response to an allergen in an anaphylactic reaction often includes a rapid heart rate, as part of the systemic release of inflammatory mediators.

Choice D:

A sharp decrease in blood pressure:This is the correct answer. Anaphylactic reactions can lead to a sudden and severe drop in blood pressure, which is a critical and life-threatening symptom. This is due to the release of vasodilatory substances and increased permeability of blood vessels, resulting in a decrease in blood volume within the vessels.

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Question 4:

A nurse is planning care for a client who is scheduled for an intravenous pyelogram. Which of the following actions is appropriate for the nurse to include?

A. Assist the client with a bowel cleansing. B. Ensure the client is free of metal objects. C. Monitor the client for pain in the suprapubic region. D. Administer 240 mL. (8 oz) of oral contrast before the procedure

Answer and Explanation

Choice A:

Assist the client with a bowel cleansing:This action is not directly related to an intravenous pyelogram (IVP). IVP is a radiographic examination of the kidneys, ureters, and bladder. Bowel cleansing is more commonly associated with procedures such as colonoscopy.

Choice B:

Ensure the client is free of metal objects:This is the correct answer. Metal objects can interfere with the imaging process during an IVP. Therefore, it is essential to ensure that the client does not have any metal objects, such as jewelry or clothing with metal components, that could affect the quality of the radiographic images.

Choice C:

Monitor the client for pain in the suprapubic region:While it is important to monitor for pain or discomfort during and after the procedure, pain in the suprapubic region may not specifically indicate complications related to the IVP. Monitoring for general discomfort or any signs of an allergic reaction to contrast material is crucial.

Choice D:

Administer 240 mL (8 oz) of oral contrast before the procedure:This action is more relevant to procedures such as a CT scan with oral contrast, not an IVP. In an IVP, contrast material is typically injected intravenously, not taken orally.

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Question 5:

A nurse is performing an eye assessment for a newly admitted client. Which of the following findings should the nurse expect?

A. Eyelashes that curl slightly outward. B. Eyelids that blink involuntarily 30 to 35 times per minute C. Corneas with an opaque appearance D. Pupils that are 8 to 9 mm in diameter

Answer and Explanation

Choice A:

Eyelashes that curl slightly outward:This is the correct answer. The direction and curl of eyelashes vary among individuals, but eyelashes that curl slightly outward are a normal and expected finding. This characteristic does not typically indicate any pathology or abnormality.

Choice B:

Eyelids that blink involuntarily 30 to 35 times per minute:The normal range for involuntary blinking is approximately 15 to 20 times per minute. A rate of 30 to 35 blinks per minute may suggest increased nervousness or anxiety and is not within the expected normal range.

Choice C:

Corneas with an opaque appearance:Normal corneas should have a clear and transparent appearance. Opacity of the cornea can be indicative of various eye conditions, such as corneal edema or scarring, and is not an expected finding in a healthy eye.

Choice D:

Pupils that are 8 to 9 mm in diameter:The normal range for pupil size is approximately 2 to 6 mm in diameter. Pupils that are 8 to 9 mm in diameter may indicate abnormal dilation (mydriasis) and can be associated with conditions such as drug toxicity or neurological issues.

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Question 6:

A nurse is caring for a client who is postoperative and is on bed rest. Which of the following actions should the nurse take to decrease the client's risk of developing a pressure injury?

A. Ensure the client's heels are not touching the mattress. B. Massage the client's bony prominences. C. Raise the head of the client's bed to a 60° angle. D. Reposition the client every 4 hr.

Answer and Explanation

Choice A:

Ensuring the client's heels are not touching the mattress: Pressure injuries, particularly on the heels, are common in clients who are immobile and on bed rest. Elevating the heels off the mattress helps to alleviate pressure and reduce the risk of developing pressure injuries in this area.

Choice B:

Massaging the client's bony prominences: Massage can increase the risk of tissue damage and is not recommended as a preventive measure for pressure injuries.

Choice C:

Raising the head of the client's bed to a 60° angle: While elevation may be beneficial for certain conditions, it is not a direct preventive measure for pressure injuries. Repositioning and pressure relief are more crucial.

Choice D:

Repositioning the client regularly is indeed a crucial measure to prevent pressure injuries. However, repositioning every 2 hours is typically recommended for clients at risk of developing pressure injuries, as prolonged pressure on any one area can lead to tissue damage.

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Question 7:

A nurse is caring for a client who has dysphagia. When assisting the client during breakfast, which of the following actions by the client indicates the nurse should intervene?

A. The client tucks their chin when they swallow. B. The client adjusts the head of their bed to 90°. C. The client drinks their thickened juice with a straw. D. The client takes frequent breaks while eating.

Answer and Explanation

Choice A:

The client tucks their chin when they swallow:This is a proper swallowing technique. Tucking the chin helps close off the airway during swallowing, reducing the risk of aspiration. It facilitates the safe passage of food or liquids into the esophagus

Choice B:

The client adjusts the head of their bed to 90°:This action is appropriate. Keeping the head of the bed elevated to 30 to 45 degrees is recommended for clients with dysphagia as it helps prevent aspiration during swallowing.

Choice C:

The client drinks their thickened juice with a straw:This action indicates a potential problem. The use of a straw with thickened liquids is generally not recommended for clients with dysphagia. Thickened liquids are used to slow down the flow of the liquid and reduce the risk of aspiration. Drinking thickened juice through a straw may compromise the effectiveness of thickening and increase the risk of aspiration.

Choice D:

The client takes frequent breaks while eating:This action is also appropriate. Clients with dysphagia may need to take breaks between bites to ensure safe and effective swallowing. It allows the client to pace themselves and reduces the risk of aspiration.

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Question 8:

A nurse enters the room of a client who has a seizure disorder. The client is sitting in a chair and begins to experience a seizure. Which of the following actions should the nurse take first?

A. Loosen the client's clothing. B. Help the client lie on the floor. C. Turn the client onto their side. D. Move items in the room away from the client.

Answer and Explanation

Choice A:

Loosen the client's clothing:While ensuring a patent airway is essential, it is not the immediate priority when the client is actively seizing. The primary concern is preventing injury by helping the client lie on the floor.

Choice B:

Help the client lie on the floor:This is the correct answer. When a client is having a seizure, the priority is to ensure their safety. Lying the client on the floor helps prevent injury during the seizure, reducing the risk of falling from a chair or bed. Placing the client in a lateral (side) position can also help maintain an open airway.

Choice C:

Turn the client onto their side:This action is part of the process after helping the client lie on the floor. Turning the client onto their side helps prevent aspiration in case of vomiting and maintains an open airway.

Choice D:

Move items in the room away from the client:While creating a safe environment by moving objects away is important, the immediate priority is to prevent injury to the client. Helping the client lie on the floor takes precedence to minimize the risk of injury during the seizure.

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Question 9:

A home health nurse is teaching a client about home safety. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.)

A. I need to set my hot water heater to 140 degrees Fahrenheit." B. "I will use the grab bars when getting in and out of the bathtub." C. will apply tape over frayed areas of electrical cords." D. "I need to check my medications for expiration dates." E. "I need to have a fire escape plan with my family."

Answer and Explanation

Choice A:

"I need to set my hot water heater to 140 degrees Fahrenheit":This statement is incorrect. The recommended safe temperature for a hot water heater is generally set to 120 degrees Fahrenheit (49 degrees Celsius) to prevent scalds and burns. A setting of 140 degrees Fahrenheit increases the risk of burns, especially for vulnerable populations such as children and the elderly.

Choice B:

"I will use the grab bars when getting in and out of the bathtub":This statement indicates an understanding of the importance of using safety features, such as grab bars, to prevent falls in the bathroom. Using grab bars provides support and stability during activities like getting in and out of the bathtub, reducing the risk of accidents.

Choice C:

"I will apply tape over frayed areas of electrical cords":This statement is incorrect. Using tape on frayed electrical cords is not a safe or effective solution. Frayed cords should be replaced to avoid the risk of electrical shock or fire. Using tape may not adequately address the underlying safety issue and can be a hazard itself.

Choice D:

"I need to check my medications for expiration dates":This statement reflects an understanding of the importance of medication safety. Checking medication expiration dates is crucial to ensure the efficacy and safety of the medications. Expired medications may be less effective or potentially harmful.

Choice E:

"I need to have a fire escape plan with my family":
This statement shows awareness of the importance of having a fire escape plan at home. Having a plan in place helps ensure that everyone in the household knows what to do in case of a fire, improving overall safety.

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Question 10:

A nurse is caring for a client who has left lower-lobe atelectasis. In which of the following positions should the nurse place the client for postural drainage?

A. Supine in low-Fowler's position B. Side-lying with the right side of the chest elevated C. Right lateral in Trendelenburg position D. Prone with pillows under the lower extremities

Answer and Explanation

Choice A:

This position is not effective for draining the left lower lobe.

Choice B:

This position would not effectively drain the left lower lobe.

Choice C:

This is correct. Placing the client on their right side with the chest lower than the hips (Trendelenburg position) helps gravity assist in draining secretions from the left lower lobe.

Choice D:

This position would not be effective for draining the left lower lobe.

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Total Questions : 54

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RN FUNDAMENTALS 2023

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