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Question 1 of 5

An elderly client who experiences nighttime confusion wanders from his room into the room of another client. The nurse can best help decrease the client's confusion by:

Correct Answer: D

Rationale: A night light reduces confusion by improving visibility and orientation. Constant supervision is impractical, room-sharing may worsen confusion, and sedatives increase fall risk.

Question 2 of 5

Which teaching instructions should the nurse reinforce to a client with advanced chronic obstructive pulmonary disease?

Correct Answer: B,C,E

Rationale: Pneumococcal vaccine (
B), reporting increased sputum (
C), and incentive spirometry (E) manage COPD. A high-calorie diet, not low-calorie (
A), is needed. Iron (
D) is only indicated for confirmed anemia.

Question 3 of 5

The nurse answers a call light on a client not assigned to the nurse. The client, who was just admitted from the emergency department, requests a cup of coffee. What is the appropriate intervention?

Correct Answer: D

Rationale: Suggesting water (
D) is safe until dietary orders are confirmed. Coffee (A,
C) may be contraindicated, and waiting (
B) doesn't address the request.

Question 4 of 5

The graduate nurse (GN) is caring for a client with a fractured femur in balanced suspension skeletal traction. Which action by the GN will require the precepting nurse to intervene?

Correct Answer: B

Rationale: Lifting traction weights (
B) disrupts alignment and healing, requiring intervention. Hydration and fiber (
A), monitoring sites (
C), and pulse checks (
D) are appropriate.

Question 5 of 5

The nurse caring for a client with an ileal conduit observes that the stoma appears bluish gray. What is the nurse's best action?

Correct Answer: D

Rationale: A bluish-gray stoma (
D) indicates ischemia, requiring immediate reporting. Antibiotics (
A) are premature, monitoring (
B) delays care, and resizing the pouch (
C) is irrelevant.

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The charge nurse in a long-term care facility is making assignments. When assigning personnel to care for residents, which principle is important?
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