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Questions 149

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Question 1 of 5

During a pre-op assessment, the nurse would chart which finding(s) as subjective data? Select all that apply.

Correct Answer: B,C,E

Rationale: Subjective data are client-reported, including statements about surgery concerns, weight loss, and pain ratings. Sweating/wringing hands and blood pressure are objective (observable/measurable).

Question 2 of 5

The nurse is preparing to walk the postpartum client for the first time since delivery. Before walking the client, the nurse should:

Correct Answer: B

Rationale: Dangling the legs before walking helps assess for orthostatic hypotension and ensures the client is stable, reducing the risk of fainting.

Question 3 of 5

The physician has ordered a low-potassium diet for a client with acute glomerulonephritis. Which snack is suitable for the client with potassium restrictions?

Correct Answer: A

Rationale: Raisins are lower in potassium compared to oranges, apricots, and bananas, making them suitable for a low-potassium diet.

Question 4 of 5

The nurse caring for the child with a large meningomylocele is aware that the priority care for this client is to:

Correct Answer: A

Rationale: Moist, sterile gauze prevents infection and drying of the meningomyelocele defect.

Question 5 of 5

The nurse is reviewing the results of a sweat test taken from a child with cystic fibrosis. Which finding supports the client's diagnosis?

Correct Answer: B

Rationale: A sweat chloride concentration greater than 60 mEq/L is diagnostic for cystic fibrosis, indicating defective chloride transport.

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