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Question 1 of 5

The nurse is beginning nutritional counseling/teaching with a pregnant woman. What is the initial step in this interaction?

Correct Answer: D

Rationale: Assessment is always the first step in planning teaching for any client. A thorough and accurate history is essential for gathering the needed information.

Question 2 of 5

An adult client in an acute care facility says to the nurse, 'I hope this hospital doesn't have student doctors and nurses. I do not want a student taking care of me.' The nurse's response should be based on which of the following understandings?

Correct Answer: B

Rationale: Clients have the right to know about student involvement and refuse student care, respecting autonomy. Consent doesn't inherently include students, and special forms or mandatory acceptance are incorrect.

Question 3 of 5

The nurse is caring for a client with tuberculosis who is on airborne isolation precautions. The nurse can delegate which tasks to experienced unlicensed assistive personnel? Select all that apply.

Correct Answer: C, D

Rationale: Posting signs and stocking equipment (
C) and reminding visitors about precautions (
D) are within UAP scope. Alerting departments (
A), explaining to the client (
B), and educating family (E) require nursing judgment.

Question 4 of 5

The nurse observes an ambulating client begin to experience a tonic-clonic seizure. Which nursing actions should be implemented immediately? Select all that apply.

Correct Answer: A, C, E, F

Rationale: Guiding to the floor (
A), clearing objects (
C), positioning laterally (E), and observing (F) ensure safety.
Tongue blades (
B) are dangerous, and restraining (
D) increases injury risk.

Question 5 of 5

The nurse is preparing to obtain a urine specimen for culture and sensitivity from a client who has an indwelling urinary catheter that was inserted 2 days ago. Which of the following actions should the nurse take?

Correct Answer: A

Rationale: Using a sterile syringe at the specimen port (
A) ensures a clean sample. Balloon port (
B), drainage bag (
C), or 24-hour collection (
D) risk contamination.

Similar Questions

A 13-month-old child is admitted to the pediatric unit with diarrhea and vomiting. The mother tells the nurse that she is worried because her son does not yet walk. She says her other children walked at eight and nine months and asks what could be wrong with this child. How should the nurse respond?
The nurse is caring for a client who had a chest tube inserted and attached to portable water seal drainage two days ago. There is no bubbling in the water seal chamber. What should the nurse assess initially?
The nurse is caring for a client with hypothyroidism who has become lethargic and difficult to rouse. Which action is the priority?
The nurse is caring for a client with polycythemia vera. Which of the following actions should the nurse take? Select all that apply.
A nurse aide is taking care of a 2 year-old child with Wilm's tumor. The nurse aide asks the nurse why there is a sign above the bed that says DO NOT PALPATE THE ABDOMEN? The best response by the nurse would be which of these statements?

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