RN Concept Based Assessment Level 1 Online Practice A with Answers (100 Solved Questions)

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1.A nurse is admitting a client who has pulmonary tuberculosis. Which of the followingtransmission-based precautions should the nurse initiate?AirborneRationale: Pulmonary tuberculosis is an infection that is transmitted by airbornedroplets smaller than 5 microns in diameter. Therefore, this client requiresairborne precautions to prevent communicating this infection to others2.A nurse in a mental health facility is preparing an educational program for a group ofstaff nurses about the proper use of restraints. Which of the following informationshould the nurse plan to include?An adult client may be in a mechanical restraint for up to 4 hoursRational: The nurse should specify that a client who is 18 years or older may be ina restraint for no more than 4 hr. Children who are 9 to 17 years old are limitedto 2 hr and children who are younger than 9 years old are limited to 1 hr3.A nurse is teaching sleep hygiene to a client who has insomnia. Which of the followingstatements should the nurse make?Exercise in the morning after arisingRationale: Daily exercise has many benefits, including enhancing cardiovascular,psychological, and musculoskeletal health. The nurse should recommend that theclient avoid exercising within 2 hr of bedtime to limit stimulation and enhancesleep4.A nurse is preparing to leave the room of a client who is on isolation precautions. Whichof the following actions should the nurse take when removing a tied surgical mask?Remove the mask by securely holding the ties and moving it away from the faceRationale: The nurse should untie the bottom strings and then the top strings.Finally, while still holding the strings, the nurse should remove the mask from herface. This action prevents the nurse from touching the front of the mask, which iscontaminated5.A nurse is caring for an adolescent client who is in critical condition following a motorvehicle crash in which he was the passenger. The client's parent shouts at the nurse,asking why her son is dying instead of the driver. Which of the following actions shouldthe nurse take to provide emotional support to the parent?Inform the parent that anger is a natural response when dealing with lossRationale: The nurse should identify that the parent is in the anger stage of grief.The nurse should assist the parent to understand that anger is a natural responseto loss and encourage her to talk about her feelings6.A community health nurse is planning prevention strategies for hypertension amongmembers of her community. The nurse should identify that which of the following ethnicgroups in the community is at greatest risk of developing hypertension?African Americans

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Rationale: Evidence-based practice indicates that individuals of African-Americanethnicity have the highest prevalence of hypertension. Therefore, the nurseshould identify community members of this ethnicity are at greatest risk ofdeveloping hypertension.7.A community health nurse is planning interventions to promote Healthy People 2020initiatives in the community. Which of the following actions should the nurse plan totake first?Determine the level of health equity among groups in the communityRationale: Health equity among all groups in the community is a Healthy People2020 initiative. Using the nursing process, the first action the nurse should take isto assess the needs of the community. By identifying disparities in communityhealth, the nurse can develop interventions targeted at the community's specificneeds.8.A nurse is reviewing a client's new prescriptions that were just documented in theclient's medical record by the provider. Which of the following abbreviations should thenurse clarify with the provider?Enoxaparin 40 mg SQ QDRationale: The nurse should clarify this prescription with the provider. Theabbreviations "SQ" and "QD" are considered error-prone and should not be usedin documentation. The nurse should clarify that the provider intends theprescription to be administered subcutaneously once daily. "Subcutaneous" or"subcut" should be used instead of "SQ" and "daily" should be used instead of"QD."9.A nurse is talking with a client who has major depressive disorder. The client states,"Nobody cares if I'm around or not." Which of the following responses should the nursetake?It sounds as though you’re feeling hopelessRationale: This statement by the nurse is an example of restating, which is atherapeutic response. This technique restates the main idea the client hasexpressed and allows the client to clarify any misunderstanding.10. A nurse is preparing to administer a unit of packed RBCs to a client. In adherence withthe Joint Commission National Patient Safety Goals regarding blood administration,which of the following actions should the nurse plan to take?Verify the client and blood component using a two-person processRationale: The Joint Commission National Patient Safety Goals regarding bloodtransfusions includes improving the accuracy of client identification. The nurseshould eliminate transfusion errors related to client misidentification by using atwo-person verification process to identify the client and the blood component.11. A nurse on a medical-surgical unit is caring for a group of clients. Which of the followingclients should the nurse monitor for the development of reflex urinary incontinence?A client who has a T12 spinal cord injury

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Rationale: The nurse should identify that a client who has a C1 to S2 spinal cordinjury is at risk of developing reflex urinary incontinence. With this type ofincontinence, the client is unaware that the bladder is full and therefore lacks theurge to void, resulting in the involuntary loss of urine. The nurse should monitorfor this form of incontinence and implement interventions such as intermittentcatheterization.12. A nurse is documenting an assessment in a client's electronic health record when anassistive personnel (AP) asks to enter the morning blood glucose for the client. Which ofthe following actions should the nurse take?Request that the AP use another computer to enter the dataRationale: The nurse should request that the AP to go to another computer thatis not in use to enter the morning blood glucose from the client. This is time-sensitive data that needs to be entered in the computer as soon as possible.13. A nurse is preparing to administer acetaminophen 120 mg PO to a toddler. Available isacetaminophen drops 80mg/0.8 mL. How many mL should the nurse administer? (Roundthe answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailingzero.)1.2 mLRationale:Ratio and ProportionSTEP 1: What is the unit of measurement the nurse should calculate? mLSTEP 2: What is the dose the nurse should administer? Dose to administer =Desired 120 mgSTEP 3: What is the dose available? Dose available = Have 80 mgSTEP 4: Should the nurse convert the units of measurement? NoSTEP 5: What is the quantity of the dose available? 0.8 mLSTEP 6: Set up an equation and solve for X.Have/Quantity = Desired/X80 mg/0.8 mL = 120 mg/X mLX = 1.2STEP 7: Round if necessary.STEP 8: Reassess to determine whether the amount to give makes sense. If thereare 80 mg/0.8 mL and the amount prescribed is 120 mg, it makes sense toadminister 1.2 mL. The nurse should administer acetaminophen 1.2 mL PO.Desired Over HaveSTEP 1: What is the unit of measurement the nurse should calculate? mLSTEP 2: What is the dose the nurse should administer? Dose to administer =Desired 120 mgSTEP 3: What is the dose available? Dose available = Have 80 mgSTEP 4: Should the nurse convert the units of measurement? NoSTEP 5: What is the quantity of the dose available? 0.8 mLSTEP 6: Set up an equation and solve for X.Desired x Quantity/Have = X

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120 mg x 0.8 mL/80 mg = X mL1.2 = XSTEP 7: Round if necessary.STEP 8: Reassess to determine whether the amount to give makes sense. If thereare 80 mg/0.8 mL and the amount prescribed is 120 mg, it makes sense toadminister 1.2 mL. The nurse should administer acetaminophen 1.2 mL PO.Dimensional AnalysisSTEP 1: What is the unit of measurement the nurse should calculate? mLSTEP 2: What is the quantity of the dose available? 0.8 mLSTEP 3: What is the dose available? Dose available = Have 80 mgSTEP 4: What is the dose the nurse should administer? Dose to administer =Desired 120 mgSTEP 5: Should the nurse convert the units of measurement? NoSTEP 6: Set up an equation and solve for X.X = Quantity/Have x Conversion (Have)/Conversion (Desired) x Desired/X mL = 0.8 mL/80 mg x 120 mg/X = 1.2STEP 7: Round if necessary.STEP 8: Reassess to determine whether the amount to give makes sense. If thereare 80 mg/0.8 mL and the amount prescribed is 120 mg, it makes sense toadminister 1.2 mL. The nurse should administer acetaminophen 1.2 mL PO14. A nurse is preparing to administer 0.9% sodium chloride 1,000 mL over 8 hr IV to aclient. The nurse should set the infusion pump to deliver how many mL/hr? (Round theanswer to the nearest whole number. Use a leading zero if it applies. Do not use atrailing zero.)125 mL/hrRationale:Follow these steps to calculate the infusion rate:STEP 1: What is the unit of measurement the nurse should calculate? mL/hrSTEP 2: What is the volume the nurse should infuse? 1,000 mLSTEP 3: What is the total infusion time? 8 hrSTEP 4: Should the nurse convert the units of measurement? NoSTEP 5: Set up an equation and solve for X.Volume (mL)/Time (hr) = X mL/hr1,000 mL/8 hr = X mL/hrX = 125STEP 6: Round if necessary.STEP 7: Reassess to determine if the amount to administer makes sense. If theamount prescribed is 1,000 mL to infuse over 8 hr, it makes sense to administer125 mL/hr. The nurse should set the IV pump to deliver 0.9% sodium chloride at125 mL/hr for 8 hr.

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15. A nurse is providing teaching about nutrition management to the parent of an 18-month-old toddler who has phenylketonuria. Which of the following foods should thenurse recommend?Baked potatoRationale: The nurse should recommend low-protein foods to the parent of atoddler who has phenylketonuria. The nurse should also recommend the parentoffer the toddler fruits, juices, and cereals with limited phenylalanine.16. A nurse is preparing to extinguish a small fire in a client's room. Which of the followingactions should the nurse take when using the fire extinguisher?Slide the pin on top of the fire extinguisher straight putRationale: The nurse should pull the pin on the top of the fire extinguisher toallow for use to extinguish the fire.17. A nurse is planning meals for a client who practices Judaism and reports that she strictlyadheres to orthodox dietary laws. The nurse should recognize that which of thefollowing dietary practices applies to the client's beliefs?The client is permitted to eat fish that have scales:Rationale: The nurse should recognize that Orthodox Jewish dietary laws permitthe client to eat fish that have fins and scales, such as tuna. However, fish that donot have scales, such as catfish, are considered unclean and are not permitted.18. A nurse is caring for a client who has a Clostridium difficile infection and is incontinent ofstool following long-term antibiotic therapy. Which of the following actions should thenurse take?Wear a gown while providing care for the clientRationale: The nurse should wear a gown when providing care for a client whohas aC. difficileinfection and is incontinent of stool. Applying a clean, water-resistant gown prior to entering the client's room prevents the nurse's clothingfrom becoming contaminated while caring for the client. The nurse shouldremove the gown prior to exiting the client's room.19. A nurse is planning the menu for a client who practices Seventh-Day Adventism. Whichof the following food selections should the nurse make?Scrambled eggsRationale: The nurse should select scrambled eggs in the client's dietary mealplan for a client who practices Seventh-Day Adventism. Most clients who practiceSeventh-Day Adventistism are lacto-ovo vegetarians who consume vegetables,eggs, and dairy, but not meat. Clients who practice this religion also do notconsume caffeine or alcohol.20. A nurse in a long-term care facility discovers a small fire in a client's trash can. Aftermoving the client to safety, which of the following actions should the nurse take next?Pull the alarm to notify emergency services

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Rationale: Evidence-based practice indicates the nurse should first rescue andremove clients in immediate danger and then activate the alarm to notifyauthorities of the situation.21. A community health nurse is developing a brochure about the use of smokeless tobacco.Which of the following information should the nurse plan to include?Smokeless tobacco provides a higher dose of nicotine than cigarettesRationale: Smokeless tobacco is placed in the mouth, where nicotine is thenabsorbed sublingually. A higher dose of nicotine is delivered with the use ofsmokeless tobacco compared to smoking cigarettes, because heat destroysnicotine.22. A nurse is preparing to administer three medications to a client who has an NG tube: alevothyroxine tablet, an ibuprofen gel cap, and a delayed-release omeprazole capsule.Which of the following actions should the nurse take?Crush the levothyroxine tablet into a powder and dissolve it in 30 mL of warmsterile waterRationale: The nurse should prepare simple tablets for NG administration bycrushing them into a fine powder and dissolving them in at least 30 mL of warmsterile water. Cold water can cause discomfort. Sterile water eliminates thepossible problem of chemicals in tap water interacting with the medication.23. A nurse is caring for a child who has contact dermatitis due to poison ivy. The parentasks the nurse how to prevent further reactions. Which of the following responsesshould the nurse make?Wash your child’s exposed clothing with hot water and detergentRationale: The nurse should instruct the parent to wash the child's clothing in hotwater and detergent after exposure to the poison ivy plant. This will remove theoil, urushiol, which causes the skin reaction.24. A nurse is planning care for a client who has an indwelling urinary catheter. Which of thefollowing interventions should the nurse include in the plan to prevent the developmentof a catheter-associated urinary tract infection (CAUTI)?Secure the catheter tubing to the client’s legRationale: The nurse should assess the client's need for urinary catheterizationand should follow evidence-based practice to prevent or reduce the risk of CAUTIdevelopment. This includes securing the catheter tubing to the client's leg so thatthe catheter does not move, reducing the risk of urethral trauma andintroduction of bacteria into the urinary system25. A nurse in a long-term care facility is admitting a new client following a brief stay inacute care. In adherence with the Joint Commission National Patient Safety Goalsregarding medication administration, which of the following actions should the nursetake?Compare a list of the client’s current medications with the ones he will take inlong-term careRationale: The Joint Commission National Patient Safety Goals regardingmedication reconciliation includes maintaining and communicating accurate

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