Nokea
A client sustains an injury to his heel while the unlicensed assistive personnel
and the nurse are moving him up in bed. What force caused the injury?
- A. Shearing or friction
- B. Twisting and bending
- C. Pressure or gravity
- D. Chemical or pressure
Correct Answer: A
Rationale:
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A client has sustained an open fracture. How can the nurse best prevent
osteomyelitis in this client?
- A. Administer pain medication
- B. Use proper hand hygiene and strict infection control
- C. Delegate all client personal care to specific unlicensed assistive personnel
- D. Plate the client in contact precautions
Correct Answer: B
Rationale:
An area of erythema on the child's skin is being assessed by the nurse. The
nurse presses down on the area, and the area becomes white. What time does
the nurse document for this finding?
- A. Non-blanching
- B. Blanching
- C. Redness
- D. Warmth
Correct Answer: B
Rationale:
A man has been admitted to the hospital unit with a medical diagnosis of
COPD. He is receiving supplemental oxygen at 2 L/min via nasal cannula.
Which positioning technique will best assist him with his breathing?
- A. Prone position
- B. Sim's position
- C. Lateral position
- D. Fowler's position
Correct Answer: D
Rationale:
What steps are NOT included in preparing a sterile field?
- A. Do not turn away from the sterile field
- B. Obtain PAPR mask
- C. Prepare the client before setting up the sterile field
- D. Cover the sterile field once it is set up
Correct Answer: B
Rationale:
A nurse is providing oral hygiene for an unconscious client. What is the priority
nursing intervention?
- A. Position the client on one side with the head turned towards you
- B. Handle dentures with care
- C. Use gentle brushing and flossing techniques for clients with fragile mucosa
- D. Have a suction apparatus ready at the bedside
Correct Answer: A
Rationale: