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单项选择题

The nurse is interviewing the mother of a 7-year-old child. Which of the following symptoms reported by the mother would most lead the nurse to suspect that the child has type 1 diabetes

A. Recent bed wetting.
B. Poor appetite.
C. Weight gain.
D. Boundless energy.
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单项选择题

The nurse is caring for a client undergoing IV antibiotic therapy with gentamicin sulfate. Which of the following interventions is most important

A. Infuse the medication quickly to minimize its irritating effect on the walls of blood vessels.
B. Obtain renal function tests, such as blood urea nitrogen (BUN) and creatinine levels, throughout the course of therapy.
C. Assess for pulmonary and peripheral edema.
D. Obtain an order for an antiemetic to counteract the common adverse effect of nause
单项选择题

A 34-year-old client at 32 weeks’ gestation tells the nurse that her baby will be sick because she saw a dead dog on the road yesterday. What’s the best response by the nurse

A. "Your baby will be fine. That’s just superstition. "
B. "Don’t worry. We’ll make sure your baby is okay. "
C. "I can see that you are concerned. Let’s talk about what’s bothering you. "
D. "Perhaps so. Your baby should be seen by a physician as soon as it’s born. "
单项选择题

The nurse is caring for a client who has just had a modified radical mastectomy with immediate reconstruction. She’s in her 30s and has two young children. Although she’s worried about her future, she seems to be adjusting well to her diagnosis. What should the nurse do to support her coping

A. Tell the client’s spouse or partner to be supportive while she recovers.
B. Encourage the client to proceed with the next phase of treatment.
C. Recommend that the client remain cheerful for the sake of her children.
D. Refer the client to the American Cancer Society’s Reach for Recovery program or another support program.
单项选择题

The nurse is preparing to discharge a child who has rheumatic fever. Which of the following medications is prescribed to prevent recurrence of rheumatic fever

A. Glucocorticoids.
B. Digoxin.
C. Antibiotics.
D. Anti-inflammatory medications.
单项选择题

The nurse is giving instructions to a client who is going home with a cast on his leg. Which point is most critical

A. Using crutches properly.
B. Exercising joints above and below the cast, as ordered.
C. Avoiding walking on a leg cast without the physician’s permission.
D. Reporting signs of impaired circulation.
单项选择题

The nurse is caring for a client with otosclerosis scheduled to undergo a stapedectomy. The client asks the nurse when her hearing will improve. Which response by the nurse is most appropriate

A. Your hearing may not improve but you’ll no longer be bothered by tinnitus.
B. Your hearing may be dramatically improved right after surgery.
C. You may notice improved hearing within 1 to 2 weeks.
D. Your hearing may improve 3 to 6 weeks after surgery.
单项选择题

A child with rheumatic fever complains of painful joints. What nonpharmacologic measures should the nurse use to reduce the child’s pain

A. Performing gentle passive range-of-motion (ROM) exercises.
B. Gently massaging the painful joints.
C. Using a bed cradle to keep linens off the joints.
D. Encouraging position changes in bed every 2 hours.
单项选择题

The nurse is assessing a 71-year-old female client with ulcerative colitis. Which assessment finding related to the family will have the greatest impact on the client’s rehabilitation after discharge

A. The family’s ability to take care of the client’s special diet needs.
B. The family’s expectation that the client will resume responsibilities and role-related activities.
C. Emotional support from the family.
D. The family’s ability to understand the ups and downs of the illness.
单项选择题

A client with coronary artery disease reports intermittent chest pain that occurs with exertion. The physician prescribes sublingual nitroglycerin. When teaching the client about nitroglycerin administration, the nurse should include which instruction

A. "Be careful after taking nitroglycerin because it may cause dizziness. "
B. "Make sure you replace your nitroglycerin tablets every 6 months to ensure potency. "
C. "A burning sensation after taking nitroglycerin indicates medication potency. "
D. "When you experience chest pain, take one tablet every 30 minutes until the pain is relieved. "
单项选择题

A 14-year-old female client in skeletal traction for treatment of a fractured femur is expected to be hospitalized for several weeks. When planning care, the nurse should take into account the client’s need to achieve what developmental milestone

A. Autonomy.
B. Initiative.
C. Industry.
D. Identity.
单项选择题

The nurse is teaching a client who receives nitrates for the relief of chest pain. Which of the following instructions should the nurse emphasize

A. Repeat the dose of sublingual nitroglycerin every 15 minutes for three doses.
B. Store the drug in a cool, well-lit place.
C. Lie down or sit in a chair for 5 to 10 minutes after taking the drug.
D. Restrict alcohol intake to two drinks per day.
单项选择题

The nurse is caring for a client admitted to the hospital with a bowel obstruction. The nurse should wear sterile gloves when

A. inserting an indwelling urinary catheter.
B. giving a back rub on intact skin.
C. changing an oxygen system.
D. inserting an IV catheter.
单项选择题

The nurse is interviewing a 19-year-old female at a clinic. It’s her first visit, and she says that she has been exposed to herpes by her boyfriend. Initially, with primary genital or type 2 herpes simplex, the nurse would expect the client to have

A. burning or tingling on the vulva, perineum, or vagina.
B. dysuria and urine retention.
C. perineal ulcers and erosions.
D. bilateral inguinal lymphadenopathy.
单项选择题

The nurse is caring for a client with adult respiratory distress syndrome (ARDS). What is the most likely laboratory finding in the early stages of this disease

A. Increased carboxyhemoglobin.
B. Decreased partial pressure of arterial oxygen (PaO2).
C. Increased partial pressure of arterial carbon dioxide (PaCO2).
D. Decreased bicarbonate (
).
单项选择题

Which of the following nursing interventions would be included in the care of a client with anorexia nervosa as therapy progresses

A. Let the client eat alone to avoid embarrassment.
B. Weigh the client once a week in the same clothing.
C. Monitor the client for self-destructive tendencies.
D. Praise the client for "looking better" and remind the client that she isn’t "too fat. "
单项选择题

The nurse is taking the health history of an 85-year-old client. Which information will be most useful to the nurse for planning care

A. General health for the last 10 years.
B. Current health promotion activities.
C. Family history of diseases.
D. Marital status.
单项选择题

The nurse is providing postoperative care for a client recovering from abdominal surgery. The client is receiving morphine through a client-controlled analgesia pump. Which finding would indicate that the client is obtaining adequate pain relief

A. Awakening several times during the night to redose.
B. Respiratory rate of 10 breaths/minute.
C. Pain rating of 2 or 3 on a scale of 0 to 10.
D. Complaint of itching as an adverse effect of the analgesi
单项选择题

A client is taking spironolactone (Aldactone) to control her hypertension. Her serum potassium level is 6 mEq/L. For this client, the nurse’s priority would be to assess her

A. neuromuscular function.
B. bowel sounds.
C. respiratory rate.
D. electrocardiogram (ECG) results.
单项选择题

A 3288. 5g baby boy is born by spontaneous vaginal delivery. During the initial assessment at 1 hour postpartum, the nurse notices lanugo, acrocyanosis, mongolian spots, and hemangiomas. Which of these is an abnormal finding in a neonate

A. Lanugo.
B. Acroeyanosis.
C. Mongolian spots.
D. Hemangiomas.
单项选择题

The nurse is teaching a client with a history of atherosclerosis. To decrease the risk of atherosclerosis, the nurse should encourage the client to

A. avoid focusing on his weight.
B. increase his activity level.
C. follow a regular diet.
D. continue leading a high-stress lifestyl
单项选择题

A high school student is referred to the school nurse for suspected substance abuse. Following the nurse’s assessment and interventions, what would be the most desirable outcome

A. The student discusses conflicts over drug use.
B. The student accepts a referral to a substance abuse counselor.
C. The student agrees to inform his parents of the problem.
D. The student reports increased comfort with making choices.
单项选择题

The nurse is teaching a psychiatric client about her prescribed drugs, chlorpromazine and benztropine. Why is benztropine administered

A. To reduce psychotic symptoms.
B. To reduce extrapyramidal symptoms.
C. To control nausea and vomiting.
D. To relieve anxiety.
单项选择题

The nurse is caring for a client who underwent a total hip replacement. What should the nurse and other caregivers do to prevent dislocation of the new prosthesis

A. Keep the affected leg in a position of adduction.
B. Use measures other than turning to prevent pressure ulcers.
C. Prevent internal rotation of the affected leg.
D. Keep the hip flexed by placing pillows under the client’s kne
单项选择题

The nurse is providing care to a client with catatonic type of schizophrenia who exhibits extreme negativism. To help the client meet his basic needs, the nurse should

A. ask the client which activity he would prefer to do first.
B. negotiate a time when the client will perform activities.
C. tell the client specifically and concisely what needs to be done.
D. prepare the client ahead of time for the activity.
单项选择题

A male client with a total hip replacement is progressing well and expects to be discharged tomorrow. On returning to bed after ambulating, he complains of severe pain in the surgical wound. Which action should the nurse take

A. Assume he’s anxious about discharge, and administer pain medication.
B. Assess the surgical site and affected extremity.
C. Reassure the client that pain is a direct result of increased activity.
D. Suspect a wound infection, and monitor the client’s temperature and vital signs.
单项选择题

Shortly after being admitted to the coronary care unit with an acute myocardial infarction (MI), a client reports midsternal chest pain radiating down the left arm. The nurse notices that the client is restless and slightly diaphoretic, and measures a temperature of 99. 6°F (37.6℃), a heart rate of 102 beats/minute; regular, slightly labored respirations at 26 breaths/minute; and a blood pressure of 150/90mmHg. Which nursing diagnosis takes highest priority

A. Risk for imbalanced body temperature.
B. Decreased cardiac output.
C. Anxiety.
D. Acute pain.
单项选择题

A recent immigrant from Vietnam is diagnosed with pulmonary tuberculosis (TB). Which intervention is most important for the nurse to implement with this client

A. Client teaching about the cause of TＢ.
B. Reviewing the risk factors for TＢ.
C. Developing a list of people with whom the client has had contact.
D. Client teaching about the importance of TＢ testin
单项选择题

A 6-year-old girl has been hospitalized with rheumatic fever for 4 weeks. Her symptoms have gradually subsided, and she’s now ready for discharge. Which of the following plans for her health care is most important for her future well-being

A. Arrange for her to return to school as soon as possible to promote psychosocial development.
B. Encourage her to engage in unrestricted physical activity to regain physical strength.
C. Arrange for the administration of prophylactic antibiotics to prevent a recurrence of rheumatic fever.
D. Maintain seizure precautions, as central nervous system involvement may persist for several months.
单项选择题

Which of the following positions is most appropriate for a neonate with congenital hip dislocation

A. Semi-Fowler’s with both legs flexed.
B. Legs adducted with head elevated.
C. Swaddled in a baby carrier.
D. Prone position with hips abducte
单项选择题

A client with hepatitis C develops liver failure and GI hemorrhage. The blood products that would most likely bring about hemostasis in the client are

A. whole blood and albumin.
B. platelets and packed red blood cells.
C. fresh frozen plasma and whole blood.
D. cryoprecipitate and fresh frozen plasm
单项选择题

A 35-year-old client is undergoing a brain computed tomography (CT) scan because of continued migraine headaches. He’s placed in the CT scanner and suddenly begins to complain of palpitations, sweating, shortness of breath, and shaking. The client is most likely experiencing

A. an allergic reaction.
B. a myocardial infarction (MI).
C. a panic attack.
D. a hypoglycemic episod
单项选择题

The nurse is caring for an elderly client who exhibits signs of dementi

a. The most common cause of dementia in an elderly client isA. delirium.B. depression.C. excessive drug use.D. Alzheimer’s diseas
单项选择题

The nurse is caring for an elderly female with osteoporosis. When teaching the client, the nurse should include information about which major complication

A. Bone fracture.
B. Loss of estrogen.
C. Negative calcium balance.
D. Dowager’s hump.
单项选择题

A client is in the first postoperative day after a total laryngectomy and radical neck dissection. Which of the following is a priority goal

A. Communicate by use of esophageal speech.
B. Improve body image and self-esteem.
C. Attain optimal levels of nutrition.
D. Maintain a patent airway.
单项选择题

The nurse is developing a teaching plan for a client diagnosed with diabetes insipidus. The nurse should include information about which hormone, commonly lacking in clients with diabetes insipidus

A. Antidiuretic hormone (ADH).
B. Thyroid-stimulating hormone (TSH).
C. Follicle-stimulating hormone (FSH).
D. Luteinizing hormone (LH).
单项选择题

The physician orders IV fluid volume replacement with lactated Ringer’s solution at a rate of 75 mL/hour. Using an infusion set that provides 15 gtt/mL, the nurse should calculate the flow rate to be

A. 10 gtt/min.
B. 12 gtt/min.
C. 19 gtt/min.
D. 75 gtt/min.
单项选择题

A client has just finished his glucose tolerance test. How many hours should it take for his blood glucose level to return to normal

A. 2 hours.
B. 3 hours.
C. 5 hours.
D. 6 hours.
单项选择题

While auscultating heart sounds of a client with heart failure, the nurse hears an extra heart sound immediately after the second heart sound (S2). The nurse should document this as

A. a first heart sound (S1).
B. a third heart sound (S3).
C. a fourth heart sound (S4).
D. a murmur.
单项选择题

A client is to have a cesarean delivery because of continuous vaginal bleeding and an abnormal fetal heart rate tracing. Which of the following would be the best preoperative medication for this client

A. Meperidine (Demerol).
B. Oxytocin (Pitocin).
C. Promethazine (Phenergan).
D. Glycopyrrolate (Robinul).
单项选择题

The nurse is caring for a client with a fractured hip. The client is combative and confused, and he’s trying to get out of bed. The nurse should

A. leave the client and get help.
B. obtain a physician’s order to restrain the client.
C. read the facility’s policy on restraints.
D. order soft restraints from the storeroom.
单项选择题

While evaluating the needs of a client during the second trimester, the nurse can anticipate which of the following

A. Feelings of disbelief and ambivalence.
B. Feelings of clumsiness and "ugliness".
C. Increasing introspection but a general sense of well-being.
D. Anxiety about the labor and delivery experienc
单项选择题

The nurse is performing a painless, noninvasive procedure to measure arterial oxygen saturation (SaO2). What procedure is it

A. Incentive spirometry.
B. Arterial blood gas (ABG) measurement.
C. Peak flow measurement.
D. Pulse oximetry.
单项选择题

A primigravida client with acquired immunodeficiency syndrome (AIDS) is in labor at term. In preparing her nursing care plan, the nurse should include which of the following nursing diagnoses

A. Risk for fetal or maternal injury related to the crisis of childbearing.
B. Risk for infection related to suppressed immune status.
C. Risk for deficient fluid volume related to dehydration.
D. Risk for fetal injury related to uteroplacental insufficiency.
单项选择题

When reporting to the surgeon that a chest tube is malfunctioning, the nurse is ordered to reposition the tube and obtain a chest radiograph. The nurse should

A. inform the surgeon this isn’t within her scope of practice.
B. report the surgeon to the Ethics Committee.
C. report the surgeon to the nursing supervisor.
D. follow the order as requested by the surgeon.
单项选择题

A 16-year-old student has been admitted to your psychiatric unit after fainting in physical education class. She has a diagnosis of anorexia nervosa, weighs 88 lb (40 kg), and is 5’4" (1.6 m) tall. She has been weighing herself several times per day at home and has lost 30 lb (13.5 kg) in the past 3 months. Which nursing diagnosis would be most appropriate for the client

A. Disturbed thought processes.
B. Impaired adjustment.
C. Imbalanced nutrition. Less than body requirements.
D. Ineffective sexuality patterns.
单项选择题

A 7-year-old boy is hospitalized with cystic fibrosis. To help him manage secretions and avoid respiratory distress, the nurse should

A. perform chest physiotherapy every 4 hours.
B. give pancreatic enzymes as ordered.
C. place the child in an oxygen tent and have oxygen administered continuously.
D. serve a high-calorie diet.
单项选择题

The nurse is caring for a client who has hemoconcentration after fluid loss. Which IV fluids would be the most appropriate fluid replacement therapy for this client

A. Distilled water.
B. Dextrose 5% in water (D5W) only.
C. DSW with 40 mEq of potassium chloride.
D. Dextrose 10% in salin
单项选择题

The nurse is preparing to remove a previously applied topical medication from a client. The rationale for removing previously applied topical medications before applying new medications is to

A. decrease the possibility of absorption on the nurse’s skin.
B. allow distribution of medication.
C. prevent soiling of the client’s clothes.
D. avoid administering more than the prescribed dos
单项选择题

A client has been prescribed 75 mg of amitriptyline (Elavil) at bedtime and 15 mg of phenelzine (Nardil) three times per day. Which nursing action takes priority

A. Teaching the client about the adverse effects.
B. Calling the physician and questioning the order.
C. Instituting dietary restrictions.
D. Taking baseline vital signs.
单项选择题

The nurse is administering sublingual nitroglycerin to a client with chest pain. The nurse should place the medication

A. in the cheek.
B. on the tip of the tongue.
C. under the tongue.
D. under the lower lid of the ey
单项选择题

A 4-month-old infant is brought to the pediatrician by his parents because they’re concerned about his frequent respiratory infections, poor feeding habits, frequent vomiting, and colic. The physician notes that the baby has failed to gain expected weight and recommends that the baby have a sweat test performed to detect possible cystic fibrosis. To prepare the parents for the test, the nurse should explain that

A. the baby will need to fast before the test.
B. a sample of blood will be necessary.
C. a low-sodium diet is necessary for 24 hours before the test.
D. a low-intensity, painless electrical current is applied to the skin.
单项选择题

The nurse is teaching a new group of mental health aides. The nurse should teach the aides that setting limits is most important for

A. a depressed client.
B. a manic client.
C. a suicidal client.
D. an anxious client.
单项选择题

A 15-year-old primigravida gave birth 2 days ago. She tells the nurse that having her own little baby will be wonderful. Which nursing response would best evaluate the accuracy of the client’s expectations

A. "Tell me what your day will be like after you take your baby home. "
B. "Will anyone be available to help you at home with the baby"
C. "Have you had any experience taking care of babies"
D. "What are you planning to do with your baby when you return to school"
单项选择题

The nurse has a client at 30 weeks’ gestation who has tested positive for the human immunodeficiency virus (HIV). What should the nurse tell the client when she says that she wants to breast-feed her neonate

A. Encourage breas-feeding so that she can get her rest and get healthier.
B. Encourage breast-feeding because it’s healthier for the neonate.
C. Encourage breast-feeding to facilitate bonding.
D. Discourage breast-feeding because HIV can be transmitted through breast milk.
单项选择题

The nurse is assigned to care for a postoperative client who has diabetes mellitus. During the assessment interview, the client reports that he’s impotent and says that he’s concerned about its effect on his marriage. In planning this client’s care, the most appropriate intervention would be to

A. encourage the client to ask questions about personal sexuality.
B. provide time for privacy.
C. provide support for the spouse or significant other.
D. suggest referral to a sex counselor or other appropriate professional.
单项选择题

A 26-year-old primigravida is in labor. Her cervix is 5 cm dilated and 75% effaced; the fetus is at 0 station. The client requests medication to relieve the discomfort of contractions, and the physician prescribes an epidural regional block. What position should the nurse help the client to assume when the epidural is administered

A. Lithotomy.
B. Supine.
C. Prone.
D. Lateral.
单项选择题

A client is admitted for detoxification after a cocaine overdose. The client tells the nurse that he frequently uses cocaine but that he can control his use if he chooses. Which coping mechanism is he using

A. Withdrawal.
B. Logical thinking.
C. Repression.
D. Denial.
单项选择题

The nurse is administering warfarin (Coumadin) to a client with deep vein thrombophlebitis. Which laboratory value indicates warfarin is at therapeutic levels

A. Partial thromboplastin time (PTT)
to 2 times the control.
B. Prothrombin time (PT)
to 2 times the control.
C. International normalized ratio (INR) of 3 to 4.
D. Hematocrit of 32%.
单项选择题

The nurse is caring for a client who is suicidal. When accompanying the client to the bathroom, the nurse should

A. give him privacy in the bathroom.
B. allow him to shave.
C. open the window and allow him to get some fresh air.
D. observe him.
单项选择题

The nurse provides fluid replacement for a client with burns on 35% of his body. It has been 12 hours since the burns occurred. His blood pressure is 85/60 mmHg. His pulse is 124 beats/minute. Urine output was 25 mL during the past hour. What orders should the nurse expect to receive from the physician

A. Maintain IV fluids at the present rate, and continue to reassess vital signs and urine output hourly.
B. Increase the IV rate, and continue to reassess vital signs and urine output hourly.
C. Decrease the IV rate, and continue to reassess vital signs and urine output hourly.
D. Administer a vasoconstrictor, and reassess vital signs and urine output hourly.
单项选择题

The nurse is teaching a client about using vaginal medications. The nurse should instruct the client to

A. use a tampon after insertion to increase medication absorption.
B. release and pull up on the applicator before removal.
C. never refrigerate suppositories.
D. use only a water-soluble lubricant when inserting a suppository.
单项选择题

Which finding is considered normal in a neonate during the first few days after birth

A. Weight loss of 25%.
B. Birth weight of 2,000 to 2,500g.
C. Weight loss then return to birth weight.
D. Weight gain of 25%.
单项选择题

A multigravida in her 34th week of gestation presents in the emergency department complaining of vaginal bleeding. Which of the following should be the nurse’s first action

A. Establish IV access.
B. Assess fetal heart rate (FHR) and maternal blood pressure.
C. Prepare the client for a cesarean delivery.
D. Assess maternal heart rate and respiratory rat
单项选择题

The nurse administers racemic epinephrine to a child. Ten minutes after administration, the nurse should be alert for

A. respiratory distress.
B. profound tachycardia.
C. signs of improved oxygenation.
D. diminished cyanosis.
单项选择题

When inserting a urinary catheter, the nurse can facilitate the insertion by asking the client to

A. initiate a stream of urine.
B. breathe deeply.
C. turn to the side.
D. hold the labia or shaft of penis.
单项选择题

The nurse walks into the room of a client who has had surgery for testicular cancer. The client says that he’ll be undesirable to his wife, and he becomes tearful. He expresses that he’s spoiled a happy, satisfying sex life with his wife, and says that he thinks it might be best if he would just die. Based on these signs and symptoms, which nursing diagnosis would be most appropriate for planning purposes

A. Situational low self-esteem.
B. Unilateral neglect.
C. Social isolation.
D. Risk for loneliness.
单项选择题

A 4-year-old girl is admitted to the hospital to rule out leukemi

a. Which of the following would be the best room assignmentA. With a 4-year-old girl who has rheumatoid arthritis.B. With a 5-year-old boy who is having a tonsillectomy.C. With a 4-year-old girl who has leukemia.D. Alone in a private room.
单项选择题

A client’s blood glucose level is 45 mg/dL. The nurse should be alert for which signs and symptoms

A. Coma, anxiety, confusion, headache, and cool, moist skin.
B. Kussmaul’s respirations, dry skin, hypotension, and bradycardia.
C. Polyuria, polydipsia, hypotension, and hypernatremia.
D. Polyuria, polydipsia, polyphagia, and weight loss.
单项选择题

The nurse is caring for a client infected with methicillin-resistant Staphylococcus aureus (MRSA). What’s the major infection control measure to reduce MRSA and other nosocomial pathogens in a health care setting

A. Using antibacterial soap when bathing clients with MRSＡ.
B. Conducting culture surveys periodically.
C. Ensuring that personnel wash their hands before and after contact with every client.
D. Using specific housekeeping practices for environmental cleanin
单项选择题

The client is to receive an IV infusion of 3000 mL of dextrose and normal saline solution over 24 hours. The nurse observes that the rate is 150mL/hour. If the solution runs continuously at this rate, the infusion will be completed in

A. 12 hours.
B. 20 hours.
C. 24 hours.
D. 50 hours.
单项选择题

Which of the following assessments indicates fetal distress

A. Fetal scalp pH of 7.14.
B. Fetal heart rate (FHR) of 144 beats/minute.
C. Acceleration of FHR with contractions.
D. Long-term variability.
单项选择题

The nurse is caring for a client who’s hypoglycemic. This client will have a blood glucose level

A. below 70 mg/dL.
B. between 70 and 120 mg/dL.
C. between 120 and 180 mg/dL.
D. above 180 mg/dL.
单项选择题

The nurse-manager of a hospital unit holds monthly staff meetings. During these meetings, she maintains control over the meeting and agenda, resists consensus decision making, and uses discipline and coercion to elicit desired behavior from staff. This manager uses what type of leadership style

A. Autocratic.
B. Democratic.
C. Participative.
D. Laissez-fair
单项选择题

Which client has the highest risk of ovarian cancer

A. 30-year-old woman taking oral contraceptive pills.
B. 45-year-old woman who has never been pregnant.
C. 40-year-old woman with three children.
D. 36-year-old woman who had her first child at age 22.
单项选择题

Which procedure or practice is associated with surgical asepsis

A. Hand washing.
B. Nasogastrie (NG) tube irrigation.
C. Colostomy irrigation.
D. IV catheter insertion.
单项选择题

The nurse is providing postprocedure care for a client who underwent percutaneous
lithotripsy. In this procedure, an ultrasonic probe inserted through a nephrostomy tube into the renal pelvis generates ultra-high-frequency sound waves to shatter renal calculi. The nurse should instruct the client to

A. limit oral fluid intake for 1 to 2 weeks.
B. report the presence of fine, sandlike particles through the nephrostomy tube.
C. notify the physician about cloudy or foul-smelling urine.
D. report bright pink urine within 24 hours after the procedur
单项选择题

The nurse is providing home care to a client with failing vision due to macular degeneration. The nurse is concerned about the client’s safety. Which of the following activities would help to lessen the client’s risk of falling

A. Arranging pieces of furniture close together so the client can use them for guidance and support.
B. Encouraging the client to wear a medical identification bracelet that describes the client’s visual deficit.
C. Installing a flashing light to indicate when the phone or doorbell is ringing.
D. Installing handrails in hallways, in bathrooms, and on steps.
单项选择题

The nurse is performing wound care. Which of the following practices violates surgical asepsis

A. Holding sterile objects above the waist.
B. Considering a 1" (2.5 cm) edge around the sterile field as being contaminated.
C. Pouring solution onto a sterile field cloth.
D. Opening the outermost flap of a sterile package away from the body.
单项选择题

A client with a neurogenic bladder is beginning bladder training. Which of the following nursing actions is most important

A. Set up specific times to empty the bladder.
B. Force fluids.
C. Provide adequate roughage.
D. Encourage the use of an indwelling urinary catheter.
单项选择题

The nurse is providing care for an immobilized client. For this client, the most appropriate and most effective nursing intervention would be

A. getting the client out of bed and into a chair for 30 minutes, twice daily.
B. avoiding repositioning the client if he’s comfortable.
C. repositioning the client on alternate sides at least every 2 hours.
D. positioning the client with the greatest pressure at the bony prominenc
单项选择题

The nurse is developing a care plan for a client who’s at risk for ineffective coping due to the effects of chronic illness. Which factor provides the best evidence that the client is at risk for difficulty in coping with his illness

A. Poor sleeping habits.
B. Lack of social support.
C. Adverse drug effects.
D. Presence of panic disorder.
单项选择题

The nurse is caring for a neonate with congenital clubfoot. After the final cast has been removed, which member of the health care team will most likely help the neonate with leg and ankle exercises and provide his parents with a home exercise regimen

A. Occupational therapist.
B. Physical therapist.
C. Recreational therapist.
D. Speech therapist.
单项选择题

The nurse is teaching family members of a client with hepatitis A virus (HAV). Family members were exposed to the client and, therefore, should receive immunoglobulin. The nurse should tell the family members that immunoglobulin

A. prevents hepatitis infection in all people.
B. provides immunity for life.
C. must be administered within 2 weeks of exposure.
D. should be administered even if the person has anti-HAV antibodies.
单项选择题

A client with hypotonic labor dysfunction is receiving oxytoein augmentation. Her contractions become more frequent and intense. Dilation progresses to 8 cm, but the fetal head remains at station +1. The nurse notes a soft bulge just above the symphysis. Which of the following actions is best

A. Re-evaluate the fetal presentation.
B. Change the client’s position.
C. Offer a narcotic analgesic.
D. Help the client urinat
单项选择题

A 19-year-old primigravida is admitted to the labor and delivery unit in labor. She’s 2 cm dilated and 50% effaced, and the fetal head is at 0 station. She’s having moderately strong 40-second contractions every 5 minutes. She seems rather anxious and becomes very tense during each contraction. When the client asks for pain relief, what should the nurse do next

A. Determine the source of her anxiety and institute interventions to help her relax.
B. Immediately check the physician’s order and give her the analgesic ordered.
C. Inform her that the neonate’s head isn’t down far enough just yet but that, as soon as it is, medication will be given.
D. Tell her that her contractions are only moderately strong and that she should wait until later to take medication.
单项选择题

A client who agreed to become an organ donor is pronounced dead. What is the most important factor in selecting a transplant recipient

A. Blood relationship.
B. Sex and size.
C. Compatible blood and tissue types.
D. Nee
单项选择题

The nurse is caring for a client who underwent a subtotal gastrectomy 24 hours earlier. The client has a nasogastric (NG) tube. The nurse should

A. apply suction to the NG tube every hour.
B. clamp the NG tube if the client complains of nausea.
C. irrigate the NG tube gently with normal saline solution.
D. reposition the NG tube if pulled out.
单项选择题

Which one of the following clients is at the greatest risk for aspiration

A. A stroke client with dysarthria.
B. An ambulatory client with Alzheimer’s disease.
C. A 92-year-old client who needs help with activities of daily living (ADLs).
D. A client with severe, deforming rheumatoid arthritis.
单项选择题

A client with paranoid type schizophrenia becomes angry and tells the nurse to leave him alone. The nurse should

A. tell him that she’ll leave for now but will return soon.
B. ask him if it’s okay if she sits quietly with him.
C. ask him why he wants to be left alone.
D. tell him that she won’t let anything happen to him.
单项选择题

The nurse teaches a mother how to provide adequate nutrition for her toddler, who has cerebral palsy. Which of the following observations indicates that teaching has been effective

A. The toddler stays neat while eating.
B. The toddler finishes the meal within a specified period of time.
C. The child lies down to rest after eating.
D. The child eats finger foods by himsel
单项选择题

The nurse is caring for a
-year-old male client with tetralogy of Fallot. Which assessment findings should the nurse expect

A. Aortic stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy.
B. Pulmonary artery stenosis, intraventricular septal defect, overriding aorta, right ventricular hypertrophy.
C. Pulmonary artery stenosis, patent ductus arteriosus, overriding aorta, right ventricular hypertrophy.
D. Transposition of the great vessels, intraventricular septal defect, right ventricular hypertrophy, patent ductus arteriosus.
单项选择题

A 24-year-old client on the labor unit is being coached in the Lamaze method by her husband. On assessment, the nurse finds the client to be 5 cm dilated, 90% effaced, at +1 station with contractions coming every 2 to 3 minutes and lasting 35 to 40 seconds. The client has asked for pain relief. What’s the nurse’s best action

A. Check maternal blood pressure and pulse and fetal heart rate in response to contractions.
B. Realize that it’s too early to give pain medication, and encourage the husband to continue with the Lamaze coaching.
C. Arrange for a sonogram to determine fetal position.
D. Perform a vaginal examination to determine dilation, effacement, and station.
单项选择题

A 38-year-old client is hospitalized with obsessive-compulsive disorder. On admission, she becomes nervous and asks to go to the bathroom to brush her teeth. Her husband says that she brushes her teeth at least 25 times per day. The nurse notes that the client’s gums are inflamed and bleeding. What’s the best nursing intervention

A. Have her stop brushing her teeth until the gums heal.
B. Allow her to continue her routine of daily brushing.
C. Monitor her dental care and set limits on the amount of daily brushing.
D. Brush her teeth for her.
单项选择题

The nurse is teaching parents how to reduce the spread of impetigo. The nurse should encourage parents to

A. teach children to cover mouths and noses when they sneeze.
B. have their children immunized against impetigo.
C. teach children the importance of proper hand washing.
D. isolate the child with impetigo from other members of the family.
单项选择题

A primigravida in labor for 13 hours clenches her fists, tightens her muscles, and screams during every contraction. Her reaction to labor seems exaggerated compared to the contraction pattern recording from the electronic fetal monitor (EFM). What’s the nurse’s best response

A. Explain to the client that the EFM shows mild contractions, so she should just relax and let the contractions work.
B. Take over as her coach because her husband isn’t helping her properly.
C. Ignore her reactions, realizing that this is her first time in labor and her reactions will soon match the intensity of contractions shown on the EFM.
D. Palpate her abdomen to determine the intensity of labor contractions as they’re taking plac
单项选择题

A client is admitted for a suspected eating disorder. Which of the following statements would indicate that the client may be suffering from anorexia nervosa

A. "I’ve gained 3 pounds in the last month. "
B. "I eat loads of spinach and yellow vegetables each day. "
C. "I’m a perfectionist, and I work hard to get A’s. "
D. "I binge frequently in the morning and feel fat. "
单项选择题

The employer of a client on the psychiatric unit calls the nursing station inquiring about the client’s progress. The nurse doesn’t know if the client has given consent to allow the staff to give information out to callers on the phone. Which of the following would be the nurse’s best response

A. "I’m not permitted to discuss her progress. "
B. "I’ll give you the name and telephone number of her physician. "
C. "I’ll have her call you. "
D. "I can’t confirm whether your employee is a client here. "
单项选择题

The nurse is providing care for a postoperative client who has undergone a small bowel resection. The nurse may use an epidural catheter for which of the following

A. Antibiotic therapy.
B. Pain management.
C. Blood transfusion.
D. Anticoagulation.
单项选择题

The nurse is caring for a neonate with a myelomeningocele. The priority nursing care of a neonate with a myelomeningocele is primarily directed toward

A. ensuring adequate nutrition.
B. preventing infection.
C. promoting neural tube sac drainage.
D. conserving body heat.
单项选择题

37-year-old teacher is hospitalized with complaints of weakness, incoordination, dizziness, and loss of balance. The diagnosis is multiple sclerosis (MS). Which of the following signs and symptoms, discovered during the history and physical assessment, is typical of MS

A. Diplopia, history of increased fatigue, and decreased or absent deep tendon reflexes.
B. Flexor spasm, clonus, and negative Babinski’s reflex.
C. Blurred vision, intention tremor, and urinary hesitancy.
D. Hyperactive abdominal reflexes and history of unsteady gait and episodic paresthesia in both legs.
单项选择题

A 72-year-old client seeks help for chronic constipation. This is a common problem for elderly clients due to several factors related to aging. Which of the following is one such factor

A. Increased intestinal motility.
B. Decreased abdominal strength.
C. Increased intestinal bacteria.
D. Decreased production of hydrochloric aci
单项选择题

A 78-year-old client with sensorineural hearing loss is admitted to a rehabilitation center after hip replacement surgery. A risk factor for this client would be

A. altered perceptions.
B. toxic levels of pain medication.
C. impaired cognitive function.
D. impaired sense of tim
单项选择题

A client is receiving chemotherapy for cancer. The nurse reviews his laboratory report and notes that he has thrombocytopeni

a. To which nursing diagnosis should the nurse give the highest priorityA. Activity intolerance.B. Impaired tissue integrity.C. Impaired oral mucous membranes.D. Ineffective tissue perfusion (cerebral, cardiopulmonary, GI).
单项选择题

The nurse is developing a plan to teach a mother how to reduce her baby’s risk of developing otitis medi

a. Which of the following directions should the nurse include in the teaching planA. Administer antibiotics whenever the baby has a cold.B. Place the baby in an upright position when giving a bottle.C. Avoid getting the ears wet while bathing or swimming.D. Clean the external ear canal daily.
单项选择题

The nurse is administering total parenteral nutrition (TPN) to a client who underwent surgery for gastric cancer. What is a major complication of TPN

A. Hyperglycemia.
B. Extreme hunger.
C. Hypotension.
D. Hypoglycemi
单项选择题

The nurse is preparing a treatment plan for a client taking oral corticosteroids to control severe chronic asthm

a. Which statement indicates that the client understands his treatment planA. "I should take corticosteroids on an empty stomach. "B. "I need to take corticosteroids to help build up my immune system. "C. "I should stop taking corticosteroids if I haven’t had an asthma attack for 1 week. "D. "I’ll tell my other health care providers that I’m taking a corticosteroid. "
单项选择题

Which phrase is used to describe the volume of air inspired and expired with a normal breath

A. Total lung capacity.
B. Forced vital capacity.
C. Tidal volume.
D. Residual volum
单项选择题

A nurse in the nursery is preparing to perform phenylketonuria (PKU) testing. Which neonate is ready for the nurse to test

A. A 3-day-old neonate who has been fed IV since birth.
B. A 2-day-old neonate who has been breast-fed.
C. A 1-day-old neonate receiving formula.
D. A breast-fed neonate being discharged within 24 hours of birt
单项选择题

The nurse is caring for a woman with phenylketonuria who wants to start a family. Which of the following guidelines should the nurse provide the woman

A. Follow a low-phenylalanine diet before trying to conceive.
B. A low-phenylalanine diet is necessary only during the first trimester.
C. Begin a low-phenylalanine diet when pregnancy is confirmed.
D. Dietary restrictions won’t be necessary.
单项选择题

A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client

A. This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually.
B. The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days.
C. The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse.
D. The human papillomavirus (HPV), which causes condylomata aeuminata, can’t be transmitted during oral sex.
单项选择题

The nurse is admitting a client with a suspected fluid imbalance. The most sensitive indicator of body fluid balance is

A. daily weight.
B. serum sodium levels.
C. measured intake and output.
D. blood pressur
单项选择题

A client with type 1 diabetes mellitus is pregnant for the second time. Her previous pregnancy ended in spontaneous abortion at 18 weeks’ gestation. She’s now at 22 weeks’ gestation. The nurse is responsible for teaching the client about exercise during her pregnancy. Which of the following statements indicates that the client has an appropriate understanding of her exercise needs

A. "I know I need to walk with a friend or family member. "
B. "I know I need to vary the times of day when I exercise. "
C. "I know I need to exercise before meals. "
D. "I know I need to drink fluids while I walk. "
单项选择题

The nurse is assessing a client with possible osteoarthritis. The most significant risk factor for osteoarthritis is

A. congenital deformity.
B. age.
C. trauma.
D. obesity.
单项选择题

A client hospitalized with pneumonia has thick, tenacious secretions. To help liquefy these secretions, the nurse should

A. turn the client every 2 hours.
B. elevate the head of the bed 30 degrees.
C. encourage increased fluid intake.
D. maintain a cool room temperatur
单项选择题

Every morning a client with type 1 diabetes receives 15 units of Humulin 70/30. What does this type of insulin contain

A. 70 units of NPH insulin and 30 units of regular insulin.
B. 70 units of regular insulin and 30 units of NPH insulin.
C. 70% NPH insulin and 30% regular insulin.
D. 70% regular insulin and 30% NPH insulin.
单项选择题

A client with heart failure develops pink frothy sputum, coarse crackles, and restlessness. Which of the following actions should the nurse take first

A. Check the client’s blood pressure.
B. Place the client in high Fowler’s position.
C. Calculate the client’s fluid balance.
D. Notify the physician.
单项选择题

The nurse is caring for a client with diabetes mellitus. When teaching the client about foot care, which instruction should the nurse provide

A. Examine feet once per week for redness, blisters, and abrasions.
B. Apply lotion to dry feet, especially between the toes.
C. Avoid hot-water bottles and heating pads.
D. Dry feet vigorously after each bat
单项选择题

A 10-year-old girl visits the clinic for a checkup before entering school. The child’s mother questions the nurse about what to expect of her daughter’s growth and development at this stage. Which response is most appropriate

A. "Her physical development will be rapid at this stage, and rapid development will continue from now on. "
B. "She’ll become more independent and won’t require parental supervision. "
C. "Don’t anticipate any changes at this stage in her growth and development. "
D. "Friends will be very important to her, and she’ll develop an interest in the opposite sex. "
单项选择题

A 22-year-old client is diagnosed with dependent personality disorder. Which behavior is most likely evidence of ineffective individual coping

A. Inability to make choices and decisions without advice.
B. Showing interest only in solitary activities.
C. Avoiding developing relationships.
D. Recurrent self-destructive behavior with history of depression.
单项选择题

The nurse is caring for a client who is in labor. The physician still isn’t present. After the neonate’s head is delivered, which nursing intervention would be most appropriate

A. Checking for the umbilical cord around the neonate’s neck.
B. Placing antibiotic ointment in the neonate’s eyes.
C. Turning the neonate’s head to the side, to drain secretions.
D. Assessing the neonate for respirations.
单项选择题

In planning a presentation that advocates a decrease in the client-to-nurse ratio from 8:1 to 6:1, a nurse should emphasize its effect on

A. institutional resources.
B. standards of practice.
C. client-care quality.
D. nursing recruitment.
单项选择题

A client with cholecystitis is receiving propantheline bromide. The client is given this medication because it

A. reduces gastric solution production and hypermobility.
B. slows emptying of the stomach and reduces chyme in the duodenum.
C. inhibits contraction of the bile duct and gallbladder.
D. decreases bile secretions.
单项选择题

The nurse is caring for four clients on a step-down intensive care unit. The client at the highest risk for developing nosocomial pneumonia is the one who

A. has a respiratory infection.
B. is intubated and on a ventilator.
C. has pleural chest tubes.
D. is receiving feedings through a jejunostomy tub
单项选择题

The nurse is assessing a client who gave birth yesterday. Where should the nurse expect to find the top of the client’s fundus

A. One fingerbreadth above the umbilicus.
B. One fingerbreadth below the umbilicus.
C. At the level of the umbilicus.
D. Below the symphysis pubis.
单项选择题

A client with acute respiratory failure is intubated and placed on mechanical ventilation. Which intervention is most appropriate when suctioning the client

A. Insert the suction catheter while applying suction.
B. Apply suction until all the secretions have been removed.
C. Use the same catheter to first suction the mouth, then the endotraeheal tube.
D. Preoxygenate with 100% oxygen before suctionin
单项选择题

The nurse is caring for a client admitted to the emergency department after a motor vehicle accident. Under the law, the nurse must obtain informed consent before treatment unless

A. the client is mentally ill.
B. the client refuses to give informed consent.
C. the client is in an emergency situation.
D. the client asks the nurse to give substituted consent.
单项选择题

A client in her 7th month of pregnancy has been complaining of back pain and wants to know what can be done to relieve it. Which of the following responses by the nurse is most effective

A. "You need to lie down more during the day to get off your feet. "
B. "Avoid lifting heavy loads, and try using the pelvic tilt exercise. "
C. "Have others pick things up for you so you don’t have to bend over so much. "
D. "Your back pain will go away after the baby is born. "
单项选择题

The nurse is assessing a 15-year-old female who is being admitted for treatment of anorexia nervos

a. Which clinical manifestation is the nurse most likely to findA. Tachycardia.B. Warm, flushed extremities.C. Parotid gland tenderness.D. Coarse hair growt
单项选择题

Which nursing action takes priority when admitting a elient with right lower lobe pneumonia

A. Elevating the head of the bed 45 to 90 degrees.
B. Auscultating the chest for adventitious sounds.
C. Obtaining a sputum specimen for culture.
D. Notifying the physician of the client’s admission.
单项选择题

The nurse suspects that a 68-year-old client has digoxin toxicity. The nurse should assess for

A. hearing loss.
B. vision changes.
C. decreased urine output.
D. gait instability.
单项选择题

To assess a client’s cranial nerve function, the nurse should

A. assess hand grip.
B. assess orientation to person, time, and place.
C. assess arm drifting.
D. assess gag reflex.
单项选择题

The nurse is preparing to give a 9-year-old client a preoperative IM injection. Which size needle should the nurse use

A. 22G,
.
B. 22G, 1".
C. 20G,
.
D. 20G, 1".
单项选择题

The nurse is assessing a neonate. Health history findings indicate that the mother drank 3 oz (88.7mL) or more of alcohol per day throughout her pregnancy. Which characteristic should the nurse expect to find

A. Prominent nasal bridge.
B. Thick upper lip.
C. Upturned nose.
D. Large for gestational ag
单项选择题

A client at term arrives at the labor room experiencing contractions every 4 minutes. After a brief assessment, she’s admitted and an electronic fetal monitor is applied. Which of the following would alert the nurse to an increased potential for fetal distress

A. Weight gain of 30 lb (13.6 kg).
B. Maternal age of 32 years.
C. Blood pressure of 146/90 mmHg.
D. Treatment for syphilis at 15 weeks’ gestation.
单项选择题

A client in her 36th week of pregnancy is admitted to the hospital with vaginal bleeding. After undergoing an ultrasonic scan, she’s diagnosed with placenta previ

a. Which assessment finding would best confirm this diagnosisA. A rigid abdomen.B. A soft, nontender uterus.C. Painful vaginal bleeding.D. Hypotension.
单项选择题

A 2-month-old neonate with diarrhea and vomiting has been receiving IV fluids for the past 24 hours. The specific gravity of the neonate’s urine is 1.012. What should the nurse do next

A. Check the neonate’s blood pressure.
B. Check the specific gravity again as soon as possible.
C. Notify the physician.
D. Continue the ordered IV flow rat
单项选择题

Which of the following statements about external otitis is true

A. External otitis is eharaeterized by pain when the pinna of the ear is pulled.
B. External otitis is usually accompanied by a high fever in children.
C. External otitis is usually related to an upper respiratory infection.
D. External otitis can be prevented by using cotton-tipped applicators to clean the ear.
单项选择题

Which of the following nutritional deficiencies may delay wound healing

A. Lack of thiamine.
B. Lack of vitamin Ｃ.
C. Lack of folate.
D. Lack of vitamin Ａ.
单项选择题

During the assessment of a geriatric client, a nurse would expect which findings

A. Eye structure and visual acuity changes.
B. Facial hair decreasing in a female client.
C. Facial hair increasing in a male client.
D. Wounds healing more quickly.
单项选择题

A 56-year-old male has a blood pressure reading of 146/96mmHg. Upon hearing the reading, he exclaims, "My pressure has never been this high. Will I need to take medication to reduce it" Which of the following responses by the nurse would be best

A. "Yes. Hypertension is prevalent among males; it’s fortunate we caught this during your routine examination. "
B. "We’ll need to reevaluate your blood pressure because your age places you at high risk for hypertension. "
C. "A single elevated blood pressure doesn’t confirm hypertension. You’ll need to have your blood pressure reassessed several times before a diagnosis can be made. "
D. "You have no need to worry. Your pressure is probably elevated because you’re in the doctor’s office. "
单项选择题

When prioritizing a client’s care plan based on Maslow’s hierarchy of needs, the nurse’s first priority would be

A. allowing the family to see a newly admitted client.
B. ambulating the client in the hallway.
C. administering pain medication.
D. placing wrist restraints on the client.
单项选择题

The nurse is assessing a client with possible Cushing’s syndrome. In a client with Cushing’s syndrome, the nurse would expect to find

A. hypotension.
B. thick, coarse skin.
C. deposits of adipose tissue in the trunk and dorsocervical area.
D. weight gain in arms and legs.
单项选择题

The nurse-manager has noticed a sharp increase in the mediation errors with IV antibiotics over the last month. She discusses the situation with each nurse involved. What other action should she take

A. Document it on their evaluation.
B. Ask them to attend inservice training for administration of IV medications.
C. Report them to the supervisor.
D. Report the incidents to the hospital attorney.
单项选择题

A nurse performs cardiopulmonary resuscitation (CPR) for 1 minute on an infant without calling for assistance. In reassessing the infant after I minute of CPR, the nurse finds that he still isn’t breathing and that he has no pulse. The nurse should then

A. resume CPR beginning with breaths.
B. declare her efforts futile.
C. resume CPR beginning with chest compressions.
D. call for assistanc
单项选择题

The nurse is providing care for a pregnant 16-year-old client. The client says that she’s concerned she may gain too much weight and wants to start dieting. The nurse should respond by saying.

A. "Now isn’t a good time to begin dieting because you are eating for two. "
B. "Let’s explore your feelings further. "
C. " Nutrition is important because depriving your baby of nutrients can cause developmental and growth problems. "
D. "The prenatal vitamins should ensure the baby gets all the necessary nutrients. "
单项选择题

Drugs to treat acute anxiety are prescribed to a client hospitalized for an acute myocardial infarction. The client is reluctant to take anti-anxiety drugs. The nurse suspects that the client is holding the drugs under his tongue and disposing of them after she has left the room. What should the nurse do first

A. Report her suspicions to the client’s physician.
B. Talk to the client about his attitude toward the medications.
C. Search the client’s room for evidence of the medications.
D. Tell the client that his behavior must stop for his own well-bein
单项选择题

A woman in her 8th month of pregnancy is having dinner with her husband at their favorite restaurant. The woman suddenly chokes on a piece of chicken and appears to lose consciousness. What would be the best action by a nurse sitting at the next table

A. Apply abdominal thrust.
B. Apply chest thrust.
C. Begin cardiopulmonary resuscitation (CPR).
D. Reposition the client on her sid
单项选择题

A family member is caring for a client diagnosed with Alzheimer’s disease. Which of the following is most likely to cause the caregiver depression and role strain

A. The caregiver had a close relationship with the client before diagnosis of the illness.
B. The caregiver has no formal support, such as a visiting nurse or day care worker.
C. The caregiver understands the full reality of the disease and its inevitable progression.
D. The caregiver feels unable to control the client and unable to cope with caregivin
单项选择题

An elderly client with Alzheimer’s disease begins supplemental tube feedings through a gastrostomy tube to provide adequate calorie intake. The nurse should be concerned most with the potential for

A. hypoglycemia.
B. fluid volume excess.
C. aspiration.
D. constipation.
单项选择题

The nurse is interviewing the mother of a 7-year-old child. Which of the following symptoms reported by the mother would most lead the nurse to suspect that the child has type 1 diabetes

A. Recent bed wetting.
B. Poor appetite.
C. Weight gain.
D. Boundless energy.
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