Kaplan Diagnostic A Practice Test

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• A partner of a client with a history of myocardial infarction and heart failure tells the nurse, 'I do not want my partner to be kept alive on machines if the heart stops.' Which action is most important for the nurse to take?
• Which action should be avoided when caring for a patient with a newly created arteriovenous fistula?
• After thyroidectomy, hoarseness may indicate injury to which structure?
• The parent of a preschooler with a tracheostomy asks why suctioning is needed less frequently; the nurse's response should reflect that suctioning is least necessary when which situation occurs?
• Which toy is most appropriate for an 18-month-old child?
• An initial nursing assessment of septic shock would most likely reveal which symptoms?
• The nurse supervises a nursing assistive personnel caring for a client after abdominal surgery. Which observation requires intervention?
• A nurse administers morphine 10 mg IM; The order for morphine had been deleted and replaced with hydromorphone 4 mg IM; Which documentation is best?
• When taking ferrous sulfate, which statement indicates the patient understands the education?
• Caring for a client with anorexia nervosa, which goal is the highest priority initially?
• During a routine Mantoux skin test, which action assesses the test's outcome?
• The nurse observes an LPN/LVN irrigating an abdominal wound. Which action by the LPN/LVN requires the nurse's intervention?
• Five hours after knee replacement, which drainage observation is most consistent with expected postoperative drainage?
• An adolescent is being evaluated for type I diabetes. Which statement would the nurse expect the parents to make?
• Which statement indicates a need for further instruction after a cholecystectomy?
• The nurse cares for the client in the psychiatric Hospital. The client has not slept for several nights, talks rapidly, and wrings the hands. Which is the highest nursing priority during the first few days of hospitalization for this client?
• After a total right hip arthroplasty, which immediate postoperative activity is most important for the nurse to assist the client with?
• In addressing a disoriented client who is describing a fantasy world, which communication approach is most effective?
• A client is taking naproxen. Which symptom should be reported to the healthcare provider as most important?
• When transferring a patient from bed to a chair using a transfer belt, which step is essential for safety?
• A patient with Alzheimer's disease wanders from room to room. Which action is appropriate?
• During CPR for an 8-month-old, which observation would require intervention by the nurse?
• When turning a patient after left total hip arthroplasty, the nurse places the patient in which position?
• When teaching a school-aged child to use crutches correctly, which action requires intervention?
• A 60-year-old with polyuria and hyperglycemia; labs show hyperosmolar state; No ketones; The provider should initially order which treatment?
• A client is found lying face down on the floor. First action?
• For a patient with COPD, which feeding approach is considered a priority to maintain energy and nutrition?
• Which statement best reflects understanding about the cardiac catheterization procedure?
• A client with a new double-barrel colostomy complains of odor. What action should the nurse take initially?
• After a right total hip arthroplasty, which finding justifies the nurse calling the healthcare provider?
• A client who has undergone an above-knee amputation reports the missing limb still feels present. Which statement best explains this sensation?
• To support an Alzheimer's patient who wanders, which approach is most appropriate?
• Which symptom cluster best supports a Ménière's disease diagnosis?
• A confused client discusses thoughts about a fantasy world. Which action should the nurse take?
• A client with Alzheimer’s disease wanders around the unit and disturbs other clients. The client’s gate is steady. Which action is most appropriate?
• A client with aphasia after a stroke; Which communication approach is most effective?
• The results of a recent CBC for the female client are WBC 1000 cells/mm3, Platelets 200,000/mm3, Hgb 14 g/dL, Hct 39%. Which is the most important nursing goal for this client?
• Postoperative care after a right modified radical mastectomy includes which appropriate action?
• During a staff meeting about client care concerns, a nurse who is not a native English speaker remains silent. Which action should the charge nurse take to ensure understanding?
• For Buck’s extension traction in an 18-month-old, which action is most important for the nurse to perform?
• A client is prescribed digoxin 0.25 mg and furosemide 40 mg daily. Which action should the nurse take?
• The nurse plans care for the client diagnosed with osteoporosis. Which exercise is recommended to help maintain bone density?
• A postpartum client reports tenderness in the groin and pain in the calf. What action should the nurse take first?
• Prior to discharge of a school-age child with Type I diabetes, which action should be taught for a sudden loss of consciousness?
• A client with bipolar disorder becomes angry and starts throwing objects. Which action should the nurse take first?
• For a patient with a history of alcoholism, which discharge planning strategy best supports relapse prevention?
• A client with a left traumatic below-knee amputation has a tourniquet in place and a perineal tear. Which action should the nurse take first?
• In a manic patient, which behavior most clearly indicates improvement?
• In third-trimester bleeding with dark red spotting and no uterine pain or tenderness, which condition is most likely?
• The nurse cares for the client with a history of chronic alcohol abuse, nutritional problems, and confabulation. In planning for the client's nursing care, which action is the first priority of the nurse?
• During peritoneal dialysis, if 1000 mL returns after a 2000 mL exchange, what is the recommended next action?
• A healthcare provider orders tobramycin for a 3-year-old. The child does not have an identification bracelet. Which action by the nurse is most appropriate?
• A newborn two hours old shows which of the following observations would be unexpected?
• Postoperative orders after a left total hip arthroplasty include turning. In which position should the patient be placed to implement this order?
• When monitoring a child on prednisone, which parameter should be most closely watched?
• Observation that indicates the initial nursing action for a prolapsed umbilical cord is effective is most precisely which observation?
• The nurse cares for a client six hours after his traditional cholecystectomy. It is most beneficial for the nurse to take which action before encouraging the client to cough and deep breathe?
• When delirium is suspected in a hospitalized patient, which approach helps reduce risk?
• Rheumatoid arthritis with activity intolerance should be addressed with which intervention?
• In a four-month-old who has stopped breathing, which action is recommended by nursing practice?
• The client reports menstruating constantly for one year. Which question is most important for the nurse to ask?
• Which action best supports communication with a patient who has aphasia due to stroke?
• A nurse cares for a 6 lb 7 oz newborn delivered two hours ago. Which observation is expected?
• Which statement best describes an appropriate exercise goal for a 50-year-old client with chronic bronchitis?
• A client experiencing a panic attack says, 'Get out of here, and leave me alone.' What action should the nurse take?
• A parent arrives from overseas to visit; the child is depressed, disheveled and suspicious of family; Which nursing order should be included in the care plan?
• What is the correct sequence when mixing regular insulin with NPH insulin in the same syringe?
• What is the best nursing intervention to support energy conservation for a patient with rheumatoid arthritis?
• What is the correct sequence for using a metered-dose inhaler with a spacer for a bronchodilator?
• Which snack is best for a four-year-old during snack time in a daycare setting?
• A client with chronic alcohol abuse and a risk of thiamine deficiency requires which initial intervention to prevent deficiency-related complications?
• A client has a chest tube attached to a three-chamber water-sealed drainage system. If the chest tube becomes disconnected from the system, what action should the nurse take first?
• During morning rounds, a teenager who recently had rotator cuff repair refuses fentanyl 100 mcg IV PRN. Which action should the nurse take first?
• A six-year-old's blood pressure is needed, but a properly sized cuff is unavailable. Which action should the nurse take?
• In a client admitted for evaluation of epilepsy, which action is the highest priority for the nurse?
• Which statement by the nurse is best regarding a patient scheduled for a liver biopsy?
• Which statement indicates a need for further instruction after a cholecystectomy?
• A 29-week pregnant client presents with symptoms of preterm labor. Which assessment is most helpful in confirming this diagnosis?
• A client with type I diabetes asks why an insulin pill is not used. What is the best nursing response?
• The nurse cares for the client diagnosed with a loss of ability to use language following a stroke; Which action does the nurse take?
• A client with neutropenia is admitted. Which measure is most important to reduce infection risk?
• Immediately after a percutaneous liver biopsy, the nurse places the client in which position?
• Which finding indicates a chest tube is functioning properly?
• Which action in performing a urinary catheterization on a preschool child requires intervention?
• Which statement indicates a student traveler needs further teaching about preventing hepatitis during travel?
• The nurse cares for the client after the delivery of an 8 lb 7 oz newborn. Which measure carries the highest priority on the first day postpartum?
• Which technique is correct for venipuncture to establish IV access?
• A client with peptic ulcer bleeding has multifocal premature ventricular contractions. Which electrolyte disturbance is most likely the cause?
• For testing the biceps reflex in a child, which action specifically demonstrates proper technique?
• A patient undergoing hemodialysis takes digoxin and furosemide. When should the digoxin be given?
• After a right total hip arthroplasty, which assessment finding warrants immediate provider notification?
• Which sign would most readily indicate dehydration in a newborn?
• Which combination of signs is most typical of early septic shock?
• To auscultate for breath sounds in the middle lobe of the lung, which location is correct?
• In a patient with heart failure during a routine clinic visit, which question is most important for the nurse to ask first?
• A nurse assesses a client who uses crack cocaine several times a week. Which assessment finding most strongly suggests withdrawal?
• A five-month-old infant at a well-baby visit shows which finding that is unexpected?
• For a 2-month-old infant with hypospadias, which assessment is essential before surgical correction?
• In managing a patient with a severe head injury, which assessment is essential to prevent secondary brain injury?
• A patient has a radium implant for cervical cancer. Which intervention is appropriate for the nurse to implement?
• A nurse who is three months pregnant is assigned to pass medications to a group of clients. The nurse asks another nurse to administer which medication?
• Which electrolyte disturbance is most likely to cause multifocal premature ventricular contractions?
• During peritoneal dialysis, 2000 mL of dialysate is infused and 1000 mL returns. What action should the nurse take next?
• Which situation most suggests that a nurse may be addicted to alcohol or habit-forming medications?
• Which menu demonstrates an effective dietary adjustment for osteoporosis?
• To obtain a urine specimen from a client with an indwelling catheter, which action is performed first?
• A quality assurance evaluation of assignments among three RNs and one LPN/LVN is performed. The assignments are appropriate if the LPN/LVN is assigned to which client?
• A hospitalized client says, 'I’m not sure I want to stay here. I feel so frightened and alone.' Which response by the nurse is most appropriate?
• In the emergency department after an assault and robbery, which intervention is the most appropriate initial response?
• The home health nurse changes dressings four times a week for the client with a stage III pressure ulcer; The hospital admitting nurse notes the dressing was not applied as ordered; Which action is most important to take?
• In the immediate postpartum period, which assessment most strongly indicates potential hemorrhage requiring action?
• The client with a long-leg walking cast reports numbness in the toes. Which action is most urgent to take first?
• A patient learns how to use a walker. Which observation indicates that the walker is being used correctly?
• Which action helps prevent dislocation after a left total hip arthroplasty?
• If a nurse discovers a client in the bathroom attempting self-harm, which action should be taken first?
• The client's family reports the patient has early-stage Alzheimer's disease. Which symptom would you expect to observe first?
• Following a postoperative fall while awaiting cataract surgery, which action demonstrates the safety priority?
• A two-year-old on aminophylline infusion shows which sign requiring immediate attention?
• Preoperative teaching for a total right hip arthroplasty includes postoperative exercises. Which exercise, if performed, indicates further teaching is necessary?
• The nurse finds one of the housekeeping staff sleeping in an unoccupied client room. Which action does the nurse take?
• Which laboratory pair is most consistent with active inflammation in rheumatoid arthritis?
• When caring for a school-age child on prednisone, which information is most important to assess?
• Which observation is within expected parameters after knee arthroplasty?
• A client scheduled for a vaginal hysterectomy expresses a desire to read her medical record. Which action should the nurse take?
• An adolescent with full-thickness burns on the upper chest and partial-thickness burns on the hands, arms, and face, which communication method should the nurse encourage?
• A client with type I diabetes asks why an insulin pill cannot be used. Which is the correct nursing explanation?
• A client with newly diagnosed type I diabetes asks why injection sites must be rotated. What is the best explanation?
• Which TB teaching statement indicates effective understanding at discharge?
• In the above scenario of the below-knee amputation care, which option best describes the patient’s transport for report handoff?
• The preschool child is prescribed pancreatin capsules. Which parental statement indicates a need for further teaching?
• Which statement best describes the munchies commonly seen with marijuana use?
• The nurse is caring for a school-aged child with cystic fibrosis who is receiving aerosol therapy. Which outcome best reflects the expected result of the therapy?
• In acute phase rheumatoid arthritis, what is the primary nursing goal?
• While teaching self-monitoring blood glucose (SMBG), which action by the client indicates successful learning?
• Which nursing outcome is primary for a client with acute rheumatoid arthritis?
• A preschooler fears monsters and bogeymen in the bedroom at night. Which parental action indicates appropriate management of the child's fears?
• In parenteral nutrition therapy, if a PN container is unavailable, which solution is commonly hung temporarily to maintain glucose supply?
• During the second stage of labor, a partner asks to leave. Which response is appropriate?
• Which statement best describes the primary purpose of neomycin in the treatment of hepatic encephalopathy?
• A pediatric client is on a continuous aminophylline infusion. Which finding requires immediate intervention?
• When administering a medication to a child who does not have an identification bracelet, which action is most appropriate?
• The nurse is assigned to four clients. Which client should be seen first?
• During a dressing change, after opening a sterile pack and donning sterile gloves, the nurse notices the dressings needed are missing. What action should be taken next?
• The nurse uses an otoscope to examine the tympanic membrane of an adult. Which behavior indicates proper technique?
• A prominent member of society is hospitalized; People are calling about the client’s condition. Which action should the nurse take?
• In a patient with schizophrenia, which observation would most require immediate safety intervention due to risk of self-harm?
• In primary adrenocortical insufficiency, which laboratory pattern is expected?
• A patient with rheumatoid arthritis is being evaluated. Which laboratory results are elevations expected in?
• A patient is scheduled for cardiac catheterization. Which statement indicates effective teaching?
• A patient who was assaulted becomes calm in the ED. This change is best explained by which reason?
• The client receives parenteral nutrition (PN) via the internal jugular vein. Which action does the nurse take if the next container of PN solution is not available when it is needed?
• During the transition phase of labor, a client reports lightheadedness and tingling in the fingers. Which action is most appropriate?
• The test for phenylketonuria (PKU) is most reliable at which timeframe?
• Which medication is contraindicated for a pregnant nurse to administer?
• During a physical assessment of a school-age child, which behavior demonstrates proper technique for examining the deep tendon reflexes?
• Which technique correctly describes how to mix intermediate-acting insulin with short-acting insulin?
• When a four-month-old stops breathing, which action is the recommended first intervention by the nurse?
• The nurse cares for the client with an above-knee amputation four days post-op; The nurse teaches the client about care of the residual limb prior to being fitted with a temporary prosthesis; Which intervention is most important for the nurse to include in instruction?
• The nurse cares for four clients. Which client should be seen first?
• Which toy is most appropriate for an 18-month-old child?
• Which action helps prevent furosemide-induced hypokalemia?
• The nurse discusses foods that are included on a diabetic diet. Which food, if selected by the client diagnosed with type I diabetes, indicates the nurse teaching is successful?
• For a 2-month-old infant admitted for surgical correction of hypospadias, which assessment should the nurse complete?
• If the adolescent’s insulin dosage is reduced, which symptom would confirm the need for ongoing adjustment?
• A nurse cares for a client with a dramatic left leg amputation after an automobile accident. The client frequently presses the call light and makes angry remarks toward staff. Which statement best explains the reason for the client's behavior?
• Which principle best guides nursing care for pregnant adolescents?
• The parents bring their 9-month-old child to the clinic; Which observation by the nurse indicates a delay in development?
• A client in a manic phase of bipolar disorder shows improvement. Which behavior most clearly indicates improvement?
• To ensure a safe hospital environment for a 2-year-old toddler, which intervention is appropriate?
• Which signs and symptoms are expected with Ménière's disease?
• Which fetal heart rate pattern indicates uteroplacental insufficiency?
• A newborn displays the stepping (dance) reflex. What is the appropriate interpretation?
• In managing an adolescent with orchitis, which action is most important for the nurse to take?
• Which observation five hours after a right total knee arthroplasty requires nursing intervention?
• When a client with a history of drug abuse says, I can’t imagine life without them, what is the best initial nurse response?
• Which statement about applying nitroglycerin ointment is a safety concern?
• How should a charge nurse respond to a non-native English-speaking nurse who remains silent during a staff meeting to promote communication?
• An adolescent on 10 units of intermediate-acting insulin every morning at 07:00; which symptom would suggest the dose should be reduced?
• Which description best matches the stool of a 10-day-old breast-fed infant?
• Which action is appropriate when a nurse identifies a discrepancy between a medication order and the administered dose?
• The nurse cares for the client in labor at 35 weeks gestation. Which statement, if found by the nurse in the client's medical records, is unexpected?
• Which statement demonstrates successful discharge teaching for orchitis?
• A client with epilepsy asks about managing the condition. Which statement indicates a need for further teaching?
• Which auscultation finding is associated with a right-sided pneumothorax?
• Which statement about activity therapy for a depressed client is most accurate?
• Which discharge instruction indicates successful teaching about orchitis home care?
• The nurse cares for the client diagnosed with menopause. The client asks the nurse, 'why is estrogen replacement therapy (ERT) given?' Which explanation by the nurse is most accurate?
• In the scenario where the nurse must complete several tasks before handing off the report, which sequence is correct for the order of tasks?
• During the second stage of labor, a partner asks to go to the cafeteria. Best nurse response?
• In a nursing team consisting of one RN, one LPN/LVN, and an experienced nursing assistant (NAP), which task distribution is appropriate for: straight catheterization for urinary retention after cholecystectomy, tracheostomy care two days after laryngectomy, and a blood glucose determination for a patient receiving PN through a central venous catheter?
• An hour and a half after admission to the nursery, the nurse observe spontaneous jerky movements of the limbs in an infant born to a mother with diabetes mellitus; Based on these signs, which condition does the nurse expect in the infant?
• A client with back pain has a partner who reports increased alcohol use; which symptom cluster would indicate withdrawal?
• Which parental statement indicates a need for further teaching about pancreatin administration?
• A client with low back pain has a partner who reports increased alcohol use since the back injury. Which symptom cluster would the nurse observe?
• During peritoneal dialysis, which finding indicates a malfunction in the system?
• Which pattern is most indicative of fetal well-being and adequate oxygenation?
• After a right modified radical mastectomy, which action should the nurse avoid to prevent venous return impairment and edema in the affected arm?
• During rounds, a client with schizophrenia states, 'I know you are conspiring with my spouse to keep me locked away.' What is the most appropriate nurse response?
• During the admission assessment, a client with a history of schizophrenia tells the nurse, 'I must submerge myself in hot water to atone for my sins.' The nurse is most concerned if which observation is made?
• A nurse who previously worked in a rural hospital with total client care now works in a suburban hospital with a team-based system. What is the most appropriate initial action to address this difference?
• A parent brings a 4-month-old for DTaP and IPV immunizations. Which statement indicates understanding of when to return for the next DTaP dose?
• In placenta previa, which practice should be avoided to prevent bleeding complications?
• After cholecystectomy, the T-tube drainage is 300 mL of greenish brown fluid. What action should the nurse take initially?
• After administration of preoperative medication for cataract surgery, the patient is found on the floor at the foot of the bed 10 minutes later. What action should the nurse take first?
• Which statement demonstrates understanding of the next DTaP vaccination visit?
• A client who recently underwent surgery for a leg amputation demonstrates anger and frequently directs remarks toward staff. Which nursing action best addresses the client's body image concerns?
• Discharge teaching for emphysema. Which statement indicates the patient understands?
• In interpreting a Mantoux skin test, which finding is used to determine a positive reaction?
• Which statement demonstrates that teaching about nitroglycerin was successful?
• Which symptom requires an intervention in a client with a recently performed tracheostomy?
• When assessing an IV site on the left forearm, which finding would rule out the occurrence of IV infiltration?
• Which feeding approach should be used for a patient with COPD to support energy needs?
• A nurse asks how to tell if a teenage child is under the influence of marijuana. Which statement by the teen's parent is best?
• During a dressing change, if a required dressing is missing after the pack is opened and sterile gloves are on, which action is correct?
• A client receiving parenteral nutrition via a subclavian catheter requires a unit of packed red blood cells. What is the correct nursing action?
• Before discharge, the nurse teaches a client who underwent ileal conduit surgery. Which instruction is most important?
• In the management of a prolapsed umbilical cord, observation that indicates the initial nursing action is effective is most precisely which observation?
• In environmental rounds, which problem should the nurse address first?
• The nurse demonstrates a focus on safety by initiating plans that address both clinical and psychosocial needs. Which action best reflects a comprehensive approach?
• In planning care for a client with a severe head injury, which is the highest priority?
• Morning care for a client with a cuffed tracheostomy cuff deflated; next action?
• In a nursing QA scenario, which client is appropriately assigned to the LPN/LVN?
• Which finding is most significant for a mother who just delivered an 8 lb 4 oz baby?
• The nurse asks a family member about a partner's preference to withhold life-sustaining treatment; what is the nurse's first step?
• To demonstrate abstract thinking in evaluating health decisions, which statement shows consideration of consequences and multiple perspectives?
• During bucks traction for a hip fracture, which observation requires intervention?
• The parents of an 18-month-old with a fractured femur plan to leave the room. Which statement should the nurse suggest the parents tell the child?
• A 10-day-old infant who is breast-fed is expected to have stools with which characteristics?
• When evaluating a patient’s understanding of treatment options, which statement demonstrates abstract thinking?
• Which statement indicates a traveler has a misunderstanding about hepatitis prevention?
• In suspected toxic shock syndrome, what is the first nursing action?
• In the emergency department, after monitoring for a patient with chest pain, which action addresses potential oxygenation issues?
• At 32 weeks gestation, a patient reports dizziness. Which condition best explains this symptom?
• During a penicillin infusion over 20 minutes, which concurrent action is appropriate for the nurse to perform?
• During patient education about medical records, a patient asks to view her medical record. Which action should the nurse take?
• If a chest tube becomes disconnected from the drainage system, which action should be performed first?
• Before discharge, which instruction about care of an arteriovenous fistula in the right arm is correct?
• Which statement by a client taking amitriptyline indicates adequate understanding of the medication?
• Which statement indicates the client with alcoholism has gained insight?
• Which observation indicates the walker is being used incorrectly?
• A client diagnosed with primary adrenocortical insufficiency is being evaluated. Which laboratory finding would you expect?
• A client with breast cancer receives tamoxifen citrate. Tamoxifen acts as which of the following?
• Which statement best explains phantom limb sensation after an amputation?
• Which position is used after left total hip arthroplasty to help prevent dislocation?
• To promote skin integrity around a new ileal conduit, which nursing action is most appropriate?
• In a patient with tuberculosis under airborne precautions, which observation by a nursing assistant would not require an intervention?
• During oral hygiene for a patient with a cuffed tracheostomy, the cuff is deflated; which action should the nurse take to document cuff status?
• A penicillin infusion is to occur over 20 minutes. Which action can the nurse take while this medication infuses?
• Which observation indicates a significant Mantoux reaction in an HIV-positive client?
• For a client with an ileal conduit, which action is essential to prevent leakage and skin irritation around the stoma?
• Which milestone is expected for a 5-month-old infant?
• During assessment of a client with a chest tube and a three-chamber water-seal drainage system, which finding requires nursing intervention?
• A client with depression says, 'I'm too tired to take a shower. Please don't bother with me today.' Which action is most appropriate for the nurse to take?
• Which snack choice would be appropriate for a four-year-old during daycare snack time considering choking risk?
• The nurse observed the student nurse suctioning a client. Which action indicates proper suctioning technique?
• The nurse teaches the client what to expect during a cardiac catheterization. Which statement indicates further teaching is necessary?
• Which action should be avoided to protect an arteriovenous fistula in the arm?
• Which action best supports the management of placenta previa with ongoing bleeding?
• Which of the following is the best initial action for a client with a new colostomy experiencing odor?
• During the transition phase of labor, a client reports lightheadedness and tingling in the fingers. Which action is most appropriate?
• During a routine prenatal visit, fetal heart rate (FHR) is auscultated. If the fetal position is left sacrum posterior (LSP), where is the FHT best heard?
• During peritoneal dialysis, which finding indicates a malfunction of the system?
• Which common characteristic is associated with people at risk for anorexia nervosa?
• A patient found lying face down on the floor; which action should be taken first?
• An adolescent scheduled for facial scar repair demonstrates abstract thinking when responding to which statement?
• When performing an otoscopic examination on an adult, which technique demonstrates proper visualization of the tympanic membrane?
• After attaching a cardiac monitor for a client with chest pain and shortness of breath, which order should the nurse implement first?
• Post subtotal thyroidectomy, which observation is most concerning?