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2)A client who is recovering from abdominal surgery has a penrose drain. Which of the
following should the nurse include in the care of this client? 2) _______
A)Make sure there is a safety pin on the end of the drain.
B)Clean the wound with normal saline every two hours.
C)Empty the drain every 30 minutes.
D)Remove the drain four hours postoperatively.
3)A client is in the recovery room. Which of the following members of the healthcare team
should the nurse contact regarding the client's level of pain control? 3) _______
A)The surgeon B) The anesthesiologist
C)The scrub nurse D) The circulating nurse
4)During the assessment of a postoperative client's bowel sounds, the nurse auscultates high-
pitched sounds over all four abdominal quadrants. The nurse realizes this finding could indicate:
4) _______
A)Normal bowel function. B) The onset of stool.
C)The onset of flatus. D) Paralytic ileus.
5)A client is being transferred from the operating room to the recovery room. The nurse in the
recovery room will be providing which phase of nursing care? 5) _______
A)Intraoperative B) Preoperative
C)Restorative D) Postoperative
6)A client is being scheduled for surgery. Which of the following should be included in the
preoperative teaching provided by the nurse? 6) _______
A)The credentials of the anesthesiologist
B)Information concerning the surgical procedure which will be performed by the surgeon
C)Cost of the procedure
D)Planned length of stay at the hospital
7)A client is being positioned for a hip replacement procedure. In which of the following
positions will this client most likely be placed? 7) _______
A)Dorsal recumbent B) Lateral chest
C)Semi-sitting D) Prone
8)A postoperative client tells the nurse, "A book I read said that I should not eat after surgery for
at least a week." Which of the following statements would be an appropriate nursing response?
8) _______
A)"You don't need any food to heal anyway."
B)"That's true."
C)"That's not true. You could get an infection in your stomach."
D)"I'll be giving you intravenous feedings anyway."
9)An elderly postoperative client is given an antiemetic for nausea. Which of the following signs
would indicate this client is experiencing a possible reaction to the medication? 9) _______
A)Dry mouth
B)Involuntary muscle movements
C)Breakthrough vomiting
D)Confusion
10)A client is signing a surgical consent. Afterwards, the nurse also signs the form. What is the
meaning of the nursing signature? 10) ______
A)It means the client was alert and aware of what was being signed.
B)It means there is a likelihood of a successful outcome.
C)It means the client understood the procedure as described by the nurse.
D)It means the surgeon was too busy to wait for the client to sign the form.
11)A client's endotracheal tube is being removed after the surgical procedure. The intra-operative
nurse realizes this client is in which phase of the general anesthesia process? 11) ______
A)Induction B) Maintenance
C)Reduction D) Emergence
12)An elderly client is being prepared for orthopedic surgery. The nurse realizes this client is at
risk for which of the following? 12) ______
A)Prolonged effects of anesthesia because of herbal supplements
B)Decreased tolerance of general anesthesia
C)Increased hypotensive effects of anesthesia
D)Wound dehiscence
13)The client who is preparing for surgery asks the nurse to keep their glasses and hearing aid in-
place until they are under anesthesia. Which of the following statements by the nurse
demonstrates accurate, therapeutic communication? 13) ______
A)"I will contact the surgery department to discuss you requests."
B)"Certainly, you can keep them for that time."
C)"You cannot keep those in."
D)"The policies in the surgery unit will not allow it."
14)A client has just arrived in the recovery room. How often should the nurse assess the client?
14) ______
A)Every 15 minutes for 30 minutes and then every one hour afterwards.
B)Every 15 minutes for the first hour.
C)Every hour.
D)Every two hours.
15)A client who is being admitted for surgery asks the nurse why information is being collected
about the client's use of herbal and natural supplements. Which of the following statements is an
appropriate nursing response? 15) ______
A)"The physician is in charge of medications."
B)"Herbal supplements may interact with anesthesia agents."
C)"Herbal remedies may cause pain relievers to be ineffective."
D)"There is no need to take these preparations."
16)An elderly client is completing preoperative diagnostic testing. The nurse notes that the
client's carbon dioxide level is elevated. Which of the following nursing interventions would be
indicated for this client? 16) ______
A)Monitor serum sodium level.
B)Monitor serum potassium level.
C)Monitor respiratory status and arterial blood gases.
D)Monitor intake and output.
17)A client is prescribed patient-controlled analgesia for postoperative pain. Which of the
following should the nurse instruct the client about this analgesia? 17) ______
A)"Use this analgesia every hour on the hour."
B)"Use this analgesia only when the pain is extremely severe."
C)"Avoid the use of this because of the risk of addiction."
D)"Use this analgesia regularly."
18)A client has received conscious sedation for a surgical procedure. The nurse realizes this
client will most likely: 18) ______
A)Respond to physical and verbal stimuli.
B)Not respond to any stimuli.
C)Need an endotracheal tube inserted.
D)Need blood product replacements.
19)A client is in his fifth postoperative day and has sanguineous drainage with a thick, reddish
appearance. The nurse realizes this client's wound is in which stage of healing? 19) ______
A)Stage III B) Stage IV C) Stage I D) Stage II
20)A recovery room nurse is consulting with a circulating nurse about a client who is having a
surgical procedure. These nurses are most likely in which zone of the surgical department? 20)
______
A)Banned B) Semi-restricted
C)Restricted D) Unrestricted
21)A nurse has delegated the collection of vital signs, including blood pressure readings, to two
unlicensed assistive personnel. The of this work means the nurse is: 21) ______
A)Not accountable for these vital signs.
B)Responsible to re-measure all of the vital signs.
C)Not responsible for these vital signs.
D)Accountable for the care that was delegated.
22)The nurse working on a quality improvement study wants to evaluate a client care process.
Which of the following can the nurse use to evaluate this process? 22) ______
A)Variance analysis B) Critical pathway
C)Evidence-based practice D) Nursing process
23)The new nurse is studying the five core competencies for healthcare providers. Which of the
following are a part of these core competencies? (Select all that apply.) 23) ______
A)Work in interdisciplinary teams.
B)Use informatics to deliver care.
C)Use evidence-based practice.
D)Replace quality improvement initiatives with work redesign methods.
E)Use primary nursing to deliver care.
24)A client tells the nurse, "I have an advance directive that I want you to follow." Which of the
following will this document provide for the nurse? 24) ______
A)A complete plan of care for the client
B)The answers to any care dilemmas for the client
C)The client's preferences for healthcare should the client become mentally incapacitated
D)Directions regarding when to use universal precautions for the client
25)Client chart audits provide the nurses with information that impacts the future outcomes of
client care. What should the nurses do with this information? 25) ______
A)Use the information to create an action plan to address any negative findings.
B)Nothing
C)Submit it to the agency's accrediting body.
D)Place it in a file to compare with the next set of audits.
26)The nurse is preparing a client to go home. Which of the following skills are the most
important for the nurse to adequately prepare this client? 26) ______
A)Familiarity with adult learning principles
B)The ability to support client decision making
C)The ability to use critical thinking
D)The ability to follow written orders
27)The nurse is implementing a plan of care for a client. After providing care, what should the
nurse do as the final step in the process? 27) ______
A)Reassess the client.
B)Give the charge nurse a report.
C)Document
D)Nothing
28)At the completion of an assessment, the nurse chooses a nursing diagnosis that best defines
the client's health problems. Which type of clinical judgment will this nurse use? 28) ______
A)Diagnostic reasoning B) Evidence-based practice
C)Nursing process D) Critical pathway
29)A client tells the nurse, "I have pain in my leg when I stand too long." This information would
be considered: 29) ______
A)Subjective data B) Objective data
C)Evaluative data D) Qualitative data
30)The nurse is consulting a critical pathway to help make client care decisions. Which type of
care delivery model is this nurse most likely using to provide client care? 30) ______
A)Team nursing B) Primary nursing
C)Functional nursing D) Case management
31)While providing care to a client, the nurse stops to assess a new client problem. The
assessment in this situation would be: 31) ______
A)An objective assessment B) An initial assessment
C)A focused assessment D) A subjective assessment
32)A graduate nurse is attending a seminar regarding the role of the nurse as a client advocate.
After the session, the students engage in a discussion. Which of the following statements by the
graduate nurse indicates the need for further education? 32) ______
A)"Being a client advocate entails making efforts to improve client outcomes."
B)"Client advocates have the authority to make decisions for the client."
C)"Communicating client needs to the members of the healthcare team is a role of the client
advocate."
D)"Providing education to the client and family is a key way to be a positive client advocate."
33)The nurse is using a specific process to plan smoking cessation activities for a client. Which
of the following is this nurse most likely using to plan the care for this client? 33) ______
A)Evidence-based practice B) Nursing process
C)Variance analysis D) Critical pathways
34)The nurse is creating outcome criteria for the nursing diagnoses for a client. Which of the
following should the nurse include when creating the criteria? 34) ______
A)They should be written as psychomotor only.
B)They should be written to address the client, and be time-specific and measurable.
C)They should be written as statements.
D)They should be written as nursing goals.
35)The nurse stops to think about a previous client care situation before providing care to a
current client. This nurse is using what critical thinking skill? 35) ______
A)Divergent thinking B) Reflection
C)Reasoning D) Clarifying
36)A client care issue has been raised about the actions taken by a nurse who was asked to
provide care to a client whose healthcare decisions were considered controversial. The unit's
nurse manager is concerned that care was not appropriately provided. Which of the following
should be consulted to protect the client and to evaluate the care in question? 36) ______
A)Nursing code of ethics
B)Hospital quality improvement guidelines
C)Critical pathway
D)Nurse practice act
37)The nurse is reviewing the outcome of client care that was provided. Which of the following
nursing process steps should the nurse use next? 37) ______
A)Implementation B) Planning
C)Assessment D) Evaluation
38)The nurse is preparing to provide client care information to a group of unlicensed assistive
personnel. Which type of care delivery system is this nurse most likely using to provide client
care? 38) ______
A)Primary nursing B) Team nursing
C)Functional nursing D) Case management
39)A new nurse tells her mentor "you always seem so poised when you interact with the client. It
is as if you always know what to do. Can you teach me how to do that?" What characteristic does
this mentor possess in relation to critical thinking? 39) ______
A)Independent thinking B) Discipline
C)Empathy D) Self-confidence
40)Which of the following best demonstrates a nurse using critical thinking when providing
client care? 40) ______
A)A nurse checks a laboratory manual before providing care.
B)A nurse lists alternative interventions available to provide client care.
C)A nurse checks every intervention with the charge nurse before providing care.
D)A nurse is confused when the only planned intervention fails to help a client.
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'Pitääkö kauhtana lämpimänsä?' Sellainen häpeä
kaupungillemme!… Siitä saatte vastata!"
"Erotkaa!"
"Poikanne?"
"Ei ole tapani peljätä", virkkoi toinen ylväästi. "Koska minun pitää
lähteä?"
"En."
"Lähden pois; minun täytyy se tehdäkin, sillä jos jään, olen iäksi
kuollut. Mutta jos olen poissa, voi käydä niinkin, että vielä kutsuvat
minut takaisin. Olaj beg on järkimies; vainajata hän ei voi mihinkään
käyttää, elävällä sitävastoin on arvoa, jos esim. tahtoo orjakauppaa
hieroa. Pahimmassa tapauksessa hän heitättää minut tyrmään.
Ainahan voi jotakin uskaltaa."
Sitten hän antoi hevoselleen uuden iskun, joka tosin oli tarkoitettu
triumvireille, mutta jonka tuo luontokappale alistuen sieti. Pureva
tuuli alkoi puhaltaa. Csalanos-lammikon takaa kuului etäistä tohinaa
ja melua: tatarien leirielämän kohua.
"On hyvä, että olette tullut hevosen selästä, sillä minä aijon heti
nousta satulaan. Tulkaa tänne muurin suojaan, mutta heti, ja
antakaa minulle viitta."
"Oletko mieletön?"
Maks vastustelihe.
Czinna kääntyi.
Beg Olaj katseli nyt viitan selkäpuolta. Sitten hän hyppäsi
satulasta, heittäytyi Czinnan eteen maahan ja suuteli kolmesti viitan
lievettä. Czinna tuijotti häneen suurilla mustilla silmillään, hän luuli
uneksivansa.
7.
"Älä lorua!"
"Todellakin!"
"Kun Olaj beg sen näki, hyppäsi hän satulasta, suuteli sen lievettä
kolme kertaa ja kysyi hyvin nöyrästi, mitä minä suvaitsin käskeä.
Minä tietysti käskin heidän heti poistua seudulta. He noudattivatkin
määräystä ja lähtivät."
Hänen hämiänsä kesti toki vain tuokion; hän oli vanha, ovela kettu,
joka osasi helposti päästä aseman herraksi.
Kun melu oli hieman hälvennyt (sillä sali oli tungokseen asti
täynnä yhteiskuntaelämän ylhäisöä), otti valkohapsinen Matteus
Puszta puheenvuoron ja ilmoitti heikolla, iltakellon kaltaisella vienolla
äänellä Lestyakin ansioista ja huudahti lopuksi:
"En ole sinulle vielä kertonutkaan, poikani, niin, koskapa siitä olisin
voinut sinulle puhuakaan, että minulla nykyisin on työssä
apulainenkin, me aherramme nyt kaksin miehin."
"Minun täytyi hänet ottaa silloin kun lähdin Budan pashan luo
neuvottelemaan. Sillä minä olen sinusta tehnyt ylituomarin, ettäs sen
nyt tiedät. (Vanhuksen silmiin tuli vihertävä hohde.) Vanha Lestyak
on mies kerrassaan, eikö?… Kisälli, sanon, haki työtä, vaikka
huomaankin, ettei hän rahtuakaan saa valmista. Minulla ei ole ollut
tilaisuutta tutkia, mihin hän pystyy. Tähän asti olen hosunut
politiikassa. Älä naura, nuori mies, taikka minä närkästyn. Nyt saat
sinä hoitaa politiikan. Suurta rotua, Lestyakien suku. Mutta kas, nyt
olemme kotona."
Vanhus huoahti:
"Minkävuoksi?"
"Sen mustalaisletukan vuoksi, jos häntä vielä muistat. Eikö keitto
olekaan hyväksi suolattu? Tuopas suolasalkkari tänne, Laczi."
"Hän väitti, että tyttö oli livistänyt teidän kanssanne, ja kunnes hän
oli palannut tai ilmoitti missä hän oli, pidättäisi hän minut vankina.
Sanoin, etten ollut sen koommin nähnyt hänen varjoaankaan."
"Syönhän jo; mutta isä, ette ole vielä kertonut loppuun Budan
seikkailua."
"Hän on hätäillyt."
"Kuka? Minäkö?"
"Et sinä, vaan pasha."
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