Tiêu đề RECALLS 7 - NP3 - SC ✅

45. A hospital administrator has implemented a change in the method of assigning nurses to client care units. A group of registered nurses is resistant to the change, and the nursing administrator anticipates that the nurses will not facilitate the process of change. Which approach is best for the administrator to take initially in dealing with the resistance? A. Cancel the implementation of the change. B. Implement the change first on a trial basis. C. Delay implementing the change for a few weeks. D. Encourage the nurses to verbalize feelings regarding the change. Situation: Various clients will undergo different post op positioning from various procedures. 46. After Pneumonectomy, a client is positioned: A. Right side lying B. Affected side C. Left side lying D. Unaffected side 47. While after Lobectomy, the client is positioned: A. Right side lying B. Affected side C. Left side lying D. Unaffected side 48. After Liver Biopsy, The client is positioned: A. Right side lying B. Supine C. Left side lying D. Semi Fowlers Situation: A nurse is teaching a group of healthcare workers the proper technique for handwashing in a clinical setting. 49. What is the first step of the handwashing process to ensure proper hygiene and minimize the spread of infections? A. Apply soap to hands B. Wet hands with water C. Scrub the hands for 20 seconds D. Rinse hands with clean water 50. According to WHO guidelines, how long is the recommended duration for the entire procedure of handwashing? A. 20 – 30 secs B. 30 – 60 secs C. 40 – 60 secs D. 15 – 20 secs Situation: You are the ICU nurse handling high-risk cardiovascular patients and post-surgical cases. Prompt recognition of life-threatening signs is critical. 51. A nurse assessing a client who reports persistent lower back pain and a sensation of “beating” in the abdomen. Upon palpation, the nurse notes a pulsating mass in the abdomen. Which of the following is the nurse’s priority action? A. Notify the health care provider B. Apply deep pressure to assess the mass C. Measure abdominal girth D. Reassure the client and continue monitoring 52. A client with left-sided heart failure is admitted with dyspnea and orthopnea. What additional sign is the nurse most likely to find? A. Hepatomegaly B. Crackles in lung bases C. Dependent edema D. Jugular vein distention 53. A patient receiving nitroglycerin IV for chest pain develops a BP of 70/30 mmHg. What is the nurse’s priority action? A. Stop the infusion immediately B. Elevate the foot of the bed C. Notify the provider and reduce the dose D. Administer IV fluids rapidly 54. A client with pericardial effusion suddenly becomes dyspneic and restless. The nurse notes BP 80/50 mmHg, muffled heart sounds, and jugular vein distention. Which nursing action takes priority? A. Elevate the head of the bed to 90 degrees B. Administer high-flow oxygen via non-rebreather mask C. Prepare for emergency pericardiocentesis D. Initiate a rapid IV fluid bolus 55. A client recently discharged after mitral valve replacement returns to the clinic with complaints of fatigue. Which finding is most concerning? A. INR of 2.3 B. Irregular pulse C. Fever and chills D. Mild fatigue Situation: You are preparing patients for discharge and monitoring for high-risk cardiac medication effects. 56. Which client is most at risk for developing digoxin toxicity? A. A client with hyperkalemia B. A client taking a loop diuretic C. A client with low BUN D. A client with a high-potassium diet 57. A client is being discharged after heart surgery. Which statement signals need for further teaching? A. “I will avoid heavy lifting.” B. “I can resume sex when I can climb two flights of stairs.” C. “I’ll take my medications only if I feel chest pain.” D. “I’ll walk daily as tolerated.” 58. A client on IV heparin infusion for atrial fibrillation has an aPTT of 110 seconds. What is the nurse’s best action? A. Stop the infusion B. Slow the infusion and reassess in 2 hours C. Continue as ordered and monitor for bleeding D. Document the result and recheck in the morning 59. Which discharge instruction is most appropriate for a patient with an abdominal aortic aneurysm (AAA) repair? A. “Resume weightlifting in 1 week to regain strength.” B. “Call the provider for back or abdominal pain.” C. “Check blood pressure once a month.” D. “Take your blood pressure only when you feel dizzy.” 60. The nurse is monitoring a client who received IV furosemide. Which finding requires immediate follow-up? A. Serum potassium 2.9 mEq/L B. Mild decrease in BP after ambulation C. Urine output 200 mL after 2 hours D. Complaint of mild muscle cramp Situation: You are the nurse caring for clients with respiratory conditions and trauma. Quick recognition of abnormal signs and proper patient education is key. 61. The nurse is teaching a client with asthma about proper inhaler use. Which statement indicates correct technique? A. “I inhale before pressing the inhaler.” B. “I hold my breath after inhaling the medication.” C. “I exhale immediately after using it.” D. “I don’t need to shake the canister.” 62. The nurse is caring for a client with chest trauma after a road traffic accident. Which finding requires immediate action? A. Paradoxical chest movement B. Chest pain when coughing C. Decreased breath sounds on one side D. Rib tenderness on palpation 63. Which client condition warrants placing them in High Fowler’s position? A. Post-lumbar puncture B. Hypovolemic shock C. Acute respiratory distress D. Severe dizziness 64. A nurse is monitoring a client with asthma. Which finding is most concerning? A. Use of accessory muscles B. Audible wheezing C. Sudden absence of wheezing D. Reports of chest tightness Situation: You are caring for clients with respiratory disorders requiring immediate assessment and intervention. 4 | Page