Q a Week from ncsbn

i've been collecting these for a few months and thought i'de share. i'm sure all of you are doing these but just in case.

1. A client has just joined a health care maintenance organization (HMO) and asks for information about the payment obligations with this plan. The most accurate description of health care costs is that the client will be charged in which manner?
1. Only for services provided by specialists
2. One flat rate for each service rendered
3. A pre-determined fee for all services *
4. The usual and customary fee for services
(12-2-08)

2. A nurse, assisting in the application of a plaster cast for a client with a broken arm, should understand which action is a priority
1. the cast material should be dipped several times into warm water
2. the cast should be uncovered until it dries
3. the wet cast should be handled with the palms of hands for 48 to 72 hours *
4. the casted extremity should be placed on a supporting surface
(12-8-08)

3. A nurse detects blood-tinged fluid leaking from the nose and ears of a client diagnosed with head trauma. What is the appropriate nursing action?
1. pack the nose and ears with sterile gauze
2. put manual pressure on the draining sites
3. apply bulky, loose sterile dressing to the nose and ears *
4. position an ice pack to the back of the neck
(12-15-08)

4. To prevent keratitis in an unconscious client, a nurse should apply moisturizing ointment to which site?
1. finger and toenail quicks
2. lower eyelid *
3. perianal area
4. external ear canals
(12-22-08)

5. A female client diagnosed with genital herpes simplex virus 2 complains of dysuria, dyspareunia and leukorrhea. Lesions are found on the labia and perianal skin areas. A nurse should suggest for the client to implement which action?
1. take three to four warm sitz baths per day *
2. wash hands at least every two hours
3. spray water over genitalia while voiding
4. apply heat or cold to lesions, whichever is most soothing
(12-30-08)




6. During a morning bath for a client who has a colostomy, a nurse should reinforce that the collection pouch should be emptied at what time?
1. .when it is 1/3 to 1/2 full *
2. prior to going to sleep at night
3. after each fecal elimination
4. at the same time each day
(1-8-09)


7. A client has just returned to the medical-surgical unit after a segmental lung resection. What should be the first nursing action upon entering the room?
1. administer pain medication
2. suction excessive tracheobronchial secretions *
3. assist client to turn, cough and deep breathe
4. check oxygen saturation by pulse oximeter
(1-13-08)


8. A client is receiving heparin therapy for a deep vein thrombosis of the left leg. Which side effect should the nurse address first ?
1.fine red rash on left leg
2.black, tarry stools *
3.fever and chills
4.pain in the left leg
(1-19-09)

9. A nurse enters a client's room to discover that the client has no pulse or respirations. After calling for help and giving two breaths, what is the next action the nurse should take?
1. continue to oxygenate with a pocket mask
2. check for a carotid pulse
3. initiate closed-chest massage at a rate of 100 bpm *
4. obtain the crash cart from the hallway
(2-1-09)


10. A client is admitted with the diagnosis of infective endocarditis (IE). History of which finding is most important for the nurse to report to the registered nurse (RN)?
1. tiredness and drowsiness
2. a rash that appeared suddenly *
3. fever for the past 24 hours
4. .clubbing of the nails
(2-16-09)


11.) A client takes digoxin for heart failure. A nurse should report which side effects to the charge nurse?
1. bradycardia, hypotension *
2. blurred vision, yellow vision
3. anorexia, vomiting
4. fatigue, headache
(2-25)