Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is conducting the Weber's test on a client. Which of the following is an appropriate action for the nurse to take?
A. Deliver a series of high-pitched sounds at random intervals.
B. Hold an activated tuning fork against the client's mastoid process.
C. Whisper a series of words softly into one ear.
D. Place an activated tuning fork in the middle of the client's forehead.
Place an activated tuning fork in the middle of the client's forehead. The rationale for this answer is that Weber's test is used to assess for conductive or sensorineural hearing loss by comparing bone conduction in both ears. The nurse places an activated tuning fork in the middle of the client's forehead and asks if the sound is heard equally in both ears or louder in one ear.
This question is an excerpt from Nurse Dive's nursing test bank - ATI Rn Nursing Care of Children 2020 Proctored Exam. Take the full exam now
Full Explanation
Place an activated tuning fork in the middle of the client's forehead. The rationale for this answer is that Weber's test is used to assess for conductive or sensorineural hearing loss by comparing bone conduction in both ears. The nurse places an activated tuning fork in the middle of the client's forehead and asks if the sound is heard equally in both ears or louder in one ear.
Similar Questions
A nurse is monitoring a client who is receiving continuous IV fluid therapy via a peripheral vein in the left forearm. Which of the following findings indicates that the client has developed phlebitis at the IV site?
A. Coolness of the client's left forearm
B. Pallor of the client's left forearm
C. Erythema along the path of the vein
The rationale for this answer is that phlebitis is inflammation of a vein caused by mechanical, chemical, or bacterial irritation from an IV catheter or fluid. It manifests as redness, warmth, tenderness, and swelling along the path of the vein.
D. Pitting edema at the insertion site
Full Explanation
The rationale for this answer is that phlebitis is inflammation of a vein caused by mechanical, chemical, or bacterial irritation from an IV catheter or fluid. It manifests as redness, warmth, tenderness, and swelling along the path of the vein.
A nurse receives a new prescription over the telephone from a client's provider. Which of the following actions should the nurse take first?
A. Ensure that the provider signs the prescription.
B. Document the prescription as a telephone prescription in the medical record.
C. Read back the prescription to the provider
The rationale for this answer is that reading back the prescription to the provider is a safety measure that helps prevent medication errors and ensures accuracy and clarity of communication. It also allows for confirmation and verification of any unclear or incomplete information.
D. Write down the complete prescription.
Full Explanation
The rationale for this answer is that reading back the prescription to the provider is a safety measure that helps prevent medication errors and ensures accuracy and clarity of communication. It also allows for confirmation and verification of any unclear or incomplete information.
A nurse is preparing to bathe a client who has dementia. Which of the following actions should the nurse take?
A. Complete the bath even if the client is in distress
B. Give detailed instructions for the client to follow.
C. Allow the client to select the temperature of the bath water
D. Use distractions when bathing
The rationale for this answer is that using distractions such as music, conversation, or toys can help reduce anxiety and agitation in clients with dementia who may resist bathing. It also helps create a positive and comfortable environment for the client.
Full Explanation
The rationale for this answer is that using distractions such as music, conversation, or toys can help reduce anxiety and agitation in clients with dementia who may resist bathing. It also helps create a positive and comfortable environment for the client.