39. The nurse is caring for an older adult with mild dementia with heart failure. What nursing

care will be helpful for this client in reducing potential confusion related to hospitalization

and change in routine? Select all that apply.

A. Reorient frequently to time, place and situation.

B. Put the client in a quiet room furthest from the nursing station.

C. Perform the necessary procedures quickly.

D. Arrange for familiar pictures or special items at bedside.

E. Limit the client’s visitors.

F. Spend time with the client, establishing a trusting relationship.

40. Which would be most helpful when coaching a client to stop smoking?

A. Review the negative effects of smoking on the body.

B. Discuss the effects of passive smoking on environmental pollution.

C. Establish the client’s daily smoking pattern.

D. Explain how smoking worsens high blood pressure.

41. A nurse is helping a suspected choking victim. The nurse should perform the Heimlich

maneuver when the victim:

A. Starts to become cyanotic

B. Cannot speak due to airway obstruction

C. Can make only minimal vocal noises

D. Is coughing vigorously

42. While the nurse is providing preoperative teaching for a client with peripheral vascular

disease who is to have a below-the-knee amputation, the client says. “I hate the idea of

being an invalid after they cut off my leg.” The nurse’s most therapeutic response should

be:

A. “Focusing on using your one good leg will make your recovery easier.”

B. “Tell me more about how you are feeling.”

C. “We will talk more about this after your surgery.”

D. “You are fortunate to have a wife who can take care of you.”

43. Which indicates that a client has achieved the goal of correctly demonstrating deep

breathing for an upcoming splenectomy? The client:

A. Breathes in through the nose and out through the mouth

B. Breathes in through the mouth and out through the nose

C. Uses diaphraphragmatic breathing in the lying, sitting, and standing positions.

D. Takes a deep breath in through the nose, holds it for seconds, and blows it out

through pursed lips

44. Which nursing action is most important in preventing cross-contamination?

A. Changing gloves immediately after use

B. Standing 2 feet (61cm) from the client

C. Speaking minimally when in the room

D. Wearing protective coverings