2020 NCLEX-RN
TEST PREP QUESTIONS AND ANSWERS
WITH EXPLANATIONS
Study Guide to Pass the License Exam Effortlessly
Fun Science Group
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TABLE OF CONTENTS
Introduction
7 Secrets to Studying – How to Pass Any Exam
STUDY MODE: Practice Exam Questions with Answers & Explanations
Basic Nursing Care
Management and Practice Directives
Preventing Risks and Complications
Caring for Acute and Chronic Conditions
Safety
Mental Health
Pharmacology
Growth and Development
TEST MODE: Practice Exam Questions
Basic Nursing Care
Management and Practice Directives
Preventing Risks and Complications
Caring for Acute and Chronic Conditions
Safety
Mental Health
Pharmacology
Growth and Development
Test Answer Keys
Conclusion and Limits of Liability
INTRODUCTION
Congratulations on finishing nursing school. Now it’s time to pass the
National Council Licensure Examination for Registered Nurses (NCLEXRN®).
The NCLEX is developed through the National Council of State Boards of
Nursing (NCSBN), and although you will be under the jurisdiction of your
state board of nursing where you will be working, the NCSBN works with
each state to standardize the testing for registered nurse examinees.
The NCLEX questions are written based on the practices of entry-level
registered nurses and formulated by registered nurses with advanced
education and training. They are designed to test your knowledge of nursing
concepts and provide scenarios that will require you to consider what to do
next. The NCLEX questions go beyond just technical skill requirements and
knowledge and include concepts as client education, caring, communication
with others, knowledge of the nursing process and documentation of work.
The most effective way to pass the NCLEX is to review the information
you have learned in nursing school and take the time to study it thoroughly.
The exam is difficult and those that do not pass will need to take the test
again. Do not put off studying. Cramming at the last minute will only lead
to a poor outcome. Take your time; allow yourself plenty of study time
before the date of your exam. This is an important test and is the measure of
the work you will perform someday as a registered nurse.
Good luck and study well!
7 SECRETS TO STUDYING – HOW TO PASS ANY EXAM
Exams! A cause of nervousness, fears, and even terror, yet a necessary rite
of passage toward a worthwhile goal.
The good news is there are many things you can do before and during your
final exam that will almost guarantee a passing grade.
The two most important things you need are motivation and an effective
study plan!
Motivation will take a bit of effort, but it’s the key to achieving your goals.
To stay motivated, remember why you took this course and review the
benefits you'll derive from passing the exam and receiving your certificate.
Perhaps you’re looking forward to increased income, increased self-respect
or self-employment. You enrolled in this course because you’re looking
forward to a brighter future!
In the following pages, we’ll provide tips and information on how to create
an effective study plan. You’ll discover seven guidelines for creating a
worthwhile program for yourself. If you want to do well and you want to
put forth the effort, use these simple techniques. They have helped many
people succeed, and if you use them, they will work for you as well!
SECRET #1: No Excuses! Make Studying a Habit Worth Having
The very first thing you need to do is accept the fact that studying is a
requirement, and a necessary part of the learning process.
Set up a Winning Schedule
Next, set up a schedule and follow it! By doing so, you are developing a
HABIT of studying. A habit (as you may already know) takes on a life of
it’s own and starts to generate its own energy, making it easier and easier
for you to continue. Remember, consistency is the key to developing a
positive study habit.
How to develop a strong, effective study habit:
• Start small. Start with only 10-15 minutes of studying at a time and then
build up to longer amounts as you progress in the material.
• Set time aside for studying every day if possible.
• On the other hand, be realistic. Be sure to set up a reasonable schedule that
you can easily follow.
SECRET #2: Create the “Right” Study Environment
Avoid All Distractions
Try your best to avoid distractions during your study time. Eliminate all the
obvious distractions like phone calls, or friends dropping by. Tell your
family members, spouse or children that you need time alone to concentrate
on your studies. Unplug your phone, shut the door, move the newspaper and
magazines to another part of the house. Keep the television and radio off.
Take control of your environment!
Don’t Procrastinate!
Don’t be tempted to put off studying for even two or three hours just
because the garage needs to be cleaned out, or the closets need
reorganizing. Those tasks can wait.
Remember to stick to your schedule.
BONUS TIP: Study Shorter, More Often!
We absorb a lot more information if we learn in small, manageable portions,
instead of trying to learn everything at once.
Break it down! Study small sections, take a break, then study again.
SECRET #2: Create the “Right” Environment (continued)
Where to Study
Find a quiet, comfortable (but not too comfortable) place to study. If you
find too many distractions at home, go to your local library. Find a part of
the library that is well-lit and ventilated. This will help you to concentrate.
Pack a box with everything you need to study, so that when it’s time to go,
you can just pick up the box and take off.
The RIGHT Study Environment:
• Studying in the same place each time will help you concentrate and will
reinforce your positive study habits.
• If your exam is proctored, try to recreate the same environment as your
final exam. This means that if you will be taking the exam sitting at a desk,
make sure you study sitting at a desk. If you do this, you will form an
association with knowing the material and sitting at a desk. Make your
study situation as similar as possible to the exam situation, and, believe it or
not, this will actually help you during the exam!
(Later we’ll talk about forming a “mental attitude” during study that you
will duplicate during the exam.)
The WRONG Study Environment:
• Don’t study lying in bed. Your unconscious mind associates your bed with
sleep. You’re more likely to nod off than get any real studying done!
• Don’t study in front of the television set.
• Don’t eat while studying. Food can be the greatest distraction of all!
BONUS TIP: Eat Light & Eat Right
Do you study in the evening? If you feel sluggish, it could be because you
ate a heavy meal.
Also stay away from foods high in sugar, like candy bars or chocolate.
You’ll get an initial surge, but you’ll soon crash! Instead, eat carbohydrates
(bread or pasta), fruits or protein (nuts, meat).
SECRET #3: Maximize Your Time
Take Study Breaks
Make sure you take a break! Periodically stand up, gently rotate your neck,
touch your toes and feel the stretch along the back of your legs. If possible,
take a short walk to get some fresh air.
Find Your Peak Performance Time
Have you noticed that you’re more alert during a certain time of day? For
some, their peak time of day is in the afternoon, while others feel sharpest
in the early morning hours. Most people claim they’re either a morning
person or a night owl. Which are you? Find out, then study during those
hours, whether it’s 7:00 a.m. or midnight. However, don’t study when
you’re too tired. It’s a waste of your valuable time and it won’t do you any
good!
BONUS TIP: Avoid Cramming!
Cramming is a good way to guarantee poor results. Don’t expect to retain
any information you try to learn at the last minute. In the days before your
exam, you should review the material you’ve already gone over.
SECRET #4: Use Study Aids to Your Advantage
Plan a review of each chapter as you go along, so that you don’t have to
review everything all at once right before the exam. Remember, no
cramming!
Make up your own questions for each chapter. Use the chapter headings and
subheadings for ideas. Can you answer these questions quickly?
Flash cards are very good tools, particularly for memorization of important
terms and definitions. You can create them out of the words and terms
you’re having the most difficulty with. Review them in random order until
you feel confident that you know them.
Videos, (if offered with your course) are excellent study aids, because
watching and listening to videos involve more of your senses than just
reading. Plus, videos can be rewound and replayed as often as you need.
Practice exams (if available) can also help prepare you for the real thing. If
you can score 90% or more on your practice exams, you’re doing well!
Remember, effective studying is a result of active involvement, not just
passively reading the text and materials.
BONUS TIP: Score at least 90% correct on your study aids
Your study aids are a valuable tool! Use them to track your progress. You’ll
know instantly which topics you’re weaker on and which areas you need to
review again.
SECRET #5: Remember to use Memorization Tools!
Associative Memory Techniques
What’s the best way to recall important facts? When you associate
something familiar to you with those facts. Here are some examples of
associative memory techniques that will work for you.
Acrostics
Have you ever heard of the phrase, “Every good boy does fine?” This is an
example of an acrostic. The first letter in each word stands for the note on
the musical staff — “E, G, B, D, F”. This is an aid to memory. For instance,
in real estate, when you want to remember property tax dates, use the
acrostic “No Darn Fooling Around” (for November, December, February,
and April). See if you can make up creative acrostics for areas you need
help remembering. Sometimes the more outrageous, the better!
Acronyms
Acronyms are actual words formed from the first letters of a series or list of
words you need to remember. In grade school when you had to remember
the names of the Great Lakes, you probably used the word “homes” to
remember all five lakes - Huron, Ontario, Michigan, Erie, and Superior. Be
creative in making up acronyms for yourself!
Rhymes
Making up a simple rhyme can be a very effective memorization tool.
Remember, “i before e, except after c?”
Imaging Techniques
Visualization engages a different part of your brain than reading or
listening, thereby adding to your learning success. You can use “LINKING”
to recall a list or series of words by creating a visualization that contains all
the words you need to recall. The more outlandish the image, the more
likely you’ll remember it. For instance, say you want to recall the errands
you need to run that day. You need to go to the post office, buy milk, pick
up your daughter at soccer practice, and buy dog food. “Link” these
together by visualizing a dog with a letter in its mouth being chased by a
cow kicking a soccer ball. It might sound strange, but it works!
BONUS TIP: Make Sure You Understand What You Read
NEVER go past a word you don’t understand in the textbook. Stop and look
it up, then continue. If you don’t understand a sentence or paragraph in the
text, take it a phrase at a time until it makes sense to you. Write down any
term you find difficult and make it into a flash card. Review it the next day
at the start of your study session. Soon you’ll know them all!
SECRET #5: Remember to use Memorization Tools! (continued)
Other Memory Techniques
Recitation
Probably the most powerful tool you have to transfer ideas from your shortterm memory to your long-term memory is to say those ideas out loud and
in your own words.
Interest
You’ll remember things better if you are truly interested in remembering
them. It may sound simple, but it’s true! Therefore, periodically recall your
reasons for taking this course in the first place. Imagine all the benefits of
your new career. Keep your goals in sight. This will refresh your interest in
learning the material and aid in your study success.
Repetition
Remember, memory is interest plus repetition. Reading and rereading is
helpful, but also say things out loud, write them down, invent acronyms or
use the linking technique. Practice what you’ve learned on your family or
friends. Have them ask you questions based on the material you’ve studied.
We learn through repetition. How do you think we learn the lyrics to a
popular song or all those television ad lines and jingles? Because we’ve
heard them over and over and over and . . .
SECRET #6: Visualize Your Success and Tame Your Fears!
If you’re like most people, you may have a little discomfort at the thought
of taking a quiz or an exam. You may remember past experiences that
didn’t work out, or you may focus on how you’ll feel if you don’t do well.
Your anxiety may even be intense enough to classify as real fear.
However, it’s important to transform a fearful or negative attitude into a
positive attitude, because a positive attitude counts for at least a third of
your success on any exam! Luckily, we have the power to focus our
attention on thoughts and feelings that serve us better.
BONUS TIP: The past doesn’t equal the future!
Whatever happened before is not destined to happen again. So if you’ve
failed in the past, it doesn’t mean you’ll fail in the future. The past is gone,
so forget it. Let’s start fresh!
SECRET #6: Visualize Your Fears and Tame Your Success! (continued)
But how do you generate a positive attitude? First, let’s shift our focus away
from how we’ll feel if we fail to how we’ll feel when we succeed! Each
night (or day) at the end of your study session, visualize yourself receiving
your Certificate of Completion. See the words, “Congratulations, you’ve
passed your course.” Smile, take a deep breath, relax and imagine telling
your best friend or family member the good news. Enjoy your success. Pat
yourself on the back for all that studying and good work. You deserve it!
At first, you may have difficulty visualizing if your fear level is high or if
you’ve had a disappointment or two in the past. However, if you persist,
little by little, the visualization will become easier. It can actually be quite
fun!
Here’s another visualization tip. Remember when we talked about
duplicating the same study environment that you’d have during the actual
exam as an aid to doing well? Another good visualization technique is to
duplicate the “mental attitude” during study that you’d like to have during
the exam.
You’d probably like to be relaxed, confident, clear-minded and alert during
the exam. So, before each study session, take a minute to imagine yourself
in the exam room, your feet planted on the floor, a clock on the wall in
view, your pencils, eraser, and calculator on the desk in front of you. If this
makes you nervous — fine. Next, close your eyes and take a long, deep
breath. Inhale through your nose, slowly filling up your diaphragm first,
then inhaling upward, filling your lungs. Hold your breath to the count of
three, then exhale slowly through your mouth while saying the word “relax”
in your mind. As you exhale, imagine your whole body letting go of any
tension. Do this three or four times until you feel relaxed. With your eyes
still closed, take a moment and concentrate on how it feels to be relaxed.
Tell yourself, “I am in the exam room and I’m completely relaxed and
feeling fine. I feel confident and intelligent! I remember everything I
studied.” (If you wish, substitute other sentences that feel helpful to you.) If
you do this breathing technique and affirmation each time you study, you
will develop a relaxation response. This relaxation response will become
stronger each time you practice it.
BONUS TIP: Anticipation Jitters are Normal!
Don’t deny what you’re feeling! You’re experiencing anxiety because you
realize the importance of passing this exam it’s a natural reaction. However,
don’t let this fear paralyze you. Remember your visualization and relaxation
techniques.
SECRET #6: Visualize Your Fears and Tame Your Success! (continued)
When you actually find yourself in the exam room, you can close your eyes
and repeat this procedure. The relaxation response you developed sitting in
your study area will be recalled by your body and will help you relax during
the exam. It works!
You can also add a cue to your relaxation response if you’d like. For
example, in order to relax during an exam, you can program yourself to
deep breathe and relax while gently tapping your index finger on the table.
Practice this technique over and over again until your mind associates the
relaxation response with the tapping of your finger. Then, if you feel tense
when you’re taking the actual exam, all you need to do is gently tap your
index finger on the desk and you’ll calm down!
If you psychologically prepare yourself for success, your chances for real
success will increase dramatically. Professional athletes frequently use
visualization techniques to improve their performance. They don’t allow
room for a single negative thought, and neither should you. Tell yourself
you’re looking forward to your exam, because it will be the culmination of
all your hard work and in the end, you’ll have a rewarding new career!
SECRET #7: Don’t Cram The Night Before - What to Do Instead!
The Day Before the Exam...
If your exam is proctored and you need to drive to the location, make sure
you load the car up with gas the day before your exam. Also review the two
routes you’ve planned to take to get to the exam location. Think through
and write down your pre-exam schedule so that you know when you have to
leave the house to arrive at the exam early. Give yourself adequate time to
shower, dress, eat, etc. Gather all the materials you’ll need for the exam and
put them in a box or bag.
The Night Before...
Some people recommend not studying at all after dinner on the night before
the exam. Instead, go for a long walk, or read, or hit some golf balls whatever relaxes you. If you’ve followed your study schedule and used the
suggestions in this booklet, you should be well prepared! Now all you need
to do is make sure you get a good night’s sleep. Staying up late, or going
out to a party won’t help your test results!
BONUS SECTION: Tips For During The Exam
Regardless of whether your exam is proctored or not, read the directions
carefully. Don’t assume you already know what they say. Take nothing for
granted. Be sure to note if you’ll be penalized for wrong answers or not. If
you’re not penalized for wrong answers, then it’s okay to guess.
Next, do a quick preview of the exam. If you don’t already know how the
exam is broken down, this will give you some idea. If any information
comes into your mind during the preview, write it down quickly on your
scrap paper for use later. Previewing the exam quickly may even give you
some answers to questions. Also, your subconscious will be working on the
difficult questions you’ve seen before you get to them.
Once you know how the exam breaks down, then you can quickly calculate
how much time is reasonable to allot for each section. For instance, an
essay question worth only a few points is not worth spending 30 minutes
on!
If the exam is all multiple choice, you can calculate how much time each
question should take in the following manner. Divide your time into
quarterly segments. For instance, if you have 4 hours to complete the exam,
and there are 150 questions, then set a goal to finish the exam in 3 hours.
(We will explain why later.) Therefore, divide 3 hours by 4 and you’ll get 4
forty-five minute segments. Write down when you should be done with
one-quarter of the questions, one- half of the questions, three-quarters of the
questions, and finally the whole exam. It will look something like this.
Time
Question#
9:00 - 9:45
#1 - #39
9:45 - 10:30
#38 - #75
10:30 - 11:15
#76 - #113
11:15 - 12:00
#114 - #150
BONUS SECTION: Tips For During The Exam (continued)
This way, if at 9:45 you’re still on question #12, you’ll know you’re moving
too slow. But luckily, you’ve spotted your error early and you have time to
pick up speed! If you’re right at question #38, you know you’re on time and
doing well. Keep checking your progress periodically.
Work on the easiest parts of the exam first, but be sure to allow enough time
for the difficult parts of the exam. If the exam is all multiple-choice
questions, then just go ahead sequentially. But if the exam contains some
multiple-choice and some essay questions, and you have a definite
preference for one type of question over the other, complete the type of
question you like better first. As a result, you’ll gain confidence and
momentum. Then when you go back to the harder questions, your
subconscious mind has already been working on them.
When answering essay questions, write notes in the margin of your scrap
paper to help you organize your ideas briefly before writing. Be sure to
make your writing easy to read.
Any question you don’t understand can be restated in your own words to
make it easier for you to understand. However, be sure not to change the
original meaning of the question!
Go Through Your Exam Four Times!
You’re going to go through your exam four different times. That’s why we
took that extra hour away from your first pass through the exam. This last
hour allows you time for the subsequent passes through the exam.
The first time through the exam, skip any questions you don’t know the
answers to. Draw a line on your scrap paper, and write down the numbers of
those questions you skip.
After you’ve gone all the way through the exam the first time, count how
many questions you’ve skipped and quickly calculate how much time you
have for each of them, then go back through the exam a second time to
answer those questions you’ve skipped. Try to answer them, but don’t take
longer than the time you allotted for each one. If you still don’t know the
answer, leave it blank.
The third time through the exam, go ahead and guess on those questions
you left blank (if you won’t be penalized for guessing).
BONUS SECTION: Tips For During The Exam (continued)
The fourth time through the exam, proofread your answers. When you
proofread, you’re looking for these three things: clerical, mathematical or
perceptual errors. Did you misunderstand the question? Is the decimal point
in the right place? Did you mistakenly pencil in “A” for answer #23 instead
of “B”? On the other hand, don’t change any of the answers unless you’re
absolutely sure they’re incorrect. Your first instincts are usually right.
It may be difficult for you to review the exam the fourth time. You’re under
stress and you may just want to finish as quickly as possible. But don’t give
up yet. You’ve worked hard, so see it through. Use all the time you have
been allotted for the exam. Don’t leave until the proctor says, “Time is up!”
After The Exam.....
Congratulations! You’ve worked hard, and you’ve done well, so now you
can relax. If you’ve faithfully followed these steps, you’ll soon be able to
enjoy your success!
BASIC NURSING CARE (STUDY MODE)
1.
In which of the following ways can the nurse promote the sense of taste for
an older adult?
a. Mix foods together on the dinner tray
b. Avoid cologne, air fresheners, or room deodorizers
c. Encourage the client to chew food thoroughly
d. Discourage the use of salt or seasonings with prepared food
ANSWER C: As clients age, their sense of taste may diminish, reducing
the joy that comes with eating. A nurse can promote the sense of taste for a
client by encouraging him to chew his food thoroughly while eating. This
results in longer contact of food with the taste buds and a greater chance of
tasting the food.
2.
Which of the following is classified as a prerenal condition that affects
urinary elimination?
a. Nephrotoxic medications
b. Pericardial tamponade
c. Neurogenic bladder
d. Polycystic kidney disease
ANSWER B: A prerenal condition is that which causes reduced urinary
elimination due to a diminished blood flow to the kidneys. A condition such
as cardiac tamponade affects the heart's ability to pump adequate amounts
of blood, thereby reducing blood flow to vital organs throughout the body,
including the kidneys.
3.
A nurse is assessing an African American client for risks of a pressure
ulcer. Which of the following best describes what the nurse might find with
an early pressure ulcer in this client?
a. Skin has a purple/bluish color
b. Capillary refill is 1 second
c. Skin appears blanched at the pressure site
d. Tenting appears when checking skin turgor
ANSWER A: When assessing for signs of developing pressure ulcers in a
client with dark skin, decreased circulation may not always be readily
apparent. For instance, blanching, the red undertones seen in light-skinned
clients, will not always be present. Instead, the skin of an early pressure
ulcer may develop a purple or bluish color.
4.
A term used to refer to generalized wasting of body tissues and malnutrition
is called:
a. Entropion
b. Confabulation
c. Induration
d. Cachexia
ANSWER D: Cachexia is a term used to describe the generalized wasting
of body tissues, ill health, and malnutrition that is associated with some
chronic diseases. Cachexia involves a loss of fat tissue to protect the bones
and joints. Clients with cachexia are at risk of pressure ulcers in addition to
complications associated with malnutrition and poor health.
5.
Which of the following clients is at a higher risk of developing oral health
problems?
a. A pregnant client
b. A client with diabetes
c. A client receiving chemotherapy
d. Both b and c
ANSWER D: Some clients are at higher risk of developing oral health
problems due to changes in the mouth associated with certain diseases, or
an inability to provide proper self care and oral hygiene. Diabetic clients
may be more likely to develop periodontal disease, gingivitis, or mouth
dryness. Clients receiving chemotherapy may have mouth ulcers or
gingivitis, leading to further pain and infection.
6.
Which nursing intervention is most appropriate to reduce environmental
stimuli that may cause discomfort for a client?
a. Loosen pressure dressings on wounds
b. Use assistance to pull a client up in bed
c. Check temperature of water used in a sponge bath
d. Position the client prone
ANSWER C: A nurse can reduce environmental stimuli that can cause
discomfort for a client through several interventions. When giving a sponge
bath, the nurse can check the temperature of the bath water to ensure it is
not too hot to avoid burns, nor too cold, to avoid causing discomfort. Other
measures the nurse can perform include lifting clients rather than pulling
them up in bed, changing wet dressings, and providing proper positioning
while in bed.
7.
A client has developed a vitamin C deficiency. Which of the following
symptoms might the nurse most likely see with this condition?
a. Cracks at the corners of the mouth
b. Altered mental status
c. Bleeding gums and loose teeth
d. Anorexia and diarrhea
ANSWER C: A client with a severe vitamin C deficiency has a condition
called scurvy. Clients with scurvy are most likely to develop bleeding gums,
loose teeth, poor wound healing, and easy bruising.
8.
Which of the following interventions should a nurse perform for a female
client who is incontinent with impaired skin integrity?
a. Turn the client at least every 8 hours
b. Apply lotion to the skin before a bath
c. Provide perineal care after the client uses the bathroom
d. Bathe the client every 3 days
ANSWER C: A nurse can help protect the skin integrity of some clients,
especially female clients who are incontinent, by performing cares that keep
the skin clean and dry. Providing perineal care after the client uses the
bathroom promotes good skin integrity by removing excess secretions that
could cause odor and infection.
9.
A client has fallen asleep in his bed in the hospital. His heart rate is 65 bpm,
his muscles are relaxed, and he is difficult to arouse. Which stage of the
sleep cycle is this client experiencing?
a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4
ANSWER C: A client in stage 3 of the sleep cycle has moved into deeper
stages of sleep and is more difficult to arouse. The client may have relaxed
muscles, a decrease in vital signs, and may lie very still. Stage 3 of sleep is
a type of non-REM sleep in which the client progresses toward REM sleep
and vivid dreams.
10.
A nurse is assisting a client who uses an intraaural hearing aid. Once the aid
has been placed in the ear, it begins to whistle. What is the next action of
the nurse?
a. Try to reposition the hearing aid
b. Change the batteries
c. Remove the device and have it cleaned
d. Notify the physician that the hearing aid is not working
ANSWER A: An intraaural hearing aid, sometimes called an in-the-ear
hearing aid, is one that is placed in the ear canal. When positioning the
hearing aid, a whistling sound indicates it may be positioned improperly. If
whistling sounds begin after placement, the nurse should try to reposition
the hearing aid.
11.
A nurse is preparing to irrigate a client's indwelling catheter through a
closed, intermittent system. Which of the following steps must the nurse
take as part of this process?
a. Use sterile solution from the refrigerator
b. Position the client in the prone position
c. Clamp the catheter at the level above the injection port
d. Inject sterile solution through the injection port into the catheter
ANSWER D: When performing a closed intermittent system of catheter
irrigation, the nurse should draw up sterile solution that has been at room
temperature using sterile technique. The client should be positioned for easy
access to the catheter site and to assess the abdomen during the procedure.
After clamping the tubing below the level of the injection port and
cleansing the site, the nurse injects fluid into the port, which travels up the
catheter to irrigate the tubing and the bladder.
12.
Which of the following is a negative outcome associated with impaired
mobility?
a. Increased amounts of calcium are absorbed from circulation
b. A drop in blood pressure occurs when rising from a sitting to a standing
position
c. The amount of mucous in the bronchi and lungs decreases
d. The vessel walls of the circulatory system thicken
ANSWER B: A client with impaired mobility may develop many changes
in body systems that put him at risk of further illness or injury. Orthostatic
hypotension occurs when blood pressure drops more than 25 mmHg
systolic or 10 mmHg diastolic upon rising from a sitting or lying position to
standing. Orthostatic hypotension may develop in the client with impaired
mobility when blood circulates more slowly or pools in the distal
extremities.
13.
A nurse is caring for a client who died approximately one hour ago. The
nurse notes that the client's temperature has decreased in the last hour since
his death. Which of the following processes explains this phenomenon?
a. Rigor mortis
b. Postmortem decomposition
c. Algor mortis
d. Livor mortis
ANSWER C: Algor mortis occurs after death when the body's circulation
stops and the client's temperature begins to fall. The client's temperature
will drop by approximately 1.8 degrees per hour until it reaches room
temperature. The client's skin gradually loses its elasticity during this time.
14.
A nurse is calculating a client's intake and output. During the last shift, the
client has had ½ cup of gelatin, a skinless chicken breast, 1 cup of green
beans, and 300 cc of water. The client has urinated 250 cc and has had 2
bowel movements. What is this client's intake and output for this shift?
a. 420 cc intake, 250 cc output
b. 300 cc intake, 250 cc output
c. 550 cc intake, 550 cc output
d. 300 cc intake, 550 cc output
ANSWER A: This client has had a 420 cc intake and 250 cc output during
the last shift. One-half cup of liquid, such as gelatin, is approximately 120
cc, which should be added to the 300 cc of water ingested. The nurse does
not convert food to cc's, although hospital protocol may dictate
documentation of the amount of food eaten, such as one whole chicken
breast or a cup of beans. Output is urine in ccs, which is 250 cc in this shift.
The nurse may measure output of vomit, diarrhea, or gastric suction.
Formed bowel movements are not converted to ccs, but the nurse may need
to document the number of client stools.
15.
A nurse is caring for a client with ariboflavinosis. Which of the following
foods should the nurse serve this client?
a. Citrus fruits
b. Milk
c. Fish
d. Potatoes
ANSWER B: Ariboflavinosis is a vitamin B-2 deficiency. The client may
develop cracks around the mouth, inflammation of the tongue, or sensitivity
to light. The nurse should serve foods that are good sources of vitamin B-2,
including milk, liver, green vegetables, or whole grains.
16.
A client is taking a walk down the hallway when she suddenly realizes that
she needs to use the restroom. Although she tries to make it to the bathroom
on time, she is incontinent of urine before reaching the toilet. What type of
incontinence does this situation represent?
a. Reflex incontinence
b. Urge incontinence
c. Total incontinence
d. Functional incontinence
ANSWER D: Functional incontinence occurs when a client develops an
urge to void but may not be able to reach the toilet in time. Functional
incontinence may be related to conditions that cause the client to forget
bladder sensation until the last minute, such as cognitive changes; or the
client may have mobility problems that prevent her from reaching the
bathroom in time.
17.
Which of the following is part of client teaching regarding anti-embolism
stockings?
a. Instruct the client to roll the top portion of the stocking down if it is too
long
b. Stockings are applied with the toes uncovered at the end
c. Measure for thigh-high stockings from the foot to the knee
d. Stockings are to be smooth from end to end without wrinkles
ANSWER D: Anti-embolism stockings are often applied for clients who
have surgery or those with mobility problems. Anti-embolism stockings
reduce the chance of blood clot formation in the legs. When applying the
stockings, the nurse should teach the client that the stockings should be free
from wrinkles from end to end, as wrinkles can impair circulation.
18.
Which of the following reasons is the most likely cause of constipation in a
client?
a. Postponing bowel movement when the urge to defecate occurs
b. Intestinal infection
c. Antibiotic use
d. Food allergies
ANSWER A: Clients who postpone bowel movements by either ignoring
the urge to defecate or not evacuating for some reason like not being near a
bathroom may be at higher risk of developing constipation. This causes a
decrease in the frequency of bowel movements, slowed motility of the
intestinal tract, and increased absorption of fecal water, contributing to hard,
dry stools that are difficult to pass.
19.
Which of the following statements best describes footdrop?
a. The foot is permanently fixed in the dorsiflexion position
b. The foot is permanently fixed in the plantar flexion position
c. The toes of the foot are permanently fanned
d. The heel of the foot is permanently rotated outward
ANSWER B: Footdrop results in the foot becoming permanently fixed in a
plantar flexion position. This position points the toes downward. The client
may be unable to put weight on the foot, making ambulation difficult.
Footdrop can be caused by immobility or chronic illnesses that cause
muscle changes, such as multiple sclerosis or Parkinson's disease.
20.
A nurse is assisting a client with range of motion exercises. She moves his
leg in a pattern of circumduction. Which movement is this nurse
performing?
a. Bending the leg at the knee
b. Turning the foot inward and outward
c. Moving the leg in a circle
d. Moving the leg forward and up
ANSWER C: Circumduction is the process of moving a limb in a circle. In
this case, circumduction of the leg is a range of motion exercise where the
nurse moves the leg in a circle, working the muscles of the gluteus
maximus and gluteus medius.
21.
A nurse is assisting a client to lie in the Sims' position. In what position
does the nurse arrange the client?
a. The client lies on his side with the upper leg flexed
b. The client lies on his back with his head lower than his feet
c. The client lies on his abdomen with a pillow supporting his head
d. The client is sitting up at a 90-degree angle
ANSWER A: The Sims' position is a side-lying position for clients that
may be used for examinations or to lie comfortably. The Sims' position
involves aligning the client to lie on his side with his abdomen slightly
downward. The upper leg is flexed, while the lower arm under the client is
positioned behind his body. A pillow may be used to support the leg.
22.
A nurse is instructing a client about how to use his crutches. Which of the
following information should the nurse include in her teaching?
a. Place the majority of body weight on the axilla
b. Dry crutch tips with a paper towel if they become wet
c. Use the crutches for support to lift both feet simultaneously when
ascending stairs
d. Both a and b
ANSWER B: When instructing a client as to how to use crutches for
ambulation, the nurse should teach the client the importance of keeping the
crutch tips dry. If the tips become wet, the client could slip while supporting
his weight on the crutches. The nurse can teach the client to inspect the
crutch tips for moisture and dry them with a paper towel if they become
wet.
23.
Which of the following is a disadvantage of using a dry heat application?
a. Dry heat is more likely to cause burns than moist heat
b. Dry heat penetrates deeply into the tissues
c. Dry heat causes the skin to dry out more quickly
d. Dry heat can quickly cause skin breakdown
ANSWER C: When applying a heat application for therapy, the nurse often
has a choice between moist or dry applications. Dry applications may be
less likely to cause burns and are less likely to contribute to skin
breakdown. However, dry heat applications do not penetrate deeply into the
tissues and may cause the skin to dry out more quickly.
24.
A nurse is preparing to administer an enema to a 64-year old client. Which
of the following actions of the nurse is most appropriate?
a. Assist the client to lie in the semi-Fowler position
b. Apply lubricating jelly to the tip of the catheter before insertion
c. Instill a total of 30cc of fluid into the client's rectum
d. Ask the client to hold the solution in for 30 seconds
ANSWER B: When administering an enema to a client, the nurse should
place the client in the Sims' position for easy access. Lubricating the tip of
the catheter, the nurse should instill a maximum of 750 to 1000 cc of fluid
for an adult client. Following administration, the nurse should ask the client
to hold the solution for at least 5 minutes.
25.
Which of the following is an example of a positive effect of exercise on a
client?
a. Decreased basal metabolic rate
b. Decreased venous return
c. Decreased work of breathing
d. Decreased gastric motility
ANSWER C: There are many positive benefits that clients can derive from
exercise, including increased metabolic rate, increased gastric motility, and
increased venous return. Exercise decreases a client's work of breathing,
such that regular activities require less effort.
26.
A client is having difficulties reading an educational pamphlet. He cannot
find his glasses. In order to read the words, he must hold the pamphlet at
arm's length, which allows him to read the information. Which vision
deficit does this client most likely suffer from?
a. Cataracts
b. Glaucoma
c. Astigmatism
d. Presbyopia
ANSWER D: Presbyopia is a condition that occurs when the lens of the
eye loses accommodation and is unable to focus light on objects nearby. As
a result, clients are unable to see or read items up close but may have
success when holding the same item at arm's length. Many clients with
presbyopia must wear bifocals, but long-distance vision remains unaffected.
27.
A nurse is caring for Mrs. T, a client with expressive aphasia. During a bath,
she begins to gesture wildly and point toward the bath water, yet is unable
to say anything. Which response from the nurse is most appropriate?
a. Is something wrong with the bath water?"
b. Just calm down, we'll finish your bath soon."
c. Are you trying to tell me something?"
d. Shall I turn on the television?"
ANSWER A: A client with expressive aphasia can understand when others
speak to her, but may be unable to form the correct words or phrases to
respond. In this situation, the client is obviously trying to tell the nurse
something, but cannot get the words out. The nurse should try to pinpoint
the subject the client is trying to bring up.
28.
A nurse is assisting a client with shampooing his hair while he is still in
bed. While helping the client, the nurse raises the bed to approximately the
level of her waist. What is the rationale for this action?
a. To prevent shampoo from getting into the client's eyes
b. To allow excess water to run off the edge of the bed
c. To decrease strain on the nurse's back
d. To prevent the client's hair from developing tangles
ANSWER C: When assisting a client with activities of daily living in
which the client remains in bed, the nurse may raise the bed to a level that is
appropriate for working. This reduces strain on the nurse's back and legs
when she must stand at the bedside to assist the client.
29.
Which of the following signs or symptoms indicates a possible nutritional
deficiency?
a. Subcutaneous fat at the waist and abdomen
b. Presence of papillae on the surface of the tongue
c. Straight arms and legs
d. Pale conjunctiva
ANSWER D: A client with poor nutritional intake may have pale mucous
membranes surrounding the eye, or the conjunctiva. This area should
normally be pink, indicating good circulation and a lack of irritation or
dryness. Improper nutrition can manifest as numerous signs in the body,
including bowed legs, pale mucous membranes, a smooth or beefy tongue,
and poor muscle tone.
30.
A nurse is preparing to insert a small-bore nasogastric feeding tube for a
client's enteral feedings. In which method does the nurse measure the
correct length of the tube?
a. From the tip of the nose to the xiphoid process
b. From the tip of the nose to the earlobe to the xiphoid process
c. From the earlobe to the xiphoid process
d. From the tip of the nose to the earlobe to the umbilicus
ANSWER B: When preparing to insert a nasogastric tube, the nurse must
measure for the correct length to ensure that the end of the tube will be in
the correct position in the stomach. To gauge the correct length, the nurse
should measure from the tip of the nose to the earlobe to the xiphoid
process. This length puts the end of the tube in the stomach, rather than the
small intestine or esophagus.
31.
In which of the following ways can a nurse promote sleep for a client who
is experiencing insomnia?
a. Assist the client to use the bathroom one hour after going to bed
b. Give the client a massage after he wakes up in the morning
c. Tuck bed sheets and blankets tightly around the client once he is settled
in bed
d. Give the client a pair of socks to wear if his feet become cold
ANSWER D: A nurse can promote sleep for a client who suffers from
insomnia by removing any barriers that may contribute to sleeplessness. If a
client develops cold feet, the nurse can give him a pair of socks or an extra
blanket to keep his feet warm. Caring for small measures such as these may
make a difference in a client's comfort level, promoting sleep.
32.
A client is complaining of pain that starts in the shoulder and travels down
the length of his arm. This type of pain is referred to as:
a. Referred pain
b. Superficial pain
c. Radiating pain
d. Precipitating pain
ANSWER C: Radiating pain is that type of pain that starts in one part of
the body and travels to other related areas. Examples of radiating pain
include pain that travels along an extremity or pain that moves from the
front of the body toward the back. Radiating pain may be constant or it may
come and go.
33.
A client with an enlarged prostate is having trouble starting his flow of
urine when using the bathroom. Another name for this condition is:
a. Hesitancy
b. Oliguria
c. Retention
d. Urgency
ANSWER A: Urinary hesitancy occurs when a client has difficulty with
starting a flow of urine while using the bathroom. Hesitancy may be due to
physiological factors, such as obstruction from an enlarged prostate, or due
to psychological factors, such as anxiety or embarrassment.
34.
A nurse is preparing to irrigate a client's colostomy. Which of the following
situations is a contraindication for this type of irrigation?
a. The client has an incontinent ostomy
b. The client has an irregular bowel routine
c. The client has diverticulitis
d. The colostomy bag contains fecal material
ANSWER C: A client with a colostomy may need irrigation of the site on a
regular basis to clear gas from the colon and reduce odor. There are some
situations, however, when irrigation is contraindicated, such as when the
client has a gastrointestinal illness that would be exacerbated by irrigation,
such as diverticulitis.
35.
Which of the following statements best describes substance P?
a. Substance P decreases a client's sensitivity to pain
b. Substance P levels are drawn before administration of narcotic analgesics
c. Substance P is found in the brain and is responsible for pain control and
management of depression
d. Substance P is found in the dorsal horn of the spinal column
ANSWER D: Substance P is a type of neurotransmitter that is found in the
brain and the dorsal horn of the spinal column. Substance P may cause
inflammation and edema, as well as pain. It may be associated with specific
syndromes that produce pain for the client, including fibromyalgia or
arthritis.
36.
Which of the following is a fat-soluble vitamin?
a. Vitamin C
b. Vitamin D
c. Vitamin B-6
d. Riboflavin
ANSWER B: Fat-soluble vitamins are those that can be stored within the
body. If a person takes in more than necessary, excess amounts can be
stored to be used for later. Although this may be beneficial to avoid vitamin
deficiencies, fat-soluble vitamin toxicities may also occur. Fat-soluble
vitamins are vitamins A, E, D, and K.
37.
A nurse is preparing to administer an enteral feeding through a gastrostomy
tube. Before administering the feeding, the nurse aspirates some stomach
contents and checks the pH. The result is 3.9. What is the next action of the
nurse?
a. Administer the feeding as ordered
b. Pull the feeding tube out approximately 3 cm
c. Flush the feeding tube with 60 cc of water
d. Contact the physician
ANSWER A: Checking the pH before administering an enteral feeding
verifies placement that the gastrostomy tube is in the correct position. A pH
of 4 or less indicates that the tube is in the stomach and the nurse may
continue with the enteral feeding.
38.
Which of the following interventions is most appropriate for a client with a
diagnosis of Risk for Activity Intolerance?
a. Perform nursing activities throughout the entire shift
b. Assess for signs of increased muscle tone
c. Minimize environmental noise
d. Teach clients to perform the Valsalva maneuver
ANSWER C: When caring for a client who is at risk of activity
intolerance, the nurse can diminish the impact of environmental stimuli by
reducing noise. Environmental noise may require further energy from the
client in order to manage his responses to stimuli. Reducing excess noise
promotes rest and energy conservation.
39.
A nurse is working with Mr. L, a client who is being seen for disrupted
sleep patterns. The nurse encourages Mr. L to verbalize his feelings about
sleep and his inability to maintain adequate sleep habits. What is the
rationale for this action?
a. Mr. L most likely has a mental illness that should be treated before his
sleep issues
b. Mr. L may have unrecognized anxiety or fear that could be contributing
to poor sleep habits
c. Mr. L may become tired once he starts talking
d. None of the above
ANSWER B: Some clients have difficulties with sleep due to unrecognized
anxiety or fears. By encouraging clients to express their feelings and
thoughts regarding sleep and sleep issues, the nurse allows the client the
chance to work through negative feelings. By working out potential issues,
the client may experience greater peace and relaxation, promoting sleep.
40.
A nurse is preparing to attach a TENS unit to a client who is experiencing
pain. Which of the following actions is most appropriate in this situation?
a. Tell the client that he may experience tingling sensations
b. Connect the TENS unit before the client goes to bed for the night
c. Tell the client that the TENS unit may have pain-reducing effects for 10
to 15 days
d. After treatment, notify the client that he may not use a TENS unit again
for at least 2 weeks
ANSWER A: A transcutaneous electrical nerve stimulation (TENS) unit is
a non-pharmacological form of pain control that is used by attaching
electrodes to a client's skin near areas where he is feeling pain. A client
using a TENS unit should feel tingling sensations, but not to the extent that
the muscles begin to twitch. The therapeutic effects of a TENS unit may last
3 to 5 days.
41.
Preload refers to:
a. The volume of blood entering the left side of the heart
b. The volume of blood entering the right side of the heart
c. The pressure in the venous system that the heart must overcome to pump
the blood
d. The pressure in the arterial system that the heart must overcome to pump
the blood
ANSWER B: Preload is the volume of blood that enters the right side of
the heart. This volume stretches the fibers in the heart prior to contraction.
Preload is commonly measured as atrial pressure.
42.
Nursing care plans are _______________.
a. written by CNAs before they provide care
b. guidelines of care that all nursing team members use
c. used by nurses but not by nursing assistants
d. used by nursing assistants but not by nurses
ANSWER B: Nursing care plans are documents that are developed by RNs
but shared with all members of the nursing care team. The purpose of these
nursing care plans is to insure that all patients have quality care in a
consistent manner.
43.
Nursing care plans contain which of the following?
a. nursing diagnoses.
b. medical diagnoses.
c. MD orders.
d. intake and output forms
ANSWER A: Nursing care plans are legal documents that contain nursing
diagnoses, such as an "Alteration of respiratory function". They also contain
patient goals and nursing interventions.
44.
One major difference between long term care and respite centers is the fact
that long term care facilities:
a. provide only physical care and respite centers give both physical and
emotional care.
b. provide care for residents on a long term basis and respite centers offer
only outpatient services.
c. provide care for residents on a long term basis and respite centers offer
only temporary services.
d. There is no difference. Long term care and respite care are the same.
ANSWER C: The major difference between long term care and respite
centers is the fact that long term care facilities provide both physical and
emotional care on an ongoing, long term, basis. On the other hand, respite
care centers provide these same services but on a short term, or temporary,
basis so family members can have time off from their daily caregiver role.
45.
You have taken the vital signs for your patient. They are normal for the
patient. What should you do next?
a. Report the vital signs to the doctor
b. Write the vital signs on a scrap paper
c. Call the family members
d. Document them on the graphic VS form
ANSWER D: Vital signs for a patient are documented on a graphic VS
form, not a scrap of paper. The vital signs are normal for your patient so
you do not have to report these VS to the doctor. Simply document them.
46.
Penny Thornton has had a stroke, or CVA. She is having difficulty eating on
her own. Soon, she will be getting some assistive devices for eating meals.
Which healthcare worker will be getting Penny these assistive devices?
a. A physical therapist
b. A speech therapist
c. A social worker
d. An occupational therapist
ANSWER D: Occupational therapists assess the needs of residents and
patients in terms of their need for assistive devices that can help them with
the activities of daily living. Some of these assistive devices include
weighted plates and special forks or spoons to assist the person to eat on
their own. These devices enable the person to be as independent as possible.
47.
A patient will be discharged from the hospital today. Which person will
most likely arrange the discharge of this patient to his or her own home, to a
nursing home, or assisted living facility?
a. A physical therapist
b. A speech therapist
c. A social worker
d. An occupational therapist
ANSWER C: Social workers collaboratively work with other healthcare
professionals, such as nurses and doctors, to discharge patients from the
hospital to the best type of facility that meets their needs. They help the
team to insure the continuum of care after discharge.
48.
Who is the center of care?
a. The nurse
b. The doctor
c. The administrator
d. The patient
ANSWER D: The PATIENT is the center of care and the center of the
team. The PATIENT is the most important member of the team. Healthcare
workers must all work together, as a team, to best meet the needs of the
patient. The healthcare team works every day and every minute towards the
goal of good health care. The patient is the main decision maker; the patient
is the main focus of the team. They have a right to good care by all of the
members of the healthcare team.
49.
You are working as a valued member of the team on your nursing care unit.
You are trying to figure out whether or not the team is doing well. Which of
the following is a sign that your team is doing well?
a. Conflict occurs but this is seen as an opportunity for team growth and
development.
b. No negative feelings are ever expressed so everyone is happy and
satisfied.
c. Mistakes are NOT tolerated. Mistakes result in disciplinary action.
d. People are not taking risks and they are sticking to the status quo.
ANSWER A: Some of the signs that a team is successful include the
existence of conflict and the belief that this conflict can be resolved and it
can also lead to team growth and development. Other signs of a successful
team include accepting mistakes as learning opportunities and the ability to
express negative feelings when these feelings arise.
50.
The primary purpose of a patient care meeting or conference is to determine
which of the following?
a. the patient's ability to pay for the costs of their care.
b. how the healthcare team can best meet the patient's needs.
c. the patient's physical status and condition.
d. the patient's psychosocial status and condition.
ANSWER B: The primary purpose of a patient care meeting, or
conference, is to determine how the members of the entire healthcare team
can best meet the unique, individual needs of the patient. The patient and
family members should be included at this conference or meeting. The
patient is the center of care.
51.
Who should be members of a patient care conference?
a. Doctors, nurses and nursing assistants since they are healthcare providers
b. Doctors, nurses and the patient and/or the family members
c. ALL members of the healthcare team
d. ALL members of the healthcare team and the patient/resident.
ANSWER D: The patient, or resident, is the center of care. The patient or
resident and/or their family members along with all other members of the
healthcare team should be included in a patient care conference. Family
members may, or may not, be included in accordance with the patient's or
resident's wishes.
52.
Who is legally able to make decisions for the patient or resident during a
patient care conference when the patient is not mentally able to make
decisions on their own?
a. The patient or their health care proxy
b. Only the patient
c. Only the health care proxy
d. The doctor
ANSWER C: When a person is not able to mentally make decisions, it is
the healthcare proxy that legally makes decisions on their behalf.
Incompetent patients cannot legally make decisions. Additionally, it is not
the doctor, but only the patient or healthcare proxy, that makes decisions.
Doctors can make suggestions and recommendations, but not decisions.
53.
Which of the following is an example of physical abuse?
a. A slap to the person's hand
b. Threatening the person
c. Ignoring and isolating a person
d. Leaving a patient soiled for hours
ANSWER A: Slapping, hitting, and punching are examples of physical
abuse. Physical abuse is defined as doing something that can physically
harm or injure a person.
54.
Which of the following is an example of emotional abuse?
a. A slap to the person's hand
b. Threatening the person
c. Ignoring and isolating a person
d. Leaving a patient soiled for hours
ANSWER B: Threatening a patient is an example of emotional abuse.
55.
Which of the following is an example of emotional neglect?
a. A slap to the person's hand
b. Threatening the person
c. Ignoring and isolating a person
d. Leaving a patient soiled for hours
ANSWER C: Ignoring and isolating patients are examples of emotional
neglect. Emotional neglect is not doing the right things in order to meet the
emotional needs of patients.
56.
Patients have a right to ______________.
a. only enough information so they can comply with care
b. ALL of their health related information
c. small amounts of information so they do not get nervous
d. moderate amounts of information unless they are old
ANSWER B: Patients have a legal right to all of their health related
information. Nurses must legally, ethically and morally uphold this patient's
right.
57.
You are working the 8 am to 4 pm shift. You begin to vomit at 3 pm and
you do not think that you are able to continue working. You decide to
immediately go home without notifying your RN supervisor. You have
_________________.
a. enough sick time so this is not a problem
b. finished all your work so this is not a problem
c. seriously abandoned the patients
d. seriously abused and neglected the patients
ANSWER C: Patient abandonment is very serious and it can be grounds
for disciplinary action and immediate termination of employment. It is
defined as leaving the patients without getting the consent of the supervisor.
58.
A patient has a goal of eating at least 50% of each meal. The patient refuses
to eat so a nurse force feeds the patient in order for them to reach their goal
of eating at least 50% of the meal. The nurse has committed __________
against this patient.
a. assault
b. battery
c. physical neglect
d. emotional neglect
ANSWER B: Battery happens when a person is actually touched without
their permission. It is battery if a nursing assistant slaps or pushes a patient.
This is also physical abuse.
59.
You see a patient lying on the floor of the bathroom. You are NOT assigned
to this patient. What is the first thing that you should do?
a. Get the nurse who is caring for the patient.
b. Tell the nurse that the patient has had another seizure.
c. Observe the patient for any injuries and call out for help.
d. Nothing. This patient is not one of your assignments.
ANSWER C: You should observe the patient for any injuries and call out
for help. This is an emergency and you must act immediately even if the
patient is not part of your assignment. You did not see this patient before
they fell so you do not know that the person has had a seizure.
60.
You are taking care of 5 patients today. One of your patients wants water;
another needs help walking to the bathroom; another just stated that they
have chest pain; and another is crying because his daughter did not visit him
today. Which patient care problem must you deal with first?
a. The water
b. Help to the bathroom
c. The chest pain
d. The crying person
ANSWER C: The chest pain must be addressed immediately, before the
other issues are dealt with. Chest pain is a very serious physical problem
that could indicate that the patient is having a heart attack.
61.
You are taking care of 7 patients today. One of your residents wants water;
another needs help walking to the bathroom; another just stated that they
have chest pain; and another is crying because his daughter did not visit him
today. Which patient care is the lowest in terms of priority?
a. The water
b. Help to the bathroom
c. The chest pain
d. The crying person
ANSWER D: The crying person is the lowest priority. All of the other
needs are physical needs that take priority over emotional needs. This does
not mean that you should not address the crying. You must address it but it
is the LOWEST priority at this time.
62.
You are caring for Mrs. Thomas. You see a notation on the nursing care
plan that states "ambulate at least 10 yards qid". This patient will be assisted
with ambulation at which of the following times?
a. 10 am
b. 10 am and 2 pm
c. 10 am, 2 pm and 6 pm
d. 10 am, 2 pm, 6 pm and 10 pm
ANSWER D: Qid is the acceptable abbreviation for four times per day.
These times, in most facilities, are 10 am, 2 pm, 6 pm and 10 pm.
63.
The supervising RN asks you to bring the unit's collected lab specimens to
the lab "stat". You should ______________.
a. not do this errand because nurses do not do "stats".
b. run this errand as soon as you can.
c. run this errand immediately and without delay.
d. Before the end of your shift or after your lunch.
ANSWER C: Stat is the acceptable abbreviation for immediately and
without any delay. Doing errands, like bringing lab specimens to the lab,
can be done by nurses.
64.
You are working the 4 pm to 12 midnight evening shift. You are taking care
of a group of patients. The supervising RN identifies 5 patients who get a
medication at "HS". When will you give this medication?
a. After the dinner meal
b. Whenever requested
c. At the patient's bedtime
d. Before the end of the shift
ANSWER C: HS is the acceptable abbreviation for at the hours of sleep or
at bedtime.
65.
You are caring for Mr. Charles Y. You see a notation on the nursing care
plan that states, "remind the patient to use the incentive spirometer tid".
This patient will be reminded at which of the following times?
a. 10 am
b. 10 am and 2 pm
c. 10 am, 2 pm and 6 pm
d. 10 am, 2 pm, 6 pm and 10 pm
ANSWER C: Tid is the abbreviation for 3 times a day. These times are
usually 10 am, 2 pm and 6 pm
66.
A nursing care plan states, "Assist the patient to the bedside commode prn".
When will this patient get this assistance to the commode?
a. Whenever needed
b. At bedtime
c. During the night
d. During the day
ANSWER A: PRN is the acceptable abbreviation for whenever needed or
whenever necessary.
67.
You see a sign over Mary Jones' bed when you arrive at 7 am to begin your
day shift. The sign says, "NPO". Ms. Jones is on a regular diet. The patient
asks for milk and some crackers. You _____________.
a. can give her the milk but not the crackers.
b. can give her both the milk and the crackers.
c. can give her the crackers but not the milk.
d. cannot give her anything to eat or drink.
ANSWER D: NPO is the acceptable abbreviation for nothing by mouth.
Mary Jones can have nothing to eat or drink.
68.
Match the abbreviation with the correct definition:
a. bid: at bedtime
b. tid: tomorrow
c. ac: before meals
d. pc: patient care
ANSWER C: The abbreviation ac means before meals. Bid is twice a day;
tid is three times a day and pc is after meals.
69.
Which is NOT an acceptable abbreviation?
a. D/C
b. tid
c. bid
d. qid
ANSWER A: D/C is not an acceptable abbreviation. It can be confused
with both discharge and discontinue.
70.
You are taking Mr. D's blood pressure. The first sound that you hear is at
162 and the second sound that you hear is at 86. You should document and
report that the blood pressure is _____________.
a. 86/162
b. irregular and high
c. 162/86
d. normal for people of all ages
ANSWER C: You should document and report that the blood pressure
measurement for Mr. D. is 162/86. The first sound that is heard is the
systolic reading, or the top number; and the second sound that is heard is
the diastolic reading, or the bottom number. Blood pressures are not
observed as irregular; pulses can be irregular. This blood pressure is not
normal for people of all ages. It is high.
71.
Your elderly patient has a temperature of 98.5 degrees. Is there anything
else that a nurse should do, in addition to documenting this temperature?
a. No, this temperature is within normal limits.
b. No, this temperature is normally hyperthermic.
c. Yes, this temperature is highly hyperthermic.
d. Yes, this temperature is highly hypothermic.
ANSWER A: No, there is nothing else that a nurse should do. This
temperature, for an elderly patient, is within normal limits.
72.
When cleansing the genital area during perineal care, the nurse should
_______________.
a. cleanse the penis with a circular motion starting from the base and
moving toward the tip.
b. replace the foreskin after it has been pushed back to cleanse an
uncircumcised penis.
c. cleanse the rectal area first and then clean the patient's genital area.
d. use the same area on the washcloth for each washing and rinsing stroke
for a female resident.
ANSWER B: It is important to retract the foreskin of uncircumcised male
patients in order to remove the smegma that collects under the foreskin.
This smegma can lead to bacterial growth and infection. The foreskin is
then replaced after the penis is cleaned.
73.
You are ready to give your resident a complete bed bath. The temperature of
this bath water should be which of the following?
a. Cooler than a tub bath.
b. Hotter than a tub bath.
c. About 106 degrees.
d. Over 120 degrees.
ANSWER C: The temperature of all bath and shower water should be
about 106 degrees. A bath thermometer should be used to determine the
temperature of all bath water to make sure that it is not too hot. Hot water
can scald and burn a patient or resident. You must also be sure that the
temperature is not too cool. Cool water is not comfortable for a bath or
shower and it can lead to shivering and chilling.
74.
You are ready to wash your patient's face. You would start by washing what
area of the face?
a. The forehead
b. The eyes
c. The ears
d. The cheeks
ANSWER B: The eyes are the first area to be cleaned. The eye area is
considered the priority in terms of moving from an area that can be
potentially infected to areas of the face and body that are least able to
become infected with a washcloth.
75.
The nurse should wash from the ________________________ when
washing a patient's eye area.
a. outer canthus to the inner canthus
b. inner canthus to the inner canthus
c. internal nares to the external nares
d. external nares to the internal nares
ANSWER B: You would wash from the inner canthus of the eye near the
nose to the outer canthus of the eye. This is done because you are moving
from the cleanest area of the eye to the "dirtiest" part of the eye. The nares
are the nasal passages.
76.
Your patient had a stroke, or CVA, five years ago. The resident still has
right sided weakness. You are ready to transfer the resident from the bed to
the
wheelchair.
The
wheelchair
should
be
positioned
at
the
_______________.
a. head of the bed on the patient's right side
b. head of the bed on the patient's left side
c. bottom of the bed on the patient's right side
d. bottom of the bed on the patient's left side
ANSWER B: The wheelchair should be positioned at the head on the bed
on the resident's left side so the resident can assist with the transfer with
their stronger left side.
77.
Patients who cannot move in their bed on their own should be turned at
least ________________.
a. once a day
b. twice a day
c. every 2 hours
d. every 4 hours
ANSWER C: Patients and residents who cannot freely move about in bed
must be turned at least every 2 hours in order to prevent pressure ulcers and
skin breakdown. Some need even more frequent turning. For example, a
patient who is incontinent of urine must be cleaned, dried and turned more
often.
78.
You have measured the urinary output of your resident at the end of your 8
hour shift. The output is 25 ounces. You should do what next?
a. Convert the number of ounces into cc s.
b. Convert the number of ounces into cm s.
c. Immediately report this poor output to the nurse.
d. Know that 25 ounces of urine is too much in 8 hours.
ANSWER A: You have to mathematically convert the ounces into cc s
because cc s is the unit of measurement that is used to record intake and
output. This urinary output is within normal limits so there is no reason to
immediately report it to the nurse. You must report urinary outputs of less
than 30 cc per hour.
79.
How many cc s are there in 25 ounces?
a. 250
b. 500
c. 750
d. 1000
ANSWER C: There are 30cc per ounce. There are 750 cc in 25 ounces.
80.
Your patient has finished a 12 ounce can of ice tea and 8 ounces of fresh
orange juice. What will you record on the Intake and Output form for this
patient's intake?
a. 20 cc
b. 20 cm
c. 600 cc
d. 600 cm
ANSWER C: You will record 600 cc of fluid intake. There are 600 cc in 20
ounces (8+12=20) of fluid intake.
81.
Your patient ate an 8 ounce cup of Italian ice. How much will you record on
the patient's Intake and Output form in terms of this patient's fluid intake?
a. 240 cc
b. 120 cc
c. 8 cc
d. 0 cc because Italian ice is not a fluid.
ANSWER A: You will record 240 cc of fluid intake. Italian ice is
considered a fluid.
82.
You are getting the patient ready to eat. The patient is on complete bed rest.
You will put the head of the bed up at ___________ degrees or more.
a. 10
b. 15
c. 20
d. 30
ANSWER D: The head of the bed should be up at a 30 degree angle or
more. This will prevent choking and aspiration of food while the patient is
eating.
83.
Cheryl M. has a serious swallowing disorder. She has asked you for a glass
of water. The doctor has ordered honey thickness fluids for her. Water is not
a honey thickness fluid. It is much thinner. What should you do?
a. Tell the resident that she cannot have water.
b. Give her applesauce instead of the water.
c. Tell Cheryl that she is NPO until midnight.
d. Thicken the water and give it to her.
ANSWER D: You can give Cheryl the water that she has requested;
however, you must thicken it with a commercial thickener before giving it
to her.
84.
You have been asked to record the amount of food that the person has eaten
during each meal. What kinds of words or numbers would you use to record
this food intake?
a. A little, a moderate amount or all of the meal
b. 50 cc, 100 cc or 500 cc of the meal
c. 25%, 50% or 100% of the meal
d. Either a or c
ANSWER C: Food intake is measured in terms of the percentage (%) of
food that has been eaten. For example, you would record 25% of the
vegetable if the patient has eaten about ¼ of the vegetables on the plate.
The terms little and moderate are too vague and not specific enough. Fluids,
not solid foods, are measured in terms of cc.
85.
The abbreviation ac is defined as _____________.
a. before the meal
b. with the meal
c. after the meal
d. ante corpis
ANSWER A: The abbreviation ac is defined as before the meal.
86.
The abbreviation pc is defined as ________________.
a. before the meal.
b. with the meal
c. after the meal
d. post corpi.
ANSWER C: The abbreviation pc is defined as after the meal.
87.
Your patient has shortness of breath. You should position the patient in the
___________________ position.
a. prone
b. left lateral
c. right lateral
d. Fowler's
ANSWER D: The patient should be placed in the Fowler's position. The
Fowler's position is having the patient on their back with the head of the
bed at a 45 degree angle. This position drops the patient's diaphragm,
increases chest expansion and helps the person's shortness of breath and
dyspnea (difficulty breathing).
88.
The Sims' position is MOST similar to the ________ position.
a. prone
b. lateral
c. supine
d. Fowler's
ANSWER B: The Sims' position is most similar to the lateral position. The
patient is on their side for both; it is the position of the arms and legs that
differ.
89.
You take an adult's blood pressure and it is 40/20. You place the patient in a
Trendelenberg position before rechecking the blood pressure. You will
____________to put the patient into the Trendelenberg position.
a. lower the head of the bed and raise the foot of the bed
b. raise the head of the bed up to about 60 to 75 degrees
c. raise the head of the bed up to about 75 to 90 degrees
d. raise the siderails and place the bed in the high position
ANSWER A: The Trendelenberg position is used for low blood pressure.
This position involves raising the foot of bed and lowering the head of the
bed so the blood pressure will rise.
90.
You have been assigned to take an apical pulse for one of the patients on the
nursing unit. How will you do this?
a. You will place the stethoscope over the heart and listen for any irregular
beats
b. You will place the stethoscope over the heart and count the beats per
minute
c. You will place your finger tip over the patient's wrist and feel for any
irregular beats
d. You will place your finger tip over the patient's wrist and count the beats
per minute
ANSWER B: An apical pulse is taken by placing a stethoscope over the
heart and counting the number of beats per minute. Although you will also
listen for an irregular pulse, an apical pulse is the number of beats per
minute.
91.
When a nurse does a pulse, he should note which of the following?
a. Rate
b. Rate and quality
c. Rate, quality and fullness
d. Rate, quality, fullness and regularity
ANSWER C: When you do pulses, you should note all the characteristics
of the pulse. These characteristics are rate (number of beats per minute),
quality (is it regular or irregular?), and fullness (is it thread and weak or is it
full and bounding?).
92.
Mr. Thomas is a well groomed 68 year old male patient. He had prostate
surgery two days ago. He has an indwelling catheter and a urinary drainage
bag. You have weighed him at 9 am each morning for 3 mornings in a row.
Today, on the 4th day, his morning weight is 3 pounds more than it was the
day before. Why could he have gained these 3 pounds in one day, on a 1000
calorie diet?
a. It is obvious that his visitors have been sneaking him junk food from the
local fast food restaurant.
b. It may be that his urinary drainage bag was not emptied today and it was
emptied on previous days.
c. It is obvious that the scale is broken and it should be replaced
immediately to prevent these false weights.
d. A 3 pound weight gain is not significant enough to question and should
just be noted.
ANSWER B: It is very possible that the urinary drainage bag was emptied
on previous days and not emptied today. This very often happens. Nothing
is obvious. Everything should be explored and looked into.
93.
You are providing mouth care to a patient who is in a coma. You
should________________ to provide good and safe mouth care.
a. keep the head of the bed up so that the patient does not aspirate
b. brush the teeth and rinse the mouth with a cup of water
c. use a special foam swab to brush only the tongue
d. use a special foam swab to brush the tongue and teeth
ANSWER D: Patients in a coma also need mouth care. You have to modify
the mouth care procedures to meet the special needs of people in a coma.
There are special foam mouth swabs that are used to clean all areas of the
mouth, including the cheeks and the tongue. You cannot use water for
mouth care when a patient is in a coma, so there is no need to keep the bed
up to avoid aspiration.
94.
What term is used to describe the sexual response changes among middle
aged men?
a. Menopause
b. Climacteric
c. Generativity
d. Maturity
ANSWER B: Sexual arousal among both men and women takes longer in
midlife than it did in younger years. For men, this period of time is called
the climacteric and for women, it is called menopause.
95.
Mr. Roberts, a 68-year-old man, notices a gradual loss of hearing. This
sensory change is called _____________.
a. presbycusis
b. xerostomia
c. myopia
d. presbyopia
ANSWER A: Presbycusis, is the loss of hearing ability related to the aging
process. It is considered a normal physical change in the elderly age group.
96.
Changes, such as retirement, grand parenting and increased dependence on
others, are examples of what kind of changes?
a. Moral
b. Psychosocial
c. Self-esteem
d. Psychomotor
ANSWER B: Retirement, grand parenting and increased dependence on
others are examples of psychosocial changes.
97.
The term, "Afferent Nerve," means:
a. Carrying an impulse to the brain
b. Carrying an impulse away from the brain
c. Carrying impulses to the motor neurons of the appendicular muscles
d. None of the above
ANSWER A: Afferent nerves carry sensory signals to the brain. Efferent
nerves carry motor signals from the brain.
98.
The medical term, "basophilia," refers to:
a. an attachment of the epithelial cells of the skin to a basement membrane
b. An overabundance of a particular white blood cell in the peripheral blood
c. An underrepresentation of basophils on a blood smear.
d. None of the above
ANSWER B: Basophilia is an increased number of basophils in the
peripheral blood. Basophilia is found in certain blood disorders such as
leukemia and also in some types of allergic reactions.
99.
When considering the structural organization of the human body, which of
the following is the basic unit of life?
a. Chemicals
b. Atoms
c. Molecules
d. Cells
ANSWER D: The basic unit of life is the cell. Cells are made up of atoms,
molecules, and chemical structures, however, these items are not considered
life forms.
100.
When a patient is standing in anatomical position, where are his feet?
a. Facing forward with the toes spread open
b. Facing out to the sides to open the hips
b. Side by side and facing forward; toes resting comfortably.
d. The feet are pointed inward.
ANSWER B: A person standing in anatomical position is standing with his
feet side by side, palms of the hands facing forward from arms that are
straight and slightly away from the sides.
101.
A physician asks you to place the patient with his dorsal side facing the
exam table. Which of the following accurately describes the how the patient
is positioned?
a. The patient is lying prone.
b. The patient is lying supine.
c. The patient is lying in the recovery position.
d. The patient is lying on his stomach.
ANSWER B: The dorsal side of the body is on the back or posterior. When
the back is lying on the table, the patient is facing up toward the ceiling.
102.
The body plane that divides the body into right and left sides is the:
a. Frontal Plane
b. Medical Plane
c. Median Plane
d. Transverse Plane
ANSWER C: The median plane, also known as the sagittal plane, divides
the body into right and left sides. The frontal, or coronal plane, divides the
body into front and back. The transverse plane divides the body into
superior and inferior sections.
103.
A patient is asked to abduct her arms. Which of the following accurately
describes her arm movement?
a. She moves her arms away from her trunk.
b. She moves her arms toward her trunk.
c. She rotates her arms at the wrists while holding them toward her feet.
d. She crosses her arms over her abdomen.
ANSWER A: Abduction means to move away from the midline. Adduction
means to add to the midline, or bring it closer.
104.
Which of the following sets of word parts means, "Pain"?
a. dynia and -algia
b. a- and anc. ia and -ac
d. pathy and -osis
ANSWER A: The meaning, "Pain," can be derived from the following
word parts: dys-, -algia, and -dynia.
105.
One of the three smallest bones in the body is the:
a. Vomer
b. Distal phalange of the small toe
c. Stapes
d. Coccyx
ANSWER C: The three smallest bones in the body are located in the inner
ear and include the malleus, incus and stapes.
106.
Which of the following organs would be described as being located
retroperitoneally?
a. Kidneys
b. Thymus
c. Small Intestines
d. Spleen
ANSWER A: The term, "retroperitoneal," means to be placed behind the
peritoneum. The kidneys are located in this area.
107.
The heat-regulating center of the brain is the:
a. Hypothalamus
b. Pituitary Gland
c. Pons
d. Medulla Oblongata
ANSWER A: The hypothalamus is the heat-regulating center of the brain.
It also has control over the pituitary glans, which is the master endocrine
gland.
108.
The anatomic structure located in the middle of the heart which separates
the right and left ventricles is the:
a. Septum
b. Sputum
c. Separatator
d. None of the above.
ANSWER A: The septum is located in the middle of the heart and
separates the right and left sides. Cells of the cardiac conduction system can
also be found in this structure.
109.
Which of the following boney landmarks is described by, "large, blunt,
irregularly shaped process, such as that found on the lateral aspect of the
proximal femur"?
a. Tubercle
b. Tuberosity
c. Condyle
d. Trochanter
ANSWER D: The Greater Trochanter is found on the lateral aspect of the
proximal femur and is a bony process that is large. This process forms the
attachment site for many muscle of the legs.
110.
The Atlas and the Axis:
a. are found in the vertebrae.
b. can be described as being cervical.
c. are the first two bones that form the column for the spine on the superior
aspect.
d. All of the above.
ANSWER D: The Atlas and the Axis are the first two cervical vertebrae
and are designated C1 and C2. The Atlas (C1) forms support for the skull
and the Axis (C2) allows for rotation of the skull.
111.
The body system that functions to maintain fluid balance, support immunity
and contains the spleen is the:
a. Lymphatic System
b. Digestive System
c. Urinary System
d. Reproductive System
ANSWER A: The Lymphatic System functions both for protection from
foreign invaders and for fluid balance. In addition to the spleen, the
Lymphatic System also includes the tonsils, thymus, lymph nodes, and
lymph vessels.
112.
The duodenum:
a. is the third section of the small intestine, which leads immediately to the
colon.
b. is the section of the stomach where the gall bladder delivers bile.
c. is the section of the small intestine where the pancreas delivers insulin.
d. None of the above.
ANSWER D: The duodenum is the first part of the small intestine where
the majority of digestion takes place in the gut. The gall bladder and
pancreas will deliver its digestive juices to this section of the small
intestine. The pancreas will deliver amylase and lipase while the gall
bladder will deliver bile.
113.
This particular gland of the endocrine system secretes a hormone that is
known to assist with the sleep/ wake cycle. What gland is it?
a. Pituitary
b. Pineal
c. Pancreas
d. Hypothalamus
ANSWER B: The pineal gland, located in the brain, secretes melatonin.
This hormone is known to regulate the sleep/ wake cycle in response to
exposure to light.
114.
The flap of tissue that covers the trachea upon swallowing is called the:
a. Epidermis
b. Endocardium
c. Epiglottis
d. Epistaxis
ANSWER C: The epiglottis is a flap of tissue that covers the windpipe
upon swallowing to protect the Respiratory System from becoming blocked
by food or liquid products.
115.
A physician's order instructs a nurse to take a temperature at the axilla.
Where would the nurse place the thermometer?
a. In the rectum
b. In the mouth
c. On the temples
d. In the armpit
ANSWER D: The axilla is the area of the armpit located under the arms,
proximal to the trunk.
116.
Which of the following medical terms means, "surgical fixation of the
stomach"?
a. Abdominorrhaphy
b. Gastroplasty
c. Gastropexy
d. Abdominorrhexis
ANSWER C: Gastropexy is a medical term meaning, "to surgically fix the
stomach in place." The similarly spelled, "gastroplasty," is a surgical
reconstruction of the abdomen.
117.
A procedure that examines a portion of the large intestine with an
endoscope is called:
a. Colposcopy
b. Sigmoidoscopy
c. Upper GI
d. Cardiac catheterization
ANSWER B: The sigmoid colon is located in the descending colon. A
special scope is inserted into the rectum and takes video and still images of
the lining of the large intestine. An Upper GI is used to take still photos and
video of the esophagus and stomach. A KUB is a radiography procedure
looking specifically at the kidneys, ureters, and bladder. A Cardiac
Catheterization is a procedure where a thin instrument is placed through the
femoral artery and threaded up the vasculature to the heart where
procedures can then be performed.
118.
The mitral valve is synonymous with the term:
a. Left ventricle
b. Right atrium
c. Bicuspid valve
d. Tricuspid valve
ANSWER C: The mitral valve is also known as the bicuspid valve and can
be found on the left side of the heart. The bicuspid valve is located between
the left atrium and the left ventricle.
119.
In the term, "Hemoglobin," the suffix, "-globin," means:
a. Protein
b. Iron
c. Metal
d. Blood
ANSWER A: The word part, "-globin," means, "protein." Hemoglobin is a
medical term meaning, "blood protein."
120.
A patient suffering from hyperglycemia would be experiencing:
a. Low blood sugar
b. High blood sugar
c. Normal blood sugar
d. None of the above.
ANSWER B: Patients with hyperglycemia have a high concentration of
glucose in the bloodstream. Most likely the patient will also be diagnosed
with diabetes, commonly referred to in laymen's terms as, "The sugar."
121.
Which of the following scenarios provides an example of a nurse
overcoming a barrier to communication?
a. A nurse uses lecture as a means of explaining how to run a finger stick
glucose test to an elderly patient.
b. A nurse writes her directions to a patient that is hearing impaired.
c. A nurse speaks loudly to a patient who speaks a non-English language.
d. A nurse uses the terms, "micturate," and, "defecation," while talking with
a minor.
ANSWER B: Overcoming barriers of communication involve using
methods of communication that is understandable to the receiver. In the
example provided, a deaf or hearing impaired patient would have an easier
time understanding directions if they are written to overcome the obstacle
of the hearing loss.
122.
A patient who is displaying the defense mechanism of Compensation
would:
a. Refuse to hear unwanted information.
b. Transfer feelings of negativity to someone else.
c. Overemphasize behaviors which accommodate for perceived weaknesses.
d. Place blame on others for personal actions or mistakes.
ANSWER C: Compensation means to overcome a perceived weakness by
over compensating another behavior or personality trait.
123.
Assuming that an elderly patient will have a difficult time understanding the
directions for how to take medication is an example of:
a. Prejudice
b. Stereotyping
c. Encoding
d. Rationalization
ANSWER B: Stereotyping is defined as providing a generalization about a
person based on his culture. The nurse in this situation was stereotyping her
patient by believing that her patient would automatically have a difficult
time understanding directions based solely on the fact that the patient is
elderly. A prejudice is forming a negative opinion of someone based on his
or her heritage or culture.
124.
Which of the following questions is considered, "Open Ended,"?
a. What time did you last take your medications?
b. Are you feeling ok right now?
c. Please describe your symptoms?
d. What day are you available for a follow-up appointment?
ANSWER C: Open ended questions are questions that will yield an answer
that is detailed and descriptive. Closed ended questions will yield answers
that are one or two words in length.
125.
A patient displays the following body language: Slumped shoulders,
grimace, and stiff joints. What message is this patient sending?
a. Anger
b. Aloofness
c. Empathy
d. Depression
ANSWER A: Body language is a form of non-verbal communication.
Negative messages can be sent easily with the use of improper or tense
posture. Anger is conveyed by grimacing as if in pain and tensing the
shoulders.
126.
A patient who refuses to believe a terminal diagnosis is exhibiting:
a. Regression
b. Mourning
c. Denial
d. Rationalization
ANSWER C: Denial is a defense mechanism that allows a patient the
ability to avoid negative emotions that result from an unacceptable reality.
127.
A nurse realizes after a patient has left the office that she forgot to put the
patient's complaint of a sore throat. Which of the following choices would
BEST correct her error?
a. Pull out that page of the chart and rewrite it with the correct information.
b. Put one line through the original Chief Complaint, write, "ERROR", your
initials and today's date. Make the correction by rewriting the CC with the
correct information.
c. Go to the next available line of the SOAP notes. Write the current date,
then, "Late Entry." Place the date and time when the patient stated she had a
sore throat. Sign and date the entry.
d. All of the above are incorrect.
ANSWER C: When placing additional information into a patient's chart,
using the phrase, "Late Entry," will alert the reader that the information was
added after the fact and will reduce discrepancies that may result from
confusion.
128.
Which of the following vital signs can be expected in a child that is
afebrile?
a. Rectal Temp of 100.9 degrees F.
b. Oral Temp of 38 degrees C.
c. Axillary Temp of 98.6 degrees F.
d. All of the above are incorrect.
ANSWER C: Afebrile means to be without fever. An axillary temperature
is taken in the arm pit and is normal at 98.6 degrees F.
129.
Intermittent fevers are:
a. fevers which come and go.
b. fevers which rise and fall but are always considered above the patient's
average temperature.
c. fevers which fluctuate more than three degrees in never return to normal.
d. None of the above.
ANSWER A: Intermittent fevers are fevers that come and go. They
alternate between periods of being febrile then afebrile. Continuous fevers
rise and fall slightly over a period of 24 hours. Remittent fevers fluctuate
considerably; more than 3 degrees and do not return to normal body
temperature.
130.
A patient's body temperature has varied over the last 24 hours from 97.6
degrees F in the morning to 99 degrees F in the evening. The patient is
worried that this change in temperature may indicate the beginning of a
fever. Which of the following BEST explains this phenomenon?
a. The patient definitely has a fever in the evening and should be seen by a
doctor.
b. The patient is experiencing changes related to a diurnal rhythm.
c. The patient is more than likely taking her temperature incorrectly.
d. The patient is male and is experiencing changes related to fluctuating
monthly hormones.
ANSWER B: Diurnal rhythm is the phenomenon of body temperature
fluctuating depending on the time of day. Temperatures taken in the
morning are typically lower than those take throughout the rest of the day.
131.
The most accurate reading for a temperature is done:
a. Orally.
b. Aurally through a clean canal.
c. Rectally.
d. Axially.
ANSWER B: Aural readings are done in the ear. The tympanic membrane
shares a blood supply with the hypothalamus, which is an area of the brain
that controls body temperature. Provided the ear canal is clean and free
from debris, the tympanic temperature is the most accurate.
132.
A patient is having difficulty understanding how to properly run her glucose
meter. Which of the following teaching methods would best help the patient
understand how to use her instrument correctly?
a. Give the patient an instruction booklet and have her call the office if she
has questions.
b. Tell the patient to have a family member demonstrate how to use the
instrument.
c. Have the patient watch a video on the use of the instrument.
d. Demonstrate the proper use of the instrument and then have the patient
perform the process while still in the office.
ANSWER D: By using a demonstration and performance method of patient
education, the patient is offered a chance to perform a task and have
learning assessed while still in the office. This ensures that any questions
that the patient has can be answered immediately and any performance
issues that are observed by the medical assistant can also be corrected
immediately.
133.
The pulse point located on the top of the foot is:
a. the dorsalis pedis.
b. is checked in patients with peripheral vascular problems.
c. absent in some patients due to a congenital anomaly.
d. All of the above.
ANSWER D: The dorsalis pedis pulse point is located on the arch of the
foot, slightly lateral to the midline. It is frequently used to assess adequate
blood flow in patients that have poor circulation. Some patients are born
without this pulse point.
134.
Over a patient's lifespan, the pulse rate:
a. starts out fast and decreases as the patient ages.
b. starts out slower and increases as the patient ages.
c. Varies from slow to fast throughout the lifespan.
d. Stays consistent from birth to death.
ANSWER A: Normal pulse rates in infants average around 140 beats per
minute. This rate falls to an average of 80 beats per minute in adults.
135.
A common error when taking a pulse is:
a. placing the index finger on the radial artery which is located on the
thumb side of a patient's wrist.
b. noting a pulse as being "weak" when the pulsation disappears upon
adding pressure.
c. counting the pulse for 15 seconds and multiplying the number by four.
d. None of the above will cause errors.
ANSWER C: To accurately assess a patient's heart rate or pulse, the pulse
must be counted for a full minute. Arrhythmias and intermittent pulsations
may be missed if not counted for a full minute. Proper finger placement is
on the radial artery which is located on the thumb side of the patient's wrist.
136.
A patient is in the office for a cyst removal and is very anxious about the
procedure. Which of the following descriptions of his respirations would be
expected?
a. Bradypnea
b. Orthopnea
c. Tachypnea
d. Dyspnea
ANSWER C: Tachypnea is defined as a respiration rate that is rapid, quick
and shallow. Patients experiencing anxiety over a procedure may be
hyperventilating, which occurs frequently with tachypnea.
137.
Rales and rhonchi are frequently noted during an examination of lung
sounds. What is the difference between the two?
a. Rales are louder.
b. Rhonchi are noted only in infants.
c. Rales occur on inspiration, rhonchi on expiration.
d. Rales are noted only in infants.
ANSWER C: Rales are often heard during while a patient is taking in a
breath, while rhonchi are heard when a breath being exhaled is obstructed
by thick secretions in the respiratory tract.
138.
To accurately assess a patient's respiration rate, which of the following
methods would be BEST?
a. Tell the patient, "Please remain silent while I count your number of
breaths."
b. Count respirations at the same time you are counting the pulse rate.
c. Count the pulse rate for one minute, then, while keeping your index
fingers on the patient's radial artery, count the respirations for an additional
minute.
d. Count the patient's respiration rate, then take the patient's temperature,
and then take the pulse rate.
ANSWER C: The most accurate assessment of a patient's respiration rate is
to count the breaths while the patient is unaware that you are doing so.
Patients who are aware that their respirations are being counted may breathe
abnormally.
139.
A patient is diagnosed with essential hypertension. Which of the following
blood pressures would you expect to see in this patient prior to taking
medications for his condition?
a. 142/92
b. 118/72
c. 120/80
d. 138/88
ANSWER A: Essential hypertension occurs when the blood pressure
reading has a systolic pressure reading of equal to or greater than 140
and/or a diastolic reading equal to or greater than 90.
140.
Korotkoff sounds are:
a. sounds noted during diastole.
b. the result of the vibration of blood against artery walls while blood
pressure readings are being taken.
c. are only noted by skilled cardiologists.
d. distinct sounds which are classified into 6 phases.
ANSWER B: Korotkoff sounds are sounds generated when the blood starts
to flow in an artery that has been temporarily collapsed during a blood
pressure reading. There are 5 phases to the Korotkoff sounds and many
different health care providers are trained to assess these phases.
141.
Which of the following is an anthropomorphic measurement?
a. Blood pressure
b. Temperature
c. Pulse Rate
d. Weight
ANSWER D: Anthropomorphic measurements are measurements of body
size, weight and proportion.
142.
The procedure for taking a pulse rate on an infant differs from an adult
how?
a. Pulse rates are not taken on infants.
b. The apical pulse method is used on infants.
c. Pulse rates on infants are taken with a sphygmomanometer.
d. Pulse rates on infants are taken apically in the third intercostal space.
ANSWER B: The apical pulse method is used in infants by placing a
stethoscope in the fifth intercostal space, mid clavicular line and counting
the beats for a full minute. This method can also be used on adults if the
radial pulse method is difficult to perform.
143.
The patient position that is most useful for proctologic exams is the:
a. Trendelenburg
b. Semi-Fowler's
c. Full Fowler's
d. Jack Knife
ANSWER D: The jack knife position is used on a specially designed table
which allows the patient to lay face down, but keeps the buttocks elevated.
144.
A physician may assess turgor when:
a. iron deficiency is suspected.
b. heart and lung issues are suspected.
c. dehydration is suspected.
d. None of the above.
ANSWER C: Skin turgor is assessed when dehydration is expected. The
skin is slightly pinched and the amount of time that the skin takes to
reassume the normal position is related to a patient's level of hydration. The
longer the skin stays folded in the pinched position, the better the chance
the patient is dehydrated.
145.
When performing an EKG, the patient starts to laugh out of feelings of
anxiety. What would you expect the EKG to show? (Choose the BEST
answer.)
a. Increased pulse rate, normal EKG
b. Decreased pulse rate, abnormal EKG
c. Tachycardia, poor EKG graph.
d. Bradycardia, poor EKG graph.
ANSWER C: Patients who are unable to lie still on the exam table while
having an EKG will have poor read outs on the EKG. Electrical signals
given off by large moving muscles will inhibit the collection of data from
the chest leads. Patients who are very anxious will usually display a rapid
heartbeat.
146.
When printing out an EKG, a nurse notices that the QRS complexes are
extremely small. What should be the next step?
a. Alert the physician immediately as this is a sign of impending cardiac
arrest.
b. Check to see that all leads are attached and rerun the EKG.
c. Increase the sensitivity control to 20 mm deflection.
d. Decrease the run speed to 50.
ANSWER C: Increasing the sensitivity control to 20mm will double the
sensitivity which will allow for better observation of the small QRS
complexes.
147.
Each small square on the EKG paper is:
a. 04 seconds long and 5mm tall
b. 2 seconds long and 5mm tall
c. 04 seconds long and 20mm tall
d. 04 seconds long and 1mm tall
ANSWER D: Each small square of the EKG paper represents 0.04 seconds
long and 1mm tall. One large square will be 5 small squares long and 5
small squares tall, equating to 0.2 seconds long and 5mm tall (0.5 mV).
148.
When teaching a patient to use the three point gait technique of crutch use:
a. The injured leg moves ahead at the same time as both crutches.
b. One crutch moves at a time and then followed by the injured leg.
c. Both crutches move ahead at the same time followed by both legs at the
same time.
d. None of the above are correct.
ANSWER A: A three point gait is used when patients cannot bear total
weight on one of the legs. The injured leg will move ahead with both
crutches followed by the uninjured leg.
149.
A nurse is asked to draw blood in the antecubital (AC) space. Which of the
following veins are found in the AC?
a. Cephalic
b. Median cubital
c. Basilic
d. All of the above.
ANSWER D: All three of these veins are located in the antecubital space,
which is the space opposite the elbow on the arm.
150.
A patient's urine specimen tested positive for bilirubin. Which of the
following is most true?
a. The patient should be evaluated for kidney disease.
b. The specimen was probably left at room temperature for more than two
hours.
c. The specimen is positive for bacteria.
d. The specimen should be stored in an area protected from light.
ANSWER D: Bilirubin is easily broken down by light, so all samples
testing positive for bilirubin should be protected from light exposure. Any
urine samples that are brown in color should be suspect for the presence of
bilirubin.
151.
Which vacutainer tubes should be used when a requisition calls for blood to
be drawn for an H&H and glucose test?
a. One light blue, one red
b. Two lavenders
c. One lavender, one grey
d. One green, one red
ANSWER C: An H&H stands for hemoglobin and hematocrit, which are
tests that are found in a complete blood count. These tests are drawn in a
lavender tube. Blood for glucose testing is drawn into grey tubes.
152.
Specific gravity in urinalysis:
a. compares the concentration of urine to that of distilled water.
b. is useless when the patient is dehydrated.
c. can only be done with a refractometer.
d. None of the above.
ANSWER A: Specific gravity measures the concentration of solutes in a
liquid compared to the concentration of distilled water. Normal specific
gravity readings of human urine range from 1.005-1.030.
153.
When placing a patient in the AP position for an X-ray, what position
would the patient be in?
a. Facing the film.
b. Right side against the film.
c. Left side against the film.
d. Facing away from the film.
ANSWER D: The AP position is the Anteroposterior Projection. Patients in
the AP position are facing away from the X-ray film.
154.
A patient's urine tests positive for glucose. The doctor asks you to confirm
this finding. Which of the following would BEST confirm this finding?
a. Run the urine on the hand-held glucometer.
b. Have another MA do a repeat dipstick.
c. Run a Clinitest.
d. Run an Acetest.
ANSWER C: Clinitest tablets are used to detect glucosuria. This test is
useful when urines are discolored and proper color assessment cannot be
done.
155.
A patient has been told to monitor her LH levels. Which of the following
potential conditions might the patient be suffering from?
a. Menorrhagia
b. Grave's Disease
c. Menopause
d. Infertility
ANSWER D: Luteinizing hormone is released by the pituitary gland to
stimulate ovulation. Women with infertility monitor LH levels to time
intercourse to achieve conception.
156.
Manual hematocrits are done:
a. to monitor anemia.
b. by using a microcrit tube.
c. to measure the percentage of plasma to cells.
d. All of the above.
ANSWER D: Manual hematocrits are a CLIA Waived method for
monitoring anemia. Blood is collected in a microcrit tube, centrifuged, and
the percentage of plasma to cells is measured.
157.
The BEST blood collection location for a newborn is:
a. the AC.
b. the veins of the forehead.
c. the heel.
d. the fingertips.
ANSWER C: Collecting blood specimens from newborns is most safely
done by collecting blood from the lateral or medial aspect of the baby's
heel.
158.
A patient has come to the office for a blood draw. The patient starts to sweat
and is very anxious. Which of the following would be the BEST way to
proceed?
a. Do not perform the procedure. Notify the physician of the reason why.
b. Perform the procedure but pay close attention for signs of potential
syncope.
c. Allow the patient to reschedule for a time where he isn't as anxious.
d. Have the physician draw the blood.
ANSWER B: Sweating is a common occurrence with anxiety. Provided the
patient is not showing signs of fainting, the phlebotomy procedure can be
performed. Notify the physician if the patient does faint.
159.
Which of the following tests would MOST LIKELY be performed on a
patient that is being monitored for coagulation therapy?
a. PT/INR
b. CBC
c. HCT
d. WBC
ANSWER A: Prothrombin times (PT/INR) are frequently used to monitor
Coumadin (warfarin) therapy. This medication is an anticoagulant which
slows the bloods ability to clot.
160.
Which of the following is MOST TRUE about the ESR test?
a. The results are diagnostic for certain conditions.
b. Abnormal results are indicative of a potentially fatal illness.
c. Abnormal results should be followed with additional testing.
d. Results are reported in millimeters per minute.
ANSWER C: The erythrocyte sedimentation rate is a screening test for
inflammation. The test is not used to diagnose any condition and abnormal
results should be investigated further. Results are reported in millimeters
per hour.
161.
A patient who is blood type AB:
a. can receive plasma from a type B donor.
b. can receive whole blood from a type A donor.
c. can receive packed RBCs from a type O donor.
d. All of the above.
ANSWER C: A patient who has blood type AB has AB antigens on his red
blood cells. A donor that has antibodies to AB antigens cannot donate
plasma to an AB patient. Of the above listed answers, only an O type donor
can donate to this patient as O donors have no antibody stimulating antigens
and no donated antibodies since the donation was packed red blood cells.
162.
Which of the following is considered an abnormal lab result?
a. WBC 10,000/ mm cubed
b. Hct 50%
c. ESR 22 mm/hour
d. All of the above are normal.
ANSWER C: Normal values for ESR are 0-10 mm/hr for men and 0-20
mm/hr for women.
163.
The mordant in the Gram Stain procedure is:
a. the chrystal violet
b. the methyl alcohol
c. Iodine
d. Safranin
ANSWER C: The Gram Stain procedure uses 4 chemicals: chrystal violet
(primary stain), Gram's Iodine (mordant), Methyl Alcohol (decolorizer) and
Safranin (counterstain).
164.
To properly read a meniscus,
a. hold the measuring device at eye level and read the bottom of the curve
of the liquid level.
b. hold the measuring device at eye level and read the top of the curve of
the liquid level where the liquid holds to the walls of the container.
c. hold the measuring device at table level and looking down into the
measuring device, read the bottom of the curve of the liquid level.
d. hold the measuring device at table level and looking down into the
measuring device, read the top of the curve of the liquid level.
ANSWER A: To accurately measure liquids that are in containers, hold the
container at eye level and read the volume at the bottom of the meniscus.
165.
A urine pregnancy test:
a. May be negative even if a blood pregnancy test is positive.
b. Is positive only during the first trimester of pregnancy.
c. Will be negative if the amount of LH isn't enough to meet or exceed the
sensitivity of the testing device.
d. All of the above.
ANSWER A: Urine pregnancy tests detect HCG in a pregnant woman's
urine. Blood levels of HCG are usually higher and register earlier than HCG
levels in the urine.
166.
The Sinoatrial Node (SA) is located within which of the following heart
structures:
a. Mitral Valve
b. Right Ventricle
c. Right Atrium
d. Left Atrium
ANSWER C: The SA node is located within the upper wall of the Right
Atrium of the heart.
167.
Which of the following puts the layers of skin in correct order from right to
left?
a. Dermis, epidermis, hypodermis
b. Hypodermis, epidermis, dermis
c. Epidermis, dermis, hypodermis
d. None of the above
ANSWER C: The layers of skin from outermost layer to innermost layer is
the epidermis, dermis and the hypodermis.
168.
Digestion, elimination and ___________ are the three functions of the
digestive system.
a. constriction
b. relaxation
c. adsorption
d. peristalsis
ANSWER C: Adsorption is a function, in addition to digestion and
elimination, which make up the three functions of the digestive system.
169.
The Loop of Henle is located in which of the following body organs?
a. Liver
b. Kidney
c. Heart
d. Ear
ANSWER B: The Loop of Henle is located in both kidneys and is the site
of action for Loop Diuretic medications.
170.
The main artery that supplies blood to the arms is called the _________
artery.
a. femoral
b. brachial
c. subclavian
d. carotid
ANSWER B: The main artery that supplies blood to the arms is called the
brachial artery.
171.
Which of the following organs is part of the lymphatic system?
a. Pancreas
b. Spleen
c. Liver
d. Gallbladder
ANSWER B: The spleen, an organ that plays a large role in the production
and storage of red blood cells, is part of the lymphatic system.
MANAGEMENT AND PRACTICE DIRECTIVES (STUDY
MODE)
1.
At the beginning of the shift, a nurse receives report for her daily
assignment. Which of the following situations should the nurse give first
priority?
a. A diabetic client with a blood glucose level of 195 mg/dL
b. A family member of an elderly client who has questions
c. A client with COPD with an oxygen saturation of 84%
d. A client who requires assistance to use the bathroom
ANSWER C: When prioritizing needs of clients, the nurse must begin with
the unstable client or manage conditions that affect airway, breathing, or
circulation first. The client with COPD has a condition that affects
breathing and is exhibiting decreased oxygen saturation levels; therefore,
this client should be the first priority.
2.
Mr. W has orders for a physical therapy consult. The nurse contacts the
appropriate department but 12 hours later, no one has come to see the client.
Which is the most appropriate action of the nurse?
a. Call the supervisor and file a complaint against the physical therapy
department
b. Contact the physician to notify him that the orders were not carried out
c. Assess the client's activity level by assisting with ambulation using a gait
belt
d. Contact the physical therapy department again and repeat the order
ANSWER D: Nurses must typically work as part of a larger
interdisciplinary team that involves collaboration with other professionals.
In order to fulfill the client's needs, communication between disciplines
should remain respectful, with clear directions about each discipline's
responsibilities. Communication between all parties minimizes confusion
about the client's care.
3.
The "B" in the SBAR acronym stands for:
a. Background
b. Basic
c. Beginning
d. Break
ANSWER A: The "B" in the SBAR acronym stands for Background. The
SBAR is a communication tool used between providers that regulates the
type and amount of information given. When contacting a physician, the
nurse provides information about the situation, the client's background, the
nurse's assessment, and further recommendations.
4.
Decide which of the following tasks may be delegated to unlicensed
assistive personnel.
a. Cleansing a wound with peroxide
b. Irrigating a colostomy
c. Assisting with performing incentive spirometry
d. Removing a saline-lock IV
ANSWER C: The nurse may delegate certain tasks to unlicensed assistive
personnel as part of working together and reducing heavy workloads.
Assistive personnel may perform tasks that involve activities of daily living,
non-invasive skin care, or assessment of vital signs, including assisting the
client with incentive spirometry. Despite appropriate delegation, the nurse is
ultimately responsible for the actions of the unlicensed assistive personnel.
5.
According to HIPAA, which of the following is considered an individual
right for privacy of a client's protected health information?
a. The right to receive medical bills for care received
b. A copy of the organization's privacy practices
c. A right to change personal health information
d. An understanding that protected health information will only be used in
regards to client treatments
ANSWER B: According to HIPAA, individuals receiving care at healthcare
facilities have rights surrounding their protected health information. This
information may be used for treatments or billing purposes, and clients may
receive copies of how the information was used. All organizations must
provide clients with copies of current privacy practices.
6.
Which of the following clients is most likely ready to be dismissed from an
inpatient care setting to home?
a. A 65-year old male with urine output of 60cc in the past four hours.
b. A 2-month old female with a temperature of 100.6 rectally
c. A 38-year old female who transitioned from IV TPN to full liquids six
hours ago
d. A 4-year old male with an oxygen saturation of 96% on room air
ANSWER D: Clients must meet a certain amount of set criteria before they
will be discharged from a healthcare facility. Although guidelines may vary
between locations, most healthcare facilities expect clients to have adequate
oxygenation, nutrition, and elimination; and be free from fever, vomiting,
and significant pain.
7.
The nurse is performing discharge teaching for Mrs. S after cardiac
angioplasty. Her husband is present for the teaching. While explaining the
prescription for antiplatelet medication to use at home, Mrs. S's husband
states, "I don't think I can afford to refill that medication." What is the most
appropriate response of the nurse?
a. Don't worry, your insurance will cover it."
b. I'll ask the physician if he can prescribe a medication that is more
affordable."
c. You should apply for Medicare to see if they can help you."
d. This medication is essential for her care and should be given priority over
all others that she is taking."
ANSWER B: In some situations, clients are sent home with prescriptions
for important medications that they cannot afford. If a client mentions this
to the nurse before discharge, she may be able to ask the provider for a
prescription that has the same action but is more affordable to the client,
such as through generic formulations or a different manufacturer.
8.
The discharge planning team is discussing plans for the dismissal of a 16year old admitted for complications associated with asthma. The client's
mother has not participated in any of the discharge planning process, but
has stated that she wants to be involved. Which of the following reasons
might prohibit this mother from participating in discharge planning?
a. The client is an emancipated minor
b. The mother has to work and is unavailable
c. The client has a job and a driver's license
d. The mother does not speak English
ANSWER A: Clients who are under the age of 18 usually need parent
involvement in their care and planning after they will be dismissed from a
facility. There are times when it is inappropriate or impossible for a parent
to be present during the discharge planning process. If a client is under age
18 but is an emancipated minor, he may specify that he does not want his
parent present at discharge planning meetings.
9.
A nurse enters a client's room and finds her lying on the floor near the
bathroom door. As the nurse provides assistance, the client states, "I thought
I could get up on my own." What information must the nurse document in
this situation?
a. A statement explaining the condition the client was found in, quoting the
client's words about the situation
b. An explanation of how the fall happened and when the physician was
notified
c. An account of the conditions of the room that contributed to the client's
fall
d. A description of the client's condition and the reasons why she should
have had assistance to the bathroom
ANSWER A: When a fall or injury occurs while under nursing care, the
nurse should carefully document the known aspects of the situation, as well
as her response to the injury. In this case, the nurse did not actually witness
the client falling, but can quote the client's response to the situation. Listing
events that potentially caused the fall implies blame on the parties involved
and should be avoided.
10.
Which of the following may be a cultural barrier that impacts a nurse's
ability to provide care or education to the client?
a. A nurse offers educational materials to a client that are written at an 8th
grade reading level
b. A Vietnamese woman wants to use steaming in addition to her
prescription antibiotics
c. A nurse uses pantomime to explain a procedure to a deaf client
d. A Native American client requests a healing ritual before he will consider
surgery
ANSWER C: Cultural barriers can impede communication, preventing the
nurse from providing education or instruction about a client's care. Cultural
barriers may be subtle or obvious; however, the nurse may not always know
the various practices and beliefs performed by other cultures. Pantomiming
instructions to a deaf person implies that the nurse does not recognize the
importance of a sign language interpreter. This barrier is likely to cause
miscommunication if the client does not understand the nurse's gestures and
actions.
11.
Which of the following is an example of low health literacy skills?
a. A nurse's aide cannot calculate the correct IV rate for Ringer's lactate
b. A client cannot read an admission form to sign it
c. A nurse is unable to explain the dose, indications, side effects, and
structural formula of carbamazepine
d. A client does not understand the treatment for his cholecystectomy
ANSWER D: Some clients or families have low health literacy skills,
rendering them unable to understand the reasons for health treatments or
diagnoses or to make informed decisions about healthcare. Low health
literacy differs from literacy skills in that reading and writing abilities are
not necessarily reflective of understanding medical terminology.
12.
A 39-year old woman presents for treatment of excessive vaginal bleeding
after giving birth to twins one week ago. Which nursing diagnosis is most
appropriate in this situation?
a. Knowledge Deficit related to post-partum blood loss
b. Self-Care Deficit related to post-partum neglect
c. Fluid Volume Deficit related to post-partum hemorrhage
d. Body Image Disturbance related to body changes after delivery
ANSWER C: Post-partum hemorrhage may be more common among
women in some situations, such as those who experienced complications
during delivery or those who carried multiple gestations. Post-delivery
hemorrhage puts this client at risk of fluid volume deficit related to
bleeding and overall loss of blood volume.
13.
Mr. K is admitted to the orthopedic unit one morning in preparation for a
total knee replacement to start in two hours. Which of the following is a
priority topic to instruct this client on admission?
a. The approximate length of the surgery
b. The type of anticoagulants that will be prescribed
c. The time of the next meal of solid food
d. The length of time until the client can return to work
ANSWER A: While follow-up care and discharge instructions are
important to review throughout hospitalization, pre-surgical teaching should
focus on what to expect for the upcoming procedure. The client may be
more focused on the surgery and may want to know facts about the
procedure to better prepare him or to relieve anxiety. Information about
what to expect after the procedure can be presented well before the
procedure and then reviewed again afterward.
14.
Which of the following is an example of the intervention phase of the
individualized nursing care plan for a client who receives a colostomy after
a bowel resection?
a. Taking a health history and performing a physical exam prior to the
procedure
b. Instructing the client about how to care for his colostomy stoma
c. Developing goals that state the client will ambulate three times a day
d. Determining that the client may need more support at home after
dismissal
ANSWER B: The intervention stage of the individualized nursing care plan
is the point of care in which the nurse provides care, treatments, or
education to help the client meet the devised outcomes. Instructing the
client about how to care for his colostomy stoma supports the process of
helping the client to meet the outcomes designed for this case: to care for
his colostomy after a bowel resection.
15.
Research participants are involved in a trial that incidentally separates them
into two groups. One group receives an intervention, while the other group
does not. Both groups are compared for outcomes. What type of research
method is this?
a. Experimental design
b. Double-blind experiment
c. Randomized controlled trial
d. Repeated measures design
ANSWER C: A randomized controlled trial is one in which participants are
randomly divided into two groups. This type of research is often preferred
for some studies because the results do not imply bias toward one outcome
over another. The group that receives the intervention is called the treatment
or experimental group, while the group that does not receive the
intervention is called the control group.
16.
A nurse is caring for an in-patient client in the hospital who is from another
country and who fasts for temporary periods in order to promote his own
spiritual growth. The nurse responds by saying, "You need to eat something
while you are here. Food and proper nutrition is extremely important for
your health." What social philosophy is the nurse demonstrating?
a. Ethnocentrism
b. Relativism
c. Stereotyping
d. Xenocentrism
ANSWER A: Ethnocentrism is a concept that believes a person's own
cultural practices are superior to all others. Ethnocentrism does not accept
other practices as being valid, but instead insists that certain beliefs are
better or correct for all people. In this case, the nurse was unable to see past
her own set of beliefs about healthcare to understand why the client did not
want to eat.
17.
A nurse is using active listening as a form of therapeutic communication
when:
a. She uses humor to put the client at ease in a situation
b. She restates what the client said in slightly different words
c. She uses eye contact and maintains an open stance while the client is
talking
d. She provides personal information to show the client she can relate to
him
ANSWER C: Active listening is a form of therapeutic communication in
which the nurse encourages a client to speak or share his thoughts. Some
clients may be uncomfortable discussing their care, their thoughts, or
feelings with nurses; however, nurses can encourage this dialogue by
maintaining eye contact and keeping an open stance that indicates listening,
rather than trying to work and talk at the same time.
18.
A client asks a nurse, "Do you think I should move back home after this
procedure?" and the nurse responds by saying, "do you think you should
move back home?" What type of therapeutic communication is the nurse
representing?
a. Observation
b. Reflection
c. Summarizing
d. Validating
ANSWER B: When using reflection after a client asks a question, the nurse
turns the conversation around so that the client considers his own answers
to the question. Reflection often involves restating a statement or question
so that it is directed from the nurse to the client, rather than the other way
around. This requires the client to reconsider his own question or thoughts
about a situation.
19.
Which of the following is an example of a living will?
a. A client's son has been appointed to make his healthcare decisions if he
becomes incapacitated
b. A client has designated which of his children will receive his home and
property before he dies
c. A client has instructions that he does not want to be resuscitated through
chest compressions if his heart stops beating
d. A client designates what type of burial or cremation services he would
want after his death
ANSWER C: A living will is a type of advanced directive that a client
develops to stipulate his preferences for healthcare in the event that he is
unable to do so. A living will involves instructions about various situations
that may occur and the client's preferences for treatment in each case, which
may involve using or discontinuing life-saving measures.
20.
What is involved with obtaining informed consent?
a. An explanation of the reasons for the procedure
b. A signature on a form that states the client agrees to the procedure
c. A statement affirming liability if complications arise during the
procedure
d. Both a and c
ANSWER A: Informed consent is the process of explaining the reasons for
the procedure, the risks, benefits, and alternatives. Although the nurse may
have a client sign a consent form indicating agreement, actual informed
consent occurs when a physician has a discussion about the procedure with
the client to educate him about the process.
21.
Which of the following questions must the nurse ask when formulating a
nursing diagnosis?
a. What diagnosis did the physician make for this client?
b. What is the issue that I can solve for this client?
c. What physician orders will resolve this issue?
d. What underlying disease does this client have?
ANSWER B: When formulating a nursing diagnosis for a client, the nurse
must remember to create a diagnosis based on the client's problems that she
can meet through interventions. Nursing diagnoses differ from medical
diagnoses in that the physician or medical provider diagnoses a client upon
admission, but nursing interventions and related outcomes are based on
nursing care of the client.
22.
A nurse walks into a client's room to find the nursing assistant yelling "sit
back down or I won't help you eat and then you will starve!" This type of
behavior is known as:
a. Psychological abuse
b. Abandonment
c. Material exploitation
d. Physical abuse
ANSWER A: This behavior is classified as psychological abuse. This type
of abuse harms another person through words or threats. The person
instilling the abuse may yell, harass, call names, threaten, or humiliate
another person. In this situation, the nursing assistant was exercising control
over the client by using psychological abuse to threaten him.
23.
A physician has written an order for "2.0 mg MS q 2-4 hr prn pain." What is
the nurse's response to this order?
a. Give 2 mg of morphine sulfate to the client
b. Give 20 mg of morphine sulfate to the client
c. Contact the pharmacy to clarify the order
d. Contact the physician to rewrite the order
ANSWER D: This order has errors that could potentially result in harm to
the client if not followed correctly. The use of 2.0 involves a trailing
decimal point, which can cause confusion as to the dose of the drug. The
abbreviation MS is one of the Joint Commission's Do Not Use
abbreviations, as this could mean morphine sulfate or magnesium sulfate.
Although the order states the drug should be used for pain, the nurse should
clarify with the physician as to the exact dose and drug to be used.
24.
A client is being admitted to the stroke care unit of a rehabilitation center.
Which of the following best describes the action of the nurse at admission?
a. Collect and arrange documents to be placed in the client's medical record
b. Prepare the client's identification bracelet
c. Identify pertinent health history data as well as current needs and
limitations
d. Gather the client's valuables and place them in a locked container
ANSWER C: Upon admission to a new care unit, the nurse's initial
responsibility is to assess the client and identify any pertinent health history
data that will affect his care. The nurse should also assess the client's needs
and limitations, which allows her to formulate a nursing diagnosis as well
as establish outcomes for this client while in her care.
25.
A client is refusing to undergo any more treatments in the hospital and
wants to leave against medical advice. When the nurse requests the client
sign an AMA order, the client refuses and leaves. What is the next action of
the nurse?
a. Call security to hold the client until he will sign the order
b. Notify the physician to convince the client that he needs to stay
c. Speak with the client's spouse to persuade him to stay
d. Allow the client to leave and document the refusal in his chart
ANSWER D: The nurse cannot force the client to stay in the hospital to
receive treatment or even to sign an AMA order. While she may try to use
the physician or spouse to convince the client to stay, ultimately, the nurse
should clarify the situation and document the client's refusal to sign the
AMA form and file it in the chart.
26.
Which example best describes a nurse who exhibits moral courage?
a. A nurse feels angry when a parent refuses important treatment for his
child.
b. A nurse considers seeking help for depression when she feels she cannot
meet the needs of her clients in the oncology unit.
c. A nurse contacts a physician for further orders when he fails to order
comfort measures for a client with a terminal illness.
d. A nurse is frustrated when the laboratory is slow in responding to an
order for a stat blood glucose.
ANSWER C: Moral courage involves taking action to do what is right,
even when there might be negative consequences. The nurse who contacted
a physician for further orders acted as a client advocate to seek help, even
though she may have faced such consequences as lost time, decreased
productivity, or criticism from the physician.
27.
Which method is most appropriate for managing moral distress in the
workplace?
a. Recognizing that life is unfair and nurses cannot meet every need of
every client
b. Declining to act when clients or visitors make requests that are not
justifiable
c. Developing a new policy that would address the problematic situation
d. Both a and b
ANSWER C: Moral distress involves negative feelings or frustration
toward situations that are deemed unfair, unethical, or that cause the nurse
to feel helpless in her work. Moral distress can lead to nurse burnout when
ongoing issues are not resolved. A nurse can work to manage moral distress
by not only recognizing the potential for its development; but also creating
policies that may help to change current standards, which can reduce the
number of situations that create moral distress.
28.
A nurse is required to float to another unit within the hospital where he is
asked to care for a client on a ventilator. The nurse is uncomfortable with
this assignment, as he has not had a ventilated client since nursing school.
What is the nurse's most appropriate response?
a. Explain to the nursing supervisor the level of discomfort and ask for a
different assignment
b. State that the client's needs are outside the nurse's scope of practice and
request a different assignment
c. Accept the assignment, asking for help when necessary
d. Request to return to the home unit and send another nurse who can
perform the job
ANSWER A: When floating to another unit and asked to take an
assignment that falls outside a nurse's comfort zone, the nurse should notify
the area supervisor of the level of discomfort and request a different
assignment. Caring for ventilated clients typically falls within the scope of
nursing practice; however, discomfort with the situation may not
necessarily be overcome by accepting the assignment. Alternatively, the
effects could be harmful to the client if the nurse is unfamiliar with this type
of care.
29.
A nurse is asked to perform a task that she believes is outside her scope of
practice. What is the appropriate response to this issue?
a. Contact the state board of nursing licensure to report the offense
b. Review the state scope of practice standards for nurses
c. Ask another nurse to perform the task to learn the procedure
d. Contact the house supervisor to make the decision as to whether the
nurse should perform the task
ANSWER B: There may be times when it is unclear if certain practice
standards fall within the nursing scope of practice. Because guidelines vary
between states, the nurse should review the scope of practice for nurses for
this particular state to discern whether the action is permissible. If it is not
possible to check the scope of standards herself, or if the standards are
unclear, the nurse should then contact a supervisor.
30.
A nursing unit is implementing a new electronic charting program for the
nursing staff to use. Which of the following best describes a disadvantage
of using electronic charting?
a. The information is more likely to be lost or used inappropriately
b. Any provider in the unit can have access to the client's medical records
c. The system diminishes communication between nurses and providers
d. The program may be confusing and difficult to implement
ANSWER D: A disadvantage to implementing a new form of electronic
health charting on a unit is the complexity of the system involved. Starting
a new system and expecting all staff to use it appropriately may take time
and education for everyone involved. The system may cause confusion
while all users practice learning how to navigate charting techniques.
31.
A client has volunteered to take part in a research study. After participating
for two months, he decides that he can no longer tolerate the study and
decides to leave. What are the client's rights in this situation?
a. The client has a right to be released from the study but must reimburse
the researchers for charges incurred
b. The client has a right to be released from the study without any liability
c. The client has a right to be released from the study but is prohibited from
participating in any future studies
d. The client does not have the right to be released from the study; he must
finish his participation
ANSWER B: If a client chooses to take part in a research study and then
decides that he no longer wants to be involved, he may withdraw from the
study at his own right. Forcing a voluntary study participant to remain in a
research study violates his personal rights.
32.
A client is seen in the emergency room as a victim of suspected domestic
violence. The nurse's aide brings the client to a center curtained area, gives
her a gown to change into, and asks her to wait for the nurse. What is the
most appropriate action of the nurse upon arrival?
a. Ask the client to undress to visualize any injuries
b. Take the client into a private room
c. Notify the police to file an initial report
d. Notify the house supervisor to keep security on alert
ANSWER B: A client who is seen as a possible victim of domestic
violence should be given privacy in a safe room or location. Until the nurse
can discern whether the case is the result of abuse or that the situation is
unsafe, she should refrain from notifying authorities until she has more
information.
33.
A nurse is examining a woman who has bruises on her face and back in
various stages of healing. The client states "sometimes he just gets so
angry." Which of the following statements is most appropriate as a response
from the nurse?
a. Do you mean your boyfriend?"
b. You need to leave him as soon as possible."
c. No one will ever hurt you again."
d. Tell me more about what happens when he gets angry."
ANSWER D: The nurse assessing this client should try to derive more
information from her before making a judgment or decision. Additionally,
the nurse should find out more details of the situation, such as whom the
client is talking about or what happens when he gets angry, and she should
not give advice or make false promises.
34.
A nurse is performing an end-of-shift count of narcotics kept in the locked
cabinet. The narcotic log states there should be 26 oxycodone pills left, but
there are only 24 in the drawer. What is the first action of the nurse?
a. Perform the count again
b. Contact the pharmacy to determine if the narcotic log is incorrect
c. Check with the last nurse to sign out narcotics from the system
d. Notify the house supervisor that narcotic medications are missing
ANSWER A: Before notifying other personnel or filing a report, the nurse
should initially perform the count again. If the nurse is the only one
checking the narcotic count, there could be a miscount the first time that
might require a repeated calculation.
35.
Which example best describes the concept of beneficence?
a. A client has an advanced directive in place stating that he does not want
intubation if he needs CPR
b. A nurse provides pain medication for a client in the recovery room who
is experiencing pain
c. At the request of the client, a nurse does not inform his family about his
cancer diagnosis
d. A nurse withholds narcotic medication for a client in pain, knowing that
he is currently disoriented
ANSWER B: Beneficence is the concept of doing what is good and right
for the client. A recovery room nurse who cares for a client who is having
pain after surgery follows beneficence when providing pain medication to
make him more comfortable.
36.
A nurse is caring for a dying client whose family wants to be with him in
the operating suite. The surgeon, however, does not allow families to be
present during surgery. The nurse recognizes this as an ethical dilemma.
What is the initial step of the nurse when managing this situation?
a. Contact the physician to amend the order for the client
b. Document an account of the situation to ensure adequate coverage of
details
c. Consult with the medical ethics committee to determine a safe and
workable solution
d. Speak with the chief nursing officer to change the policy governing this
situation
ANSWER A: In this type of situation, the first action of the nurse should
be to ask the physician to make a change based on the circumstances. While
documentation and consulting with higher authorities may be necessary
eventually, the first step is to try to meet the needs of the client with the
potentially short time allotted.
37.
A nurse is at the beginning of her shift in a long-term care facility. Which of
the following clients should she check on first?
a. A 91-year old man who needs help eating breakfast
b. An 86-year old man who has been incontinent in his bed
c. An 82-year old woman who needs IV antibiotics
d. A 75-year old man who is recovering from an injury who needs an ice
pack
ANSWER C: When determining which client to see first while in a longterm care facility, the nurse should decide what tasks are most important
that only she can do. If other assistive personnel are present, the nurse can
delegate some tasks to continue to meet the needs of the clients. In this
scenario, the IV medication is the only task that must be done by the nurse.
38.
The charge nurse is notified that the unit will be receiving an admission of a
client from another bed in the hospital in order to make room for others
being admitted through the emergency room. The unit is the Women's
Health Center of the hospital. Which of the following people would be most
appropriate to be transferred to this unit?
a. A 26-year old woman who had a bowel resection
b. A 40-year old man who underwent a hernia repair
c. A 31-year old woman with septicemia and who is on a ventilator
d. A 91-year old man with Alzheimer's disease recovering from a fall
ANSWER A: When making decisions about the transfer of clients between
units in the hospital, the nurse must decide on the most appropriate person
to be transferred based on the client's condition, the staffing levels of the
unit, and the purposes of the unit overall. The Women's Health unit of a
hospital would accept female clients that do not require intensive or 1:1
care.
39.
A nurse in the emergency room enters a client's care area to start an IV. She
finds a man sitting on the table, hunched over, and attempting to take deep
breaths. He states, "my chest hurts so much!" His wife is sitting on a chair
in the corner, crying. Which of the following is the first action of the nurse?
a. Bring the IV kit and quickly start an IV
b. Assess his breathing and provide oxygen, if necessary
c. Administer medication to control chest pain
d. Talk with his wife and find out why she is crying
ANSWER B: In the above scenario, the first action of the nurse is to assess
the client's airway and breathing and administer oxygen if necessary. The
client may be suffering from chest pain that causes breathing difficulties,
but air exchange is essential to address before treating other needs.
40.
Examples of preservation of self-integrity include all of the following
except:
a. Using assistive equipment to move bariatric clients
b. Participating in wellness programs
c. Accepting the challenge of caring for clients with oppositional beliefs or
practices
d. Using hand hygiene and personal protective equipment
ANSWER C: Preserving self-integrity involves taking care of oneself in
order to maintain positive nursing practices and to avoid burnout. Selfintegrity involves self-care and is manifested in actions that protect or
support the nurse. If barriers exist within care settings that are too
challenging for nurses to overcome without sacrificing their integrity, they
should request a different assignment in order to uphold their own self-care.
41.
Which method best describes the use of evidence-based practice?
a. Reading and analyzing research reports to see how they can be
implemented into nursing practice
b. Collecting data to determine how efficiently nursing practice is
contributing to quality care
c. Monitoring unit practices to determine compliance with Joint
Commission standards
d. Using the most effective, current, and applicable information available to
guide nursing care for the best of the clients.
ANSWER D: While evidence-based practice may use resources such as
research reports or quality review, its practice involves using all information
available and deciding what is most appropriate for nursing standards
involved. The act of reviewing available information is what supports
evidence-based practice, rather than the just the information itself.
42.
A public health nurse discovers that many of the children in the
neighborhood where she works are developing lead toxicity. She
implements a program to screen for lead exposures among clients in the
community. This is an example of:
a. Social justice
b. Policy resources
c. Autonomy
d. Moral justification
ANSWER A: Social justice involves working on behalf of others to find
solutions to current issues and is not prohibited by class, gender, or race.
Nurses perform acts of social justice when they see an issue or a wrong and
work to solve it in order to provide a workable solution for those involved.
Social justice determines that everyone deserves fair treatment and should
have the opportunities for better care.
43.
Which of the following is an example of whistle blowing?
a. A nurse contacts administration about a colleague who takes supplies to
use for a mission trip
b. A client sues a nurse because she failed to call the physician about his
wound infection
c. A nursing assistant calls for help when a client falls out of bed
d. A client developed a sacral pressure ulcer when he was not turned in bed
for over four hours
ANSWER A: Whistle blowing involves notifying administration or a
supervisor about activities taking place that are unethical or illegal. Nurses
who act as whistle blowers may be reluctant to speak up because of fear of
reproach from colleagues or the consequences of their actions on the person
acting unjustly.
44.
Which situation might require an occupational health nurse consult?
a. A nurse is injured from using incorrect body mechanics to lift a client
b. A nurse receives a subpoena to testify in court about a client's case
c. A client who has been injured in a diving accident needs assistance with
planning rehabilitation and surgery
d. A nursing unit is implementing a new electronic health record system
ANSWER A: Occupational health nurses assess the work environment and
educate those working about safety with practice and infection control.
When an injury or exposure occurs, the occupational health nurse may need
to be notified in order to document the situation and help the employee
access care or treatment.
45.
Which of the following is the most appropriate example of anticipatory
guidance for a 16-year old who has been hospitalized for an ankle fracture?
a. Changes associated with puberty
b. Driving and staying safe
c. The health hazards of smoking
d. Social media influences
ANSWER B: Anticipatory guidance is an educational process that provides
information important to a client's situation. The nurse anticipates that the
client will need the information based on his background, such as his life
stage and diagnosis. A 16-year old teen that receives care for a fractured
ankle will most likely need anticipatory guidance related to overall safety
and driving, as this is age-appropriate and may prevent future injuries.
46.
Which action represents the evaluation stage of the plan of care?
a. The nurse assigns a nursing diagnosis of Impaired Skin Integrity related
to diminished skin circulation
b. The nurse assesses the client's vital signs and asks about symptoms
c. The nurse determines that the client is not meeting his set outcomes and
makes revisions
d. The nurse discusses the client's health history
ANSWER C: The evaluation stage of the nursing process involves
reviewing the assessments, diagnoses, and interventions given to the client
and then determining if he is meeting expected outcomes. Evaluation
involves interpreting the achievement of structured goals and making
changes when necessary, such as when a client maintains an ongoing
problem or when an expected outcome has been met.
47.
A nurse is assigned to care for a deaf client. During her lunch hour, she
visits the hospital library and reads more about deaf culture in order to
better provide appropriate care for her client. This action is an example of:
a. Cultural knowledge
b. Cultural noise
c. Cultural diversity
d. Cultural divide
ANSWER A: Cultural knowledge involves looking for information and
educating oneself about different cultural groups. The nurse who cares for a
client with a language that differs from her own and who strives to learn
more about the deaf culture is exhibiting cultural knowledge. Practicing
cultural knowledge works to reduce cultural barriers that can impede
communication between nurses and clients.
48.
A nurse is providing discharge instructions for a client who had back
surgery. All of the following exhibit that the client is ready for discharge
EXCEPT:
a. The client still has sutures at the incision site
b. The client is able to take a shower
c. The client must still use an ice pack at the wound site
d. The client has a temperature of 100.8 F
ANSWER D: While providing discharge teaching for a client who is ready
to go home, the nurse must assess that there are no signs or symptoms of
emerging illness or failure to heal adequately before sending the client
home. A nurse dismissing a client with a post-operative temperature of
100.8 degrees Fahrenheit should contact the physician to ensure the client is
not developing an infection.
49.
Which of the following is an example of intragroup conflict?
a. A nurse writes a grant for a non-profit organization to raise money for
advertising
b. Members of a multidisciplinary team cannot agree on the best course of
action for a client
c. A client does not receive his medication on time because the nurse was
on break
d. A nurse feels frustrated that her employer does not provide on-site child
care
ANSWER B: Intragroup conflict occurs when disagreements happen
between members of a same group. Various professionals serving on a
multidisciplinary team may develop intragroup conflict if those involved
cannot agree on a decision of how best to care for a client.
50.
A nurse is providing dismissal instructions for a child who was admitted for
rotavirus. Which of the following statements by the parent indicates the
need for further teaching?
a. I'll start giving him his antibiotics as soon as we get home."
b. I will call the physician if he becomes dizzy or overly fussy."
c. He will need to wash his hands a lot to keep this from spreading."
d. I'll watch to see when he stops having diarrhea stools."
ANSWER A: A child who is being treated for rotavirus will need
prevention of dehydration due to excessive diarrhea associated with the
illness. Because rotavirus is a viral illness, antibiotics are ineffective as a
form of treatment. The parent who is expecting antibiotics is misinformed
as to the cause of the illness and the nurse needs to provide further teaching.
51.
A teacher brings a 5-year old child to the school nurse because of a bruise
under her eye. When asked about the bruise, the child responds, "my daddy
did it." What is the nurse's initial action in this situation?
a. Allow the child to return to class and monitor for future events that are
suggestive of abuse
b. Call the parent and request an explanation for the bruises
c. Call the police and ask for a warrant for the parent's arrest
d. Notify the school administrator
ANSWER D: When faced with a potentially abusive situation in the school
setting, the school nurse's initial response is to contact her supervisor, such
as the principal or school administrator. Together, the nurse and
administrator can contact the appropriate authorities to properly report the
findings based on state requirements.
52.
What does an anti-kickback statute prevent?
a. It prevents healthcare workers from providing food or parties to celebrate
special occasions at work
b. It promotes thorough and complete documentation when a client
becomes injured
c. It forbids giving or accepting gifts to promote or provide referrals for
certain services
d. It prevents physicians from ordering treatments that may require nursing
care that is over and above the usual amount
ANSWER C: An anti-kickback statue prevents healthcare providers,
clients, consultants, or related organizations from giving or accepting gifts
in order to reward others for referring services. Organizations that provide
gifts of food, donations, or personal items targeted toward nursing staff in
exchange for referral of services are violating this statute.
53.
Which of the following is an example of restorative care?
a. A nurse teaches a new mother how to breastfeed her infant
b. A nurse helps a client with developing a bladder-retraining program
c. A nurse places an allergy wristband on a client's wrist to notify other
providers of potential reactions
d. A nurse contacts the family of a client to tell them he will be out of
surgery soon
ANSWER B: Restorative care involves helping clients regain or maintain
the highest level of function that is possible for them. The nurse who
practices restorative care helps clients to perform their own activities in
order to promote self-care, such as through activities of daily living or
certain types of therapies. A nurse who helps a client with a bladderretraining program is assisting the client with regaining bladder function.
54.
Which of the following clients have a barrier to accessing healthcare?
a. A 36-year old client who must use a wheelchair for mobility
b. A 44-year old client who is visiting the United States on a visa from
India
c. An 81-year old client who is unable to drive
d. All of the above
ANSWER D: Barriers to accessing healthcare may take many forms,
whether it is physical, financial or cultural. Clients who have physical
limitations may face barriers with movement or travel; those with language
barriers may have difficulties with communication if an interpreter is not
present or available; and clients who are unable to access their services,
such as those who are homebound, face barriers to receiving healthcare.
55.
A client in a long-term care facility tells the nurse "my daughter never visits
me." The nurse responds by telling the client that when her own mother was
in a long-term care facility, she found it difficult to visit. This is an example
of which communication technique?
a. Empathy
b. Self-disclosure
c. Disapproval
d. False reassurance
ANSWER B: Self-disclosure is a type of therapeutic communication
technique that nurses may use with clients to encourage them to share more
information. Self-disclosure may help a client to feel more comfortable with
sharing, believing that the nurse personally understands. Self-disclosure
may also be a negative technique if the nurse shares too much information
or the client becomes uncomfortable.
56.
Which of the following is an example of intrapersonal conflict?
a. Hospital bills are denied by an insurance company due to policies
b. A nurse is called to testify in court about a client she cared for three years
ago
c. A nurse feels guilty when she administers essential medication that
causes a client to have nausea and vomiting
d. The spouse of a nurse is upset that she is working overtime
ANSWER C: Intrapersonal conflict involves negative feelings or
frustrations within oneself. Intrapersonal conflict may be related to
decisions or actions that clash with personal morals or beliefs. A nurse who
feels guilty about administering important medication that involves
negative side effects may be struggling with intrapersonal conflict.
57.
A nurse with five years of experience working in a hospital unit is promoted
as a mentor and preceptor to a new nursing staff. This is an example of:
a. Collegiality
b. Competence
c. Advocacy
d. Integration
ANSWER A: Collegiality is the action of forming relationships and
supporting others through work experiences. A nurse who becomes a
mentor to other nurses fosters an encouraging educational relationship with
those she mentors by demonstrating appropriate nursing care. Nurses who
act as preceptors often teach skills to new nurses, further advancing
educational goals and activities.
58.
Which of the following is an example of libel?
a. A client overhears a nurse telling her assistant that he is "too high
maintenance"
b. A client reads disparaging remarks that a nurse has written about him in
his chart
c. A nurse fails to notify a physician when a client's hemoglobin level is 8.1
gm/dL
d. A nurse administers narcotic pain medication to a client in pain but does
not have an order
ANSWER B: Libel involves statements against another person that are in
written form. The information injures the other person's reputation or
feelings. Libel occurs when a client reads negative remarks about himself
that were made by the nurse and were written in his chart.
59.
All of the following are essential components of supervision EXCEPT:
a. All tasks to be delegated or supervised are within the nurse's scope of
practice
b. The necessary tasks require repeated assessments
c. The nurse has adequate time to develop staff assignments
d. Policies have been developed that govern nursing practice
ANSWER B: Nursing supervision of staff requires several components that
must be in place in order for the nurse to provide adequate management.
The nursing actions should fall within the nursing scope of practice and
should be governed by the appropriate policies. Adequate staff must be
available to perform the necessary work, but each task should not require
repeated assessments to be completed. Repeating assessments negates the
need for delegation when the nurse must follow through on the delegated
work.
60.
Which of the following is an example of a breach to a client's right to
privacy?
a. A nurse who is not caring for the client reads his personal information in
his chart
b. A client is not allowed to keep a copy of his original medical record
c. A nurse filed an incident report about a client that was reviewed with all
staff at a meeting
d. A client's photograph was used without permission for the hospital
newsletter
ANSWER D: A client's right to privacy includes his right to receive
treatment without interfering with his personal information in a manner that
is above and beyond reasonable levels. This includes a client's right to be
left alone during his care. Photographs, information about the client's name
or background, or otherwise encroaching on a client's private information
are all breaches of privacy if not given permission.
61.
Which of the following abides by the Americans with Disabilities Act of
1990?
a. A nurse is allowed to have a leave of absence to recover after a back
injury
b. A nurse manager cannot cancel an interview with a potential employee
because he has left-sided paralysis
c. A nurse is mandated to receive 12 weeks' off of work after having a baby
d. A nurse manager must hire a nurse who uses a walker for mobility
ANSWER B: The Americans with Disabilities Act of 1990 provides
accommodation for persons with disabilities in that employers cannot
discriminate against a person because he is disabled. The Act protects the
application and employment process of people with disabilities. While a
nurse manager cannot discriminate against someone for having a disability
by failing to interview, this Act does not require employers to hire a person
with a disability if he is not qualified.
62.
Because of budget cuts in the hospital, the nursing manager informs the
staff that they must either float to other units more often or take their turns
staying home from work. Which principle is this nurse manager
demonstrating?
a. Justice
b. Paternalism
c. Veracity
d. Fraternity
ANSWER C: Veracity involves truth telling, even when the situation is
difficult. Staff nurses have a right to know if their shifts will be changing,
which may eventually affect their pay or the areas in which they will be
expected to work. The nurse manager is demonstrating veracity by giving
them notice of the upcoming changes.
63.
A new nursing unit is opening in the hospital. In order to meet the staffing
needs of the unit, nurses from other areas will be moved and required to
work in the new area. When notifying the nurses chosen to staff this area,
the nurse manager states "you will either move to work on this unit or you
will no longer be employed at this hospital." Which of the following
strategies is this nurse manager using?
a. Manipulation
b. Facilitation
c. Co-optation
d. Coercion
ANSWER D: This nurse manager is using a coercion tactic to convince
nurses of their job changes. Coercion involves using power to force others
to make a choice. In this example, the nurses must choose to work on the
new unit or they will lose their jobs.
64.
A group of nurses who work on the quality assurance council of a unit have
gathered to discuss ideas about how to educate their coworkers about Joint
Commission requirements. Each of the nurses gives ideas, which are listed
together without initially criticizing any of the suggestions. Eventually, all
ideas on the list will be discussed as to their validity. This activity is known
as:
a. Optimizing
b. Satisficing
c. Brainstorming
d. Centralizing
ANSWER C: Brainstorming occurs when members of a group throw out
ideas for possible solutions. The ideas are not initially discussed or
criticized as being valid or convincing; they are instead listed together as a
collection of thoughts or plans. Once all ideas have been suggested, the
team can then discuss the practicality of implementing some of the ideas.
65.
An assisted living facility is an example of which type of healthcare
provider?
a. Primary care
b. Secondary care
c. Tertiary care
d. None of the above
ANSWER C: An assisted living facility is an example of a tertiary care
provider. A tertiary care provider is one that provides rehabilitation or longterm care after a client has practiced prevention of illness or has been
treated for disease.
66.
Which of the following statements is true regarding non-profit
organizations?
a. They are located in poor or rural areas to provide care to the largest
number of people.
b. They are mandated to care for people, even if clients are unable to pay
for services
c. The money they receive for services is divided among stockholders that
have invested in the organization
d. They are also called proprietary organizations
ANSWER B: Non-profit organizations are those that return the money they
receive from clients into their own business in order to develop further
services. Non-profit organizations may be located in any areas, but if their
services involve care of others, they are required to provide care regardless
of whether the client can pay. There are many hospitals, community clinics,
and healthcare educational organizations that are considered non-profit.
67.
Which of the following is a function of risk management?
a. To consider the problems that arise if errors happen and their effect on
the healthcare environment
b. To identify how nursing care responds to specific client problems
c. To view clients as customers and decide what actions will provide a
satisfying healthcare experience
d. To analyze physician-nurse relationships and determine where
collaboration efforts can improve
ANSWER A: The risk management department of a healthcare
organization looks at potential losses and how they could negatively impact
the organization. The department also works to implement strategies that
will minimize these losses, thereby providing cost savings to the
organization as a whole. While not all nurses will work in specifically
within the risk management department, all nurses play a role in risk
management by monitoring their own work to minimize losses in each of
their own areas.
68.
A nurse caring for a pediatric client shows little concern when the parents
attempt to speak with her about their daughter's illness. When approached
by the nurse manager about her behavior, the nurse responds by saying "I
don't want to get involved. It doesn't matter what I do anyway; my work
does not make much of a difference." This nurse is exhibiting which of the
following characteristics?
a. Objectivity
b. Depersonalization
c. Procrastination
d. Disruption
ANSWER B: A nurse who sets herself apart from her clients to avoid
becoming involved is using depersonalization. This behavior may occur
among nurses suffering from burnout as a result of stress. Depersonalization
is often the result of poor morale or feelings of moral distress and may act
as a defense mechanism to avoid feeling greater burdens when under stress
or emotional exhaustion.
69.
Which of the following is an example of effective time management?
a. Always agreeing to others' requests for help
b. Arranging long meetings to discuss important data
c. Using multiple forms of technology to communicate or educate others
d. Working in a secluded area to minimize interruptions
ANSWER D: Effective time management skills are essential to
accomplishing daily goals and providing adequate care for clients without
becoming overwhelmed. Time management practices may be as simple as
working in an isolated area to chart or catch up on paperwork in order to
avoid becoming distracted or being interrupted. Responding to all requests
for help, arranging long meetings, and submitting to information overload
through various forms of technology all contribute to ineffective time
management.
70.
A nurse is asked by a physician to speak to a colleague about her
unprofessional behavior in front of a client. The nurse does not want to
create conflict with her colleague, so she does not confront her and stays
away from the physician when he comes in to work the next day. Which
type of conflict resolution is this nurse exhibiting?
a. Accommodation
b. Competition
c. Avoidance
d. Negotiation
ANSWER C: Avoidance is a form of conflict resolution that seeks to
ignore the problem in hopes that it might go away on its own. Avoidance is
a passive form of resolution in that it usually does not accomplish the
intended action. While keeping distance may allow others involved to
obtain more insight about the situation, avoidance often does not result in
resolution of issues or problems.
71.
You are caring for a patient with newly diagnosed multiple sclerosis.
Discharge instructions will likely include all of the following EXCEPT:
a. PT referral for development of a planned exercise program.
b. Avoidance of prolonged sun exposure.
c. Hot baths to promote muscle relaxation.
d. Instructions to evaluate the home environment to ensure safety
ANSWER C: Excessive heat from sun or hot baths should be avoided since
this can cause acute exacerbations of symptoms. The MS patient should
begin to evaluate the home environment to ensure a safe environment as
symptoms progress.
72.
The BRAT diet is often prescribed for patients with gastroenteritis. This
acronym stands for:
a. Bananas, Rice, Applesauce, and Toast
b. Bread, Rice, Apricots, and Tapioca
c. Bananas, Rolls, Apricots, and Toast
d. Bananas, Rolls, Applesauce, and Tapioca
ANSWER A: The BRAT diet should be started as soon as diarrhea
subsides. This bland diet consists of banana, rice, applesauce and toast. The
diet is recommended for the low fiber and high potassium content that
allows the patient's stools to firm while replacing nutrients lost to vomiting
and diarrhea.
73.
OSHA has very strict standards for hospital employees who may encounter
hazardous materials or patients who have been exposed to them. These
regulations include all of the following EXCEPT:
a. Respiratory protection must be provided to all employees who might be
exposed.
b. Training on respiratory protection must be provided.
c. Employers must provide personal protective equipment to all employees.
d. All ED personnel must be trained in decontamination procedures.
ANSWER D: All ED personnel should have first responder awareness of
hazmat situations but may or may not be trained in decontamination
procedures. However, any ED employee who will be participating in
decontamination must be trained in the process.
74.
Which of the following screening tools have been found to have a high
diagnostic accuracy for screening for intimate partner violence?
a. Hurt, Insult, Threaten and Scream (HITS)
b. Humiliation, Afraid, Rape, and Kick (HARK)
c. Slapped, Threatened and Thrown (STaT)
d. All the above
ANSWER D: According to the National Preventive Services Task Force,
these three screening tools have been shown to have high diagnostic
capability to show current or recent intimate partner violence. The Partner
Violence screen may have value in predicting future intimate partner
violence.
75.
What is the relationship between HIPPA and technological advances?
a. Technology helps to foster HIPPA confidentiality.
b. Computers help us to share information with others.
c. Computer screens are not visible to others in the area.
d. Technology places us at risk for HIPPA violations.
ANSWER D: Technology places us at risk for HIPPA violations. For
example, not logging off and having the computer screen in the view of
others, can lead to HIPPA violations. Although computers do help us share
information with others, this has nothing to do with HIPPA when they are
used properly.
76.
Which technological advance is MOST likely to place you at risk for
HIPPA violations?
a. Social media
b. Word processing programs
c. Spreadsheets
d. Clouds and SOEs
ANSWER A: Social media, like Facebook, can place you at risk for HIPPA
violations. No patient related information or comments should ever be put
on social media websites.
77.
A patient is having a colposcopy procedure performed. How should the
patient be instructed to prepare for the procedure?
a. NPO for 8-12 hours before the procedure.
b. D/C all HTN Rx for two days prior to the procedure.
c. Take three Dulcolax tablets and two containers of Miralax the day before
to clear out the lower GI system.
d. None of the above prep is necessary for this type of procedure.
ANSWER D: A colposcopy procedure is done to view the vagina and
cervix. The only preparation that is necessary is to wash the external
genitals with soap and water the morning before the procedure.
78.
A physician is explaining a procedure to a patient that may cure her
recurring Staph infection. The doctor explains how the procedure is done,
what to expect, the odds of the procedure curing the infection, and possible
side effects and risks. The physician is:
a. Preparing the patient to give informed consent.
b. Protecting HIPAA by listing all of the steps of the procedure with the
risks involved.
c. Not required to inform the patient of any alternative therapies.
d. None of the above.
ANSWER A: Giving informed consent is the process of giving a physician
permission to perform a procedure after all of the risks are made known to
the patient. Informed consent is required in most cases, but may not be
necessary in some emergency situations.
79.
After a lengthy explanation of a medical procedure, the patient asks many
questions. The physician answers all of the questions to the best of her
ability. The patient then gives consent for treatment. The costly equipment
and supplies are put into place and the patient is prepared. Two minutes
before the procedure is to start, the patient begins panicking and changes
her mind. Which of the following situations would be the best way to avoid
litigation?
a. Document that the patient originally gave consent and proceed if the
benefits of the procedure outweigh the patient's wishes.
b. Have the patient sign a form that she is refusing consent. If she refuses to
sign, proceed with the procedure.
c. Repeat the explanation of the procedure until the patient understands that
having the procedure done is the best form of treatment. Proceed with the
procedure.
d. Do not proceed. Document the patient's refusal, have the patient sign a
refusal to consent to treatment. If the patient refuses to sign the form, have a
witness available to sign.
ANSWER D: A patient who refuses treatment has the right to do so at any
point during the procedure as long as the procedure has not reached a point
where stopping would potentially harm the patient.
80.
Who of the following wrote a medical code of ethics?
a. Hammurabi
b. Tomas Percival
c. Hippocrates
d. All of the above.
ANSWER D: All of these philosophers wrote some form of medical ethics
code. Hammurabi wrote the first code in 2500 BC. Hippocrates is famed
for, "Do no harm." Thomas Percival was a physician with an interest in
sociological medicine and wrote a Code of Medical Ethics in 1803.
81.
In which of the following examples would informed consent be required?
a. A patient is apprehensive about an upcoming surgery and chooses not to
learn of the risks involved with the procedure.
b. A child is rushed to the Emergency Room after falling from a third story
window.
c. An adult in a coma in a mental health institution with no listed next of
kin.
d. None of the above require informed consent.
ANSWER D: In emergency situations where delaying treatment could
mean the difference between life and death, in situations where the patient
refuses to hear the risks, and in situations where patients are mentally
incapacitated and no next of kin is designated, informed consent is not
required.
82.
A woman has died as a result of a motor vehicle accident. She is listed as an
organ donor and her family is considering whether to comply with her
wishes. Which of the following is true?
a. The woman would have had to list herself as an organ donor and notify
her family prior to her death that she has considered donating her organs.
b. The Uniform Anatomical Gift Act requires the physician caring for the
patient to inform the family who receives the donor organs.
c. Physicians can choose to go against the deceased's wishes if the family
decides that organ donation is not an acceptable choice.
d. Physicians have the legal responsibility to inform patients of the risks
involved in donating organs.
ANSWER C: Families that are left behind after the death of a loved one
may not agree with organ donation. Physicians may choose to go with the
wishes of the family over the wishes of the deceased if the family will
suffer emotional trauma from the donation.
83.
Which of the following choices would best answer the question, "Who
owns a patient's medical record?"
a. The patient
b. The physician
c. The Legal Counsel of the Office
d. No one owns a medical record.
ANSWER B: Physicians own their patients' medical records, but patients
have the right to have copies of their records.
84.
Which of the following choices would best answer the question, "Who
owns a patient's x-rays?"?
a. The patient
b. The doctor
c. The facility that performed the procedure.
d. None of the above.
ANSWER C: X-rays, while considered part of a patient's medical record,
are owned by the facility that performs the procedure.
85.
Which of the following reasons would be legal when considering a patient's
medical record?
a. Allowing a patient's brother to view her chart to find out her birthdate and
address so that he can mail her a card
b. Not allowing a patient to view her own chart because the physician feels
this information would be detrimental to her wellbeing.
c. Not allowing a patient to view her chart because she is behind on her
payments.
d. All of the above are legal.
ANSWER B: Physicians are not required to tell a patient certain health
information if that information will potentially cause harm to that patient.
For example, if a patient with very high levels of anxiety learns that she
may be undergoing testing for a potentially fatal illness, she may react
negatively by having a mental breakdown due to her anxiety.
86.
Choose the BEST answer. To ensure adequate protection for legal issues,
offices should maintain patients' charts for:
a. 10 years
b. Forever
c. until the age of majority
d. 2 years after the patient was last seen in the office
ANSWER B: Keeping medical charts forever will ensure that the charts are
available in the event of litigation.
87.
The purpose of performing quality control is to:
a. create a paper trail to show that the laboratory is compliant with OSHA
standards for quality control.
b. improve the odds that the results that are reported for any given test are
as accurate and reliable as possible.
c. Are required by law to be part of a quality assurance program.
d. All of the above.
ANSWER B: Quality controls are done for each analyte tested to ensure
reliability of the results obtained from that test. There are no laws requiring
that QC be performed, but most accrediting bodies will require QC to be
done in order to maintain accreditation.
88.
Richard is a 72-year-old with stage 4 lung cancer who has been admitted to
the hospital for pneumonia. He is alert and oriented, and states he would
like to sign a do not resuscitate (DNR) order. His wife enters the room after
he has signed it and is very upset that he has made this decision without
discussing it with her. She wants to know what she can do to get the DNR
reversed. What should your first response be?
a. Contact the unit manager to talk with her
b. Contact the hospital's attorney to discuss with her
c. Try to talk Richard out of his decision
d. Offer caring support for both parties
ANSWER D: Offering caring support for both parties is the best option,
since Richard is entitled to make this decision for himself and receive
support to do so. His wife's feelings are understandable, and caring support
by the nurse will be helpful in facilitating a discussion between them, as
well as enforcing Richard's right to make this decision.
89.
You are on the unit and overhear another nurse talking on the phone to a
patient's friend who wants to see her patient who is comatose and on a
ventilator. Since you cared for that patient yesterday, you know that the
patient's significant other, who is also the designated health care surrogate
(HCS) and has power of attorney (POA), has expressly stated that he wants
this person on the list for restricted visitors. The nurse whispers that she'll
call him to visit as soon as the significant other has gone home. What
should your first response be?
a. Inform the significant other
b. Report the nurse to the nurse manager
c. Speak with the nurse directly in private
d. Call the visitor and tell him he can't visit
ANSWER C: Speaking with the nurse directly and privately is the most
constructive manner in which to handle this situation, and advocate for the
significant other's wishes. Doing so will open communication with a peer,
and build the relationship, instead of alienating the other nurse by taking
action which does not involve her and will cast her in a negative light with
others. Express your concerns regarding honoring the significant other's
requests and rights regarding limitation of visitors.
90.
Teresa is an 84-year-old with stage 4 ovarian cancer who has been admitted
for a bowel obstruction. She recently stated that she has decided that she
doesn't want any further aggressive care and is requesting to be placed
under hospice care. Her husband and daughter are supportive of her
decision. She spoke with her oncologist about it, and he stated that he did
not agree, and wrote orders on her chart for chemotherapy. What would be
the best first response to this situation?
a. Give the patient a list of other oncologists
b. Tell the family to report the doctor to the state quality board
c. Notify the doctor that the patient refuses the chemotherapy
d. Give the patient hospice information
ANSWER C: The patient has the right to refuse any treatment, and the
doctor should be notified that the orders on the chart cannot be performed,
with appropriate documentation. Depending on the doctor's response,
discussing the patient's wishes in a calm and professional manner provides
the opportunity for him to understand her viewpoint and perhaps support
her decision. Providing hospice information is a good second option, as the
patient has the right to make this decision, and is able to initiate her own
hospice evaluation.
91.
Upon entering an elderly patient's room, you find a research assistant with a
clipboard, obtaining consent to participate in a new study. After signing the
form, the patient begins to ask questions about the study. The assistant
smiles and says, "Don't worry about all that, we'll take good care of you.
Now enjoy the chocolate I brought." What should your first response be?
a. Ignore the patient's questions
b. Stop the assistant and question the consent
c. Notify the nurse manager
d. Notify the research department
ANSWER B: The patient has not given informed consent if she still has
questions that are not answered prior to participating in the study. The
assistant should be stopped, the consent questioned, and the patient's
questions answered to ensure she understands all aspects of participation in
the study. Additionally, notifications may need to take place as appropriate
to prevent this individual from obtaining future consents in an unethical
manner.
92.
Monica is a 28-year-old nurse who had been admitted to the hospital after a
near-drowning in which she suffered cardiac arrest and hypoxic
encephalopathy. She has been stabilized and has a tracheostomy to room air.
She has been on the general floor for several weeks, is in a persistent
vegetative state, and has a very poor prognosis for any improvement in her
neurological status. Monica had previously signed a living will, which
indicated that she did not wish to receive enteral feedings to be kept alive if
she had a terminal condition or was in a persistent vegetative state from
other causes. Her parents have decided to move her to the hospice unit and
have given permission for removal of her feeding tube. The patient care
technician who has been caring for Monica is very distressed over this
decision and feels that the parents are "killing" her. What would be an
appropriate initial response?
a. This will relieve the burden for her parents."
b. Her parents have a right to make decisions for their child."
c. Monica has stated her wishes and they should be honored."
d. The ethics committee should be consulted."
ANSWER C: The purpose of a living will is to provide individuals with the
opportunity to express their wishes prior to the occurrence of a catastrophic
event in which they may not be able to speak for themselves. Monica has
clearly stated her wishes, and honoring those wishes is the most appropriate
manner in which to advocate for her. Such decisions are sometimes difficult
for healthcare personnel, and caring support with appropriate resources
should be provided to those with questions and concerns.
93.
Jack is a 2-month-old with a diagnosis of spinal muscular atrophy (SMA)
type I. He has been admitted to the hospital for progressive respiratory
difficulty. His parents have been informed that if he is not placed on
ventilatory support, he will continue to decompensate and die of respiratory
failure. Jack's physician discusses the poor prognosis of Jack's condition,
and tells the parents that he will not be able to be removed from ventilatory
support once it is initiated, due to his progressive neurological disease.
After much discussion, the parents have decided to decline ventilatory
support, agree to a do not resuscitate (DNR) order, and request hospice care
for Jack. Another parent heard them discussing Jack's situation in the
waiting room and says she could never do that to her baby. What is the most
appropriate response to this parent?
a. You never know what you'll do until you're in that situation."
b. I can't discuss another patient's situation."
c. They have been through too much already."
d. You can contact administration with your concerns."
ANSWER B: Privacy regulations prevent healthcare professionals from
discussing patient situations with others who are not involved in that
patient's care. Providing caring support that protects the privacy of others is
sometimes a delicate task, as the waiting room of an intensive care unit is
often a very emotional environment. Even if family members share details
with each other, health care professionals are not permitted to engage in
conversations that would breach confidentiality.
94.
Albert is a patient in the hospital who is scheduled for surgery the following
morning. After the pre-operative visit from the anesthesia staff member
who has obtained surgical consent, Albert asks for an explanation of what
type of surgery he is going to have. He states that he's not sure what he just
signed. What is your best response?
a. Don't worry, they'll explain it in the operating room."
b. It's standard procedure to get the consent, you don't need to worry."
c. Let me ask the nurse anesthetist to come back and explain it further."
d. Someone will review it with you prior to surgery."
ANSWER C: If the patient does not understand what he consented to, it is
not an informed consent, which is required prior to surgery. The staff
member who obtained the consent should be notified that the consent is not
valid, and a request made for the patient to receive an additional visit with
further explanation and new consent obtained.
95.
If a nurse prevents intentional harm from occurring to a patient, which
ethical principle is she supporting?
a. Beneficence
b. Nonmaleficence
c. Justice
d. Fidelity
ANSWER B: Nonmaleficence is the ethical principle of preventing
intentional harm. Beneficence is the ethical principle which means to do
good, not harm, to others.
96.
What ethical principle has led to the need for informed consent?
a. Autonomy
b. Justice
c. Fidelity
d. Beneficence
ANSWER A: Autonomy is the ethical principle that states that patients
have the right to make their own decisions for themselves, if they are
mentally competent to do so. Informed consent has been one of the
outcomes of this principle, since patients should be thoroughly educated
and informed prior to providing consent. Autonomy is a often a difficult
concept for healthcare professionals, since patients often make decisions for
themselves which healthcare professionals do not always agree with.
97.
Victor is a 43-year-old patient who is HIV positive with a diagnosis of
pneumocystis carinii pneumonia (PCP) who has been admitted to the
hospital. His prognosis is very poor, and his partner, Roger, would like to
have a ceremony performed in his room to honor their union in case
something happens to Victor, who is in agreement. What is the most
appropriate response to their request?
a. Inform him that Victor is too ill for a ceremony
b. Ask the social worker to intervene
c. Tell him it's against unit policy
d. Coordinate with other disciplines to support their request
ANSWER D: The most appropriate caring response is to respect their
relationship, and honor their wishes. A multidisciplinary approach supports
their needs, and will help facilitate the process. According to the ANA
Code of Ethics, nurses must treat all persons with dignity and respect
regardless of personal viewpoints on any given issue.
98.
A victim of a gunshot wound to the abdomen has been admitted to the
hospital, accompanied by a police officer. When questioned, the officer
states that the patient is a suspect in a homicide, which occurred as part of
the same incident. A small child was killed as the result of a stray bullet.
The patient is combative, yells that he's in pain and demands medication.
What is your most appropriate response?
a. Tell him you'll take care of him after your other patients
b. Reinforce restraints
c. Perform a pain assessment and administer pain medication
d. Ask the officer for more details of the incident
ANSWER C: The most appropriate and caring response is to perform a
pain assessment and administer the pain medication that has been ordered.
Regardless of personal feelings about any given situation, the nurse's
responsibility is to provide unbiased, appropriate and supportive care, as
stated in the American Nurses Association (ANA) Code of Ethics.
99.
You have accompanied the physician into the family waiting room to tell a
young husband that his wife has not survived the car accident she was in.
The husband is crying and distraught. What is the most appropriate
approach to supporting this family member?
a. Ask if he would like to donate his wife's organs
b. Sit quietly with him
c. Ask about funeral arrangements
d. Consult social services
ANSWER B: The most caring and supportive approach in a time of
extreme distress is usually to sit quietly with the distressed party, until he's
had the opportunity to absorb the news and gather himself. Providing a
supportive presence is often the most valuable tool a nurse can use when
circumstances provide overwhelming emotional pain to those they are
caring for.
100.
Rachel is a 48-year-old mother of three who has been admitted after a drug
overdose in a failed suicide attempt. When she regains consciousness, she
states that she is ashamed and embarrassed that she tried to take her own
life. What is the most therapeutic response to Rachel's statement?
a. It's a blessing your children weren't left without a mother."
b. What were you thinking?"
c. We're here to help patients who value life."
d. I know life can be difficult. We're here to help you."
ANSWER D: Offering non-judgmental support and hope is the most
therapeutic response which will help the patient to maintain her self-esteem.
The nurse's role is to treat all patients with respect and dignity, regardless of
the situation, and offer supportive measures which will benefit healing in all
realms.
101.
Family members of an patient ask repeated questions about the monitors
and various readings in the patient's room. What is the most supportive
response to their questions?
a. Inform them that you can't take to the time to answer all their questions
b. Provide detailed explanations for each device
c. Tell them it's too technical to explain
d. Provide an overview and encourage them to spend their time with the
patient
ANSWER D: Addressing the family's questions and providing an overview
of information validates their concerns and addresses their requests.
Limiting details and encouraging them to focus on the patient helps to avoid
anxiety which could be created by focusing on values that should be
interpreted in the context of the patient's situation by professionals with
experience with such data. It also encourages them to provide what they
uniquely have to offer, a comforting presence for their loved one.
102.
The mother of a 3-year-old pediatric patient would like to remain at the
patient's bedside throughout the night. The patient seems to be calmer when
she is present. What is the most caring and appropriate response?
a. Reinforce visiting hours
b. Allow her to stay for a short period beyond normal hours
c. Allow her to stay throughout the night
d. Offer to get bedding for a couch in the waiting room
ANSWER C: Allowing the mother to stay throughout the night is the most
caring and appropriate response. Most pediatric facilities recognize the vital
role the parent plays in the patient's care, and are supportive of unlimited
visitation. Providing supportive understanding of the needs of both the
patient and mother will enhance rapport and cooperation.
103.
You are caring for a Hispanic patient who is scheduled for surgery in the
morning. A member of the surgery staff is in a hurry when she visits the
patient to obtain surgical consent. You know that the patient speaks limited
English, and can see that he does not really understand what's being said.
What is the most appropriate next action?
a. Call a family member to interpret
b. Consult the hospital translator to assist
c. Allow the consent to be signed
d. Ask the staff member to come back later
ANSWER B: Consulting the hospital translator is the most reliable means
of ensuring accuracy in the information that the patient is receiving. Family
members can be helpful, but may have difficulty understanding the medical
procedures well enough to explain them, and may skew the message being
delivered, depending on their view of the situation. Translator collaboration
is vitally important to ensure that language barriers do not adversely affect
patient care.
104.
Becky is a 17-year-old type I diabetic who has been admitted for her third
episode of diabetic ketoacidosis (DKA) since being diagnosed last year. She
states that she hates feeling different than her friends and refuses to take her
insulin as recommended. What would be the most helpful action for Becky?
a. Scold her for not taking her insulin
b. Recommend that she use an insulin pump
c. Contact the local support group for diabetic teens
d. Tell her parents they must provide more strict oversight
ANSWER C: Contacting the local support group for diabetic teens to see if
another diabetic teenager would be available to provide support for Becky
would be the most helpful action. Such collaboration would provide her
with the ability to identify with someone in her peer group who faces the
same issues she does, decreasing her feeling of isolation and being
"different".
105.
Ruth is a 72-year-old patient who has been upset and crying all morning.
When asked why she is upset, she turns toward the wall in silence. What
collaborative process may be helpful in caring for this patient?
a. Speak with the patient care technician
b. Call the chaplain
c. Call the social worker
d. Call the patient's husband
ANSWER A: Collaborating with the patient care technician is an excellent
option in this situation. Patient care technicians and nurses' aides provide
some of the most hands-on and intimate care that patients receive. Often,
patients feel more comfortable discussing feelings and building
relationships with these individuals than others.
106.
Brandon is a 38-year-old with a history of cocaine addiction who has just
been admitted for his second myocardial infarction that was due to cocaine
use. What collaborative process should begin as soon as Brandon is stable
enough to interact with additional resources?
a. Law enforcement for further prevention
b. Social services for rehab
c. Narcotics anonymous
d. Financial counselor to apply for assistance
ANSWER B: After stabilization, Brandon should be connected with
additional resources to help him deal with his addiction. Social services is
an excellent collaborative partner, as these professionals have access to
available resources in the community that would be helpful for Brandon's
issues.
107.
The previous charge nurse fell during her shift and was taken to the
emergency room. You have been assigned to take over as charge nurse
without any report. At the end of the shift, you have made the assignments
for the next shift's nurses and posted them. As the nurses come in, they
begin to complain that the assignments make no sense, based on patient
acuity. One refuses to take her assignment and threatens to go home. What
could you have done to prevent their dissatisfaction?
a. Reviewed the notes of the previous charge nurse
b. Tried to contact the previous charge nurse in the emergency room
c. Collaborated with the nurse manager
d. Collaborated with the other nurses on your shift
ANSWER D: Collaborating with the other nurses on your shift would have
permitted them to provide the most updated information regarding patient
status and acuity. Requesting their input into creating assignments would
have provided shared governance and assurance that the unit staffing was
arranged appropriately.
108.
What consideration is important when caring for a female Muslim patient?
a. Make eye contact
b. Provide long-sleeved gowns or allow her to use her own
c. Touch while talking
d. Assign male caregivers when possible
ANSWER B: Most Muslim women are very conscious of covering their
whole body, and may want to remain clothed during examinations. Long
gowns with long sleeves should be provided, or the patient should be
permitted to use her own. Additional considerations are the avoidance of
eye contact, not touching while talking, and assigning female caregivers. If
a male caregiver or male physician must work with the patient, the husband
may request to be in the room.
109.
Of the following, what is an important component of Vietnamese culture to
consider when teaching the Vietnamese patient who has been treated for
pneumonia, who needs to complete her antibiotic regimen at home?
a. Cupping will help to pull toxins from the body
b. Coining will help to release the wind or bad energy from the body
c. Once symptoms disappear there is no longer an illness
d. Most households consist of a least 3 generations
ANSWER C: The Vietnamese tend to believe that once symptoms
disappear, there is no longer an illness that needs to be treated. Therefore,
discharge teaching regarding completing oral antibiotic therapy needs to
include this understanding with a delicate approach to optimize treatment
completion.
110.
If you are caring for a patient of the Hindu culture, what may you anticipate
regarding visitors?
a. Limited visitors, respectful of privacy
b. Family members only
c. Large number of visitors/community support
d. None of the above
ANSWER C: The Hindu community is very supportive of its members,
and large numbers of visitors often come to see the patient at the hospital.
Although this may seem inconvenient, appropriate accommodations as
possible should be made, since the patient will generally receive benefit
from this level of support.
111.
You have noticed that the last several patients you have cared for have had
questionable blood pressure readings from their arterial lines. When
checked against cuff pressures, a discrepancy has been noted, and further
investigation has revealed faulty transducers. This is not the first product
issue with this company. What positive step could you take to help resolve
this situation?
a. Use the old stock from a previous company
b. Verify the cuff pressures every hour to ensure accuracy
c. Notify the risk manager
d. Form a peer workgroup to evaluate new products
ANSWER D: Forming a peer workgroup to evaluate new products would
be an excellent opportunity for collaboration among peers, management and
the purchasing department. When clinicians are engaged to work toward
solutions that address patient care issues, they experience more
empowerment and control over their work environments.
112.
The family of a patient who is receiving therapeutic hypothermia states they
do not understand why the patient is being kept so cold. What objective
information can you provide to help address their concerns?
a. Let them talk to another patient who has had the same therapy
b. Provide research-based information about therapeutic hypothermia
c. Connect them with the nurse manager
d. Call the physician and ask him to talk to the family
ANSWER B: Providing research-based information about the benefits of
therapeutic hypothermia for their loved one will provide evidence that this
is an established therapy with generally positive outcomes. Families are
certainly not expected to be familiar with critical care interventions, and
their concerns should be addressed with evidenced-based data whenever
possible.
113.
A family member is complaining that the lights are too dim in the middle of
the night when she comes in to visit her husband. What is the most
objective response?
a. Patients sleep better with the lights dimmed."
b. The nightshift nurses prefer to work with less light."
c. It's time for him to sleep, and you should, too."
d. There's a reason we do that. Let me share a research study with you."
ANSWER D: Providing the results of a research study with the patient's
wife may help her to understand that the unit is operating from the principle
of evidence-based practice. This knowledge may help put her mind at ease,
and help to assure her that her husband is getting the most appropriate care
possible.
114.
You are attempting to teach the wife of a Greek patient how to administer
his gastrostomy tube feedings once he returns home. She smiles and nods
through your explanations, but when you ask her for a return demonstration,
she looks confused and shakes her head. Her daughter enters the room and
states that she does not speak English. What would be most helpful in this
situation?
a. Teach the daughter instead
b. Teach both and ask the daughter to translate for you
c. Contact a home health agency to provide care
d. Provide a pamphlet with detailed instructions
ANSWER B: Teaching both the patient's wife and the daughter is the best
option, since the daughter may not always be available, and the wife is
eager to care for her husband at home. Although a hospital interpreter if
often preferred, asking the daughter to interpret is a good option, as she will
receive instruction and reinforce it for herself as she is translating it to her
mother.
115.
What is a key principle of patient teaching that must take place to ensure
patient safety?
a. Family members should be present
b. Teaching must be documented
c. Understanding must be confirmed
d. Teaching should be provided by multiple staff members
ANSWER C: A key principle of patient teaching that ensures patient safety
is confirmation of understanding. This can be done by asking the patient to
repeat the understanding of the information that has been given, and if a
procedure, by asking for a return demonstration. Patient understanding
should be appropriately documented as part of the teaching record.
PREVENTING RISKS AND COMPLICATIONS (STUDY
MODE)
1.
Which of the following nursing interventions is appropriate for a client who
is suffering from a fever?
a. Avoid giving the client food
b. Increase the client's fluid volume
c. Provide oxygen
d. All answers are correct
ANSWER B: Interventions for a client who is suffering from a fever
include increasing the client's volume of fluid and providing oxygen. A
fever increases the body's metabolism, causing the client to breath at a
faster rate and increasing the work of the heart. The client is at risk of fluid
loss due to increased respiration and sweating. In some cases, depending on
the reason for the fever, the increased work of the heart requires more
oxygen to maintain perfusion to the tissues.
2.
A client has started sweating profusely due to intense heat. His overall fluid
volume is low and he has developed electrolyte imbalance. This client is
most likely suffering from:
a. Malignant hyperthermia
b. Heat exhaustion
c. Heat stroke
d. Heat cramps
ANSWER B: Heat exhaustion occurs when a person has enough
diaphoresis that he becomes dehydrated. Intense sweating can cause both
fluid and electrolyte imbalances. Untreated heat exhaustion can lead to heat
stroke, which results in organ damage, loss of consciousness, or death.
3.
A nurse is attempting to assess a client's pulse in his foot. She palpates the
pulse on the anterior aspect of his ankle, below the lower end of the medial
malleolus. Which type of pulse is this nurse taking?
a. Dorsalis pedis
b. Popliteal
c. Posterior tibial
d. Femoral
ANSWER C: The nurse can palpate the posterior tibial pulse to assess
circulation to the foot and ankle. The posterior tibial pulse is felt by
palpating the inner side of the ankle, behind the medial malleolus.
4.
Which of the following conditions may cause an increased respiratory rate?
a. Stooped posture
b. Narcotic analgesics
c. Injury to the brain stem
d. Anemia
ANSWER D: A client who has anemia has decreased levels of hemoglobin
in the red blood cells. Because hemoglobin is responsible for carrying
oxygen molecules to the body's tissues, the client may need to breathe faster
to bring in more oxygen to make up for this deficit.
5.
Mr. N is a client who entered the hospital with a diagnosis of diabetic
ketoacidosis. The nurse enters his room to check his vital signs and finds
him breathing at a rate of 32 times per minute; his respirations are deep and
regular. Which type of respiratory pattern is Mr. N most likely exhibiting?
a. Kussmaul respirations
b. Cheyne-Stokes respirations
c. Biot's respirations
d. Cluster breathing
ANSWER A: Kussmaul respirations may be associated with some
conditions such as metabolic acidosis. This type of breathing is actually a
form of hyperventilation, resulting in increased buildup of carbon dioxide in
the body. Kussmaul respirations are typically rapid, regular, and deep.
6.
A nurse is attempting to check a blood pressure on a client when she
realizes that the cuff is too wide for the size of his arm. What type of
reading might this blood pressure cuff produce?
a. A normal result
b. An abnormally low reading
c. An abnormally high reading
d. A low reading, followed by a normal reading
ANSWER B: A blood pressure cuff that is too large for the size of a client's
arm may produce an abnormally low blood pressure result. The cuff should
be placed to appropriately fit the size of the client's arm. If a nurse gets an
abnormally low blood pressure reading in a client who is not symptomatic,
she should check the size of the cuff.
7.
Which of the following is a true statement about assessing blood pressure
by palpation?
a. Only the diastolic blood pressure can be assessed through palpation.
b. The palpation technique is most useful for infants and small children.
c. Hypertension is a common condition that might need to be assessed
through blood pressure palpation.
d. Only the systolic blood pressure can be assessed through palpation.
ANSWER D: Palpating a blood pressure may be necessary in some clients
with pressures that are too low to be heard through a traditional stethoscope.
Clients who have fluid volume deficits or decreased cardiac outputs may
need blood pressure assessed through palpation. When performing this
maneuver, only the systolic blood pressure can be assessed.
8.
A nurse is caring for a client who has just come from surgery and is in the
recovery room. The client still has an endotracheal tube in place. The nurse
deflates the cuff on the tube and pulls it out, at which time the client sits up
in bed, grasps his throat, and begins to make wheezing sounds. Which of
the following conditions is the most likely cause of this situation?
a. The client is choking on part of the tube
b. The client has anxiety
c. The client is having a laryngospasm
d. The client is having a normal response from anesthesia
ANSWER C: Some clients, after being intubated and receiving
medications through anesthesia for surgery, may develop a laryngospasm
during the time period of emergence from anesthesia. A laryngospasm
results in occlusion of the laryngeal opening after a spasm of the vocal
cords. The nurse should emergently open the airway to facilitate breathing
and administer muscle relaxants if ordered.
9.
A client with adrenal insufficiency has a potassium level of 7.2 mEq/L.
Which of the following signs or symptoms might the client exhibit with this
result?
a. Peaked T waves on the ECG
b. Muscle spasms
c. Constipation
d. A prominent U wave on the ECG
ANSWER A: A client with hyperkalemia may exhibit peaked T waves on
an electrocardiogram. This manifestation is an early sign of high potassium
levels, but diagnosis should not be based on this aspect alone. Untreated,
hyperkalemia can lead to progressively worsening cardiac instability.
10.
A nurse is assisting Mrs. K, a client who is undergoing a lumbar puncture.
Which of the following elements should the nurse use to instruct Mrs. K
about this procedure?
a. A lumbar puncture takes a sample of blood from the back, which will be
analyzed by the lab
b. The physician will insert a needle at the level of L4-L5 in the spinal cord
c. Mrs. K should lie flat on her back for 24 hours following the procedure
d. The risks of the procedure include nausea, rash, and hypotension
ANSWER B: A lumbar puncture is used to draw cerebrospinal fluid to
check for potential infection, hemorrhage, or other conditions that can cause
a client's illness. The nurse should instruct the client to lie on her side or to
sit leaning over a table with her back rounded. The physician will insert a
needle into the back at about the level of the L4-L5 vertebral spines.
11.
A nurse is caring for a client who has a right-sided chest tube. The chest
tube shows 50 cc of serosanguinous fluid in the collection chamber and air
bubbles are collecting in the water seal chamber. Which action is most
appropriate of the nurse at this time?
a. Do nothing; this is a normal response
b. Strip the tubing to remove any clots
c. Place a clamp on the tube near the client's chest
d. Remove the collection chamber and connect the tubing to a new device
ANSWER C: The water seal of a chest tube is designed to act as a one-way
valve. Air bubbles that are present in the water seal indicate the occurrence
of a leak somewhere between the client and the chamber. The nurse should
briefly clamp the tube near the client's chest to identify the source of the
leak. Once the leak is identified, the nurse should unclamp the tubing and
notify the physician right away.
12.
A nurse is caring for a client with a broken femur who is in a traction splint
in bed. All of the following interventions are part of care of this client
EXCEPT:
a. Palpating the temperature of both feet
b. Evaluating pulses bilaterally
c. Turning the client to a side-lying position
d. Relieving heel pressure by placing a pillow under the foot
ANSWER C: A client who has been placed in traction for a fracture of a
large bone such as a femur will be unlikely to turn to a side-lying position
while in bed. A client with this type of injury is at risk of skin breakdown
and the nurse should attempt to reposition and relieve pressure on certain
points that are more likely to have diminished circulation.
13.
A nurse is assessing a client with right-sided heart failure. Which of the
following symptoms would the nurse most likely see in this client?
a. Weight loss and vomiting
b. Coughing and 3+ pitting edema
c. Muscle cramps and hyperreflexia
d. Lethargy and paroxysmal nocturnal dyspnea
ANSWER B: Right-sided heart failure, also called cor pulmonale, affects a
client's abilities to breathe as the right side of the heart may have greater
difficulty pumping blood toward the lungs. The client may develop
symptoms of respiratory distress or coughing. Additionally, the feet and
ankles may swell, resulting in pitting edema.
14.
A nurse is caring for a client who is post-op day #1 after a total hip
replacement. Although the client was alert with a normal affect in the
morning, by lunchtime, the nurse notes the client is confused, has slurred
speech and is having trouble with her balance. Her blood glucose level is 48
mg/dl. What is the next action of the nurse?
a. Contact the physician immediately
b. Administer a bolus of 50 cc of D20W through the IV
c. Administer 10 units of regular insulin
d. Give the client 6 oz. of orange juice
ANSWER D: A client with a blood glucose level of 48 mg/dl is
experiencing significant hypoglycemia, as manifested by confusion, balance
difficulties, and slurred speech. The nurse should work to correct this
situation as rapidly as possible. The first measure that can be performed
quickly and will have fast results is to give the client something to eat or
drink that contains glucose, such as 6 oz. of orange juice.
15.
A nurse is educating a client about her cholesterol. Which of the following
statements from the client indicates the need for further teaching?
a. I would like my HDL levels to be over 50."
b. It is better for me to have high HDL levels and low LDL levels."
c. It is better for me to have high LDL levels and low HDL levels."
d. My goal is to get my total cholesterol down below 200."
ANSWER C: A client who states "it is better for me to have high LDL
levels and low HDL levels" when talking about cholesterol indicates a need
for further teaching. Low-density lipoproteins (LDL) contribute to
atherosclerosis while high-density lipoproteins (HDL) can protect against
heart disease. A client should understand that she needs to lower her levels
of LDL while increasing her levels of HDL.
16.
A nurse is preparing to draw a blood specimen from an adult client's central
line. All of the following actions for this procedure are correct EXCEPT:
a. Disconnect the current infusion
b. Clean the cap with alcohol and attach a 5 cc syringe
c. Draw 5 cc of a blood sample to discard
d. Flush with saline after the sample
ANSWER B: When drawing a blood specimen from a central line, the
nurse should disconnect any infusions that are currently running and that
could contaminate the specimen. The nurse should always use a minimum
size of a 10 cc syringe when using a central line to avoid placing too much
pressure on the catheter.
17.
Which of the following situations might warrant a laboratory magnesium
level?
a. Hyperthyroidism
b. Arthritis
c. Ulcerative colitis
d. Depression
ANSWER C: Ulcerative colitis causes abdominal pain, fever, diarrhea, and
weight loss for those clients suffering from this condition. The condition
may affect how the body absorbs certain nutrients, such as magnesium.
Clients admitted with chronic gastrointestinal conditions should be checked
for electrolyte imbalances related to improper digestion.
18.
Mr. G has been admitted to the hospital with a head injury after a 12-foot
fall. Which of the following nursing interventions is most appropriate when
monitoring intracranial pressure?
a. Administer hypotonic solutions
b. Keep the head of the bed flat
c. Increase the client's core body temperature to 99.9 degrees
d. Administer corticosteroids as ordered
ANSWER D: Corticosteroids may be used in clients at risk of increased
intracranial pressure to reduce swelling of brain tissues. Corticosteroids
may be used for a client suffering from a traumatic brain injury. Monitoring
intracranial pressure also involves elevating the head of the bed,
administering hypertonic solutions, and preventing fever in the client.
19.
A nurse is assessing a client's pulse oximetry on the surgical unit. As part of
routine interventions, the nurse turns off the exam light over the client's
bed. Which of the following best describes the rationale for this
intervention?
a. External light sources may cause falsely high oximetry values
b. A bright light in the client's face may cause a low pulse oximetry
c. External light sources may cause falsely low oximetry values
d. The client needs a dark and quiet room to recover and maintain proper
oxygenation
ANSWER A: When assessing a client's pulse oximetry values, the nurse
should turn off any extra environmental lights that are unnecessary,
including exam lights or over-bed lights. External light sources may cause
falsely high oximetry values when the extra light binds to the sensor of the
oximeter.
20.
A nurse is educating a client who is preparing to give a stool sample for
occult blood. All of the following information is part of teaching for this
client EXCEPT:
a. Avoid eating red meat for 3 days before the test
b. Collect the stool from the toilet after having a bowel movement
c. The stool does not need to be kept in a container with preservative
d. A small part of the stool from two areas will be tested using a smear
ANSWER B: When checking a stool sample for occult blood, the nurse
may need to provide some teaching for the client, particularly if the client
collects the stool himself. Part of education in this situation involves
teaching the client to avoid red meat, as the blood in the meat may interfere
with the test. The client should not collect the stool from the toilet as this
may disturb the test results.
21.
A nurse is caring for a 3-day old infant who needs an exchange transfusion.
Which of the following statements is appropriate for teaching the child's
parents about this procedure?
a. The registered nurse will be performing the procedure.
b. The procedure takes approximately 1 ½ hours.
c. The nurse will draw out 250cc of blood and then immediately replace it
with 250cc.
d. The infant will continue to receive phototherapy during the procedure.
ANSWER B: An exchange transfusion is a method of controlling high
bilirubin levels in infants when traditional phototherapy is unsuccessful.
During an exchange transfusion, the physician removes 5-10 cc of blood
and then replaces it with donor blood. The parents of this infant should
know that the procedure is always performed by a physician and will take
approximately 1 ½ hours to complete.
22.
Which of the following interventions is necessary before insertion of an
arterial line into the radial artery?
a. Ensure that the client does not need surgery
b. Assess the client's grip strength
c. Perform an Allen test
d. Check a serum potassium level
ANSWER C: Before a physician inserts an arterial line using the radial
artery, the nurse should perform an Allen test to assess the client's
circulation. To perform the Allen test, the nurse compresses both the radial
and ulnar arteries that provide circulation to the hand. She then maintains
occlusion on the radial artery while releasing the ulnar artery and checks the
blood flow to the hand. This test ensures that if the radial artery is
cannulated with an arterial line, the ulnar artery can still provide adequate
blood flow.
23.
A client with asthma is being admitted for breathing difficulties. His arterial
blood gas results are pH 7.26, PCO2 49, PaO2 90, and HCO3- 21. Which of
the following best describes this condition?
a. Uncompensated respiratory acidosis
b. Compensated respiratory alkalosis
c. Uncompensated metabolic acidosis
d. Compensated metabolic alkalosis
ANSWER A: Acidosis can occur in a client who is having breathing
difficulties when the body retains excess CO2. The normal range of pCO2
from an arterial source is between 35 and 45 mmHg. This client has an
elevated level of pCO2 at 49 mmHg. Additionally, the pH should have a
level between 7.35 and 7.45. This level of 7.26 indicates acidosis that is
uncompensated because the body can no longer maintain an adequate level
of pH to manage the elevated levels of pCO2.
24.
Mrs. M has had diabetes for seven years. She has worked hard to control
her blood glucose levels and watch her dietary intake. Her physician orders
a hemoglobin A1C test. Which of the following best describes the action of
this test?
a. The test determines if the client is anemic and needs iron supplements
b. The test determines if there is excess glucose building up in the urine
c. The test determines the amount of hemoglobin reaching the liver to
support gluconeogenesis
d. The test determines the amount of hemoglobin that is coated with glucose
ANSWER D: A hemoglobin A1C test, also known as a glycated
hemoglobin test, determines the amount of hemoglobin that is coated with
glucose. Excess glucose in the bloodstream may cause it to attach to
hemoglobin on red blood cells. Because the life of these cells is between 2
and 3 months, the hemoglobin A1C is an accurate measurement of a client's
glucose during that time.
25.
Mrs. O is seen for follow-up after an episode of acute pancreatitis. Her
physician orders a serum amylase level and the result is 200 U/L. Which of
the following is a potential cause of this result?
a. The client is pregnant
b. The client has hypertension
c. The client is in renal failure
d. The client has pancreatitis
ANSWER D: An elevated serum amylase level following pancreatitis may
mean the client is experiencing another attack of the condition. Serum
amylase may be ordered as part of routine follow-up after pancreatitis.
Elevated levels may also mean other, related gastrointestinal conditions,
such as cholecystitis or an intestinal blockage, so further testing should be
performed on this client.
26.
Which of the following conditions increases a client's risk of aspiration of
stomach contents?
a. A client has a scaphoid abdomen
b. A client is in restraints
c. A client is lying prone
d. More than one answer is correct
ANSWER B: Some clients may be at higher risk of aspiration of gastric
stomach contents into the airways, placing them at risk of pneumonia. A
client who is in restraints may be unable to use his hands to help himself
turn or move if he begins to vomit. Other situations that increase risk of
aspiration include a client with a full and rounded abdomen and a client that
is lying flat and supine.
27.
A nurse is monitoring a client for decreased tissue perfusion and increased
risk of skin breakdown. Which measure best improves tissue perfusion in
this client?
a. Massaging the reddened areas
b. Performing range of motion exercises
c. Administering antithrombolytics as ordered
d. Feeding the client a high-carbohydrate diet
ANSWER B: A client at risk of impaired skin integrity should increase
mobility as much as possible to increase tissue perfusion. For a client who
is mobile, frequent ambulation may help improve circulation. For a client
who is unable to get out of bed, frequent turning or range of motion
exercises will increase tissue perfusion and decrease the risk of skin
breakdown.
28.
Which of the following situations warrants a measurement for orthostatic
hypotension?
a. A 36-year old male with a spinal injury
b. An 86-year old female with significantly altered mental status
c. A 58-year old female with near-syncope
d. A 41-year old male with acute deep vein thrombosis
ANSWER C: Orthostatic hypotension occurs when a client's blood
pressure drops greater than 20 mmHg systolic when rising from a sitting or
lying position to standing. Clients at greatest risk of orthostatic hypotension
are those with syncope or near-syncope, clients with symptomatic
hypovolemia, and clients who are considered to be at risk for falls.
29.
A nurse is assisting a pregnant client who is having an amniocentesis.
Which of the following statements by the nurse indicates the correct
teaching for this procedure?
a. I'm going to help you lie flat on your back for this."
b. Don't worry, I'm sure everything will be all right."
c. I will need to help you remove your shirt for this procedure."
d. Now that the procedure is finished, I will put a small bandage over the
puncture site."
ANSWER D: An amniocentesis is performed to draw amniotic fluid from
the sac around the fetus during pregnancy. It may be analyzed for certain
disorders or complications associated with pregnancy. Following the
procedure, the nurse should wash the client's abdomen and place a small
bandage over the puncture site.
30.
A nurse is caring for a client in who is in labor. The nurse has attached an
electronic fetal monitor to the client's abdomen and is assessing the baby's
heart rate. She notes that the baby's heart rate seems to slow down during
each contraction. The heart rate does not return to normal limits until after
the contraction is complete. Which type of fetal heart rate change does this
pattern describe?
a. Variable decelerations
b. Late decelerations
c. Early decelerations
d. Accelerations
ANSWER B: Late decelerations occur when a baby's heart rate declines in
utero during each contraction. The heart rate drops below baseline and
remains there until after the contraction is complete. Late decelerations are
a non-reassuring sign and should be reported to a physician.
31.
Which of the following reasons indicates a need for a non-stress test in a
pregnant client?
a. The client is overdue
b. The baby has not been moving
c. The mother is carrying twins
d. All answers are correct
ANSWER D: A non-stress test is performed to assess the baby's heart rate
and activity during pregnancy without adding any stress to the fetus. A nonstress test may be performed on a woman who has not felt movement from
her baby recently, a woman who is overdue, or a woman who is considered
to have a higher-risk pregnancy, such as someone carrying twins.
32.
A nurse is caring for a client who has a sodium level of 126 mEq/L. Which
of the following symptoms should the nurse expect to see with this client?
a. Nystagmus
b. Orthostatic hypotension
c. Hallucinations
d. Dry skin
ANSWER C: A client with a sodium level of 126 mEq/L has significant
hyponatremia. The nurse would expect to see mental status changes in this
client that could include confusion, hallucinations, or coma. Hyponatremia
may also manifest as headache, irritability, muscle weakness, or seizures.
33.
A 58-year old client is being tested for rheumatoid arthritis. Her physician
orders an erythrocyte sedimentation rate (ESR). Which of the following
results is most likely to be associated with arthritis?
a. 5 mm/hr
b. 12 mm/hr
c. 28 mm/hr
d. 40 mm/hr
ANSWER D: The erythrocyte sedimentation rate (ESR) measures levels of
inflammation in the body. The results of the ESR may be higher than
normal in clients suffering from some autoimmune conditions, such as
rheumatoid arthritis. A normal ESR for a woman above 50 is <30 mm/hr;
therefore, a client of this age with rheumatoid arthritis may have a higher
level, such as 40 mm/hr.
34.
A nurse is caring for an 83-year old man who has had swallowing
difficulties. All of the following interventions are appropriate for this client
EXCEPT:
a. Keep the client in an upright position at all times
b. Auscultate lung sounds every shift and after feedings
c. Maintain suction equipment at the client's bedside
d. Instruct the client about how to perform swallowing exercises
ANSWER A: A client who has difficulty swallowing is at risk of aspiration
of food into the lungs. Nursing interventions in this situation include
auscultating lung sounds each shift and after meals to assess for changes in
breathing patterns, helping the client with swallowing exercises through
occupational therapy, and maintaining suctioning equipment at the bedside
in case of difficulties.
35.
Which of the following statements best describes compartment syndrome?
a. An injury causes pain and tingling that starts in the buttock and travels
down the leg
b. An injury causes swelling within muscle tissue that leads to anoxia of
nerves and muscles
c. An injury causes permanent flexion of the interphalangeal joint, resulting
in deformity
d. An injury causes pain and swelling of the median plantar nerve
ANSWER B: Swelling and pressure that increases within the muscle
compartment is known as compartment syndrome. The condition may be
related to an injury, such as application of a cast after a fracture. If left
untreated, compartment syndrome can lead to decreased oxygen to the
nerves and muscles of the affected area, causing necrosis.
36.
A nurse is preparing to insert an indwelling catheter in a female client.
Which of the following positions of the client is most appropriate for this
procedure?
a. Lithotomy position
b. Prone position
c. Dorsal recumbent position
d. High Fowler's position
ANSWER C: When preparing to insert an indwelling catheter for a female
client, the nurse may have success placing the client in the dorsal recumbent
position. In this position, the client lies supine with the knees bent. The
nurse may ask the client to rotate the legs outward, relaxing the thighs. A
client who cannot lie supine may also be comfortable in the Sims' position.
37.
Mrs. G is seen for follow-up after testing for chronically high blood glucose
levels. Her physician diagnoses her with type 1 diabetes. Which of the
following information is part of this client's education about this condition?
a. Type 1 diabetes occurs from increased carbohydrate intake and decreased
exercise
b. Type 1 diabetes is treated through diet and exercise
c. Type 1 diabetes occurs from destruction of beta cells in the pancreas
d. Type 1 diabetes results in the cells rejecting the body's insulin
ANSWER C: Type 1 diabetes occurs when the beta cells in the pancreas
are unable to produce enough insulin. Insulin is necessary to control
glucose in the bloodstream and to help the body's cells utilize glucose for
energy. Part of education about diabetes is differentiating the causes of each
type so the client can be prepared for treatment.
38.
A client is preparing to undergo a cystoscopy for stones. Which of the
following statements indicates that the client understands the procedure?
a. I better drink a lot of fluid now because I won't be able to after the test."
b. I will probably see a little blood when I urinate."
c. I will be able to go home after 3 days in the hospital."
d. I won't need any pain medicine; this probably will not hurt."
ANSWER B: A cystoscopy is a procedure that involves inserting a scope
into a client's bladder to inspect the structures or to remove objects such as
stones. A cystoscopy is typically done under local or general anesthesia and
the client may experience a small amount of hematuria or pink-colored
urine following the procedure.
39.
Which of the following conditions may warrant a serum creatinine level?
a. Rhabdomyolysis
b. Digitalis toxicity
c. Glomerulonephritis
d. All answers are correct
ANSWER D: Creatinine is a by-product of the breakdown of creatine,
which is created by the muscles. The kidneys excrete creatinine. This test
may be performed for a client who has had an injury to the muscles that
may produce a significant amount of creatinine or a client who has a
condition that can impair renal function.
40.
Which nursing intervention is most appropriate to maintain the patency of a
client's nasogastric tube?
a. Maintain constant connection to low-intermittent suction
b. Irrigate the tube as per physician order
c. Suction the mouth and nose every shift
d. Perform a daily fecal occult blood sample
ANSWER B: A client with a nasogastric tube may be at increased risk of
the tube kinking or clotting off, rendering it unusable and putting the client
at risk of abdominal distention or vomiting. The nurse can assess for tube
patency by irrigating the tube with water or fluid as ordered by the
physician on a routine basis or by facility policy.
41.
A nurse is caring for a client who is having blood tests and who has an
elevated lymphocyte level. Based on knowledge of cellular components, the
nurse knows that these cells:
a. Contain histamine and provide protection during allergic reactions
b. Are involved in phagocytosis
c. Provide protection and immunity against foreign substances
d. Carry hemoglobin and oxygen to body tissues
ANSWER C: Lymphocytes are types of white blood cells that work to
support the body's immune system. These cells produce substances that
protect the body against infection and foreign substances that can make a
client ill. Two types of lymphocytes are T cells, produced in the thymus,
and B cells, produced in the lymph tissue.
42.
Mrs. F has been diagnosed with hyperparathyroidism. Which of the
following complications is Mrs. F at highest risk of developing?
a. Hyponatremia
b. Hypocalcemia
c. Hypermagnesemia
d. Hypercalcemia
ANSWER D: The parathyroid glands are responsible for regulating
calcium, vitamin D, and phosphorus in the body. A person diagnosed with
hyperparathyroidism produces too much parathyroid hormone, which
causes the body to remove excess calcium from the bones to be moved to
the bloodstream. This results in elevated levels of blood calcium, or
hypercalcemia.
43.
Mr. Y had surgery two days ago and is recovering on the surgical unit of the
hospital. Just before lunch, he develops chest pain and difficulties with
breathing. His respiratory rate is 32/minute, his temperature is 100.8, and he
has rales on auscultation. Which of the following nursing interventions is
most appropriate in this situation?
a. Place the client in the Trendelenburg position
b. Contact the physician for an order or antibiotics
c. Administer oxygen therapy
d. Decrease his IV rate
ANSWER C: Chest pain, dyspnea, tachypnea, mild fever, and rales or
crackles on auscultation in a client who had surgery 2 days ago may be
indicative of a pulmonary embolism. The nurse should administer oxygen
to address his breathing and assist him to a comfortable position to facilitate
better oxygenation before contacting the physician.
44.
A client has entered disseminated intravascular coagulation (DIC) after
becoming extremely ill after surgery. Which of the following laboratory
findings would the nurse expect to see with this client?
a. Elevated fibrinogen level
b. Prolonged PT
c. Elevated platelet count
d. Depressed d-dimer level
ANSWER B: A client who has entered DIC may have a prolonged
prothrombin time (PT). The PT is a measure of how quickly blood can clot.
A prolonged PT indicates that blood is clotting slowly, contributing to
increased bleeding associated with DIC.
45.
A client returns from surgery after having a colon resection. The nurse is
performing his assessment and notes the wound edges have separated. This
condition is called:
a. Evisceration
b. Hematoma
c. Dehiscence
d. Granulation
ANSWER C: Wound dehiscence occurs when the edges of a wound pull
apart. The condition may occur following a surgical procedure if the sutures
were deficient. Wound dehiscence may also occur following a wound
infection or in cases where a client significantly stretches or overuses the
associated tissues.
46.
The OR nursing staff are preparing a client for a surgical procedure. The
anesthesiologist has given the client medications and the client has entered
the induction stage of anesthesia. The nursing staff can expect which of the
following symptoms and activities from the client during this time?
a. Irregular breathing patterns
b. Minimal heartbeat, dilated pupils
c. Relaxed muscles, regular breathing, constricted pupils
d. Euphoria, drowsiness, dizziness
ANSWER D: During the induction stage of anesthesia, the client may
appear euphoric, drowsy, or dizzy. The anesthesiologist is just beginning to
administer medications during this stage. The induction stage ends when the
client loses consciousness.
47.
A physician has administered ketamine to a client who is preparing to
undergo general anesthesia. Which of the following side effects should the
nurse monitor for in this client?
a. Delirium
b. Muscle rigidity
c. Hypotension
d. Pinpoint rash
ANSWER A: Ketamine is a type of anesthetic that produces dissociation
and lack of awareness for a client. It may be used prior to general anesthesia
or as part of sedation for a short procedure. Ketamine may cause side
effects of delirium, hallucinations, hypertension, and respiratory depression.
48.
A nurse is caring for a client who must use a non-rebreathing oxygen mask.
Which of the following statements is true regarding this type of mask?
a. A non-rebreather can provide an FiO2 of 40%.
b. A client should breathe through his mouth when using a non-rebreather.
c. A non-rebreather offers a reservoir from which the client inhales.
d. The mask of a non-rebreather should be changed every 3 hours.
ANSWER C: A non-rebreather mask is used for supplemental oxygen
delivery for clients who are having breathing difficulties. The nonrebreather is constructed with a one-way valve on the mask that allows
exhaled air to escape. The client inhales oxygenated air from a reservoir bag
attached to the mask. A non-rebreather mask can provide up to 90% FiO2.
49.
A client is admitted to a nursing unit with a remittent fever. Which
statement best describes this pattern of fever?
a. A persistent fever that has lasted over 24 hours
b. A fever that lasts 2 days followed by normal temperature for 2 days,
followed by fever again
c. A fever that lasts 2 days followed by normal temperature for 12 hours,
followed by fever again
d. A fever that spikes and then lowers without returning to normal
ANSWER D: A remittent fever occurs when a client has a high
temperature that rises and falls. The temperature may be very high or may
fall to a low-grade fever, but remittent fever does not return to normal
temperature during fluctuations.
50.
Which of the following components is associated with hypertonic
dehydration?
a. Plasma sodium levels between 130 and 150 mEq/L
b. Fluid moves from extracellular space to intracellular space
c. Water loss is greater than electrolyte loss
d. Physical signs and symptoms are grossly apparent
ANSWER C: A person with hypertonic dehydration will lose more water
than electrolytes, resulting in high concentrations of electrolytes in the
body. Hypertonic dehydration involves plasma sodium levels above 150
mEq/L as fluid in the body moves from the extracellular space to the
intracellular space.
51.
Hepatitis C virus (HCV) can be spread through hugging, sneezing,
coughing, sharing eating utensils and other forms of casual contact.
a. True
b. False
ANSWER B: False. HCV is spread by direct contact with human blood
through blood transfusions, improperly sterilized needles and syringes,
needle sharing, or occasionally through sexual contact.
52.
The primary route of transmission of MRSA is via:
a. Shared needles
b. Hands of healthcare workers
c. Items in the healthcare environment
d. Blood transfusions
ANSWER B: It is well documented that the primary route of transmission
of MRSA is via unwashed hands of healthcare workers who carry the Staph
aureus organism from one patient to another.
53.
The key to the prevention of a pandemic influenza is:
a. Early detection.
b. Early antibiotic treatment.
c. Vaccination of at risk populations.
d. Isolation of suspected cases.
ANSWER A: Early detection of influenza is the key to prevention of a
pandemic. The most important warning signal is when clusters of patients
with clinical symptoms of influenza are detected.
54.
Your patient has been diagnosed with herpes simplex virus 2. Which of the
following would NOT be included in your teaching of this patient?
a. If you have symptoms, you should avoid sexual contact with other
individuals.
b. With treatment, this condition can be cured.
c. This disease is highly contagious.
d. You may experience tingling in the skin before an active outbreak occurs.
ANSWER B: Treatment for the herpes simplex virus (HSV) is
symptomatic and palliative rather than curative. This disease is extremely
contagious and sexual contact should be avoided during active breakouts.
Many patients do experience a tingling prodrome prior to an active outbreak
of the disease.
55.
Sinusitis is caused by a:
a. Bacteria
b. Fungus
c. Virus
d. Any of the above
ANSWER D: Although typically caused by a bacterial infection that results
from an upper respiratory tract infection, chronic sinusitis can also be
caused by a virus or fungus.
56.
Your patient has been diagnosed with a left ankle sprain. On the discharge
instructions, the physician has prescribed the RICE protocol. This acronym
stands for:
a. Rest, Ice, Compression, Elevation
b. Radiology, Ice, Compression, Elevation
c. Rest, Ice, Cast, Elevation
d. Radiology, Ice, Cast, Elevation
ANSWER A: Appropriate treatment for an ankle sprain is Rest, Ice (20
minutes on each hour while awake), Compression (usually with an elastic
bandage), and Elevation of the foot above the level of the heart.
57.
Which risk factor places patients and residents at the greatest risk for falls?
a. Old age
b. Middle years
c. Pneumonia
d. COPD
ANSWER A: The elderly are at great risk for falls. Those in middle years
are less at risk than the elderly population. COPD and pneumonia are not
risk factors associated with falls.
58.
You are taking care of Mary Eden. She is an elderly and frail 91 year old
resident. She gets confused during evening hours and at times she thinks
that she hears her daughter calling her from the other side of the nursing
home. Which physical problem places Mary Eden at risk for falls?
a. Her confusion
b. Her daughter
c. Evening hours
d. Her frailness
ANSWER D: Mary Eden has frail and weak muscles. This places her at
risk for falls. Her confusion places her at risk as well; however, this is an
emotional or thinking problem, not a physical problem.
59.
What kind of preventive measures is MOST likely to be used to prevent
Mary Eden from falling because of her muscular frailness?
a. Physical therapy for muscle strengthening exercises
b. Physical therapy for range of motion exercises
c. Occupational therapy to help her with confusion
d. Medications in order to have her sleep more
ANSWER A: Mary Eden will most likely benefit from physical therapy
muscle strengthening exercises because of her muscular frailness. Range of
motion may also be used, but muscle strengthening exercises will be the
most beneficial. Occupational therapists do not treat confusion and sleeping
medications add to falls risk, they do not prevent falls.
60.
Tommy R., your 68 year old patient, is at risk for falls. He has fallen 3 times
in the last month. You should keep Tommy's ______________ in order to
prevent him from falling again.
a. bed side rails up at all times
b. bed in the low position
c. call bell within reach
d. family members in the room at all time
ANSWER C: A nurse should keep all patient call bells within the patient's
reach so they can call for help and assistance when they need it. This
prevents falls. Although low beds are highly useful because they decrease
the extent of injury when a patient falls, they do not prevent falls. It is not
realistic to expect family members to remain in Tommy's room at all times.
Lastly, side rails do not prevent falls and, in fact, they increase the severity
of a fall when the patient climbs over them. Also, side rails to prevent falls
are considered a restraint and patients often get entrapped in side rails.
61.
You will be escorting a patient to the operating room on a stretcher. In order
to prevent this patient from falling, you must do which of the following?
a. make sure the locks are not locked as you move the patient onto the
stretcher from the bed
b. use a safety belt or strap on the patient throughout their escort to the
operating room
c. put the bed in low position as you move the patient onto the stretcher
from the bed
d. All answers are correct
ANSWER B: A nurse must place a safety belt or strap on the patient
throughout their escort to the operating room in order to prevent the patient
from falling. This type of safety belt is not treated as a restraint because it is
a routine part of care when using a stretcher. The bed must be in the high
position so it is level with the stretcher when you are moving the patient
from the bed to the stretcher. It is very important that you lock the wheels of
a stretcher and a wheelchair before you transfer a patient into or onto it.
Falls occur when a nurse fails to lock these pieces of equipment.
62.
Albert B. is incontinent of urine. He also wears glasses and hearing aids.
His ____________ lead(s) to his risk for falls.
a. incontinence and loss of vision
b. loss of vision
c. incontinence
d. loss of hearing
ANSWER A: Albert B. is at risk for falls because of two factors. His
incontinence and his loss of vision are two risk factors associated with falls.
This is the best choice for this question.
63.
All hospitals and nursing homes are mandated to have the goal of a restraint
free
environment.
The
best
way
to
achieve
this
goal
is
to________________.
a. ban the use of all restraints under all circumstances.
b. limit restraints to only those situations when falls cannot be prevented.
c. keep all bed side rails up for all patients during the nighttime hours.
d. use no skid socks and sheets to prevent falls from chairs.
ANSWER B: All hospitals and nursing homes are mandated by JCAHO
and state departments of health to have the goal of a restraint free
environment. This does not mean that no restraints can ever be used under
any circumstances. It means that all healthcare facilities must have this as a
goal. In order to move toward the goal of a restraint free environment,
restraints should be used only when all preventive measures have failed and
the patient is in danger of injury. When a restraint is necessary, the hospital
or nursing home must use the restraint that is least restrictive to the patient
but can also prevent injuries.
64.
Which of these devices is considered a protective device, rather than a
restraint?
a. A mitten on the hands to prevent scratching
b. A mitten on the hands so the person cannot pull their IV out
c. A side rail to prevent the patient from falling
d. A soft wrist restraint to prevent the patient from pulling their IV tubing
ANSWER A: Hand mittens to prevent scratching are considered a
protective device and not a restraint. However, when the same mittens are
used to prevent a person from pulling their IV out, it is considered a
restraint. The same is true for the side rail and the soft wrist restraint.
65.
Mr. Freeman has difficulty getting out of bed. The nurse should encourage
Mr. Freeman to ______________.
a. ask for assistance before getting out of the bed.
b. remain in bed because it is safer and he will not fall.
c. instruct him to stand up quickly from the bed.
d. lean forward and push up and off the bed.
ANSWER A: The nurse should encourage Mr. Freeman to use his call bell
and ask for assistance before getting out of bed. This can prevent him from
falling. Patients should not stay in bed; they should be encouraged to get
out of the bed as much as possible. Quick movement from a lying to a
standing position is not advised. It can make the patient dizzy and they may
fall. They also should not lean forward and push up; they should ask for
help.
66.
Restraints are sometimes used for what patient conditions or situations?
a. Punishment when the patient is uncontrollable
b. To prevent the patient from pulling their IV out
c. When a patient is a danger to self and others
d. Both b and c
ANSWER D: Restraints are sometimes used to prevent a patient from
pulling their IV, or another life saving tube, out and when the person is a
serious danger to themselves and/or others. Restraints are never used for
punishment.
67.
The chain of infection includes the ________________.
a. germ, agent, reservoir, exit portal, mode of transmission, entry port, and
susceptible host
b. active natural, active artificial, passive natural and passive artificial
c. opportunism, weakness, immunity, and colonization
d. intrinsic, extrinsic, internal and external transmission
ANSWER A: The chain, or cycle, of infection includes the germ, or
microorganism, the reservoir, the exit portal, the mode of transmission, the
entry port, and the susceptible host. The types of immunity, not the chain of
infection, include active natural immunity, active artificial immunity,
passive natural immunity and passive artificial immunity. It is important to
learn the cycle, or chain, of infection so you can stop the spread of infection
by breaking one or more of these chains. For example, you will break the
chain of infection when you stop the mode of transmission by washing your
hands.
68.
Asepsis is defined as ________________.
a. the absence of all microorganisms
b. the absence of disease causing germs
c. a urinary infection
d. a pathogenic infection
ANSWER B: Asepsis is defined as the absence of disease causing germs. It
is surgical asepsis that is defined as the absence of all microorganisms,
including spores. A pathogenic infection is an invasion of the body by a
pathogen, or disease or germ, and a urinary infection is only one type of
infection.
69.
Mary T. was admitted to a nursing home on May 1st. On July 4th, she was
diagnosed with a skin infection. This infection is considered a
________________ infection.
a. nosocomial
b. systemic
c. resident flora
d. resident aura
ANSWER A: This infection is considered a nosocomial infection. A
noscocomial infection is defined as one that is not present upon admission
to a healthcare admission, but instead, occurs during the time that the
patient or resident is in the hospital or nursing home. Nosocomial infections
are a major problem within our hospitals, nursing homes and other
healthcare facilities. Infection control procedures aim to prevent and stop
the spread of nosocomial infections.
70.
A local sign of infection is which of the following?
a. Swelling.
b. Rapid pulse.
c. Fever.
d. High white blood count.
ANSWER A: The signs and symptoms of infection can be local and
systemic, or body wide and more diffuse. Some of the local signs of
infection include swelling, heat, pain, and redness near the area.
71.
A systemic sign of infection is ______________.
a. swelling
b. redness
c. heat
d. a lack of appetite
ANSWER D: The signs and symptoms of infection can be local and
systemic, or body wide and more diffuse. Some of the systemic signs of
infection include a loss of appetite, rapid pulse, fever and a high white
blood count.
72.
Mobility is an important human function. The hazards of immobility lead to
many physical problems and emotional problems. Immobility can lead to
detrimental cardiac, muscular, respiratory, skeletal, urinary, gastrointestinal,
skin and emotional changes. Which of the following is an example of a
skeletal hazard of immobility?
a. Contractures.
b. Constipation.
c. Calcium loss.
d. Catabolism.
ANSWER C: All answers are correct choices are hazards of immobility.
However, only the calcium loss from the bones is a skeletal system
impairment that results from immobility.
73.
Which is a physical, integumentary risk among the elderly population?
a. Skin tears
b. Thickened skin
c. Thinning toe nails
d. Less nasal hair
ANSWER A: Skin tears are a physical, integumentary (skin) risk among
the elderly population. The skin thins and becomes more fragile. Toe nails
thicken and nasal hair becomes thicker.
74.
Elderly patients are more prone to dehydration than younger people because
the elderly ___________.
a. drink more coffee and tea
b. have more stomach mucus production
c. have more saliva
d. have less sense of thirst
ANSWER D: Elderly patients are prone to dehydration because the elderly
have a lower and diminished sense of thirst. They do not get "thirsty" in the
same way as younger people do. The elderly also have less stomach mucus
production and less saliva but these changes do not impact on thirst or
dehydration.
75.
You are turning your patient in bed and you see that this confused and
lethargic patient had loose car keys and lipstick in the bed and had been
lying on them. What is this person at risk for because of all three of these
factors: the confusion, lethargy and items in the bed?
a. Falls
b. Skin breakdown
c. Apnea
d. Lack of mobility
ANSWER B: This patient is at great risk for skin breakdown because this
patient has three risk factors associated with skin breakdown. These three
risk factors are confusion, lethargy and the presence of items in the bed.
This patient is at risk for falls because of the confusion. The person is at
risk for a lack of mobility because of the confusion and lethargy, but only
skin breakdown is associated with all three of these risk factors.
76.
Select the age group that is coupled with an infectious disease that is most
common in this age group.
a. Infants: High billirubin
b. Pre-School and School Age Children: Shingles
c. Young Adults and Teenagers: Sexually transmitted diseases
d. The Elderly: Malaria
ANSWER C: Young adults and teenagers are at greatest risk for sexually
transmitted diseases. High billirubin is a laboratory finding and not an
infectious disease. Pre-school and school age children are not at great risk
for shingles, the elderly are. Lastly, old age is not associated with malaria. It
is associated with shingles.
77.
A complication of osteoporosis is _______________.
a. rheumatoid arthritis
b. gouty arthritis
c. dorsal flexion
d. joint deformity
ANSWER D: Joint deformity is a complication of osteoporosis. Gout and
rheumatoid arthritis are other types of arthritis. Dorsal flexion is not a
complication of osteoporosis. It is part of the range of motion for the foot.
78.
One of the complications of complete bed rest and immobility is which of
the following?
a. Plantar flexion.
b. Dorsal flexion
c. Extension contractures
d. Adduction contractures
ANSWER A: Plantar flexion, or foot drop, is a complication of complete
bed rest and immobility. Dorsal flexion is when you move your foot
upwards. Contractures can also occur as a complication of complete bed
rest and immobility. However, these contractions are flexion, not extension
or adduction contractures.
79.
Plantar flexion can be prevented with ________________.
a. foot soaks
b. foot boards
c. toe nail care
d. proper shoes
ANSWER B: Plantar flexion, or foot drop, can be prevented with foot
boards, special splints and range of motion exercises.
80.
Alzheimer's disease patients wander. The dangers associated with this
wandering can be prevented with which of the following?
a. Bed alarms
b. Chair alarms
c. Door alarms
d. All answers are correct
ANSWER D: Bed alarms, chair alarms and door alarms that ring when a
wandering person tries to leave the building help to keep patients safe.
Listen for and respond to alarms immediately.
81.
The smallest of the white blood cells which also can be involved in humoral
immunity is the:
a. Lymphocyte
b. Monocyte
c. Basophil
d. Erythrocyte
ANSWER A: The smallest of the white blood cells is the lymphocyte.
Monocytes are the largest white blood cells.
CARING FOR ACUTE OR CHRONIC CONDITIONS
(STUDY MODE)
1.
Mrs. J is in the adult ICU on a ventilator. The nurse caring for her
recognizes that her endotracheal tube needs suctioning. Based on the nurse's
understanding of this procedure, what level of pressure should the nurse
apply while suctioning?
a. 70-80 mmHg
b. 100-120 mmHg
c. 150-170 mmHg
d. 200 mmHg
ANSWER B: When suctioning the endotracheal tube of an adult client, the
nurse should set the suction apparatus at a level no higher than 150 mmHg,
with a preferable level between 100 and 120 mmHg. Suction pressure that
is too high can contribute to the client's hypoxia. Alternatively, too low of
suction pressure may not clear adequate amounts of secretions.
2.
The nurse caring for Mrs. J is prepared to suction her endotracheal tube.
Which of the following interventions will reduce hypoxia during this
procedure?
a. Hyperoxygenate Mrs. J for up to 60 seconds prior to starting
b. Administer 15 cc of sterile fluid into the tube prior to suctioning
c. Suction for no longer than 30 seconds at a time
d. Wait 30 seconds after suctioning before attempting again
ANSWER A: Before suctioning a client's endotracheal tube, the nurse
should provide extra oxygen for approximately 30 to 60 seconds.
Hyperoxygenating a client before suctioning increases oxygen delivery to
the tissues and reduces hypoxia that may develop during the procedure.
3.
Which of the following conditions is a contraindication for performing a
diagnostic peritoneal lavage?
a. A client who is 9 weeks' pregnant
b. A client with a femur fracture
c. A morbidly obese client
d. A client with hypertension
ANSWER C: Diagnostic peritoneal lavage is contraindicated in clients
who are morbidly obese because excess body fat makes finding essential
landmarks for this procedure difficult. Additionally, the equipment used for
the procedure may not be large enough to accommodate an obese person.
Finally, morbid obesity puts excess strain on the cardiovascular and
respiratory systems, such that anesthetic agents used during the procedure
could cause further complications.
4.
A nurse finds one of her clients unresponsive in his room. He is not
breathing and does not have a pulse. After calling for help, what is the next
action of the nurse?
a. Administer 2 ventilations
b. Perform a head-tilt, chin lift to open the airway
c. Begin chest compressions
d. Perform a jaw thrust to open the airway
ANSWER C: After finding a client unresponsive who is not breathing and
who does not have a pulse, the nurse should call for help and immediately
begin chest compressions. Chest compressions should be at a rate of at least
100 per minute, at a depth of at least 2 inches.
5.
A nurse is caring for a client with severe mitral regurgitation and decreased
cardiac output. The nurse assesses the client for mental status changes.
What is the rationale for this intervention?
a. Decreased cardiac output can cause hypoxia to the brain
b. Mental status changes may be a side effect of the client's medication
c. Mitral regurgitation is a complication associated with some neurological
disorders
d. The client may be confused about his diagnosis
ANSWER A: When assessing a client who has decreased cardiac output
due to ineffective cardiac activity, the nurse should assess for mental
changes. Diminished cardiac output could cause hypoxia of vital organs,
including the brain, which can lead to mental confusion, restlessness, or
lethargy.
6.
A client is undergoing radiation therapy for treatment of thyroid cancer.
Following the radiation, the client develops xerostomia. Which of the
following best describes this condition?
a. Cracks in the corners of the mouth
b. Peeling skin from the tongue and gums
c. Increased dental caries
d. Dry mouth
ANSWER D: Xerostomia is another name for dry mouth, a condition that
may occur among clients who are undergoing radiation therapy, particularly
in the head and neck regions. Xerostomia may occur if the salivary glands
are damaged during therapy, decreasing the client's abilities to wet his
mouth.
7.
A nurse is providing information for a woman who is 36 weeks' pregnant
and who has hepatitis B. Which of the following statements from the client
indicates understanding of this condition?
a. Now I know I will need a cesarean section."
b. My baby will need two shots soon after his birth."
c. I will not be able to breastfeed."
d. My baby's father does not need testing; I know I am the one with
hepatitis."
ANSWER B: A baby born to a mother with hepatitis B should ideally
receive two injections following birth to diminish his chances of contracting
the disease. Within the first 12 hours following birth, a baby born to a
hepatitis B-positive mother should receive the first in the series of hepatitis
B vaccines. The baby should also receive an injection of hepatitis B
immune globulin (HBIG) to provide further protection against the virus.
8.
A nurse is caring for a 2-day old infant who has a bilirubin level of 19
mg/dl. The physician has ordered phototherapy. Which of the following
actions indicates correct preparation of the infant for this procedure?
a. Undress the baby down to a diaper and hat
b. Place the baby in his mother's arms before turning on the light
c. Position the phototherapy light approximately 3 inches above the baby's
skin
d. Secure eye protection for the infant without occluding the nose
ANSWER D: Phototherapy is used to treat high levels of bilirubin among
infants, typically evidenced as jaundice. The nurse must position the infant
carefully during this procedure in order to maximize the benefits of the light
therapy while protecting the baby at the same time. The nurse should place
protective eyewear over the baby's eyes without occluding the nose, in
order to protect the eyes from the ultraviolet light.
9.
A nurse is preparing to change a client's dressing for a burn wound on his
foot. Which of the following interventions is appropriate for this process?
a. Wash the wound with cleanser, rinse, and pat dry
b. Bind the wound tightly, secure with tape, and elevate the foot
c. Contact the physician after the dressing change is complete
d. Provide analgesics for the client after the procedure
ANSWER A: The nurse must carefully assess and care for a burn wound
during dressing changes to avoid infection, minimize pain, and promote
healing to the site. Once the nurse has removed the old dressing from the
burn wound in this situation, she should wash it gently with an approved
cleanser, rinse the area, and pat dry.
10.
A nurse is caring for a client who seeks treatment for a sore throat, swollen
lymph nodes in the neck, fever, chills, and extreme fatigue. Based on these
symptoms, which of the following illnesses could the nurse consider for this
client?
a. Methicillin-resistant staphylococcus aureus (MRSA)
b. Hepatitis B
c. Infectious mononucleosis
d. Norovirus infection
ANSWER C: Infectious mononucleosis is a contagious viral disease
caused by the Epstein-Barr virus. Infectious mononucleosis causes
symptoms of sore throat, fever, chills, swollen lymph nodes, and
exhaustion. Diagnosis is based on the client's history and blood tests for the
Epstein-Barr virus.
11.
A client in end-stage renal disease is receiving peritoneal dialysis at home.
The nurse must educate the client about potential complications associated
with this procedure. All of the following are complications associated with
peritoneal dialysis EXCEPT:
a. Hypotriglyceridemia
b. Abdominal hernia
c. Anorexia
d. Peritonitis
ANSWER A: The client undergoing peritoneal dialysis is at risk of
developing abdominal complications due to the placement of the catheter.
Peritonitis occurs as an infection and inflammation of the peritoneal cavity
and the nurse should educate the client regarding signs and symptoms of
this condition. The client may also develop an abdominal hernia, anorexia,
low back pain, or abdominal bleeding.
12.
A nurse is assisting Mr. L, a client who has a new colostomy after a bowel
resection. The nurse is teaching this client how to care for his colostomy
bag. Which of the following statements from Mr. L indicates the need for
more education?
a. I can clean the skin around the ostomy site with soap and water when I
change the bag."
b. I should irrigate the stoma regularly to avoid buildup of gas and odor."
c. I need to wait ½ hour after I irrigate to replace the colostomy bag."
d. I should change the bag when it is one-third to one-fourth full."
ANSWER C: A client with a colostomy needs education about care of the
stoma, care and changing of the bag, and irrigation of the colostomy site.
The nurse should teach the client the basics of these actions as well as
measures to prevent infection or other complications. The client may
irrigate the ostomy and reapply the bag as soon as the skin is dry.
13.
Which of the following interventions must the nurse implement while a
client is having a grand mal seizure?
a. Open the jaw and place a bite block between the teeth
b. Try to place the client on his side
c. Restrain the client to prevent injury
d. Place pillows around the client
ANSWER B: A grand mal seizure may place the client at risk of injury due
to severe, involuntary muscle spasms and contractions. The nurse should
avoid restraining the client or inserting objects into his mouth, as these
actions may produce further injury. Instead, the nurse should try to position
the client on his side to facilitate drainage of oral secretions and to assist
with keeping the airway open.
14.
An 85-year old client is diagnosed with hypernatremia due to lack of fluid
intake and dehydration. The nurse knows that symptoms of hypernatremia
include:
a. Lack of thirst
b. Pale skin
c. Hypertension
d. Swollen tongue
ANSWER D: Hypernatremia among elderly clients may be caused by
dehydration and lack of fluid intake. Hypernatremia results in sodium levels
greater than 145 mEq/L. The most common symptoms of this condition are
mental status changes, a thick or swollen tongue, excessive thirst, and
flushed skin.
15.
Which of the following clients is most appropriate for receiving telemetry?
a. A client with syncope potentially related to cardiac dysrhythmia
b. A client with unstable angina
c. A client with sinus rhythm and PVCs
d. A client who had a myocardial infarction 6 hours ago
ANSWER A: Telemetry is used to monitor the cardiac rhythms of clients
with potentially unstable conditions or those rhythms that affect activities.
Telemetry is not indicated for acutely unstable clients, such as those who
have recently had heart attacks, or those with chest pain related to cardiac
activity.
16.
A client is brought into the emergency department after finishing a course
of antibiotics for a urinary tract infection. The client is experiencing
dyspnea, chest tightness and is agitated. Her blood pressure is 88/58, she
has generalized hives over the course of her body and her lips and tongue
are swollen. After the nurse calls for help, what is the next appropriate
action?
a. Start an IV and administer a 1-liter bolus of Lactated Ringer's solution
b. Administer 0.3 mg of 1:1000 epinephrine IM
c. Administer 15 mg diphenhydramine IM
d. Monitor the client until help arrives
ANSWER B: A client experiencing an anaphylactic reaction will most
likely present with rash or hives; swelling of the lips, face, or tongue;
hypotension, or dyspnea. A client who is experiencing breathing difficulties
should rapidly be given an intramuscular injection of 0.3 mg of 1:1000
epinephrine to relax the muscles of the airway and facilitate better breathing
and increased oxygenation.
17.
Mr. B is recovering from a surgical procedure that was performed four days
ago. The nurse’s assessment finds this client coughing up rust-colored
sputum; his respiratory rate is 28/minute with expiratory grunting, and his
lung sounds have coarse crackles on auscultation. Which of the following
conditions is the most likely cause of these symptoms?
a. Tuberculosis
b. Pulmonary edema
c. Pneumonia
d. Histoplasmosis
ANSWER C: A client who is experiencing dyspnea, productive cough, and
diminished or coarse breath sounds following surgery may have developed
pneumonia. This condition occurs as inflammation or infection of the lung
tissue with certain organisms, particularly when excess fluid develops and
is trapped in the tissues.
18.
Based on Mr. B's assessment, what is the first action of the nurse after
assessing his condition?
a. Immediately place the client in a negative-pressure room
b. Set the client up to receive a bronchoscopy
c. Contact the physician for antifungal medications
d. Administer oxygen and assist the client to sit in the semi-Fowler's
position
ANSWER D: The initial action of the nurse caring for a client with
suspected pneumonia is to administer oxygen and assist him to sit up in the
semi-Fowler's position. Supplemental oxygen will assist Mr. B with oxygen
perfusion to the tissues. Sitting up better facilitates breathing and removal
of secretions.
19.
A nurse is assessing a client who is post-op day #3 after an abdominal
hernia repair. After a bout of harsh coughing, the client states, "it feels like
something gave way." The nurse assesses his abdomen and notes an
evisceration from the surgical site. What is the next action of the nurse?
a. Turn the client on his side
b. Push the abdominal contents back inside the wound using sterile gloves
c. Ask the client to take a breath and hold it
d. Cover the intestine with sterile saline dressings
ANSWER D: A wound evisceration occurs when the edges of an
abdominal wound separate, allowing the coils of the intestine to protrude
outside of the body. The nurse should notify the physician at once if this
occurs. While waiting for treatment, the nurse should cover the intestines
with sterile gauze soaked in saline.
20.
A nurse is performing CPR on a client when a co-worker brings an
automated external defibrillator (AED). The nurse prepares to apply the
patches to the client's chest when she notes that he has a large amount of
thick chest hair. What is the next action of the nurse?
a. Apply the pads to the chest and provide a shock
b. Wipe the client's chest down with a towel before applying the pads
c. Shave the client's chest to remove the hair
d. Do not use the AED
ANSWER C: In most cases, AED pads will adhere to a client's chest, even
if he has chest hair. In cases of thick chest hair, however, the AED pads may
not conduct current properly. Many AED kits contain a razor, allowing the
nurse to shave the area of the chest to apply the pad. The nurse should act
quickly and limit time spent preparing the client.
21.
A nurse is educating a client who was recently diagnosed with
diverticulosis. What types of foods should the nurse recommend for this
client?
a. Whole grain cereal
b. Eggs
c. Cottage cheese
d. Fish
ANSWER A: A client with diverticulosis has a condition that causes small
protrusions in the intestinal tract. If the protrusions become infected or
inflamed, the condition is called diverticulitis. Diverticulosis can be
managed by a high-fiber diet and the nurse should recommend foods that
contain fiber such as whole grain cereal; fruit, such as apples or prunes; or
vegetables, including beans, squash, or cauliflower.
22.
A client is in need of hemodialysis for end-stage renal failure. The
physician has inserted an AV fistula. Which of the following nursing
interventions are appropriate when caring for this access site?
a. Assess for clotting in fistula tubing
b. Apply a dressing over the fistula site
c. Assess for a bruit or thrill at the site of the fistula
d. Assess circulation proximal to the fistula site
ANSWER C: An AV fistula internally connects an artery and a vein; the
site is accessed by venipuncture when used for hemodialysis. The nurse
should auscultate for the sound of a bruit over the site or palpate a thrill at
the site to ensure that it is patent and ready to use.
23.
A client is brought into the emergency room where the physician suspects
that he has cardiac tamponade. Based on this diagnosis, the nurse would
expect to see which of the following signs or symptoms in this client?
a. Fever, fatigue, malaise
b. Hypotension and distended neck veins
c. Cough and hemoptysis
d. Numbness and tingling in the extremities
ANSWER B: Cardiac tamponade occurs when fluid or blood accumulates
in the pericardium, preventing the heart from contracting properly. Cardiac
tamponade results in decreased cardiac output and is a medical emergency.
Symptoms of this condition include low blood pressure, distended neck
veins, chest pain, and muffled heart sounds.
24.
Mr. S has just been diagnosed with active tuberculosis. Which of the
following nursing interventions should the nurse perform to prevent
transmission to others?
a. Begin drug therapy within 72 hours of diagnosis
b. Place the client in a positive-pressure room
c. Initiate standard precautions
d. Place the client in a negative-pressure room
ANSWER D: A client diagnosed with active tuberculosis should be placed
in isolation in a negative-pressure room to prevent transmission of infection
to others. A negative-pressure room exhausts air to the outside and receives
air from surrounding areas, preventing tuberculin particles from traveling
through the ventilation system to infect others.
25.
Which of the following descriptions best describes the function of the
thyroid gland?
a. The thyroid gland converts glucose into glycogen
b. The thyroid hormone secretes cortisol during times of stress
c. The thyroid gland regulates body metabolism
d. The thyroid gland affects skin pigmentation
ANSWER C: The thyroid gland is responsible for secreting thyroxine (T4)
and triiodothyronine (T3), which work to regulate metabolism of the body's
cells. The thyroid also regulates carbohydrate, protein and fat metabolism
as well as regulates both physical and mental development.
26.
A nurse is instructing a client in the use of his incentive spirometer. Which
of the following statements from the nurse indicates correct teaching about
using this device?
a. Lie back in a reclining position while doing this."
b. Take rapid, quick breaths to reach your goal."
c. Set a goal of using the spirometer at least 3 times per day."
d. Practice coughing after taking 10 breaths."
ANSWER D: An incentive spirometer is a device used to open the alveoli
of the lungs; it may be used with clients to reduce the incidence of lung
atelectasis. The nurse should instruct the client to sit up and take slow deep
breaths to reach his set goal. Following use, the nurse should encourage the
client to cough in case using the spirometer has loosened any secretions.
27.
A client in the ICU has been intubated and placed on a ventilator. The
physician orders synchronous intermittent mandatory ventilation (SIMV).
Which statement best describes the work of this mode of ventilation?
a. The ventilator delivers a set rate and tidal volume regardless of whether
the client is attempting to breathe
b. The ventilator coordinates delivered breaths with the client's respiratory
efforts
c. The ventilator provides a supplemental breath for every third breath of
the client
d. The ventilator provides breaths during the expiratory phase of the client's
respirations
ANSWER B: Synchronous intermittent mandatory ventilation (SIMV) is a
ventilation mode that coordinates delivered breaths with the client's own
respiratory efforts. The delivered breaths from the ventilator have preset
pressures as ordered by the physician. This type of ventilation may be used
among clients as a standard form of ventilation or to wean from the
ventilator.
28.
A nurse is caring for a client in the post-anesthesia care unit (PACU). Upon
admission, the client is shivering despite having several layers of blankets.
What is the next action of the nurse?
a. Turn the client to the prone position
b. Assist the client to breathe deeply
c. Administer meperidine as ordered
d. None of the above
ANSWER C: A client who has had surgery may return to the recovery
room with a low temperature, manifesting as shivering or chills. The
operating suite may expose the client to cool temperatures for an extended
period of time. Meperidine (Demerol) may be ordered as an agent to reduce
shivering in clients who are cold.
29.
Mrs. D is a pregnant client who is 33 weeks' gestation and is admitted for
bright red vaginal bleeding. Her physician suspects placenta previa. All of
the following nursing interventions are appropriate for this client except:
a. Institute complete bed rest for the client
b. Assess uterine tone to determine condition
c. Perform a vaginal exam to assess cervical dilation
d. Measure and record blood loss each shift
ANSWER C: A client with placenta previa has part of the placenta
covering some or all of the cervical opening. A vaginal exam for placenta
previa may cause significant bleeding and should be avoided unless
directed by a physician and preparations are made for emergency delivery.
30.
Which of the following interventions should the nurse use when working
with a Jackson-Pratt drain?
a. Strip the tubing to remove clots by milking the tubing back toward the
client
b. Empty the drain when the amount of fluid reaches 25 cc
c. Strip the tubing to remove clots by milking the tubing away from the
client
d. Maintain the level of the drain above the client's incision
ANSWER C: A Jackson-Pratt drain is type of active wound drain that may
be placed following a surgical procedure. This type of drain looks like a
grenade and when collapsed, it actively draws excess blood and fluid out of
the wound. If clots develop within the tubing, the nurse can strip the tubing
by milking it in a direction away from the client.
31.
Which of the following techniques can help to prevent skin irritation or
breakdown around a tracheostomy site?
a. Manage secretions by providing suction on a regular basis
b. Cleanse the site daily with a mixture of povidone-iodine and water
c. Avoid using tube ties to secure the tube
d. None of the above
ANSWER A: Excess secretions from the tracheostomy tube can collect
near the stomal opening and cause skin breakdown. Management of
secretions through regular suctioning will keep the area clean and dry,
minimizing skin irritation.
32.
A client is seen for testing to rule out Rocky Mountain Spotted Fever.
Which of the following signs or symptoms is associated with this
condition?
a. Fever and rash
b. Circumoral cyanosis
c. Elevated glucose levels
d. All of the above
e. Both a and d only
ANSWER A: Rocky Mountain Spotted Fever (RMSP) is caused by the R.
rickettsii pathogen and causes damage to the blood vessels. A person with
RMSP may present with fever, edema, and a rash that starts in the hands
and feet and then spreads throughout the body. The condition starts after a
bite from an infected tick.
33.
A nurse is assisting with a physical exam for a client who presents with
possible meningitis. The nurse bends the client's leg at the hip to a 90degree angle. When she extends the leg at the knee, the client experiences
severe pain. Which type of test is this nurse performing?
a. Brudzinski's sign
b. Romberg's sign
c. Kernig's sign
d. Babinski's sign
ANSWER C: A client may be tested for meningitis by testing for a positive
Kernig's sign during the physical exam. The Kernig's sign is performed by
bending the client's leg at a 90-degree angle at the hip and then attempting
to extend the leg at the knee. If the client cannot extend the leg due to pain,
this is considered a positive sign of irritation of the meningeal membranes.
34.
Which of the following types of dressing changes works as a form of
wound debridement?
a. Dry dressing
b. Transparent dressing
c. Composite dressing
d. Wet to dry dressing
ANSWER D: A wet to dry dressing works as a method of wound
debridement, collecting drainage and debris from the wound after
application. The dressing change involves applying sterile soaked gauze to
the wound and covering it. As the dressing dries, it sticks to the wound and
pulls excess debris away when it is removed.
35.
A nurse is caring for a newborn infant in the nursery who has developed
vomiting, poor feeding, lethargy and respiratory distress. The physician has
diagnosed this infant with necrotizing enterocolitis. Which of the following
nursing interventions is most appropriate for this infant?
a. Feed the infant 30 cc of sterile water
b. Position the infant on his back
c. Administer antibiotics as ordered
d. Allow the infant to breastfeed
ANSWER C: Necrotizing enterocolitis (NEC) occurs when part of the
bowel becomes ischemic, causing gastrointestinal problems, periods of
apnea, lethargy and poor feeding, and potentially sepsis and death. A nurse
caring for an infant with NEC should stop oral feedings, insert a nasogastric
tube, and administer antibiotics as ordered.
36.
Mr. C is brought to the hospital with severe burns over 45% of his body. His
heart rate is 124 bpm and thready, BP 84/46, respirations 24/minute and
shallow. He is apprehensive and restless. Which of the following types of
shock is Mr. C at highest risk for?
a. Septic shock
b. Hypovolemic shock
c. Neurogenic shock
d. Cardiogenic shock
ANSWER B: A client who has suffered severe burns may be at risk of
hypovolemic shock. Burns cause a loss of plasma volume, depleting the
amount of fluid in circulation and decreasing perfusion to essential organs
and to the extremities.
37.
Based on Mr. C's assessment, which of the following nursing interventions
is most appropriate?
a. Elevate the lower extremities to 45 degrees to promote venous return
b. Place Mr. C in the Trendelenburg position
c. Administer total parenteral nutrition
d. Monitor urine output
ANSWER D: A client in hypovolemic shock may have decreased urine
output related to poor kidney perfusion. The nurse should administer fluids
as ordered and monitor urine output to ensure that it remains above
30cc/hour.
38.
Mr. L was working in his garage at home and had an accident with a power
saw. He is brought into the emergency department by a neighbor with a
traumatic hand amputation. What is the first action of the nurse?
a. Place a tourniquet at the level of the elbow
b. Apply direct pressure to the injury
c. Administer a bolus of 0.9% Normal Saline
d. Elevate the injured extremity on a pillow
ANSWER B: When a client is seen for an injury that causes excessive
bleeding, the first action of the nurse is to apply direct pressure to the
wound. Firm pressure with a sterile dressing can be applied while the rest of
the emergency team works together to stabilize the injury and prepare for
surgery.
39.
A nurse is caring for a client who was recently diagnosed with breast
cancer. The oncologist uses the TNM staging system to classify this case as
T2, N2, M0. The nurse understands that TNM stands for:
a. Tumor, Necrosis, Metastasis
b. Tumor, Node Involvement, Mastectomy
c. Tumor, Node Involvement, Metastasis
d. Therapy, Necrosis, Metastasis
ANSWER C: The TNM staging system is a classification system for
determining the size and extent of cancerous tissue. The TNM system helps
providers to identify the most accurate forms of treatment. The T stands for
tumor, then N stands for node involvement, and the M stands for metastasis.
40.
A nurse is caring for a client who has undergone radiation therapy. The skin
on her chest and abdomen itches and is red. The client complains of burning
pain and the skin is beginning to slough. Which nursing intervention is most
appropriate for this client?
a. Apply ointment to the skin to avoid moisture
b. Wash the area gently with water and pat dry
c. Use a mild antiseptic soap to wash the area and pat dry
d. Apply talcum powder to keep the skin dry
ANSWER B: Skin redness, itching, and burning are all side effects of
radiation therapy. The client's skin may begin to ooze or slough. The nurse
should avoid applying ointments, lotions, or powders to the skin and instead
keep it clean and dry. The nurse should use plain water, avoid soap, and pat
the area dry.
41.
A client is admitted for a head injury. His body is lying in an abnormal
position and the physician states he is exhibiting decorticate posturing.
Based on this assessment, the nurse can expect to find the client with:
a. The legs extended and rotated internally; the elbow, wrists, and fingers
flexed
b. The legs pulled toward the chest; the head bent back at a 30-degree angle
c. The back arched; the arms and legs extended and rigid
d. The legs extended and rotated externally; the head turned to the right or
the left
ANSWER A: Decorticate posturing indicates an injury to the corticospinal
tract; the client may exhibit this posture unexpectedly or it may develop
when the client's body is stimulated. A client who exhibits decorticate
posturing lies with the legs extended and rotated internally; the elbows,
wrists, and fingers are flexed inward.
42.
All of the following signs are indicative of increased intracranial pressure
EXCEPT:
a. Decreased level of consciousness
b. Projectile vomiting
c. Sluggish pupil dilation
d. Increased heart rate
ANSWER D: A client with increased intracranial pressure may develop
life-threatening complications if the condition remains untreated. The nurse
should be aware of early signs of this condition among clients at risk to
avoid herniation of brain tissue. Signs of increased intracranial pressure
include decreased level of consciousness, decreased heart rate, abnormal
respirations, sluggish pupil dilation, and projectile vomiting.
43.
Mr. V is receiving treatment for a spinal cord injury after falling off of his
deck at home. He has undergone spinal surgery, and has been placed in a
halo traction device. Which of the following nursing interventions are most
appropriate for a client with a spinal cord injury?
a. Turn the client and use incentive spirometry each shift
b. Administer stool softeners as ordered
c. Turn the head slowly to avoid further damage to the spine
d. Change NPO status
ANSWER B: A client recovering from a spinal injury may be at higher risk
of constipation due to decreased mobility. The nurse should assist with
preventing constipation and possible fecal impaction by administering stool
softeners or rectal suppositories as ordered.
44.
Based on assessment and testing, the physician has diagnosed Mr. V with a
cord transection at the level of C8 of the spine. Which of the following
types of paralysis is Mr. V most likely to suffer?
a. Hemiplegia
b. Quadriplegia
c. Paraplegia
d. None
ANSWER B: A client with an injury or cord transection at the level of C1C8 is most likely to have quadriplegia, or paralysis of all four extremities
and the lower portion of the body. Cord transection involves permanent
paralysis but the client may retain some reflexes after the initial swelling
from the injury resolves.
45.
A client is diagnosed with Meniere's disease after suffering from a viral
infection. The nurse recognizes that this condition causes:
a. Chronic rash, inflamed skin, and encrusted lesions
b. Orthostatic hypotension and swelling of the extremities
c. Altered potassium levels and increased risk of cardiac dysrhythmias
d. Vertigo, tinnitus, vomiting, and hearing loss
ANSWER D: Meniere's disease is a condition affecting the inner ear that
manifests as recurrent vertigo and tinnitus. The client may develop nausea,
vomiting, or nystagmus and the condition may result in hearing loss. The
nurse can assist this client by providing a dark and quiet environment and
administering medications as ordered to control nausea and vomiting.
46.
Mrs. P is being admitted for complications of coronary artery disease. The
nurse places her on a cardiac monitor and notes that her heart rate is 210
bpm and occasionally irregular. She is unable to measure the P-R interval
because the rate is too fast; the QRS complexes are wide. Which of the
following conditions does this client most likely have?
a. Premature ventricular contractions
b. Atrial fibrillation
c. Ventricular tachycardia
d. Sinus tachycardia
ANSWER C: A client with a heart rate between 110 and 250 bpm with
wide QRS complexes may be in ventricular tachycardia. The condition is
often caused from complications of coronary artery disease, after an acute
myocardial infarction; or through such conditions as hypokalemia or
digoxin toxicity.
47.
A nurse is reading a rhythm strip from a cardiac monitor. She counts 6 QRS
complexes within a 6-second strip. What is the heart rate?
a. 36 bpm
b. 60 bpm
c. 100 bpm
d. 120 bpm
ANSWER B: A nurse can calculate a client's heart rate per minute by
assessing a 6-second strip from the cardiac monitor. The nurse should
multiply the number of QRS complexes within 6 seconds by 10. In this
scenario, 6 QRS complexes multiplied by 10 equals 60 beats per minute.
48.
A nurse is caring for Mr. W, who has been HIV-positive for seven years.
Mr. W was recently diagnosed with mycobacterium avium complex
(MAC). Based on this diagnosis, the nurse can expect which of the
following symptoms from this client?
a. Cardiac dysrhythmias
b. Swelling of the lips and face
c. Headache and a ruddy complexion
d. Lethargy and diarrhea
ANSWER D: An HIV-positive client who develops MAC may show
symptoms of lethargy, diarrhea, fever, weight loss, or night sweats. The
condition may progress to cause hepatitis or pneumonia as well.
Mycobacterium avium complex is type of opportunistic infection that
causes illness among people with decreased immune systems.
49.
Based on Mr. W's diagnosis of MAC, which of the following information
should be provided to this client?
a. He should be started on antiretroviral therapy as ordered
b. He is no longer just HIV-positive, he most likely has AIDS
c. He should be tested for other illnesses, such as anemia
d. Both b and c
ANSWER D: A diagnosis of MAC in a client who is HIV-positive occurs
when the associated bacteria takes advantage of a compromised immune
system. The client's CD4 count has typically dropped low enough that he
cannot protect himself from opportunistic infections. Because of this, Mr.
W most likely has progressed to AIDS. He should be tested for other
illnesses that may develop because of MAC, including anemia or hepatitis.
50.
All of the following are complications associated with hypothermia during
the perioperative period EXCEPT:
a. Decreased blood urea nitrogen levels
b. Cardiac arrhythmias
c. Decreased immunity
d. Increased oxygen needs
ANSWER A: Clients are at increased risk of developing hypothermia
during the perioperative period when they are exposed to cool temperatures
for long periods of time or they receive large amounts of fluids that may
lower core temperatures. Hypothermia during the perioperative period
places a client at increased risk of cardiac arrhythmias, decreased immunity,
poor renal perfusion, and a decreased ability to metabolize medications.
51.
A nurse is caring for a client who had a bone marrow transplant two weeks
ago. Which of the following is most likely to cause an infection during this
time period?
a. Cytomegalovirus
b. Varicella zoster virus
c. Herpes simplex virus
d. Hepatitis B virus
ANSWER C: A client undergoing a bone marrow transplant is at higher
risk of developing an infection due to neutropenia. Many clients undergo
chemotherapy and radiation prior to receiving a bone marrow transplant.
The first 30 days following the transplant is known as the pre-engraftment
period. During this time, a client is more susceptible to certain types of
infections, including fungal, bacterial, and infection with the herpes simplex
virus.
52.
A nurse is caring for Mrs. L, a pregnant client who is 35 weeks' gestation.
The client complains of abdominal pain; her abdomen is rigid and she has
little vaginal bleeding. The nurse notes few fetal accelerations on the fetal
monitor. Which of the following conditions most likely describes these
symptoms?
a. Placenta previa
b. Prolapsed cord
c. Preeclampsia
d. Abruptio placentae
ANSWER D: Abruptio placentae occurs when the placenta separates from
the wall of the uterus before the baby is delivered. A clot may form between
the placenta and the uterine wall, causing internal bleeding that may not be
outwardly apparent. Signs and symptoms of abruptio placentae include a
rigid, boardlike abdomen; increased fundal height, little vaginal bleeding or
discharge, and late decelerations on the fetal monitor.
53.
Mrs. L's blood pressure has dropped to 86/58 and her heart rate is 112 bpm.
Based on her assessment, what is the most appropriate action of the nurse?
a. Insert two large-bore IVs
b. Elevate the head of the bed
c. Insert an indwelling catheter
d. Both a and c
ANSWER D: Depending on the amount of bleeding, abruptio placentae
can be life-threatening to both the mother and the fetus because of fluid
loss. The nurse should insert two large-bore IVs in order to administer
fluids and blood products if ordered. Mrs. L is showing symptoms of
hypovolemia based on her vital sign changes. Because she is 35 weeks'
gestation, the nurse should insert an indwelling catheter for prompt cesarean
delivery.
54.
A client begins to choke on food while eating in her room and a nurse is
attempting to perform the Heimlich maneuver. After several seconds, the
client becomes unconscious. What is the next action of the nurse?
a. Continue to support the client's body weight by standing behind her and
performing abdominal thrusts
b. Ask a co-worker to hold the client while continuing to perform
abdominal thrusts
c. Ease the client to the ground and expose the chest
d. Perform a blind finger sweep to remove any objects and begin rescue
breathing
ANSWER C: A client who becomes unconscious while choking should be
carefully eased to the ground before attempting further measures. The nurse
should look in the client's mouth to determine if any foreign objects are
present that have caused the choking. If the object is visible, the nurse can
perform a finger sweep to remove it.
55.
Which of the following actions is part of suture removal for a client
following surgery?
a. Cut the suture and pull the wire through the wound
b. Avoid removing further sutures if wound dehiscence occurs
c. Do not remove sutures that are embedded in the skin
d. All of the above
ANSWER B: A nurse may remove sutures for a client following surgery if
the physician orders this procedure. Using a suture removal set, the nurse
should cut the suture away from the skin and avoid pulling the wire through
the wound. If the wound edges begin to pull apart, suture removal should be
discontinued until the physician has been notified.
56.
Mrs. H has been diagnosed with multiple myeloma. Based on the risk
factors associated with this condition, which of the following background
information is most likely true for Mrs. H?
a. Mrs. H is younger than 30 years old
b. Mrs. H has a BMI of 31
c. Mrs. H is Caucasian
d. Mrs. H has four children
ANSWER B: Multiple myeloma is a type of cancer that develops within
plasma cells in the bone marrow. Clients with multiple myeloma develop
plasma cell tumors that may occur throughout the body. Those at risk of
developing this condition are clients who are older than 40 years and clients
who are overweight or obese. A client with a body mass index (BMI) of
greater than 30 is considered obese; if Mrs H has a BMI of 31, she may be
at a greater risk of multiple myeloma.
57.
Based on Mrs. H's diagnosis, which of the following complications is she
most likely to develop?
a. Anemia
b. Hyperlipidemia
c. Cirrhosis
d. Stroke
ANSWER A: A client with multiple myeloma is at risk of anemia when
increased cancerous cells replace red blood cells. Other complications
associated with multiple myeloma include decreased immunity, decreased
renal function, osteoporosis, and increased fractures.
58.
Which of the following statements best describes postural drainage as part
of chest physiotherapy?
a. Tapping on the chest wall to loosen secretions
b. Squeezing the abdomen to increase expansion of the upper chest
c. Using gravity to move secretions in the lung tissue
d. Dilating the trachea to facilitate better release of secretions
ANSWER C: Postural drainage is a type of chest physiotherapy used in
clients who need to move fluid or secretions that have accumulated in the
lungs. This method involves positioning the client in various manners that
use gravity to move fluid away from the areas of accumulation.
59.
Mr. R has come into the emergency room after an injury at work in which
his upper body was pinned between two pieces of equipment. The nurse
notes bruising in the upper abdomen and chest. He is complaining of sharp
chest pain, he has difficulty with breathing, and his trachea is deviated to
the left side. Which of the following conditions are these symptoms most
closely associated with?
a. Left-sided pneumothorax
b. Pleural effusion
c. Atelectasis
d. Right-sided pneumothorax
ANSWER D: Mr. R is most likely suffering from a right-sided
pneumothorax. Symptoms include sharp chest pain, difficulties with
breathing, decreased vocal fremitus, absent breath sounds and tracheal shift
to the opposite of the affected side.
60.
The physician has decided to perform a thoracentesis based on Mr. R's
assessment. Which of the following actions from the nurse is most
appropriate?
a. Instruct the client not to talk during the procedure
b. Assist the client to lie face-down on the bed
c. Insert a 20-gauge needle just above the 4th intercostal space
d. Connect the needle to suction to remove air that has collected in the
pleural space
ANSWER A: The nurse should provide a rapid explanation and ensure that
consent forms are signed for a client undergoing a thoracentesis. Mr. R
should be instructed not to talk or cough while the physician performs the
procedure.
61.
An 80-year old patient is admitted with dyspnea, dependent edema, rales
and distended neck veins. As the nurse monitors the patient, he becomes
increasingly short of breath and begins to have cardiac dysrhythmias. The
most critical intervention for this patient is to:
a. Ensure his airway is open and unobstructed.
b. Apply oxygen to keep his oxygen saturation over 94%.
c. Administer Dobutamine to increase cardiac output.
d. Start an IV for monitoring of intake.
ANSWER A: Although all of these interventions are important for a patient
with heart failure, an open and unobstructed airway is always the most
important intervention if the patient has a palpable pulse.
62.
You are caring for a 20-year old patient with pericarditis. What is the likely
cause of pericarditis in a young patient?
a. Heart failure
b. Acute MI
c. Hypertension
d. Infectious processes
ANSWER D: In younger patients, pericarditis is typically caused by an
infection
commonly
caused
by
Coxsackie
virus,
streptococcus,
staphylococcus, or Haemophilus influenzae. In older adults, the most
common cause is AMI.
63.
A systolic blood pressure of 145 mm Hg is classified as:
a. Normotensive
b. Prehypertension
c. Stage I hypertension
d. Stage II hypertension
ANSWER C: Normotensive is a systolic pressure less than 120.
Prehypertension is a systolic pressure of 120-139. Stage I hypertension is a
systolic pressure of 140-159. Stage II hypertension is a systolic pressure
greater than 160.
64.
Your patient has been diagnosed with acute bronchitis. You should expect
that all of the following will be ordered EXCEPT:
a. Increased fluid intake
b. Cough medications
c. Antibiotics
d. Use of a vaporizer.
ANSWER C: Unless the patient has a secondary infection, antibiotics will
typically not be ordered. It is important to obtain a chest x-ray to be sure the
patient does not have pneumonia since the symptoms can be similar.
Increasing fluids and use of a vaporizer will help liquefy secretions.
65.
You are caring for an asthmatic patient with an early-phase reaction. Which
of the following is indicative of an early phase reaction?
a. Rapid bronchospasms
b. Inflammatory epithelial lesions
c. Increased secretions
d. Increased mucosal edema
ANSWER A: Rapid bronchospasms are a symptom of an early-phase
reaction in an asthmatic patient. The other symptoms are indicative of latephase reactions.
66.
Clinical manifestations of asthma include:
a. Decreased expiratory time
b. Increased peak expiratory flow
c. Increased use of accessory muscles
d. Increased oxygen saturation
ANSWER C: Clinical manifestations of asthma include increased use of
accessory muscles, increased expiratory time, decreased peak expiratory
flow, and decreased oxygen saturation.
67.
What drives respiration in a patient with advanced chronic respiratory
failure?
a. Hypoxemia
b. Hypocapnia
c. Hypercapnia
d. None of the above
ANSWER A: In normal people, increased carbon dioxide levels provide
the drive for respirations. However, in advanced chronic respiratory disease,
carbon dioxide levels no longer provide the respiratory drive. Instead,
hypoxia, or low blood oxygen, drive the respiratory effort.
68.
Which of the following is NOT a warning sign that compensatory
mechanisms in a patient in shock are failing?
a. Increasing heart rate above normal for the patient's age.
b. Absent peripheral pulses.
c. Decreasing level of consciousness.
d. Increasing blood pressure.
ANSWER D: As compensatory mechanisms begin to fail, systolic blood
pressure will begin to decrease. Hypotension is a late and very ominous
sign for the patient in shock.
69.
How does shock usually progress?
a. Compensated to hypotensive shock in hours and hypotensive shock to
cardiac arrest in minutes
b. Compensated to hypotensive shock in minutes and hypotensive shock to
cardiac arrest in hours
c. Hypotensive to compensated shock in hours and compensated shock to
cardiac arrest in minutes
d. Hypotensive to compensated shock in minutes and compensated shock to
cardiac arrest in hours
ANSWER A: It is critical to recognize the patient in compensated shock
because you still have time to intervene before the shock state
decompensates into hypotensive shock. Once the patient is in hypotensive
shock, he will quickly decompensate into cardiac arrest without very
aggressive treatment.
70.
Septic, anaphylactic and neurogenic shock are all categorized as:
a. Hypovolemic shock
b. Cardiogenic shock
c. Distributive shock
d. Obstructive shock
ANSWER C: The three types of distributive shock are septic, anaphylactic
and neurogenic.
71.
Which of the following is TRUE about shock?
a. A patient with severe shock always has an abnormally low blood pressure
b. Confusion and deteriorating mentation are indicative of hypotensive
shock.
c. Patients with compensated shock may be unable to maintain a normal
blood pressure.
d. A normal blood pressure implies that the patient is stable.
ANSWER B: A patient with hypotensive shock will develop deteriorating
mental status. Patients can be in severe shock without any change in blood
pressure. Therefore, blood pressure is an unreliable indicator of shock
status.
72.
Signs and symptoms of stroke may include all of following EXCEPT:
a. Sudden weakness or numbness of the face, arm or leg.
b. Sudden confusion.
c. Sudden headache with no known cause.
d. Hypotension.
ANSWER D: Hypotension is typically not a sign of acute stroke.
Hypertension, extremity weakness or numbness, confusion and sudden
headache are all symptoms of stroke.
73.
Which of the following may cause coup-contrecoup injuries?
a. Rotational forces
b. Deformation forces
c. Deceleration forces
d. Acceleration forces
ANSWER C: Deceleration forces are those in which the head is moving
and strikes a stationary object. Deceleration injuries can include skull
fractures, contusions and hematomas, and coup-contrecoup injuries. In the
coup-contrecoup injury, the brain is injured on opposite sides as the brain
first hits against one side of the skull and then bounces back and hits the
other side of the skull.
74.
Meningitis that is fatal in half of the infected patients is caused by a:
a. Virus
b. Bacteria
c. Fungus
d. Noninfectious agent
ANSWER B: Bacterial meningitis is characterized by acute onset and is
commonly caused by Streptococcus pneumoniae, Haemophilus influenzae,
Listeria monocytogenes and Neisseria meningitides. Bacterial meningitis
commonly presents with the classic triad of symptoms: fever, stiff neck and
diminished level of consciousness. Bacterial meningitis is fatal in
approximately 50% of all cases.
75.
Which of the following may alter the level of consciousness in a patient?
a. Alcohol
b. Electrolytes
c. Infection
d. All of the above may cause altered level of consciousness
e. Both a and c only
ANSWER D: An acronym that can be used to remember possible causes of
decreased level of consciousness is AEIOU-TIPPS. These letters stand for
Alcohol, Epilepsy or Electrolytes, Insulin (either hypo or hyperglycemia),
Opiates, Uremia, Trauma, Infection, Poison, Psychosis, and Syncope.
76.
The term used to define uterine bleeding in which there is no menstruation
in a 24-year-old woman is:
a. Oligomenorrhea
b. Amenorrhea
c. Menorrhagia
d. Metrorrhagia
ANSWER B: Amenorrhea is a lack of a menstrual period in a woman of
child-bearing age.
77.
Which of the following diseases, or disorders, is acute?
a. Pneumonia
b. Paralysis
c. Alzheimer's disease
d. Diabetes
ANSWER A: Pneumonia is an acute disorder, or illness. It is temporary. It
comes on quickly and it can be cured. All of the other choices are chronic
diseases or disorders. They are permanent, but they can be treated.
78.
You are caring for Thomas N. Thomas is 77 years old. He has edema, or
swelling, in his legs and he has a fluid restriction in terms of his fluid
intake. You have been assigned to weigh him daily. Based on these
symptoms and the care that he is being given, what disorder is he most
likely affected with?
a. Diabetes
b. Dementia
c. Congestive heart failure
d. Continguous heart disease
ANSWER C: Thomas N. has the symptoms and care indicative of the fact
that Thomas has congestive heart failure, not dementia or diabetes. People
with congestive heart failure (CHF) have dependent edema of the legs.
They have too much volume in their blood so the person will have a fluid
intake restriction and a low salt diet. The person will also get daily weights
to determine how much water weight the person is gaining or losing each
day.
79.
The major difference between a grand mal and petit mal seizure is that a
person with a grand mal seizure will have _______________ and the person
with a petit mal seizure will not.
a. convulsive movements
b. sleep apnea
c. atonic movement
d. flaccidity
ANSWER A: Grand mal seizures are accompanied with convulsive
movements. Petit mal seizures do not have convulsive movement, but
usually only some eye blinking or staring. Sleep apnea is not associated
with seizures. It is a separate disorder. Flaccidity and atonia are poor and
absent tone.
80.
Your patient has shown the following signs and symptoms : Feeling very
thirsty Large amount of water intake Dryness of the mouth Urinary
frequency What physical disorder does this patient most likely have?
a. Diabetes
b. Angina
c. Hypertension
d. Hypotension
ANSWER A: This patient is exhibiting the classic signs of diabetes and
high blood glucose, or blood sugar. Some of the others signs include poor
vision, weight loss, tingling of the feet and hands and feeling tired and
weak.
81.
Which fact about diabetes is true?
a. Only children get type 1 diabetes.
b. Only adults get type 2 diabetes.
c. Children and adults can have type 1 diabetes.
d. Both a and b
ANSWER C: Both children and adults can have type 1, or insulin
dependent, diabetes. Although type 1 diabetes is also referred to as
"childhood diabetes", it affects adults as well. Both children and adults can
also have type 2 or "adult onset" diabetes, primarily due to the fact that
some children are obese.
82.
Diabetic patients are more prone to ____________ than other people
without this chronic disorder.
a. infection
b. increased oxygen saturation
c. low fibrinogen
d. constipation
ANSWER A: Diabetic patients are more prone to infection than other
people without this chronic disorder. Diabetes has no direct impact on the
other disorders above.
83.
A common childhood illness is caused by the Bordatella pertussis
bacterium. Which of the following diseases is caused by this bacteria?
a. German Measles
b. RSV
c. Meningitis
d. Whooping Cough
ANSWER D: Bordatella pertussis is the causative bacteria for the disease
state of Whooping Cough. Meningitis can be caused by bacteria, but is not
caused by the B. pertussis bacteria. German Measles and RSV are both
caused by viruses.
84.
Which of the following glands found in the skin secretes a liquid called,
"Sebum?"
a. Apocrine Glands
b. Sebaceous Glands
c. Lacrimal Glands
d. Sweat Glands
ANSWER B: Sebum is a fluid that is secreted by glands in the skin called
sebaceous glands. Sebum lubricates the skin to help maintain its integrity.
85.
A patient that has been diagnosed with alopecia would be described as
having:
a. body lice
b. lack of ear lopes
c. Indigestion
d. hair loss
ANSWER D: Alopecia is a medical term meaning hair loss.
86.
A patient presents with vesicles covering the upper torso. Which of the
following situations could cause this condition?
a. Knife fight
b. Auto accident
c. Sun burn
d. Fungal infection
ANSWER C: Vesicles is the medical term for blisters. A second degree
sunburn could blister, forming vesicles over the affected area.
87.
A child is diagnosed with a Greenstick Fracture. Which of the following
most accurately describes the broken bone?
a. compound fracture of the fibula
b. a partial break in a long bone
c. fracture of the growth plate of the ulna near the wrist
d. Colles fracture of the tibia
ANSWER B: Greenstick fractures are commonly found in children.
Sudden impact of a bone could lead to the bone bending and partially
breaking, such as what is seen when a green stick from a tree is bent in half.
88.
When reading a lab report, you notice that a patient's sample is described as
having anisocytosis. Which of the following most accurately describes the
patient's condition?
a. The patient has an abnormal condition of skin cells.
b. The patient's red blood cells vary in size.
c. The patient has a high level of fat cells and is obese.
d. The patient's cells are indicative of necrosis.
ANSWER B: Anisocytosis is a term meaning variation in size. Patients
with anisocytosis will have red blood cells that vary in size. Poikilocytosis
is a term meaning variation in shape of the red blood cells. Both are
commonly found in blood diseases.
89.
A patient with Bell's Palsy would have which of the following complaints?
a. Paralysis of the right or left arm
b. Malfunction of a certain cranial nerve
c. A sub-condition of Cerebral Palsy
d. A side effect of a stroke
ANSWER B: Bell's Palsy has symptoms similar to stroke, but is caused by
a malfunction of the Facial nerve, which is cranial nerve VII.
90.
A pathologic condition described as, "Increased intraocular pressure of the
eye," is:
a. Detached Retina
b. Fovea Centralis
c. Presbyopia
d. Glaucoma
ANSWER D: Glaucoma is a condition that is caused by increased
intraocular pressure in the eye. If not treated, glaucoma can lead to
blindness.
91.
A physician believes that a patient may be experiencing pancreatitis. Which
of the following tests would be best to diagnose this condition?
a. CK and Troponin
b. BUN and Creatinine
c. Amylase and Lipase
d. HDL and LDL Cholesterol Levels
ANSWER C: Patients experiencing pancreatitis will have increased blood
levels of amylase and lipase, two enzymes produced by the pancreas that
break down carbohydrates and lipids, respectively.
92.
A patient presents to the office with a pencil that has completely penetrated
the palm of her hand. Which of the following treatments would be BEST in
this situation?
a. Assist the doctor while she sedates the patient and removes the pencil
from her hand.
b. Have the patient gently pull the pencil out of her hand and assist the
physician with stitches.
c. Wrap a gauze wrap around the pencil, securing it as much as possible
until the patient can get to a local emergency room.
d. Tell the patient to go the local emergency room. With a doctor's order,
give the patient some aspirin for the pain.
ANSWER C: Penetrating wounds that leave behind an object may have
broken and then blocked important blood vessels. Removing the object may
cause intense bleeding. The patient's wound should be gently wrapped with
the object intact. The patient should then be taken to the nearest emergency
room to have the object removed.
93.
What is the most common complication of chest wall injury?
a. Hemothorax
b. Atelectasis
c. Pneumonia
d. Pneumothorax
ANSWER C: Pneumonia is the most common complication of chest wall
trauma. Therefore, management of chest wall trauma is directed toward
protecting the underlying lung and supporting adequate oxygenation,
ventilation and pulmonary toilet.
94.
Of the following, which best describes why subdural hemorrhages are more
common in the elderly?
a. Increased anticoagulant use
b. Increased risk of falls
c. Brain atrophy
d. Inconsistent care giving
ANSWER C: The elderly are at higher risk for subdural hematoma due to
cerebral atrophy that occurs as a normal part of the aging process. Such
atrophy may cause stretching of the bridging veins, which are then more
fragile and susceptible to tearing, even with minor trauma. The other factors
noted may contribute to the morbidity and mortality of subdural hematomas
in this population.
95.
Of the following, which is the most common type of malignant brain tumor
in the United States?
a. Meningioma
b. Glioblastoma multiforme
c. Acoustic neuroma
d. Pituitary adenoma
ANSWER B: Glioblastoma multiforme is the most common malignant
brain tumor in the United States, and carries a poor prognosis. Surgical
resection followed by radiation and chemotherapy is the most common
approach to treatment.
96.
Renal failure is broadly divided into specific categories. Which type is the
type II diabetic patient most likely to experience secondary to the diabetes?
a. Acute renal failure (ARF)
b. Intermittent renal failure (IRF)
c. Chronic renal failure (CRF)
d. Reversible renal failure (RRF)
ANSWER C: Chronic renal failure (CRF) and acute renal failure (ARF)
are the two broad categories of renal failure. Diabetic nephropathy is
common in the diabetic population, and an increasing cause of chronic renal
failure (CRF) in the United States. Other common causes of CRF include
chronic glomerulonephritis, chronic pyelonephritis, polycystic kidney
disease, connective tissue disorders and amyloidosis. Chronic renal failure
(CRF) differs from acute renal failure partly in the time frame of disease
onset and reversibility of the disorder. If treated in a timely and appropriate
manner, ARF has a much better prognosis and is usually reversible. Chronic
renal failure is not reversible. Depending on severity, patients may be
placed on renal replacement therapy (RRT) and may be candidates for
kidney transplant.
97.
Many nurses are not comfortable dealing with the topic of suicide with a
patient who may be at risk. Of the following, what would be an appropriate
action if a patient uses language indicative of suicidal intentions?
a. Ask if the patient has a plan
b. Ask the patient to describe details of the plan
c. Ask the patient to agree to a no-harm contract
d. All of the above
ANSWER D: All of the options noted are important aspects of providing a
suicide assessment and intervention with patients who may be indicating
such thoughts. Most patients are relieved to be able to talk about their
thoughts with a caring professional. The more detailed the patient's plan, the
more serious they typically are about carrying it out. Use of a no-harm
contract helps the patient take control of his own behavior and empowers
him in his care. Such contracts are not a legal document, but a suicide
prevention tool in which certain steps are outlined that the patient agrees to
take if he has thoughts of suicide. The substantive agreement by the patient
is that by no means will he die by suicide, with specific steps to take and
contacts to make in the event of suicidal thoughts. Patients who have
indicated suicidal thought and intent must be monitored closely with 1:1
observation and receive care directed by a multidisciplinary team in order to
experience optimal outcomes.
SAFETY (STUDY MODE)
1.
Which of the following is an example of client handling equipment?
a. Wheelchair
b. Height-adjustable bed
c. Shower chair
d. Call light
ANSWER B: Client handling equipment is designed to reduce the stress
and workload on nurses who must assist, turn, or lift clients. This
equipment decreases the risk of injuries associated with improper lifting. A
height-adjustable bed raises the client up to a proper working height for the
nurse who must provide assistance.
2.
Which practice will help to reduce the risk of a needlestick injury?
a. Only expose the end of the needle once ready to enter the room for the
procedure
b. Always place the cap back on a needle after it has been used
c. Keep a sharps container nearby where it can be easily accessed
d. Pass needles between nurses by using the hand-over technique
ANSWER C: When administering an injection or using sharps for a
procedure, the nurse can minimize safety risks by keeping a sharps
container nearby. This provides easy access for quick disposal to prevent
the possibility of a needlestick. Needles should never be recapped after use
and nurses should always exchange needles from a central area rather than
passing them between workers.
3.
Which of the following is an organizational factor that affects workplace
violence directed at nurses?
a. Clients who have short hospital stays
b. The presence of security guards
c. Restricted client areas
d. Understaffing of nursing personnel
ANSWER D: Understaffing of nursing personnel may be an organizational
risk associated with workplace violence for nurses. Understaffing involves
too few nurses on duty, which may not be enough to meet client needs at
the time or may result in longer delays for provision of care. Greater
amounts of activity and diminished numbers of nurses to provide care may
result in aggression, violence, or anger from clients or families directed
toward staff.
4.
Which of the following actions can a nurse do to prevent a fire from
occurring in the area where he works?
a. Use an adaptor when plugging in client equipment
b. Mark equipment that is not working properly and use carefully until it
can be inspected by maintenance
c. Notify visitors or post signs that state oxygen is in use in certain areas
d. Keep extra equipment stored in one area with other supplies and
materials
ANSWER C: Because oxygen is a combustible material, clients, workers,
and visitors to the healthcare facility should be aware of its use. All people
should be reminded of the consequences of improper oxygen use through
signs or pictures that depict this risk.
5.
Which principle of body mechanics may help to reduce the risk of a back
injury incurred by the nurse?
a. Maintain a narrow base of support
b. Bend from the waist, not the knees
c. Keep the back straight while lifting
d. If possible, lift objects rather than pushing or pulling
ANSWER C: A nurse may minimize the risk of strain or injury by
employing proper body mechanics while lifting, moving, or turning.
Keeping the back straight, bending at the knees, maintaining a wide base of
support, and pushing or pulling rather than lifting are all proper body
mechanics that can reduce the risk of injury.
6.
A physician has ordered that a client must be placed in a high Fowler's
position. How does the nurse position this client?
a. The client is placed face-down
b. The client lies on his back with his head lower than his feet
c. The client lies on his back with the knees drawn up toward the chest
d. The client is sitting with the backrest at a 90-degree angle
ANSWER D: A high Fowler's position is a modification of the semiFowler's position, in which the client is seated with arms resting at the sides
or in the lap. The high Fowler's position requires that the client's head and
upper chest are elevated; the backrest is at a 90-degree angle, which
supports breathing and appropriate chest wall movement.
7.
A nurse has applied a cold pack to a client's arm to help decrease swelling
and inflammation after an injury. Which of the following signs indicates
that the cold pack should be removed?
a. The skin on the arm appears mottled
b. The cold pack has been in place for 10 minutes
c. The client complains of feeling nauseated
d. The capillary refill in the area distal to the arm is 2 seconds
ANSWER A: When using a cold pack for therapeutic purposes, the nurse
must monitor the site to avoid tissue damage. Cold therapy that has been
used for too long may result in pale, mottled skin that has a bluish
appearance. The client may also complain of feeling cold, or circulation to
the area may be diminished.
8.
A client in a long-term care facility has developed reddened skin over the
sacrum, which has cracked and started to blister. The nurse confirms that
the client has not been assisted with turning while in bed. Which stage of
pressure ulcer is this client exhibiting?
a. Stage I
b. Stage II
c. Stage III
d. Stage IV
ANSWER B: A stage II pressure ulcer develops as a partial thickness
wound that affects both the epidermis and the dermal layers of skin. The
client may develop skin that is red, with blisters or cracking. The wound
may appear shallow and moist. The ulcer does not extend to the underlying
tissues at this stage.
9.
A nurse caring for a client diagnosed with pertussis is ordered to maintain
droplet precautions. Which of the following actions of the nurse upholds
droplet precautions?
a. Assign the client to stay in a negative-pressure room
b. Use sterilized equipment when sharing between this client and another
person with pertussis
c. Wear a mask if coming within 3 feet of the client
d. Both a and c
ANSWER C: When working with a client who needs droplet precautions,
the nurse should wear a mask when coming within 3 feet of the client. If the
client coughs or sneezes, droplet particles could be transmitted through the
air to infect the nurse without proper precautions. Droplet precautions
should also involve the practice of standard precautions, such as regular
hand hygiene and personal protective equipment when coming in contact
with blood or body fluids.
10.
Mr. and Mrs. K have just adopted a newborn infant and are preparing to
take him home from the hospital for the first time. Which safety measure is
most appropriate for the clients in this situation?
a. Turn the handles of pans on the stove inward
b. Set up a baby gate at the top of the stairs
c. Cover electrical outlets with child-proof plugs
d. Install an approved car seat that is facing backward in the back seat
ANSWER D: Parents of newborn infants should use an approved car seat
that has been installed facing backward in the back seat of the car. Securing
infants in car seats, even from the first ride home from the hospital,
promotes safety while transporting. While safety measures at home such as
baby gates or outlet covers are important, they are not priority safety
measures until the baby is old enough to be mobile.
11.
A nurse is treating a client with suspected carbon monoxide poisoning.
Which of the following symptoms are associated with this condition?
a. Red rash across the trunk and extremities
b. Nausea, vomiting, seizures
c. Flushing of the face and neck
d. Abdominal pain radiating to the back
ANSWER B: A client with carbon monoxide poisoning may present with
nausea, vomiting, muscle weakness, or lightheadedness. Untreated, the
condition may lead to seizures, coma, or death. Carbon monoxide toxicity is
a safety risk because it is a colorless and odorless gas. Many people
exposed to carbon monoxide may be unaware of toxic levels that can cause
serious illness.
12.
A nurse attempts to plug in a sequential compression device when she
notices a tingling sensation in her hands while touching the cord. What is
the next action of the nurse?
a. Attempt to plug the device into a different outlet
b. Inspect the cord for damage; if none is present, continue to use the device
c. Discontinue the device and send it to the maintenance department for
inspection
d. Notify the supervisor that the unit is at risk of an electrical fire
ANSWER C: Signs that electrical equipment is not working properly and
may increase the risk for damage or fire include the feeling of current in the
cord, which may manifest as a tingling sensation. Electrical equipment that
is malfunctioning should be discontinued and thoroughly checked by
maintenance or an electrician before use.
13.
A client has become combative and is attempting to pull out his IV and take
off his surgical dressings. The nurse receives an order to apply wrist
restraints. Which action of the nurse signifies that restraints are being used
safely?
a. The nurse ties the restraints in a square knot to prevent the client from
untying them
b. The restraints are attached to a movable portion of the bed
c. The padded side of the restraint is applied next to the skin of the wrist
d. The nurse assess the client's distal circulation every 24 hours
ANSWER C: Restraint use must be governed for safety of the client.
Restraints applied around the wrists should be placed so that the padded
side of the restraint is against the skin, which may help to prevent skin
breakdown. Restraints should be applied in knots that are quick-release in
case of emergency.
14.
A nurse is caring for an 86-year old client with decreased visual acuity and
who uses a cane for mobility. What should the nurse teach this client to
reduce the risk of falling at home?
a. Take off shoes while in the house and wear only socks
b. Limit activities to the lower level of the home
c. Keep a lamp near the door of every room
d. Install non-slip pads in the shower or bathtub
ANSWER D: To prevent the risk of falls at home, clients may install nonslip pads on the floor of showers or bathtubs where excess water may
accumulate. The nurse can teach the client how to prevent falls by
providing education about moving safely at home, such as keeping a light
by the bed, wearing non-slip shoes, and navigating stairs carefully.
15.
A nurse has just started a transfusion of packed red blood cells that a
physician ordered for a client. Which of the following signs may indicate a
transfusion reaction?
a. The client suddenly complains of back pain and has chills
b. The client develops dependent edema in the extremities
c. The client has a seizure
d. The client's heart rate drops to 60 bpm
ANSWER A: Signs of a transfusion reaction include back pain, chills,
dizziness, increased temperature, and blood in the urine. The nurse should
be aware of symptoms of a transfusion reaction any time blood products are
administered and watch closely for changes in the client's health status.
16.
An attack using microorganisms such as bacteria or viral agents with intent
to harm others is called:
a. Assimilation
b. Defense intervention
c. Bioterrorism
d. Environmental remediation
ANSWER C: Bioterrorism involves using harmful agents such as bacteria
or viruses with the intent to harm others. Nurses may be involved in disaster
response if weapons using bioterrorism affect the community.
17.
All of the following factors may contribute to client falls EXCEPT:
a. Contact dermatitis
b. Urinary frequency
c. Decreased visual acuity
d. Confusion
ANSWER A: Risks for falling may be due to intrinsic factors, such as
health conditions; or external factors, such as environmental circumstances
that place certain clients at risk. Some examples of factors that may
contribute to client falls include urinary frequency, requiring an increase in
trips to the bathroom; decreased visual acuity, and confusion.
18.
A small fire has erupted in a wastebasket in the client waiting room. Which
of the following is the first action of the nurse?
a. Call 9-1-1
b. Find the fire extinguisher
c. Move clients to safety
d. Throw water on the fire
ANSWER C: When a fire starts in a healthcare setting, the first action of
the nurse is to move clients and anyone who may be in danger to a safe
setting. Small fires may be contained through a fire extinguisher, but client
safety is a top priority.
19.
A nurse is preparing to assist a client from his bed into a wheelchair. Which
action is essential to maintain client safety in this situation?
a. Position the wheelchair at the foot of the bed
b. Maintain a space of at least 12 inches between the wheelchair and the bed
c. Place the footplates in the lowest position before transferring the client
d. Lock both wheels on the wheelchair before moving the client
e. Both b and d
ANSWER D: When transferring a client from a bed to a wheelchair, the
nurse must ensure several safety measures are in place to prevent injury
during the transfer. Locking both wheels on the chair stabilizes it as the
client gets in and out. The wheelchair should be next to the bed, with foot
rests up until after the client is seated.
20.
A nurse is assisting a client with ambulation in the hallway. The nurse is
using a gait belt for further assistance. The client becomes dizzy and starts
to faint while walking. What is the first action of the nurse?
a. Stand behind the client and prepare to catch him when he falls
b. Assist the client to sit in the nearest chair or slide down along a wall
c. Grasp the client under the arms and pull him upward
d. Call for help from nearby staff
ANSWER B: If a nurse is assisting a client with ambulation and he starts to
faint or fall, the nurse should assist the client into a sitting position in order
to reduce the impact of the fall. This may mean lowering the client into a
nearby chair. If a chair is not available, assist the client to lean against the
wall. Using the wall for support, help him slide to the floor.
21.
Which of the following constitutes the five "rights" of medication
administration?
a. Right client, right nurse, right time, right dose, right route
b. Right client, right time, right dose, right route, right order
c. Right client, right drug, right dose, right time, right route
d. Right physician, right nurse, right client, right drug, right dose
ANSWER C: The nurse must confirm the five rights of medication
administration when giving any drug to a client. The medication must be for
the right client as prescribed, it must be the correct drug at the prescribed
dose, and it must be given at the prescribed route at the designated time.
22.
A nurse is caring for a client following surgery when he begins to complain
of pain in his right hand. The client's IV is in this hand and the skin around
the site is slightly reddened and cool to the touch. The IV drip rate has
slowed considerably. The client states his pain is localized to the right hand
and fingers. Which situation is most likely the cause of this client's pain?
a. The client is experiencing phlebitis from the last drug administered
b. The client has a blood clot developing in the distal arteries of the wrist
c. The client's pain is associated with myocardial ischemia and he is having
a heart attack
d. The client's IV is infiltrated
ANSWER D: Pain, cool skin, and edema at an IV injection site indicate IV
infiltration. In this case, the slowing of the IV fluid drip rate supports the
fact that the client's IV is most likely infiltrating into the surrounding
tissues. Unresolved, IV infiltration can lead to extensive tissue damage and
disfigurement when medications and fluids enter the space surrounding the
vein.
23.
A nurse is dismissing a 5-year old boy from the pediatrics unit to go home
with his parents. The parents drive their car to the front door of the hospital
and the nurse helps the child get into the car. What type of seat belt restraint
should this child wear?
a. A 5-point restraint in the back seat, facing backward
b. A booster seat with a lap and shoulder belt in the back seat
c. A lap belt in the back seat
d. A lap and shoulder belt in the front seat
ANSWER B: A 5-year old child who rides in a car should use a restraint
system for safety. The Centers for Disease Control and Prevention do not
recommend children under 13 years to ride in the front seat of a car. A 5year old child most likely needs a booster seat, combined with a lap and
shoulder belt in the back seat.
24.
A nurse is employed at a district health department and must spend several
hours each day sitting at a desk. Which principle of ergonomics will most
likely help her to reduce the risk of injury or pain in this situation?
a. Adjust the chair height to keep the legs bent at the hips at a 90-degree
angle
b. Maintain the position of the computer monitor just below eye level
c. Stand up and take a walk or stretch every 4 hours
d. Rest wrists on the edge of the desk while typing
ANSWER A: When sitting for prolonged periods, adjust the height of the
chair so that the legs are bent at the hips at a 90-degree angle. This position
reduces pressure on the back, legs, and feet, and the nurse may be more
likely to use proper posture and reduce muscle fatigue. A person who must
sit for several hours a day should get up to move around at least once every
hour to support circulation and to stretch.
25.
A client is receiving high-dose brachytherapy as a form of cancer treatment.
What type of teaching must the nurse include when educating this client
about safety?
a. The client must remain in isolation under airborne precautions
b. The client should stay in a private room at the hospital
c. The client may need to limit visits from friends and family
d. Both b and c
ANSWER D: A client who receives high-dose brachytherapy has had a
radiation implant placed in his body for the treatment of cancer. Because the
implant may give off radiation, the client should be placed in a private
hospital room to avoid exposing the radiation to a roommate. Additionally,
friends and family may need to limit visits to avoid overexposure to
radiation while the client is receiving treatment.
26.
Which of the following indicates the need to file an incident report?
a. The neon sign directing parking for visitors has burned out
b. A nurse must send a syringe pump to maintenance for annual service
c. A client's blood pressure dropped to 90/55 after receiving a dose of
morphine
d. A client's spouse becomes angry and is asked to leave the premises
ANSWER D: An incident report is a form of reporting for nurses that
accounts for any activity that occurred that was unexpected. At times,
incidents may happen that the nurse is not prepared for and that may
involve other departments, such as client accidents, medication errors, or
security problems. A situation in which a client or family who is asked to
leave the premises because of behavior should be documented in case of
future issues.
27.
A nurse is suctioning the endotracheal tube of an intubated client on a
ventilator. What length of time is the nurse allowed to suction in this
method?
a. Five seconds or less
b. Ten seconds or less
c. At least 30 seconds
d. No longer than 60 seconds
ANSWER B: When providing endotracheal suctioning, the nurse should
suction for no longer than ten seconds at a time. Suctioning for longer than
ten seconds may cause hypoxia or bronchospasm. Extended suctioning may
also place the client at risk of injury to the bronchial and tracheal structures.
28.
A nurse is giving a client information about his new prescription for
warfarin. The nurse should remember to tell the client:
a. He should have his white blood cell count tested once a month
b. He should avoid any activities that could lead to injury
c. He should avoid eating leafy green vegetables
d. Both a and b
ANSWER B: Warfarin is a drug that prevents blood from clotting, putting
the client who takes this medication at risk of bleeding from injuries. The
client should be instructed to limit activities that could cause injury, leading
to potentially uncontrolled bleeding as a result.
29.
Which of the following actions of the nurse is most appropriate to reduce
the risk of infection during the post-operative period?
a. Flush the central line with heparin at least every four hours
b. Administer narcotic analgesics prn
c. Remove the urinary catheter as soon as the client is ambulatory
d. Order a high-protein diet for the client
ANSWER C: A significant way to reduce the risk of infection is to remove
the urinary catheter as soon as the client is ambulatory. Urinary catheters
may harbor bacteria that can lead to infection of the bladder or urethra.
30.
A nurse is assessing a client who is post-op day #1 after a
hemilaminectomy. The nurse removes the dressing as ordered and notes that
the incision appears slightly red, with a small amount of serous drainage
coming from the site. The edges of the incision are approximated. What is
the next action of the nurse?
a. Assist the client to shower as ordered and monitor the site for further
changes
b. Instruct the client to lie prone to allow the site to dry
c. Place antibiotic ointment and a sterile dressing over the site
d. Notify the physician for an antibiotic order
ANSWER A: An incision that appears slightly red with a small amount of
serous drainage on the first day following surgery is going through a normal
healing process. If the client has orders for showering or bathing, the nurse
should assist to keep the area clean and monitor for changes, including
increased redness or drainage, or changes in approximation of the wound
edges.
31.
A nurse is preparing to administer a dose of platelets to a client. Which of
the following actions must the nurse perform before giving the platelets?
a. Start an IV of ½ Normal Saline to administer with the platelets
b. Ensure the container with the platelets is intact and not damaged
c. Verify the client's name and address
d. Check the client's chart to ensure he is not taking any antibiotics
ANSWER B: Before giving a transfusion of blood products such as
platelets, the nurse should ensure that the solution is in an intact container
that does not have any leaks or drainage. Cracks in the exterior container of
blood products can allow bacteria to accumulate, which can cause an
infection.
32.
Which of the following is an example of an environmental hazard that may
put the nurse at risk of injury?
a. Loud noise from the hospital maintenance system
b. Airborne powder that contains latex
c. Chemicals containing ethylene oxide
d. All of the above
e. Both b and c only
ANSWER D: Nurses are exposed to various environmental hazards that
may negatively impact their physical or mental health. Hazards come in
several forms, some of which may be unlikely sources, including noise
pollution which can damage hearing; latex powder, which can cause allergic
responses; and certain chemicals, such as ethylene oxide, which is used as a
sterilizing agent and can cause cancer.
33.
A nurse is caring for a client's wound that has started to bleed. After
providing wound care, the nurse removes her gloves and notes that a small
amount of the client's blood has come in contact with her hand. What is the
next action of the nurse?
a. Use an alcohol-based hand sanitizer to disinfect the hands
b. Wash hands with soap and water using appropriate technique
c. Notify the occupational health nurse about an exposure to a client's blood
d. Sample some of the client's blood to determine the presence of diseases
ANSWER B: If a nurse comes in contact with blood or body fluids, she
should treat the situation as if the client has an infectious illness, whether
this is true or not. If the skin was intact, the nurse can effectively wash her
hands with soap and water, which is the best method of hand hygiene when
hands are visibly soiled.
34.
A nurse must attend a high-risk delivery in a client's room. After the infant
has been delivered, the nurse immediately takes him to a warmer for
assessment. What is the minimum amount of personal protective equipment
for the nurse when working with this newborn?
a. Sterile gown, gloves
b. Mask, gown, shoe covers
c. Gloves
d. Hat, mask, gloves, gown, shoe covers
ANSWER C: When working with a newborn infant who has just been
delivered, the nurse must wear gloves as a minimum level of personal
protective equipment. Before the first bath, the infant may have the mother's
blood or body fluids on his skin that may be exposed to the nurse.
35.
Which of the following diseases would require the nurse to wear an N95
respirator as part of personal protective equipment?
a. Human immunodeficiency virus
b. Clostridium difficile enterocolitis
c. Vancomycin-resistant enterococcus
d. Measles
ANSWER D: Infections that require airborne precautions necessitate use of
an N95 respirator, a type of mask that filters particles that are 5 micrograms
or smaller. Illnesses that require airborne precautions include Measles,
Varicella, Severe Acute Respiratory Syndrome (SARS) and tuberculosis.
36.
Which of the following teaching topics should the nurse discuss when
working with an immunocompromised client?
a. Avoid canned foods and increase consumption of fresh fruits and
vegetables
b. Hand-wash utensils after use and allow them to air dry
c. Only drink tap water that has been filtered or boiled before consumption
d. Never eat meals prepared in restaurants
ANSWER C: When counseling the immunocompromised client about
safety and protection against infection, the nurse should remind the client to
avoid activities that may promote bacterial growth. Tap water should be
filtered or boiled for at least 10 minutes before consumption in case of any
pathogens that might be present.
37.
Which of the following is the correct sequence for removing personal
protective equipment?
a. Remove gown, gloves, shoe covers, mask
b. Remove mask, gloves, gown, shoe covers
c. Remove gloves, gown, mask, shoe covers
d. Remove shoe covers, mask, gloves, gown
ANSWER C: The sequence of removing personal protective equipment is
as important as the sequence for applying it. When exiting a surgical or
aseptic situation requiring a gown, gloves, mask, and shoe covers, the
proper sequence of removal is to first remove the sterile gloves and then the
gown. Once these items have been removed, the nurse can then remove the
mask and any other protective equipment, such as shoe covers.
38.
A nurse is completing an incident report about a medication error that she
made when she accidentally administered too much insulin to a diabetic
client. All of the following are components of this documentation EXCEPT:
a. The reason why she gave the wrong dose
b. The type of drug involved
c. The amount of insulin that was given
d. Any adverse effects on the client
ANSWER A: When documenting a medication error on an incident report,
the nurse should state the facts about the situation: the type of error, how
much was given or withheld, and any adverse effects that the error had on
the client. The nurse should refrain from admitting fault in the situation and
instead focus on the facts of the medication administration.
39.
A home health nurse is preparing to visit her next client, whom she has
never visited before. Which of the following actions indicates the nurse is
upholding safety precautions?
a. Send a text to the client to confirm the location of the house
b. Leave her purse and valuables on the seat in the car and lock the doors
c. Ask the client to keep an extra set of keys in case the car is locked
d. Keep the car windows rolled up when in an unfamiliar environment
ANSWER D: Nurses who work in home health care have some safety
standards that differ from the hospital environment. When driving to clients'
homes, the nurse can protect herself by keeping the doors of her car locked
and the windows rolled up, particularly when driving in an unfamiliar area.
40.
A nurse is caring for newborn infants in a nursery when a man enters the
area to take his baby back to the room. The man does not have an
identification bracelet and the nurse does not recognize him. What is the
next action of the nurse?
a. Call security and ask them to escort the man out of the nursery
b. Ask the man to wait and check the infant's chart
c. Ask the man to return to his room and bring an identification band
d. Allow the man to take the baby to his room
ANSWER C: The safety of infants in newborn nurseries is upheld by
asking parents to wear identification bracelets to distinguish themselves as
the proper parents. This reduces the chance of mistakenly allowing a parent
or other adult to take a baby that is not theirs. If the nurse does not know the
man in question, she should request some form of identification from him,
such as the hospital bracelet.
41.
According to the American Heart Association standards, high quality CPR
for an adult includes all of the following EXCEPT:
a. Push hard
b. Push fast
c. Allow chest recoil between compressions
d. Pause CPR as each drug is administered
ANSWER D: CPR should not be interrupted for drug administration. CPR
should be applied at a rate of at least 100 per minute, at a depth of at least 2
inches for adults, allowing recoil of the chest between compressions.
42.
Which of the following may represent an upper airway obstruction?
a. Retractions
b. Elongated expiratory phase
c. Stridor
d. Expiratory wheezing
ANSWER B: An elongated expiratory phase may indicate an upper airway
obstruction. Lower airway obstruction is characterized by retractions,
stridor and wheezing with expiration.
43.
The primary purpose of emergency planning is to do which of the
following?
a. Comply with the laws of the state.
b. Comply with the laws of the U.S.
c. Comply with both state and U.S. laws.
d. Maintain safety.
ANSWER D: The primary purpose of emergency planning is to insure and
maintain the safety of people and the preservation of objects, such as
buildings and personal possessions. There are both federal and state laws
that require healthcare agencies to have emergency planning; however, the
PRIMARY purpose of emergency planning is to maintain life and the safety
of people.
44.
One of your patients is dependent on a mechanical ventilator for their
respiratory needs. The patient cannot breath on their own. Suddenly, the
lights in the patient's room and the entire nursing unit go off. You realize
that the electric power has been lost. What is the first thing that you should
do for this patient?
a. Plug the ventilator into the red outlet in the room.
b. Plug the ventilator into the blue outlet in the room.
c. Use an Ambu bag to ventilate the patient.
d. Call the doctor about this emergency.
ANSWER A: All hospitals, nursing homes and other healthcare facilities
must have emergency generators in case the electricity supply ends.
Healthcare facilities have red outlets that will work in the event of a power
outage because they are connected to the emergency generator.
45.
You must wear gloves when you are _______________.
a. preparing infant formula for a newborn baby
b. transferring breast milk into a baby bottle
c. knocking on a patient's door
d. opening a patient's door
ANSWER B: Breast milk is considered a bodily fluid, so you must wear
gloves when you are transferring breast milk into a baby bottle. It is not
necessary to wear gloves when you prepare infant formula because formula
is not a bodily fluid. Lastly, you do not have to wear gloves when you
knock on, or open, a patient door.
46.
You are taking care of a patient who has active TB. The patient has been put
on airborne precautions. The patient is in a special room. You must wear a
HEPA mask when you enter the room. Now, the patient has to leave the
room and go to the radiology department. How can you transport this
patient to the radiology department without spreading the TB throughout
the hospital?
a. Have everyone along the route to the radiology department wear a HEPA
mask.
b. Have patients along the route to the radiology department wear a HEPA
mask.
c. Have staff along the route to the radiology department wear a HEPA
mask.
d. Place a HEPA mask on the patient.
ANSWER D: You would place the HEPA mask on the patient to prevent
the spread of the TB throughout the hospital. It is not realistic to expect all
staff, patients and visitors along the route to wear a HEPA mask. They are
very costly and they require special fittings.
47.
A patient's Foley catheter has been discontinued. You will dispose of this
patient equipment by doing which of the following?
a. Wearing gloves and then placing this equipment in the regular trash can
after it is placed in a paper bag.
b. Simply placing this equipment in the regular trash can after it is placed in
a paper bag.
c. Wearing gloves and then placing this equipment into a special "hazardous
waste" container.
d. Simply placing this equipment in the "hazardous waste" container after it
is placed in a paper bag.
ANSWER C: All used patient equipment that has come in contact with
bodily fluids is considered hazardous waste. You must wear gloves and then
place the Foley bag and tubing into the "hazardous waste" container. These
containers are red and they are clearly marked as "Hazardous". Bags, rather
than containers, can be used.
48.
Your AIDS/HIV patient has just died. Should you still use standard
precautions as you provide post mortem care?
a. Yes, because the virus is still transmissible
b. Yes, because you must still treat them with respect
c. No, because the virus is no longer transmissible
d. No, because this is not respectful
ANSWER A: You must still use standard precautions, even when a know
HIV+ person is dead. The virus can still be transmitted.
49.
Your patient has just died from a massive heart attack. As far as you know,
patient had no other diseases, illnesses or infections. Should you still use
standard precautions as you provide post mortem care?
a. Yes, because the patient must be treated with respect
b. Yes, you still must use standard precautions
c. No, because the patient had no infections
d. No, because this is not respectful
ANSWER B: You must still use standard precautions for all people at all
times.
50.
The proper personal protective equipment necessary for collecting a sputum
specimen would include: (Choose the BEST answer.)
a. Gloves and face mask
b. Level Three Bio containment uniforms
c. Eye protection and shoe covers
d. Splash shield and face mask
ANSWER A: Sputum samples could contain potential airborne droplets
that may spread disease. Using a face mask and gloves will prevent the
spread of infectious agents by protecting the respiratory tract and gloves
will prevent the spread of contaminants by the hands.
51.
Surgical asepsis is being performed when:
a. wiping down exam tables with bleach.
b. sterilizing instruments.
c. changing table paper.
d. wearing gloves when performing injections.
ANSWER B: Surgical asepsis is the process of preventing pathogens from
entering a patient's body. This is done by using sterilization procedures.
52.
The most effective step of hand washing is:
a. using friction to remove potential pathogens.
b. using hospital grade soap.
c. moisturizing the hands after washing to prevent cracking.
d. washing hands for at least 15 seconds.
ANSWER A: While all of the answers are part of an effective hand
washing procedure, the use of friction when washing is the most effective
method of removing debris and potential pathogens from the hands.
53.
MSDS sheets:
a. Contain the ordering information for each piece of equipment in the
office.
b. Are required by OSHA to be accessible to all employees of the office.
c. Can be used to treat patients who have been injured in equipment
accidents.
d. None of the above.
ANSWER B: Materials Safety Data Sheets are used to provide employees
information on all chemicals that are used in their place of work. Health
information is readily accessible and can be used to help employees who
have been injured by the use of these chemicals.
54.
The most virulent blood borne pathogen is: (Choose the BEST answer.)
a. HCV
b. HPV
c. HIV
d. HBV
ANSWER A: Hepatitis C is 100 times more virulent than Hepatitis B.
55.
The NFPA diamond has four colors. The blue diamond:
a. indicates hazards to health.
b. designates that it is safe to use water to put out this type of fire.
c. indicates that ice is necessary to treat an injury with this type of chemical.
d. indicates that the chemical may be incinerated upon disposal.
ANSWER A: The National Fire Protection Agency has designated a safety
diamond to be used to indicate the threat level of a particular chemical. The
blue diamond indicates potential hazards to a user's health when the
particular chemical is used.
56.
Which would be the first step when a patient passes out at the front desk?
a. Call 911.
b. Initiate CPR.
c. Shake the patient and ask if he is ok.
d. Check for a pulse.
ANSWER C: Any time a patient passes out or appears to be sleeping,
shake the patient to see if you can rouse him. Checking for a pulse, calling
911, and initiating CPR would all follow if the patient does not become
alert.
57.
When performing CPR, at what rate should chest compressions be applied?
a. 100 per minute
b. 60 per minute
c. As quickly as possible.
d. 200 per minute
ANSWER A: Chest compressions given during CPR should be done at a
rate of 100 compressions per minute.
58.
Which acronym would BEST describe the procedure for assessing a patient
that appears unconscious?
a. WBC
b. QRS
c. XYZ
d. ABC
ANSWER D: The ABC method stands for: Airway, Breathing, Circulation.
When encountering a patient who appears unconscious, first assess for
adequate airway by performing the "head lift, chin tilt." Next look, listen
and feel for breathing. Finally, check for a pulse.
59.
The acronym FAST is used to help responders remember the steps to
recognizing which of the following conditions?
a. Onset of labor in a pregnant woman
b. Stroke
c. Heart attack
d. Migraine
ANSWER B: The acronym FAST stands for: Face, Arms, Sentence, and
Time. Patients that are having a stroke will show asymmetry of the face,
will not be able to hold his arms at the same level out to the sides, will not
be able to repeat a sentence, and needs to get to the emergency room
without wasting time.
60.
The Rule of Nines is used to:
a. determine the amount of the body surface that has been burned.
b. assess the level of oxygen saturation in a body that has been burned.
c. determine the level of tissue damage that has occurred in a burn.
d. None of the above.
ANSWER A: The Rule of Nines is used to assess the amount of body
surface that has been burned. Most body areas are divided out based on 9%,
with the exception of the genitalia, which is only 1%.
61.
First aid for frostbite includes:
a. Running cold water over the affected area. Warm or hot water will shock
the area and cause more tissue damage.
b. Run warm water over the area to rapidly rewarm the affected area.
c. Run hot water over the area to warm the area as quickly as possible.
d. Cover the area with a blanket, using a heating pad if the blanket isn't
warm enough.
ANSWER A: Frostbite is dangerous because it can take away a patient's
ability to accurately assess the temperature of water that is used to treat it.
This could result in potential burns, making the frostbite even more
dangerous. Warm water should be used to warm the area. Medical
assistance is necessary if the tissue appears to be necrotic.
62.
Improper placement of the hands under the rib cage when performing the
Heimlich maneuver could result in:
a. damage to the manubrium of the sternum.
b. damage to the coccyx.
c. a broken xiphoid process.
d. None of the above is possible, even with improper hand placement.
ANSWER C: The xiphoid process is located at the inferior aspect of the
sternum. If the hands are placed too close to this process and pressure is
applied, the process can break off and damage internal organs.
63.
Which type of shock is related to low blood volume?
a. Psychogenic
b. Cardiogenic
c. Anaphylactic
d. Hemorrhagic
ANSWER D: Hemorrhagic or hypovolemic shock are the result of major
blood loss.
64.
A patient is bleeding profusely from an injury near her wrist. Which of the
following first aid procedures would be MOST appropriate?
a. Place a tourniquet on her arm above the injury.
b. Place pressure on her brachial artery.
c. Place pressure on her radial nerve.
d. Cover the bleeding area with wet towels.
ANSWER B: Applying pressure to the brachial pulse point will slow the
bleeding coming from the injury. Tourniquets should not be used as they
could potentially inhibit blood flow to the area which could lead to necrosis
of the surrounding tissue.
65.
Patients that are exhibiting signs of cyanosis will:
a. show signs of hyperoxia.
b. will have increased O2 saturation.
c. will have blood levels of CO2 that are higher than O2 levels.
d. None of the above.
ANSWER C: Cyanosis is defined as a condition of being blue. This
condition occurs when patients are having difficulty oxygenating their
tissues. Blood gas chemistry results will show low blood oxygen levels and
high CO2 levels.
66.
The medical term, "diaphoresis," means:
a. Profuse vomiting
b. Profuse sweating
c. Gasping for air
d. None of the above.
ANSWER B: Diaphoresis is a medical term meaning, "profuse sweating,"
and is often associated with emergency situations such as heart attacks or
diabetic episodes.
67.
When would chest thrusts be performed in an emergency situation?
a. When performing CPR to initiate cardiovascular circulation.
b. When assessing responsiveness of an unconscious patient.
c. When assisting a pregnant woman who is choking.
d. None of the above examples indicate the need for chest thrusts.
ANSWER C: To properly attempt to dislodge solid materials from the
airway of a pregnant woman, chest thrusts are used in lieu of abdominal
thrusts. Chest thrusts, while not as effective as abdominal thrusts, will
reduce the risk of harming the fetus.
68.
Madge is a 91-year-old nursing home resident with a history of dementia
and atrial fibrillation who has been admitted to the hospital for treatment of
pneumonia. As you are performing her bed bath, you note bruising around
her breasts and genital area. What potential issue should be of major
concern in Madge's situation?
a. Idiopathic thrombocytopenia purpura (ITP)
b. Embolic stroke
c. Sexual abuse
d. Nursing home acquired pneumonia (NHAP)
ANSWER C: Bruising around the breasts and genitals should trigger
concern for sexual abuse. Elder abuse is a growing problem in America,
and nurses are uniquely positioned to recognize and intervene on the behalf
of vulnerable populations, such as the elderly. According to the National
Center of Elder Abuse (NCEA), major types of elder abuse include physical
abuse, sexual abuse, emotional or psychological abuse, neglect,
abandonment, financial or material exploitation and self-neglect.
MENTAL HEALTH (STUDY MODE)
1.
A client has been diagnosed with a form of terminal cancer and has started
receiving hospice care. The nurse notes that both the client and his family
avoid talking about the diagnosis. All attempts at discussion result in
changing the subject. The nurse recognizes that this family is exhibiting:
a. Closed awareness
b. Mutual pretense
c. Open awareness
d. Powerless assessment
ANSWER B: Mutual pretense is a form of awareness as a response to
death or dying in which those involved avoid discussing the situation. In a
case of terminal illness, a client and his family are aware of the diagnosis;
but the client may not want to talk about the situation for various reasons,
such as saving his family from feelings of grief, fear of the future, or
discomfort with talking about feelings.
2.
A nurse is preparing to talk about body changes with a client who just had a
bilateral mastectomy. Which of the following actions of the nurse is most
appropriate during this discussion?
a. Provide a room that offers minimal distractions
b. Ask closed-ended questions to allow the client to think about her
situation
c. Write detailed notes during the conversation to track important
information
d. Ask personal questions about the client's background to determine how
the procedure has affected her self-concept
ANSWER A: When preparing to talk with a client about a difficult subject,
the nurse can provide an environment that is private and that offers minimal
distractions. This gives the client an opportunity to open up about personal
feelings without being interrupted, and may provide more open
communication between the nurse and client.
3.
A nurse is attempting to speak with a client about his personal feelings of
self-esteem and self-concept. Which of the following questions is most
appropriate for assessing a client's personal identity?
a. What is your educational background?"
b. Are your parents still living?"
c. What do you like about your life right now?"
d. Where do you see yourself in 10 years?"
ANSWER C: When assessing a client's personal identity, the nurse should
focus on questions that determine how the client feels about himself. This
may mean asking questions that help him identify his personal strengths and
weaknesses, as well as how he thinks others see him.
4.
A term that refers to a comprehensive set of thoughts or images of oneself
is called:
a. Global self
b. Core self-concept
c. Personal identity
d. Ideal self
ANSWER A: Global self refers to a comprehensive set of thoughts or
images about oneself. A nurse can assess a client's global self-concept by
asking him to use a phrase that describes himself completely at any given
time. The phrase, "I am a man" is an example of a global self-concept.
5.
Which of the following interventions is most appropriate when supporting
the psychosocial needs of a client who is experiencing negative side effects
associated with chemotherapy?
a. Read the client's discharge instructions well in advance of dismissal
b. Provide medications to reduce nausea and vomiting
c. Give simple instructions about self-care while in the hospital
d. Determine the levels of support from significant others
ANSWER D: The nurse can address the psychosocial needs of a client who
is undergoing changes in health and body image by determining the levels
of support from the client's significant others. This may be family, a spouse,
or friends who will provide help and support when the nurse is not directly
caring for the client. Organizing these resources can address fears about the
future, it prepares caregivers for the needs of the client, and it provides
transition for the client who will eventually be discharged from nursing
care.
6.
Which of the following clients is at the highest risk of becoming a victim of
intimate partner violence?
a. A 36-year old woman who is recently divorced
b. A 22-year old man who is unemployed but living with friends
c. A 20-year old woman who grew up with a psychologically abusive father
d. A 40-year old man diagnosed with schizophrenia
ANSWER C: Intimate partner violence is a form of domestic violence that
includes physical, psychological, or sexual abuse from a spouse or partner.
While intimate partner violence may occur with anyone in an intimate
relationship, there are some risk factors that may be associated with a
greater chance of becoming a victim. Young age, depression, low selfesteem, financial difficulties, little education, and being a former victim of
some sort of abuse all contribute as risk factors for intimate partner
violence.
7.
A nurse is assessing a client who is being seen for increased anxiety,
restlessness, and insomnia. Which of the following interventions is the first
priority of the nurse?
a. Administer anti-anxiety medications as ordered by the physician
b. Talk with the client about methods to improve rest and sleep
c. Take the client to a private room and remain with him
d. Review the client's medical history to determine if he has been treated for
these issues before
ANSWER C: The first priority when working with a client who has a
potential mental health issues is to ensure safety of the client. The nurse
should take the client to a private room to minimize distractions and stay
with the client to ensure his safety. Other interventions, such as
administering prescribed medications, can be performed after the nurse has
instilled a trusting relationship.
8.
Which of the following is an example of an opioid?
a. Mescaline
b. Diazepam
c. Phenobarbital
d. Methadone
ANSWER D: Opioids are a type of drug classified as narcotics. Opioids
may be one category of drug that nurses see when working with clients with
substance abuse. Examples of opioids that may cause addiction among
some clients include methadone, codeine, morphine, or hydromorphone.
9.
A client comes into the emergency room and asks to see a doctor. He is
anxious, visibly upset, and keeps looking behind him to the waiting room.
When the nurse asks his chief complaint, he says, "My roommate is trying
to kill me." Which of the following is the most appropriate initial response
of the nurse?
a. Just wait here and I will notify security."
b. I'm going to speak with the physician about getting some medication that
may help you."
c. Why is your roommate trying to kill you?"
d. Have you called the police to report this?"
ANSWER C: Upon initial assessment of a client who appears anxious and
overstimulated and who presents with questionable claims, the nurse should
initially try to gain more information about the situation. It is possible that
this client's roommate is actually trying to kill him, or he could have a
mental health disorder causing him to think inappropriately. It is the nurse's
responsibility to gather more information to determine what is true in this
situation.
10.
A 17-year old Asian client is being seen for lower abdominal pain in the
right quadrant. The client is accompanied by his parents. The nurse notes
that the client's father does not make eye contact and shows little response
when told that the client will need surgery. Which of the following is the
most appropriate action of the nurse?
a. Contact an interpreter to give the information again in the father's native
language
b. Continue to provide information about surgery to both the client and his
parents
c. Call social services to evaluate the parent's standard of care
d. Contact the physician about postponing the surgery
ANSWER B: Nurses may work with clients who have varying cultural
beliefs. Because of this, nurses must remain aware of the cultural practices
associated with certain ethnic groups. Asian Americans may avoid eye
contact as a sign of respect; additionally, emotional responses may be
avoided except for in private situations. If this family did not have a
language barrier, the nurse should continue to provide appropriate
information about the surgery and recognize the cultural differences that
exist.
11.
Which of the following best describes Eye Movement Desensitization and
Reprocessing (EMDR)?
a. A client follows the nurse's finger with his eyes until he reaches a
hypnotic state
b. A client reads a story about a traumatic event and then visualizes the
result
c. A client focuses on a negative thought in his mind while moving his eyes
back and forth
d. None of the above
ANSWER C: Eye Movement Desensitization and Reprocessing (EMDR)
is a form of therapy used for dealing with negative thoughts or traumatic
memories. It may be used among clients with post-traumatic stress disorder.
A client who undergoes EMDR focuses on a negative thought or memory
and the feelings associated with it while simultaneously moving the eyes
back and forth. Eye movement may be through following an object or
receiving tactile or auditory stimulation. The EMDR process is not the same
as hypnosis as a form of treatment.
12.
Which of the following is an example of neurofeedback used with a child
diagnosed with reactive attachment disorder (RAD)?
a. Parents or a nurse hold a child close during play until he becomes angry
enough to unleash his rage
b. Parents give their child a sticker when he behaves appropriately
c. A child uses a sand tray to draw shapes and to release stress while talking
with a nurse
d. A child's brain waves are monitored through electrodes placed on the
scalp
ANSWER D: Neurofeedback is a form of treatment that may be used for
children
diagnosed
with
reactive
attachment
disorder
(RAD).
Neurofeedback involves attaching electrodes to the scalp in a method
similar to an EEG. The child's brainwaves are then monitored while he is
exposed to positive images or games in order to produce positive brain
patterns.
13.
An increase in the neurotransmitter dopamine is associated with which of
the following illnesses?
a. Schizophrenia
b. Depression
c. Alzheimer's disease
d. Anxiety
ANSWER A: Schizophrenia is a type of mental illness that may be
associated with increased levels of the neurotransmitter dopamine in the
brain. Increased dopamine could be related to some of the symptoms of
schizophrenia, such as hallucinations or delusions.
14.
A nurse is using therapeutic techniques to help a client who is having
difficulty applying for a job because of panic and anxiety. The nurse
pretends to be the job supervisor while the client practices answering
questions during an imaginary interview. This technique is an example of:
a. Reinforcement
b. Presenting reality
c. Role playing
d. Summarizing
ANSWER C: Role-playing involves practicing appropriate behaviors
during imaginary scenarios that would be similar to what the client will
experience. Role-playing allows the client to prepare how he would act or
what he would say if the situation were real. This technique is useful for
clients who feel paralyzed by feelings or thoughts that cause inaction.
15.
Which of the following actions of the nurse is most appropriate when
working with a client who is extremely angry?
a. Place a light hand on the client's shoulder to imply understanding
b. Maintain close proximity to convey trust
c. Temporarily change the subject if the client's behavior is changing
d. Close the door to the room to provide privacy
ANSWER C: A nurse who is working with a client that is angry can
employ several techniques that may be calming or will keep her safe while
providing care. If the client's behavior starts to escalate or he begins to
fixate on a subject that makes him angry, the nurse can temporarily change
the subject as a method of distraction from the original idea.
16.
Which of the following is an advantage of working with psychiatric clients
in a group setting?
a. Clients assist each other through therapeutic interventions without a need
for a nurse
b. Clients can behave however they wish while knowing the group will not
lead to long-term contact with others
c. Clients can remain anonymous in sharing private information without the
legal constraints of reporting illegal activities
d. Clients learn from others when their behaviors are inappropriate in a safe
and trusting environment
ANSWER D: Group therapy may be used in some mental health treatment
situations. Placing clients together in groups may help individuals to
express thoughts and feelings without being judged or criticized for their
behavior. Clients who work in groups can learn from others in the group
about inappropriate behaviors because group members may share some of
the same struggles. Groups are often meant to be trustworthy to encourage
clients to open up.
17.
Which of the following interventions is most appropriate when working
with the family of a client who is being treated for substance abuse?
a. Advocate for the client before the family
b. Provide referrals for community resources and support groups
c. Take the side of the family before the client
d. Both b and c
ANSWER B: When working with families of clients being treated for
substance abuse, the nurse must remember that families have needs and
issues that must be addressed in addition to the client's. The nurse can
provide support for families through encouraging open and honest
communication, advocating for both the client and his family, and including
the family in the discharge planning process. If necessary, the nurse can
provide referrals for community resources and support groups.
18.
A term used to describe members of the same group based on physiological
characteristics, such as skin color or body structure is known as:
a. Ethnicity
b. Culture
c. Race
d. Minority
ANSWER C: Race is a term used to describe people who are members of
the same group that is based on physiological characteristics, such as skin
color. Race may be paired with ethnicity, in that members of the same race
may be of the same ethnic background.
19.
Which of the following is an example of non-reversible dementia?
a. Pick's disease
b. Syphilis
c. Encephalopathy
d. Hyperthyroidism
ANSWER A: Non-reversible dementia is a condition in which a client
develops an altered mental state that typically manifests as changes in
personality or judgment, alterations in intellectual functioning or changes in
affect. Non-reversible dementia is that condition which is not caused by a
metabolic or temporary disorder that affects brain function. Instead, nonreversible dementia is typically considered a permanent and often
progressive condition. Examples include Pick's disease, Alzheimer's
disease, Parkinson's disease, and Creutzfeldt-Jakob disease.
20.
Which of the following is a nursing intervention for a client who is having
an acute panic attack?
a. Encourage the client to sit down in a quiet environment
b. Allow the client to direct the situation
c. Try to focus the client on one aspect of care, such as regulating breathing
patterns
d. Speak in a commanding tone of voice to get the client's attention
ANSWER C: When caring for a client who is having an acute panic attack,
the nurse's goal is to help reduce the client's anxiety levels until the
situation can be managed and controlled. The nurse may want to direct the
client to focus on one area that can be controlled, such as regulating
breathing. Clients that are hyperventilating can be directed to slow down
and take deep breaths or breathe into a paper bag.
21.
A nurse is assisting a client who has been diagnosed with depression.
Which of the following is an example of a short-term outcome as part of the
nursing process for this client?
a. Client will verbalize that depression symptoms have lifted
b. Client will identify life stressors that may be contributing to depression
c. Client's insomnia will be resolved as evidenced by 8 hours of sleep each
night
d. Client will identify a mental health counselor in the community with
whom she can meet for ongoing therapy
ANSWER B: Short-term outcomes are those goals that the client may need
to meet before advancing toward long-term outcomes. A client with
depression may need to initially identify causes of the depression in order to
work through some feelings of grief or sadness before she can move toward
long-term goals of therapy and depression management.
22.
Which of the following is an example of passive aggression?
a. Clenched fists
b. Yelling
c. Jealousy
d. Intimidation
ANSWER C: Passive aggression involves directing anger to others in a
way that is not overt. A person who exhibits passive aggression may not be
openly hostile and this type of anger may be difficult to recognize or treat.
Examples of passive aggression include jealousy, resentment, stubbornness,
and pouting.
23.
A client is being treated for anxiety and desires to be free from anxious
feelings and despair. According to Maslow's hierarchy of needs, which level
does this client need to meet?
a. Physiological
b. Safety
c. Belonging
d. Self esteem
ANSWER B: An individual's need for safety includes feelings of security.
This includes a desire to be free from anxiety or those feelings that make a
client feel unsafe or unsure of himself. Treating anxiety and moving beyond
anxious feelings to a feeling of safety will meet a client's needs to move on
to the next level in the hierarchy.
24.
Which of the following is an age-related developmental task for a 68-year
old client?
a. Dealing with loss of friends
b. Commitment to parenthood
c. Setting career goals
d. Solidification of sense of self
ANSWER A: A person who is 68 years old may be dealing with several
changes associated with retirement and advancing age. Loss of friends due
to death, ending of a career, loss of a spouse, and loss of some physical
functions and abilities are all associated with aging.
25.
Which of the following examples indicates that the nurse is giving
recognition as a form of therapeutic communication?
a. You need to take your medicine now, Adam."
b. Jill, your father is trying to make amends with you."
c. The physician wants to meet with you and your husband, Amy."
d. Linda, you brushed your hair this morning."
ANSWER D: Recognition is a form of therapeutic communication in
which the nurse points out some positive aspect of the client's behavior.
Noting that a client brushed her hair herself indicates that the nurse
recognizes the client's attempts at self-care. This recognition shows the
client that the nurse is paying attention and may be open to further
communication.
26.
During her shift at the hospital, a nurse receives a stern reprimand from a
physician over something which she had no control. The nurse does not
respond. When she returns home that evening, she sees her children's toys
all over the floor, gets mad, and begins to yell at them. Which form of
defense mechanism is this nurse using?
a. Symbolization
b. Suppression
c. Displacement
d. Projection
ANSWER C: Displacement is the process of targeting feelings or impulses
from one person toward another. Often, displacement directs negative
reactions to someone who is more vulnerable or less threatening than the
original person involved. In this situation, the nurse did not respond to the
physician, but instead took her negative feelings out on her children, who
have less authority.
27.
A client is receiving treatment for delusional behavior. He believes that his
neighbor is purposefully poisoning his water system in an attempt to make
him sick. Which of the following responses of the nurse is most
appropriate?
a. Did you have the water tested to be sure?"
b. Why do you feel like your neighbor is trying to poison you?"
c. Let's just sit here and watch this television program."
d. Don't be silly; your neighbor would do no such thing."
ANSWER B: When a client presents with delusional beliefs, the nurse
should avoid arguing with the client and accept his initial need to hold onto
the delusions. He may want to further express his beliefs. By responding in
a non-threatening manner, the nurse builds trust, after which she may be
able to encourage him to start giving up his delusions.
28.
Which of the following people is at highest risk of suicide?
a. An 80-year old man who lost his wife last year
b. A 36-year old woman whose former neighbor committed suicide
c. A 40-year old married businessman
d. A 46-year old former alcoholic who has been sober for 12 years
ANSWER A: Certain groups of people are at higher risk of suicide than
others. The elderly, adolescents, those in high-profile professions, and those
with a loved one who has previously committed suicide are all at higher
risk. Women are more likely to attempt suicide; however, men are more
likely to succeed when they do attempt it.
29.
Which of the following is a typical assessment finding of a 24 year old
female with anorexia nervosa?
a. Weight loss of more than 2% body fat
b. Frequent binge-eating episodes following by induced vomiting
c. A history of poor academic performance and mediocre achievements
d. Lack of menstruation
ANSWER D: Amenorrhea, or lack of menstruation, is a common
occurrence with clients who have anorexia nervosa. Induced starvation
through anorexia may influence the body's hormones, leading to a lack of
menstruation and ultimately osteoporosis and infertility.
30.
A client is undergoing treatment for alcoholism. Twelve hours after his last
drink, he develops tremors, increased heart rate, hallucinations, and
seizures. Which stage of withdrawal is this client experiencing?
a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4
ANSWER C: With recovery of significant alcoholism, stage 3 of alcohol
withdrawal typically begins approximately 12-48 hours after the last drink.
Stage 3 encompasses the symptoms associated with stages 1 and 2, such as
tremor, tachycardia, mild hallucinations, hyperactivity, and confusion. By
stage 3, the client may have severe hallucinations and seizures.
31.
Which of the following nursing interventions is essential when working
with a client who has antisocial personality disorder?
a. Monitor intake and output
b. Set strict limits on behavior
c. Provide diversion for the client
d. Limit visits from family or friends
ANSWER B: Antisocial personality disorder is associated with
manipulative behavior from the client, which may extend to nurses, the
client's family or friends, or other clients in the hospital. The nurse must set
strict limits on behavior to avoid letting the client manipulate others, act
impulsively, or tell lies that are behaviors often associated with this
disorder.
32.
Which is a true statement regarding stress related disorders?
a. Stress related disorders are only caused by stress
b. Symptoms of stress related disorders would not exist if the client was not
experiencing stress
c. Stress related disorders are also called psychophysiologic disorders
d. None of the above
ANSWER C: Stress related disorders, also called psychophysiologic
disorders, are illnesses that develop and are exacerbated by stress. These
conditions have a physiologic basis for their development, but extreme
stress worsens symptoms. Some examples of stress related disorders might
be hypertension, migraine headaches, fatigue, eczema, or colitis.
33.
Which of the following nursing outcomes is most appropriate during the
crisis stage of caring for a victim of domestic violence?
a. The client will verbalize community resources from which to seek shelter
after discharge
b. The client will write a plan to keep herself and her children safe
c. The client will contact an attorney for help with pressing charges
d. The client will be safe and receive treatment for injuries
ANSWER D: During the crisis phase of caring for a victim of domestic
violence, the nurse's priority outcomes are for the initial safety of the client
and treatment of injuries incurred because of the abuse. Eventually, the
client may be able to verbalize options for self care after treatment, but the
crisis phase meets the client's initial needs for safety and health.
34.
Which of the following is a symptom associated with sensory overload?
a. Disorientation
b. Drowsiness
c. Emotional lability
d. Depression
ANSWER A: A client who is experiencing sensory overload may become
disoriented when the brain becomes overloaded with too much information.
The client may be unable to concentrate and he may develop racing
thoughts and restless behavior. Sensory overload occurs when a person is
either unable to control the amount of environmental stimuli he is
experiencing, or he is unable to process the stimuli that he takes in.
35.
A nurse is providing care for a client who has just died. Her son states, "She
was the most wonderful mother. There was no one who was a better mother
than she was. She was perfect." Which stage of grief is this son
experiencing?
a. Denial
b. Anger
c. Idealization
d. Shock
ANSWER C: The idealization stage of grief occurs when a person left
behind idealizes the loved one who dies. The person may speak about the
deceased person in a way that implies he or she was perfect or had no
faults. The grieving person temporarily forgets the negative aspects of the
person who has died as a method of coping.
36.
Which of the following is a true statement about palliative care?
a. The goal of palliative care is to provide end of life care for a client as he
transitions toward death
b. Palliative care provides comfort and support for those who may have a
terminal illness
c. Palliative care provides resources for funeral arrangements after death
d. Palliative care is a support network for family and friends after the death
of a loved one
ANSWER B: Palliative care is a type of care that provides support and
comfort to clients. In many situations, the client may be experiencing
terminal illness, or the client may have a diagnosis that involves severe pain
or discomfort. Palliative care differs from hospice care in that the client is
not always dying.
37.
According to the CDC, people in which of the following age groups are
most likely to meet the criteria for major depression?
a. 18-24 years
b. 25-34 years
c. 35-44 years
d. 45-64 years
ANSWER D: People aged 45-64 years old are most likely to suffer major
depression. When all types of depression are considered, patients in the 1824 year age group are most likely to report symptoms of depression.
38.
Your patient has been confused for years. Your patient can be best described
as a patient with a chronic ___________ disorder.
a. physical
b. psychotic
c. thinking
d. palliative
ANSWER C: Patients who have long term confusion are suffering from a
chronic thinking, or cognitive, disorder. Alzheimer's disease is an example
of a disorder that leads to long term confusion and memory loss.
39.
At the end of your shift, Sophie T. starts crying when you walk into their
room. Sophie is usually very cheerful. You speak to Sophie and she tells
you that she is very sad because she has not seen her family in weeks. What
should you do?
a. Listen to Sophie with genuine concern.
b. Tell Sophie that she should not cry.
c. Immediately call the family so Sophie stops crying.
d. You should leave because your shift is over.
ANSWER A: You should listen to the Sophie and her feelings with genuine
concern and compassion. Patients and residents should be allowed to
ventilate their feelings. Listening is a part of good communication. You
should not tell the person to stop crying. This is not helpful.
40.
The primary reason that people act out with disturbed behavior in a
healthcare facility is because the person has a _________ problem.
a. social
b. spousal
c. thinking
d. physical
ANSWER C: The primary reason that people act out with disturbed
behavior in a healthcare facility, like a nursing home, is because the resident
has a thinking problem, like dementia or Alzheimer's disease. Social
problems, spousal issues and physical problems may, at times, lead to some
degree of poor behavior. However, it is thinking problems that most often
lead to disturbed behavior.
41.
The best way for a nurse, and a healthcare facility, to control the effects of
poor and disruptive patient behavior is to _________________.
a. prevent it
b. restrain the patient
c. medicate the patient
d. isolate the patient
ANSWER A: The best way to manage and control the effects of poor and
disruptive patient behavior is to prevent it from happening at all. Restraints
and isolation are a last resort, and not a good way to manage behavior. They
simply prevent injuries to self and others. Medications to control poor
behavior are called "chemical restraints" and, like physical restraints, they
are not recommended.
42.
Identify the "trigger" type with the correct "trigger" that can possibly lead to
disturbed behavior.
a. Emotional: room coldness
b. Environmental: boredom
c. Physical: pain
d. Communication: silence
ANSWER C: Pain is an example of a physical "trigger" that can lead to
disturbed behavior, particularly when the resident, or patient, is unable to
express this pain to their healthcare providers. Room coldness is an
environmental "trigger"; boredom is an emotional "trigger" and silence is a
part of communication and not a "trigger" for poor behavior.
43.
Jerry is a 55-year-old veteran who has been admitted after a motor vehicle
accident with multiple injuries. His friend reported that he had been using
synthetic marijuana prior to the accident, and that he also sees a psychiatrist
at the VA hospital for an unknown diagnosis. He stated that Jerry
sometimes gets “hyper” for no reason, starts “ranting” and becomes violent.
Of the following, which general psychiatric disorder is characterized by a
pattern of aggression or violence which includes irritability, agitation, and
violent behavior during manic or psychotic episodes?
a. Schizophrenia
b. Post-traumatic stress disorder (PTSD)
c. Bipolar disorder
d. Delusional disorder
ANSWER C: The pattern of aggression or violence of bipolar disorder
includes irritability, agitation, and violent behavior during manic or
psychotic episodes, which is highly co-morbid with substance use, which
worsens the prognosis. The Diagnostic and Statistical Manual of Mental
Disorders identifies several disorders which may carry a higher risk for
violent and/or aggressive behaviors, which is a concern when patients with
co-morbid psychiatric disorders are admitted to the ICU or general floor for
medical-surgical needs.
44.
Of the following, which would NOT be helpful to include when developing
Jerry's plan of care?
a. Limiting choices
b. Providing structure
c. Encouraging patient input
d. Ensuring availability of prn medications
ANSWER A: Limiting choices would not be helpful in Jerry's plan of care.
Providing options, even if between limited choices, provides the patient
with a sense of independence as opposed to controlling the patient (integrity
vs. shame). Providing structure is very important, something which patients
receive on a psychiatric unit, but may lack on a medical-surgical unit.
Encouraging patient input into identification of triggers and methods which
have been effective for relief/control of aggressive impulses is critical to
both empowering the patient, and individualizing the plan of care. Ensuring
availability and prompt delivery of prn medications provides the patient
with a sense of control and safety, knowing that they will be able to obtain
needed medication when requested.
45.
Of the following, which often triggers an episode of violence or aggression
by the patient with a psychiatric diagnosis that may involve violent
behavior?
a. Obtaining a history
b. Asking for input into care
c. Enforcing rules
d. Taking a walk
ANSWER C: Enforcing rules is often a trigger for the patient with a
psychiatric diagnosis that may involve violent behavior. Limit-setting or
denying patient demands is often interpreted by the patient as a means of
control and intimidation, which can lead to aggressive or violent behavior.
Anticipation of this potential and responding with calm, appropriate and
professional behavior by nursing personnel is critical to resolving conflict
and preventing escalation of the situation. Both avoidance of such patients,
and matching emotion with them are detrimental for all parties involved.
46.
Which of the following medications would NOT be an appropriate prn
medication for use during an episode of aggression or violence for the
patient with a psychiatric diagnosis?
a. Olanzapine
b. Meperidine
c. Ziprasidone
d. Haloperidol
ANSWER B: Meperidine is an opioid used to treat pain, and is not an
appropriate medication to use to treat aggressive or violent behavior.
Second-generation anti-psychotic medications such as olanzapine and
ziprasidone, as well as traditional anti-psychotics such as haloperidol are
effective agents, with or without the concurrent use of a benzodiazepine.
47.
Which of the following is an appropriate tension-reduction intervention for
the patient who may be escalating toward aggressive behavior?
a. Asking to speak to someone
b. Asking to be alone
c. Listening to music
d. All of the above
ANSWER D: All of the above interventions are excellent tension reduction
techniques for the patient in the ICU. Others include walking the hallway,
watching the television for distraction, writing in a journal, and asking for a
prn medication. When the plan of care is being developed, patient input
should be obtained regarding what triggers create an episode of aggression,
and what tension reduction techniques have been most effective in the past.
Patients who are in the midst of escalation are often unable to recognize the
need for a tension reducing intervention. Therefore, it is very helpful for
staff to be able to both recognize potential triggers, and offer appropriate
tension reduction techniques that have been individualized to the patient's
needs.
48.
Causes which contribute to delirium are often remembered as an acronym
of the same name. What cause does the E in DELIRIUM represent?
a. EEG
b. EKG
c. Electrolytes
d. Echocardiogram
ANSWER C: The E in the acronym DELIRIUM represents electrolytes,
since an electrolyte imbalance can contribute to this state. The other letters
represent the following: D = Dementia; L = Lung, liver, heart, kidney,
brain; I = Infection; R = Rx Drugs; I = Injury, Pain, Stress; U = Unfamiliar
environment; M = Metabolic. Delirium is often misdiagnosed as dementia,
which may be a coexisting diagnosis. Dementia should not be given as a
differential diagnosis until delirium is ruled out, as many factors which
contribute to delirium can be treated and may resolve the condition.
49.
Which of the following mental health situations is considered a psychiatric
emergency?
a. Seasonal Affective Disorder (SAD)
b. Depression with melancholic features
c. Major depressive episode with psychotic features
d. Bipolar depression
ANSWER C: Major depressive disorder (MDD) with psychotic features is
considered a psychiatric emergency which may require hospitalization.
There are a variety of depression classifications, which include: major
depressive disorder (MDD), depression with melancholic or catatonic
features, atypical depression, psychotic features, bipolar depression, single
or recurrent episode, dysthymia, and seasonal affective disorder (SAD). As
many as 66% of people who have depression don't realize it may be
treatable, and therefore do not seek help.
PHARMACOLOGY (STUDY MODE)
1.
A drug form in which medication particles are instilled into a liquid and
combined through agitation of the solution is called:
a. Suspension
b. Elixir
c. Syrup
d. Tincture
ANSWER A: A suspension is a type of medicine that combines medication
particles with a liquid solution. When not administered, medication
particles within the suspension may settle to the bottom, requiring the nurse
to shake the solution to mix. Suspensions are typically given as oral
solutions.
2.
Following a dose of medication, a client develops inflamed mucous
membranes and nasal discharge. What type of minor reaction is this client
experiencing?
a. Urticaria
b. Pruritis
c. Hives
d. Rhinitis
ANSWER D: Rhinitis may occur as a mild reaction following some types
of medication administration. Rhinitis involves itchy or inflamed mucous
membranes, particularly around the eyes, nose and mouth. The client may
also develop swelling of the nasal passages or clear discharge.
3.
Mr. Y is receiving medication through a catheter that has been placed into
the subarachnoid space of his spinal column. What route of medication
administration is this called?
a. Intrapleural
b. Intraosseous
c. Intrathecal
d. Intraperitoneal
ANSWER C: Medications administered through the intrathecal route are
given through a catheter that has been placed into the subarachnoid space of
the spinal column. These medications are given into cerebrospinal fluid,
often for pain control. Placement of an intrathecal catheter is typically done
by a trained physician or advanced-practice nurse.
4.
A client is having difficulties swallowing a large tablet of medication.
Which of the following interventions from the nurse may best assist this
client?
a. Help the client to lie down while taking the medication
b. Obtain an order to give the medication intravenously instead
c. Dissolve the tablet in a glass of pineapple juice
d. Assist the client to drink a full glass of water when taking the tablet
ANSWER D: When a client has trouble swallowing a large tablet, the
nurse can assist him by helping him to sit in an upright position and to drink
a full glass of water while taking the medication. If the client still has
difficulty, the nurse may ask the physician if the medication can be crushed
and mixed with a soft food, such as applesauce.
5.
A nurse is attempting to find the ventrogluteal muscle to administer an
intramuscular medication. In which method does the nurse find this site?
a. The nurse places her palm on the client's hip at the level of the greater
trochanter, pointing the thumb toward the client's groin and administering
the injection between the first and second fingers
b. The nurse measures two finger-widths below the acromion process and
administers the injection at this point
c. The nurse estimates the upper and outer quadrant of the buttock and gives
the injection 3 inches below the iliac crest
d. The nurse grasps the muscle of the upper thigh and administers the
injection 6 inches above the knee
ANSWER A: The ventrogluteal muscle is a location for an intramuscular
injection that can be found by placing a palm on the client's hip. The index
finger should point toward the anterior iliac spine, while the thumb should
point toward the client's groin. The nurse administers the injection between
the first and second fingers in this position.
6.
A nurse is administering total parenteral nutrition for a client. The solution
contains 12% dextrose and 5% amino acids. Which of the following sites is
most appropriate to administer this solution?
a. Left radial arterial line
b. Right subclavian catheter
c. Left peripheral intravenous catheter
d. Both a and c
ANSWER B: When administering total parenteral nutrition solutions, a
mixture that contains greater than 10% dextrose should be given through a
central line to reduce the incidence of blood clot formation. A subclavian
line is a type of central line that is large enough to receive this type of fluid.
7.
Mr. S is complaining of pain following a surgical procedure. The nurse
checks his orders and finds that he has an order for meperidine 25 mg prn q
4 hrs for shivering. What is the next action of the nurse?
a. Give 25mg of the medication and use it for pain
b. Contact the pharmacy to clarify the purpose of the medication
c. Check the medication record for other prn pain medications
d. Administer 12.5 mg of the medication and document that the client was
shivering
ANSWER C: When administering medications on a prn basis, the nurse
must give the medication according to its indications and in the time
allotted. If a medication is ordered for symptoms other than what the client
is having, the nurse should check for other, more appropriate medications to
manage the symptoms or follow the facility policy for administering the prn
drug.
8.
Which of the following medications is an example of an adjuvant drug?
a. Ibuprofen
b. Fentanyl
c. Hydromorphone
d. Hydroxyzine
ANSWER D: Hydroxyzine (Vistaril) is an example of an adjuvant drug.
Adjuvants are those drugs that work with analgesics to improve pain relief.
For example, a nurse may administer an adjuvant that works as a muscle
relaxant in addition to a narcotic analgesic for a client who is complaining
of pain and who has a lot of tension.
9.
Which of the following is a potential complication of administering a
dorsogluteal intramuscular injection?
a. Striking the bone of the humerus with the needle
b. Inserting the needle into the sciatic nerve
c. Causing extravasation of medication into the subcutaneous tissues
d. Causing an air embolus in the superior iliac artery
ANSWER B: The dorsogluteal site, which is found on the upper and outer
quadrant of the buttocks, may be a site for administration of intramuscular
medications. However, the nurse must assess the site carefully before
administration to avoid hitting the sciatic nerve that runs near this site and
along the length of the leg. Inserting the needle into the sciatic nerve can
cause significant nerve pain, numbness, or tingling in the buttock and the
leg.
10.
A nurse is preparing to administer a rectal suppository to a client. After
applying gloves, checking the client's identification band, and closing the
door, what is the next step of the nurse?
a. Assist the client to lie in the Trendelenburg position
b. Unwrap the suppository and lubricate the end
c. Remove gloves and wash hands
d. Record the date, time, and amount of suppository to give
ANSWER B: Once the nurse has prepared the supplies needed to give a
client a suppository, she should assist the client to lie in the Sims' position,
unwrap the suppository, and lubricate the end of the medication to facilitate
easier insertion. Following administration, the nurse removes her gloves
and documents the date, time and amount given.
11.
Mr. F has been prescribed isocarboxazid, a monoamine oxidase inhibitor, as
part of treatment for depression. Which of the following foods should the
nurse instruct the client to avoid while taking this drug?
a. Wine
b. Sweet potatoes
c. Spinach
d. Apple juice
ANSWER A: Monoamine oxidase inhibitors are a type of antidepressant
drug that may have negative interactions with certain foods. Clients who
take these drugs should be taught to avoid foods that contain tyramine, such
as wine, beer, pickled foods, and some types of cheeses. Contact with these
foods while taking this medication can cause severely high blood pressure.
12.
A nurse is preparing to administer digoxin to a client who suffers from heart
failure. What must the nurse consider before administering this medication?
a. The presence of pitting edema in the lower extremities
b. The sound of rales on lung auscultation
c. The rate of the apical pulse
d. The presence of jaundiced skin
ANSWER C: Digoxin is a drug that works to increase cardiac contractility
among clients who suffer from conditions such as heart failure, atrial
fibrillation, or atrial flutter. Because digoxin may work to slow a rapid heart
rate, the nurse should check an apical pulse before administering this
medication.
13.
A client has been taking his antianxiety medications for four years, even
though he no longer struggles with acute anxiety. Instead, he has a routine
of taking the medication each evening and feels better knowing that he has
taken it. Which of the following best describes this action?
a. Physiologic need
b. Physiologic dependence
c. Drug abuse
d. Drug habituation
ANSWER D: Drug habituation is a mild form of dependence on a certain
type of drug that occurs when a user takes the drug out of habit. The client
may not need to take his antianxiety medications on a daily basis, but he has
formed a habit for the drug and feels better after using it. Drug habituation
may be detrimental to a client if he no longer truly needs to take the drug
but uses it anyway.
14.
Which of the following is a disadvantage of taking medication through an
oral route?
a. The drug may be absorbed too rapidly
b. The drug may have a bad taste
c. The drug is more expensive to use
d. Both a and b
ANSWER B: Medications that are administered orally may have an
unpleasant taste, making them difficult to take or swallow for some clients.
While oral medications are often convenient and cost effective, they may
not be used for clients who cannot swallow, those who are unconscious, or
those with nausea or vomiting.
15.
One tablespoon of medication is equal to how many milliliters of fluid?
a. 5 ml
b. 15 ml
c. 30 ml
d. 60 ml
ANSWER B: One tablespoon of fluid is equal to 15 ml. Some nurses may
assist clients with measuring medications while in the home environment.
There are also some over the counter products that list servings in
tablespoons and the nurse should know how to convert these household
systems into metric systems.
16.
Which of the following must the nurse consider before administering
medications through a nasogastric tube?
a. The nurse must determine whether a tablet can be crushed
b. The nurse must use 5 cc of cold water to instill the medication
c. The nurse must aspirate from the tube after giving the medication
d. The nurse must immediately reconnect low-intermittent suction after the
medication
ANSWER A: When giving medications through a nasogastric tube, the size
of the tube limits the type of medications that can be instilled. If a tablet is
ordered for a client, the nurse must check to ensure that the tablet can be
crushed and then mixed with warm water. Enteric-coated medications and
those that are extended-release may not be crushed to use through a
nasogastric tube.
17.
What gauge of needle is most appropriate when giving an adult a
subcutaneous injection?
a. 16 gauge
b. 18 gauge
c. 24 gauge
d. 30 gauge
ANSWER C: When administering a subcutaneous injection to an adult, the
nurse should use a fine-gauge needle that is large enough to provide the
medication and reach the subcutaneous fat. However, because the needle
will only reach the fat and does not need to inject through muscle, a largebore needle is also not appropriate. An appropriate size for an adult client is
between #24 and #26 gauge of needle.
18.
Which is the most appropriate muscle site for an intramuscular injection for
a 9-month old child?
a. Deltoid
b. Ventrogluteal
c. Dorsogluteal
d. Vastus lateralis
ANSWER D: The vastus lateralis is the site of choice for administering
intramuscular medications to babies and young children. This muscle is
developed enough even in young children that an injection in this location
is ideal. The vastus lateralis muscle is located on the anterior and lateral
portion of the thigh.
19.
A nurse is caring for a client who is breastfeeding her baby. Which of the
following medications can the nurse administer to this client?
a. Aspirin
b. Lipitor
c. Prednisone
d. Amiodarone
ANSWER C: Some drugs are not safe for use during breastfeeding, as they
may enter the mother's breast milk and transfer to the baby, causing unsafe
exposure. There are also some drugs that are not recommended when
breastfeeding because they decrease a mother's milk supply. A nurse should
read the contraindications associated with any drug before administering it
to a mother who is breastfeeding. Some drugs, such as corticosteroids, have
been shown to be safe while breastfeeding.
20.
A nurse is administering a blood transfusion when the client begins to
complain of a headache and difficulty breathing. His blood pressure is
170/110 mmHg. What is the next action of the nurse?
a. Administer a sedative and analgesic as directed
b. Assist the client to sit upright and slow the transfusion
c. Check the client's urinary output
d. Assist the client to lie supine in the Trendelenburg position
ANSWER B: When administering blood or blood products and the client
develops symptoms of fluid overload, the blood may be given faster than
the client can tolerate. Signs or symptoms of fluid overload include
headache, high blood pressure, cough, dyspnea, or rales on auscultation.
The nurse should assist the client to sit up to facilitate easier work of
breathing and slow the transfusion.
21.
A nurse is caring for a client who has a triple-lumen, peripherally inserted
central catheter (PICC) in the right arm. Which of the following is a
consideration when working with this type of central line?
a. The client should be restricted to showers only, no baths
b. The nurse should flush one of the ports with saline solution every 8 hours
c. The nurse should avoid taking a blood pressure in the right arm
d. The client should avoid exercise until the PICC has been removed
ANSWER C: When caring for a client who has a peripherally inserted
central catheter (PICC), the nurse must refrain from taking a blood pressure
in the affected arm. If necessary, the nurse may need to post signs in the
client's room for other personnel to avoid procedures in the affected arm.
22.
A nurse is caring for a client who has low blood pressure. The physician has
ordered dopamine 2 mcg/kg/min on a continuous infusion. The nurse notes
that the client weights 186 pounds. What is the appropriate rate for this
infusion?
a. 168 mcg/min
b. 372 mcg/min
c. 168 mg/min
d. 372 mg/min
ANSWER A: When administering medications that require dosage
calculation based on kilograms, the nurse may need to convert the client's
weight in pounds. In this example, the client's weight is 186 pounds, which
is approximately 84 kg. This weight, multiplied by 2 micrograms (mcg) of
dopamine, is equal to 168 mcg administered per minute.
23.
A nurse needs to administer 15 units of regular insulin and 20 units of NPH
subcutaneously to a client with diabetes. In what order does the nurse draw
these medications?
a. Draw 20 units of NPH, then 15 units of regular, in the same syringe
b. Draw 15 units of regular, then 20 units of NPH, in the same syringe
c. Draw 15 units of regular, then 20 units of NPH, in different syringes
d. Draw 5 units of regular, then 20 units of NPH, then 10 more units of
regular, in different syringes
ANSWER B: When administering two different types of insulin
subcutaneously, the nurse may draw both NPH and regular insulin in the
same vial as long as they are drawn in the correct order. The nurse should
draw regular insulin first, followed by NPH, because NPH contains protein
that should not contaminate the regular insulin vial.
24.
When preparing to give a client a narcotic analgesic, which of the following
information should the nurse provide as part of education?
a. Take the medication on an empty stomach
b. Lie down for one hour after taking the medication
c. The medication may cause constipation
d. The medication may cause heartburn
ANSWER C: Narcotic analgesics may cause constipation in some clients.
Before administration, the nurse should assess the client's bowel sounds and
review his bowel habits. The nurse should provide information about how
to prevent constipation for the client and to make him aware that this is a
common side effect.
25.
A nurse is caring for a client who is recovering from surgery. He is
complaining of pain rated at a "9" on a 0-10 scale. The nurse administers 2
mg Morphine Sulfate for pain control. After the medication, the client falls
asleep, his blood pressure is 95/48, and his heart rate is 62 bpm. After ten
minutes, the client awakens and asks for more pain medicine, rating his
pain at an "8." What is the most appropriate action of the nurse?
a. Administer 2mg of Morphine Sulfate
b. Check the medication record for a non-narcotic analgesic
c. Tell the client that he cannot have any more medication
d. Contact the physician about the client's vital signs
ANSWER B: Narcotic analgesics may have negative effects for a client,
such as a decrease in vital signs and increased somnolence. Although the
client is complaining of pain, too many narcotics can be detrimental. The
nurse should determine if there is another alternative to narcotics to help
this client control his pain.
26.
After administering a drug, the time when the body first starts to respond to
the medication is called:
a. Plateau
b. Peak plasma level
c. Onset of action
d. Drug half-life
ANSWER C: The onset of action is the time after a drug administration in
which the body initially responds to the medication. Some drugs may have
a rapid onset of action but a short half-life, while others may have a slower
onset, but their effects last longer.
27.
Which of the following abbreviations is acceptable to use as part of
medication documentation?
a. Q.O.D.
b. MS
c. IU
d. prn
ANSWER D: Writing prn after a medication dose indicates that a
medication may be given on an as-needed basis. This requires the nurse to
use her judgment when administering medications; there may also be a
maximum amount that can be given. There have been many abbreviations
that are listed as "unacceptable," as they may cause confusion and should
instead be written out.
28.
How many milliliters are equal to one quart of fluid?
a. 250 ml
b. 500 ml
c. 1000 ml
d. 2000 ml
ANSWER C: One quart of fluid is equal to 1000 ml. The nurse should be
aware of fluid volumes when administering intravenous fluids and
medications. In some situations, the apothecary system of one quart must be
converted to milliliters.
29.
A nurse receives an order for Iansoprazole (Prevacid) 15 mg daily. The
medication is available in syrup form of 5 mg/ml. How many milliliters
must this nurse give?
a. 5 ml
b. 1 ml
c. 3 ml
d. 15 ml
ANSWER C: When calculating drug dosages, the nurse must determine
how many milligrams are available per milliliter and multiply to reach the
correct dose. In this example, 5 mg of Prevacid is available in 1 ml of fluid.
Multiplying 5 mg x 3ml = 15 mg.
30.
A nurse asks her coworker to administer Mr. J's 12pm medication because
she is running behind. Which of the following information must the nurse
verify with Mr. J before giving him his medication?
a. His name and address
b. His name and hospital identification number
c. His name and room number
d. His name and diagnosis
ANSWER B: To avoid mistakes in medication administration, the nurse
should verify the client's name and hospital identification number before
giving a drug. This information is usually available on a client's
identification band when in the hospital. Verification should be done on all
clients but is especially important in those situations when the client is
previously unknown to the nurse.
31.
Which of the following is more likely to occur with aging as a complication
of medication administration?
a. Increased renal function
b. Increased gastrointestinal absorption
c. Increased visual acuity
d. Increased ratio of fat compared to lean body mass
ANSWER D: Aging adults develop an increased ratio of fat to lean body
mass, which affects how their bodies process medications. Increased fat
tissues may cause the body to retain fat-soluble medications, which in turn
places the older adult at risk of drug toxicity.
32.
Which of the following interventions should the nurse consider when giving
an oral medication to a child?
a. Mix the medication with milk to mask the taste
b. Dilute the medication in a glass of water
c. Refeed the medication if the child pushes it out with his tongue
d. Mix the medication in a food the child enjoys
ANSWER C: When administering oral medications to a child, he may not
want to cooperate with taking the medicine, particularly if the flavor is
unpleasant. Small children who push medication back using their tongues
can be re-fed the medication as long as it stays on or near the spoon or cup.
Avoid mixing medications with a child's favorite foods, as unpleasant
medications may create a negative association with the food.
33.
Which of the following methods best describes administration of an
intradermal injection?
a. Pull the skin taut and insert the needle bevel-up just slightly under the
skin; inject medication to create a wheal
b. Pull the skin taut and insert the needle bevel-down just slightly under the
skin; inject medication to create a wheal
c. Pinch the skin and insert the needle bevel-down into the skin fold to
create a wheal
d. Pinch the skin and insert the needle bevel-up at a 45-degree angle into the
skin
ANSWER A: When administering an intradermal medication, the nurse
uses a fine-gauge needle and inserts it, bevel-up, into the dermis layer of the
skin. The nurse should pull the skin taut before injection to facilitate easy
needle entry. Producing a wheal verifies that the medication is in the dermis
and not the subcutaneous fat.
34.
Which of the following is a disadvantage of administering intravenous
medications through the IV-push method?
a. It is impossible to determine the full effect of the drug on the client
b. The drug may be irritating to the client's veins
c. The peak onset of action is slower when a drug is given IV-push
d. None of the above
ANSWER B: A disadvantage of giving medications through IV-push is that
the medicine quickly enters the bloodstream and may be irritating to the
client's veins. The nurse must be aware of the effects of the medication on
the client's circulation as well as the medication's purposes. Once a drug has
been given IV-push, it cannot be taken back, so the nurse must always
remain aware of what and how much she is giving.
35.
A nurse is preparing to administer an ophthalmic medication to Mrs. W.
Which of the following statements demonstrates that the nurse is
performing this procedure correctly?
a. Open your eyes wide and look toward the floor."
b. I will hold your eyelashes to keep your eye open."
c. I'm going to give this drop in the lower part of your eye."
d. Try to keep your eyes open after I give this medicine."
ANSWER C: A nurse who is administering ophthalmic medications should
instruct the client to look up while she holds the eye open by pulling the
lower eyelid down toward the cheekbone. The medication should be
instilled into the lower conjunctiva and the client instructed to close her
eyes just following the drops to distribute the medication.
36.
Which of the following effects does obesity have on drug distribution?
a. Drugs are distributed more quickly in obese persons because blood flow
is increased through fat tissue
b. Drugs are distributed more slowly in obese persons because blood flow is
decreased through fat tissue
c. Obesity has a paradoxical effect on drug distribution in that blood flow is
decreased but distribution is increased
d. Obesity has no effect on drug distribution
ANSWER B: Obese persons may have slower levels of drug distribution
after taking medications. Blood travels more slowly through fat tissues and
increased amounts of fatty tissues further hampers the distribution of the
drug throughout the body. The obese person may have to wait a greater
amount of time after taking a drug for it to be released.
37.
Which of the following is a potential side effect of ibuprofen?
a. Headache
b. Urinary retention
c. Hematuria
d. Low blood pressure
ANSWER C: Hematuria may be a side effect of ibuprofen. This type of
drug is a non-steroidal anti-inflammatory drug (NSAID), which may be
more likely to cause small amounts of bleeding. Nurses should consider
clients' urinary output, as well as monitor liver enzymes and gastrointestinal
function before administering ibuprofen.
38.
Mr. B is recovering from anesthesia after surgery. During the case, he was
given opioid analgesics, but now his respiratory rate is only 8 respirations
per minute. Which of the following medications may be most appropriate at
this time?
a. Amobarbital
b. Flurazepam
c. Phenytoin
d. Naloxone hydrochloride
ANSWER D: Naloxone hydrochloride (Narcan) may be used in cases of
respiratory depression related to opioid analgesics. Narcan binds to opioid
receptor sites in the body, minimizing or reversing the effects of these
analgesics.
39.
Which of the following is an adverse effect of diuretics?
a. Hypokalemia
b. High blood pressure
c. Decreased BUN
d. Anxiety
ANSWER A: Diuretics decrease blood volume by blocking the body's
ability to reabsorb sodium in the kidneys. Increased water is excreted
during this process, causing increased urinary output and changes in
electrolyte levels. Potassium is an electrolyte that can be affected by
diuretics, causing low levels, or hypokalemia.
40.
Mr. R is being seen in his physician's office for swollen and painful joints.
The most obvious joint affected is his great toe, which has become large,
red, and painful. Which of the following medications is most appropriate
for this condition?
a. Docusate sodium
b. Bismuth subsalicylate
c. Allopurinal
d. Cromolyn sodium
ANSWER C: Allopurinal is a medication often used in the treatment of
gout. Gout occurs with a buildup of uric acid crystals in the body, which
collect in the joints, causing warmth, redness, and tenderness. Gout often
affects the great toe as a main source of uric acid collection. Allopurinal
works by inhibiting production of uric acid.
41.
Which of the following interventions reduces the risk of infection when
administering an intramuscular injection?
a. Draw up the solution approximately 5 minutes before administration
b. Keep the tip of the needle covered until administration
c. Clean the skin with an antiseptic swab in a ½-inch radius
d. Check the client's temperature immediately after administering the
injection
ANSWER B: A nurse places a client at risk of infection when
administering intramuscular injections because of a break in the skin. The
nurse can reduce this risk by keeping the needle of the syringe covered after
drawing up the solution until she is ready to administer the drug. This
reduces the risk of needle contamination that would introduce pathogens
into the client's body.
42.
A nurse is attempting to start an IV in a client's arm and is having difficulty
with finding a vein to use. The client's skin is cold. Which intervention of
the nurse may improve this situation?
a. Raise the client's hand so that it remains at a level above the heart
b. Place a warm pack on the clients arm for 5 minutes before looking for a
vein
c. Instruct the client to drink a quart of warm water
d. Apply a tourniquet 12 inches above the IV site
ANSWER B: Cold skin may cause sluggish circulation and increased
difficulty with starting an IV. A nurse can apply a warm pack to the area
where she plans to insert the catheter, leaving it in place for approximately
5 minutes. This action will warm the skin and surrounding tissues and
increase blood flow to the site.
43.
A client is being admitted on a routine basis for fluids to correct an
electrolyte balance. Which of the following sites is most appropriate for
starting an IV in this client?
a. A vein in the antecubital fossa
b. A vein in the dominant hand
c. A vein in the foot
d. A vein in the non-dominant hand
ANSWER D: If a nurse has a choice of sites in which to start an IV and the
situation is not an emergency, she should try to start a line in the client's
non-dominant hand. This frees the client to use his dominant hand while
receiving fluids at the same time. Hands are the most frequent site of
insertion, as well as the most convenient. Many emergency situations
necessitate the use of the vein in the antecubital fossa.
44.
Which of the following interventions best helps to facilitate insertion of an
intravenous catheter?
a. Ask the client to look away during the procedure
b. Puncture the skin at a 5 to 10-degree angle
c. Advance the catheter until resistance is met
d. Secure the device at a 45-degree angle to the skin
ANSWER C: The nurse can have greater success with starting an IV by
following a few protocols that will facilitate easier insertion. The client
should be aware that the nurse is starting an IV. Once the catheter is
inserted, the nurse should advance it until a small amount of resistance is
met. This indicates the catheter has reached the vein. By lowering the
needle slightly, the nurse can then enter the vein, which should provide a
flashback of blood in the catheter.
45.
All of the following actions are components of a peripherally inserted IV
dressing change EXCEPT:
a. Remove the current dressing
b. Cleanse the areas under the dressing
c. Pat the area dry with a towel
d. Apply the new dressing and label it with the date
ANSWER C: Changing a peripherally inserted IV dressing may be
necessary due to facility policy or if the site becomes soiled. When
performing this procedure, the nurse should remove the old dressing and
cleanse the site, allowing it to air dry. The new dressing should be applied
and labeled with the date of the change.
46.
A client with an IV is complaining of pain at the insertion site. There is a
bruise at the site, the skin is tender, and the IV fluid will not flow. Which of
the following conditions is the most likely cause of these symptoms?
a. Hematoma
b. Phlebitis
c. Extravasation
d. Venous spasm
ANSWER A: A hematoma may occur at an IV site when blood leaks from
the vessel into the surrounding space. A hematoma may feel painful and the
area may be tender. A bruise may also develop at the site if blood collects in
the tissue under the skin.
47.
Which of the following solutions is compatible with administration of
packed red blood cells?
a. Lactated Ringer's
b. 0.9% Normal Saline
c. D5 ½ Normal Saline
d. Normosol-R
ANSWER B: During blood administration, the only acceptable solution
that is compatible is 0.9% Normal Saline. This is an isotonic solution that
maintains the balance of fluid moving into and out of the cells. Other
products may have additives that can cause the blood to form small clots in
the solution.
48.
Which of the following is an example of a colloid solution?
a. 5% Dextrose in water (D5W)
b. Albumin
c. Lactated Ringer's
d. Normal Saline
ANSWER B: Colloid solutions are those that have large enough particles
that they do not cross cell membranes from the bloodstream. Instead,
colloids often remain in the bloodstream, which is why they might be used
as volume expanders in some clients, such as those with low blood pressure
due to low blood volume. An example of a colloid is albumin.
49.
A nurse is preparing to administer packed red cells for Mr. H when she
realizes that he does not have an IV. What is the minimum size of catheter
the nurse must use in this situation?
a. 30 gauge
b. 28 gauge
c. 24 gauge
d. 20 gauge
ANSWER D: When administering packed red blood cells, the nurse should
give the infusion through an IV that is large enough to permit the flow of
cells into the client's body. Small-bore IV catheters may not be large enough
to accommodate the size of red blood cells. When given a choice of IV to
use for packed cell administration, the nurse should choose an IV that is
size #20 gauge or larger.
50.
A nurse is caring for a client who has been ordered to receive a rapid
infusion of packed cells to support his intravascular blood volume. She
starts to administer the blood at a fast drip rate and realizes that the blood is
not infusing. Which of the following actions may the nurse perform to
correct this situation?
a. Raise the client's arm above his head
b. Place the client in the Trendelenburg position
c. Place a pressure bag around the blood container
d. Start a new IV and simultaneously administer a second unit of blood
ANSWER C: A pressure bag is a device used for intravenous fluids that
increases the rate of administration. A pressure bag is placed around the bag
of fluid or blood and is connected to a small hand pump, similar to that of a
sphygmomanometer. The nurse inflates the pump, which causes the
pressure bag to squeeze the fluid bag. This squeezing action creates the
pressure needed to propel fluid through the tubing and into the client at a
faster rate.
51.
Which of the following actions is part of preparation of a medication from
an ampule?
a. Snap the neck of the ampule toward the body
b. Hold the ampule upside down when drawing up the medication
c. Expel excess air bubbles back into the ampule
d. Always use the same needle for drawing as the one used for the injection
ANSWER B: Ampules are glass vials that contain medication for
intramuscular or intravenous use. Because of their composition, ampules
should be handled carefully. The nurse should cover the neck of the ampule
with an alcohol wipe and snap it open in a direction away from the body.
Holding the vial upside down, the nurse draws up the formula, using a
different needle than the one that will be used for injection of the
medication to the client.
52.
A nurse is preparing to add a medication to an IV that is already infusing
for a client. Which of the following practices is most appropriate for this
process?
a. Draw the medication to be added from a vial using sterile technique
b. Inject the solution through the air vent port of the IV bag
c. Shake the bag vigorously after the medication has been added
d. Clamp the IV tubing for 30 minutes after adding the medication
ANSWER A: In some situations, a nurse must add medication to an
existing bag of IV fluid without changing the bag. The nurse can add to the
bag by initially drawing up the medication to be added using a sterile
technique. Because the medication will be added to a solution that will enter
the client's body, using sterile technique prevents infection when mixing
medication with fluid.
53.
Which of the following information should the nurse tell a client who needs
to use a metered-dose inhaler?
a. Shake the inhaler after using
b. Place the mouthpiece in the mouth before compressing the inhaler
c. Take a breath and hold it before compressing the inhaler
d. Immediately repeat the next compression if more than one puff is ordered
ANSWER B: A metered-dose inhaler contains medication to assist some
client's with breathing, such as those who have asthma or chronic
obstructive pulmonary disease. Although the inhaler contains a set amount
of medication to administer when compressed, some clients have
difficulties coordinating use of the inhaler with breathing. One method of
assisting the client is to teach him to place the mouthpiece in the mouth
before compressing the inhaler.
54.
Which of these clients is the best candidate for using patient-controlled
analgesia?
a. An 86-year old man in the memory disorders unit
b. A 6-year old boy with a tibia-fibula fracture
c. A 56-year old man post-op day #1 after a hernia repair
d. A 70-year old woman with end-stage brain cancer
ANSWER C: Patient-controlled analgesia (PCA) is a method of pain
control that gives the client more freedom with managing his own pain. He
can self-administer pain medications without waiting to ask the nurse. Some
clients, however, are not good candidates for PCA in that they may not
understand how to self-regulate their pain control or they may not
remember to push the button. Those with memory disorders, those in the
late stages of terminal illness who may have disorientation and children are
not good candidates for PCA.
55.
Which of the following clients is most likely to benefit from receiving a
peripheral nerve block?
a. A client undergoing a cesarean section
b. A client undergoing an appendectomy
c. A client undergoing a cervical discectomy
d. A client undergoing a total knee replacement
ANSWER D: A peripheral nerve block is a type of anesthetic that involves
blocking the sensation of a particular nerve in the arm or leg. This type of
anesthesia is useful for clients who are undergoing a procedure that affects
only one body part; clients may or may not need general anesthesia with
this procedure, but it offers pain control and diminished sensation to the
affected area. An example of a procedure that uses a peripheral nerve block
is a total knee replacement.
56.
Mrs. V is a pregnant client who is receiving fluid and electrolyte therapy
after being diagnosed with hyperemesis gravidarum. The nurse enters Mrs.
V's room to find that she has a decreased level of consciousness, fever, and
is sweating profusely. Her urine specific gravity is 1.026 and her hematocrit
level is 55%. Which of the following conditions most likely explains this
situation?
a. Third-space syndrome
b. Fluid volume excess
c. Fluid volume deficit
d. Hyperosmolar imbalance
ANSWER C: Fluid volume deficit occurs when the client develops a lack
of adequate fluid for normal body processes. Fluid volume deficit may
occur due to such conditions as vomiting, excess sweating, diarrhea, large
blood loss, or renal failure. The urine of a client with fluid volume deficit
will be more concentrated and have a higher specific gravity; additionally,
the blood may have a higher hematocrit level, requiring administration of
fluids.
57.
Which of the following clients is most likely in need of fluid restriction?
a. A 67-year man with cor pulmonale
b. An 86-year old man with recent vomiting
c. A 24-year old pregnant woman
d. A 47-year old woman with severe burns
ANSWER A: Some clients with excess fluid volume may need to be given
fluid restrictions to avoid further overload of their circulatory systems.
Clients with conditions such as cor pulmonale, congestive heart failure, or
renal failure, need fluid restriction and strict monitoring of both IV and oral
intake of fluid to regulate their circulation and prevent complications.
58.
A nurse has been given an order for a 20 cc bolus to a client with a central
line. The only syringes she has available are 5 or 10 cc in size. What is the
most appropriate action of the nurse?
a. Give 4 boluses of 5 cc each
b. Give 2 boluses of 10 cc each
c. Find a 20 cc syringe
d. Either b or c
ANSWER D: When administering small amounts of fluid through a central
line, such as with a medication or giving a bolus, the nurse must use a
minimum size syringe of 10 cc. A syringe of a smaller size may place too
high of pressure on the internal catheter. In this situation, the nurse could
either split the bolus into 2 10-cc injections, or find a 20 cc syringe to use
for this purpose.
59.
Mr. L is in the emergency room with a traumatic amputation. The physician
determines that he needs a rapid infusion of packed red cells. Mr. L is
unconscious and the nurse does not know his blood type. Which of the
following blood types might be the safest to use in this situation?
a. Type Ab. Type AB+
c. Type Bd. Type OANSWER D: Type O negative blood is considered a universal donor type
and may be used in cases when a client's blood type is not immediately
available. Type O negative blood is compatible with all blood types because
it does not contain any antigen markers. Although type O negative blood
can be used in emergencies, it is preferable to establish a client's blood type
prior to administering blood, if possible.
60.
Which of the following describes a benefit of using a Groshong® tunneled
catheter?
a. It does not require regular heparin flushes
b. It is less prone to kinks in the line when compared with other central
catheters
c. It can easily be placed at the bedside by a certified nurse
d. It does not require an x-ray to confirm placement
ANSWER A: One of the advantages of a Groshong® catheter is that it is
constructed so that it does not require heparin for flushes. Instead, the nurse
may use a normal saline flush per facility protocol. A Groshong catheter is
typically inserted by a physician in an operating suite and its placement
must be confirmed by x-ray before use.
61.
Which of the following interventions should the nurse perform when
changing a cap on a central line catheter?
a. Open the supplies just before starting
b. Unclamp the catheter
c. Cleanse the catheter cap with povidone-iodine
d. Change each lumen on different days of the week
ANSWER A: Changing a cap on a central line introduces the possibility of
infection into the client's body and should be performed carefully. The
nurse can reduce the chance of infection by opening supplies just before
starting. Although the nurse will want to have supplies ready for use,
opening packages early and leaving them to sit in the work area may
increase the risk of introducing infectious particles to the client.
62.
A nurse is caring for a 5-year old child who just had an appendectomy. The
physician
wrote
orders
regarding
pain
control,
diet,
and
fluid
administration. The nurse reads the order that says "Maintain IV D5W at a
rate of 500 cc/hr." What is the most appropriate action of the nurse in this
situation?
a. Administer the fluid at the prescribed rate
b. Take the client's blood pressure before changing the IV rate
c. Administer the fluid at 50 cc/hr instead
d. Contact the physician for clarification of orders
ANSWER D: When administering IV fluids and medications, the nurse
should be familiar with reasonable rates of administration. There are some
clients who need large amounts of fluid; while among other clients, too
much fluid can be dangerous. A nurse caring for a young child who has
been given this order should clarify with the physician, as the prescribed
rate is very high to give to a child.
63.
A nurse is teaching a client to care for a Broviac® catheter at home. Which
statement from the client indicates understanding of the teaching?
a. I don't need to wash my hands unless they are visibly soiled."
b. If there is drainage at the insertion site, I should notify my physician."
c. I should wash my hands after I take off the old dressing."
d. I should use either rubbing alcohol or water to clean the end of the
catheter."
ANSWER C: Some clients care for tunneled catheters in their homes and
the nurse is responsible for their teaching. A client with a Broviac® catheter
should be taught to look for signs of infection, how to change dressings, and
how to flush the line. When performing a dressing change, a client
demonstrates understanding if he knows to wash his hands between
touching the soiled dressing and adding the clean one.
64.
Which of the following actions should the nurse consider when working
with a multi-dose medication vial?
a. Discard the vial after two uses
b. Clean the stopper with 70% alcohol before each use
c. Puncture the vial with only one needle and connect multiple syringes
d. All of the above
ANSWER B: Multi-dose vials of medication can potentially increase the
risk for infection if used improperly. Most facilities have policies regarding
their use and labeling for when these vials become outdated. Because the
multi-dose vial stopper may be punctured multiple times with different
needles, the nurse can reduce the chance of infection by cleaning the
stopper with an alcohol swab before puncturing.
65.
What common drug can be administered to treat wheezing in a patient with
infectious pneumonitis?
a. Dexamethasone
b. ibuprofen
c. albuterol
d. None of the above.
ANSWER C: Albuterol is a beta-adrenergic stimulant that can be used to
treat wheezing caused by obstructive lung disease. Albuterol works by
relaxing muscles in the airways to increase airflow to the lungs.
66.
A doctor writes out a prescription for medication to be taken as needed for
pain. Which of the following abbreviations could the nurse expect to see on
the prescription form?
a. CHF
b. ATB
c. Ac
d. Prn
ANSWER D: The abbreviation "prn" is used to indicate, "as needed." It is
commonly found on prescription sheets that are used to fill a medication
order for pain medications.
67.
A patient has been diagnosed with a mycotic condition. Which of the
following drug types would be used to treat this condition?
a. Antifungal
b. Antiarrhythmic
c. Diuretic
d. Antiemetic
ANSWER A: Mycotic infections are caused by fungi. To appropriately
treat this condition, an antifungal medication would be needed.
68.
Which of the following abbreviations means, "before meals"?
a. Ac
b. Prn
c. Qid
d. Qh
ANSWER A: The abbreviation meaning before meals is ac. PRN means as
needed. QID is 4 times a day. QH means hours sleep or take at bedtime.
69.
Which of the following anticoagulants would be found in a light blue
vacutainer tube?
a. EDTA
b. Sodium Oxalate
c. Lithium Heparin
d. Sodium Citrate
ANSWER D: Sodium citrate is found in the light blue collection tubes.
This tube is used most often for tests that assess coagulation times.
70.
If a doctor's order calls for the administration of 500 mg of medication, how
many grams should be given?
a. 500
b. 50
c. 0.5
d. 5
ANSWER C: One gram is equal to 1000 milligrams. Giving 500
milligrams of medication would equate to 0.5 grams of the same
medication.
71.
Which of the following medications would be given to treat vomiting?
a. Simvistatin
b. Acetaminophen
c. Lisinopril
d. Promethazine
ANSWER D: Phenergan (promethazine) is an antiemetic prescribed to treat
nausea and vomiting.
72.
A patient has been diagnosed with an irregular heartbeat. Which of the
following medications would be prescribed to treat this condition?
a. Antiarrhythmic
b. Antipsychotic
c. Cathartic
d. Antiseptic
ANSWER A: Antiarrhythmic medications are prescribed to treat
conditions where the heart is beating irregularly.
73.
Which of the following drugs would be used to treat GERD?
a. Claritin
b. Nexium
c. Nuprin
d. Celebrex
ANSWER B: Nexium is a medication used to control acid secretions of the
stomach and can help to decrease the symptoms of acid reflux.
74.
Of the following medications, which is not used to treat depression?
a. sertraline hydrochloride
b. paroxetine hydrochloride
c. Citalopram
d. Nifedipine
ANSWER D: Zoloft (sertraline hydrochloride), Paxil (parozetine
hydrochloride), and Celexa (citalopram) are all prescribed to treat
depression. Procardia (nifedipine) is a calcium ion influx inhibitor and is
used to treat pathology of the coronary circulation.
75.
A doctor's order is written to give a patient a medication using a nonparenteral route. Which of the following is a non-parenteral route of
medication administration?
a. Rectal Suppository
b. Intracardiac
c. IV drip
d. IM injection
ANSWER A: Parenteral medications are given through routes other than
the GI tract. Non-parenteral medications are injected or given through the
skin or mucous membranes.
76.
A patient is morbidly obese. Which of the following needles would be best
to give an IM injection in the deltoid?
a. 25 gauge 5/8 inch
b. 27 gauge 1/2 inch
c. 21 gauge needle 1 1/2 inches
d. 16 gauge needle 3 inch
ANSWER C: Medications that are to be administered by the intramuscular
method are intended to be delivered to muscle tissue. Patients whom are
obese will have a larger area of subcutaneous tissue covering the muscles.
Using a longer needle will ensure the medication is delivered in the proper
area. However, a needle that is too long could damage bones, nerves, and
other anatomical structures.
77.
When giving an injection of insulin, which of the following is TRUE?
a. The deltoid muscle is the preferred injection site for insulin.
b. The angle of the needle should be 90 degrees.
c. The site should not be massaged after medication administration.
d. All of the above are true.
ANSWER C: Insulin injections are given subcutaneously. The site should
not be massaged after administration as the medication needs to distribute
slowly.
78.
Buccal administration of medications:
a. should be done under the tongue.
b. are done to allow controlled dosing through the mucosa.
c. are best to use in small children.
d. All of the above.
ANSWER B: Buccal administration methods are used to control the flow
of medication through the mucosa of the cheek in the inner mouth.
Monitoring this process in small children is difficult as infants and toddlers
may swallow the medication.
79.
If a medication order states that 300 mg of medication are to be given q.i.d.
for 10 days, how many total milligrams of medication will be given over
those 10 days?
a. 3000 mg
b. 9000 mg
c. 12000 mg
d. None of the above.
ANSWER C: The abbreviation q.i.d. means four times per day. Three
hundred milligrams times four times per day times 10 days is equal to
12,000 mg.
80.
A doctor orders 500 mg of medication. Available in stock are one gram
tablets. How many tablets should be given to the patient?
a. One
b. Two
c. One half
d. Three quarters
ANSWER C: The first step is to convert milligrams to grams. It takes one
thousand milligrams to make one gram, so divide 500 by 1000. The result is
0.500 grams. 0.5 grams is one half of 1 gram. Therefore one half of a tablet
should be given
81.
Which class of medications is foundational to treating the patient with
delirium tremens (DTs)?
a. Phenothiazines
b. Butyrophenones
c. Benzodiazepines
d. Anticonvulsants
ANSWER C: Benzodiazepines are foundational to the treatment of
delirium tremens, and adequate dosing must be ensured, especially if other
medications such as sympatholytics and neuroleptics are also administered.
Such medications may mask the early signs and symptoms that indicate a
progression to delirium tremens. Delirium tremens (DTs) is the most severe
form of alcohol withdrawal, and is manifested by global confusion and
autonomic hyperactivity, which can progress to collapse of the
cardiovascular system. Early treatment and recognition are vital. Alcohol
withdrawal syndrome is classified according to 4 categories: (1) Minor
withdrawal - tremulousness that occurs within 6-24 hours after patient's last
drink (2) Major withdrawal - hallucinations which occur 10-72 hours after
last drink (3) Withdrawal seizures - major motor seizures typically
generalized and brief which occur within 6-48 hours of last drink (4)
Delirium tremens - most severe form and occurs 3-10 days after last drink
with symptoms which include agitation, global confusion, disorientation,
hallucinations, fever, hypertension, diaphoresis, and tachycardia.
82.
Monica is a new nurse and has gone home for the day after giving her
report. When your patient asks for prn pain medication, which has been
ordered as a dosage range, you note that Monica has entries for
administration almost every two hours in the morning, but nothing since
then. You cannot be sure when the patient last received his medication or
what the dosage was. What is the most appropriate next action?
a. Complete an incident report
b. Contact the nurse manager
c. Contact Monica and confirm administration
d. Give the medication anyway
ANSWER C: The most appropriate next action is to contact Monica and
confirm when the patient last received his prn pain medication and at what
dose. Other options may be necessary, but this collaborative effort is in the
best interest of the patient, to ensure that his dosing and schedule is
appropriate to meet his pain management and safety needs.
83.
The route of administration that allows medication the quickest onset of
action is ____________.
a. IM
b. PO
c. PR
d. IV
ANSWER D: Medication administered by intravenous therapy (I.V.) goes
directly into the patient's veins, which allows medication to act faster than
when introduced into the body by mouth, by muscle, or rectally.
84.
Hospitalized patients who are allowed to administer pain medications to
themselves are connected to a PCA or ____________.
a. Patient Connected Anesthetic
b. Patient Communicated Analgesic
c. Patient Controlled Analgesic
d. Patient Communicated Anesthetic
ANSWER C: Patient Controlled Analgesic (PCA) is a medication delivery
system that allows patients to press a button whenever they feel pain, in
order to deliver more medication intravenously. Nurses calculate a lock-outrate into the connected pump, in order to prevent patients for overdosing.
85.
Which of the following would be an acceptable route for the delivery of
parental nutrition for an NPO patient?
a. Pills
b. intravenous
c. Liquids only
d. Aspirate
ANSWER B: Nothing by mouth is represented by "NPO." NPO patients
receive nutrients and vitamins intravenously. While receiving parenteral
treatment, patients are not allowed to orally consume.
86.
IV push and IV piggy back are different nicknames for the same method of
administering medication.
a. True
b. False
ANSWER B: IV push and IV piggy back are not the same. IV push means
that medication is injected directly into an IV line. IV piggy back is a small
bag (about 50 mL) that is delivered to a patient according to a drip rate or
number of drops per minute.
87.
After administering a drug, the time when the body first starts to respond to
the medication is called:
a. Plateau
b. Peak plasma level
c. Onset of action
d. Drug half-life
ANSWER C: The onset of action is the time after a drug administration in
which the body initially responds to the medication. Some drugs may have
a rapid onset of action but a short half-life, while others may have a slower
onset, but their effects last longer.
88.
The Controlled Substance Act categorizes substances into _______ groups
based on varying qualifications such as currently accepted medical use and
potential for abuse.
a. three
b. four
c. five
d. six
ANSWER C: Controlled substances are categorized into five groups.
Schedule I is reserved for drugs with no medicinal purpose, such as crack
cocaine and heroin. Schedule II drugs have accepted medical uses and high
potential for abuse. They must be kept in secure locations. Schedule III, IV,
and V have relatively low potential for abuse compared to Schedule I and II
and may be stored on shelves among routine medications.
89.
If a patient received a prescription for Ventolin HFA with the instructions 2
puffs TID, how many puffs per day is the patient instructed to take?
a. 2
b. 4
c. 6
d. 10
ANSWER C: The patient should inhale a total of 6 puffs per day. Since
"tid" means three times daily, 2 x 3 = 6 puffs every day.
90.
Which of the following is the correct abbreviation for electrocardiogram?
a. EKG
b. EEG
c. ECG
d. Both a and c
ANSWER D: Both EKG and ECG are correct abbreviations for
electrocardiogram
91.
A PRN order is an order for a medication that is used on a(n) ________
basis in a hospital.
a. regular
b. everyday
c. as-needed
d. nightly
ANSWER C: PRN is a medical term that means "as needed." PRN orders
are requests for mediation that is not used on a routine basis. Instead PRN
medications are used only when the patient needs it, such when Phenergan
is used for nausea and vomiting.
92.
Systemic action pertains to action throughout the body and not at the ____
of administration.
a. site
b. time
c. source
d. method
ANSWER A: Systemic action pertains to action throughout the body, as
opposed to the site of administration.
93.
The duration of a drug's action is commonly referred to as its _______.
a. half-life
b. response time
c. efficacy
d. action potential
ANSWER A: The duration of a drug's action is commonly referred to as its
half-life. This is the measure of the amount of time it takes for half of the
drug to be inactivated by the body.
94.
What do palliative drugs do?
a. Prevent symptoms
b. Cure symptoms
c. Relieve symptoms
d. Trigger symptoms
ANSWER C: Palliative care is the treatment of symptoms by relief instead
of cure. Palliative treatment is often provided to terminal patients, such as
chemotherapy patients.
95.
A physician order for a 120 mg dose of Gentamycin 40mg/mL should be
filled with ______ of Gentamycin.
a. 80 mL
b. 5 mL
c. 3 mL
d. 60 mL
ANSWER C: The correct answer is 3 mL because for every 1 mL of
Gentamycin medication there are 40 mg. 40 mg x 3 equals 120 mg, which
is the same as desired dose of 120 mg.
96.
A physician order for a 75 mg dose of Ancef 2mg/mL should be filled with
_____mL.
a. 20.5 mL
b. 32.5 mL
c. 37.5 mL
d. 40.5 mL
ANSWER C: The correct answer is 37.5 because the medication's
concentration is 2 mg for every 1 mL. The desired dose is 75 mg. 75 mg
divided by 2 = 37.5.
97.
How many units are in 1 mL of insulin?
a. 100
b. 10
c. 50
d. 5
ANSWER A: There are a total of 100 units of insulin in 1 mL of insulin.
98.
A prescription for Amoxicillin 250 mg capsules, 1 cap po tid x 10 days
should be filled with ____.
a. 15 capsules
b. 20 capsules
c. 30 capsules
d. 35 capsules
ANSWER C: The correct answer is 30 capsules because 1 capsule taken
three times daily (tid = medical term for 3x's daily) for ten days or 1 x 3 x
10 = 30.
99.
How many ounces make up one cup?
a. 8
b. 16
c. 32
d. 60
ANSWER A: There are 8 ounces in one cup. This conversion of
measurement is often used when preparing and administering solutions and
suspensions.
100.
There are ______ ounces (oz.) in a pound (lb).
a. 4
b. 6
c. 8
d. 16
ANSWER D: There are 16 ounces in a pound. This is a common
conversion that is used when weighing material on a scale.
101.
Milli- is equal to _____.
a. One billionth of the basic unit
b. One millionth of the basic unit
c. One thousandth of the basic unit
d. One hundredth of the basic unit
ANSWER C: Milli- is equals one thousandth of the basic unit.
102.
A fluid ounce is made up of how many mL?
a. 30
b. 65
c. 454
d. 2
ANSWER A: A fluid ounce is comprised of 30 mL. This is a commonly
used conversion when preparing solutions and suspensions.
103.
Kilo- is equal to ______.
a. One billionth of a basic unit
b. One millionth of a basic unit
c. 100 times the basic unit
d. 1,000 times the basic unit
ANSWER D: Kilo- is equal to 1,000 times the basic unit
104.
How many cc's make up one pint?
a. 280
b. 380
c. 480
d. 580
ANSWER C: One pint is composed of about 480 cc or 480 mL.
105.
How many quarts make up a gallon?
a. 10
b. 3
c. 5
d. 4
ANSWER D: Four quarts make up one gallon. One gallon (3,480 mL) is
composed of 8 pints (2 pints = 1 quart).
106.
How many micrograms (mcg) make up 1 milligram (mg)?
a. 10
b. 100
c. 1,000
d. 10,000
ANSWER C: 1,000 micrograms (mcg) make up 1 milligram (mg). This is
conversion is often used to calculate medications for intravenous (IV) and
oral use.
107.
There are _____ milligrams (mg) in a gram (g).
a. 10
b. 100
c. 1,000
d. 10,000
ANSWER C: 1,000 milligrams (mg) make up a gram (g).
108.
A teaspoonful is the same measurement as ___.
a. 1 mL
b. 2 mL
c. 3 mL
d. 5 mL
ANSWER D: 5 mL makes one teaspoonful. This unit of measurement is
often used to administer medication to children and elderly patient.
109.
If a patient is receiving 7 liters of IV fluids over 10 hours, how many ml
will the patient receive per minute?
a. 12.8
b. 11.5
c. 11.7
d. 13.2
ANSWER C: The patient would be receiving approximately 11.7 ml per
minute. This is found as follows: Convert the 7 liters to milliliters by
multiplying 7 * 1000 = 7000 ml Divide the amount of fluid by the total time
of infusion: 7000ml/10 hours = 700 ml per hour Divide the total number of
milliliters per hour by 60 minutes: 700 ml/ 60 mins = 11.666 Round to the
nearest tenth to get the answer: 11.7 ml
110.
If a patient is receiving 3.5 liters of IV fluids at a rate of 7 ml per minute
how many hours will the IV fluid last?
a. 6.4
b. 7.3
c. 8.3
d. 9.2
ANSWER C: The IV fluids would last approximately 8.3 hours. This is
found as follows: Convert 3.5 liters to milliliters by multiplying 3.5 *1000
= 3500 ml Divide the total amount of fluid by the amount received per
minute: 3500/7 = 500 This indicates that the IV fluid would last for 500
minutes Convert minutes to hours: 500/60 = 8.333333 hours Round to 8.3
hours
111.
A patient is receiving 1.8 liters of fluid over 5 hours from an infusion set
that delivers 5 gtt/ml. How many drops per minute will be administered to
the patient?
a. 6 gtt/min
b. 20 gtt/min
c. 24 gtt/min
d. 30 gtt/min
ANSWER D: The patient will receive 30 gtt/min. The answer is found as
follows: Convert 1.8 liters to milliliters by multiplying 1.8 * 1000 = 1800
ml Divide the total amount of fluid by the amount of time it will be
administered 1800 ml/5 hours = 360 ml/hour Divide the total amount of
fluid per hour by 60 minutes 360 ml/60 min = 6 ml per minute Multiply the
total amount of fluid per minute by the number of drops per milliliter to
find the answer
112.
A patient is receiving a 4 liter IV infusion that contains 750 mg of heparin.
If the patient is receiving 5 mg/minute of heparin, how many hours will the
infusion last?
a. 1 hour
b. 1.5 hours
c. 2 hours
d. 2.5 hours
ANSWER D: The infusion will last 2.5 hours. This is found as follows:
Divide the total amount of heparin by the amount received per minute 750/5
= 150 The above answer (150) is the amount of minutes the infusion will
last. To determine the amount of hours divide 150/60 = 2.5 hours
113.
A 150 pound man is receiving a 1 liter IV containing 500 mg of Zofran over
8 hours. If the patient is receiving 2 ml/minute of IV fluid, how many mg of
Zofran per minute is the patient receiving?
a. 1 mg
b. 2 mg
c. 3 mg
d. 4 mg
ANSWER A: The patient would be receiving 1 mg per minute of IV
Zofran. The answer is found as follows: Convert the total volume from 1
liter to milliliters: 1 * 1000 = 1000 ml Create a ratio: 500 mg/1000 ml = X
mg/2 ml Cross multiply to get: 1000x = 1000 Divide the equation by 1000
to get, X = 1 mg
114.
How many ounces are in one pint?
a. 10
b. 12
c. 14
d. 16
ANSWER D: There are 16 ounces in one pint. If you need to convert this
to metrics, multiply 16 oz * 30 ml = 480 ml or 4.8 liters.
GROWTH AND DEVELOPMENT (STUDY MODE)
1.
Which of the following complications is associated with premature rupture
of membranes in the pregnant client?
a. Vaginal or cervical lacerations
b. Shoulder dystocia
c. Uterine rupture
d. Chorioamnionitis
ANSWER D: Premature rupture of membranes occurs when the amniotic
sac of a pregnant client has ruptured before the onset of labor. The client
may be at increased risk of chorioamnionitis, which occurs as inflammation
of the membranes of the placenta. Infection may develop when bacteria
ascend into the uterus without the protection of the intact amniotic sac.
2.
A nurse is caring for a child whose parents live in a home with several other
unrelated children and adults. Some of the people who live in the home
have visited and the nurse discovers that this group all shares finances and
living conditions. What type of family is this most likely an example of?
a. Blended family
b. Communal family
c. Foster family
d. Extended family
ANSWER B: A communal family is a group classified as a non-traditional
family. In this situation, adults who are not related may live and work with
other adults and their children all together in a household. The communal
family may share expenses, food, and childcare in the same way as a
traditional family.
3.
A nurse is educating a female client about progesterone. Which of the
following information is appropriate to include in this teaching?
a. Progesterone helps the body to maintain pregnancy
b. Progesterone stimulates the breasts to secrete milk
c. Progesterone causes uterine contractions during delivery
d. Progesterone causes development of masculine characteristics in women
ANSWER A: Progesterone is a hormone that is produced by the ovaries in
women. Progesterone affects the tissue of the endometrium by developing
the lining of the uterus in support of embryo implantation. In pregnant
women, progesterone nourishes the uterine lining and limits uterine
contractions to prevent miscarriage.
4.
A nurse is assisting with counseling for a pregnant client who has had
genetic testing performed for her unborn child. The geneticist tells this
mother that her baby has an extra copy of the 21st chromosome in every
cell. Based on this information, the nurse knows that the baby will most
likely be born with which condition?
a. Turner syndrome
b. Patau syndrome
c. Down syndrome
d. Edwards syndrome
ANSWER C: A genetic condition that causes an extra copy of
chromosome 21 in each cell is known as trisomy 21, or Down syndrome.
Trisomy occurs when there are three chromosomes for each cell instead of
the usual two. It is named and its symptoms occur based on the affected
chromosomes.
5.
A pregnant client who is at 38 weeks' gestation is seen for prenatal care at a
community clinic. The nurse asks the client to lie down while waiting for
the physician to arrive. After several minutes of lying on her back, the client
becomes dizzy and lightheaded; she is agitated and states she feels she
might faint. What is the next action of the nurse?
a. Call the physician to check the client immediately
b. Call 9-1-1 for an ambulance to transport the client to the labor and
delivery unit of the hospital
c. Check the client's blood pressure and temperature
d. Assist the client to lie on her side
ANSWER D: A pregnant client who is in the second or third trimester may
be unable to lie on her back for extended periods of time. The weight of the
baby may compress the vena cava and the descending aorta, decreasing
circulation and causing lightheadedness, dizziness, agitation, or syncope.
This is referred to as supine hypotension or vena cava syndrome and may
be resolved quickly by changing to the side-lying position, thereby restoring
circulation.
6.
Which of the following symptoms is a presumptive indication of
pregnancy?
a. Auscultation of fetal heart tones
b. A positive home pregnancy test
c. Amenorrhea
d. Ballottement
ANSWER C: Presumptive pregnancy indications are those symptoms that
may be associated with pregnancy but do not actually confirm a pregnancy.
Presumptive symptoms may all be associated with other conditions beyond
pregnancy. Amenorrhea, while often caused by pregnancy, may also be due
to other conditions, such as illness or increased exercise. Amenorrhea is
only a presumptive symptom and does not confirm a true pregnancy.
7.
A client is being seen for confirmation of pregnancy. She states her last
menstrual period was June 2nd. According to Naegele's rule, what is this
client's estimated due date (EDD)?
a. April 2
b. March 9
c. February 2
d. February 19
ANSWER B: Naegele's rule is a system of calculating a woman's estimated
due date of pregnancy based on her last menstrual period. After determining
the first day of the last menstrual period, count backward three months.
Then, add one year and seven days to the date to determine the EDD. For
example, three months prior to June 2 would be March 2. Seven days
following this date results in an EDD of March 9.
8.
A nurse attends the delivery of a full-term infant. After the infant is
delivered, she carries him to the warmer and dries him off. His heart rate is
120 bpm, his body is flexed with good muscle tone, his hands and feet are
blue while the rest of his body is pink, and he starts to cry when stimulated.
Which of the following is the most appropriate Apgar score for this infant?
a. 10
b. 9
c. 6
d. 4
ANSWER B: The Apgar score is a method of quickly evaluating an infant
immediately following birth. The score is based on characteristics of the
infant's behavior and appearance and guides the nurse as to interventions
that may be necessary. Scores are assigned from 0-2 based on heart rate,
respiratory effort, muscle tone, reflex, and color. This infant scored 2 points
for all of the above except color, as he had acrocyanosis in the hands and
feet. Removing one point for this characteristic, this infant scored a 9.
9.
A nurse is caring for a woman who just had a baby 6 hours ago. The nurse
is concerned because the mother seems more interested in letting her
husband care for the baby. Which of Rubin's puerperal phases is this mother
exhibiting?
a. Taking-in phase
b. Taking-hold phase
c. Letting-go phase
d. Handing-off phase
ANSWER A: Shortly after birth, a woman may go through certain phases
that help her to identify herself in her new role as a mother. During the
taking-in phase, the mother is often focused primarily on her own needs;
she may often let a spouse or partner take over care of the infant.
10.
A nurse is performing a birth assessment on an infant who was born one
hour ago. During her assessment, she strokes the sole of the infant's foot
from the heel up toward the toes and notices that the toes flare as a
response. Which test is this nurse performing?
a. Tonic neck reflex
b. Startle reflex
c. Babinski reflex
d. Moro reflex
ANSWER C: The Babinski reflex is performed on newborn infants and
children up to 2 years to assess for central nervous system deficits. A
normal response in a newborn includes fanning of the toes when the sole of
the foot is stroked from the heel toward the toes. No response to this
stimulation indicates a problem with the central nervous system.
11.
A sexually active client asks the nurse for information about contraception.
The client is interested in an intrauterine device as a form of birth control.
Which of the following is an advantage of an intrauterine device?
a. It protects against sexually transmitted infections
b. It can be inserted several hours before intercourse
c. It is acceptable to most religious backgrounds
d. It remains in place at all times
ANSWER D: An intrauterine device is a form of contraception that is
inserted into the uterus by a physician. This device protects against
pregnancy and remains in place at all times, giving a woman more freedom
over contraception. Intrauterine devices do not protect against sexually
transmitted infections and may not be accepted by all religious
backgrounds.
12.
Which of the following best describes the cognitive development of an 18month old child?
a. The child can follow one-part directions
b. The child understands the concept of "forever"
c. The child can name six body parts
d. The child has an attention span of approximately 5 minutes
ANSWER A: An 18-month old child's level of cognitive development
allows him to follow one-part directions from others. Children who are this
age observe and imitate the behavior of others and thoroughly explore their
environments out of curiosity. Although an 18-month old child is starting to
remember the place or location of objects, his attention span is very short.
13.
A nurse is caring for a 64-year old man whose lab work indicates he has
decreased levels of vitamin K. Which of the following symptoms is most
likely associated with this condition?
a. Gingivitis
b. Ecchymosis
c. Cardiac arrhythmias
d. Poor wound healing
ANSWER B: Vitamin K is a fat-soluble vitamin that is responsible for
helping the blood to clot. A person with decreased levels of vitamin K may
bruise easily or develop areas of ecchymosis; he may be more prone to
bleeding, particularly from the gastrointestinal or urinary systems.
14.
A nurse is assessing pain response in a 9-month old child. She uses the
CRIES scale to determine if he is having pain. The "I" in the CRIES scale
stands for:
a. Informal response
b. Increased reflexes
c. Immediate reaction
d. Increased vital signs
ANSWER D: The "I" in the CRIES scale stands for increased vital signs.
The CRIES scale is often used among infants who cannot use words to
describe their pain. Signs of pain may include crying, increased heart rate or
blood pressure, and grimacing. A nurse can use the CRIES scale to rate an
infant's pain in order to provide pain control measures.
15.
A mother who has been breastfeeding her infant since birth wants to
transition her baby to solid foods. The child is now 6 months old. Which of
the following is the most appropriate response of the nurse?
a. You should breastfeed exclusively until your baby is 12 months old."
b. You can start solid foods and change to formula feeding."
c. You can start with rice cereal and continue with breastfeeding."
d. You can start with feeding meats and vegetables."
ANSWER C: Children may start taking solid foods around the age of 5 to
6 months. The American Academy of Pediatrics recommends breastfeeding
until a child is 12 months or older; however, parents may begin to feed solid
foods in addition to breastfeeding. Grain cereals, such as rice or oats are
appropriate first solid foods, followed by those that are more complex to
digest, including vegetables, fruits, and meats.
16.
A mother brings her 6-year old daughter in to a clinic for a routine physical.
The family follows a vegan diet and the child has only eaten grain or plant
products since birth. Which of the following vitamin deficiencies is this
child most likely at risk for?
a. Vitamin C
b. Vitamin B-6
c. Vitamin K
d. Vitamin B-12
ANSWER D: The most common vitamin deficiency associated with
veganism is vitamin B-12. A vegan diet is one in which a person consumes
only plant products and avoids any type of animal products, including meat,
fish, or dairy. Animal products are good sources of vitamin B-12 and
avoiding these foods may then lead to deficiencies of this vitamin.
17.
A nurse is caring for a 16-year old client who is seen for frequent vomiting
and diarrhea. After taking a history, the nurse determines this teen has been
inducing these symptoms after eating large amounts of food. What
condition is most likely the cause of this situation?
a. Anorexia
b. Binge-eating disorder
c. Adjustment disorder
d. Bulimia
ANSWER D: Bulimia is a type of eating disorder where a person may
binge on excessive amounts of foods. These binges are followed by
attempts to purge the excess food from the body; which is often through
induced vomiting, long periods of exercise, or laxative use. Bulimia may be
associated with fears regarding weight gain and body image and it requires
help from a mental health professional and/or dietician for treatment.
18.
Which of the following is an example of a fine motor skill?
a. Jumping on a trampoline
b. Brushing hair
c. Standing on one foot
d. Climbing a ladder
ANSWER B: Fine motor skills are those that require coordination of the
muscles of the hands and forearms. Fine motor skills start to develop in
toddlerhood and take longer for children to master than large motor skills.
Examples of fine motor skills include brushing hair, scribbling with a
pencil, cutting with scissors, feeding self with finger foods, and using a
zipper.
19.
A nurse is preparing to administer an oral glucose tolerance test to a woman
who is 28 weeks' pregnant. What is the first step the nurse should perform
to administer this test?
a. Give the woman a sweetened drink that contains 75 g of glucose
b. Check the fetal heart tones for the baby
c. Check a fasting glucose on the mother
d. Tell the mother to eat an 800-calorie meal and return for a glucose check
ANSWER C: The first step of administering an oral glucose tolerance test
is to check a blood glucose level on the client. Often, the client will be
required to fast before the test; a fasting glucose level before the test gives
the nurse a baseline from which to compare future results. Following the
glucose check, the client drinks a sweetened drink with extra glucose and
the nurse checks the body's response.
20.
A nurse is examining a 36-hour old infant when she notices the child's skin
has a yellowish tint. The yellow skin appears on the baby's face and chest
but the skin on the feet and legs appears pink. What is the next action of the
nurse?
a. Check a stat bilirubin level
b. Begin phototherapy with eye protection
c. Monitor the condition and notify the physician during rounds
d. Transfer the infant to the neonatal intensive care unit
ANSWER C: Many infants develop a small amount of jaundice in the first
days after birth. Jaundice appears as a yellowing of the skin and often starts
in the face and moves in a cephalocaudal direction. Jaundice that occurs
before 24 hours of age may be associated with illness and should be
checked by a physician.
21.
A nurse is preparing to see a client who has brought her baby in because she
believes the baby has thrush. Based on this information, the nurse would
most likely expect to see:
a. Pale skin with a red, lacy rash across the trunk
b. Blue skin in the hands and feet
c. Vomiting, diarrhea, and lethargy
d. White patches in the mouth and a diaper rash
ANSWER D: Thrush occurs as an overgrowth of the fungus Candida
albicans. The classic presentation of thrush is white patches on the tongue,
lips, and gums of an infant. The patches are not easily removed and may
bleed if scraped off. Thrush may also cause a diaper rash if the infection
moves through the intestinal tract in the baby's stool.
22.
A nurse is seeing a client in an outpatient clinic for symptoms of
depression. The client tells the nurse she has been taking St. John's wort to
help her symptoms. Which of the following is the most appropriate
response of the nurse?
a. We'll make sure the physician knows this information in case he
prescribes medication for you."
b. You can either take herbal supplements or prescription medication for
depression, but you must choose."
c. St. John's wort is not actually used for depression; you should try anise
seed."
d. You should not be using any herbal supplements in your situation."
ANSWER A: If a client is seen for care and provides information about
herbal supplements used at home, the nurse should ensure the physician is
aware of the situation. If the physician decides to prescribe medication for a
client who uses herbal supplements, it must be determined if the two
products can be used together or if simultaneous use will cause adverse
effects.
23.
Which of the following is a true statement about Reye's syndrome?
a. Reye's syndrome is caused by a viral infection from improper hand
hygiene
b. Protection from Reye's syndrome requires contact precautions
c. Reye's syndrome occurs after giving aspirin to children
d. Reye's syndrome can be confirmed by genetic testing
ANSWER C: Reye's syndrome is a type of encephalopathy that may cause
confusion, changes in levels of consciousness, nausea, vomiting, and
seizures. It is most common among children between the ages of 4 and 12
years. Parents should be educated to avoid giving aspirin or products
containing salicylates to children under 19 to avoid developing Reye's
syndrome.
24.
A nurse is preparing an initial hepatitis B vaccine for a child. Which of the
following information must the nurse give to the parent as part of education
about this vaccine?
a. The hepatitis B vaccine is administered one time, typically right after
birth
b. The hepatitis B vaccine is only administered to children who are at high
risk of contracting the disease
c. The hepatitis B vaccine carries a risk of sepsis for the child after
vaccination
d. The hepatitis B vaccine must be repeated as part of a 3-part series of
injections
ANSWER D: The hepatitis B vaccine protects against the hepatitis B virus,
which may cause inflammation of the liver. While the vaccine is often
administered to those in high-risk situations, such as health care providers,
the Centers for Disease Control and Prevention recommend that all children
receive the hepatitis B series as part of standard immunization schedules.
The vaccine is administered in a 3-part series, with the second dose
following the first at approximately one month, and the third dose given at
least 4 months after the first.
25.
A nurse is caring for an aging client who has developed sarcopenia. Which
of the following symptoms would this nurse most likely see in this client?
a. Loss of muscle mass
b. Low oxygen saturations
c. Decreased white blood cell count
d. Diminished reflexes
ANSWER A: Sarcopenia is the progressive loss of muscle mass, resulting
in diminished strength. Sarcopenia contributes to increased frailty in aging
adults. For most people, the condition starts to develop after 40 years of age
and is most prominent by 75 years. It is more common among inactive
adults but may exist in physically active persons as well.
26.
Which of Erikson's stages of psychosocial development is associated with a
preschool-aged child?
a. Trust vs. Mistrust
b. Industry vs. Inferiority
c. Initiative vs. Guilt
d. Identity vs. Role Confusion
ANSWER C: A child who is in preschool is classified as being in the stage
of initiative vs. guilt, according to Erikson's stages of psychosocial
development. During this stage, a child may use his imagination more and
his play becomes more competitive. The child is resourceful in his dealings
and encounters with others.
27.
Which of the following interventions can the nurse implement to promote a
healthy self-concept for a client?
a. Provide information about antidepressant medications
b. Encourage the client to verbalize feelings about self, body image, and
relationships
c. Use absenteeism as a form of therapeutic communication
d. Assist the client with asking others to tell him what they think of him
ANSWER B: A client's self concept is the view that he has of himself: his
feelings, goals, and body image. A nurse can assist a client with developing
a healthy self concept by encouraging him to verbalize his feelings about
himself, his body, and his relationships with others. Some clients struggle
with body changes throughout the aging process, which can affect selfconcept. Nurses are in a position to promote healthy thoughts and activities
that support a healthy self-concept.
28.
A 15-year old client is talking about her family with a nurse when she
reveals that her parents are getting a divorce. The client suddenly becomes
upset and starts to cry, saying, "They don't want to be together anymore!"
What is the most appropriate response of the nurse?
a. Don't worry, it will all work out in the end."
b. I'm sorry this makes you angry. I'll ask the physician if he will speak with
your parents."
c. Will you have to decide which parent you will live with?"
d. I'm sorry that you feel upset. Would you like to talk about it some more?"
ANSWER D: A client who is grieving her parents' divorce may need time
to talk, and the nurse may provide a listening ear to help with the grieving
process. Using active listening and other therapeutic communication
techniques will encourage the client to share her feelings about the situation
and may help to work through some of the grief.
29.
Which of the following is a potential complication associated with
precocious puberty?
a. Low serum calcium levels
b. Short stature
c. Weakness and lethargy
d. Anemia
ANSWER B: Precocious puberty occurs as the onset of puberty and
secondary sex characteristics at an earlier age. In girls, precocious puberty
is considered to be puberty starting at 7-8 years; in boys, the term is used
for puberty starting before 9-10 years. Precocious puberty may be
associated with increased bone growth, which may eventually lead to bone
fusion. Although this normally takes place over time during and after
puberty, early bone fusion can ultimately lead to short stature.
30.
A nurse is working with a client and her 9-month old son. The mother tells
the nurse, "Sometimes, he is so naughty! I had to put him in time-out
yesterday for throwing toys!" What is the most appropriate response of the
nurse?
a. Where do you put him when he goes to time-out?"
b. Keep doing that to teach him the right way; eventually he will stop
throwing toys."
c. At this age, he should stay in time-out for nine minutes."
d. Remind him not to throw toys but don't discipline him for this behavior."
ANSWER D: Parents who effectively discipline their children should use
age-appropriate measures so that discipline is a learning experience. A 9month old child who throws toys does not yet understand why it is
important not to do this and will not understand the reasons for time-out.
31.
A nurse is preparing immunizations for a 5-year old child who is starting
kindergarten. Which statement by the parent indicates understanding of this
process?
a. Once he gets these shots, he'll never need to go through this again."
b. This should be the third vaccine in the 3-part hepatitis A series."
c. Most of the kids in his preschool have already had chicken pox. Why
does he need a vaccine?"
d. Last time we were here, he had a slight fever after the vaccines. Can I
give him acetaminophen if it happens again?"
ANSWER D: A child who is receiving immunizations may develop a slight
fever or soreness at the injection site. A parent who recognizes this
possibility and asks about what medications are appropriate for the child's
comfort has understanding of some of the side effects of immunizations.
Redness or soreness at the injection site, as well as a mild fever following
the vaccine are not contraindications to immunization.
32.
A client asks for assistance with correctly preparing bottles of formula for
her baby. Which of the following statements should the nurse include as
part of teaching?
a. If commercial formula is unavailable, substitute one-half of the amount
with cow or goat's milk.
b. Formula must be sterilized before feeding.
c. Never heat a bottle of formula in the microwave
d. Always boil tap water before using it to mix formula
ANSWER C: When teaching a client about how best to prepare formula
for an infant, the nurse should explain that bottles of formula should never
be heated in the microwave. This may result in uneven areas of heating,
with some parts of the formula much hotter than others. Because the
microwave does not evenly heat bottles, these hot spots can cause burns in
the baby's mouth.
33.
A client who has entered the hospital for surgery tells the nurse that he
wants to try and quit smoking. What is the most appropriate action of the
nurse?
a. Ask the client if he would like more information about smoking cessation
programs
b. Assist the client with throwing out any cigarettes that he has with him
c. Notify the physician that the client needs a nicotine patch
d. Remind the client of the many negative impacts that smoking has on
health
ANSWER A: When a client admits that he needs help with smoking
cessation, the nurse can provide resources that will help him to make this
decision and stay with it. Most people who smoke are aware of the dangers
and negative impacts smoking has on health. Assisting the client with stopsmoking information through classes, counseling, or referrals may guide
him to continue taking steps to quit.
34.
A nurse is providing care to a 7-year old child in the emergency room.
Which of the following interventions may be most helpful in this situation?
a. Distract the child with a toy that has flashing lights
b. Provide treatments with the parents out of the room if possible
c. Explain the process of treatment in simple terms
d. Avoid talking about the child's concerns related to treatment
ANSWER C: When providing treatment that is associated with frightening
circumstances for a child who is 7 years old, the nurse should explain what
she is going to do and the purpose of the treatments in simple terms that the
child can understand. Children of this age may have significant fears related
to medical care but can understand if the nurse talks directly to them and
does not avoid addressing their concerns.
35.
A client presents with several areas of blotchy skin that has decreased
pigmentation when compared with the rest of his skin color. Which
condition is this client most likely exhibiting?
a. Erythema
b. Carotenemia
c. Vitiligo
d. Nevi
ANSWER C: Vitiligo is a condition that manifests as areas of skin
depigmentation. The skin may appear blotchy and its color is lighter than
the client's normal skin tone. Vitiligo may be associated with some
autoimmune conditions, including hyperthyroidism, Addison's disease, or
pernicious anemia.
36.
Which of the following persons is at highest risk of developing type 2
diabetes?
a. A 40-year old Caucasian man with a BMI of 27
b. A 48-year old Hispanic woman with low levels of HDL cholesterol
c. A 39-year old Asian woman who recently had a baby weighing 8 lbs, 2
oz.
d. A 50-year old Caucasian man with low levels of LDL cholesterol
ANSWER B: There are certain factors associated with a higher risk of
developing type 2 diabetes, including age, ethnic background, and the
presence of health issues, such as gestational diabetes or high cholesterol.
People over 45 years old, those with low levels of HDL cholesterol, and
those of Hispanic, Asian, African American, Native American, or Alaskan
Native descent are at higher risk of developing type 2 diabetes.
37.
In which of the following methods should a nurse assess for scoliosis in a
child?
a. The child should stand with both arms reaching forward while the nurse
measures the difference in arm lengths
b. The child should stand with her back against the wall while the nurse
views her from the side
c. The child should bend over at the waist while the nurse looks for
asymmetry in the back
d. The child should sit in a chair while the nurse checks for both feet to be
flat on the floor
ANSWER C: Screening for scoliosis often involves the Adam's Forward
Bend Test. This test asks a child to bend over at the waist to touch the toes.
The nurse assesses the child's back to look for asymmetry of the ribs,
uneven shoulders, or one hip that is slightly higher than the other.
38.
Which of the following is an example of a natural family planning method?
a. Basal body temperature
b. Intrauterine device
c. Periodic abstinence
d. All of the above
e. Both a and c
ANSWER E: Natural family planning is a method of birth control that does
not use artificial means to prevent conception. Instead, couples may
determine a woman's fertile time and take measures to avoid fertilization,
such as through withdrawal or abstinence. Basal body temperature
measurement is one method of determining a woman's fertile period. Once
this is determined, couples can abstain from intercourse to reduce the
possibility of conception from occurring.
39.
A client who suffers from a neuromuscular disability wants to try
Feldenkrais to increase some flexibility. Which of the following best
describes this alternative healing method?
a. The client uses mind/body exploration to increase awareness
b. Fine needles are placed along certain points in the body to promote
energy flow
c. Intravenous injections of amino acids work to detoxify the body
d. Magnets are applied to parts of the body that are causing the greatest
issues
ANSWER A: Feldenkrais is an alternative treatment therapy that uses mind
and body techniques to increase awareness to retrain neuromuscular
function. This method may also be used to increase flexibility and agility,
both physically and through patterns of thought.
40.
Which of the following is an example of a teratogen?
a. Colace
b. Diphenhydramine
c. Warfarin
d. Acetaminophen
ANSWER C: Teratogens are substances that, when taken during
pregnancy, can cause birth defects or abnormalities with the unborn baby.
Nurses should be aware of common teratogens and counsel clients about
what substances to avoid during pregnancy. Warfarin is a type of teratogen
because it can cause birth defects or excessive bleeding in the fetus.
41.
In infants and children, most cardiac arrests result from:
a. Ventricular fibrillation.
b. Ventricular tachycardia.
c. Respiratory failure or shock.
d. None of the above
ANSWER C: Although the ventricular arrhythmias may precipitate cardiac
arrest, the most common cause of cardiac arrest in children is respiratory
failure or shock.
42.
An 8-year-old child has been diagnosed with infectious conjunctivitis.
Discharge instructions will include:
a. Good hand hygiene is critical.
b. The child should be kept home from school for a week.
c. Antibiotic drops or ointments will not be effective.
d. Eyes should be irrigated with sterile saline.
ANSWER A: The child must understand the importance of keeping his
hands away from his eyes and washing his hands often. Irrigation of the
eyes is not therapeutic and may cause more irritation than relief. Antibiotic
drops or ointment will usually be prescribed. Because this disease is so
contagious, it is critical that the child be kept home from school for 24
hours after treatment starts or until symptoms subside -- typically in one or
two days.
43.
You have been caring for a 6-year-old patient who has been diagnosed with
mild food poisoning. The child is alert, mucous membranes are moist, and
skin turgor is within normal limits. He is being sent home with family.
Instructions for this patient are likely to include all of the following
EXCEPT:
a. Stay hydrated by frequently drinking sips of clear liquids.
b. Do not eat solid foods while nauseous or vomiting.
c. Give over the counter medications to stop any diarrhea
d. Begin a BRAT diet after all nausea and vomiting have passed.
ANSWER C: Children should not receive over the counter anti-diarrheals
unless prescribed by their pediatrician. If diarrhea persists, the child should
be evaluated by the pediatrician.
44.
A child is being discharged to home with a diagnosis of ringworm.
Discharge instructions should include the information that:
a. The infection is caused by a worm and cannot be passed from person to
person.
b. The infection is caused by a virus and can be passed from person to
person.
c. The infection is caused by a bacteria and cannot be passed from person to
person.
d. The infection is caused by a fungus and can be passed from person to
person.
ANSWER D: Ringworm is caused by a fungus and not by a worm as its
name implies. This infection can be passed easily from one person to
another. The fungus can also be passed through infected items such as
combs, clothing, or shower surfaces. Pets can also carry the fungus.
45.
A child presented to the ED with itchy scalp, irritation of the scalp, and
infected areas on the child's head. Assessment reveals lice and nits in the
child's hair. Discharge instructions will include:
a. Permethrin 10% applied to hair and body after shower and shampoo
b. Manual removal of nits must be done for several days to ensure they do
not hatch
c. Washing sheets and towels in hot water
d. Child should not return to school until all lice and nits are gone
ANSWER C: Sheets and towels should be washed in hot water to remove
any lice. The CDC and American Association of Pediatrics both
recommend that "no-nit" policies in schools should be discontinued.
Although nits may persist after treatment with Permethrin 1% (not 10%),
they are usually not viable and are unlikely to hatch into crawling lice. The
child should be checked a week or 10 days after treatment to determine if
all lice have been removed.
46.
Johnny Tate, a 2 year old boy, is hospitalized with pneumonia. This child
will most likely _________.
a. lie quietly as the nurse listens to his lung.
b. ask many questions about what the nurse is doing
c. fuss, cry and push the nurse away
d. plays cheerfully with a stethoscope
ANSWER C: Johnny will most likely fuss, cry and reject strangers. A 2
year old is considered a toddler. Toddlers typically demonstrate negative
behavior. They are hesitant around strangers and they resist close contact
with people they do not know. They react to separation anxiety when their
parents are not close to them. They do not yet have good language skills so
they often cry in order to communicate their distress.
47.
At what age does a child begin to accept the fact that death is permanent?
a. Less than 5 years old
b. 5-9 years old
c. 9-12 years old
d. 12-18 years old
ANSWER B: Until about 5 years of age, children think that death is
reversible. Between 5 and 9 years of age, the child realizes that death is
permanent.
48.
Identify the age group with the correct range of years.
a. Infancy: Up to 6 months of age
b. Pre-School Child: 3 to 6 years of age
c. Adolescent: 13 to 18 years of age
d. Elderly: Over 60 years of age
ANSWER C: The adolescent or teenage is 13 to 18 years of age. The
neonate is a newborn up to 4 weeks of life; the infant is defined as up to one
year. The toddler years are from 1 to 3 years of age. The preschool years are
from 3 to 5 years of age and the school age child is from 6 to 12 years of
age. The adolescent or teenage is 13 to 18 years of age. The young adult is
19 to 44 years of age; the middle age adult is from 45 to 65 and the elderly
years are defined as over 65 years of age.
49.
Identify the developmental task with the correct age group.
a. Infancy: autonomy
b. Toddler: initiative
c. Pre-School Child: trust
d. School age child: industry
ANSWER D: The developmental task for the school age child is industry.
The infant's developmental task is trust and the toddler's developmental task
is autonomy. The developmental task for the pre-school child is initiative.
50.
Your 47 year old patient is concerned about guiding the next generation?
What developmental task is this 47 year old patient addressing?
a. Generativity
b. Initiative
c. Industry
d. Ego integrity
ANSWER A: The patient is addressing the developmental task of
generativity. The other developmental tasks for the other age groups are
below: Initiative: Preschool child Industry: School age child Ego integrity:
Elderly
51.
Your 2 year old pediatric patient is always saying "No" to your requests.
What should you do?
a. Report this abnormal negatively to the nurse
b. Scold that child and tell them that they must cooperate
c. Tell the parents to discipline the child for this negativity
d. Understand that the child is seeking autonomy which is normal
ANSWER D: Toddlers seek autonomy. They are the "No" age group. This
is normal for this age group. You should never scold a child and there is no
need for parental discipline because this is a normal behavior.
52.
The gradual decrease of the body's temperature after death is called
____________.
a. rigor mortis
b. algor mortis
c. livor mortis
d. shrouding
ANSWER B: Algor mortis is the gradual decrease of the body's
temperature after death. It occurs because blood circulation has stopped and
the hypothalamus ceases, our internal thermostat, has stopped functioning.
Body temperature falls about 1.8 degrees F per hour until it reaches room
temperature.
53.
Rigor mortis occurs about________ hours after death.
a. 0-1
b. 3-4
c. 5-7
d. 9-12
ANSWER B: Rigor mortis is the stiffening of the body that occurs about 34 hours after death
54.
Some people have dyspnea at the end of life. Dyspnea is difficulty
___________.
a. walking
b. breathing
c. talking
d. eating
ANSWER B: Dyspnea is difficulty breathing. It can occur among people
who have some kind of acute or chronic lung disorder, like pneumonia and
chronic obstructive pulmonary disease (COPD). It is also seen among
people at the end of life.
55.
At the end of life, many people have a fear of __________.
a. insects
b. rejection
c. acceptance
d. being alone
ANSWER D: People at the end of life have special emotional needs. Many
people have a fear of being alone. Some people may be also be very sad, or
depressed.
56.
You are caring for Judy F. She is at the end of life. A lot of visitors are
seeing her. You notice that she is giving things, like her jewelry, to her
visitors. What should you do?
a. Tell her to stop giving away her valuable jewelry.
b. Take the jewelry away from the visitors.
c. Understand that she is confused.
d. Nothing. This is normal at the end of life.
ANSWER D: Many people accept the fact that they are dying. They accept
the fact that death is near and they prepare for it. They may do certain
things like taking care of their money matters, selling their house, giving
their possessions away and writing a will, if not already done.
57.
Which fact about the end of life is true?
a. All people at the end of life are religious.
b. All people at the end of life are spiritual.
c. Some people are not religious or spiritual.
d. Family members do not have spiritual needs.
ANSWER C: Many, but not all, patients and family members have spiritual
needs at the end of life. Some may want to see a rabbi, priest or minister
during the end of life. They may want to pray, go to church and read the
bible. Others may not be spiritual or religious at all.
58.
Many people at the end of life fear being alone. What can you, as the nurse,
do to lessen this fear?
a. Keep the patient in their bed at the nursing station.
b. Require that the family stay with the patient 24/7.
c. Ask a visitor from another room to visit with the patient.
d. Sit and talk or listen to the patient as much as possible.
ANSWER D: You should sit and talk or listen to the patient as much as
possible. You cannot require that the family stay with the patient. You can
encourage it but you cannot require it. The patient's right to privacy and a
peaceful, quiet environment is not fulfilled by placing the patient at the
nursing station.
59.
A "Living Will" is another term for ________________.
a. DNR
b. advance directives
c. NPO
d. at the end of life
ANSWER B: A living will is another term for advance directives. Patients
and residents across the country are encouraged to write what treatments
they do and do not want when they are at the end of life. These things are
put in a "living will" or "advance directives".
60.
Another term for "health care proxy" is _______________.
a. medical power of attorney
b. durable power of attorney
c. limited power of attorney
d. a living will
ANSWER A: Another term for "health care proxy" is medical power of
attorney. This proxy makes medical decision for the patient when the
patient is no longer able to make decisions.
61.
Of the following, which would be important to include as nursing
interventions when caring for the patient with delayed growth and
development?
a. Assessment of baseline mental/emotional status
b. Caregiver/parent input
c. Assessment of baseline physical status/limitations
d. All of the above
ANSWER D: All options are important to include when developing a plan
of care for the patient with developmental delay. This is a very broad
category of patients, who can have a wide variety of physical, mental and
psychosocial issues which need to be addressed as part of care in the
intensive care unit. Caregivers and parents play a critical role in reducing
patient anxiety and maintaining some semblance of structure and familiarity
for these patients, who may have difficulty adjusting to a different
environment, especially one which can be highly stimulating and invasive.
62.
Geriatric failure to thrive (GFTT) has 4 major characteristics. Of the
following, which is NOT one of them?
a. Impaired physical function
b. Malnutrition
c. Cardiovascular disease
d. Cognitive impairment
ANSWER C: Cardiovascular disease is not one of the characteristics which
define geriatric failure to thrive (GFTT), although it may be a co-morbid
condition which contributes to it. The 4 major characteristics are impaired
physical function, malnutrition, depression and cognitive impairment.
GFTT can have many contributory factors, and requires a multidisciplinary
approach for treatment which aligns with patient and family wishes.
63.
Your patient is concerned about their health insurance and the costs
associated with their hospital care. Which of Maslow's needs is your patient
expressing?
a. Physical needs
b. Security needs
c. Self actualization
d. Self esteem and the esteem of other
ANSWER B: Health and life insurance are examples of security needs.
64.
Verbal bullying, among school aged children, threatens which of Maslow's
needs?
a. Physical needs
b. Self actualization needs
c. Love and belonging needs
d. Safety needs
ANSWER C: Verbal bullying, among school aged children, threatens the
love and belonging needs of these young children. They want to be
accepted by others as a member of their peer group. Bullying of all kinds is
not acceptable.
65.
Physical bullying, among school aged children, threatens which of
Maslow's needs?
a. Physical needs
b. Love and belonging needs
c. Safety needs
d. All of the above
ANSWER D: Physical bullying can injure a person (physical needs). It can
also threaten the child's psychological and physical safety and security, in
addition to the fact that all bullying, including physical bullying, leads to a
person feeling rejected, rather than loved and belonging to the group.
66.
Your patient has had a very full and rewarding life. She has had a lot of
success in her personal and professional life. She has achieved all of her
goals and she has maximized her potential. This patient can be best
described as a person who has achieved Maslow's___________.
a. self actualization
b. exploration
c. closeness
d. protection
ANSWER A: This person has moved along Maslow's hierarchy and is now
self actualized. Exploration, closeness and protection are not part of
Maslow's hierarchy.
BASIC NURSING CARE (TEST MODE)
1.
In which of the following ways can the nurse promote the sense of taste for
an older adult?
a. Mix foods together on the dinner tray
b. Avoid cologne, air fresheners, or room deodorizers
c. Encourage the client to chew food thoroughly
d. Discourage the use of salt or seasonings with prepared food
2.
Which of the following is classified as a prerenal condition that affects
urinary elimination?
a. Nephrotoxic medications
b. Pericardial tamponade
c. Neurogenic bladder
d. Polycystic kidney disease
3.
A nurse is assessing an African American client for risks of a pressure
ulcer. Which of the following best describes what the nurse might find with
an early pressure ulcer in this client?
a. Skin has a purple/bluish color
b. Capillary refill is 1 second
c. Skin appears blanched at the pressure site
d. Tenting appears when checking skin turgor
4.
A term used to refer to generalized wasting of body tissues and malnutrition
is called:
a. Entropion
b. Confabulation
c. Induration
d. Cachexia
5.
Which of the following clients is at a higher risk of developing oral health
problems?
a. A pregnant client
b. A client with diabetes
c. A client receiving chemotherapy
d. Both b and c
6.
Which nursing intervention is most appropriate to reduce environmental
stimuli that may cause discomfort for a client?
a. Loosen pressure dressings on wounds
b. Use assistance to pull a client up in bed
c. Check temperature of water used in a sponge bath
d. Position the client prone
7.
A client has developed a vitamin C deficiency. Which of the following
symptoms might the nurse most likely see with this condition?
a. Cracks at the corners of the mouth
b. Altered mental status
c. Bleeding gums and loose teeth
d. Anorexia and diarrhea
8.
Which of the following interventions should a nurse perform for a female
client who is incontinent with impaired skin integrity?
a. Turn the client at least every 8 hours
b. Apply lotion to the skin before a bath
c. Provide perineal care after the client uses the bathroom
d. Bathe the client every 3 days
9.
A client has fallen asleep in his bed in the hospital. His heart rate is 65 bpm,
his muscles are relaxed, and he is difficult to arouse. Which stage of the
sleep cycle is this client experiencing?
a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4
10.
A nurse is assisting a client who uses an intraaural hearing aid. Once the aid
has been placed in the ear, it begins to whistle. What is the next action of
the nurse?
a. Try to reposition the hearing aid
b. Change the batteries
c. Remove the device and have it cleaned
d. Notify the physician that the hearing aid is not working
11.
A nurse is preparing to irrigate a client's indwelling catheter through a
closed, intermittent system. Which of the following steps must the nurse
take as part of this process?
a. Use sterile solution from the refrigerator
b. Position the client in the prone position
c. Clamp the catheter at the level above the injection port
d. Inject sterile solution through the injection port into the catheter
12.
Which of the following is a negative outcome associated with impaired
mobility?
a. Increased amounts of calcium are absorbed from circulation
b. A drop in blood pressure occurs when rising from a sitting to a standing
position
c. The amount of mucous in the bronchi and lungs decreases
d. The vessel walls of the circulatory system thicken
13.
A nurse is caring for a client who died approximately one hour ago. The
nurse notes that the client's temperature has decreased in the last hour since
his death. Which of the following processes explains this phenomenon?
a. Rigor mortis
b. Postmortem decomposition
c. Algor mortis
d. Livor mortis
14.
A nurse is calculating a client's intake and output. During the last shift, the
client has had ½ cup of gelatin, a skinless chicken breast, 1 cup of green
beans, and 300 cc of water. The client has urinated 250 cc and has had 2
bowel movements. What is this client's intake and output for this shift?
a. 420 cc intake, 250 cc output
b. 300 cc intake, 250 cc output
c. 550 cc intake, 550 cc output
d. 300 cc intake, 550 cc output
15.
A nurse is caring for a client with ariboflavinosis. Which of the following
foods should the nurse serve this client?
a. Citrus fruits
b. Milk
c. Fish
d. Potatoes
16.
A client is taking a walk down the hallway when she suddenly realizes that
she needs to use the restroom. Although she tries to make it to the bathroom
on time, she is incontinent of urine before reaching the toilet. What type of
incontinence does this situation represent?
a. Reflex incontinence
b. Urge incontinence
c. Total incontinence
d. Functional incontinence
17.
Which of the following is part of client teaching regarding anti-embolism
stockings?
a. Instruct the client to roll the top portion of the stocking down if it is too
long
b. Stockings are applied with the toes uncovered at the end
c. Measure for thigh-high stockings from the foot to the knee
d. Stockings are to be smooth from end to end without wrinkles
18.
Which of the following reasons is the most likely cause of constipation in a
client?
a. Postponing bowel movement when the urge to defecate occurs
b. Intestinal infection
c. Antibiotic use
d. Food allergies
19.
Which of the following statements best describes footdrop?
a. The foot is permanently fixed in the dorsiflexion position
b. The foot is permanently fixed in the plantar flexion position
c. The toes of the foot are permanently fanned
d. The heel of the foot is permanently rotated outward
20.
A nurse is assisting a client with range of motion exercises. She moves his
leg in a pattern of circumduction. Which movement is this nurse
performing?
a. Bending the leg at the knee
b. Turning the foot inward and outward
c. Moving the leg in a circle
d. Moving the leg forward and up
21.
A nurse is assisting a client to lie in the Sims' position. In what position
does the nurse arrange the client?
a. The client lies on his side with the upper leg flexed
b. The client lies on his back with his head lower than his feet
c. The client lies on his abdomen with a pillow supporting his head
d. The client is sitting up at a 90-degree angle
22.
A nurse is instructing a client about how to use his crutches. Which of the
following information should the nurse include in her teaching?
a. Place the majority of body weight on the axilla
b. Dry crutch tips with a paper towel if they become wet
c. Use the crutches for support to lift both feet simultaneously when
ascending stairs
d. Both a and b
23.
Which of the following is a disadvantage of using a dry heat application?
a. Dry heat is more likely to cause burns than moist heat
b. Dry heat penetrates deeply into the tissues
c. Dry heat causes the skin to dry out more quickly
d. Dry heat can quickly cause skin breakdown
24.
A nurse is preparing to administer an enema to a 64-year old client. Which
of the following actions of the nurse is most appropriate?
a. Assist the client to lie in the semi-Fowler position
b. Apply lubricating jelly to the tip of the catheter before insertion
c. Instill a total of 30cc of fluid into the client's rectum
d. Ask the client to hold the solution in for 30 seconds
25.
Which of the following is an example of a positive effect of exercise on a
client?
a. Decreased basal metabolic rate
b. Decreased venous return
c. Decreased work of breathing
d. Decreased gastric motility
26.
A client is having difficulties reading an educational pamphlet. He cannot
find his glasses. In order to read the words, he must hold the pamphlet at
arm's length, which allows him to read the information. Which vision
deficit does this client most likely suffer from?
a. Cataracts
b. Glaucoma
c. Astigmatism
d. Presbyopia
27.
A nurse is caring for Mrs. T, a client with expressive aphasia. During a bath,
she begins to gesture wildly and point toward the bath water, yet is unable
to say anything. Which response from the nurse is most appropriate?
a. Is something wrong with the bath water?"
b. Just calm down, we'll finish your bath soon."
c. Are you trying to tell me something?"
d. Shall I turn on the television?"
28.
A nurse is assisting a client with shampooing his hair while he is still in
bed. While helping the client, the nurse raises the bed to approximately the
level of her waist. What is the rationale for this action?
a. To prevent shampoo from getting into the client's eyes
b. To allow excess water to run off the edge of the bed
c. To decrease strain on the nurse's back
d. To prevent the client's hair from developing tangles
29.
Which of the following signs or symptoms indicates a possible nutritional
deficiency?
a. Subcutaneous fat at the waist and abdomen
b. Presence of papillae on the surface of the tongue
c. Straight arms and legs
d. Pale conjunctiva
30.
A nurse is preparing to insert a small-bore nasogastric feeding tube for a
client's enteral feedings. In which method does the nurse measure the
correct length of the tube?
a. From the tip of the nose to the xiphoid process
b. From the tip of the nose to the earlobe to the xiphoid process
c. From the earlobe to the xiphoid process
d. From the tip of the nose to the earlobe to the umbilicus
31.
In which of the following ways can a nurse promote sleep for a client who
is experiencing insomnia?
a. Assist the client to use the bathroom one hour after going to bed
b. Give the client a massage after he wakes up in the morning
c. Tuck bed sheets and blankets tightly around the client once he is settled
in bed
d. Give the client a pair of socks to wear if his feet become cold
32.
A client is complaining of pain that starts in the shoulder and travels down
the length of his arm. This type of pain is referred to as:
a. Referred pain
b. Superficial pain
c. Radiating pain
d. Precipitating pain
33.
A client with an enlarged prostate is having trouble starting his flow of
urine when using the bathroom. Another name for this condition is:
a. Hesitancy
b. Oliguria
c. Retention
d. Urgency
34.
A nurse is preparing to irrigate a client's colostomy. Which of the following
situations is a contraindication for this type of irrigation?
a. The client has an incontinent ostomy
b. The client has an irregular bowel routine
c. The client has diverticulitis
d. The colostomy bag contains fecal material
35.
Which of the following statements best describes substance P?
a. Substance P decreases a client's sensitivity to pain
b. Substance P levels are drawn before administration of narcotic analgesics
c. Substance P is found in the brain and is responsible for pain control and
management of depression
d. Substance P is found in the dorsal horn of the spinal column
36.
Which of the following is a fat-soluble vitamin?
a. Vitamin C
b. Vitamin D
c. Vitamin B-6
d. Riboflavin
37.
A nurse is preparing to administer an enteral feeding through a gastrostomy
tube. Before administering the feeding, the nurse aspirates some stomach
contents and checks the pH. The result is 3.9. What is the next action of the
nurse?
a. Administer the feeding as ordered
b. Pull the feeding tube out approximately 3 cm
c. Flush the feeding tube with 60 cc of water
d. Contact the physician
38.
Which of the following interventions is most appropriate for a client with a
diagnosis of Risk for Activity Intolerance?
a. Perform nursing activities throughout the entire shift
b. Assess for signs of increased muscle tone
c. Minimize environmental noise
d. Teach clients to perform the Valsalva maneuver
39.
A nurse is working with Mr. L, a client who is being seen for disrupted
sleep patterns. The nurse encourages Mr. L to verbalize his feelings about
sleep and his inability to maintain adequate sleep habits. What is the
rationale for this action?
a. Mr. L most likely has a mental illness that should be treated before his
sleep issues
b. Mr. L may have unrecognized anxiety or fear that could be contributing
to poor sleep habits
c. Mr. L may become tired once he starts talking
d. None of the above
40.
A nurse is preparing to attach a TENS unit to a client who is experiencing
pain. Which of the following actions is most appropriate in this situation?
a. Tell the client that he may experience tingling sensations
b. Connect the TENS unit before the client goes to bed for the night
c. Tell the client that the TENS unit may have pain-reducing effects for 10
to 15 days
d. After treatment, notify the client that he may not use a TENS unit again
for at least 2 weeks
41.
Preload refers to:
a. The volume of blood entering the left side of the heart
b. The volume of blood entering the right side of the heart
c. The pressure in the venous system that the heart must overcome to pump
the blood
d. The pressure in the arterial system that the heart must overcome to pump
the blood
42.
Nursing care plans are _______________.
a. written by CNAs before they provide care
b. guidelines of care that all nursing team members use
c. used by nurses but not by nursing assistants
d. used by nursing assistants but not by nurses
43.
Nursing care plans contain which of the following?
a. nursing diagnoses.
b. medical diagnoses.
c. MD orders.
d. intake and output forms
44.
One major difference between long term care and respite centers is the fact
that long term care facilities:
a. provide only physical care and respite centers give both physical and
emotional care.
b. provide care for residents on a long term basis and respite centers offer
only outpatient services.
c. provide care for residents on a long term basis and respite centers offer
only temporary services.
d. There is no difference. Long term care and respite care are the same.
45.
You have taken the vital signs for your patient. They are normal for the
patient. What should you do next?
a. Report the vital signs to the doctor
b. Write the vital signs on a scrap paper
c. Call the family members
d. Document them on the graphic VS form
46.
Penny Thornton has had a stroke, or CVA. She is having difficulty eating on
her own. Soon, she will be getting some assistive devices for eating meals.
Which healthcare worker will be getting Penny these assistive devices?
a. A physical therapist
b. A speech therapist
c. A social worker
d. An occupational therapist
47.
A patient will be discharged from the hospital today. Which person will
most likely arrange the discharge of this patient to his or her own home, to a
nursing home, or assisted living facility?
a. A physical therapist
b. A speech therapist
c. A social worker
d. An occupational therapist
48.
Who is the center of care?
a. The nurse
b. The doctor
c. The administrator
d. The patient
49.
You are working as a valued member of the team on your nursing care unit.
You are trying to figure out whether or not the team is doing well. Which of
the following is a sign that your team is doing well?
a. Conflict occurs but this is seen as an opportunity for team growth and
development.
b. No negative feelings are ever expressed so everyone is happy and
satisfied.
c. Mistakes are NOT tolerated. Mistakes result in disciplinary action.
d. People are not taking risks and they are sticking to the status quo.
50.
The primary purpose of a patient care meeting or conference is to determine
which of the following?
a. the patient's ability to pay for the costs of their care.
b. how the healthcare team can best meet the patient's needs.
c. the patient's physical status and condition.
d. the patient's psychosocial status and condition.
51.
Who should be members of a patient care conference?
a. Doctors, nurses and nursing assistants since they are healthcare providers
b. Doctors, nurses and the patient and/or the family members
c. ALL members of the healthcare team
d. ALL members of the healthcare team and the patient/resident.
52.
Who is legally able to make decisions for the patient or resident during a
patient care conference when the patient is not mentally able to make
decisions on their own?
a. The patient or their health care proxy
b. Only the patient
c. Only the health care proxy
d. The doctor
53.
Which of the following is an example of physical abuse?
a. A slap to the person's hand
b. Threatening the person
c. Ignoring and isolating a person
d. Leaving a patient soiled for hours
54.
Which of the following is an example of emotional abuse?
a. A slap to the person's hand
b. Threatening the person
c. Ignoring and isolating a person
d. Leaving a patient soiled for hours
Explanation: Threatening a patient is an example of emotional abuse.
55.
Which of the following is an example of emotional neglect?
a. A slap to the person's hand
b. Threatening the person
c. Ignoring and isolating a person
d. Leaving a patient soiled for hours
56.
Patients have a right to ______________.
a. only enough information so they can comply with care
b. ALL of their health related information
c. small amounts of information so they do not get nervous
d. moderate amounts of information unless they are old
57.
You are working the 8 am to 4 pm shift. You begin to vomit at 3 pm and
you do not think that you are able to continue working. You decide to
immediately go home without notifying your RN supervisor. You have
_________________.
a. enough sick time so this is not a problem
b. finished all your work so this is not a problem
c. seriously abandoned the patients
d. seriously abused and neglected the patients
58.
A patient has a goal of eating at least 50% of each meal. The patient refuses
to eat so a nurse force feeds the patient in order for them to reach their goal
of eating at least 50% of the meal. The nurse has committed __________
against this patient.
a. assault
b. battery
c. physical neglect
d. emotional neglect
59.
You see a patient lying on the floor of the bathroom. You are NOT assigned
to this patient. What is the first thing that you should do?
a. Get the nurse who is caring for the patient.
b. Tell the nurse that the patient has had another seizure.
c. Observe the patient for any injuries and call out for help.
d. Nothing. This patient is not one of your assignments.
60.
You are taking care of 5 patients today. One of your patients wants water;
another needs help walking to the bathroom; another just stated that they
have chest pain; and another is crying because his daughter did not visit him
today. Which patient care problem must you deal with first?
a. The water
b. Help to the bathroom
c. The chest pain
d. The crying person
61.
You are taking care of 7 patients today. One of your residents wants water;
another needs help walking to the bathroom; another just stated that they
have chest pain; and another is crying because his daughter did not visit him
today. Which patient care is the lowest in terms of priority?
a. The water
b. Help to the bathroom
c. The chest pain
d. The crying person
62.
You are caring for Mrs. Thomas. You see a notation on the nursing care
plan that states "ambulate at least 10 yards qid". This patient will be assisted
with ambulation at which of the following times?
a. 10 am
b. 10 am and 2 pm
c. 10 am, 2 pm and 6 pm
d. 10 am, 2 pm, 6 pm and 10 pm
63.
The supervising RN asks you to bring the unit's collected lab specimens to
the lab "stat". You should ______________.
a. not do this errand because nurses do not do "stats".
b. run this errand as soon as you can.
c. run this errand immediately and without delay.
d. Before the end of your shift or after your lunch.
64.
You are working the 4 pm to 12 midnight evening shift. You are taking care
of a group of patients. The supervising RN identifies 5 patients who get a
medication at "HS". When will you give this medication?
a. After the dinner meal
b. Whenever requested
c. At the patient's bedtime
d. Before the end of the shift
65.
You are caring for Mr. Charles Y. You see a notation on the nursing care
plan that states, "remind the patient to use the incentive spirometer tid".
This patient will be reminded at which of the following times?
a. 10 am
b. 10 am and 2 pm
c. 10 am, 2 pm and 6 pm
d. 10 am, 2 pm, 6 pm and 10 pm
66.
A nursing care plan states, "Assist the patient to the bedside commode prn".
When will this patient get this assistance to the commode?
a. Whenever needed
b. At bedtime
c. During the night
d. During the day
67.
You see a sign over Mary Jones' bed when you arrive at 7 am to begin your
day shift. The sign says, "NPO". Ms. Jones is on a regular diet. The patient
asks for milk and some crackers. You _____________.
a. can give her the milk but not the crackers.
b. can give her both the milk and the crackers.
c. can give her the crackers but not the milk.
d. cannot give her anything to eat or drink.
68.
Match the abbreviation with the correct definition:
a. bid: at bedtime
b. tid: tomorrow
c. ac: before meals
d. pc: patient care
69.
Which is NOT an acceptable abbreviation?
a. D/C
b. tid
c. bid
d. qid
70.
You are taking Mr. D's blood pressure. The first sound that you hear is at
162 and the second sound that you hear is at 86. You should document and
report that the blood pressure is _____________.
a. 86/162
b. irregular and high
c. 162/86
d. normal for people of all ages
71.
Your elderly patient has a temperature of 98.5 degrees. Is there anything
else that a nurse should do, in addition to documenting this temperature?
a. No, this temperature is within normal limits.
b. No, this temperature is normally hyperthermic.
c. Yes, this temperature is highly hyperthermic.
d. Yes, this temperature is highly hypothermic.
72.
When cleansing the genital area during perineal care, the nurse should
_______________.
a. cleanse the penis with a circular motion starting from the base and
moving toward the tip.
b. replace the foreskin after it has been pushed back to cleanse an
uncircumcised penis.
c. cleanse the rectal area first and then clean the patient's genital area.
d. use the same area on the washcloth for each washing and rinsing stroke
for a female resident.
73.
You are ready to give your resident a complete bed bath. The temperature of
this bath water should be which of the following?
a. Cooler than a tub bath.
b. Hotter than a tub bath.
c. About 106 degrees.
d. Over 120 degrees.
74.
You are ready to wash your patient's face. You would start by washing what
area of the face?
a. The forehead
b. The eyes
c. The ears
d. The cheeks
75.
The nurse should wash from the ________________________ when
washing a patient's eye area.
a. outer canthus to the inner canthus
b. inner canthus to the inner canthus
c. internal nares to the external nares
d. external nares to the internal nares
76.
Your patient had a stroke, or CVA, five years ago. The resident still has
right sided weakness. You are ready to transfer the resident from the bed to
the wheelchair. The
_______________.
wheelchair
should
be
positioned
at
the
a. head of the bed on the patient's right side
b. head of the bed on the patient's left side
c. bottom of the bed on the patient's right side
d. bottom of the bed on the patient's left side
77.
Patients who cannot move in their bed on their own should be turned at
least ________________.
a. once a day
b. twice a day
c. every 2 hours
d. every 4 hours
78.
You have measured the urinary output of your resident at the end of your 8
hour shift. The output is 25 ounces. You should do what next?
a. Convert the number of ounces into cc s.
b. Convert the number of ounces into cm s.
c. Immediately report this poor output to the nurse.
d. Know that 25 ounces of urine is too much in 8 hours.
79.
How many cc s are there in 25 ounces?
a. 250
b. 500
c. 750
d. 1000
80.
Your patient has finished a 12 ounce can of ice tea and 8 ounces of fresh
orange juice. What will you record on the Intake and Output form for this
patient's intake?
a. 20 cc
b. 20 cm
c. 600 cc
d. 600 cm
81.
Your patient ate an 8 ounce cup of Italian ice. How much will you record on
the patient's Intake and Output form in terms of this patient's fluid intake?
a. 240 cc
b. 120 cc
c. 8 cc
d. 0 cc because Italian ice is not a fluid.
82.
You are getting the patient ready to eat. The patient is on complete bed rest.
You will put the head of the bed up at ___________ degrees or more.
a. 10
b. 15
c. 20
d. 30
83.
Cheryl M. has a serious swallowing disorder. She has asked you for a glass
of water. The doctor has ordered honey thickness fluids for her. Water is not
a honey thickness fluid. It is much thinner. What should you do?
a. Tell the resident that she cannot have water.
b. Give her applesauce instead of the water.
c. Tell Cheryl that she is NPO until midnight.
d. Thicken the water and give it to her.
84.
You have been asked to record the amount of food that the person has eaten
during each meal. What kinds of words or numbers would you use to record
this food intake?
a. A little, a moderate amount or all of the meal
b. 50 cc, 100 cc or 500 cc of the meal
c. 25%, 50% or 100% of the meal
d. Either a or c
85.
The abbreviation ac is defined as _____________.
a. before the meal
b. with the meal
c. after the meal
d. ante corpis
86.
The abbreviation pc is defined as ________________.
a. before the meal.
b. with the meal
c. after the meal
d. post corpi.
87.
Your patient has shortness of breath. You should position the patient in the
___________________ position.
a. prone
b. left lateral
c. right lateral
d. Fowler's
88.
The Sims' position is MOST similar to the ________ position.
a. prone
b. lateral
c. supine
d. Fowler's
89.
You take an adult's blood pressure and it is 40/20. You place the patient in a
Trendelenberg position before rechecking the blood pressure. You will
____________to put the patient into the Trendelenberg position.
a. lower the head of the bed and raise the foot of the bed
b. raise the head of the bed up to about 60 to 75 degrees
c. raise the head of the bed up to about 75 to 90 degrees
d. raise the siderails and place the bed in the high position
90.
You have been assigned to take an apical pulse for one of the patients on the
nursing unit. How will you do this?
a. You will place the stethoscope over the heart and listen for any irregular
beats
b. You will place the stethoscope over the heart and count the beats per
minute
c. You will place your finger tip over the patient's wrist and feel for any
irregular beats
d. You will place your finger tip over the patient's wrist and count the beats
per minute
91.
When a nurse does a pulse, he should note which of the following?
a. Rate
b. Rate and quality
c. Rate, quality and fullness
d. Rate, quality, fullness and regularity
92.
Mr. Thomas is a well groomed 68 year old male patient. He had prostate
surgery two days ago. He has an indwelling catheter and a urinary drainage
bag. You have weighed him at 9 am each morning for 3 mornings in a row.
Today, on the 4th day, his morning weight is 3 pounds more than it was the
day before. Why could he have gained these 3 pounds in one day, on a 1000
calorie diet?
a. It is obvious that his visitors have been sneaking him junk food from the
local fast food restaurant.
b. It may be that his urinary drainage bag was not emptied today and it was
emptied on previous days.
c. It is obvious that the scale is broken and it should be replaced
immediately to prevent these false weights.
d. A 3 pound weight gain is not significant enough to question and should
just be noted.
93.
You are providing mouth care to a patient who is in a coma. You
should________________ to provide good and safe mouth care.
a. keep the head of the bed up so that the patient does not aspirate
b. brush the teeth and rinse the mouth with a cup of water
c. use a special foam swab to brush only the tongue
d. use a special foam swab to brush the tongue and teeth
94.
What term is used to describe the sexual response changes among middle
aged men?
a. Menopause
b. Climacteric
c. Generativity
d. Maturity
95.
Mr. Roberts, a 68-year-old man, notices a gradual loss of hearing. This
sensory change is called _____________.
a. presbycusis
b. xerostomia
c. myopia
d. presbyopia
96.
Changes, such as retirement, grand parenting and increased dependence on
others, are examples of what kind of changes?
a. Moral
b. Psychosocial
c. Self-esteem
d. Psychomotor
97.
The term, "Afferent Nerve," means:
a. Carrying an impulse to the brain
b. Carrying an impulse away from the brain
c. Carrying impulses to the motor neurons of the appendicular muscles
d. None of the above
98.
The medical term, "basophilia," refers to:
a. an attachment of the epithelial cells of the skin to a basement membrane
b. An overabundance of a particular white blood cell in the peripheral blood
c. An underrepresentation of basophils on a blood smear.
d. None of the above
99.
When considering the structural organization of the human body, which of
the following is the basic unit of life?
a. Chemicals
b. Atoms
c. Molecules
d. Cells
100.
When a patient is standing in anatomical position, where are his feet?
a. Facing forward with the toes spread open
b. Facing out to the sides to open the hips
b. Side by side and facing forward; toes resting comfortably.
d. The feet are pointed inward.
101.
A physician asks you to place the patient with his dorsal side facing the
exam table. Which of the following accurately describes the how the patient
is positioned?
a. The patient is lying prone.
b. The patient is lying supine.
c. The patient is lying in the recovery position.
d. The patient is lying on his stomach.
102.
The body plane that divides the body into right and left sides is the:
a. Frontal Plane
b. Medical Plane
c. Median Plane
d. Transverse Plane
103.
A patient is asked to abduct her arms. Which of the following accurately
describes her arm movement?
a. She moves her arms away from her trunk.
b. She moves her arms toward her trunk.
c. She rotates her arms at the wrists while holding them toward her feet.
d. She crosses her arms over her abdomen.
104.
Which of the following sets of word parts means, "Pain"?
a. dynia and -algia
b. a- and anc. ia and -ac
d. pathy and -osis
105.
One of the three smallest bones in the body is the:
a. Vomer
b. Distal phalange of the small toe
c. Stapes
d. Coccyx
106.
Which of the following organs would be described as being located
retroperitoneally?
a. Kidneys
b. Thymus
c. Small Intestines
d. Spleen
107.
The heat-regulating center of the brain is the:
a. Hypothalamus
b. Pituitary Gland
c. Pons
d. Medulla Oblongata
108.
The anatomic structure located in the middle of the heart which separates
the right and left ventricles is the:
a. Septum
b. Sputum
c. Separatator
d. None of the above.
109.
Which of the following boney landmarks is described by, "large, blunt,
irregularly shaped process, such as that found on the lateral aspect of the
proximal femur"?
a. Tubercle
b. Tuberosity
c. Condyle
d. Trochanter
110.
The Atlas and the Axis:
a. are found in the vertebrae.
b. can be described as being cervical.
c. are the first two bones that form the column for the spine on the superior
aspect.
d. All of the above.
111.
The body system that functions to maintain fluid balance, support immunity
and contains the spleen is the:
a. Lymphatic System
b. Digestive System
c. Urinary System
d. Reproductive System
112.
The duodenum:
a. is the third section of the small intestine, which leads immediately to the
colon.
b. is the section of the stomach where the gall bladder delivers bile.
c. is the section of the small intestine where the pancreas delivers insulin.
d. None of the above.
113.
This particular gland of the endocrine system secretes a hormone that is
known to assist with the sleep/ wake cycle. What gland is it?
a. Pituitary
b. Pineal
c. Pancreas
d. Hypothalamus
114.
The flap of tissue that covers the trachea upon swallowing is called the:
a. Epidermis
b. Endocardium
c. Epiglottis
d. Epistaxis
115.
A physician's order instructs a nurse to take a temperature at the axilla.
Where would the nurse place the thermometer?
a. In the rectum
b. In the mouth
c. On the temples
d. In the armpit
116.
Which of the following medical terms means, "surgical fixation of the
stomach"?
a. Abdominorrhaphy
b. Gastroplasty
c. Gastropexy
d. Abdominorrhexis
117.
A procedure that examines a portion of the large intestine with an
endoscope is called:
a. Colposcopy
b. Sigmoidoscopy
c. Upper GI
d. Cardiac catheterization
118.
The mitral valve is synonymous with the term:
a. Left ventricle
b. Right atrium
c. Bicuspid valve
d. Tricuspid valve
119.
In the term, "Hemoglobin," the suffix, "-globin," means:
a. Protein
b. Iron
c. Metal
d. Blood
120.
A patient suffering from hyperglycemia would be experiencing:
a. Low blood sugar
b. High blood sugar
c. Normal blood sugar
d. None of the above.
121.
Which of the following scenarios provides an example of a nurse
overcoming a barrier to communication?
a. A nurse uses lecture as a means of explaining how to run a finger stick
glucose test to an elderly patient.
b. A nurse writes her directions to a patient that is hearing impaired.
c. A nurse speaks loudly to a patient who speaks a non-English language.
d. A nurse uses the terms, "micturate," and, "defecation," while talking with
a minor.
122.
A patient who is displaying the defense mechanism of Compensation
would:
a. Refuse to hear unwanted information.
b. Transfer feelings of negativity to someone else.
c. Overemphasize behaviors which accommodate for perceived weaknesses.
d. Place blame on others for personal actions or mistakes.
123.
Assuming that an elderly patient will have a difficult time understanding the
directions for how to take medication is an example of:
a. Prejudice
b. Stereotyping
c. Encoding
d. Rationalization
124.
Which of the following questions is considered, "Open Ended,"?
a. What time did you last take your medications?
b. Are you feeling ok right now?
c. Please describe your symptoms?
d. What day are you available for a follow-up appointment?
125.
A patient displays the following body language: Slumped shoulders,
grimace, and stiff joints. What message is this patient sending?
a. Anger
b. Aloofness
c. Empathy
d. Depression
126.
A patient who refuses to believe a terminal diagnosis is exhibiting:
a. Regression
b. Mourning
c. Denial
d. Rationalization
127.
A nurse realizes after a patient has left the office that she forgot to put the
patient's complaint of a sore throat. Which of the following choices would
BEST correct her error?
a. Pull out that page of the chart and rewrite it with the correct information.
b. Put one line through the original Chief Complaint, write, "ERROR", your
initials and today's date. Make the correction by rewriting the CC with the
correct information.
c. Go to the next available line of the SOAP notes. Write the current date,
then, "Late Entry." Place the date and time when the patient stated she had a
sore throat. Sign and date the entry.
d. All of the above are incorrect.
128.
Which of the following vital signs can be expected in a child that is
afebrile?
a. Rectal Temp of 100.9 degrees F.
b. Oral Temp of 38 degrees C.
c. Axillary Temp of 98.6 degrees F.
d. All of the above are incorrect.
129.
Intermittent fevers are:
a. fevers which come and go.
b. fevers which rise and fall but are always considered above the patient's
average temperature.
c. fevers which fluctuate more than three degrees in never return to normal.
d. None of the above.
130.
A patient's body temperature has varied over the last 24 hours from 97.6
degrees F in the morning to 99 degrees F in the evening. The patient is
worried that this change in temperature may indicate the beginning of a
fever. Which of the following BEST explains this phenomenon?
a. The patient definitely has a fever in the evening and should be seen by a
doctor.
b. The patient is experiencing changes related to a diurnal rhythm.
c. The patient is more than likely taking her temperature incorrectly.
d. The patient is male and is experiencing changes related to fluctuating
monthly hormones.
131.
The most accurate reading for a temperature is done:
a. Orally.
b. Aurally through a clean canal.
c. Rectally.
d. Axially.
132.
A patient is having difficulty understanding how to properly run her glucose
meter. Which of the following teaching methods would best help the patient
understand how to use her instrument correctly?
a. Give the patient an instruction booklet and have her call the office if she
has questions.
b. Tell the patient to have a family member demonstrate how to use the
instrument.
c. Have the patient watch a video on the use of the instrument.
d. Demonstrate the proper use of the instrument and then have the patient
perform the process while still in the office.
133.
The pulse point located on the top of the foot is:
a. the dorsalis pedis.
b. is checked in patients with peripheral vascular problems.
c. absent in some patients due to a congenital anomaly.
d. All of the above.
134.
Over a patient's lifespan, the pulse rate:
a. starts out fast and decreases as the patient ages.
b. starts out slower and increases as the patient ages.
c. Varies from slow to fast throughout the lifespan.
d. Stays consistent from birth to death.
135.
A common error when taking a pulse is:
a. placing the index finger on the radial artery which is located on the
thumb side of a patient's wrist.
b. noting a pulse as being "weak" when the pulsation disappears upon
adding pressure.
c. counting the pulse for 15 seconds and multiplying the number by four.
d. None of the above will cause errors.
136.
A patient is in the office for a cyst removal and is very anxious about the
procedure. Which of the following descriptions of his respirations would be
expected?
a. Bradypnea
b. Orthopnea
c. Tachypnea
d. Dyspnea
137.
Rales and rhonchi are frequently noted during an examination of lung
sounds. What is the difference between the two?
a. Rales are louder.
b. Rhonchi are noted only in infants.
c. Rales occur on inspiration, rhonchi on expiration.
d. Rales are noted only in infants.
138.
To accurately assess a patient's respiration rate, which of the following
methods would be BEST?
a. Tell the patient, "Please remain silent while I count your number of
breaths."
b. Count respirations at the same time you are counting the pulse rate.
c. Count the pulse rate for one minute, then, while keeping your index
fingers on the patient's radial artery, count the respirations for an additional
minute.
d. Count the patient's respiration rate, then take the patient's temperature,
and then take the pulse rate.
139.
A patient is diagnosed with essential hypertension. Which of the following
blood pressures would you expect to see in this patient prior to taking
medications for his condition?
a. 142/92
b. 118/72
c. 120/80
d. 138/88
140.
Korotkoff sounds are:
a. sounds noted during diastole.
b. the result of the vibration of blood against artery walls while blood
pressure readings are being taken.
c. are only noted by skilled cardiologists.
d. distinct sounds which are classified into 6 phases.
141.
Which of the following is an anthropomorphic measurement?
a. Blood pressure
b. Temperature
c. Pulse Rate
d. Weight
142.
The procedure for taking a pulse rate on an infant differs from an adult
how?
a. Pulse rates are not taken on infants.
b. The apical pulse method is used on infants.
c. Pulse rates on infants are taken with a sphygmomanometer.
d. Pulse rates on infants are taken apically in the third intercostal space.
143.
The patient position that is most useful for proctologic exams is the:
a. Trendelenburg
b. Semi-Fowler's
c. Full Fowler's
d. Jack Knife
144.
A physician may assess turgor when:
a. iron deficiency is suspected.
b. heart and lung issues are suspected.
c. dehydration is suspected.
d. None of the above.
145.
When performing an EKG, the patient starts to laugh out of feelings of
anxiety. What would you expect the EKG to show? (Choose the BEST
answer.)
a. Increased pulse rate, normal EKG
b. Decreased pulse rate, abnormal EKG
c. Tachycardia, poor EKG graph.
d. Bradycardia, poor EKG graph.
146.
When printing out an EKG, a nurse notices that the QRS complexes are
extremely small. What should be the next step?
a. Alert the physician immediately as this is a sign of impending cardiac
arrest.
b. Check to see that all leads are attached and rerun the EKG.
c. Increase the sensitivity control to 20 mm deflection.
d. Decrease the run speed to 50.
147.
Each small square on the EKG paper is:
a. 04 seconds long and 5mm tall
b. 2 seconds long and 5mm tall
c. 04 seconds long and 20mm tall
d. 04 seconds long and 1mm tall
148.
When teaching a patient to use the three point gait technique of crutch use:
a. The injured leg moves ahead at the same time as both crutches.
b. One crutch moves at a time and then followed by the injured leg.
c. Both crutches move ahead at the same time followed by both legs at the
same time.
d. None of the above are correct.
149.
A nurse is asked to draw blood in the antecubital (AC) space. Which of the
following veins are found in the AC?
a. Cephalic
b. Median cubital
c. Basilic
d. All of the above.
150.
A patient's urine specimen tested positive for bilirubin. Which of the
following is most true?
a. The patient should be evaluated for kidney disease.
b. The specimen was probably left at room temperature for more than two
hours.
c. The specimen is positive for bacteria.
d. The specimen should be stored in an area protected from light.
151.
Which vacutainer tubes should be used when a requisition calls for blood to
be drawn for an H&H and glucose test?
a. One light blue, one red
b. Two lavenders
c. One lavender, one grey
d. One green, one red
152.
Specific gravity in urinalysis:
a. compares the concentration of urine to that of distilled water.
b. is useless when the patient is dehydrated.
c. can only be done with a refractometer.
d. None of the above.
153.
When placing a patient in the AP position for an X-ray, what position
would the patient be in?
a. Facing the film.
b. Right side against the film.
c. Left side against the film.
d. Facing away from the film.
154.
A patient's urine tests positive for glucose. The doctor asks you to confirm
this finding. Which of the following would BEST confirm this finding?
a. Run the urine on the hand-held glucometer.
b. Have another MA do a repeat dipstick.
c. Run a Clinitest.
d. Run an Acetest.
155.
A patient has been told to monitor her LH levels. Which of the following
potential conditions might the patient be suffering from?
a. Menorrhagia
b. Grave's Disease
c. Menopause
d. Infertility
156.
Manual hematocrits are done:
a. to monitor anemia.
b. by using a microcrit tube.
c. to measure the percentage of plasma to cells.
d. All of the above.
157.
The BEST blood collection location for a newborn is:
a. the AC.
b. the veins of the forehead.
c. the heel.
d. the fingertips.
158.
A patient has come to the office for a blood draw. The patient starts to sweat
and is very anxious. Which of the following would be the BEST way to
proceed?
a. Do not perform the procedure. Notify the physician of the reason why.
b. Perform the procedure but pay close attention for signs of potential
syncope.
c. Allow the patient to reschedule for a time where he isn't as anxious.
d. Have the physician draw the blood.
159.
Which of the following tests would MOST LIKELY be performed on a
patient that is being monitored for coagulation therapy?
a. PT/INR
b. CBC
c. HCT
d. WBC
160.
Which of the following is MOST TRUE about the ESR test?
a. The results are diagnostic for certain conditions.
b. Abnormal results are indicative of a potentially fatal illness.
c. Abnormal results should be followed with additional testing.
d. Results are reported in millimeters per minute.
161.
A patient who is blood type AB:
a. can receive plasma from a type B donor.
b. can receive whole blood from a type A donor.
c. can receive packed RBCs from a type O donor.
d. All of the above.
162.
Which of the following is considered an abnormal lab result?
a. WBC 10,000/ mm cubed
b. Hct 50%
c. ESR 22 mm/hour
d. All of the above are normal.
163.
The mordant in the Gram Stain procedure is:
a. the chrystal violet
b. the methyl alcohol
c. Iodine
d. Safranin
164.
To properly read a meniscus,
a. hold the measuring device at eye level and read the bottom of the curve
of the liquid level.
b. hold the measuring device at eye level and read the top of the curve of
the liquid level where the liquid holds to the walls of the container.
c. hold the measuring device at table level and looking down into the
measuring device, read the bottom of the curve of the liquid level.
d. hold the measuring device at table level and looking down into the
measuring device, read the top of the curve of the liquid level.
165.
A urine pregnancy test:
a. May be negative even if a blood pregnancy test is positive.
b. Is positive only during the first trimester of pregnancy.
c. Will be negative if the amount of LH isn't enough to meet or exceed the
sensitivity of the testing device.
d. All of the above.
166.
The Sinoatrial Node (SA) is located within which of the following heart
structures:
a. Mitral Valve
b. Right Ventricle
c. Right Atrium
d. Left Atrium
167.
Which of the following puts the layers of skin in correct order from right to
left?
a. Dermis, epidermis, hypodermis
b. Hypodermis, epidermis, dermis
c. Epidermis, dermis, hypodermis
d. None of the above
168.
Digestion, elimination and ___________ are the three functions of the
digestive system.
a. constriction
b. relaxation
c. adsorption
d. peristalsis
169.
The Loop of Henle is located in which of the following body organs?
a. Liver
b. Kidney
c. Heart
d. Ear
170.
The main artery that supplies blood to the arms is called the _________
artery.
a. femoral
b. brachial
c. subclavian
d. carotid
171.
Which of the following organs is part of the lymphatic system?
a. Pancreas
b. Spleen
c. Liver
d. Gallbladder
MANAGEMENT AND PRACTICE DIRECTIVES (TEST
MODE)
1.
At the beginning of the shift, a nurse receives report for her daily
assignment. Which of the following situations should the nurse give first
priority?
a. A diabetic client with a blood glucose level of 195 mg/dL
b. A family member of an elderly client who has questions
c. A client with COPD with an oxygen saturation of 84%
d. A client who requires assistance to use the bathroom
2.
Mr. W has orders for a physical therapy consult. The nurse contacts the
appropriate department but 12 hours later, no one has come to see the client.
Which is the most appropriate action of the nurse?
a. Call the supervisor and file a complaint against the physical therapy
department
b. Contact the physician to notify him that the orders were not carried out
c. Assess the client's activity level by assisting with ambulation using a gait
belt
d. Contact the physical therapy department again and repeat the order
3.
The "B" in the SBAR acronym stands for:
a. Background
b. Basic
c. Beginning
d. Break
4.
Decide which of the following tasks may be delegated to unlicensed
assistive personnel.
a. Cleansing a wound with peroxide
b. Irrigating a colostomy
c. Assisting with performing incentive spirometry
d. Removing a saline-lock IV
5.
According to HIPAA, which of the following is considered an individual
right for privacy of a client's protected health information?
a. The right to receive medical bills for care received
b. A copy of the organization's privacy practices
c. A right to change personal health information
d. An understanding that protected health information will only be used in
regards to client treatments
6.
Which of the following clients is most likely ready to be dismissed from an
inpatient care setting to home?
a. A 65-year old male with urine output of 60cc in the past four hours.
b. A 2-month old female with a temperature of 100.6 rectally
c. A 38-year old female who transitioned from IV TPN to full liquids six
hours ago
d. A 4-year old male with an oxygen saturation of 96% on room air
7.
The nurse is performing discharge teaching for Mrs. S after cardiac
angioplasty. Her husband is present for the teaching. While explaining the
prescription for antiplatelet medication to use at home, Mrs. S's husband
states, "I don't think I can afford to refill that medication." What is the most
appropriate response of the nurse?
a. Don't worry, your insurance will cover it."
b. I'll ask the physician if he can prescribe a medication that is more
affordable."
c. You should apply for Medicare to see if they can help you."
d. This medication is essential for her care and should be given priority over
all others that she is taking."
8.
The discharge planning team is discussing plans for the dismissal of a 16year old admitted for complications associated with asthma. The client's
mother has not participated in any of the discharge planning process, but
has stated that she wants to be involved. Which of the following reasons
might prohibit this mother from participating in discharge planning?
a. The client is an emancipated minor
b. The mother has to work and is unavailable
c. The client has a job and a driver's license
d. The mother does not speak English
9.
A nurse enters a client's room and finds her lying on the floor near the
bathroom door. As the nurse provides assistance, the client states, "I thought
I could get up on my own." What information must the nurse document in
this situation?
a. A statement explaining the condition the client was found in, quoting the
client's words about the situation
b. An explanation of how the fall happened and when the physician was
notified
c. An account of the conditions of the room that contributed to the client's
fall
d. A description of the client's condition and the reasons why she should
have had assistance to the bathroom
10.
Which of the following may be a cultural barrier that impacts a nurse's
ability to provide care or education to the client?
a. A nurse offers educational materials to a client that are written at an 8th
grade reading level
b. A Vietnamese woman wants to use steaming in addition to her
prescription antibiotics
c. A nurse uses pantomime to explain a procedure to a deaf client
d. A Native American client requests a healing ritual before he will consider
surgery
11.
Which of the following is an example of low health literacy skills?
a. A nurse's aide cannot calculate the correct IV rate for Ringer's lactate
b. A client cannot read an admission form to sign it
c. A nurse is unable to explain the dose, indications, side effects, and
structural formula of carbamazepine
d. A client does not understand the treatment for his cholecystectomy
12.
A 39-year old woman presents for treatment of excessive vaginal bleeding
after giving birth to twins one week ago. Which nursing diagnosis is most
appropriate in this situation?
a. Knowledge Deficit related to post-partum blood loss
b. Self-Care Deficit related to post-partum neglect
c. Fluid Volume Deficit related to post-partum hemorrhage
d. Body Image Disturbance related to body changes after delivery
13.
Mr. K is admitted to the orthopedic unit one morning in preparation for a
total knee replacement to start in two hours. Which of the following is a
priority topic to instruct this client on admission?
a. The approximate length of the surgery
b. The type of anticoagulants that will be prescribed
c. The time of the next meal of solid food
d. The length of time until the client can return to work
14.
Which of the following is an example of the intervention phase of the
individualized nursing care plan for a client who receives a colostomy after
a bowel resection?
a. Taking a health history and performing a physical exam prior to the
procedure
b. Instructing the client about how to care for his colostomy stoma
c. Developing goals that state the client will ambulate three times a day
d. Determining that the client may need more support at home after
dismissal
15.
Research participants are involved in a trial that incidentally separates them
into two groups. One group receives an intervention, while the other group
does not. Both groups are compared for outcomes. What type of research
method is this?
a. Experimental design
b. Double-blind experiment
c. Randomized controlled trial
d. Repeated measures design
16.
A nurse is caring for an in-patient client in the hospital who is from another
country and who fasts for temporary periods in order to promote his own
spiritual growth. The nurse responds by saying, "You need to eat something
while you are here. Food and proper nutrition is extremely important for
your health." What social philosophy is the nurse demonstrating?
a. Ethnocentrism
b. Relativism
c. Stereotyping
d. Xenocentrism
17.
A nurse is using active listening as a form of therapeutic communication
when:
a. She uses humor to put the client at ease in a situation
b. She restates what the client said in slightly different words
c. She uses eye contact and maintains an open stance while the client is
talking
d. She provides personal information to show the client she can relate to
him
18.
A client asks a nurse, "Do you think I should move back home after this
procedure?" and the nurse responds by saying, "do you think you should
move back home?" What type of therapeutic communication is the nurse
representing?
a. Observation
b. Reflection
c. Summarizing
d. Validating
19.
Which of the following is an example of a living will?
a. A client's son has been appointed to make his healthcare decisions if he
becomes incapacitated
b. A client has designated which of his children will receive his home and
property before he dies
c. A client has instructions that he does not want to be resuscitated through
chest compressions if his heart stops beating
d. A client designates what type of burial or cremation services he would
want after his death
20.
What is involved with obtaining informed consent?
a. An explanation of the reasons for the procedure
b. A signature on a form that states the client agrees to the procedure
c. A statement affirming liability if complications arise during the
procedure
d. Both a and c
21.
Which of the following questions must the nurse ask when formulating a
nursing diagnosis?
a. What diagnosis did the physician make for this client?
b. What is the issue that I can solve for this client?
c. What physician orders will resolve this issue?
d. What underlying disease does this client have?
22.
A nurse walks into a client's room to find the nursing assistant yelling "sit
back down or I won't help you eat and then you will starve!" This type of
behavior is known as:
a. Psychological abuse
b. Abandonment
c. Material exploitation
d. Physical abuse
23.
A physician has written an order for "2.0 mg MS q 2-4 hr prn pain." What is
the nurse's response to this order?
a. Give 2 mg of morphine sulfate to the client
b. Give 20 mg of morphine sulfate to the client
c. Contact the pharmacy to clarify the order
d. Contact the physician to rewrite the order
24.
A client is being admitted to the stroke care unit of a rehabilitation center.
Which of the following best describes the action of the nurse at admission?
a. Collect and arrange documents to be placed in the client's medical record
b. Prepare the client's identification bracelet
c. Identify pertinent health history data as well as current needs and
limitations
d. Gather the client's valuables and place them in a locked container
25.
A client is refusing to undergo any more treatments in the hospital and
wants to leave against medical advice. When the nurse requests the client
sign an AMA order, the client refuses and leaves. What is the next action of
the nurse?
a. Call security to hold the client until he will sign the order
b. Notify the physician to convince the client that he needs to stay
c. Speak with the client's spouse to persuade him to stay
d. Allow the client to leave and document the refusal in his chart
26.
Which example best describes a nurse who exhibits moral courage?
a. A nurse feels angry when a parent refuses important treatment for his
child.
b. A nurse considers seeking help for depression when she feels she cannot
meet the needs of her clients in the oncology unit.
c. A nurse contacts a physician for further orders when he fails to order
comfort measures for a client with a terminal illness.
d. A nurse is frustrated when the laboratory is slow in responding to an
order for a stat blood glucose.
27.
Which method is most appropriate for managing moral distress in the
workplace?
a. Recognizing that life is unfair and nurses cannot meet every need of
every client
b. Declining to act when clients or visitors make requests that are not
justifiable
c. Developing a new policy that would address the problematic situation
d. Both a and b
28.
A nurse is required to float to another unit within the hospital where he is
asked to care for a client on a ventilator. The nurse is uncomfortable with
this assignment, as he has not had a ventilated client since nursing school.
What is the nurse's most appropriate response?
a. Explain to the nursing supervisor the level of discomfort and ask for a
different assignment
b. State that the client's needs are outside the nurse's scope of practice and
request a different assignment
c. Accept the assignment, asking for help when necessary
d. Request to return to the home unit and send another nurse who can
perform the job
29.
A nurse is asked to perform a task that she believes is outside her scope of
practice. What is the appropriate response to this issue?
a. Contact the state board of nursing licensure to report the offense
b. Review the state scope of practice standards for nurses
c. Ask another nurse to perform the task to learn the procedure
d. Contact the house supervisor to make the decision as to whether the
nurse should perform the task
30.
A nursing unit is implementing a new electronic charting program for the
nursing staff to use. Which of the following best describes a disadvantage
of using electronic charting?
a. The information is more likely to be lost or used inappropriately
b. Any provider in the unit can have access to the client's medical records
c. The system diminishes communication between nurses and providers
d. The program may be confusing and difficult to implement
31.
A client has volunteered to take part in a research study. After participating
for two months, he decides that he can no longer tolerate the study and
decides to leave. What are the client's rights in this situation?
a. The client has a right to be released from the study but must reimburse
the researchers for charges incurred
b. The client has a right to be released from the study without any liability
c. The client has a right to be released from the study but is prohibited from
participating in any future studies
d. The client does not have the right to be released from the study; he must
finish his participation
32.
A client is seen in the emergency room as a victim of suspected domestic
violence. The nurse's aide brings the client to a center curtained area, gives
her a gown to change into, and asks her to wait for the nurse. What is the
most appropriate action of the nurse upon arrival?
a. Ask the client to undress to visualize any injuries
b. Take the client into a private room
c. Notify the police to file an initial report
d. Notify the house supervisor to keep security on alert
33.
A nurse is examining a woman who has bruises on her face and back in
various stages of healing. The client states "sometimes he just gets so
angry." Which of the following statements is most appropriate as a response
from the nurse?
a. Do you mean your boyfriend?"
b. You need to leave him as soon as possible."
c. No one will ever hurt you again."
d. Tell me more about what happens when he gets angry."
34.
A nurse is performing an end-of-shift count of narcotics kept in the locked
cabinet. The narcotic log states there should be 26 oxycodone pills left, but
there are only 24 in the drawer. What is the first action of the nurse?
a. Perform the count again
b. Contact the pharmacy to determine if the narcotic log is incorrect
c. Check with the last nurse to sign out narcotics from the system
d. Notify the house supervisor that narcotic medications are missing
35.
Which example best describes the concept of beneficence?
a. A client has an advanced directive in place stating that he does not want
intubation if he needs CPR
b. A nurse provides pain medication for a client in the recovery room who
is experiencing pain
c. At the request of the client, a nurse does not inform his family about his
cancer diagnosis
d. A nurse withholds narcotic medication for a client in pain, knowing that
he is currently disoriented
36.
A nurse is caring for a dying client whose family wants to be with him in
the operating suite. The surgeon, however, does not allow families to be
present during surgery. The nurse recognizes this as an ethical dilemma.
What is the initial step of the nurse when managing this situation?
a. Contact the physician to amend the order for the client
b. Document an account of the situation to ensure adequate coverage of
details
c. Consult with the medical ethics committee to determine a safe and
workable solution
d. Speak with the chief nursing officer to change the policy governing this
situation
37.
A nurse is at the beginning of her shift in a long-term care facility. Which of
the following clients should she check on first?
a. A 91-year old man who needs help eating breakfast
b. An 86-year old man who has been incontinent in his bed
c. An 82-year old woman who needs IV antibiotics
d. A 75-year old man who is recovering from an injury who needs an ice
pack
38.
The charge nurse is notified that the unit will be receiving an admission of a
client from another bed in the hospital in order to make room for others
being admitted through the emergency room. The unit is the Women's
Health Center of the hospital. Which of the following people would be most
appropriate to be transferred to this unit?
a. A 26-year old woman who had a bowel resection
b. A 40-year old man who underwent a hernia repair
c. A 31-year old woman with septicemia and who is on a ventilator
d. A 91-year old man with Alzheimer's disease recovering from a fall
39.
A nurse in the emergency room enters a client's care area to start an IV. She
finds a man sitting on the table, hunched over, and attempting to take deep
breaths. He states, "my chest hurts so much!" His wife is sitting on a chair
in the corner, crying. Which of the following is the first action of the nurse?
a. Bring the IV kit and quickly start an IV
b. Assess his breathing and provide oxygen, if necessary
c. Administer medication to control chest pain
d. Talk with his wife and find out why she is crying
40.
Examples of preservation of self-integrity include all of the following
except:
a. Using assistive equipment to move bariatric clients
b. Participating in wellness programs
c. Accepting the challenge of caring for clients with oppositional beliefs or
practices
d. Using hand hygiene and personal protective equipment
41.
Which method best describes the use of evidence-based practice?
a. Reading and analyzing research reports to see how they can be
implemented into nursing practice
b. Collecting data to determine how efficiently nursing practice is
contributing to quality care
c. Monitoring unit practices to determine compliance with Joint
Commission standards
d. Using the most effective, current, and applicable information available to
guide nursing care for the best of the clients.
42.
A public health nurse discovers that many of the children in the
neighborhood where she works are developing lead toxicity. She
implements a program to screen for lead exposures among clients in the
community. This is an example of:
a. Social justice
b. Policy resources
c. Autonomy
d. Moral justification
43.
Which of the following is an example of whistle blowing?
a. A nurse contacts administration about a colleague who takes supplies to
use for a mission trip
b. A client sues a nurse because she failed to call the physician about his
wound infection
c. A nursing assistant calls for help when a client falls out of bed
d. A client developed a sacral pressure ulcer when he was not turned in bed
for over four hours
44.
Which situation might require an occupational health nurse consult?
a. A nurse is injured from using incorrect body mechanics to lift a client
b. A nurse receives a subpoena to testify in court about a client's case
c. A client who has been injured in a diving accident needs assistance with
planning rehabilitation and surgery
d. A nursing unit is implementing a new electronic health record system
45.
Which of the following is the most appropriate example of anticipatory
guidance for a 16-year old who has been hospitalized for an ankle fracture?
a. Changes associated with puberty
b. Driving and staying safe
c. The health hazards of smoking
d. Social media influences
46.
Which action represents the evaluation stage of the plan of care?
a. The nurse assigns a nursing diagnosis of Impaired Skin Integrity related
to diminished skin circulation
b. The nurse assesses the client's vital signs and asks about symptoms
c. The nurse determines that the client is not meeting his set outcomes and
makes revisions
d. The nurse discusses the client's health history
47.
A nurse is assigned to care for a deaf client. During her lunch hour, she
visits the hospital library and reads more about deaf culture in order to
better provide appropriate care for her client. This action is an example of:
a. Cultural knowledge
b. Cultural noise
c. Cultural diversity
d. Cultural divide
48.
A nurse is providing discharge instructions for a client who had back
surgery. All of the following exhibit that the client is ready for discharge
EXCEPT:
a. The client still has sutures at the incision site
b. The client is able to take a shower
c. The client must still use an ice pack at the wound site
d. The client has a temperature of 100.8 F
49.
Which of the following is an example of intragroup conflict?
a. A nurse writes a grant for a non-profit organization to raise money for
advertising
b. Members of a multidisciplinary team cannot agree on the best course of
action for a client
c. A client does not receive his medication on time because the nurse was
on break
d. A nurse feels frustrated that her employer does not provide on-site child
care
50.
A nurse is providing dismissal instructions for a child who was admitted for
rotavirus. Which of the following statements by the parent indicates the
need for further teaching?
a. I'll start giving him his antibiotics as soon as we get home."
b. I will call the physician if he becomes dizzy or overly fussy."
c. He will need to wash his hands a lot to keep this from spreading."
d. I'll watch to see when he stops having diarrhea stools."
51.
A teacher brings a 5-year old child to the school nurse because of a bruise
under her eye. When asked about the bruise, the child responds, "my daddy
did it." What is the nurse's initial action in this situation?
a. Allow the child to return to class and monitor for future events that are
suggestive of abuse
b. Call the parent and request an explanation for the bruises
c. Call the police and ask for a warrant for the parent's arrest
d. Notify the school administrator
52.
What does an anti-kickback statute prevent?
a. It prevents healthcare workers from providing food or parties to celebrate
special occasions at work
b. It promotes thorough and complete documentation when a client
becomes injured
c. It forbids giving or accepting gifts to promote or provide referrals for
certain services
d. It prevents physicians from ordering treatments that may require nursing
care that is over and above the usual amount
53.
Which of the following is an example of restorative care?
a. A nurse teaches a new mother how to breastfeed her infant
b. A nurse helps a client with developing a bladder-retraining program
c. A nurse places an allergy wristband on a client's wrist to notify other
providers of potential reactions
d. A nurse contacts the family of a client to tell them he will be out of
surgery soon
54.
Which of the following clients have a barrier to accessing healthcare?
a. A 36-year old client who must use a wheelchair for mobility
b. A 44-year old client who is visiting the United States on a visa from
India
c. An 81-year old client who is unable to drive
d. All of the above
55.
A client in a long-term care facility tells the nurse "my daughter never visits
me." The nurse responds by telling the client that when her own mother was
in a long-term care facility, she found it difficult to visit. This is an example
of which communication technique?
a. Empathy
b. Self-disclosure
c. Disapproval
d. False reassurance
56.
Which of the following is an example of intrapersonal conflict?
a. Hospital bills are denied by an insurance company due to policies
b. A nurse is called to testify in court about a client she cared for three years
ago
c. A nurse feels guilty when she administers essential medication that
causes a client to have nausea and vomiting
d. The spouse of a nurse is upset that she is working overtime
57.
A nurse with five years of experience working in a hospital unit is promoted
as a mentor and preceptor to a new nursing staff. This is an example of:
a. Collegiality
b. Competence
c. Advocacy
d. Integration
58.
Which of the following is an example of libel?
a. A client overhears a nurse telling her assistant that he is "too high
maintenance"
b. A client reads disparaging remarks that a nurse has written about him in
his chart
c. A nurse fails to notify a physician when a client's hemoglobin level is 8.1
gm/dL
d. A nurse administers narcotic pain medication to a client in pain but does
not have an order
59.
All of the following are essential components of supervision EXCEPT:
a. All tasks to be delegated or supervised are within the nurse's scope of
practice
b. The necessary tasks require repeated assessments
c. The nurse has adequate time to develop staff assignments
d. Policies have been developed that govern nursing practice
60.
Which of the following is an example of a breach to a client's right to
privacy?
a. A nurse who is not caring for the client reads his personal information in
his chart
b. A client is not allowed to keep a copy of his original medical record
c. A nurse filed an incident report about a client that was reviewed with all
staff at a meeting
d. A client's photograph was used without permission for the hospital
newsletter
61.
Which of the following abides by the Americans with Disabilities Act of
1990?
a. A nurse is allowed to have a leave of absence to recover after a back
injury
b. A nurse manager cannot cancel an interview with a potential employee
because he has left-sided paralysis
c. A nurse is mandated to receive 12 weeks' off of work after having a baby
d. A nurse manager must hire a nurse who uses a walker for mobility
62.
Because of budget cuts in the hospital, the nursing manager informs the
staff that they must either float to other units more often or take their turns
staying home from work. Which principle is this nurse manager
demonstrating?
a. Justice
b. Paternalism
c. Veracity
d. Fraternity
63.
A new nursing unit is opening in the hospital. In order to meet the staffing
needs of the unit, nurses from other areas will be moved and required to
work in the new area. When notifying the nurses chosen to staff this area,
the nurse manager states "you will either move to work on this unit or you
will no longer be employed at this hospital." Which of the following
strategies is this nurse manager using?
a. Manipulation
b. Facilitation
c. Co-optation
d. Coercion
64.
A group of nurses who work on the quality assurance council of a unit have
gathered to discuss ideas about how to educate their coworkers about Joint
Commission requirements. Each of the nurses gives ideas, which are listed
together without initially criticizing any of the suggestions. Eventually, all
ideas on the list will be discussed as to their validity. This activity is known
as:
a. Optimizing
b. Satisficing
c. Brainstorming
d. Centralizing
65.
An assisted living facility is an example of which type of healthcare
provider?
a. Primary care
b. Secondary care
c. Tertiary care
d. None of the above
66.
Which of the following statements is true regarding non-profit
organizations?
a. They are located in poor or rural areas to provide care to the largest
number of people.
b. They are mandated to care for people, even if clients are unable to pay
for services
c. The money they receive for services is divided among stockholders that
have invested in the organization
d. They are also called proprietary organizations
67.
Which of the following is a function of risk management?
a. To consider the problems that arise if errors happen and their effect on
the healthcare environment
b. To identify how nursing care responds to specific client problems
c. To view clients as customers and decide what actions will provide a
satisfying healthcare experience
d. To analyze physician-nurse relationships and determine where
collaboration efforts can improve
68.
A nurse caring for a pediatric client shows little concern when the parents
attempt to speak with her about their daughter's illness. When approached
by the nurse manager about her behavior, the nurse responds by saying "I
don't want to get involved. It doesn't matter what I do anyway; my work
does not make much of a difference." This nurse is exhibiting which of the
following characteristics?
a. Objectivity
b. Depersonalization
c. Procrastination
d. Disruption
69.
Which of the following is an example of effective time management?
a. Always agreeing to others' requests for help
b. Arranging long meetings to discuss important data
c. Using multiple forms of technology to communicate or educate others
d. Working in a secluded area to minimize interruptions
70.
A nurse is asked by a physician to speak to a colleague about her
unprofessional behavior in front of a client. The nurse does not want to
create conflict with her colleague, so she does not confront her and stays
away from the physician when he comes in to work the next day. Which
type of conflict resolution is this nurse exhibiting?
a. Accommodation
b. Competition
c. Avoidance
d. Negotiation
71.
You are caring for a patient with newly diagnosed multiple sclerosis.
Discharge instructions will likely include all of the following EXCEPT:
a. PT referral for development of a planned exercise program.
b. Avoidance of prolonged sun exposure.
c. Hot baths to promote muscle relaxation.
d. Instructions to evaluate the home environment to ensure safety
72.
The BRAT diet is often prescribed for patients with gastroenteritis. This
acronym stands for:
a. Bananas, Rice, Applesauce, and Toast
b. Bread, Rice, Apricots, and Tapioca
c. Bananas, Rolls, Apricots, and Toast
d. Bananas, Rolls, Applesauce, and Tapioca
73.
OSHA has very strict standards for hospital employees who may encounter
hazardous materials or patients who have been exposed to them. These
regulations include all of the following EXCEPT:
a. Respiratory protection must be provided to all employees who might be
exposed.
b. Training on respiratory protection must be provided.
c. Employers must provide personal protective equipment to all employees.
d. All ED personnel must be trained in decontamination procedures.
74.
Which of the following screening tools have been found to have a high
diagnostic accuracy for screening for intimate partner violence?
a. Hurt, Insult, Threaten and Scream (HITS)
b. Humiliation, Afraid, Rape, and Kick (HARK)
c. Slapped, Threatened and Thrown (STaT)
d. All the above
75.
What is the relationship between HIPPA and technological advances?
a. Technology helps to foster HIPPA confidentiality.
b. Computers help us to share information with others.
c. Computer screens are not visible to others in the area.
d. Technology places us at risk for HIPPA violations.
76.
Which technological advance is MOST likely to place you at risk for
HIPPA violations?
a. Social media
b. Word processing programs
c. Spreadsheets
d. Clouds and SOEs
77.
A patient is having a colposcopy procedure performed. How should the
patient be instructed to prepare for the procedure?
a. NPO for 8-12 hours before the procedure.
b. D/C all HTN Rx for two days prior to the procedure.
c. Take three Dulcolax tablets and two containers of Miralax the day before
to clear out the lower GI system.
d. None of the above prep is necessary for this type of procedure.
78.
A physician is explaining a procedure to a patient that may cure her
recurring Staph infection. The doctor explains how the procedure is done,
what to expect, the odds of the procedure curing the infection, and possible
side effects and risks. The physician is:
a. Preparing the patient to give informed consent.
b. Protecting HIPAA by listing all of the steps of the procedure with the
risks involved.
c. Not required to inform the patient of any alternative therapies.
d. None of the above.
79.
After a lengthy explanation of a medical procedure, the patient asks many
questions. The physician answers all of the questions to the best of her
ability. The patient then gives consent for treatment. The costly equipment
and supplies are put into place and the patient is prepared. Two minutes
before the procedure is to start, the patient begins panicking and changes
her mind. Which of the following situations would be the best way to avoid
litigation?
a. Document that the patient originally gave consent and proceed if the
benefits of the procedure outweigh the patient's wishes.
b. Have the patient sign a form that she is refusing consent. If she refuses to
sign, proceed with the procedure.
c. Repeat the explanation of the procedure until the patient understands that
having the procedure done is the best form of treatment. Proceed with the
procedure.
d. Do not proceed. Document the patient's refusal, have the patient sign a
refusal to consent to treatment. If the patient refuses to sign the form, have a
witness available to sign.
80.
Who of the following wrote a medical code of ethics?
a. Hammurabi
b. Tomas Percival
c. Hippocrates
d. All of the above.
81.
In which of the following examples would informed consent be required?
a. A patient is apprehensive about an upcoming surgery and chooses not to
learn of the risks involved with the procedure.
b. A child is rushed to the Emergency Room after falling from a third story
window.
c. An adult in a coma in a mental health institution with no listed next of
kin.
d. None of the above require informed consent.
82.
A woman has died as a result of a motor vehicle accident. She is listed as an
organ donor and her family is considering whether to comply with her
wishes. Which of the following is true?
a. The woman would have had to list herself as an organ donor and notify
her family prior to her death that she has considered donating her organs.
b. The Uniform Anatomical Gift Act requires the physician caring for the
patient to inform the family who receives the donor organs.
c. Physicians can choose to go against the deceased's wishes if the family
decides that organ donation is not an acceptable choice.
d. Physicians have the legal responsibility to inform patients of the risks
involved in donating organs.
83.
Which of the following choices would best answer the question, "Who
owns a patient's medical record?"
a. The patient
b. The physician
c. The Legal Counsel of the Office
d. No one owns a medical record.
84.
Which of the following choices would best answer the question, "Who
owns a patient's x-rays?"?
a. The patient
b. The doctor
c. The facility that performed the procedure.
d. None of the above.
85.
Which of the following reasons would be legal when considering a patient's
medical record?
a. Allowing a patient's brother to view her chart to find out her birthdate and
address so that he can mail her a card
b. Not allowing a patient to view her own chart because the physician feels
this information would be detrimental to her wellbeing.
c. Not allowing a patient to view her chart because she is behind on her
payments.
d. All of the above are legal.
86.
Choose the BEST answer. To ensure adequate protection for legal issues,
offices should maintain patients' charts for:
a. 10 years
b. Forever
c. until the age of majority
d. 2 years after the patient was last seen in the office
87.
The purpose of performing quality control is to:
a. create a paper trail to show that the laboratory is compliant with OSHA
standards for quality control.
b. improve the odds that the results that are reported for any given test are
as accurate and reliable as possible.
c. Are required by law to be part of a quality assurance program.
d. All of the above.
88.
Richard is a 72-year-old with stage 4 lung cancer who has been admitted to
the hospital for pneumonia. He is alert and oriented, and states he would
like to sign a do not resuscitate (DNR) order. His wife enters the room after
he has signed it and is very upset that he has made this decision without
discussing it with her. She wants to know what she can do to get the DNR
reversed. What should your first response be?
a. Contact the unit manager to talk with her
b. Contact the hospital's attorney to discuss with her
c. Try to talk Richard out of his decision
d. Offer caring support for both parties
89.
You are on the unit and overhear another nurse talking on the phone to a
patient's friend who wants to see her patient who is comatose and on a
ventilator. Since you cared for that patient yesterday, you know that the
patient's significant other, who is also the designated health care surrogate
(HCS) and has power of attorney (POA), has expressly stated that he wants
this person on the list for restricted visitors. The nurse whispers that she'll
call him to visit as soon as the significant other has gone home. What
should your first response be?
a. Inform the significant other
b. Report the nurse to the nurse manager
c. Speak with the nurse directly in private
d. Call the visitor and tell him he can't visit
90.
Teresa is an 84-year-old with stage 4 ovarian cancer who has been admitted
for a bowel obstruction. She recently stated that she has decided that she
doesn't want any further aggressive care and is requesting to be placed
under hospice care. Her husband and daughter are supportive of her
decision. She spoke with her oncologist about it, and he stated that he did
not agree, and wrote orders on her chart for chemotherapy. What would be
the best first response to this situation?
a. Give the patient a list of other oncologists
b. Tell the family to report the doctor to the state quality board
c. Notify the doctor that the patient refuses the chemotherapy
d. Give the patient hospice information
91.
Upon entering an elderly patient's room, you find a research assistant with a
clipboard, obtaining consent to participate in a new study. After signing the
form, the patient begins to ask questions about the study. The assistant
smiles and says, "Don't worry about all that, we'll take good care of you.
Now enjoy the chocolate I brought." What should your first response be?
a. Ignore the patient's questions
b. Stop the assistant and question the consent
c. Notify the nurse manager
d. Notify the research department
92.
Monica is a 28-year-old nurse who had been admitted to the hospital after a
near-drowning in which she suffered cardiac arrest and hypoxic
encephalopathy. She has been stabilized and has a tracheostomy to room air.
She has been on the general floor for several weeks, is in a persistent
vegetative state, and has a very poor prognosis for any improvement in her
neurological status. Monica had previously signed a living will, which
indicated that she did not wish to receive enteral feedings to be kept alive if
she had a terminal condition or was in a persistent vegetative state from
other causes. Her parents have decided to move her to the hospice unit and
have given permission for removal of her feeding tube. The patient care
technician who has been caring for Monica is very distressed over this
decision and feels that the parents are "killing" her. What would be an
appropriate initial response?
a. This will relieve the burden for her parents."
b. Her parents have a right to make decisions for their child."
c. Monica has stated her wishes and they should be honored."
d. The ethics committee should be consulted."
93.
Jack is a 2-month-old with a diagnosis of spinal muscular atrophy (SMA)
type I. He has been admitted to the hospital for progressive respiratory
difficulty. His parents have been informed that if he is not placed on
ventilatory support, he will continue to decompensate and die of respiratory
failure. Jack's physician discusses the poor prognosis of Jack's condition,
and tells the parents that he will not be able to be removed from ventilatory
support once it is initiated, due to his progressive neurological disease.
After much discussion, the parents have decided to decline ventilatory
support, agree to a do not resuscitate (DNR) order, and request hospice care
for Jack. Another parent heard them discussing Jack's situation in the
waiting room and says she could never do that to her baby. What is the most
appropriate response to this parent?
a. You never know what you'll do until you're in that situation."
b. I can't discuss another patient's situation."
c. They have been through too much already."
d. You can contact administration with your concerns."
94.
Albert is a patient in the hospital who is scheduled for surgery the following
morning. After the pre-operative visit from the anesthesia staff member
who has obtained surgical consent, Albert asks for an explanation of what
type of surgery he is going to have. He states that he's not sure what he just
signed. What is your best response?
a. Don't worry, they'll explain it in the operating room."
b. It's standard procedure to get the consent, you don't need to worry."
c. Let me ask the nurse anesthetist to come back and explain it further."
d. Someone will review it with you prior to surgery."
95.
If a nurse prevents intentional harm from occurring to a patient, which
ethical principle is she supporting?
a. Beneficence
b. Nonmaleficence
c. Justice
d. Fidelity
96.
What ethical principle has led to the need for informed consent?
a. Autonomy
b. Justice
c. Fidelity
d. Beneficence
97.
Victor is a 43-year-old patient who is HIV positive with a diagnosis of
pneumocystis carinii pneumonia (PCP) who has been admitted to the
hospital. His prognosis is very poor, and his partner, Roger, would like to
have a ceremony performed in his room to honor their union in case
something happens to Victor, who is in agreement. What is the most
appropriate response to their request?
a. Inform him that Victor is too ill for a ceremony
b. Ask the social worker to intervene
c. Tell him it's against unit policy
d. Coordinate with other disciplines to support their request
98.
A victim of a gunshot wound to the abdomen has been admitted to the
hospital, accompanied by a police officer. When questioned, the officer
states that the patient is a suspect in a homicide, which occurred as part of
the same incident. A small child was killed as the result of a stray bullet.
The patient is combative, yells that he's in pain and demands medication.
What is your most appropriate response?
a. Tell him you'll take care of him after your other patients
b. Reinforce restraints
c. Perform a pain assessment and administer pain medication
d. Ask the officer for more details of the incident
99.
You have accompanied the physician into the family waiting room to tell a
young husband that his wife has not survived the car accident she was in.
The husband is crying and distraught. What is the most appropriate
approach to supporting this family member?
a. Ask if he would like to donate his wife's organs
b. Sit quietly with him
c. Ask about funeral arrangements
d. Consult social services
100.
Rachel is a 48-year-old mother of three who has been admitted after a drug
overdose in a failed suicide attempt. When she regains consciousness, she
states that she is ashamed and embarrassed that she tried to take her own
life. What is the most therapeutic response to Rachel's statement?
a. It's a blessing your children weren't left without a mother."
b. What were you thinking?"
c. We're here to help patients who value life."
d. I know life can be difficult. We're here to help you."
101.
Family members of an patient ask repeated questions about the monitors
and various readings in the patient's room. What is the most supportive
response to their questions?
a. Inform them that you can't take to the time to answer all their questions
b. Provide detailed explanations for each device
c. Tell them it's too technical to explain
d. Provide an overview and encourage them to spend their time with the
patient
102.
The mother of a 3-year-old pediatric patient would like to remain at the
patient's bedside throughout the night. The patient seems to be calmer when
she is present. What is the most caring and appropriate response?
a. Reinforce visiting hours
b. Allow her to stay for a short period beyond normal hours
c. Allow her to stay throughout the night
d. Offer to get bedding for a couch in the waiting room
103.
You are caring for a Hispanic patient who is scheduled for surgery in the
morning. A member of the surgery staff is in a hurry when she visits the
patient to obtain surgical consent. You know that the patient speaks limited
English, and can see that he does not really understand what's being said.
What is the most appropriate next action?
a. Call a family member to interpret
b. Consult the hospital translator to assist
c. Allow the consent to be signed
d. Ask the staff member to come back later
104.
Becky is a 17-year-old type I diabetic who has been admitted for her third
episode of diabetic ketoacidosis (DKA) since being diagnosed last year. She
states that she hates feeling different than her friends and refuses to take her
insulin as recommended. What would be the most helpful action for Becky?
a. Scold her for not taking her insulin
b. Recommend that she use an insulin pump
c. Contact the local support group for diabetic teens
d. Tell her parents they must provide more strict oversight
105.
Ruth is a 72-year-old patient who has been upset and crying all morning.
When asked why she is upset, she turns toward the wall in silence. What
collaborative process may be helpful in caring for this patient?
a. Speak with the patient care technician
b. Call the chaplain
c. Call the social worker
d. Call the patient's husband
106.
Brandon is a 38-year-old with a history of cocaine addiction who has just
been admitted for his second myocardial infarction that was due to cocaine
use. What collaborative process should begin as soon as Brandon is stable
enough to interact with additional resources?
a. Law enforcement for further prevention
b. Social services for rehab
c. Narcotics anonymous
d. Financial counselor to apply for assistance
107.
The previous charge nurse fell during her shift and was taken to the
emergency room. You have been assigned to take over as charge nurse
without any report. At the end of the shift, you have made the assignments
for the next shift's nurses and posted them. As the nurses come in, they
begin to complain that the assignments make no sense, based on patient
acuity. One refuses to take her assignment and threatens to go home. What
could you have done to prevent their dissatisfaction?
a. Reviewed the notes of the previous charge nurse
b. Tried to contact the previous charge nurse in the emergency room
c. Collaborated with the nurse manager
d. Collaborated with the other nurses on your shift
108.
What consideration is important when caring for a female Muslim patient?
a. Make eye contact
b. Provide long-sleeved gowns or allow her to use her own
c. Touch while talking
d. Assign male caregivers when possible
109.
Of the following, what is an important component of Vietnamese culture to
consider when teaching the Vietnamese patient who has been treated for
pneumonia, who needs to complete her antibiotic regimen at home?
a. Cupping will help to pull toxins from the body
b. Coining will help to release the wind or bad energy from the body
c. Once symptoms disappear there is no longer an illness
d. Most households consist of a least 3 generations
110.
If you are caring for a patient of the Hindu culture, what may you anticipate
regarding visitors?
a. Limited visitors, respectful of privacy
b. Family members only
c. Large number of visitors/community support
d. None of the above
111.
You have noticed that the last several patients you have cared for have had
questionable blood pressure readings from their arterial lines. When
checked against cuff pressures, a discrepancy has been noted, and further
investigation has revealed faulty transducers. This is not the first product
issue with this company. What positive step could you take to help resolve
this situation?
a. Use the old stock from a previous company
b. Verify the cuff pressures every hour to ensure accuracy
c. Notify the risk manager
d. Form a peer workgroup to evaluate new products
112.
The family of a patient who is receiving therapeutic hypothermia states they
do not understand why the patient is being kept so cold. What objective
information can you provide to help address their concerns?
a. Let them talk to another patient who has had the same therapy
b. Provide research-based information about therapeutic hypothermia
c. Connect them with the nurse manager
d. Call the physician and ask him to talk to the family
113.
A family member is complaining that the lights are too dim in the middle of
the night when she comes in to visit her husband. What is the most
objective response?
a. Patients sleep better with the lights dimmed."
b. The nightshift nurses prefer to work with less light."
c. It's time for him to sleep, and you should, too."
d. There's a reason we do that. Let me share a research study with you."
114.
You are attempting to teach the wife of a Greek patient how to administer
his gastrostomy tube feedings once he returns home. She smiles and nods
through your explanations, but when you ask her for a return demonstration,
she looks confused and shakes her head. Her daughter enters the room and
states that she does not speak English. What would be most helpful in this
situation?
a. Teach the daughter instead
b. Teach both and ask the daughter to translate for you
c. Contact a home health agency to provide care
d. Provide a pamphlet with detailed instructions
115.
What is a key principle of patient teaching that must take place to ensure
patient safety?
a. Family members should be present
b. Teaching must be documented
c. Understanding must be confirmed
d. Teaching should be provided by multiple staff members
PREVENTING RISKS AND COMPLICATIONS (TEST
MODE)
1.
Which of the following nursing interventions is appropriate for a client who
is suffering from a fever?
a. Avoid giving the client food
b. Increase the client's fluid volume
c. Provide oxygen
d. All answers are correct
2.
A client has started sweating profusely due to intense heat. His overall fluid
volume is low and he has developed electrolyte imbalance. This client is
most likely suffering from:
a. Malignant hyperthermia
b. Heat exhaustion
c. Heat stroke
d. Heat cramps
3.
A nurse is attempting to assess a client's pulse in his foot. She palpates the
pulse on the anterior aspect of his ankle, below the lower end of the medial
malleolus. Which type of pulse is this nurse taking?
a. Dorsalis pedis
b. Popliteal
c. Posterior tibial
d. Femoral
4.
Which of the following conditions may cause an increased respiratory rate?
a. Stooped posture
b. Narcotic analgesics
c. Injury to the brain stem
d. Anemia
5.
Mr. N is a client who entered the hospital with a diagnosis of diabetic
ketoacidosis. The nurse enters his room to check his vital signs and finds
him breathing at a rate of 32 times per minute; his respirations are deep and
regular. Which type of respiratory pattern is Mr. N most likely exhibiting?
a. Kussmaul respirations
b. Cheyne-Stokes respirations
c. Biot's respirations
d. Cluster breathing
6.
A nurse is attempting to check a blood pressure on a client when she
realizes that the cuff is too wide for the size of his arm. What type of
reading might this blood pressure cuff produce?
a. A normal result
b. An abnormally low reading
c. An abnormally high reading
d. A low reading, followed by a normal reading
7.
Which of the following is a true statement about assessing blood pressure
by palpation?
a. Only the diastolic blood pressure can be assessed through palpation.
b. The palpation technique is most useful for infants and small children.
c. Hypertension is a common condition that might need to be assessed
through blood pressure palpation.
d. Only the systolic blood pressure can be assessed through palpation.
8.
A nurse is caring for a client who has just come from surgery and is in the
recovery room. The client still has an endotracheal tube in place. The nurse
deflates the cuff on the tube and pulls it out, at which time the client sits up
in bed, grasps his throat, and begins to make wheezing sounds. Which of
the following conditions is the most likely cause of this situation?
a. The client is choking on part of the tube
b. The client has anxiety
c. The client is having a laryngospasm
d. The client is having a normal response from anesthesia
9.
A client with adrenal insufficiency has a potassium level of 7.2 mEq/L.
Which of the following signs or symptoms might the client exhibit with this
result?
a. Peaked T waves on the ECG
b. Muscle spasms
c. Constipation
d. A prominent U wave on the ECG
10.
A nurse is assisting Mrs. K, a client who is undergoing a lumbar puncture.
Which of the following elements should the nurse use to instruct Mrs. K
about this procedure?
a. A lumbar puncture takes a sample of blood from the back, which will be
analyzed by the lab
b. The physician will insert a needle at the level of L4-L5 in the spinal cord
c. Mrs. K should lie flat on her back for 24 hours following the procedure
d. The risks of the procedure include nausea, rash, and hypotension
11.
A nurse is caring for a client who has a right-sided chest tube. The chest
tube shows 50 cc of serosanguinous fluid in the collection chamber and air
bubbles are collecting in the water seal chamber. Which action is most
appropriate of the nurse at this time?
a. Do nothing; this is a normal response
b. Strip the tubing to remove any clots
c. Place a clamp on the tube near the client's chest
d. Remove the collection chamber and connect the tubing to a new device
12.
A nurse is caring for a client with a broken femur who is in a traction splint
in bed. All of the following interventions are part of care of this client
EXCEPT:
a. Palpating the temperature of both feet
b. Evaluating pulses bilaterally
c. Turning the client to a side-lying position
d. Relieving heel pressure by placing a pillow under the foot
13.
A nurse is assessing a client with right-sided heart failure. Which of the
following symptoms would the nurse most likely see in this client?
a. Weight loss and vomiting
b. Coughing and 3+ pitting edema
c. Muscle cramps and hyperreflexia
d. Lethargy and paroxysmal nocturnal dyspnea
14.
A nurse is caring for a client who is post-op day #1 after a total hip
replacement. Although the client was alert with a normal affect in the
morning, by lunchtime, the nurse notes the client is confused, has slurred
speech and is having trouble with her balance. Her blood glucose level is 48
mg/dl. What is the next action of the nurse?
a. Contact the physician immediately
b. Administer a bolus of 50 cc of D20W through the IV
c. Administer 10 units of regular insulin
d. Give the client 6 oz. of orange juice
15.
A nurse is educating a client about her cholesterol. Which of the following
statements from the client indicates the need for further teaching?
a. I would like my HDL levels to be over 50."
b. It is better for me to have high HDL levels and low LDL levels."
c. It is better for me to have high LDL levels and low HDL levels."
d. My goal is to get my total cholesterol down below 200."
16.
A nurse is preparing to draw a blood specimen from an adult client's central
line. All of the following actions for this procedure are correct EXCEPT:
a. Disconnect the current infusion
b. Clean the cap with alcohol and attach a 5 cc syringe
c. Draw 5 cc of a blood sample to discard
d. Flush with saline after the sample
17.
Which of the following situations might warrant a laboratory magnesium
level?
a. Hyperthyroidism
b. Arthritis
c. Ulcerative colitis
d. Depression
18.
Mr. G has been admitted to the hospital with a head injury after a 12-foot
fall. Which of the following nursing interventions is most appropriate when
monitoring intracranial pressure?
a. Administer hypotonic solutions
b. Keep the head of the bed flat
c. Increase the client's core body temperature to 99.9 degrees
d. Administer corticosteroids as ordered
19.
A nurse is assessing a client's pulse oximetry on the surgical unit. As part of
routine interventions, the nurse turns off the exam light over the client's
bed. Which of the following best describes the rationale for this
intervention?
a. External light sources may cause falsely high oximetry values
b. A bright light in the client's face may cause a low pulse oximetry
c. External light sources may cause falsely low oximetry values
d. The client needs a dark and quiet room to recover and maintain proper
oxygenation
20.
A nurse is educating a client who is preparing to give a stool sample for
occult blood. All of the following information is part of teaching for this
client EXCEPT:
a. Avoid eating red meat for 3 days before the test
b. Collect the stool from the toilet after having a bowel movement
c. The stool does not need to be kept in a container with preservative
d. A small part of the stool from two areas will be tested using a smear
21.
A nurse is caring for a 3-day old infant who needs an exchange transfusion.
Which of the following statements is appropriate for teaching the child's
parents about this procedure?
a. The registered nurse will be performing the procedure.
b. The procedure takes approximately 1 ½ hours.
c. The nurse will draw out 250cc of blood and then immediately replace it
with 250cc.
d. The infant will continue to receive phototherapy during the procedure.
22.
Which of the following interventions is necessary before insertion of an
arterial line into the radial artery?
a. Ensure that the client does not need surgery
b. Assess the client's grip strength
c. Perform an Allen test
d. Check a serum potassium level
23.
A client with asthma is being admitted for breathing difficulties. His arterial
blood gas results are pH 7.26, PCO2 49, PaO2 90, and HCO3- 21. Which of
the following best describes this condition?
a. Uncompensated respiratory acidosis
b. Compensated respiratory alkalosis
c. Uncompensated metabolic acidosis
d. Compensated metabolic alkalosis
24.
Mrs. M has had diabetes for seven years. She has worked hard to control
her blood glucose levels and watch her dietary intake. Her physician orders
a hemoglobin A1C test. Which of the following best describes the action of
this test?
a. The test determines if the client is anemic and needs iron supplements
b. The test determines if there is excess glucose building up in the urine
c. The test determines the amount of hemoglobin reaching the liver to
support gluconeogenesis
d. The test determines the amount of hemoglobin that is coated with glucose
25.
Mrs. O is seen for follow-up after an episode of acute pancreatitis. Her
physician orders a serum amylase level and the result is 200 U/L. Which of
the following is a potential cause of this result?
a. The client is pregnant
b. The client has hypertension
c. The client is in renal failure
d. The client has pancreatitis
26.
Which of the following conditions increases a client's risk of aspiration of
stomach contents?
a. A client has a scaphoid abdomen
b. A client is in restraints
c. A client is lying prone
d. More than one answer is correct
27.
A nurse is monitoring a client for decreased tissue perfusion and increased
risk of skin breakdown. Which measure best improves tissue perfusion in
this client?
a. Massaging the reddened areas
b. Performing range of motion exercises
c. Administering antithrombolytics as ordered
d. Feeding the client a high-carbohydrate diet
28.
Which of the following situations warrants a measurement for orthostatic
hypotension?
a. A 36-year old male with a spinal injury
b. An 86-year old female with significantly altered mental status
c. A 58-year old female with near-syncope
d. A 41-year old male with acute deep vein thrombosis
29.
A nurse is assisting a pregnant client who is having an amniocentesis.
Which of the following statements by the nurse indicates the correct
teaching for this procedure?
a. I'm going to help you lie flat on your back for this."
b. Don't worry, I'm sure everything will be all right."
c. I will need to help you remove your shirt for this procedure."
d. Now that the procedure is finished, I will put a small bandage over the
puncture site."
30.
A nurse is caring for a client in who is in labor. The nurse has attached an
electronic fetal monitor to the client's abdomen and is assessing the baby's
heart rate. She notes that the baby's heart rate seems to slow down during
each contraction. The heart rate does not return to normal limits until after
the contraction is complete. Which type of fetal heart rate change does this
pattern describe?
a. Variable decelerations
b. Late decelerations
c. Early decelerations
d. Accelerations
31.
Which of the following reasons indicates a need for a non-stress test in a
pregnant client?
a. The client is overdue
b. The baby has not been moving
c. The mother is carrying twins
d. All answers are correct
32.
A nurse is caring for a client who has a sodium level of 126 mEq/L. Which
of the following symptoms should the nurse expect to see with this client?
a. Nystagmus
b. Orthostatic hypotension
c. Hallucinations
d. Dry skin
33.
A 58-year old client is being tested for rheumatoid arthritis. Her physician
orders an erythrocyte sedimentation rate (ESR). Which of the following
results is most likely to be associated with arthritis?
a. 5 mm/hr
b. 12 mm/hr
c. 28 mm/hr
d. 40 mm/hr
34.
A nurse is caring for an 83-year old man who has had swallowing
difficulties. All of the following interventions are appropriate for this client
EXCEPT:
a. Keep the client in an upright position at all times
b. Auscultate lung sounds every shift and after feedings
c. Maintain suction equipment at the client's bedside
d. Instruct the client about how to perform swallowing exercises
35.
Which of the following statements best describes compartment syndrome?
a. An injury causes pain and tingling that starts in the buttock and travels
down the leg
b. An injury causes swelling within muscle tissue that leads to anoxia of
nerves and muscles
c. An injury causes permanent flexion of the interphalangeal joint, resulting
in deformity
d. An injury causes pain and swelling of the median plantar nerve
36.
A nurse is preparing to insert an indwelling catheter in a female client.
Which of the following positions of the client is most appropriate for this
procedure?
a. Lithotomy position
b. Prone position
c. Dorsal recumbent position
d. High Fowler's position
37.
Mrs. G is seen for follow-up after testing for chronically high blood glucose
levels. Her physician diagnoses her with type 1 diabetes. Which of the
following information is part of this client's education about this condition?
a. Type 1 diabetes occurs from increased carbohydrate intake and decreased
exercise
b. Type 1 diabetes is treated through diet and exercise
c. Type 1 diabetes occurs from destruction of beta cells in the pancreas
d. Type 1 diabetes results in the cells rejecting the body's insulin
38.
A client is preparing to undergo a cystoscopy for stones. Which of the
following statements indicates that the client understands the procedure?
a. I better drink a lot of fluid now because I won't be able to after the test."
b. I will probably see a little blood when I urinate."
c. I will be able to go home after 3 days in the hospital."
d. I won't need any pain medicine; this probably will not hurt."
39.
Which of the following conditions may warrant a serum creatinine level?
a. Rhabdomyolysis
b. Digitalis toxicity
c. Glomerulonephritis
d. All answers are correct
40.
Which nursing intervention is most appropriate to maintain the patency of a
client's nasogastric tube?
a. Maintain constant connection to low-intermittent suction
b. Irrigate the tube as per physician order
c. Suction the mouth and nose every shift
d. Perform a daily fecal occult blood sample
41.
A nurse is caring for a client who is having blood tests and who has an
elevated lymphocyte level. Based on knowledge of cellular components, the
nurse knows that these cells:
a. Contain histamine and provide protection during allergic reactions
b. Are involved in phagocytosis
c. Provide protection and immunity against foreign substances
d. Carry hemoglobin and oxygen to body tissues
42.
Mrs. F has been diagnosed with hyperparathyroidism. Which of the
following complications is Mrs. F at highest risk of developing?
a. Hyponatremia
b. Hypocalcemia
c. Hypermagnesemia
d. Hypercalcemia
43.
Mr. Y had surgery two days ago and is recovering on the surgical unit of the
hospital. Just before lunch, he develops chest pain and difficulties with
breathing. His respiratory rate is 32/minute, his temperature is 100.8, and he
has rales on auscultation. Which of the following nursing interventions is
most appropriate in this situation?
a. Place the client in the Trendelenburg position
b. Contact the physician for an order or antibiotics
c. Administer oxygen therapy
d. Decrease his IV rate
44.
A client has entered disseminated intravascular coagulation (DIC) after
becoming extremely ill after surgery. Which of the following laboratory
findings would the nurse expect to see with this client?
a. Elevated fibrinogen level
b. Prolonged PT
c. Elevated platelet count
d. Depressed d-dimer level
45.
A client returns from surgery after having a colon resection. The nurse is
performing his assessment and notes the wound edges have separated. This
condition is called:
a. Evisceration
b. Hematoma
c. Dehiscence
d. Granulation
46.
The OR nursing staff are preparing a client for a surgical procedure. The
anesthesiologist has given the client medications and the client has entered
the induction stage of anesthesia. The nursing staff can expect which of the
following symptoms and activities from the client during this time?
a. Irregular breathing patterns
b. Minimal heartbeat, dilated pupils
c. Relaxed muscles, regular breathing, constricted pupils
d. Euphoria, drowsiness, dizziness
47.
A physician has administered ketamine to a client who is preparing to
undergo general anesthesia. Which of the following side effects should the
nurse monitor for in this client?
a. Delirium
b. Muscle rigidity
c. Hypotension
d. Pinpoint rash
48.
A nurse is caring for a client who must use a non-rebreathing oxygen mask.
Which of the following statements is true regarding this type of mask?
a. A non-rebreather can provide an FiO2 of 40%.
b. A client should breathe through his mouth when using a non-rebreather.
c. A non-rebreather offers a reservoir from which the client inhales.
d. The mask of a non-rebreather should be changed every 3 hours.
49.
A client is admitted to a nursing unit with a remittent fever. Which
statement best describes this pattern of fever?
a. A persistent fever that has lasted over 24 hours
b. A fever that lasts 2 days followed by normal temperature for 2 days,
followed by fever again
c. A fever that lasts 2 days followed by normal temperature for 12 hours,
followed by fever again
d. A fever that spikes and then lowers without returning to normal
50.
Which of the following components is associated with hypertonic
dehydration?
a. Plasma sodium levels between 130 and 150 mEq/L
b. Fluid moves from extracellular space to intracellular space
c. Water loss is greater than electrolyte loss
d. Physical signs and symptoms are grossly apparent
51.
Hepatitis C virus (HCV) can be spread through hugging, sneezing,
coughing, sharing eating utensils and other forms of casual contact.
a. True
b. False
52.
The primary route of transmission of MRSA is via:
a. Shared needles
b. Hands of healthcare workers
c. Items in the healthcare environment
d. Blood transfusions
53.
The key to the prevention of a pandemic influenza is:
a. Early detection.
b. Early antibiotic treatment.
c. Vaccination of at risk populations.
d. Isolation of suspected cases.
54.
Your patient has been diagnosed with herpes simplex virus 2. Which of the
following would NOT be included in your teaching of this patient?
a. If you have symptoms, you should avoid sexual contact with other
individuals.
b. With treatment, this condition can be cured.
c. This disease is highly contagious.
d. You may experience tingling in the skin before an active outbreak occurs.
55.
Sinusitis is caused by a:
a. Bacteria
b. Fungus
c. Virus
d. Any of the above
56.
Your patient has been diagnosed with a left ankle sprain. On the discharge
instructions, the physician has prescribed the RICE protocol. This acronym
stands for:
a. Rest, Ice, Compression, Elevation
b. Radiology, Ice, Compression, Elevation
c. Rest, Ice, Cast, Elevation
d. Radiology, Ice, Cast, Elevation
57.
Which risk factor places patients and residents at the greatest risk for falls?
a. Old age
b. Middle years
c. Pneumonia
d. COPD
58.
You are taking care of Mary Eden. She is an elderly and frail 91 year old
resident. She gets confused during evening hours and at times she thinks
that she hears her daughter calling her from the other side of the nursing
home. Which physical problem places Mary Eden at risk for falls?
a. Her confusion
b. Her daughter
c. Evening hours
d. Her frailness
59.
What kind of preventive measures is MOST likely to be used to prevent
Mary Eden from falling because of her muscular frailness?
a. Physical therapy for muscle strengthening exercises
b. Physical therapy for range of motion exercises
c. Occupational therapy to help her with confusion
d. Medications in order to have her sleep more
60.
Tommy R., your 68 year old patient, is at risk for falls. He has fallen 3 times
in the last month. You should keep Tommy's ______________ in order to
prevent him from falling again.
a. bed side rails up at all times
b. bed in the low position
c. call bell within reach
d. family members in the room at all time
61.
You will be escorting a patient to the operating room on a stretcher. In order
to prevent this patient from falling, you must do which of the following?
a. make sure the locks are not locked as you move the patient onto the
stretcher from the bed
b. use a safety belt or strap on the patient throughout their escort to the
operating room
c. put the bed in low position as you move the patient onto the stretcher
from the bed
d. All answers are correct
62.
Albert B. is incontinent of urine. He also wears glasses and hearing aids.
His ____________ lead(s) to his risk for falls.
a. incontinence and loss of vision
b. loss of vision
c. incontinence
d. loss of hearing
63.
All hospitals and nursing homes are mandated to have the goal of a restraint
free
environment.
The
best
way
to
achieve
this
goal
is
to________________.
a. ban the use of all restraints under all circumstances.
b. limit restraints to only those situations when falls cannot be prevented.
c. keep all bed side rails up for all patients during the nighttime hours.
d. use no skid socks and sheets to prevent falls from chairs.
64.
Which of these devices is considered a protective device, rather than a
restraint?
a. A mitten on the hands to prevent scratching
b. A mitten on the hands so the person cannot pull their IV out
c. A side rail to prevent the patient from falling
d. A soft wrist restraint to prevent the patient from pulling their IV tubing
65.
Mr. Freeman has difficulty getting out of bed. The nurse should encourage
Mr. Freeman to ______________.
a. ask for assistance before getting out of the bed.
b. remain in bed because it is safer and he will not fall.
c. instruct him to stand up quickly from the bed.
d. lean forward and push up and off the bed.
66.
Restraints are sometimes used for what patient conditions or situations?
a. Punishment when the patient is uncontrollable
b. To prevent the patient from pulling their IV out
c. When a patient is a danger to self and others
d. Both b and c
67.
The chain of infection includes the ________________.
a. germ, agent, reservoir, exit portal, mode of transmission, entry port, and
susceptible host
b. active natural, active artificial, passive natural and passive artificial
c. opportunism, weakness, immunity, and colonization
d. intrinsic, extrinsic, internal and external transmission
68.
Asepsis is defined as ________________.
a. the absence of all microorganisms
b. the absence of disease causing germs
c. a urinary infection
d. a pathogenic infection
69.
Mary T. was admitted to a nursing home on May 1st. On July 4th, she was
diagnosed with a skin infection. This infection is considered a
________________ infection.
a. nosocomial
b. systemic
c. resident flora
d. resident aura
70.
A local sign of infection is which of the following?
a. Swelling.
b. Rapid pulse.
c. Fever.
d. High white blood count.
71.
A systemic sign of infection is ______________.
a. swelling
b. redness
c. heat
d. a lack of appetite
72.
Mobility is an important human function. The hazards of immobility lead to
many physical problems and emotional problems. Immobility can lead to
detrimental cardiac, muscular, respiratory, skeletal, urinary, gastrointestinal,
skin and emotional changes. Which of the following is an example of a
skeletal hazard of immobility?
a. Contractures.
b. Constipation.
c. Calcium loss.
d. Catabolism.
73.
Which is a physical, integumentary risk among the elderly population?
a. Skin tears
b. Thickened skin
c. Thinning toe nails
d. Less nasal hair
74.
Elderly patients are more prone to dehydration than younger people because
the elderly ___________.
a. drink more coffee and tea
b. have more stomach mucus production
c. have more saliva
d. have less sense of thirst
75.
You are turning your patient in bed and you see that this confused and
lethargic patient had loose car keys and lipstick in the bed and had been
lying on them. What is this person at risk for because of all three of these
factors: the confusion, lethargy and items in the bed?
a. Falls
b. Skin breakdown
c. Apnea
d. Lack of mobility
76.
Select the age group that is coupled with an infectious disease that is most
common in this age group.
a. Infants: High billirubin
b. Pre-School and School Age Children: Shingles
c. Young Adults and Teenagers: Sexually transmitted diseases
d. The Elderly: Malaria
77.
A complication of osteoporosis is _______________.
a. rheumatoid arthritis
b. gouty arthritis
c. dorsal flexion
d. joint deformity
78.
One of the complications of complete bed rest and immobility is which of
the following?
a. Plantar flexion.
b. Dorsal flexion
c. Extension contractures
d. Adduction contractures
79.
Plantar flexion can be prevented with ________________.
a. foot soaks
b. foot boards
c. toe nail care
d. proper shoes
80.
Alzheimer's disease patients wander. The dangers associated with this
wandering can be prevented with which of the following?
a. Bed alarms
b. Chair alarms
c. Door alarms
d. All answers are correct
81.
The smallest of the white blood cells which also can be involved in humoral
immunity is the:
a. Lymphocyte
b. Monocyte
c. Basophil
d. Erythrocyte
CARING FOR ACUTE OR CHRONIC CONDITIONS (TEST
MODE)
1.
Mrs. J is in the adult ICU on a ventilator. The nurse caring for her
recognizes that her endotracheal tube needs suctioning. Based on the nurse's
understanding of this procedure, what level of pressure should the nurse
apply while suctioning?
a. 70-80 mmHg
b. 100-120 mmHg
c. 150-170 mmHg
d. 200 mmHg
2.
The nurse caring for Mrs. J is prepared to suction her endotracheal tube.
Which of the following interventions will reduce hypoxia during this
procedure?
a. Hyperoxygenate Mrs. J for up to 60 seconds prior to starting
b. Administer 15 cc of sterile fluid into the tube prior to suctioning
c. Suction for no longer than 30 seconds at a time
d. Wait 30 seconds after suctioning before attempting again
3.
Which of the following conditions is a contraindication for performing a
diagnostic peritoneal lavage?
a. A client who is 9 weeks' pregnant
b. A client with a femur fracture
c. A morbidly obese client
d. A client with hypertension
4.
A nurse finds one of her clients unresponsive in his room. He is not
breathing and does not have a pulse. After calling for help, what is the next
action of the nurse?
a. Administer 2 ventilations
b. Perform a head-tilt, chin lift to open the airway
c. Begin chest compressions
d. Perform a jaw thrust to open the airway
5.
A nurse is caring for a client with severe mitral regurgitation and decreased
cardiac output. The nurse assesses the client for mental status changes.
What is the rationale for this intervention?
a. Decreased cardiac output can cause hypoxia to the brain
b. Mental status changes may be a side effect of the client's medication
c. Mitral regurgitation is a complication associated with some neurological
disorders
d. The client may be confused about his diagnosis
6.
A client is undergoing radiation therapy for treatment of thyroid cancer.
Following the radiation, the client develops xerostomia. Which of the
following best describes this condition?
a. Cracks in the corners of the mouth
b. Peeling skin from the tongue and gums
c. Increased dental caries
d. Dry mouth
7.
A nurse is providing information for a woman who is 36 weeks' pregnant
and who has hepatitis B. Which of the following statements from the client
indicates understanding of this condition?
a. Now I know I will need a cesarean section."
b. My baby will need two shots soon after his birth."
c. I will not be able to breastfeed."
d. My baby's father does not need testing; I know I am the one with
hepatitis."
8.
A nurse is caring for a 2-day old infant who has a bilirubin level of 19
mg/dl. The physician has ordered phototherapy. Which of the following
actions indicates correct preparation of the infant for this procedure?
a. Undress the baby down to a diaper and hat
b. Place the baby in his mother's arms before turning on the light
c. Position the phototherapy light approximately 3 inches above the baby's
skin
d. Secure eye protection for the infant without occluding the nose
9.
A nurse is preparing to change a client's dressing for a burn wound on his
foot. Which of the following interventions is appropriate for this process?
a. Wash the wound with cleanser, rinse, and pat dry
b. Bind the wound tightly, secure with tape, and elevate the foot
c. Contact the physician after the dressing change is complete
d. Provide analgesics for the client after the procedure
10.
A nurse is caring for a client who seeks treatment for a sore throat, swollen
lymph nodes in the neck, fever, chills, and extreme fatigue. Based on these
symptoms, which of the following illnesses could the nurse consider for this
client?
a. Methicillin-resistant staphylococcus aureus (MRSA)
b. Hepatitis B
c. Infectious mononucleosis
d. Norovirus infection
11.
A client in end-stage renal disease is receiving peritoneal dialysis at home.
The nurse must educate the client about potential complications associated
with this procedure. All of the following are complications associated with
peritoneal dialysis EXCEPT:
a. Hypotriglyceridemia
b. Abdominal hernia
c. Anorexia
d. Peritonitis
12.
A nurse is assisting Mr. L, a client who has a new colostomy after a bowel
resection. The nurse is teaching this client how to care for his colostomy
bag. Which of the following statements from Mr. L indicates the need for
more education?
a. I can clean the skin around the ostomy site with soap and water when I
change the bag."
b. I should irrigate the stoma regularly to avoid buildup of gas and odor."
c. I need to wait ½ hour after I irrigate to replace the colostomy bag."
d. I should change the bag when it is one-third to one-fourth full."
13.
Which of the following interventions must the nurse implement while a
client is having a grand mal seizure?
a. Open the jaw and place a bite block between the teeth
b. Try to place the client on his side
c. Restrain the client to prevent injury
d. Place pillows around the client
14.
An 85-year old client is diagnosed with hypernatremia due to lack of fluid
intake and dehydration. The nurse knows that symptoms of hypernatremia
include:
a. Lack of thirst
b. Pale skin
c. Hypertension
d. Swollen tongue
15.
Which of the following clients is most appropriate for receiving telemetry?
a. A client with syncope potentially related to cardiac dysrhythmia
b. A client with unstable angina
c. A client with sinus rhythm and PVCs
d. A client who had a myocardial infarction 6 hours ago
16.
A client is brought into the emergency department after finishing a course
of antibiotics for a urinary tract infection. The client is experiencing
dyspnea, chest tightness and is agitated. Her blood pressure is 88/58, she
has generalized hives over the course of her body and her lips and tongue
are swollen. After the nurse calls for help, what is the next appropriate
action?
a. Start an IV and administer a 1-liter bolus of Lactated Ringer's solution
b. Administer 0.3 mg of 1:1000 epinephrine IM
c. Administer 15 mg diphenhydramine IM
d. Monitor the client until help arrives
17.
Mr. B is recovering from a surgical procedure that was performed four days
ago. The nurse’s assessment finds this client coughing up rust-colored
sputum; his respiratory rate is 28/minute with expiratory grunting, and his
lung sounds have coarse crackles on auscultation. Which of the following
conditions is the most likely cause of these symptoms?
a. Tuberculosis
b. Pulmonary edema
c. Pneumonia
d. Histoplasmosis
18.
Based on Mr. B's assessment, what is the first action of the nurse after
assessing his condition?
a. Immediately place the client in a negative-pressure room
b. Set the client up to receive a bronchoscopy
c. Contact the physician for antifungal medications
d. Administer oxygen and assist the client to sit in the semi-Fowler's
position
19.
A nurse is assessing a client who is post-op day #3 after an abdominal
hernia repair. After a bout of harsh coughing, the client states, "it feels like
something gave way." The nurse assesses his abdomen and notes an
evisceration from the surgical site. What is the next action of the nurse?
a. Turn the client on his side
b. Push the abdominal contents back inside the wound using sterile gloves
c. Ask the client to take a breath and hold it
d. Cover the intestine with sterile saline dressings
20.
A nurse is performing CPR on a client when a co-worker brings an
automated external defibrillator (AED). The nurse prepares to apply the
patches to the client's chest when she notes that he has a large amount of
thick chest hair. What is the next action of the nurse?
a. Apply the pads to the chest and provide a shock
b. Wipe the client's chest down with a towel before applying the pads
c. Shave the client's chest to remove the hair
d. Do not use the AED
21.
A nurse is educating a client who was recently diagnosed with
diverticulosis. What types of foods should the nurse recommend for this
client?
a. Whole grain cereal
b. Eggs
c. Cottage cheese
d. Fish
22.
A client is in need of hemodialysis for end-stage renal failure. The
physician has inserted an AV fistula. Which of the following nursing
interventions are appropriate when caring for this access site?
a. Assess for clotting in fistula tubing
b. Apply a dressing over the fistula site
c. Assess for a bruit or thrill at the site of the fistula
d. Assess circulation proximal to the fistula site
23.
A client is brought into the emergency room where the physician suspects
that he has cardiac tamponade. Based on this diagnosis, the nurse would
expect to see which of the following signs or symptoms in this client?
a. Fever, fatigue, malaise
b. Hypotension and distended neck veins
c. Cough and hemoptysis
d. Numbness and tingling in the extremities
24.
Mr. S has just been diagnosed with active tuberculosis. Which of the
following nursing interventions should the nurse perform to prevent
transmission to others?
a. Begin drug therapy within 72 hours of diagnosis
b. Place the client in a positive-pressure room
c. Initiate standard precautions
d. Place the client in a negative-pressure room
25.
Which of the following descriptions best describes the function of the
thyroid gland?
a. The thyroid gland converts glucose into glycogen
b. The thyroid hormone secretes cortisol during times of stress
c. The thyroid gland regulates body metabolism
d. The thyroid gland affects skin pigmentation
26.
A nurse is instructing a client in the use of his incentive spirometer. Which
of the following statements from the nurse indicates correct teaching about
using this device?
a. Lie back in a reclining position while doing this."
b. Take rapid, quick breaths to reach your goal."
c. Set a goal of using the spirometer at least 3 times per day."
d. Practice coughing after taking 10 breaths."
27.
A client in the ICU has been intubated and placed on a ventilator. The
physician orders synchronous intermittent mandatory ventilation (SIMV).
Which statement best describes the work of this mode of ventilation?
a. The ventilator delivers a set rate and tidal volume regardless of whether
the client is attempting to breathe
b. The ventilator coordinates delivered breaths with the client's respiratory
efforts
c. The ventilator provides a supplemental breath for every third breath of
the client
d. The ventilator provides breaths during the expiratory phase of the client's
respirations
28.
A nurse is caring for a client in the post-anesthesia care unit (PACU). Upon
admission, the client is shivering despite having several layers of blankets.
What is the next action of the nurse?
a. Turn the client to the prone position
b. Assist the client to breathe deeply
c. Administer meperidine as ordered
d. None of the above
29.
Mrs. D is a pregnant client who is 33 weeks' gestation and is admitted for
bright red vaginal bleeding. Her physician suspects placenta previa. All of
the following nursing interventions are appropriate for this client except:
a. Institute complete bed rest for the client
b. Assess uterine tone to determine condition
c. Perform a vaginal exam to assess cervical dilation
d. Measure and record blood loss each shift
30.
Which of the following interventions should the nurse use when working
with a Jackson-Pratt drain?
a. Strip the tubing to remove clots by milking the tubing back toward the
client
b. Empty the drain when the amount of fluid reaches 25 cc
c. Strip the tubing to remove clots by milking the tubing away from the
client
d. Maintain the level of the drain above the client's incision
31.
Which of the following techniques can help to prevent skin irritation or
breakdown around a tracheostomy site?
a. Manage secretions by providing suction on a regular basis
b. Cleanse the site daily with a mixture of povidone-iodine and water
c. Avoid using tube ties to secure the tube
d. None of the above
32.
A client is seen for testing to rule out Rocky Mountain Spotted Fever.
Which of the following signs or symptoms is associated with this
condition?
a. Fever and rash
b. Circumoral cyanosis
c. Elevated glucose levels
d. All of the above
e. Both a and d only
33.
A nurse is assisting with a physical exam for a client who presents with
possible meningitis. The nurse bends the client's leg at the hip to a 90degree angle. When she extends the leg at the knee, the client experiences
severe pain. Which type of test is this nurse performing?
a. Brudzinski's sign
b. Romberg's sign
c. Kernig's sign
d. Babinski's sign
34.
Which of the following types of dressing changes works as a form of
wound debridement?
a. Dry dressing
b. Transparent dressing
c. Composite dressing
d. Wet to dry dressing
35.
A nurse is caring for a newborn infant in the nursery who has developed
vomiting, poor feeding, lethargy and respiratory distress. The physician has
diagnosed this infant with necrotizing enterocolitis. Which of the following
nursing interventions is most appropriate for this infant?
a. Feed the infant 30 cc of sterile water
b. Position the infant on his back
c. Administer antibiotics as ordered
d. Allow the infant to breastfeed
36.
Mr. C is brought to the hospital with severe burns over 45% of his body. His
heart rate is 124 bpm and thready, BP 84/46, respirations 24/minute and
shallow. He is apprehensive and restless. Which of the following types of
shock is Mr. C at highest risk for?
a. Septic shock
b. Hypovolemic shock
c. Neurogenic shock
d. Cardiogenic shock
37.
Based on Mr. C's assessment, which of the following nursing interventions
is most appropriate?
a. Elevate the lower extremities to 45 degrees to promote venous return
b. Place Mr. C in the Trendelenburg position
c. Administer total parenteral nutrition
d. Monitor urine output
38.
Mr. L was working in his garage at home and had an accident with a power
saw. He is brought into the emergency department by a neighbor with a
traumatic hand amputation. What is the first action of the nurse?
a. Place a tourniquet at the level of the elbow
b. Apply direct pressure to the injury
c. Administer a bolus of 0.9% Normal Saline
d. Elevate the injured extremity on a pillow
39.
A nurse is caring for a client who was recently diagnosed with breast
cancer. The oncologist uses the TNM staging system to classify this case as
T2, N2, M0. The nurse understands that TNM stands for:
a. Tumor, Necrosis, Metastasis
b. Tumor, Node Involvement, Mastectomy
c. Tumor, Node Involvement, Metastasis
d. Therapy, Necrosis, Metastasis
40.
A nurse is caring for a client who has undergone radiation therapy. The skin
on her chest and abdomen itches and is red. The client complains of burning
pain and the skin is beginning to slough. Which nursing intervention is most
appropriate for this client?
a. Apply ointment to the skin to avoid moisture
b. Wash the area gently with water and pat dry
c. Use a mild antiseptic soap to wash the area and pat dry
d. Apply talcum powder to keep the skin dry
41.
A client is admitted for a head injury. His body is lying in an abnormal
position and the physician states he is exhibiting decorticate posturing.
Based on this assessment, the nurse can expect to find the client with:
a. The legs extended and rotated internally; the elbow, wrists, and fingers
flexed
b. The legs pulled toward the chest; the head bent back at a 30-degree angle
c. The back arched; the arms and legs extended and rigid
d. The legs extended and rotated externally; the head turned to the right or
the left
42.
All of the following signs are indicative of increased intracranial pressure
EXCEPT:
a. Decreased level of consciousness
b. Projectile vomiting
c. Sluggish pupil dilation
d. Increased heart rate
43.
Mr. V is receiving treatment for a spinal cord injury after falling off of his
deck at home. He has undergone spinal surgery, and has been placed in a
halo traction device. Which of the following nursing interventions are most
appropriate for a client with a spinal cord injury?
a. Turn the client and use incentive spirometry each shift
b. Administer stool softeners as ordered
c. Turn the head slowly to avoid further damage to the spine
d. Change NPO status
44.
Based on assessment and testing, the physician has diagnosed Mr. V with a
cord transection at the level of C8 of the spine. Which of the following
types of paralysis is Mr. V most likely to suffer?
a. Hemiplegia
b. Quadriplegia
c. Paraplegia
d. None
45.
A client is diagnosed with Meniere's disease after suffering from a viral
infection. The nurse recognizes that this condition causes:
a. Chronic rash, inflamed skin, and encrusted lesions
b. Orthostatic hypotension and swelling of the extremities
c. Altered potassium levels and increased risk of cardiac dysrhythmias
d. Vertigo, tinnitus, vomiting, and hearing loss
46.
Mrs. P is being admitted for complications of coronary artery disease. The
nurse places her on a cardiac monitor and notes that her heart rate is 210
bpm and occasionally irregular. She is unable to measure the P-R interval
because the rate is too fast; the QRS complexes are wide. Which of the
following conditions does this client most likely have?
a. Premature ventricular contractions
b. Atrial fibrillation
c. Ventricular tachycardia
d. Sinus tachycardia
47.
A nurse is reading a rhythm strip from a cardiac monitor. She counts 6 QRS
complexes within a 6-second strip. What is the heart rate?
a. 36 bpm
b. 60 bpm
c. 100 bpm
d. 120 bpm
48.
A nurse is caring for Mr. W, who has been HIV-positive for seven years.
Mr. W was recently diagnosed with mycobacterium avium complex
(MAC). Based on this diagnosis, the nurse can expect which of the
following symptoms from this client?
a. Cardiac dysrhythmias
b. Swelling of the lips and face
c. Headache and a ruddy complexion
d. Lethargy and diarrhea
49.
Based on Mr. W's diagnosis of MAC, which of the following information
should be provided to this client?
a. He should be started on antiretroviral therapy as ordered
b. He is no longer just HIV-positive, he most likely has AIDS
c. He should be tested for other illnesses, such as anemia
d. Both b and c
50.
All of the following are complications associated with hypothermia during
the perioperative period EXCEPT:
a. Decreased blood urea nitrogen levels
b. Cardiac arrhythmias
c. Decreased immunity
d. Increased oxygen needs
51.
A nurse is caring for a client who had a bone marrow transplant two weeks
ago. Which of the following is most likely to cause an infection during this
time period?
a. Cytomegalovirus
b. Varicella zoster virus
c. Herpes simplex virus
d. Hepatitis B virus
52.
A nurse is caring for Mrs. L, a pregnant client who is 35 weeks' gestation.
The client complains of abdominal pain; her abdomen is rigid and she has
little vaginal bleeding. The nurse notes few fetal accelerations on the fetal
monitor. Which of the following conditions most likely describes these
symptoms?
a. Placenta previa
b. Prolapsed cord
c. Preeclampsia
d. Abruptio placentae
53.
Mrs. L's blood pressure has dropped to 86/58 and her heart rate is 112 bpm.
Based on her assessment, what is the most appropriate action of the nurse?
a. Insert two large-bore IVs
b. Elevate the head of the bed
c. Insert an indwelling catheter
d. Both a and c
54.
A client begins to choke on food while eating in her room and a nurse is
attempting to perform the Heimlich maneuver. After several seconds, the
client becomes unconscious. What is the next action of the nurse?
a. Continue to support the client's body weight by standing behind her and
performing abdominal thrusts
b. Ask a co-worker to hold the client while continuing to perform
abdominal thrusts
c. Ease the client to the ground and expose the chest
d. Perform a blind finger sweep to remove any objects and begin rescue
breathing
55.
Which of the following actions is part of suture removal for a client
following surgery?
a. Cut the suture and pull the wire through the wound
b. Avoid removing further sutures if wound dehiscence occurs
c. Do not remove sutures that are embedded in the skin
d. All of the above
56.
Mrs. H has been diagnosed with multiple myeloma. Based on the risk
factors associated with this condition, which of the following background
information is most likely true for Mrs. H?
a. Mrs. H is younger than 30 years old
b. Mrs. H has a BMI of 31
c. Mrs. H is Caucasian
d. Mrs. H has four children
57.
Based on Mrs. H's diagnosis, which of the following complications is she
most likely to develop?
a. Anemia
b. Hyperlipidemia
c. Cirrhosis
d. Stroke
58.
Which of the following statements best describes postural drainage as part
of chest physiotherapy?
a. Tapping on the chest wall to loosen secretions
b. Squeezing the abdomen to increase expansion of the upper chest
c. Using gravity to move secretions in the lung tissue
d. Dilating the trachea to facilitate better release of secretions
59.
Mr. R has come into the emergency room after an injury at work in which
his upper body was pinned between two pieces of equipment. The nurse
notes bruising in the upper abdomen and chest. He is complaining of sharp
chest pain, he has difficulty with breathing, and his trachea is deviated to
the left side. Which of the following conditions are these symptoms most
closely associated with?
a. Left-sided pneumothorax
b. Pleural effusion
c. Atelectasis
d. Right-sided pneumothorax
60.
The physician has decided to perform a thoracentesis based on Mr. R's
assessment. Which of the following actions from the nurse is most
appropriate?
a. Instruct the client not to talk during the procedure
b. Assist the client to lie face-down on the bed
c. Insert a 20-gauge needle just above the 4th intercostal space
d. Connect the needle to suction to remove air that has collected in the
pleural space
61.
An 80-year old patient is admitted with dyspnea, dependent edema, rales
and distended neck veins. As the nurse monitors the patient, he becomes
increasingly short of breath and begins to have cardiac dysrhythmias. The
most critical intervention for this patient is to:
a. Ensure his airway is open and unobstructed.
b. Apply oxygen to keep his oxygen saturation over 94%.
c. Administer Dobutamine to increase cardiac output.
d. Start an IV for monitoring of intake.
62.
You are caring for a 20-year old patient with pericarditis. What is the likely
cause of pericarditis in a young patient?
a. Heart failure
b. Acute MI
c. Hypertension
d. Infectious processes
63.
A systolic blood pressure of 145 mm Hg is classified as:
a. Normotensive
b. Prehypertension
c. Stage I hypertension
d. Stage II hypertension
64.
Your patient has been diagnosed with acute bronchitis. You should expect
that all of the following will be ordered EXCEPT:
a. Increased fluid intake
b. Cough medications
c. Antibiotics
d. Use of a vaporizer.
65.
You are caring for an asthmatic patient with an early-phase reaction. Which
of the following is indicative of an early phase reaction?
a. Rapid bronchospasms
b. Inflammatory epithelial lesions
c. Increased secretions
d. Increased mucosal edema
66.
Clinical manifestations of asthma include:
a. Decreased expiratory time
b. Increased peak expiratory flow
c. Increased use of accessory muscles
d. Increased oxygen saturation
67.
What drives respiration in a patient with advanced chronic respiratory
failure?
a. Hypoxemia
b. Hypocapnia
c. Hypercapnia
d. None of the above
68.
Which of the following is NOT a warning sign that compensatory
mechanisms in a patient in shock are failing?
a. Increasing heart rate above normal for the patient's age.
b. Absent peripheral pulses.
c. Decreasing level of consciousness.
d. Increasing blood pressure.
69.
How does shock usually progress?
a. Compensated to hypotensive shock in hours and hypotensive shock to
cardiac arrest in minutes
b. Compensated to hypotensive shock in minutes and hypotensive shock to
cardiac arrest in hours
c. Hypotensive to compensated shock in hours and compensated shock to
cardiac arrest in minutes
d. Hypotensive to compensated shock in minutes and compensated shock to
cardiac arrest in hours
70.
Septic, anaphylactic and neurogenic shock are all categorized as:
a. Hypovolemic shock
b. Cardiogenic shock
c. Distributive shock
d. Obstructive shock
71.
Which of the following is TRUE about shock?
a. A patient with severe shock always has an abnormally low blood pressure
b. Confusion and deteriorating mentation are indicative of hypotensive
shock.
c. Patients with compensated shock may be unable to maintain a normal
blood pressure.
d. A normal blood pressure implies that the patient is stable.
72.
Signs and symptoms of stroke may include all of following EXCEPT:
a. Sudden weakness or numbness of the face, arm or leg.
b. Sudden confusion.
c. Sudden headache with no known cause.
d. Hypotension.
73.
Which of the following may cause coup-contrecoup injuries?
a. Rotational forces
b. Deformation forces
c. Deceleration forces
d. Acceleration forces
74.
Meningitis that is fatal in half of the infected patients is caused by a:
a. Virus
b. Bacteria
c. Fungus
d. Noninfectious agent
75.
Which of the following may alter the level of consciousness in a patient?
a. Alcohol
b. Electrolytes
c. Infection
d. All of the above may cause altered level of consciousness
e. Both a and c only
76.
The term used to define uterine bleeding in which there is no menstruation
in a 24-year-old woman is:
a. Oligomenorrhea
b. Amenorrhea
c. Menorrhagia
d. Metrorrhagia
77.
Which of the following diseases, or disorders, is acute?
a. Pneumonia
b. Paralysis
c. Alzheimer's disease
d. Diabetes
78.
You are caring for Thomas N. Thomas is 77 years old. He has edema, or
swelling, in his legs and he has a fluid restriction in terms of his fluid
intake. You have been assigned to weigh him daily. Based on these
symptoms and the care that he is being given, what disorder is he most
likely affected with?
a. Diabetes
b. Dementia
c. Congestive heart failure
d. Continguous heart disease
79.
The major difference between a grand mal and petit mal seizure is that a
person with a grand mal seizure will have _______________ and the person
with a petit mal seizure will not.
a. convulsive movements
b. sleep apnea
c. atonic movement
d. flaccidity
80.
Your patient has shown the following signs and symptoms : Feeling very
thirsty Large amount of water intake Dryness of the mouth Urinary
frequency What physical disorder does this patient most likely have?
a. Diabetes
b. Angina
c. Hypertension
d. Hypotension
81.
Which fact about diabetes is true?
a. Only children get type 1 diabetes.
b. Only adults get type 2 diabetes.
c. Children and adults can have type 1 diabetes.
d. Both a and b
82.
Diabetic patients are more prone to ____________ than other people
without this chronic disorder.
a. infection
b. increased oxygen saturation
c. low fibrinogen
d. constipation
83.
A common childhood illness is caused by the Bordatella pertussis
bacterium. Which of the following diseases is caused by this bacteria?
a. German Measles
b. RSV
c. Meningitis
d. Whooping Cough
84.
Which of the following glands found in the skin secretes a liquid called,
"Sebum?"
a. Apocrine Glands
b. Sebaceous Glands
c. Lacrimal Glands
d. Sweat Glands
85.
A patient that has been diagnosed with alopecia would be described as
having:
a. body lice
b. lack of ear lopes
c. Indigestion
d. hair loss
86.
A patient presents with vesicles covering the upper torso. Which of the
following situations could cause this condition?
a. Knife fight
b. Auto accident
c. Sun burn
d. Fungal infection
87.
A child is diagnosed with a Greenstick Fracture. Which of the following
most accurately describes the broken bone?
a. compound fracture of the fibula
b. a partial break in a long bone
c. fracture of the growth plate of the ulna near the wrist
d. Colles fracture of the tibia
88.
When reading a lab report, you notice that a patient's sample is described as
having anisocytosis. Which of the following most accurately describes the
patient's condition?
a. The patient has an abnormal condition of skin cells.
b. The patient's red blood cells vary in size.
c. The patient has a high level of fat cells and is obese.
d. The patient's cells are indicative of necrosis.
89.
A patient with Bell's Palsy would have which of the following complaints?
a. Paralysis of the right or left arm
b. Malfunction of a certain cranial nerve
c. A sub-condition of Cerebral Palsy
d. A side effect of a stroke
90.
A pathologic condition described as, "Increased intraocular pressure of the
eye," is:
a. Detached Retina
b. Fovea Centralis
c. Presbyopia
d. Glaucoma
91.
A physician believes that a patient may be experiencing pancreatitis. Which
of the following tests would be best to diagnose this condition?
a. CK and Troponin
b. BUN and Creatinine
c. Amylase and Lipase
d. HDL and LDL Cholesterol Levels
92.
A patient presents to the office with a pencil that has completely penetrated
the palm of her hand. Which of the following treatments would be BEST in
this situation?
a. Assist the doctor while she sedates the patient and removes the pencil
from her hand.
b. Have the patient gently pull the pencil out of her hand and assist the
physician with stitches.
c. Wrap a gauze wrap around the pencil, securing it as much as possible
until the patient can get to a local emergency room.
d. Tell the patient to go the local emergency room. With a doctor's order,
give the patient some aspirin for the pain.
93.
What is the most common complication of chest wall injury?
a. Hemothorax
b. Atelectasis
c. Pneumonia
d. Pneumothorax
94.
Of the following, which best describes why subdural hemorrhages are more
common in the elderly?
a. Increased anticoagulant use
b. Increased risk of falls
c. Brain atrophy
d. Inconsistent care giving
95.
Of the following, which is the most common type of malignant brain tumor
in the United States?
a. Meningioma
b. Glioblastoma multiforme
c. Acoustic neuroma
d. Pituitary adenoma
96.
Renal failure is broadly divided into specific categories. Which type is the
type II diabetic patient most likely to experience secondary to the diabetes?
a. Acute renal failure (ARF)
b. Intermittent renal failure (IRF)
c. Chronic renal failure (CRF)
d. Reversable renal failure (RRF)
97.
Many nurses are not comfortable dealing with the topic of suicide with a
patient who may be at risk. Of the following, what would be an appropriate
action if a patient uses language indicative of suicidal intentions?
a. Ask if the patient has a plan
b. Ask the patient to describe details of the plan
c. Ask the patient to agree to a no-harm contract
d. All of the above
SAFETY (TEST MODE)
1.
Which of the following is an example of client handling equipment?
a. Wheelchair
b. Height-adjustable bed
c. Shower chair
d. Call light
2.
Which practice will help to reduce the risk of a needlestick injury?
a. Only expose the end of the needle once ready to enter the room for the
procedure
b. Always place the cap back on a needle after it has been used
c. Keep a sharps container nearby where it can be easily accessed
d. Pass needles between nurses by using the hand-over technique
3.
Which of the following is an organizational factor that affects workplace
violence directed at nurses?
a. Clients who have short hospital stays
b. The presence of security guards
c. Restricted client areas
d. Understaffing of nursing personnel
4.
Which of the following actions can a nurse do to prevent a fire from
occurring in the area where he works?
a. Use an adaptor when plugging in client equipment
b. Mark equipment that is not working properly and use carefully until it
can be inspected by maintenance
c. Notify visitors or post signs that state oxygen is in use in certain areas
d. Keep extra equipment stored in one area with other supplies and
materials
5.
Which principle of body mechanics may help to reduce the risk of a back
injury incurred by the nurse?
a. Maintain a narrow base of support
b. Bend from the waist, not the knees
c. Keep the back straight while lifting
d. If possible, lift objects rather than pushing or pulling
6.
A physician has ordered that a client must be placed in a high Fowler's
position. How does the nurse position this client?
a. The client is placed face-down
b. The client lies on his back with his head lower than his feet
c. The client lies on his back with the knees drawn up toward the chest
d. The client is sitting with the backrest at a 90-degree angle
7.
A nurse has applied a cold pack to a client's arm to help decrease swelling
and inflammation after an injury. Which of the following signs indicates
that the cold pack should be removed?
a. The skin on the arm appears mottled
b. The cold pack has been in place for 10 minutes
c. The client complains of feeling nauseated
d. The capillary refill in the area distal to the arm is 2 seconds
8.
A client in a long-term care facility has developed reddened skin over the
sacrum, which has cracked and started to blister. The nurse confirms that
the client has not been assisted with turning while in bed. Which stage of
pressure ulcer is this client exhibiting?
a. Stage I
b. Stage II
c. Stage III
d. Stage IV
9.
A nurse caring for a client diagnosed with pertussis is ordered to maintain
droplet precautions. Which of the following actions of the nurse upholds
droplet precautions?
a. Assign the client to stay in a negative-pressure room
b. Use sterilized equipment when sharing between this client and another
person with pertussis
c. Wear a mask if coming within 3 feet of the client
d. Both a and c
10.
Mr. and Mrs. K have just adopted a newborn infant and are preparing to
take him home from the hospital for the first time. Which safety measure is
most appropriate for the clients in this situation?
a. Turn the handles of pans on the stove inward
b. Set up a baby gate at the top of the stairs
c. Cover electrical outlets with child-proof plugs
d. Install an approved car seat that is facing backward in the back seat
11.
A nurse is treating a client with suspected carbon monoxide poisoning.
Which of the following symptoms are associated with this condition?
a. Red rash across the trunk and extremities
b. Nausea, vomiting, seizures
c. Flushing of the face and neck
d. Abdominal pain radiating to the back
12.
A nurse attempts to plug in a sequential compression device when she
notices a tingling sensation in her hands while touching the cord. What is
the next action of the nurse?
a. Attempt to plug the device into a different outlet
b. Inspect the cord for damage; if none is present, continue to use the device
c. Discontinue the device and send it to the maintenance department for
inspection
d. Notify the supervisor that the unit is at risk of an electrical fire
13.
A client has become combative and is attempting to pull out his IV and take
off his surgical dressings. The nurse receives an order to apply wrist
restraints. Which action of the nurse signifies that restraints are being used
safely?
a. The nurse ties the restraints in a square knot to prevent the client from
untying them
b. The restraints are attached to a movable portion of the bed
c. The padded side of the restraint is applied next to the skin of the wrist
d. The nurse assess the client's distal circulation every 24 hours
14.
A nurse is caring for an 86-year old client with decreased visual acuity and
who uses a cane for mobility. What should the nurse teach this client to
reduce the risk of falling at home?
a. Take off shoes while in the house and wear only socks
b. Limit activities to the lower level of the home
c. Keep a lamp near the door of every room
d. Install non-slip pads in the shower or bathtub
15.
A nurse has just started a transfusion of packed red blood cells that a
physician ordered for a client. Which of the following signs may indicate a
transfusion reaction?
a. The client suddenly complains of back pain and has chills
b. The client develops dependent edema in the extremities
c. The client has a seizure
d. The client's heart rate drops to 60 bpm
16.
An attack using microorganisms such as bacteria or viral agents with intent
to harm others is called:
a. Assimilation
b. Defense intervention
c. Bioterrorism
d. Environmental remediation
17.
All of the following factors may contribute to client falls EXCEPT:
a. Contact dermatitis
b. Urinary frequency
c. Decreased visual acuity
d. Confusion
18.
A small fire has erupted in a wastebasket in the client waiting room. Which
of the following is the first action of the nurse?
a. Call 9-1-1
b. Find the fire extinguisher
c. Move clients to safety
d. Throw water on the fire
19.
A nurse is preparing to assist a client from his bed into a wheelchair. Which
action is essential to maintain client safety in this situation?
a. Position the wheelchair at the foot of the bed
b. Maintain a space of at least 12 inches between the wheelchair and the bed
c. Place the footplates in the lowest position before transferring the client
d. Lock both wheels on the wheelchair before moving the client
e. Both b and d
20.
A nurse is assisting a client with ambulation in the hallway. The nurse is
using a gait belt for further assistance. The client becomes dizzy and starts
to faint while walking. What is the first action of the nurse?
a. Stand behind the client and prepare to catch him when he falls
b. Assist the client to sit in the nearest chair or slide down along a wall
c. Grasp the client under the arms and pull him upward
d. Call for help from nearby staff
21.
Which of the following constitutes the five "rights" of medication
administration?
a. Right client, right nurse, right time, right dose, right route
b. Right client, right time, right dose, right route, right order
c. Right client, right drug, right dose, right time, right route
d. Right physician, right nurse, right client, right drug, right dose
22.
A nurse is caring for a client following surgery when he begins to complain
of pain in his right hand. The client's IV is in this hand and the skin around
the site is slightly reddened and cool to the touch. The IV drip rate has
slowed considerably. The client states his pain is localized to the right hand
and fingers. Which situation is most likely the cause of this client's pain?
a. The client is experiencing phlebitis from the last drug administered
b. The client has a blood clot developing in the distal arteries of the wrist
c. The client's pain is associated with myocardial ischemia and he is having
a heart attack
d. The client's IV is infiltrated
23.
A nurse is dismissing a 5-year old boy from the pediatrics unit to go home
with his parents. The parents drive their car to the front door of the hospital
and the nurse helps the child get into the car. What type of seat belt restraint
should this child wear?
a. A 5-point restraint in the back seat, facing backward
b. A booster seat with a lap and shoulder belt in the back seat
c. A lap belt in the back seat
d. A lap and shoulder belt in the front seat
24.
A nurse is employed at a district health department and must spend several
hours each day sitting at a desk. Which principle of ergonomics will most
likely help her to reduce the risk of injury or pain in this situation?
a. Adjust the chair height to keep the legs bent at the hips at a 90-degree
angle
b. Maintain the position of the computer monitor just below eye level
c. Stand up and take a walk or stretch every 4 hours
d. Rest wrists on the edge of the desk while typing
25.
A client is receiving high-dose brachytherapy as a form of cancer treatment.
What type of teaching must the nurse include when educating this client
about safety?
a. The client must remain in isolation under airborne precautions
b. The client should stay in a private room at the hospital
c. The client may need to limit visits from friends and family
d. Both b and c
26.
Which of the following indicates the need to file an incident report?
a. The neon sign directing parking for visitors has burned out
b. A nurse must send a syringe pump to maintenance for annual service
c. A client's blood pressure dropped to 90/55 after receiving a dose of
morphine
d. A client's spouse becomes angry and is asked to leave the premises
27.
A nurse is suctioning the endotracheal tube of an intubated client on a
ventilator. What length of time is the nurse allowed to suction in this
method?
a. Five seconds or less
b. Ten seconds or less
c. At least 30 seconds
d. No longer than 60 seconds
28.
A nurse is giving a client information about his new prescription for
warfarin. The nurse should remember to tell the client:
a. He should have his white blood cell count tested once a month
b. He should avoid any activities that could lead to injury
c. He should avoid eating leafy green vegetables
d. Both a and b
29.
Which of the following actions of the nurse is most appropriate to reduce
the risk of infection during the post-operative period?
a. Flush the central line with heparin at least every four hours
b. Administer narcotic analgesics prn
c. Remove the urinary catheter as soon as the client is ambulatory
d. Order a high-protein diet for the client
30.
A nurse is assessing a client who is post-op day #1 after a
hemilaminectomy. The nurse removes the dressing as ordered and notes that
the incision appears slightly red, with a small amount of serous drainage
coming from the site. The edges of the incision are approximated. What is
the next action of the nurse?
a. Assist the client to shower as ordered and monitor the site for further
changes
b. Instruct the client to lie prone to allow the site to dry
c. Place antibiotic ointment and a sterile dressing over the site
d. Notify the physician for an antibiotic order
31.
A nurse is preparing to administer a dose of platelets to a client. Which of
the following actions must the nurse perform before giving the platelets?
a. Start an IV of ½ Normal Saline to administer with the platelets
b. Ensure the container with the platelets is intact and not damaged
c. Verify the client's name and address
d. Check the client's chart to ensure he is not taking any antibiotics
32.
Which of the following is an example of an environmental hazard that may
put the nurse at risk of injury?
a. Loud noise from the hospital maintenance system
b. Airborne powder that contains latex
c. Chemicals containing ethylene oxide
d. All of the above
e. Both b and c only
33.
A nurse is caring for a client's wound that has started to bleed. After
providing wound care, the nurse removes her gloves and notes that a small
amount of the client's blood has come in contact with her hand. What is the
next action of the nurse?
a. Use an alcohol-based hand sanitizer to disinfect the hands
b. Wash hands with soap and water using appropriate technique
c. Notify the occupational health nurse about an exposure to a client's blood
d. Sample some of the client's blood to determine the presence of diseases
34.
A nurse must attend a high-risk delivery in a client's room. After the infant
has been delivered, the nurse immediately takes him to a warmer for
assessment. What is the minimum amount of personal protective equipment
for the nurse when working with this newborn?
a. Sterile gown, gloves
b. Mask, gown, shoe covers
c. Gloves
d. Hat, mask, gloves, gown, shoe covers
35.
Which of the following diseases would require the nurse to wear an N95
respirator as part of personal protective equipment?
a. Human immunodeficiency virus
b. Clostridium difficile enterocolitis
c. Vancomycin-resistant enterococcus
d. Measles
36.
Which of the following teaching topics should the nurse discuss when
working with an immunocompromised client?
a. Avoid canned foods and increase consumption of fresh fruits and
vegetables
b. Hand-wash utensils after use and allow them to air dry
c. Only drink tap water that has been filtered or boiled before consumption
d. Never eat meals prepared in restaurants
37.
Which of the following is the correct sequence for removing personal
protective equipment?
a. Remove gown, gloves, shoe covers, mask
b. Remove mask, gloves, gown, shoe covers
c. Remove gloves, gown, mask, shoe covers
d. Remove shoe covers, mask, gloves, gown
38.
A nurse is completing an incident report about a medication error that she
made when she accidentally administered too much insulin to a diabetic
client. All of the following are components of this documentation EXCEPT:
a. The reason why she gave the wrong dose
b. The type of drug involved
c. The amount of insulin that was given
d. Any adverse effects on the client
39.
A home health nurse is preparing to visit her next client, whom she has
never visited before. Which of the following actions indicates the nurse is
upholding safety precautions?
a. Send a text to the client to confirm the location of the house
b. Leave her purse and valuables on the seat in the car and lock the doors
c. Ask the client to keep an extra set of keys in case the car is locked
d. Keep the car windows rolled up when in an unfamiliar environment
40.
A nurse is caring for newborn infants in a nursery when a man enters the
area to take his baby back to the room. The man does not have an
identification bracelet and the nurse does not recognize him. What is the
next action of the nurse?
a. Call security and ask them to escort the man out of the nursery
b. Ask the man to wait and check the infant's chart
c. Ask the man to return to his room and bring an identification band
d. Allow the man to take the baby to his room
41.
According to the American Heart Association standards, high quality CPR
for an adult includes all of the following EXCEPT:
a. Push hard
b. Push fast
c. Allow chest recoil between compressions
d. Pause CPR as each drug is administered
42.
Which of the following may represent an upper airway obstruction?
a. Retractions
b. Elongated expiratory phase
c. Stridor
d. Expiratory wheezing
43.
The primary purpose of emergency planning is to do which of the
following?
a. Comply with the laws of the state.
b. Comply with the laws of the U.S.
c. Comply with both state and U.S. laws.
d. Maintain safety.
44.
One of your patients is dependent on a mechanical ventilator for their
respiratory needs. The patient cannot breath on their own. Suddenly, the
lights in the patient's room and the entire nursing unit go off. You realize
that the electric power has been lost. What is the first thing that you should
do for this patient?
a. Plug the ventilator into the red outlet in the room.
b. Plug the ventilator into the blue outlet in the room.
c. Use an Ambu bag to ventilate the patient.
d. Call the doctor about this emergency.
45.
You must wear gloves when you are _______________.
a. preparing infant formula for a newborn baby
b. transferring breast milk into a baby bottle
c. knocking on a patient's door
d. opening a patient's door
46.
You are taking care of a patient who has active TB. The patient has been put
on airborne precautions. The patient is in a special room. You must wear a
HEPA mask when you enter the room. Now, the patient has to leave the
room and go to the radiology department. How can you transport this
patient to the radiology department without spreading the TB throughout
the hospital?
a. Have everyone along the route to the radiology department wear a HEPA
mask.
b. Have patients along the route to the radiology department wear a HEPA
mask.
c. Have staff along the route to the radiology department wear a HEPA
mask.
d. Place a HEPA mask on the patient.
47.
A patient's Foley catheter has been discontinued. You will dispose of this
patient equipment by doing which of the following?
a. Wearing gloves and then placing this equipment in the regular trash can
after it is placed in a paper bag.
b. Simply placing this equipment in the regular trash can after it is placed in
a paper bag.
c. Wearing gloves and then placing this equipment into a special "hazardous
waste" container.
d. Simply placing this equipment in the "hazardous waste" container after it
is placed in a paper bag.
48.
Your AIDS/HIV patient has just died. Should you still use standard
precautions as you provide post mortem care?
a. Yes, because the virus is still transmissible
b. Yes, because you must still treat them with respect
c. No, because the virus is no longer transmissible
d. No, because this is not respectful
49.
Your patient has just died from a massive heart attack. As far as you know,
patient had no other diseases, illnesses or infections. Should you still use
standard precautions as you provide post mortem care?
a. Yes, because the patient must be treated with respect
b. Yes, you still must use standard precautions
c. No, because the patient had no infections
d. No, because this is not respectful
50.
The proper personal protective equipment necessary for collecting a sputum
specimen would include: (Choose the BEST answer.)
a. Gloves and face mask
b. Level Three Bio containment uniforms
c. Eye protection and shoe covers
d. Splash shield and face mask
51.
Surgical asepsis is being performed when:
a. wiping down exam tables with bleach.
b. sterilizing instruments.
c. changing table paper.
d. wearing gloves when performing injections.
52.
The most effective step of hand washing is:
a. using friction to remove potential pathogens.
b. using hospital grade soap.
c. moisturizing the hands after washing to prevent cracking.
d. washing hands for at least 15 seconds.
53.
MSDS sheets:
a. Contain the ordering information for each piece of equipment in the
office.
b. Are required by OSHA to be accessible to all employees of the office.
c. Can be used to treat patients who have been injured in equipment
accidents.
d. None of the above.
54.
The most virulent blood borne pathogen is: (Choose the BEST answer.)
a. HCV
b. HPV
c. HIV
d. HBV
55.
The NFPA diamond has four colors. The blue diamond:
a. indicates hazards to health.
b. designates that it is safe to use water to put out this type of fire.
c. indicates that ice is necessary to treat an injury with this type of chemical.
d. indicates that the chemical may be incinerated upon disposal.
56.
Which would be the first step when a patient passes out at the front desk?
a. Call 911.
b. Initiate CPR.
c. Shake the patient and ask if he is ok.
d. Check for a pulse.
57.
When performing CPR, at what rate should chest compressions be applied?
a. 100 per minute
b. 60 per minute
c. As quickly as possible.
d. 200 per minute
58.
Which acronym would BEST describe the procedure for assessing a patient
that appears unconscious?
a. WBC
b. QRS
c. XYZ
d. ABC
59.
The acronym FAST is used to help responders remember the steps to
recognizing which of the following conditions?
a. Onset of labor in a pregnant woman
b. Stroke
c. Heart attack
d. Migraine
60.
The Rule of Nines is used to:
a. determine the amount of the body surface that has been burned.
b. assess the level of oxygen saturation in a body that has been burned.
c. determine the level of tissue damage that has occurred in a burn.
d. None of the above.
61.
First aid for frostbite includes:
a. Running cold water over the affected area. Warm or hot water will shock
the area and cause more tissue damage.
b. Run warm water over the area to rapidly rewarm the affected area.
c. Run hot water over the area to warm the area as quickly as possible.
d. Cover the area with a blanket, using a heating pad if the blanket isn't
warm enough.
62.
Improper placement of the hands under the rib cage when performing the
Heimlich maneuver could result in:
a. damage to the manubrium of the sternum.
b. damage to the coccyx.
c. a broken xiphoid process.
d. None of the above is possible, even with improper hand placement.
63.
Which type of shock is related to low blood volume?
a. Psychogenic
b. Cardiogenic
c. Anaphylactic
d. Hemorrhagic
64.
A patient is bleeding profusely from an injury near her wrist. Which of the
following first aid procedures would be MOST appropriate?
a. Place a tourniquet on her arm above the injury.
b. Place pressure on her brachial artery.
c. Place pressure on her radial nerve.
d. Cover the bleeding area with wet towels.
65.
Patients that are exhibiting signs of cyanosis will:
a. show signs of hyperoxia.
b. will have increased O2 saturation.
c. will have blood levels of CO2 that are higher than O2 levels.
d. None of the above.
66.
The medical term, "diaphoresis," means:
a. Profuse vomiting
b. Profuse sweating
c. Gasping for air
d. None of the above.
67.
When would chest thrusts be performed in an emergency situation?
a. When performing CPR to initiate cardiovascular circulation.
b. When assessing responsiveness of an unconscious patient.
c. When assisting a pregnant woman who is choking.
d. None of the above examples indicate the need for chest thrusts.
68.
Madge is a 91-year-old nursing home resident with a history of dementia
and atrial fibrillation who has been admitted to the hospital for treatment of
pneumonia. As you are performing her bed bath, you note bruising around
her breasts and genital area. What potential issue should be of major
concern in Madge's situation?
a. Idiopathic thrombocytopenia purpura (ITP)
b. Embolic stroke
c. Sexual abuse
d. Nursing home acquired pneumonia (NHAP)
MENTAL HEALTH (TEST MODE)
1.
A client has been diagnosed with a form of terminal cancer and has started
receiving hospice care. The nurse notes that both the client and his family
avoid talking about the diagnosis. All attempts at discussion result in
changing the subject. The nurse recognizes that this family is exhibiting:
a. Closed awareness
b. Mutual pretense
c. Open awareness
d. Powerless assessment
2.
A nurse is preparing to talk about body changes with a client who just had a
bilateral mastectomy. Which of the following actions of the nurse is most
appropriate during this discussion?
a. Provide a room that offers minimal distractions
b. Ask closed-ended questions to allow the client to think about her
situation
c. Write detailed notes during the conversation to track important
information
d. Ask personal questions about the client's background to determine how
the procedure has affected her self-concept
3.
A nurse is attempting to speak with a client about his personal feelings of
self-esteem and self-concept. Which of the following questions is most
appropriate for assessing a client's personal identity?
a. What is your educational background?"
b. Are your parents still living?"
c. What do you like about your life right now?"
d. Where do you see yourself in 10 years?"
4.
A term that refers to a comprehensive set of thoughts or images of oneself
is called:
a. Global self
b. Core self-concept
c. Personal identity
d. Ideal self
5.
Which of the following interventions is most appropriate when supporting
the psychosocial needs of a client who is experiencing negative side effects
associated with chemotherapy?
a. Read the client's discharge instructions well in advance of dismissal
b. Provide medications to reduce nausea and vomiting
c. Give simple instructions about self-care while in the hospital
d. Determine the levels of support from significant others
6.
Which of the following clients is at the highest risk of becoming a victim of
intimate partner violence?
a. A 36-year old woman who is recently divorced
b. A 22-year old man who is unemployed but living with friends
c. A 20-year old woman who grew up with a psychologically abusive father
d. A 40-year old man diagnosed with schizophrenia
7.
A nurse is assessing a client who is being seen for increased anxiety,
restlessness, and insomnia. Which of the following interventions is the first
priority of the nurse?
a. Administer anti-anxiety medications as ordered by the physician
b. Talk with the client about methods to improve rest and sleep
c. Take the client to a private room and remain with him
d. Review the client's medical history to determine if he has been treated for
these issues before
8.
Which of the following is an example of an opioid?
a. Mescaline
b. Diazepam
c. Phenobarbital
d. Methadone
9.
A client comes into the emergency room and asks to see a doctor. He is
anxious, visibly upset, and keeps looking behind him to the waiting room.
When the nurse asks his chief complaint, he says, "My roommate is trying
to kill me." Which of the following is the most appropriate initial response
of the nurse?
a. Just wait here and I will notify security."
b. I'm going to speak with the physician about getting some medication that
may help you."
c. Why is your roommate trying to kill you?"
d. Have you called the police to report this?"
10.
A 17-year old Asian client is being seen for lower abdominal pain in the
right quadrant. The client is accompanied by his parents. The nurse notes
that the client's father does not make eye contact and shows little response
when told that the client will need surgery. Which of the following is the
most appropriate action of the nurse?
a. Contact an interpreter to give the information again in the father's native
language
b. Continue to provide information about surgery to both the client and his
parents
c. Call social services to evaluate the parent's standard of care
d. Contact the physician about postponing the surgery
11.
Which of the following best describes Eye Movement Desensitization and
Reprocessing (EMDR)?
a. A client follows the nurse's finger with his eyes until he reaches a
hypnotic state
b. A client reads a story about a traumatic event and then visualizes the
result
c. A client focuses on a negative thought in his mind while moving his eyes
back and forth
d. None of the above
12.
Which of the following is an example of neurofeedback used with a child
diagnosed with reactive attachment disorder (RAD)?
a. Parents or a nurse hold a child close during play until he becomes angry
enough to unleash his rage
b. Parents give their child a sticker when he behaves appropriately
c. A child uses a sand tray to draw shapes and to release stress while talking
with a nurse
d. A child's brain waves are monitored through electrodes placed on the
scalp
13.
An increase in the neurotransmitter dopamine is associated with which of
the following illnesses?
a. Schizophrenia
b. Depression
c. Alzheimer's disease
d. Anxiety
14.
A nurse is using therapeutic techniques to help a client who is having
difficulty applying for a job because of panic and anxiety. The nurse
pretends to be the job supervisor while the client practices answering
questions during an imaginary interview. This technique is an example of:
a. Reinforcement
b. Presenting reality
c. Role playing
d. Summarizing
15.
Which of the following actions of the nurse is most appropriate when
working with a client who is extremely angry?
a. Place a light hand on the client's shoulder to imply understanding
b. Maintain close proximity to convey trust
c. Temporarily change the subject if the client's behavior is changing
d. Close the door to the room to provide privacy
16.
Which of the following is an advantage of working with psychiatric clients
in a group setting?
a. Clients assist each other through therapeutic interventions without a need
for a nurse
b. Clients can behave however they wish while knowing the group will not
lead to long-term contact with others
c. Clients can remain anonymous in sharing private information without the
legal constraints of reporting illegal activities
d. Clients learn from others when their behaviors are inappropriate in a safe
and trusting environment
17.
Which of the following interventions is most appropriate when working
with the family of a client who is being treated for substance abuse?
a. Advocate for the client before the family
b. Provide referrals for community resources and support groups
c. Take the side of the family before the client
d. Both b and c
18.
A term used to describe members of the same group based on physiological
characteristics, such as skin color or body structure is known as:
a. Ethnicity
b. Culture
c. Race
d. Minority
19.
Which of the following is an example of non-reversible dementia?
a. Pick's disease
b. Syphilis
c. Encephalopathy
d. Hyperthyroidism
20.
Which of the following is a nursing intervention for a client who is having
an acute panic attack?
a. Encourage the client to sit down in a quiet environment
b. Allow the client to direct the situation
c. Try to focus the client on one aspect of care, such as regulating breathing
patterns
d. Speak in a commanding tone of voice to get the client's attention
21.
A nurse is assisting a client who has been diagnosed with depression.
Which of the following is an example of a short-term outcome as part of the
nursing process for this client?
a. Client will verbalize that depression symptoms have lifted
b. Client will identify life stressors that may be contributing to depression
c. Client's insomnia will be resolved as evidenced by 8 hours of sleep each
night
d. Client will identify a mental health counselor in the community with
whom she can meet for ongoing therapy
22.
Which of the following is an example of passive aggression?
a. Clenched fists
b. Yelling
c. Jealousy
d. Intimidation
23.
A client is being treated for anxiety and desires to be free from anxious
feelings and despair. According to Maslow's hierarchy of needs, which level
does this client need to meet?
a. Physiological
b. Safety
c. Belonging
d. Self esteem
24.
Which of the following is an age-related developmental task for a 68-year
old client?
a. Dealing with loss of friends
b. Commitment to parenthood
c. Setting career goals
d. Solidification of sense of self
25.
Which of the following examples indicates that the nurse is giving
recognition as a form of therapeutic communication?
a. You need to take your medicine now, Adam."
b. Jill, your father is trying to make amends with you."
c. The physician wants to meet with you and your husband, Amy."
d. Linda, you brushed your hair this morning."
26.
During her shift at the hospital, a nurse receives a stern reprimand from a
physician over something which she had no control. The nurse does not
respond. When she returns home that evening, she sees her children's toys
all over the floor, gets mad, and begins to yell at them. Which form of
defense mechanism is this nurse using?
a. Symbolization
b. Suppression
c. Displacement
d. Projection
27.
A client is receiving treatment for delusional behavior. He believes that his
neighbor is purposefully poisoning his water system in an attempt to make
him sick. Which of the following responses of the nurse is most
appropriate?
a. Did you have the water tested to be sure?"
b. Why do you feel like your neighbor is trying to poison you?"
c. Let's just sit here and watch this television program."
d. Don't be silly; your neighbor would do no such thing."
28.
Which of the following people is at highest risk of suicide?
a. An 80-year old man who lost his wife last year
b. A 36-year old woman whose former neighbor committed suicide
c. A 40-year old married businessman
d. A 46-year old former alcoholic who has been sober for 12 years
29.
Which of the following is a typical assessment finding of a 24 year old
female with anorexia nervosa?
a. Weight loss of more than 2% body fat
b. Frequent binge-eating episodes following by induced vomiting
c. A history of poor academic performance and mediocre achievements
d. Lack of menstruation
30.
A client is undergoing treatment for alcoholism. Twelve hours after his last
drink, he develops tremors, increased heart rate, hallucinations, and
seizures. Which stage of withdrawal is this client experiencing?
a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4
31.
Which of the following nursing interventions is essential when working
with a client who has antisocial personality disorder?
a. Monitor intake and output
b. Set strict limits on behavior
c. Provide diversion for the client
d. Limit visits from family or friends
32.
Which is a true statement regarding stress related disorders?
a. Stress related disorders are only caused by stress
b. Symptoms of stress related disorders would not exist if the client was not
experiencing stress
c. Stress related disorders are also called psychophysiologic disorders
d. None of the above
33.
Which of the following nursing outcomes is most appropriate during the
crisis stage of caring for a victim of domestic violence?
a. The client will verbalize community resources from which to seek shelter
after discharge
b. The client will write a plan to keep herself and her children safe
c. The client will contact an attorney for help with pressing charges
d. The client will be safe and receive treatment for injuries
34.
Which of the following is a symptom associated with sensory overload?
a. Disorientation
b. Drowsiness
c. Emotional lability
d. Depression
35.
A nurse is providing care for a client who has just died. Her son states, "She
was the most wonderful mother. There was no one who was a better mother
than she was. She was perfect." Which stage of grief is this son
experiencing?
a. Denial
b. Anger
c. Idealization
d. Shock
36.
Which of the following is a true statement about palliative care?
a. The goal of palliative care is to provide end of life care for a client as he
transitions toward death
b. Palliative care provides comfort and support for those who may have a
terminal illness
c. Palliative care provides resources for funeral arrangements after death
d. Palliative care is a support network for family and friends after the death
of a loved one
37.
According to the CDC, people in which of the following age groups are
most likely to meet the criteria for major depression?
a. 18-24 years
b. 25-34 years
c. 35-44 years
d. 45-64 years
38.
Your patient has been confused for years. Your patient can be best described
as a patient with a chronic ___________ disorder.
a. physical
b. psychotic
c. thinking
d. palliative
39.
At the end of your shift, Sophie T. starts crying when you walk into their
room. Sophie is usually very cheerful. You speak to Sophie and she tells
you that she is very sad because she has not seen her family in weeks. What
should you do?
a. Listen to Sophie with genuine concern.
b. Tell Sophie that she should not cry.
c. Immediately call the family so Sophie stops crying.
d. You should leave because your shift is over.
40.
The primary reason that people act out with disturbed behavior in a
healthcare facility is because the person has a _________ problem.
a. social
b. spousal
c. thinking
d. physical
41.
The best way for a nurse, and a healthcare facility, to control the effects of
poor and disruptive patient behavior is to _________________.
a. prevent it
b. restrain the patient
c. medicate the patient
d. isolate the patient
42.
Identify the "trigger" type with the correct "trigger" that can possibly lead to
disturbed behavior.
a. Emotional: room coldness
b. Environmental: boredom
c. Physical: pain
d. Communication: silence
43.
Jerry is a 55-year-old veteran who has been admitted after a motor vehicle
accident with multiple injuries. His friend reported that he had been using
synthetic marijuana prior to the accident, and that he also sees a psychiatrist
at the VA hospital for an unknown diagnosis. He stated that Jerry
sometimes gets “hyper” for no reason, starts “ranting” and becomes violent.
Of the following, which general psychiatric disorder is characterized by a
pattern of aggression or violence which includes irritability, agitation, and
violent behavior during manic or psychotic episodes?
a. Schizophrenia
b. Post-traumatic stress disorder (PTSD)
c. Bipolar disorder
d. Delusional disorder
44.
Of the following, which would NOT be helpful to include when developing
Jerry's plan of care?
a. Limiting choices
b. Providing structure
c. Encouraging patient input
d. Ensuring availability of prn medications
45.
Of the following, which often triggers an episode of violence or aggression
by the patient with a psychiatric diagnosis that may involve violent
behavior?
a. Obtaining a history
b. Asking for input into care
c. Enforcing rules
d. Taking a walk
46.
Which of the following medications would NOT be an appropriate prn
medication for use during an episode of aggression or violence for the
patient with a psychiatric diagnosis?
a. Olanzapine
b. Meperidine
c. Ziprasidone
d. Haloperidol
47.
Which of the following is an appropriate tension-reduction intervention for
the patient who may be escalating toward aggressive behavior?
a. Asking to speak to someone
b. Asking to be alone
c. Listening to music
d. All of the above
48.
Causes which contribute to delirium are often remembered as an acronym
of the same name. What cause does the E in DELIRIUM represent?
a. EEG
b. EKG
c. Electrolytes
d. Echocardiogram
49.
Which of the following mental health situations is considered a psychiatric
emergency?
a. Seasonal Affective Disorder (SAD)
b. Depression with melancholic features
c. Major depressive episode with psychotic features
d. Bipolar depression
PHARMACOLOGY (TEST MODE)
1.
A drug form in which medication particles are instilled into a liquid and
combined through agitation of the solution is called:
a. Suspension
b. Elixir
c. Syrup
d. Tincture
2.
Following a dose of medication, a client develops inflamed mucous
membranes and nasal discharge. What type of minor reaction is this client
experiencing?
a. Urticaria
b. Pruritis
c. Hives
d. Rhinitis
3.
Mr. Y is receiving medication through a catheter that has been placed into
the subarachnoid space of his spinal column. What route of medication
administration is this called?
a. Intrapleural
b. Intraosseous
c. Intrathecal
d. Intraperitoneal
4.
A client is having difficulties swallowing a large tablet of medication.
Which of the following interventions from the nurse may best assist this
client?
a. Help the client to lie down while taking the medication
b. Obtain an order to give the medication intravenously instead
c. Dissolve the tablet in a glass of pineapple juice
d. Assist the client to drink a full glass of water when taking the tablet
5.
A nurse is attempting to find the ventrogluteal muscle to administer an
intramuscular medication. In which method does the nurse find this site?
a. The nurse places her palm on the client's hip at the level of the greater
trochanter, pointing the thumb toward the client's groin and administering
the injection between the first and second fingers
b. The nurse measures two finger-widths below the acromion process and
administers the injection at this point
c. The nurse estimates the upper and outer quadrant of the buttock and gives
the injection 3 inches below the iliac crest
d. The nurse grasps the muscle of the upper thigh and administers the
injection 6 inches above the knee
6.
A nurse is administering total parenteral nutrition for a client. The solution
contains 12% dextrose and 5% amino acids. Which of the following sites is
most appropriate to administer this solution?
a. Left radial arterial line
b. Right subclavian catheter
c. Left peripheral intravenous catheter
d. Both a and c
7.
Mr. S is complaining of pain following a surgical procedure. The nurse
checks his orders and finds that he has an order for meperidine 25 mg prn q
4 hrs for shivering. What is the next action of the nurse?
a. Give 25mg of the medication and use it for pain
b. Contact the pharmacy to clarify the purpose of the medication
c. Check the medication record for other prn pain medications
d. Administer 12.5 mg of the medication and document that the client was
shivering
8.
Which of the following medications is an example of an adjuvant drug?
a. Ibuprofen
b. Fentanyl
c. Hydromorphone
d. Hydroxyzine
9.
Which of the following is a potential complication of administering a
dorsogluteal intramuscular injection?
a. Striking the bone of the humerus with the needle
b. Inserting the needle into the sciatic nerve
c. Causing extravasation of medication into the subcutaneous tissues
d. Causing an air embolus in the superior iliac artery
10.
A nurse is preparing to administer a rectal suppository to a client. After
applying gloves, checking the client's identification band, and closing the
door, what is the next step of the nurse?
a. Assist the client to lie in the Trendelenburg position
b. Unwrap the suppository and lubricate the end
c. Remove gloves and wash hands
d. Record the date, time, and amount of suppository to give
11.
Mr. F has been prescribed isocarboxazid, a monoamine oxidase inhibitor, as
part of treatment for depression. Which of the following foods should the
nurse instruct the client to avoid while taking this drug?
a. Wine
b. Sweet potatoes
c. Spinach
d. Apple juice
12.
A nurse is preparing to administer digoxin to a client who suffers from heart
failure. What must the nurse consider before administering this medication?
a. The presence of pitting edema in the lower extremities
b. The sound of rales on lung auscultation
c. The rate of the apical pulse
d. The presence of jaundiced skin
13.
A client has been taking his antianxiety medications for four years, even
though he no longer struggles with acute anxiety. Instead, he has a routine
of taking the medication each evening and feels better knowing that he has
taken it. Which of the following best describes this action?
a. Physiologic need
b. Physiologic dependence
c. Drug abuse
d. Drug habituation
14.
Which of the following is a disadvantage of taking medication through an
oral route?
a. The drug may be absorbed too rapidly
b. The drug may have a bad taste
c. The drug is more expensive to use
d. Both a and b
15.
One tablespoon of medication is equal to how many milliliters of fluid?
a. 5 ml
b. 15 ml
c. 30 ml
d. 60 ml
16.
Which of the following must the nurse consider before administering
medications through a nasogastric tube?
a. The nurse must determine whether a tablet can be crushed
b. The nurse must use 5 cc of cold water to instill the medication
c. The nurse must aspirate from the tube after giving the medication
d. The nurse must immediately reconnect low-intermittent suction after the
medication
17.
What gauge of needle is most appropriate when giving an adult a
subcutaneous injection?
a. 16 gauge
b. 18 gauge
c. 24 gauge
d. 30 gauge
18.
Which is the most appropriate muscle site for an intramuscular injection for
a 9-month old child?
a. Deltoid
b. Ventrogluteal
c. Dorsogluteal
d. Vastus lateralis
19.
A nurse is caring for a client who is breastfeeding her baby. Which of the
following medications can the nurse administer to this client?
a. Aspirin
b. Lipitor
c. Prednisone
d. Amiodarone
20.
A nurse is administering a blood transfusion when the client begins to
complain of a headache and difficulty breathing. His blood pressure is
170/110 mmHg. What is the next action of the nurse?
a. Administer a sedative and analgesic as directed
b. Assist the client to sit upright and slow the transfusion
c. Check the client's urinary output
d. Assist the client to lie supine in the Trendelenburg position
21.
A nurse is caring for a client who has a triple-lumen, peripherally inserted
central catheter (PICC) in the right arm. Which of the following is a
consideration when working with this type of central line?
a. The client should be restricted to showers only, no baths
b. The nurse should flush one of the ports with saline solution every 8 hours
c. The nurse should avoid taking a blood pressure in the right arm
d. The client should avoid exercise until the PICC has been removed
22.
A nurse is caring for a client who has low blood pressure. The physician has
ordered dopamine 2 mcg/kg/min on a continuous infusion. The nurse notes
that the client weights 186 pounds. What is the appropriate rate for this
infusion?
a. 168 mcg/min
b. 372 mcg/min
c. 168 mg/min
d. 372 mg/min
23.
A nurse needs to administer 15 units of regular insulin and 20 units of NPH
subcutaneously to a client with diabetes. In what order does the nurse draw
these medications?
a. Draw 20 units of NPH, then 15 units of regular, in the same syringe
b. Draw 15 units of regular, then 20 units of NPH, in the same syringe
c. Draw 15 units of regular, then 20 units of NPH, in different syringes
d. Draw 5 units of regular, then 20 units of NPH, then 10 more units of
regular, in different syringes
24.
When preparing to give a client a narcotic analgesic, which of the following
information should the nurse provide as part of education?
a. Take the medication on an empty stomach
b. Lie down for one hour after taking the medication
c. The medication may cause constipation
d. The medication may cause heartburn
25.
A nurse is caring for a client who is recovering from surgery. He is
complaining of pain rated at a "9" on a 0-10 scale. The nurse administers 2
mg Morphine Sulfate for pain control. After the medication, the client falls
asleep, his blood pressure is 95/48, and his heart rate is 62 bpm. After ten
minutes, the client awakens and asks for more pain medicine, rating his
pain at an "8." What is the most appropriate action of the nurse?
a. Administer 2mg of Morphine Sulfate
b. Check the medication record for a non-narcotic analgesic
c. Tell the client that he cannot have any more medication
d. Contact the physician about the client's vital signs
26.
After administering a drug, the time when the body first starts to respond to
the medication is called:
a. Plateau
b. Peak plasma level
c. Onset of action
d. Drug half-life
27.
Which of the following abbreviations is acceptable to use as part of
medication documentation?
a. Q.O.D.
b. MS
c. IU
d. prn
28.
How many milliliters are equal to one quart of fluid?
a. 250 ml
b. 500 ml
c. 1000 ml
d. 2000 ml
29.
A nurse receives an order for Iansoprazole (Prevacid) 15 mg daily. The
medication is available in syrup form of 5 mg/ml. How many milliliters
must this nurse give?
a. 5 ml
b. 1 ml
c. 3 ml
d. 15 ml
30.
A nurse asks her coworker to administer Mr. J's 12pm medication because
she is running behind. Which of the following information must the nurse
verify with Mr. J before giving him his medication?
a. His name and address
b. His name and hospital identification number
c. His name and room number
d. His name and diagnosis
31.
Which of the following is more likely to occur with aging as a complication
of medication administration?
a. Increased renal function
b. Increased gastrointestinal absorption
c. Increased visual acuity
d. Increased ratio of fat compared to lean body mass
32.
Which of the following interventions should the nurse consider when giving
an oral medication to a child?
a. Mix the medication with milk to mask the taste
b. Dilute the medication in a glass of water
c. Refeed the medication if the child pushes it out with his tongue
d. Mix the medication in a food the child enjoys
33.
Which of the following methods best describes administration of an
intradermal injection?
a. Pull the skin taut and insert the needle bevel-up just slightly under the
skin; inject medication to create a wheal
b. Pull the skin taut and insert the needle bevel-down just slightly under the
skin; inject medication to create a wheal
c. Pinch the skin and insert the needle bevel-down into the skin fold to
create a wheal
d. Pinch the skin and insert the needle bevel-up at a 45-degree angle into the
skin
34.
Which of the following is a disadvantage of administering intravenous
medications through the IV-push method?
a. It is impossible to determine the full effect of the drug on the client
b. The drug may be irritating to the client's veins
c. The peak onset of action is slower when a drug is given IV-push
d. None of the above
35.
A nurse is preparing to administer an ophthalmic medication to Mrs. W.
Which of the following statements demonstrates that the nurse is
performing this procedure correctly?
a. Open your eyes wide and look toward the floor."
b. I will hold your eyelashes to keep your eye open."
c. I'm going to give this drop in the lower part of your eye."
d. Try to keep your eyes open after I give this medicine."
36.
Which of the following effects does obesity have on drug distribution?
a. Drugs are distributed more quickly in obese persons because blood flow
is increased through fat tissue
b. Drugs are distributed more slowly in obese persons because blood flow is
decreased through fat tissue
c. Obesity has a paradoxical effect on drug distribution in that blood flow is
decreased but distribution is increased
d. Obesity has no effect on drug distribution
37.
Which of the following is a potential side effect of ibuprofen?
a. Headache
b. Urinary retention
c. Hematuria
d. Low blood pressure
38.
Mr. B is recovering from anesthesia after surgery. During the case, he was
given opioid analgesics, but now his respiratory rate is only 8 respirations
per minute. Which of the following medications may be most appropriate at
this time?
a. Amobarbital
b. Flurazepam
c. Phenytoin
d. Naloxone hydrochloride
39.
Which of the following is an adverse effect of diuretics?
a. Hypokalemia
b. High blood pressure
c. Decreased BUN
d. Anxiety
40.
Mr. R is being seen in his physician's office for swollen and painful joints.
The most obvious joint affected is his great toe, which has become large,
red, and painful. Which of the following medications is most appropriate
for this condition?
a. Docusate sodium
b. Bismuth subsalicylate
c. Allopurinal
d. Cromolyn sodium
41.
Which of the following interventions reduces the risk of infection when
administering an intramuscular injection?
a. Draw up the solution approximately 5 minutes before administration
b. Keep the tip of the needle covered until administration
c. Clean the skin with an antiseptic swab in a ½-inch radius
d. Check the client's temperature immediately after administering the
injection
42.
A nurse is attempting to start an IV in a client's arm and is having difficulty
with finding a vein to use. The client's skin is cold. Which intervention of
the nurse may improve this situation?
a. Raise the client's hand so that it remains at a level above the heart
b. Place a warm pack on the clients arm for 5 minutes before looking for a
vein
c. Instruct the client to drink a quart of warm water
d. Apply a tourniquet 12 inches above the IV site
43.
A client is being admitted on a routine basis for fluids to correct an
electrolyte balance. Which of the following sites is most appropriate for
starting an IV in this client?
a. A vein in the antecubital fossa
b. A vein in the dominant hand
c. A vein in the foot
d. A vein in the non-dominant hand
44.
Which of the following interventions best helps to facilitate insertion of an
intravenous catheter?
a. Ask the client to look away during the procedure
b. Puncture the skin at a 5 to 10-degree angle
c. Advance the catheter until resistance is met
d. Secure the device at a 45-degree angle to the skin
45.
All of the following actions are components of a peripherally inserted IV
dressing change EXCEPT:
a. Remove the current dressing
b. Cleanse the areas under the dressing
c. Pat the area dry with a towel
d. Apply the new dressing and label it with the date
46.
A client with an IV is complaining of pain at the insertion site. There is a
bruise at the site, the skin is tender, and the IV fluid will not flow. Which of
the following conditions is the most likely cause of these symptoms?
a. Hematoma
b. Phlebitis
c. Extravasation
d. Venous spasm
47.
Which of the following solutions is compatible with administration of
packed red blood cells?
a. Lactated Ringer's
b. 0.9% Normal Saline
c. D5 ½ Normal Saline
d. Normosol-R
48.
Which of the following is an example of a colloid solution?
a. 5% Dextrose in water (D5W)
b. Albumin
c. Lactated Ringer's
d. Normal Saline
49.
A nurse is preparing to administer packed red cells for Mr. H when she
realizes that he does not have an IV. What is the minimum size of catheter
the nurse must use in this situation?
a. 30 gauge
b. 28 gauge
c. 24 gauge
d. 20 gauge
50.
A nurse is caring for a client who has been ordered to receive a rapid
infusion of packed cells to support his intravascular blood volume. She
starts to administer the blood at a fast drip rate and realizes that the blood is
not infusing. Which of the following actions may the nurse perform to
correct this situation?
a. Raise the client's arm above his head
b. Place the client in the Trendelenburg position
c. Place a pressure bag around the blood container
d. Start a new IV and simultaneously administer a second unit of blood
51.
Which of the following actions is part of preparation of a medication from
an ampule?
a. Snap the neck of the ampule toward the body
b. Hold the ampule upside down when drawing up the medication
c. Expel excess air bubbles back into the ampule
d. Always use the same needle for drawing as the one used for the injection
52.
A nurse is preparing to add a medication to an IV that is already infusing
for a client. Which of the following practices is most appropriate for this
process?
a. Draw the medication to be added from a vial using sterile technique
b. Inject the solution through the air vent port of the IV bag
c. Shake the bag vigorously after the medication has been added
d. Clamp the IV tubing for 30 minutes after adding the medication
53.
Which of the following information should the nurse tell a client who needs
to use a metered-dose inhaler?
a. Shake the inhaler after using
b. Place the mouthpiece in the mouth before compressing the inhaler
c. Take a breath and hold it before compressing the inhaler
d. Immediately repeat the next compression if more than one puff is ordered
54.
Which of these clients is the best candidate for using patient-controlled
analgesia?
a. An 86-year old man in the memory disorders unit
b. A 6-year old boy with a tibia-fibula fracture
c. A 56-year old man post-op day #1 after a hernia repair
d. A 70-year old woman with end-stage brain cancer
55.
Which of the following clients is most likely to benefit from receiving a
peripheral nerve block?
a. A client undergoing a cesarean section
b. A client undergoing an appendectomy
c. A client undergoing a cervical discectomy
d. A client undergoing a total knee replacement
56.
Mrs. V is a pregnant client who is receiving fluid and electrolyte therapy
after being diagnosed with hyperemesis gravidarum. The nurse enters Mrs.
V's room to find that she has a decreased level of consciousness, fever, and
is sweating profusely. Her urine specific gravity is 1.026 and her hematocrit
level is 55%. Which of the following conditions most likely explains this
situation?
a. Third-space syndrome
b. Fluid volume excess
c. Fluid volume deficit
d. Hyperosmolar imbalance
57.
Which of the following clients is most likely in need of fluid restriction?
a. A 67-year man with cor pulmonale
b. An 86-year old man with recent vomiting
c. A 24-year old pregnant woman
d. A 47-year old woman with severe burns
58.
A nurse has been given an order for a 20 cc bolus to a client with a central
line. The only syringes she has available are 5 or 10 cc in size. What is the
most appropriate action of the nurse?
a. Give 4 boluses of 5 cc each
b. Give 2 boluses of 10 cc each
c. Find a 20 cc syringe
d. Either b or c
59.
Mr. L is in the emergency room with a traumatic amputation. The physician
determines that he needs a rapid infusion of packed red cells. Mr. L is
unconscious and the nurse does not know his blood type. Which of the
following blood types might be the safest to use in this situation?
a. Type Ab. Type AB+
c. Type Bd. Type O60.
Which of the following describes a benefit of using a Groshong® tunneled
catheter?
a. It does not require regular heparin flushes
b. It is less prone to kinks in the line when compared with other central
catheters
c. It can easily be placed at the bedside by a certified nurse
d. It does not require an x-ray to confirm placement
61.
Which of the following interventions should the nurse perform when
changing a cap on a central line catheter?
a. Open the supplies just before starting
b. Unclamp the catheter
c. Cleanse the catheter cap with povidone-iodine
d. Change each lumen on different days of the week
62.
A nurse is caring for a 5-year old child who just had an appendectomy. The
physician
wrote
orders
regarding
pain
control,
diet,
and
fluid
administration. The nurse reads the order that says "Maintain IV D5W at a
rate of 500 cc/hr." What is the most appropriate action of the nurse in this
situation?
a. Administer the fluid at the prescribed rate
b. Take the client's blood pressure before changing the IV rate
c. Administer the fluid at 50 cc/hr instead
d. Contact the physician for clarification of orders
63.
A nurse is teaching a client to care for a Broviac® catheter at home. Which
statement from the client indicates understanding of the teaching?
a. I don't need to wash my hands unless they are visibly soiled."
b. If there is drainage at the insertion site, I should notify my physician."
c. I should wash my hands after I take off the old dressing."
d. I should use either rubbing alcohol or water to clean the end of the
catheter."
64.
Which of the following actions should the nurse consider when working
with a multi-dose medication vial?
a. Discard the vial after two uses
b. Clean the stopper with 70% alcohol before each use
c. Puncture the vial with only one needle and connect multiple syringes
d. All of the above
65.
What common drug can be administered to treat wheezing in a patient with
infectious pneumonitis?
a. Dexamethasone
b. ibuprofen
c. albuterol
d. None of the above.
66.
A doctor writes out a prescription for medication to be taken as needed for
pain. Which of the following abbreviations could the nurse expect to see on
the prescription form?
a. CHF
b. ATB
c. Ac
d. Prn
67.
A patient has been diagnosed with a mycotic condition. Which of the
following drug types would be used to treat this condition?
a. Antifungal
b. Antiarrhythmic
c. Diuretic
d. Antiemetic
68.
Which of the following abbreviations means, "before meals"?
a. Ac
b. Prn
c. Qid
d. Qh
69.
Which of the following anticoagulants would be found in a light blue
vacutainer tube?
a. EDTA
b. Sodium Oxalate
c. Lithium Heparin
d. Sodium Citrate
70.
If a doctor's order calls for the administration of 500 mg of medication, how
many grams should be given?
a. 500
b. 50
c. 0.5
d. 5
71.
Which of the following medications would be given to treat vomiting?
a. Simvistatin
b. Acetaminophen
c. Lisinopril
d. Promethazine
72.
A patient has been diagnosed with an irregular heartbeat. Which of the
following medications would be prescribed to treat this condition?
a. Antiarrhythmic
b. Antipsychotic
c. Cathartic
d. Antiseptic
73.
Which of the following drugs would be used to treat GERD?
a. Claritin
b. Nexium
c. Nuprin
d. Celebrex
74.
Of the following medications, which is not used to treat depression?
a. sertraline hydrochloride
b. paroxetine hydrochloride
c. Citalopram
d. Nifedipine
75.
A doctor's order is written to give a patient a medication using a nonparenteral route. Which of the following is a non-parenteral route of
medication administration?
a. Rectal Suppository
b. Intracardiac
c. IV drip
d. IM injection
76.
A patient is morbidly obese. Which of the following needles would be best
to give an IM injection in the deltoid?
a. 25 gauge 5/8 inch
b. 27 gauge 1/2 inch
c. 21 gauge needle 1 1/2 inches
d. 16 gauge needle 3 inch
77.
When giving an injection of insulin, which of the following is TRUE?
a. The deltoid muscle is the preferred injection site for insulin.
b. The angle of the needle should be 90 degrees.
c. The site should not be massaged after medication administration.
d. All of the above are true.
78.
Buccal administration of medications:
a. should be done under the tongue.
b. are done to allow controlled dosing through the mucosa.
c. are best to use in small children.
d. All of the above.
79.
If a medication order states that 300 mg of medication are to be given q.i.d.
for 10 days, how many total milligrams of medication will be given over
those 10 days?
a. 3000 mg
b. 9000 mg
c. 12000 mg
d. None of the above.
80.
A doctor orders 500 mg of medication. Available in stock are one gram
tablets. How many tablets should be given to the patient?
a. One
b. Two
c. One half
d. Three quarters
81.
Which class of medications is foundational to treating the patient with
delirium tremens (DTs)?
a. Phenothiazines
b. Butyrophenones
c. Benzodiazepines
d. Anticonvulsants
82.
Monica is a new nurse and has gone home for the day after giving her
report. When your patient asks for prn pain medication, which has been
ordered as a dosage range, you note that Monica has entries for
administration almost every two hours in the morning, but nothing since
then. You cannot be sure when the patient last received his medication or
what the dosage was. What is the most appropriate next action?
a. Complete an incident report
b. Contact the nurse manager
c. Contact Monica and confirm administration
d. Give the medication anyway
83.
The route of administration that allows medication the quickest onset of
action is ____________.
a. IM
b. PO
c. PR
d. IV
84.
Hospitalized patients who are allowed to administer pain medications to
themselves are connected to a PCA or ____________.
a. Patient Connected Anesthetic
b. Patient Communicated Analgesic
c. Patient Controlled Analgesic
d. Patient Communicated Anesthetic
85.
Which of the following would be an acceptable route for the delivery of
parental nutrition for an NPO patient?
a. Pills
b. intravenous
c. Liquids only
d. Aspirate
86.
IV push and IV piggy back are different nicknames for the same method of
administering medication.
a. True
b. False
87.
After administering a drug, the time when the body first starts to respond to
the medication is called:
a. Plateau
b. Peak plasma level
c. Onset of action
d. Drug half-life
88.
The Controlled Substance Act categorizes substances into _______ groups
based on varying qualifications such as currently accepted medical use and
potential for abuse.
a. three
b. four
c. five
d. six
89.
If a patient received a prescription for Ventolin HFA with the instructions 2
puffs TID, how many puffs per day is the patient instructed to take?
a. 2
b. 4
c. 6
d. 10
90.
Which of the following is the correct abbreviation for electrocardiogram?
a. EKG
b. EEG
c. ECG
d. Both a and c
91.
A PRN order is an order for a medication that is used on a(n) ________
basis in a hospital.
a. regular
b. everyday
c. as-needed
d. nightly
92.
Systemic action pertains to action throughout the body and not at the ____
of administration.
a. site
b. time
c. source
d. method
93.
The duration of a drug's action is commonly referred to as its _______.
a. half-life
b. response time
c. efficacy
d. action potential
94.
What do palliative drugs do?
a. Prevent symptoms
b. Cure symptoms
c. Relieve symptoms
d. Trigger symptoms
95.
A physician order for a 120 mg dose of Gentamycin 40mg/mL should be
filled with ______ of Gentamycin.
a. 80 mL
b. 5 mL
c. 3 mL
d. 60 mL
96.
A physician order for a 75 mg dose of Ancef 2mg/mL should be filled with
_____mL.
a. 20.5 mL
b. 32.5 mL
c. 37.5 mL
d. 40.5 mL
97.
How many units are in 1 mL of insulin?
a. 100
b. 10
c. 50
d. 5
98.
A prescription for Amoxicillin 250 mg capsules, 1 cap po tid x 10 days
should be filled with ____.
a. 15 capsules
b. 20 capsules
c. 30 capsules
d. 35 capsules
99.
How many ounces make up one cup?
a. 8
b. 16
c. 32
d. 60
100.
There are ______ ounces (oz.) in a pound (lb).
a. 4
b. 6
c. 8
d. 16
101.
Milli- is equal to _____.
a. One billionth of the basic unit
b. One millionth of the basic unit
c. One thousandth of the basic unit
d. One hundredth of the basic unit
102.
A fluid ounce is made up of how many mL?
a. 30
b. 65
c. 454
d. 2
103.
Kilo- is equal to ______.
a. One billionth of a basic unit
b. One millionth of a basic unit
c. 100 times the basic unit
d. 1,000 times the basic unit
104.
How many cc's make up one pint?
a. 280
b. 380
c. 480
d. 580
105.
How many quarts make up a gallon?
a. 10
b. 3
c. 5
d. 4
106.
How many micrograms (mcg) make up 1 milligram (mg)?
a. 10
b. 100
c. 1,000
d. 10,000
107.
There are _____ milligrams (mg) in a gram (g).
a. 10
b. 100
c. 1,000
d. 10,000
108.
A teaspoonful is the same measurement as ___.
a. 1 mL
b. 2 mL
c. 3 mL
d. 5 mL
109.
If a patient is receiving 7 liters of IV fluids over 10 hours, how many ml
will the patient receive per minute?
a. 12.8
b. 11.5
c. 11.7
d. 13.2
110.
If a patient is receiving 3.5 liters of IV fluids at a rate of 7 ml per minute
how many hours will the IV fluid last?
a. 6.4
b. 7.3
c. 8.3
d. 9.2
111.
A patient is receiving 1.8 liters of fluid over 5 hours from an infusion set
that delivers 5 gtt/ml. How many drops per minute will be administered to
the patient?
a. 6 gtt/min
b. 20 gtt/min
c. 24 gtt/min
d. 30 gtt/min
112.
A patient is receiving a 4 liter IV infusion that contains 750 mg of heparin.
If the patient is receiving 5 mg/minute of heparin, how many hours will the
infusion last?
a. 1 hour
b. 1.5 hours
c. 2 hours
d. 2.5 hours
113.
A 150 pound man is receiving a 1 liter IV containing 500 mg of Zofran over
8 hours. If the patient is receiving 2 ml/minute of IV fluid, how many mg of
Zofran per minute is the patient receiving?
a. 1 mg
b. 2 mg
c. 3 mg
d. 4 mg
114.
How many ounces are in one pint?
a. 10
b. 12
c. 14
d. 16
GROWTH AND DEVELOPMENT (TEST MODE)
1.
Which of the following complications is associated with premature rupture
of membranes in the pregnant client?
a. Vaginal or cervical lacerations
b. Shoulder dystocia
c. Uterine rupture
d. Chorioamnionitis
2.
A nurse is caring for a child whose parents live in a home with several other
unrelated children and adults. Some of the people who live in the home
have visited and the nurse discovers that this group all shares finances and
living conditions. What type of family is this most likely an example of?
a. Blended family
b. Communal family
c. Foster family
d. Extended family
3.
A nurse is educating a female client about progesterone. Which of the
following information is appropriate to include in this teaching?
a. Progesterone helps the body to maintain pregnancy
b. Progesterone stimulates the breasts to secrete milk
c. Progesterone causes uterine contractions during delivery
d. Progesterone causes development of masculine characteristics in women
4.
A nurse is assisting with counseling for a pregnant client who has had
genetic testing performed for her unborn child. The geneticist tells this
mother that her baby has an extra copy of the 21st chromosome in every
cell. Based on this information, the nurse knows that the baby will most
likely be born with which condition?
a. Turner syndrome
b. Patau syndrome
c. Down syndrome
d. Edwards syndrome
5.
A pregnant client who is at 38 weeks' gestation is seen for prenatal care at a
community clinic. The nurse asks the client to lie down while waiting for
the physician to arrive. After several minutes of lying on her back, the client
becomes dizzy and lightheaded; she is agitated and states she feels she
might faint. What is the next action of the nurse?
a. Call the physician to check the client immediately
b. Call 9-1-1 for an ambulance to transport the client to the labor and
delivery unit of the hospital
c. Check the client's blood pressure and temperature
d. Assist the client to lie on her side
6.
Which of the following symptoms is a presumptive indication of
pregnancy?
a. Auscultation of fetal heart tones
b. A positive home pregnancy test
c. Amenorrhea
d. Ballottement
7.
A client is being seen for confirmation of pregnancy. She states her last
menstrual period was June 2nd. According to Naegele's rule, what is this
client's estimated due date (EDD)?
a. April 2
b. March 9
c. February 2
d. February 19
8.
A nurse attends the delivery of a full-term infant. After the infant is
delivered, she carries him to the warmer and dries him off. His heart rate is
120 bpm, his body is flexed with good muscle tone, his hands and feet are
blue while the rest of his body is pink, and he starts to cry when stimulated.
Which of the following is the most appropriate Apgar score for this infant?
a. 10
b. 9
c. 6
d. 4
9.
A nurse is caring for a woman who just had a baby 6 hours ago. The nurse
is concerned because the mother seems more interested in letting her
husband care for the baby. Which of Rubin's puerperal phases is this mother
exhibiting?
a. Taking-in phase
b. Taking-hold phase
c. Letting-go phase
d. Handing-off phase
10.
A nurse is performing a birth assessment on an infant who was born one
hour ago. During her assessment, she strokes the sole of the infant's foot
from the heel up toward the toes and notices that the toes flare as a
response. Which test is this nurse performing?
a. Tonic neck reflex
b. Startle reflex
c. Babinski reflex
d. Moro reflex
11.
A sexually active client asks the nurse for information about contraception.
The client is interested in an intrauterine device as a form of birth control.
Which of the following is an advantage of an intrauterine device?
a. It protects against sexually transmitted infections
b. It can be inserted several hours before intercourse
c. It is acceptable to most religious backgrounds
d. It remains in place at all times
12.
Which of the following best describes the cognitive development of an 18month old child?
a. The child can follow one-part directions
b. The child understands the concept of "forever"
c. The child can name six body parts
d. The child has an attention span of approximately 5 minutes
13.
A nurse is caring for a 64-year old man whose lab work indicates he has
decreased levels of vitamin K. Which of the following symptoms is most
likely associated with this condition?
a. Gingivitis
b. Ecchymosis
c. Cardiac arrhythmias
d. Poor wound healing
14.
A nurse is assessing pain response in a 9-month old child. She uses the
CRIES scale to determine if he is having pain. The "I" in the CRIES scale
stands for:
a. Informal response
b. Increased reflexes
c. Immediate reaction
d. Increased vital signs
15.
A mother who has been breastfeeding her infant since birth wants to
transition her baby to solid foods. The child is now 6 months old. Which of
the following is the most appropriate response of the nurse?
a. You should breastfeed exclusively until your baby is 12 months old."
b. You can start solid foods and change to formula feeding."
c. You can start with rice cereal and continue with breastfeeding."
d. You can start with feeding meats and vegetables."
16.
A mother brings her 6-year old daughter in to a clinic for a routine physical.
The family follows a vegan diet and the child has only eaten grain or plant
products since birth. Which of the following vitamin deficiencies is this
child most likely at risk for?
a. Vitamin C
b. Vitamin B-6
c. Vitamin K
d. Vitamin B-12
17.
A nurse is caring for a 16-year old client who is seen for frequent vomiting
and diarrhea. After taking a history, the nurse determines this teen has been
inducing these symptoms after eating large amounts of food. What
condition is most likely the cause of this situation?
a. Anorexia
b. Binge-eating disorder
c. Adjustment disorder
d. Bulimia
18.
Which of the following is an example of a fine motor skill?
a. Jumping on a trampoline
b. Brushing hair
c. Standing on one foot
d. Climbing a ladder
19.
A nurse is preparing to administer an oral glucose tolerance test to a woman
who is 28 weeks' pregnant. What is the first step the nurse should perform
to administer this test?
a. Give the woman a sweetened drink that contains 75 g of glucose
b. Check the fetal heart tones for the baby
c. Check a fasting glucose on the mother
d. Tell the mother to eat an 800-calorie meal and return for a glucose check
20.
A nurse is examining a 36-hour old infant when she notices the child's skin
has a yellowish tint. The yellow skin appears on the baby's face and chest
but the skin on the feet and legs appears pink. What is the next action of the
nurse?
a. Check a stat bilirubin level
b. Begin phototherapy with eye protection
c. Monitor the condition and notify the physician during rounds
d. Transfer the infant to the neonatal intensive care unit
21.
A nurse is preparing to see a client who has brought her baby in because she
believes the baby has thrush. Based on this information, the nurse would
most likely expect to see:
a. Pale skin with a red, lacy rash across the trunk
b. Blue skin in the hands and feet
c. Vomiting, diarrhea, and lethargy
d. White patches in the mouth and a diaper rash
22.
A nurse is seeing a client in an outpatient clinic for symptoms of
depression. The client tells the nurse she has been taking St. John's wort to
help her symptoms. Which of the following is the most appropriate
response of the nurse?
a. We'll make sure the physician knows this information in case he
prescribes medication for you."
b. You can either take herbal supplements or prescription medication for
depression, but you must choose."
c. St. John's wort is not actually used for depression; you should try anise
seed."
d. You should not be using any herbal supplements in your situation."
23.
Which of the following is a true statement about Reye's syndrome?
a. Reye's syndrome is caused by a viral infection from improper hand
hygiene
b. Protection from Reye's syndrome requires contact precautions
c. Reye's syndrome occurs after giving aspirin to children
d. Reye's syndrome can be confirmed by genetic testing
24.
A nurse is preparing an initial hepatitis B vaccine for a child. Which of the
following information must the nurse give to the parent as part of education
about this vaccine?
a. The hepatitis B vaccine is administered one time, typically right after
birth
b. The hepatitis B vaccine is only administered to children who are at high
risk of contracting the disease
c. The hepatitis B vaccine carries a risk of sepsis for the child after
vaccination
d. The hepatitis B vaccine must be repeated as part of a 3-part series of
injections
25.
A nurse is caring for an aging client who has developed sarcopenia. Which
of the following symptoms would this nurse most likely see in this client?
a. Loss of muscle mass
b. Low oxygen saturations
c. Decreased white blood cell count
d. Diminished reflexes
26.
Which of Erikson's stages of psychosocial development is associated with a
preschool-aged child?
a. Trust vs. Mistrust
b. Industry vs. Inferiority
c. Initiative vs. Guilt
d. Identity vs. Role Confusion
27.
Which of the following interventions can the nurse implement to promote a
healthy self-concept for a client?
a. Provide information about antidepressant medications
b. Encourage the client to verbalize feelings about self, body image, and
relationships
c. Use absenteeism as a form of therapeutic communication
d. Assist the client with asking others to tell him what they think of him
28.
A 15-year old client is talking about her family with a nurse when she
reveals that her parents are getting a divorce. The client suddenly becomes
upset and starts to cry, saying, "They don't want to be together anymore!"
What is the most appropriate response of the nurse?
a. Don't worry, it will all work out in the end."
b. I'm sorry this makes you angry. I'll ask the physician if he will speak with
your parents."
c. Will you have to decide which parent you will live with?"
d. I'm sorry that you feel upset. Would you like to talk about it some more?"
29.
Which of the following is a potential complication associated with
precocious puberty?
a. Low serum calcium levels
b. Short stature
c. Weakness and lethargy
d. Anemia
30.
A nurse is working with a client and her 9-month old son. The mother tells
the nurse, "Sometimes, he is so naughty! I had to put him in time-out
yesterday for throwing toys!" What is the most appropriate response of the
nurse?
a. Where do you put him when he goes to time-out?"
b. Keep doing that to teach him the right way; eventually he will stop
throwing toys."
c. At this age, he should stay in time-out for nine minutes."
d. Remind him not to throw toys but don't discipline him for this behavior."
31.
A nurse is preparing immunizations for a 5-year old child who is starting
kindergarten. Which statement by the parent indicates understanding of this
process?
a. Once he gets these shots, he'll never need to go through this again."
b. This should be the third vaccine in the 3-part hepatitis A series."
c. Most of the kids in his preschool have already had chicken pox. Why
does he need a vaccine?"
d. Last time we were here, he had a slight fever after the vaccines. Can I
give him acetaminophen if it happens again?"
32.
A client asks for assistance with correctly preparing bottles of formula for
her baby. Which of the following statements should the nurse include as
part of teaching?
a. If commercial formula is unavailable, substitute one-half of the amount
with cow or goat's milk.
b. Formula must be sterilized before feeding.
c. Never heat a bottle of formula in the microwave
d. Always boil tap water before using it to mix formula
33.
A client who has entered the hospital for surgery tells the nurse that he
wants to try and quit smoking. What is the most appropriate action of the
nurse?
a. Ask the client if he would like more information about smoking cessation
programs
b. Assist the client with throwing out any cigarettes that he has with him
c. Notify the physician that the client needs a nicotine patch
d. Remind the client of the many negative impacts that smoking has on
health
34.
A nurse is providing care to a 7-year old child in the emergency room.
Which of the following interventions may be most helpful in this situation?
a. Distract the child with a toy that has flashing lights
b. Provide treatments with the parents out of the room if possible
c. Explain the process of treatment in simple terms
d. Avoid talking about the child's concerns related to treatment
35.
A client presents with several areas of blotchy skin that has decreased
pigmentation when compared with the rest of his skin color. Which
condition is this client most likely exhibiting?
a. Erythema
b. Carotenemia
c. Vitiligo
d. Nevi
36.
Which of the following persons is at highest risk of developing type 2
diabetes?
a. A 40-year old Caucasian man with a BMI of 27
b. A 48-year old Hispanic woman with low levels of HDL cholesterol
c. A 39-year old Asian woman who recently had a baby weighing 8 lbs, 2
oz.
d. A 50-year old Caucasian man with low levels of LDL cholesterol
37.
In which of the following methods should a nurse assess for scoliosis in a
child?
a. The child should stand with both arms reaching forward while the nurse
measures the difference in arm lengths
b. The child should stand with her back against the wall while the nurse
views her from the side
c. The child should bend over at the waist while the nurse looks for
asymmetry in the back
d. The child should sit in a chair while the nurse checks for both feet to be
flat on the floor
38.
Which of the following is an example of a natural family planning method?
a. Basal body temperature
b. Intrauterine device
c. Periodic abstinence
d. All of the above
e. Both a and c
39.
A client who suffers from a neuromuscular disability wants to try
Feldenkrais to increase some flexibility. Which of the following best
describes this alternative healing method?
a. The client uses mind/body exploration to increase awareness
b. Fine needles are placed along certain points in the body to promote
energy flow
c. Intravenous injections of amino acids work to detoxify the body
d. Magnets are applied to parts of the body that are causing the greatest
issues
40.
Which of the following is an example of a teratogen?
a. Colace
b. Diphenhydramine
c. Warfarin
d. Acetaminophen
41.
In infants and children, most cardiac arrests result from:
a. Ventricular fibrillation.
b. Ventricular tachycardia.
c. Respiratory failure or shock.
d. None of the above
42.
An 8-year-old child has been diagnosed with infectious conjunctivitis.
Discharge instructions will include:
a. Good hand hygiene is critical.
b. The child should be kept home from school for a week.
c. Antibiotic drops or ointments will not be effective.
d. Eyes should be irrigated with sterile saline.
43.
You have been caring for a 6-year-old patient who has been diagnosed with
mild food poisoning. The child is alert, mucous membranes are moist, and
skin turgor is within normal limits. He is being sent home with family.
Instructions for this patient are likely to include all of the following
EXCEPT:
a. Stay hydrated by frequently drinking sips of clear liquids.
b. Do not eat solid foods while nauseous or vomiting.
c. Give over the counter medications to stop any diarrhea
d. Begin a BRAT diet after all nausea and vomiting have passed.
44.
A child is being discharged to home with a diagnosis of ringworm.
Discharge instructions should include the information that:
a. The infection is caused by a worm and cannot be passed from person to
person.
b. The infection is caused by a virus and can be passed from person to
person.
c. The infection is caused by a bacteria and cannot be passed from person to
person.
d. The infection is caused by a fungus and can be passed from person to
person.
45.
A child presented to the ED with itchy scalp, irritation of the scalp, and
infected areas on the child's head. Assessment reveals lice and nits in the
child's hair. Discharge instructions will include:
a. Permethrin 10% applied to hair and body after shower and shampoo
b. Manual removal of nits must be done for several days to ensure they do
not hatch
c. Washing sheets and towels in hot water
d. Child should not return to school until all lice and nits are gone
46.
Johnny Tate, a 2 year old boy, is hospitalized with pneumonia. This child
will most likely _________.
a. lie quietly as the nurse listens to his lung.
b. ask many questions about what the nurse is doing
c. fuss, cry and push the nurse away
d. plays cheerfully with a stethoscope
47.
At what age does a child begin to accept the fact that death is permanent?
a. Less than 5 years old
b. 5-9 years old
c. 9-12 years old
d. 12-18 years old
48.
Identify the age group with the correct range of years.
a. Infancy: Up to 6 months of age
b. Pre-School Child: 3 to 6 years of age
c. Adolescent: 13 to 18 years of age
d. Elderly: Over 60 years of age
49.
Identify the developmental task with the correct age group.
a. Infancy: autonomy
b. Toddler: initiative
c. Pre-School Child: trust
d. School age child: industry
50.
Your 47 year old patient is concerned about guiding the next generation?
What developmental task is this 47 year old patient addressing?
a. Generativity
b. Initiative
c. Industry
d. Ego integrity
51.
Your 2 year old pediatric patient is always saying "No" to your requests.
What should you do?
a. Report this abnormal negatively to the nurse
b. Scold that child and tell them that they must cooperate
c. Tell the parents to discipline the child for this negativity
d. Understand that the child is seeking autonomy which is normal
52.
The gradual decrease of the body's temperature after death is called
____________.
a. rigor mortis
b. algor mortis
c. livor mortis
d. shrouding
53.
Rigor mortis occurs about________ hours after death.
a. 0-1
b. 3-4
c. 5-7
d. 9-12
54.
Some people have dyspnea at the end of life. Dyspnea is difficulty
___________.
a. walking
b. breathing
c. talking
d. eating
55.
At the end of life, many people have a fear of __________.
a. insects
b. rejection
c. acceptance
d. being alone
56.
You are caring for Judy F. She is at the end of life. A lot of visitors are
seeing her. You notice that she is giving things, like her jewelry, to her
visitors. What should you do?
a. Tell her to stop giving away her valuable jewelry.
b. Take the jewelry away from the visitors.
c. Understand that she is confused.
d. Nothing. This is normal at the end of life.
57.
Which fact about the end of life is true?
a. All people at the end of life are religious.
b. All people at the end of life are spiritual.
c. Some people are not religious or spiritual.
d. Family members do not have spiritual needs.
58.
Many people at the end of life fear being alone. What can you, as the nurse,
do to lessen this fear?
a. Keep the patient in their bed at the nursing station.
b. Require that the family stay with the patient 24/7.
c. Ask a visitor from another room to visit with the patient.
d. Sit and talk or listen to the patient as much as possible.
59.
A "Living Will" is another term for ________________.
a. DNR
b. advance directives
c. NPO
d. at the end of life
60.
Another term for "health care proxy" is _______________.
a. medical power of attorney
b. durable power of attorney
c. limited power of attorney
d. a living will
61.
Of the following, which would be important to include as nursing
interventions when caring for the patient with delayed growth and
development?
a. Assessment of baseline mental/emotional status
b. Caregiver/parent input
c. Assessment of baseline physical status/limitations
d. All of the above
62.
Geriatric failure to thrive (GFTT) has 4 major characteristics. Of the
following, which is NOT one of them?
a. Impaired physical function
b. Malnutrition
c. Cardiovascular disease
d. Cognitive impairment
63.
Your patient is concerned about their health insurance and the costs
associated with their hospital care. Which of Maslow's needs is your patient
expressing?
a. Physical needs
b. Security needs
c. Self actualization
d. Self esteem and the esteem of other
64.
Verbal bullying, among school aged children, threatens which of Maslow's
needs?
a. Physical needs
b. Self actualization needs
c. Love and belonging needs
d. Safety needs
65.
Physical bullying, among school aged children, threatens which of
Maslow's needs?
a. Physical needs
b. Love and belonging needs
c. Safety needs
d. All of the above
66.
Your patient has had a very full and rewarding life. She has had a lot of
success in her personal and professional life. She has achieved all of her
goals and she has maximized her potential. This patient can be best
described as a person who has achieved Maslow's___________.
a. self actualization
b. exploration
c. closeness
d. protection
TEST ANSWER KEYS
The Study Mode and Test Mode exams contain the same exact questions in
the same numbered orders. Please use the answers in the Study Mode
sections to correct your Tests Mode exams.
CONCLUSION
As mentioned before, confidence is the key. What better why to give
yourself confidence than to have this book along with the questions and
answers BEFORE you take the exam. Knowing exactly what to expect on
the day of your exam will boost your confidence level.
Thank you again! We hope this book will give you the confidence needed to
pass your exam and become a successful licensed professional.
LIMITS OF LIABILITY
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used their best efforts in preparing this program. The author and publisher
make no representation or warranties with respect to the accuracy,
applicability, fitness or completeness of the contents of this program. They
disclaim any warranties (expressed or implied), merchantability or fitness
for any particular purpose. The author and publisher shall in no event be
held liable for any loss or damages, including, but not limited to special,
incidental, consequential or other damages. This document contains
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