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Q. 1
The nurse is caring for a Patient after a motor vehicle accident. The
client has a fractured tibia, and bone is noted protruding through the skin.
Which action is of priority?
A. Provide manual traction above and below
the leg
B. Cover the bone area with a sterile
dressing
C. Apply an ACE bandage around the entire
lower limb
D. Place the client in the prone position
Ans B
Q. 2. The RN on the oncology unit is
preparing to mix and administer amphotericin B to a Patient .Which action is
contraindicated for administering this drug IV?
A. Mix the drug with normal saline
solution
B. Administer the drug over 4–6 hours
C. Hydrate with IV fluids 2 hours before
the infusion
D. Premedicate the client with ordered
acetaminophen and diphenhydramine
Ans A
Q. 3. A nurse is administering a blood
transfusion to a Patient on the oncology
unit. Which clinical manifestation indicates an acute hemolytic reaction to the
blood?
A. Low back pain
B. A temperature of 101°F
C. Urticaria
D. Neck vein distention
Ans A
Q. 4 The nurse caring for a Patient
diagnosed with metastatic cancer of the bone is exhibiting mental confusion and
a BP of 150/100. Which laboratory value would correlate with the client’s
symptoms reflecting a com-mon complication with this diagnosis?
A. Potassium 5.2mEq/L
B. Calcium 13mg/dL
C. Inorganic phosphorus 1.7mEq/L
D. Sodium 138mEq/L
Ans B
Q.5 A Patient with a stroke and
malnutrition has been placed on Total Parenteral Nutrition (TPN). The nurse
notes air entering the Patient via the central
line. Which initial action is most appropriate?
A. Notify the physician
B. Elevate the head of the bed
C. Place the client in the left lateral
decubitus position
D. Stop the TPN and hang D5 1/2 NS
Ans C
Q.6 The nurse is preparing a Patient for
cervical uterine radiation implant insertion. Which will be included in the
teaching plan?
A. TV or telephone use will not be allowed
while the implant is in place.
B. A Foley catheter is usually inserted.
C. A high-fiber diet is recommended.
D. Excretions will be considered
radioactive.
Ans B
Q.7 The nurse is caring for a Patient with
a head injury who has an intracranial pressure monitor in place. Assessment
reveals an ICP reading of 66. What is the nurse’s best action?
A. Notify the physician
B. Record the reading as the only action
C. Turn the client and recheck the reading
D. Place the client supine
Ans A
Q. 8 The nurse is caring for a Patient
with leukemia who is receiving the drug doxorubicin. Which toxic effects of
this drug would be reported to the physician immediately?
A. Rales and distended neck veins
B. Red discoloration of the urine and
output of 75mL the previous hour
C. Nausea and vomiting D. Elevated BUN and
dry, flaky skin
Ans A
Q. 9 A Patient has developed diabetes insipidous
after removal of a pituitary tumor. Which finding would the nurse expect?
A. Polyuria
B. Hypertension
C. Polyphagia
D. Hyperkalemia
Ans A
Q.10 A Patient with cancer received
platelet infusions 24 hours ago. Which of the following assessment findings
would indicate the most therapeutic effect from the transfusions?
A. Hgb level increase from 8.9 to 10.6
B. Temperature reading of 99.4°F
C. White blood cell count of 11,000
D. Decrease in oozing of blood from IV
site
Ans D
Q.11 A Patient is admitted with Parkinson’s disease who has
been taking Carbidopa/levodopa (Sinemet) for 1 year. Which clinical
manifestation would be most important to report?
A. Dry mouth
B. Spasmodic eye winking
C. Dark urine
D. Dizziness
Ans B
Q.12 The nurse who is caring for a
Patient with cancer notes a WBC of 500
on the laboratory results. Which intervention would be most appropriate to
include in the Patient’s plan of care?
A. Assess temperature every 4 hours
because of risk for hypothermia
B. Instruct the client to avoid large
crowds and people who are sick
C. Instruct in the use of a soft
toothbrush
D. Assess for hematuria
Ans B
Q.13 A Patient with Crohn’s disease
requires TPN to provide adequate nutrition. The nurse finds the TPN bag empty.
What fluid would the nurse select to hang until another bag is prepared in the
pharmacy?
A. Lactated Ringers
B. Normal saline
C. D10W
D. Normosol R
Ans C
Q. 14 The nurse is caring for a Patient
with possible cervical cancer. What clinical data would the nurse most likely
find in the Patient ’s history?
A. Post-coital vaginal bleeding
B. Nausea and vomiting
C. Foul-smelling vaginal discharge
D. Hyperthermia
Ans A
Q.15 The nurse caring for a Patient with
myasthenia gravis recognizes which of
the following as the priority nursing diagnosis?
A. Risk for injury
B. Acute pain
C. Ineffective airway clearance
D. Impaired mobility
Ans C
Q.16 A Patient is scheduled to undergo a
bone marrow aspiration from the sternum. What position would the nurse assist
the client into for this procedure?
A. Dorsal recumbent
B. Supine
C. Fowler’s
D. Lithotomy
Ans C
Q.17 The nurse is caring for a Patient
with a head injury who has increased ICP. The physician plans to reduce the
cerebral edema by constricting cerebral blood vessels. Which physician order
would serve this purpose?
A. Hyperventilation per mechanical
ventilation
B. Insertion of a ventricular shunt
C. Furosemide D. Solumedrol
Ans A
Q.18 A Patient with a T6 injury 6 months
ago develops facial flushing and a BP of 210/106. After elevating the head of
the bed, which is the most appropriate nursing action?
A. Notify the physician
B. Assess the client for a distended
bladder
C. Apply oxygen at 3L/min
D. Increase the IV fluids
Ans B
Q.19 The nurse is performing an admission
history for a Patient recovering from a
stroke. Medication history reveals the drug clopidogrel . Which clinical
manifestation alerts the nurse to an adverse effect of this drug?
A. Epistaxis
B. Abdominal distention
C. Nausea
D. Hyperactivity
Ans A
Q.20 The nurse caring for a Patient with a head injury would recognize which
assessment finding as the most indicative of increased ICP?
A. Nausea and vomiting
B. Headache
C. Dizziness
D. Papilledema
Ans D
Q.21
A Patient with angina is experiencing migraine headaches. The physician
has prescribed Sumatriptan succinate . Which nursing action is most
appropriate?
A. Call the physician to question the
prescription order
B. Try to obtain samples for the client to
take home
C. Perform discharge teaching regarding
this drug
D. Consult social services for financial
assistance with obtaining the drug
Ans A
Q.22
A Patient with COPD is in respiratory failure. Which of the following
results would be the most sensitive indicator that the client requires a
mechani-cal ventilator?
A. PCO2 58
B. SaO2 90
C. PH 7.23
D. HCO3 30
Ans C
Q. 23 The nurse in the emergency room is
caring for a Patient with multiple rib fractures and a pulmonary contusion.
Assessment reveals a respiratory rate of 38, a heart rate of 136, and
restlessness. Which associated assessment finding would require immediate
intervention?
A. Occasional hemoptysis
B. Midline trachea with wheezing on
auscultation
C. Subcutaneous air and absent breath
sounds
D. Pain when breathing deeply, with rales
in the upper lobes
Ans C
Q.24 The nurse is caring for a Patient
with myasthenias gravis who is having trouble breathing. The nurse would
encourage which of the following positions for maximal lung expansion?
A. Supine with no pillow, to maintain
patent airway
B. Side-lying with back support
C. Prone with head turned to one side
D. Sitting or in high Fowler’s
Ans D
Q. 25
The nurse is caring for Patients on a respiratory unit. Upon receiving
the following client reports, which client should be seen first?
A. Client with emphysema expecting
discharge
B. Bronchitis client receiving IV
antibiotics
C. Bronchitis client with edema and neck
vein distention
D. COPD client with PO2 of 85
Ans C
Q. 26
A Patient has sustained a severe head injury and damaged the
preoccipital lobe. The nurse should remain particularly alert for which of the
follow-ing problems?
A. Visual impairment
B. Swallowing difficulty
C. Impaired judgment
D. Hearing impairment
Ans A
Q. 27
The nurse is caring for a Patient with epilepsy who is to receive
Dilantin 100mg IV push. The client has an IV of D51/2NS infusing at 100mL/hr.
When administering the Dilantin, the nurse should first:
A. Obtain an ambu bag and put it at
bedside
B. Insert a 16g IV catheter
C. Flush the IV line with normal saline
D. Premedicate with phenergan IV push
Ans C
Q.28
A Patient with increased intracranial pressure is receiving Mannitol and
Lasix. The nurse recognizes that these two drugs are given to reverse which
effect?
A. Energy failure
B. Excessive intracellular calcium
accumulation
C. Cellular edema
D. Excessive glutamate release
Ans C
Q.29 The nurse is assessing a Patient upon
arrival to the emergency department. Partial airway obstruction is suspected.
Which clinical manifestation is a late sign of airway obstruction?
A. Rales auscultated in breath sounds
B. Restlessness
C. Cyanotic ear lobes
D. Inspiratory stridor
Ans C
Q.30 The nurse is working in the trauma
unit of the emergency room when a 24-year-old female is admitted after an MVA.
The Patient is bleeding profusely and a blood transfusion is ordered. Which
would the nurse be pre-pared to administer without a type and crossmatch?
A. AB positive
B. AB negative
C. O positive
D. O negative
Ans D
Q.31 When preparing a Patient for magnetic
resonance imaging, the nurse should implement which of the following?
A. Obtain informed consent and administer
atropine 0.4mg
B. Scrub the injection site for 15 minutes
C. Remove any jewelry and inquire about
metal implants
D. Administer Benadryl 50mg/mL IV
Ans C
Q.32 Upon admission to the hospital, a
Patient reports having ―the worst headache I’ve ever had. The nurse should give
the highest priority to:
A. Administering pain medication
B. Starting oxygen
C. Performing neuro checks
D. Inserting a Foley catheter
Ans C
Q.33 The nurse is caring for a Patient
with an acoustic neuroma brain tumor. The location of this tumor warrants which
of the following nursing diagnosis as the highest priority?
A. High risk for constipation
B. Fluid volume deficit
C. Ineffective coping
D. High risk for injury
Ans D
Q. 34 The i Patient s admitted to the ER
with multiple rib fractures on the right. The nurse’s assessment reveals that
an area over the right clavicle is puffy and that there is a ―crackling‖ noise
with palpation. The nurse should further assess the client for which of the
following problems?
A. Flail chest
B. Subcutaneous emphysema
C. Infiltrated subclavian IV
D. Pneumothorax
Ans D
Q.35 A Patient has an order for Demerol
75mg and atropine 0.4mg IM as a pre-operative medication. The Demerol vial
contains 50mg/mL, and atropine is available 0.4mg/mL. How many milliliters will
the nurse administer in total?
A. 1.0
B. 1.7
C. 2.5
D. 3.0
Ans C
Q.36 Nimodipine is ordered for the Patient
with a ruptured cerebral aneurysm. The nurse recognizes that the desired effect
of this drug is to:
A. Prevent the influx of calcium into
cells
B. Restore the client’s blood pressure to
a normal reading
C. Prevent the inflammatory process
D. Dissolve the clot that has formed
Ans A
Q.37 A is Patient admitted to the hospital
with seizures. The client has jerking of the right arm and twitching of the
face, but is alert and aware of the seizure. This behavior is characteristic of
which type of seizure?
A. Absence
B. Complex partial
C. Simple partial
D. Tonic-clonic
Ans C
Q.38 The intensive care unit is full and
the emergency room just called in a report on a ventilator-dependent Patient
who is being admitted to the medical surgical unit. It would be essential that
the nurse have which piece of equipment at the Patient ’s bedside?
A. Cardiac monitor
B. Intravenous controller
C. Manual resuscitator
D. Oxygen by nasal cannula
Ans C
Q.39 The nurse is caring for a Patient on
a ventilator that is set on intermittent mandatory ventilation (IMV).
Assessment on the ventilator is IMV mode of 8 breaths per minute. The nurse
assesses the Patient’s respiratory rate of 13 per minute. These findings
indicate that:
A. The client is fighting the ventilator.
B. Pressure support ventilation is being
used.
C. Additional breaths are being delivered
by the ventilator.
D. The client is breathing five additional
breaths on his own.
Ans D
Q.40 The nurse has given instructions on
pursed-lip breathing to a client with COPD. Which statement by the Patient
would indicate effective teaching?
A. I should inhale through my mouth.
B. I should tighten my abdominal muscles
with inhalation.
C. I should contract my abdominal muscles
with exhalation.
D. I should make inhalation twice as long
as exhalation.
Ans D
Q.41 A Patient is receiving aminophylline
IV. The nurse monitors the theophylline blood level and assesses that the level
is within therapeutic range when it is:
A. 5ug/mL
B. 8ug/mL
C. 15ug/mL
D. 25ug/Ml
Ans C
Q.42 The nurse is assessing the arterial
blood gases (ABG) of a chest trauma Patient with the results of pH 7.35, PO2
85, PCO2 55, and HCO3 27. These ABG values indicate that the client is in:
A. Uncompensated respiratory acidosis
B. Uncompensated metabolic acidosis
C. Compensated respiratory acidosis
D. Compensated metabolic acidosis
Ans C
Q. 43 A pneumonectomy is performed on a
Patient with lung cancer. Which of the following would probably be omitted from
the client’s plan of care?
A. Closed chest drainage
B. Pain-control measures
C. Supplemental oxygen
D. Coughing and deep-breathing
exercises
Ans A
Q.44 When planning the care for a Patient
after a posterior fossa (infratentorial) craniotomy, which action is
contraindicated?
A. Keeping the client flat on one side
B. Elevating the head of the bed 30°
C. Log-rolling or turning as a unit
D. Keeping the neck in a neutral
position
Ans B
Q.45 The nurse is performing discharge
teaching on a Patient with ulcerative colitis who has been placed on a
low-residue diet. Which food would need to be eliminated from this Patient ’s
diet?
A. Roasted chicken
B. Noodles
C. Cooked broccoli
D. Roast beef
Ans C
Q.46 The nurse is assisting a Patient with
diverticulitis to select appropriate foods. Which food should be avoided?
A. Bran
B. Fresh peach
C. Tomato and cucumber salad
D. Dinner roll
Ans C
Q.47 A Patient is admitted with a possible
bowel obstruction. Which question during the nursing history is least helpful
in obtaining information regarding this diagnosis?
A. Tell me about your pain.
B. What does your vomit look like?
C. Describe your usual diet.
D. Have you noticed an increase in
abdominal size?
Ans C
Q. 48 The nurse is caring for a Patient
with epilepsy who is being treated with carbamazepine . Which laboratory value
might indicate a serious side effect of this drug?
A. BUN 10mg/dL
B. Hemoglobin 13.0gm/dL
C. WBC 4,000/mm3
D. Platelets 200,000/mm3
Ans C
Q.49 A Patient is admitted with a tumor in
the parietal lobe. Which symptoms would be expected due to this tumor’s
location?
A. Hemiplegia
B. Aphasia
C. Paresthesia
D. Nausea
Ans C
Q.50 A Patient weighing 150 pounds has
received burns over 50% of his body at 1200 hours. Using the Parkland formula,
calculate the expected amount of fluid that the client should receive by 2000
hours.
A. 3,400
B. 6,800
C. 10,200
D. 13,600
Ans B
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