1001. A 6-month-old client Baby Sistofi is admitted with possible
intussuception. Which question during the nursing history is least
helpful in obtaining information regarding this diagnosis?
Select one:
A. “Tell me about his pain.”
B. “What does his vomit look like?”
C. “Describe his usual diet.”
D. None of the above
Select one:
A. “Tell me about his pain.”
B. “What does his vomit look like?”
C. “Describe his usual diet.”
D. None of the above
1002.
A 70-year-old male who is recovering from a stroke exhibits signs of
unilateral neglect. Which behavior is suggestive of unilateral neglect?
Select one:
A. The client is unable to distinguish between two tactile stimuli presented simultaneously.
B. The client is unable to complete a range of vision without turning his head side to side.
C. The client is observed shaving only one side of his face.
D. None of the above
Select one:
A. The client is unable to distinguish between two tactile stimuli presented simultaneously.
B. The client is unable to complete a range of vision without turning his head side to side.
C. The client is observed shaving only one side of his face.
D. None of the above
1003. To ensure safety while administering a nitroglycerine patch, the nurse should:
Select one:
A. Wash the area thoroughly with soap and rinse with hot water
B. Shave the area where the patch will be applied
C. Wear gloves
D. None of the above
Select one:
A. Wash the area thoroughly with soap and rinse with hot water
B. Shave the area where the patch will be applied
C. Wear gloves
D. None of the above
1004. If the nurse is unable to illicit the deep tendon reflexes of the patella, the nurse should ask the client to:
Select one:
A. Cross the legs at the ankles
B. Grimace the facial muscles
C. Pull against the palms
D. None of the above
Select one:
A. Cross the legs at the ankles
B. Grimace the facial muscles
C. Pull against the palms
D. None of the above
1005. A client is being monitored using a central venous pressure monitor. If the pressure is 2cm of water, the nurse should:
Select one:
A. Slow the intravenous infusion
B. Listen to the lungs for rales
C. Call the doctor immediately
D. None of the above
Select one:
A. Slow the intravenous infusion
B. Listen to the lungs for rales
C. Call the doctor immediately
D. None of the above
1006. The nurse overhears the patient care assistant speaking harshly to the client with dementia. The charge nurse should:
Select one:
A. Initiate a group session with the nursing assistant
B. Change the nursing assistant’s assignment
C. Explore the interaction with the nursing assistant
D. None of the above
Select one:
A. Initiate a group session with the nursing assistant
B. Change the nursing assistant’s assignment
C. Explore the interaction with the nursing assistant
D. None of the above
1007.
The nurse is performing an assessment of an elderly client with a total
hip repair. Based on this assessment, the nurse decides to medicate the
client with an analgesic. Which finding most likely prompted the nurse
to decide to administer the analgesic?
Select one:
A. The client grimaces during care.
B. The client’s pupils are dilated.
C. The client is unable to concentrate.
D. None of the above
Select one:
A. The client grimaces during care.
B. The client’s pupils are dilated.
C. The client is unable to concentrate.
D. None of the above
1008.
The doctor orders 2% nitroglycerin ointment in a 1-inch dose every 12
hours. Proper application of nitroglycerin ointment includes:
Select one:
A. Limiting applications to the chest
B. Rubbing it into the skin
C. Rotating application sites
D. None of the above
Select one:
A. Limiting applications to the chest
B. Rubbing it into the skin
C. Rotating application sites
D. None of the above
1009.
The nurse witnesses the nursing assistant hitting the client in the
long-term care facility. The nursing assistant can be charged with:
Select one:
A. Tort
B. Negligence
C. Assault
D. None of the above
Select one:
A. Tort
B. Negligence
C. Assault
D. None of the above
1010.
Nurse Bernard is making initial rounds on a client with a C5 fracture
and crutchfield tongs. Which equipment should be kept at the bedside?
Select one:
A. A pair of forceps
B. A torque wrench
C. A pair of wire cutters
D. None of the above
Select one:
A. A pair of forceps
B. A torque wrench
C. A pair of wire cutters
D. None of the above
1011.
The nurse is providing discharge teaching for a client taking
dissulfiram (Antabuse). The nurse should instruct the client to avoid
eating:
Select one:
A. Peanuts, dates, raisins
B. Pickles, salad with vinaigrette dressing, beef
C. Figs, chocolate, eggplant
D. None of the above
Select one:
A. Peanuts, dates, raisins
B. Pickles, salad with vinaigrette dressing, beef
C. Figs, chocolate, eggplant
D. None of the above
1012.
The client is admitted from the emergency room with multiple injuries
sustained from an auto accident. His doctor prescribes a histamine
blocker. The reason for this order is:
Select one:
A. To treat general discomfort
B. To correct electrolyte imbalances
C. To prevent stress ulcers
D. None of the above
Select one:
A. To treat general discomfort
B. To correct electrolyte imbalances
C. To prevent stress ulcers
D. None of the above
1013.
The nurse is assisting in the care of a patient with diverticulosis.
Which of the following assessment findings would necessitate a report to
the doctor?
Select one:
A. Constipation alternating with diarrhea
B. Bowel sounds of 5–20 seconds
C. Hemoglobin 26% and hematocrit 32
D. None of the above
Select one:
A. Constipation alternating with diarrhea
B. Bowel sounds of 5–20 seconds
C. Hemoglobin 26% and hematocrit 32
D. None of the above
1014. The nurse is caring for the client with a mastectomy. Which action would be contraindicated?
Select one:
A. Elevating the arm on the side of the mastectomy
B. Positioning the client on the unaffected side
C. Taking the blood pressure in the side of the mastectomy
D. None of the above
Select one:
A. Elevating the arm on the side of the mastectomy
B. Positioning the client on the unaffected side
C. Taking the blood pressure in the side of the mastectomy
D. None of the above
1015.
A 25-year-old male is brought to the emergency room with a piece of
metal in his eye. Which action by the nurse is correct?
Select one:
A. Use a magnet to remove the object.
B. Rinse the eye thoroughly with saline.
C. Cover both eyes with paper cups.
D. None of the above
Select one:
A. Use a magnet to remove the object.
B. Rinse the eye thoroughly with saline.
C. Cover both eyes with paper cups.
D. None of the above
1016.
A client has been receiving cyanocobalamine (B12) injections for the
past 6 weeks. Which laboratory finding indicates that the medication is
having the desired effect?
Select one:
A. Neutrophil count of 60%
B. Monocyte count of 2%
C. Reticulocyte count of 1%
D. None of the above
Select one:
A. Neutrophil count of 60%
B. Monocyte count of 2%
C. Reticulocyte count of 1%
D. None of the above
1017.
Due to a high census, it has been necessary for a number of clients to
be transferred to other units within the hospital. Which client should
be transferred to the postpartum unit?
Select one:
A. A 66-year-old female with a gastroenteritis
B. A 27-year-old male with severe depression
C. A 40-year-old female with a hysterectomy
D. None of the above
Select one:
A. A 66-year-old female with a gastroenteritis
B. A 27-year-old male with severe depression
C. A 40-year-old female with a hysterectomy
D. None of the above
1018.
The nurse is planning care for the patient with celiac disease. In
teaching about the diet, the nurse should instruct the patient to avoid
which of the following for breakfast?
Select one:
A. Cream of wheat
B. Banana
C. Puffed rice
D. None of the above
Select one:
A. Cream of wheat
B. Banana
C. Puffed rice
D. None of the above
1019.
The licensed practical nurse is observing a graduate nurse as she
assesses the central venous pressure. Which observation would indicate
that the graduate needs further teaching?
Select one:
A. The graduate turns the stop-cock to the off position from the IV fluid to the client.
B. The graduate instructs the client to perform the Valsalva maneuver during the CVP reading.
C. The graduate places the client in a supine position to read the manometer.
D. None of the above
Select one:
A. The graduate turns the stop-cock to the off position from the IV fluid to the client.
B. The graduate instructs the client to perform the Valsalva maneuver during the CVP reading.
C. The graduate places the client in a supine position to read the manometer.
D. None of the above
1020.
An elderly client is diagnosed with ovarian cancer. She has surgery
followed by chemotherapy with a fluorouracil (Adrucil) IV. What should
the nurse do if she notices crystals and cloudiness in the IV
medication?
Select one:
A. Discard the solution and order a new bag
B. Continue the infusion and document the finding
C. Warm the solution
D. None of the above
Select one:
A. Discard the solution and order a new bag
B. Continue the infusion and document the finding
C. Warm the solution
D. None of the above
1021.
The graduate licensed practical nurse is assigned to care for the
client on ventilator support, pending organ donation. Which goal should
receive priority?
Select one:
A. Maintain the client’s systolic blood pressure at 70mmHg or greater
B. Maintain the client’s urinary output greater than 300cc per hour
C. Maintain the client’s body temperature of greater than 33°F rectal
D. None of the above
Select one:
A. Maintain the client’s systolic blood pressure at 70mmHg or greater
B. Maintain the client’s urinary output greater than 300cc per hour
C. Maintain the client’s body temperature of greater than 33°F rectal
D. None of the above
1022.
Nurse Phoebe is working in the emergency room when a client arrives
with severe burns of the left arm, hands, face, and neck. Which action
should receive priority?
Select one:
A. Starting an IV
B. Obtaining blood gases
C. Applying oxygen
D. None of the above
Select one:
A. Starting an IV
B. Obtaining blood gases
C. Applying oxygen
D. None of the above
1023.
A client with osteomylitis has an order for a trough level to be done
because he is taking Gentamycin. When should the nurse call the lab to
obtain the trough level?
Select one:
A. Before the first dose
B. 30 minutes after the first dose
C. 30 minutes before the fourth dose
D. None of the above
Select one:
A. Before the first dose
B. 30 minutes after the first dose
C. 30 minutes before the fourth dose
D. None of the above
1024.
The nurse is caring for a patient with a colostomy. The patient asks,
“Will I ever be able to swim again?” The nurse’s best response would be:
Select one:
A. No, you should avoid getting the colostomy wet.
B. Yes, you should be able to swim again, even with the colostomy.
C. You should avoid immersing the colostomy in water.
D. None of the above
Select one:
A. No, you should avoid getting the colostomy wet.
B. Yes, you should be able to swim again, even with the colostomy.
C. You should avoid immersing the colostomy in water.
D. None of the above
1025.
The registered nurse is conducting an in-service for colleagues about
peptic ulcers. The nurse would be correct in identifying which of the
following as a causative factor?
Select one:
A. H. influenza
B. H. pylori
C. E. coli
D. None of the above
Select one:
A. H. influenza
B. H. pylori
C. E. coli
D. None of the above
1026.
The client with a myocardial infarction comes to the nurse’s station
stating that he is ready to go home because there is nothing wrong with
him. Which defense mechanism is the client using?
Select one:
A. Denial
B. Conversion reaction
C. Rationalization
D. None of the above
Select one:
A. Denial
B. Conversion reaction
C. Rationalization
D. None of the above
1027.
The client is receiving total parenteral nutrition (TPN). Which lab
test should be evaluated while the client is receiving TPN?
Select one:
A. Hemoglobin
B. Blood glucose
C. Creatinine
D. None of the above
Select one:
A. Hemoglobin
B. Blood glucose
C. Creatinine
D. None of the above
1028. The client has an order for FeSo4 liquid. Which method of administration would be best?
Select one:
A. Administer the medication with milk
B. Administer the medication with orange juice
C. Administer the medication with a meal
D. None of the above
Select one:
A. Administer the medication with milk
B. Administer the medication with orange juice
C. Administer the medication with a meal
D. None of the above
1029. Which laboratory test would be the least effective in making the diagnosis of a myocardial infarction?
Select one:
A. Troponin
B. Myoglobin
C. AST
D. None of the above
Select one:
A. Troponin
B. Myoglobin
C. AST
D. None of the above
1030.
When assessing a client for risk of hyperphosphatemia, which piece of
information is most important for the nurse to obtain?
Select one:
A. A history of minimal physical activity
B. A history of radiation treatment in the neck region
C. A history of recent orthopedic surgery
D. None of the above
Select one:
A. A history of minimal physical activity
B. A history of radiation treatment in the neck region
C. A history of recent orthopedic surgery
D. None of the above
1031.
A 20-year-old is admitted to the rehabilitation unit following a
motorcycle accident. Which would be the appropriate method for measuring
the client for crutches?
Select one:
A. Measuring five finger breaths under the axilla
B. Measuring 3 inches under the axilla
C. Measuring the client with the elbows flexed 10°
D. None of the above
Select one:
A. Measuring five finger breaths under the axilla
B. Measuring 3 inches under the axilla
C. Measuring the client with the elbows flexed 10°
D. None of the above
1032.
The nurse is caring for a client with a diagnosis of hepatitis who is
experiencing pruritis. Which would be the most appropriate nursing
intervention?
Select one:
A. Suggest that the client take warm showers B.I.D.
B. Add baby oil to the client’s bath water
C. Apply powder to the client’s skin
D. None of the above
Select one:
A. Suggest that the client take warm showers B.I.D.
B. Add baby oil to the client’s bath water
C. Apply powder to the client’s skin
D. None of the above
1033. Which of the following roommates would be most suitable for the client with myasthenia gravis?
Select one:
A. A client with Crohn’s disease
B. A client with pylonephritis
C. A client with hypothyroidism
D. None of the above
Select one:
A. A client with Crohn’s disease
B. A client with pylonephritis
C. A client with hypothyroidism
D. None of the above
1034. The nurse identifies ventricular tachycardia on the heart monitor. Which action should the nurse prepare to take?
Select one:
A. Administer an antiarrythmic medication such as Lidocaine
B. Administer atropine sulfate
C. Check the potassium level
D. None of the above
Select one:
A. Administer an antiarrythmic medication such as Lidocaine
B. Administer atropine sulfate
C. Check the potassium level
D. None of the above
1035. A client with cancer develops xerostomia. The nurse can help alleviate the discomfort associated with xerostomia by:
Select one:
A. Splinting swollen joints
B. Administering analgesic medications
C. Providing saliva substitute
D. None of the above
Select one:
A. Splinting swollen joints
B. Administering analgesic medications
C. Providing saliva substitute
D. None of the above
1036. Which of the following lab studies should be done periodically if the client is taking sodium warfarin (Coumadin)?
Select one:
A. White blood cell count
B. Blood glucose
C. Stool specimen for occult blood
D. None of the above
Select one:
A. White blood cell count
B. Blood glucose
C. Stool specimen for occult blood
D. None of the above
1037. The client with brain cancer refuses to care for herself. Which action by the nurse would be best?
Select one:
A. Talk to the client and explain the need for self-care
B. Explore the reason for the lack of motivation seen in the client
C. Alternate nurses caring for the client so that the staff will not get tired of caring for this client
D. None of the above
Select one:
A. Talk to the client and explain the need for self-care
B. Explore the reason for the lack of motivation seen in the client
C. Alternate nurses caring for the client so that the staff will not get tired of caring for this client
D. None of the above
1038. Which of the following roommates would be best for the client newly admitted with gastric resection?
Select one:
A. A client with Crohn’s disease
B. A client with gastritis
C. A client with phlebitis
D. None of the above
Select one:
A. A client with Crohn’s disease
B. A client with gastritis
C. A client with phlebitis
D. None of the above
1039.
The nurse is teaching a group of new graduates about the safety needs
of the client receiving chemotherapy. Before administering chemotherapy,
the nurse should:
Select one:
A. Administer an antiemetic
B. Administer pain medication
C. Administer a bolus of IV fluid
D. None of the above
Select one:
A. Administer an antiemetic
B. Administer pain medication
C. Administer a bolus of IV fluid
D. None of the above
1040.
A 60-year-old diabetic is taking glyburide (Diabeta) 1.25mg daily to
treat Type II diabetes mellitus. Which statement indicates the need for
further teaching?
Select one:
A. I will keep candy with me just in case my blood sugar drops.
B. I need to stay out of the sun as much as possible.
C. I often skip dinner because I don’t feel hungry.
D. None of the above
Select one:
A. I will keep candy with me just in case my blood sugar drops.
B. I need to stay out of the sun as much as possible.
C. I often skip dinner because I don’t feel hungry.
D. None of the above
1041.
Isoniazid (INH) has been prescribed for a family member exposed to
tuberculosis. The nurse is aware that the length of time that the
medication will be taken is:
Select one:
A. 6 months
B. 3 months
C. 18 months
D. None of the above
Select one:
A. 6 months
B. 3 months
C. 18 months
D. None of the above
1042. The nurse is assisting a client with diverticulosis to select appropriate foods. Which food should be avoided?
Select one:
A. Bran
B. Fresh peaches
C. Cucumber salad
D. None of the above
Select one:
A. Bran
B. Fresh peaches
C. Cucumber salad
D. None of the above
1043.
The physician has ordered atropine sulfate 0.4mg IM before surgery. The
medication is supplied in 0.8mg per milliliter. The nurse should
administer how many milliliters of the medication?
Select one:
A. 0.5mL
B. 1mL
C. 0.25mL
D. None of the above
Select one:
A. 0.5mL
B. 1mL
C. 0.25mL
D. None of the above
1044. The home health nurse is planning for the day’s visits. Which client should be seen first?
Select one:
A. The 5-month-old discharged 1 week ago with pneumonia who is being treated with amoxicillin liquid suspension
B. The 30-year-old with an exacerbation of multiple sclerosis being treated with cortisone via a centrally placed venous catheter
C. The 78-year-old who had a gastrectomy 3 weeks ago with a PEG tube
D. None of the above
Select one:
A. The 5-month-old discharged 1 week ago with pneumonia who is being treated with amoxicillin liquid suspension
B. The 30-year-old with an exacerbation of multiple sclerosis being treated with cortisone via a centrally placed venous catheter
C. The 78-year-old who had a gastrectomy 3 weeks ago with a PEG tube
D. None of the above
1045.
A client is admitted to the acute care unit. Initial laboratory values
reveal serum sodium of 170meq/L. What behavior changes would be most
common for this client?
Select one:
A. Depression
B. Anger
C. Mania
D. None of the above
Select one:
A. Depression
B. Anger
C. Mania
D. None of the above
1046.
The client is admitted with a BP of 210/120. Her doctor orders
furosemide (Lasix) 40mg IV stat. How should the nurse administer the
prescribed furosemide to this client?
Select one:
A. By giving it over 1–2 minutes
B. By hanging it IV piggyback
C. With normal saline only
D. None of the above
Select one:
A. By giving it over 1–2 minutes
B. By hanging it IV piggyback
C. With normal saline only
D. None of the above
1047. The schizophrenic client has become disruptive and requires seclusion. Which staff member can institute seclusion?
Select one:
A. The licensed practical nurse
B. The security guard
C. The registered nurse
D. None of the above
Select one:
A. The licensed practical nurse
B. The security guard
C. The registered nurse
D. None of the above
1048. The nurse is assigning staff for the day. Which assignment should be given to the nursing assistant?
Select one:
A. Taking the vital signs of the 10-year-old with a 2-day post-appendectomy
B. Administering medication to the 2-year-old with periorbital cellulites
C. Taking the vital signs of the 5-month-old with bronchiolitis
D. None of the above
Select one:
A. Taking the vital signs of the 10-year-old with a 2-day post-appendectomy
B. Administering medication to the 2-year-old with periorbital cellulites
C. Taking the vital signs of the 5-month-old with bronchiolitis
D. None of the above
1049. The nurse understands that the diagnosis of oral cancer is confirmed with:
Select one:
A. Biopsy
B. Scrape cytology
C. Gram Stain
D. None of the above
Select one:
A. Biopsy
B. Scrape cytology
C. Gram Stain
D. None of the above
1050.
The client is scheduled to have an intravenous cholangiogram. Before
the procedure, the nurse should assess the patient for:
Select one:
A. Reactions to blood transfusions
B. Shellfish allergies
C. Egg allergies
D. None of the above
Select one:
A. Reactions to blood transfusions
B. Shellfish allergies
C. Egg allergies
D. None of the above
1051.
Nurse Bernice is performing discharge teaching on a client with
diverticulitis who has been placed on a low-roughage diet. Which food
would have to be eliminated from this client’s diet?
Select one:
A. Roasted chicken
B. Cooked broccoli
C. Noodles
D. None of the above
Select one:
A. Roasted chicken
B. Cooked broccoli
C. Noodles
D. None of the above
1052. A 6-year-old with cerebral palsy functions at the level of an 18-month-old. Which finding would support that assessment?
Select one:
A. She pulls a toy behind her.
B. She can copy a horizontal or vertical line.
C. She dresses herself.
D. None of the above
Select one:
A. She pulls a toy behind her.
B. She can copy a horizontal or vertical line.
C. She dresses herself.
D. None of the above
1053.
A client with suspected renal disease is to undergo a renal biopsy. The
nurse plans to include which statement in the teaching session?
Select one:
A. “You will be given some medication to anesthetize the area.”
B. “You will be sitting for the examination procedure.”
C. “Portions of the procedure will cause pain or discomfort.”
D. None of the above
Select one:
A. “You will be given some medication to anesthetize the area.”
B. “You will be sitting for the examination procedure.”
C. “Portions of the procedure will cause pain or discomfort.”
D. None of the above
1054.
A new nursing graduate indicates in charting entries that he is a
licensed practical nurse, although he has not yet received the results
of the licensing exam. The graduate’s action can result in what type of
charge:
Select one:
A. Tort
B. Malpractice
C. Fraud
D. None of the above
Select one:
A. Tort
B. Malpractice
C. Fraud
D. None of the above
1055.
The client with cirrhosis of the liver is receiving Lactulose. The
nurse is aware that the rationale for the order for Lactulose is:
Select one:
A. To lower the uric acid level
B. To lower the ammonia level
C. To lower the blood glucose level
D. None of the above
Select one:
A. To lower the uric acid level
B. To lower the ammonia level
C. To lower the blood glucose level
D. None of the above
1056.
A client who has chosen to breastfeed complains to the nurse that her
nipples became very sore while she was breastfeeding her older child.
Which measure will help her to avoid soreness of the nipples?
Select one:
A. Feeding the baby during the first 48 hours after delivery
B. Applying warm, moist soaks to the breast several times per day
C. Breaking suction by placing a finger between the baby’s mouth and the breast when she terminates the feeding
D. None of the above
Select one:
A. Feeding the baby during the first 48 hours after delivery
B. Applying warm, moist soaks to the breast several times per day
C. Breaking suction by placing a finger between the baby’s mouth and the breast when she terminates the feeding
D. None of the above
1057.
The physician has ordered a culture for the client with suspected
gonorrhea. The nurse should obtain which type of culture?
Select one:
A. Genital secretions
B. Blood
C. Nasopharyngeal secretions
D. None of the above
Select one:
A. Genital secretions
B. Blood
C. Nasopharyngeal secretions
D. None of the above
1058.
The client with AIDS tells the nurse that he has been using acupuncture
to help with his pain. The nurse should question the client regarding
this treatment because acupuncture:
Select one:
A. Uses pressure from the fingers and hands to stimulate the energy points in the body
B. Uses needles to stimulate certain points on the body to treat pain
C. Uses oils extracted from plants and herbs
D. None of the above
Select one:
A. Uses pressure from the fingers and hands to stimulate the energy points in the body
B. Uses needles to stimulate certain points on the body to treat pain
C. Uses oils extracted from plants and herbs
D. None of the above
1059.
The nurse is preparing to administer a feeding via a nasogastric tube.
The nurse would perform which of the following before initiating the
feeding?
Select one:
A. Assess for tube placement by aspirating stomach content
B. Administer feeding with 50% H20 concentration
C. Place the patient in a left-lying position
D. None of the above
Select one:
A. Assess for tube placement by aspirating stomach content
B. Administer feeding with 50% H20 concentration
C. Place the patient in a left-lying position
D. None of the above
1060. Which client can best be assigned to the newly licensed practical nurse?
Select one:
A. The client with diverticulitis
B. The client post–coronary bypass
C. The client receiving chemotherapy
D. None of the above
Select one:
A. The client with diverticulitis
B. The client post–coronary bypass
C. The client receiving chemotherapy
D. None of the above
1061.
The nurse recognizes that which of the following would be most
appropriate to wear when providing direct care to a client with a cough?
Select one:
A. Mask
B. Gown
C. Gloves
D. None of the above
Select one:
A. Mask
B. Gown
C. Gloves
D. None of the above
1062. Vitamin K (aquamephyton) is administered to a newborn shortly after birth for which of the following reasons?
Select one:
A. To replace electrolytes
B. To prevent dehydration
C. To facilitate clotting
D. None of the above
Select one:
A. To replace electrolytes
B. To prevent dehydration
C. To facilitate clotting
D. None of the above
1063. A client with cancer is to undergo an intravenous pyelogram. The nurse should:
Select one:
A. Force fluids 24 hours before the procedure
B. Hold medication that affects the central nervous system for 12 hours pre- and post-test
C. Ask the client to void immediately before the study
D. None of the above
Select one:
A. Force fluids 24 hours before the procedure
B. Hold medication that affects the central nervous system for 12 hours pre- and post-test
C. Ask the client to void immediately before the study
D. None of the above
1064. Which is true regarding the administration of antacids?
Select one:
A. Antacids should be administered without regard to mealtimes.
B. Antacids should be administered with each meal and snack of the day.
C. Antacids should be administered within 1–2 hours of all other medications.
D. None of the above
Select one:
A. Antacids should be administered without regard to mealtimes.
B. Antacids should be administered with each meal and snack of the day.
C. Antacids should be administered within 1–2 hours of all other medications.
D. None of the above
1065.
An obstetrical client decides to have an epidural anesthetic to relieve
pain during labor. Following administration of the anesthesia, the
nurse should:
Select one:
A. Monitor the client for orthostatic hypotension
B. Monitor the client for respiratory depression
C. Monitor the client for seizures
D. None of the above
Select one:
A. Monitor the client for orthostatic hypotension
B. Monitor the client for respiratory depression
C. Monitor the client for seizures
D. None of the above
1066.
The client with a recent liver transplant asks the nurse how long he
will have to take cyclosporine (Sandimmune). Which response is correct?
Select one:
A. The rest of his life
B. 1 year
C. 10 years
D. None of the above
Select one:
A. The rest of his life
B. 1 year
C. 10 years
D. None of the above
1067.
The doctor has ordered a patient-controlled analgesia (PCA) pump for
the client with chronic pain. The client asks the nurse if he can become
overdosed with pain medication using this machine. The nurse
demonstrates understanding of the PCA if she states:
Select one:
A. “The machine will administer one large dose every 4 hours to relieve your pain.”
B. “The machine will administer only the amount that you need to control your pain without your taking any action.”
C. “The machine has a locking device that prevents overdosing to occur.”
D. None of the above
Select one:
A. “The machine will administer one large dose every 4 hours to relieve your pain.”
B. “The machine will administer only the amount that you need to control your pain without your taking any action.”
C. “The machine has a locking device that prevents overdosing to occur.”
D. None of the above
1068. The client with brain cancer refuses to care for herself. Which action by the nurse would be best?
Select one:
A. Talk to the client and explain the need for self-care
B. Alternate nurses caring for the client so that the staff will not get tired of caring for this client
C. Explore the reason for the lack of motivation seen in the client
D. None of the above
Select one:
A. Talk to the client and explain the need for self-care
B. Alternate nurses caring for the client so that the staff will not get tired of caring for this client
C. Explore the reason for the lack of motivation seen in the client
D. None of the above
1069.
A client visits the clinic after the death of a parent. Which statement
made by the client’s sister signifies abnormal grieving?
Select one:
A. “Sally has not been sad at all by Daddy’s death. She acts like nothing has happened.”
B. “She really had a hard time after Daddy’s funeral. She said that she had a sense of longing.”
C. “My sister still has episodes of crying, and it’s been 3 months since Daddy died.”
D. None of the above
Select one:
A. “Sally has not been sad at all by Daddy’s death. She acts like nothing has happened.”
B. “She really had a hard time after Daddy’s funeral. She said that she had a sense of longing.”
C. “My sister still has episodes of crying, and it’s been 3 months since Daddy died.”
D. None of the above
1070.
The nurse is caring for a client with a malignancy. The classification
of the primary tumor is Tis. The nurse should plan care for a tumor:
Select one:
A. With increasing lymph node involvement
B. That is in situ
C. That cannot be assessed
D. None of the above
Select one:
A. With increasing lymph node involvement
B. That is in situ
C. That cannot be assessed
D. None of the above
1071.
The nurse is assessing the client recently returned from surgery. The
nurse is aware that the best way to assess pain is to:
Select one:
A. Ask the client to rate his pain on a scale of 0–5
B. Watch the client’s facial expression
C. Take the blood pressure, pulse, and temperature
D. None of the above
Select one:
A. Ask the client to rate his pain on a scale of 0–5
B. Watch the client’s facial expression
C. Take the blood pressure, pulse, and temperature
D. None of the above
1072. The client arrives in the emergency room with a hyphema. Which action by the nurse would be best?
Select one:
A. Place the client in a supine position and apply heat to the knee
B. Insert a Foley catheter and measure the intake and output
C. Elevate the head of the bed and apply ice to the eye
D. None of the above
Select one:
A. Place the client in a supine position and apply heat to the knee
B. Insert a Foley catheter and measure the intake and output
C. Elevate the head of the bed and apply ice to the eye
D. None of the above
1073.
The client has an order for heparin to prevent post-surgical thrombi.
Immediately following a heparin injection, the nurse should:
Select one:
A. Aspirate for blood
B. Check the pulse rate
C. Check the site for bleeding
D. None of the above
Select one:
A. Aspirate for blood
B. Check the pulse rate
C. Check the site for bleeding
D. None of the above
1074.
A removal of the left lower lobe of the lung is performed on a client
with lung cancer. Which post-operative measure would usually be included
in the plan?
Select one:
A. Closed chest drainage
B. A tracheostomy
C. A mediastinal tube
D. None of the above
Select one:
A. Closed chest drainage
B. A tracheostomy
C. A mediastinal tube
D. None of the above
1075. The client with an ileostomy is being discharged. Which teaching should be included in the plan of care?
Select one:
A. Irrigate the ileostomy daily.
B. Use Karaya powder to seal the bag.
C. Stomahesive is the best skin protector.
D. None of the above
Select one:
A. Irrigate the ileostomy daily.
B. Use Karaya powder to seal the bag.
C. Stomahesive is the best skin protector.
D. None of the above
1076.
The client is receiving heparin for thrombophlebitis of the left lower
extremity. Which of the following drugs reverses the effects of heparin?
Select one:
A. Streptokinase
B. Cyanocobalamine
C. Protamine sulfate
D. None of the above
Select one:
A. Streptokinase
B. Cyanocobalamine
C. Protamine sulfate
D. None of the above
1077.
A 4-year-old male is admitted to the unit with nephotic syndrome. He is
extremely edematous. To decrease the discomfort associated with scrotal
edema, the nurse should:
Select one:
A. Apply heat to the abdominal area
B. Apply ice to the scrotum
C. Elevate the scrotum on a small pillow
D. None of the above
Select one:
A. Apply heat to the abdominal area
B. Apply ice to the scrotum
C. Elevate the scrotum on a small pillow
D. None of the above
1078.
A home health nurse is making preparations for morning visits. Which
one of the following clients should the nurse visit first?
Select one:
A. A client with brain attack (stroke) with tube feedings
B. A client with congestive heart failure complaining of nighttime dyspnea
C. A client with Parkinson’s disease
D. None of the above
Select one:
A. A client with brain attack (stroke) with tube feedings
B. A client with congestive heart failure complaining of nighttime dyspnea
C. A client with Parkinson’s disease
D. None of the above
1079.
The doctor has ordered a Transcutaneous Electrical Nerve Stimulation
(TENS) unit for the client with chronic back pain. The nurse teaching
the client with a TENS unit should tell the client:
Select one:
A. “Please report skin irritation to the doctor.”
B. “You may be electrocuted if you use water with this unit.”
C. “The unit may be used anywhere on the body without fear of adverse reactions.”
D. None of the above
Select one:
A. “Please report skin irritation to the doctor.”
B. “You may be electrocuted if you use water with this unit.”
C. “The unit may be used anywhere on the body without fear of adverse reactions.”
D. None of the above
1080. The first exercise that should be performed by the client who had a mastectomy is:
Select one:
A. Sweeping the floor
B. Squeezing a ball
C. Combing her hair
D. None of the above
Select one:
A. Sweeping the floor
B. Squeezing a ball
C. Combing her hair
D. None of the above
1081. Which of the following post-operative diets is most appropriate for the client who has had a hemorroidectomy?
Select one:
A. Bland
B. Clear-liquid
C. Low-residue
D. None of the above
Select one:
A. Bland
B. Clear-liquid
C. Low-residue
D. None of the above
1082.
The child with seizure disorder is being treated with Dilantin
(phenytoin). Which of the following statements by the patient’s mother
indicates to the nurse that the patient is experiencing a side effect of
Dilantin therapy?
Select one:
A. “She sleeps quite a bit of the time.”
B. “Her gums look too big for her teeth.”
C. “She is very irritable lately.”
D. None of the above
Select one:
A. “She sleeps quite a bit of the time.”
B. “Her gums look too big for her teeth.”
C. “She is very irritable lately.”
D. None of the above
1083.
The physician has ordered sodium warfarin (Coumadin) for the client
with thrombophlebitis. The order should be entered to administer the
medication at:
Select one:
A. 1700
B. 1200
C. 2100
D. None of the above
Select one:
A. 1700
B. 1200
C. 2100
D. None of the above
1084.
The client is taking rifampin 600mg po daily to treat his tuberculosis.
Which action by the nurse indicates understanding of the medication?
Select one:
A. Telling the client that the medication will need to be taken with juice
B. Telling the client that the medication will change the color of the urine
C. Telling the client to take the medication before going to bed at night
D. None of the above
Select one:
A. Telling the client that the medication will need to be taken with juice
B. Telling the client that the medication will change the color of the urine
C. Telling the client to take the medication before going to bed at night
D. None of the above
1085. The client is scheduled for a pericentesis. Which instruction should be given to the client before the exam?
Select one:
A. “You need to empty your bladder before the procedure.”
B. “You will be asleep during the procedure.”
C. “You will need to lay flat during the exam.”
D. None of the above
Select one:
A. “You need to empty your bladder before the procedure.”
B. “You will be asleep during the procedure.”
C. “You will need to lay flat during the exam.”
D. None of the above
1086.
The physician has ordered that the client’s medication be administered
intrathecally. The nurse is aware that medications will be administered
by which method?
Select one:
A. Intramuscularly
B. Into the cerebrospinal fluid
C. Intravenously
D. None of the above
Select one:
A. Intramuscularly
B. Into the cerebrospinal fluid
C. Intravenously
D. None of the above
1087.
The client is admitted to the hospital in chronic renal failure. A diet
low in protein is ordered. The rationale for alow-protein diet is:
Select one:
A. Protein breaks down into blood urea nitrogen and metabolic waste.
B. A high-protein diet decreases albumin production.
C. High protein increases the sodium and potassium levels.
D. None of the above
Select one:
A. Protein breaks down into blood urea nitrogen and metabolic waste.
B. A high-protein diet decreases albumin production.
C. High protein increases the sodium and potassium levels.
D. None of the above
1088.
The nurse is caring for a new mother, Mrs Ansong. The mother asks why
her baby has lost weight since he was born. The best explanation of the
weight loss is:
Select one:
A. The baby can lose up to 10% of weight due to meconium stool, loss of extracellular fluid, and initiation of breast-feeding.
B. The baby is hypoglycemic due to lack of glucose.
C. The baby is allergic to the formula the mother is giving him.
D. None of the above
Select one:
A. The baby can lose up to 10% of weight due to meconium stool, loss of extracellular fluid, and initiation of breast-feeding.
B. The baby is hypoglycemic due to lack of glucose.
C. The baby is allergic to the formula the mother is giving him.
D. None of the above
1089. Which of the following is the best indicator of the diagnosis of HIV?
Select one:
A. Western Blot
B. White blood cell count
C. ELISA
D. None of the above
Select one:
A. Western Blot
B. White blood cell count
C. ELISA
D. None of the above
1090.
During the change of shift, the oncoming nurse notes a discrepancy in
the number of Percocet (Oxycodone) listed and the number present in the
narcotic drawer. The nurse’s first action should be to:
Select one:
A. Notify the nursing supervisor
B. Notify the hospital pharmacist
C. Notify the Board of Nursing
D. None of the above
Select one:
A. Notify the nursing supervisor
B. Notify the hospital pharmacist
C. Notify the Board of Nursing
D. None of the above
1091.
The nurse is caring for a patient with suspected diverticulitis. The
nurse would be most prudent in questioning which of the following
diagnostic tests ordered?
Select one:
A. Colonoscopy
B. Barium enema
C. Complete blood count
D. None of the above
Select one:
A. Colonoscopy
B. Barium enema
C. Complete blood count
D. None of the above
1092.
The nurse is asked by the nurse aide, “Are peptic ulcers really caused
by stress?” The nurse would be correct in replying with which of the
following:
Select one:
A. “Peptic ulcers are associated with H. pylori, although there are other ulcers that are associated with stress.”
B. “Peptic ulcers are always caused from exposure to continual stress.”
C. “Peptic ulcers result from overeating fatty foods.”
D. None of the above
Select one:
A. “Peptic ulcers are associated with H. pylori, although there are other ulcers that are associated with stress.”
B. “Peptic ulcers are always caused from exposure to continual stress.”
C. “Peptic ulcers result from overeating fatty foods.”
D. None of the above
1093. The nurse is making assignments for the day. Which client should be assigned to the nursing assistant?
Select one:
A. A client with Alzheimer’s disease
B. A client with pneumonia
C. A client with appendicitis
D. None of the above
Select one:
A. A client with Alzheimer’s disease
B. A client with pneumonia
C. A client with appendicitis
D. None of the above
1094.
The nurse is visiting a home health client with osteoporosis. The
client has a new prescription for alendronate (Fosamax). Which
instruction should be given to the client?
Select one:
A. Avoid rapid movements after taking the medication
B. Take the medication with water only
C. Rest in bed after taking the medication for at least 30 minutes
D. None of the above
Select one:
A. Avoid rapid movements after taking the medication
B. Take the medication with water only
C. Rest in bed after taking the medication for at least 30 minutes
D. None of the above
1095. The nurse is preparing a client for mammography. To prepare the client for a mammogram, the nurse should tell the client:
Select one:
A. To restrict her fat intake for 1 week before the test
B. To omit creams, powders, or deodorants before the exam
C. That mammography replaces the need for self-breast exams
D. None of the above
Select one:
A. To restrict her fat intake for 1 week before the test
B. To omit creams, powders, or deodorants before the exam
C. That mammography replaces the need for self-breast exams
D. None of the above
1096.
The nurse is performing an assessment on a client with possible
pernicious anemia. Which data would support this diagnosis?
Select one:
A. A weight loss of 10 pounds in 2 weeks
B. A red, beefy tongue
C. Complaints of numbness and tingling in the extremities
D. None of the above
Select one:
A. A weight loss of 10 pounds in 2 weeks
B. A red, beefy tongue
C. Complaints of numbness and tingling in the extremities
D. None of the above
1097.
The nursing is participating in discharge teaching for the post-partal
client. The nurse is aware that an effective means of managing
discomfort associated with an episiotomy after discharge is:
Select one:
A. Sitz baths
B. Aspirin
C. Promethazine
D. None of the above
Select one:
A. Sitz baths
B. Aspirin
C. Promethazine
D. None of the above
1098. A 10-year-old is being treated for asthma. Before administering Theodur, the nurse should check the:
Select one:
A. Temperature
B. Urinary output
C. Pulse
D. None of the above
Select one:
A. Temperature
B. Urinary output
C. Pulse
D. None of the above
1099.
The nurse is taking the vital signs of the client admitted with cancer
of the pancreas. The nurse is aware that the fifth vital sign is:
Select one:
A. Pain
B. Anorexia
C. Insomnia
D. None of the above
Select one:
A. Pain
B. Anorexia
C. Insomnia
D. None of the above
1100.
The doctor has ordered 80mg of furosemide (Lasix) two times per day.
The nurse notes the patient’s potassium level to be 2.5meq/L. The nurse
should:
Select one:
A. Offer the patient a potassium-rich food
B. Withhold the drug and call the doctor
C. Administer the Lasix as ordered
D. None of the above
Select one:
A. Offer the patient a potassium-rich food
B. Withhold the drug and call the doctor
C. Administer the Lasix as ordered
D. None of the above
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