701. The nurse is caring for a client following the reimplantation
of the thumb and index finger. Which finding should be reported to the
physician immediately?
A. Temperature of 100°F
B. Coolness and discoloration of the digits
C. Complaints of pain
D. Difficulty moving the digits
A. Temperature of 100°F
B. Coolness and discoloration of the digits
C. Complaints of pain
D. Difficulty moving the digits
702. Which client is at greatest risk for a Caesarean section due to cephalopelvic disproportion (CPD)?
A. A 25-year-old gravida 2, para 1
B. A 30-year-old gravida 3, para 2
C. A 17-year-old gravida 1, para 0
D. A 32-year-old gravida 1, para 0
A. A 25-year-old gravida 2, para 1
B. A 30-year-old gravida 3, para 2
C. A 17-year-old gravida 1, para 0
D. A 32-year-old gravida 1, para 0
703.
The nurse is caring for a client with amyotrophic lateral sclerosis
(ALS, Lou Gehrig’s disease). The nurse should give priority to:
A. Assessing the client’s respiratory status
B. Providing an alternate means of communication
C. Referring the client and family to community support groups
D. Instituting a routine of active range-of-motion exercises
A. Assessing the client’s respiratory status
B. Providing an alternate means of communication
C. Referring the client and family to community support groups
D. Instituting a routine of active range-of-motion exercises
704.
The physician has ordered Claforan (cefotaxime) 1g every six hours. The
pharmacy sends the medication premixed in 100mL of D5W with
instructions to infuse the medication over one hour. The IV set delivers
20 drops per milliliter. The nurse should set the IV rate at:
A. 50 drops per minute
B. 33 drops per minute
C. 25 drops per minute
D. 12 drops per minute
A. 50 drops per minute
B. 33 drops per minute
C. 25 drops per minute
D. 12 drops per minute
705. When assessing the urinary output of a client who has had extracorporeal lithotripsy, the nurse can expect to find:
A. Cherry-red urine that gradually becomes clearer
B. Orange-tinged urine containing particles of calculi
C. Dark red urine that becomes cloudy in appearance
D. Dark, smoky-colored urine with high specific gravity
A. Cherry-red urine that gradually becomes clearer
B. Orange-tinged urine containing particles of calculi
C. Dark red urine that becomes cloudy in appearance
D. Dark, smoky-colored urine with high specific gravity
706. A client scheduled for an atherectomy asks the nurse about the procedure. The nurse understands that:
A. Plaque will be removed by rotational or directional catheters.
B. Plaque will be destroyed by a laser.
C. A balloon-tipped catheter will compress fatty lesions against the vessel wall.
D. Medication will be used to dissolve the build-up of plaque.
A. Plaque will be removed by rotational or directional catheters.
B. Plaque will be destroyed by a laser.
C. A balloon-tipped catheter will compress fatty lesions against the vessel wall.
D. Medication will be used to dissolve the build-up of plaque.
707.
An elderly client has a stage II pressure ulcer on her sacrum. During
assessment of the client’s skin, the nurse would expect to find:
A. A deep crater with a nonpainful wound base
B. A craterous area with a nonpainful wound base
C. Cracks and blisters with redness and induration
D. Nonblanchable redness with tenderness and pain
A. A deep crater with a nonpainful wound base
B. A craterous area with a nonpainful wound base
C. Cracks and blisters with redness and induration
D. Nonblanchable redness with tenderness and pain
708.
The physician has prescribed Cognex (tacrine) for a client with
dementia. The nurse should monitor the client for adverse reactions,
which include:
A. Hypoglycemia
B. Jaundice
C. Urinary retention
D. Tinnitus
A. Hypoglycemia
B. Jaundice
C. Urinary retention
D. Tinnitus
709. The suggested diet for a child with cystic fibrosis is one that contains:
A. High calories, high protein, moderate fat
B. High calories, moderate protein, low fat
C. Moderate calories, moderate protein, moderate fat
D. Low calories, high protein, low fat
A. High calories, high protein, moderate fat
B. High calories, moderate protein, low fat
C. Moderate calories, moderate protein, moderate fat
D. Low calories, high protein, low fat
710.
The physician has ordered a low-potassium diet for a client with acute
glomerulonephritis. Which snack is suitable for the client with
potassium restrictions?
A. Raisins
B. Orange
C. Apple
D. Banana
A. Raisins
B. Orange
C. Apple
D. Banana
711.
A client with increased intracranial pressure is placed on mechanical
ventilation with hyperventilation. The nurse knows that the purpose of
the hyperventilation is to:
A. Prevent the development of acute respiratory failure
B. Decrease cerebral blood flow
C. Increase systemic tissue perfusion
D. Prevent cerebral anoxia
A. Prevent the development of acute respiratory failure
B. Decrease cerebral blood flow
C. Increase systemic tissue perfusion
D. Prevent cerebral anoxia
712. The physician has ordered a blood test for H. pylori. The nurse should prepare the client by:
A. Withholding oral intake after midnight
B. Telling the client that no special preparation is needed
C. Explaining that a small dose of radioactive isotope will be used
D. Giving an oral suspension of glucose one hour before the test
A. Withholding oral intake after midnight
B. Telling the client that no special preparation is needed
C. Explaining that a small dose of radioactive isotope will be used
D. Giving an oral suspension of glucose one hour before the test
713. The nurse is preparing to give an oral potassium supplement. The nurse should give the medication:
A. Without diluting it
B. With 4oz. of juice
C. With water only
D. On an empty stomach
A. Without diluting it
B. With 4oz. of juice
C. With water only
D. On an empty stomach
714.
A client with acute alcohol intoxication is being treated for
hypomagnesemia. During assessment of the client, the nurse would expect
to find:
A. Bradycardia
B. Negative Chvostek’s sign
C. Hypertension
D. Positive Trousseau’s sign
A. Bradycardia
B. Negative Chvostek’s sign
C. Hypertension
D. Positive Trousseau’s sign
715.
The physician has ordered cultures for cytomegalovirus (CMV). Which
statement is true of the collection of cultures for cytomegalovirus?
A. Stool cultures are preferred for definitive diagnosis.
B. Pregnant caregivers may obtain cultures.
C. Collection of one specimen is sufficient.
D. Accurate diagnosis depends on fresh specimens.
A. Stool cultures are preferred for definitive diagnosis.
B. Pregnant caregivers may obtain cultures.
C. Collection of one specimen is sufficient.
D. Accurate diagnosis depends on fresh specimens.
716.
A home health nurse has four clients assigned for morning visits. The
nurse should give priority to visiting the client with:
A. Diabetes mellitus with a nongranulated ulcer of the right foot
B. Congestive heart failure who reports coughing up frothy sputum
C. Hemiplegia with tenderness in the right flank and cloudy urine
D. Rheumatoid arthritis with soft tissue swelling behind the right knee
A. Diabetes mellitus with a nongranulated ulcer of the right foot
B. Congestive heart failure who reports coughing up frothy sputum
C. Hemiplegia with tenderness in the right flank and cloudy urine
D. Rheumatoid arthritis with soft tissue swelling behind the right knee
717. Four clients are admitted to a medical unit. If only one private room is available, it should be assigned to:
A. The client with ulcerative colitis
B. The client with neutropenia
C. The client with cholecystitis
D. The client with polycythemia vera
A. The client with ulcerative colitis
B. The client with neutropenia
C. The client with cholecystitis
D. The client with polycythemia vera
718. The RN is making assignments for the morning staff. Which client should be cared for by the RN?
A. A client with hemianopsia
B. A client with asterixis
C. A client with akathesia
D. A client with hemoptysis
A. A client with hemianopsia
B. A client with asterixis
C. A client with akathesia
D. A client with hemoptysis
719. The nurse is reviewing the lab reports on several clients. Which one should be reported to the physician immediately?
A. A serum creatinine of 5.2mg/dL in a client with chronic renal failure
B. A positive C reactive protein in a client with rheumatic fever
C. A hematocrit of 52% in a client with gastroenteritis
D. A white cell count of 2,200cu/mm in a client taking Dilantin (phenytoin)
A. A serum creatinine of 5.2mg/dL in a client with chronic renal failure
B. A positive C reactive protein in a client with rheumatic fever
C. A hematocrit of 52% in a client with gastroenteritis
D. A white cell count of 2,200cu/mm in a client taking Dilantin (phenytoin)
720.
The following clients are to be assigned for daily care. The newly
licensed nurse should not be assigned to provide primary care for the
client with:
A. Full-thickness burns of the abdomen and upper thighs
B. A fractured hip scheduled for hip replacement
C. Ileal reservoir following a cystectomy
D. Noncardiogenic pulmonary edema (ARDS)
A. Full-thickness burns of the abdomen and upper thighs
B. A fractured hip scheduled for hip replacement
C. Ileal reservoir following a cystectomy
D. Noncardiogenic pulmonary edema (ARDS)
721. The RN is making assignments for clients hospitalized on a neurological unit. Which client should be assigned to the LPN?
A. A client with a C3 injury immobilized by Crutchfield tongs
B. A client with exacerbation of multiple sclerosis
C. A client with a lumbar laminectomy
D. A client with hemiplegia and a urinary tract infection
A. A client with a C3 injury immobilized by Crutchfield tongs
B. A client with exacerbation of multiple sclerosis
C. A client with a lumbar laminectomy
D. A client with hemiplegia and a urinary tract infection
722. The nurse has just received the change of shift report. The nurse should give priority to assessing the client with:
A. A thoracotomy with 110mL of drainage in the past hour
B. A cholecystectomy with an oral temperature of 100°F
C. A transurethral prostatectomy who complains of urgency to void
D. A stapedectomy who reports diminished hearing in the past hour
A. A thoracotomy with 110mL of drainage in the past hour
B. A cholecystectomy with an oral temperature of 100°F
C. A transurethral prostatectomy who complains of urgency to void
D. A stapedectomy who reports diminished hearing in the past hour
723.
A client with primary sclerosing cholangitis has received a liver
transplant. The nurse should give priority to assessing the client for
complications. Which findings are associated with an acute rejection of
the new liver?
A. Increased jaundice and prolonged prothrombin time
B. Fever and foul-smelling bile drainage
C. Abdominal distention and clay-colored stools
D. Increased uric acid and increased creatinine
A. Increased jaundice and prolonged prothrombin time
B. Fever and foul-smelling bile drainage
C. Abdominal distention and clay-colored stools
D. Increased uric acid and increased creatinine
724. The nurse is planning care for a client with adrenal insufficiency. The nurse should give priority to:
A. Monitoring the client for signs of dehydration
B. Promoting sleep and rest
C. Providing high-calorie snacks
D. Promoting a healthy body image
A. Monitoring the client for signs of dehydration
B. Promoting sleep and rest
C. Providing high-calorie snacks
D. Promoting a healthy body image
725.
A pediatric client with burns to the hands and arms has dressing
changes with Sulfamylon (mafenide acetate) cream. The nurse is aware
that the medication:
A. Will cause dark staining of the surrounding skin
B. Produces a cooling sensation when applied
C. Can alter the function of the thyroid
D. Produces a burning sensation when applied
A. Will cause dark staining of the surrounding skin
B. Produces a cooling sensation when applied
C. Can alter the function of the thyroid
D. Produces a burning sensation when applied
726.
The physician has ordered Dilantin (phenytoin) for a client with
generalized seizures. When planning the client’s care, the nurse should:
A. Maintain strict intake and output.
B. Check the pulse before giving the medication.
C. Administer the medication 30 minutes before meals.
D. Provide oral hygiene and gum care every shift.
A. Maintain strict intake and output.
B. Check the pulse before giving the medication.
C. Administer the medication 30 minutes before meals.
D. Provide oral hygiene and gum care every shift.
727.
The nurse is caring for a client receiving Capoten (captopril). The
nurse should be alert for adverse reactions to the drug, which include:
A. Increased red cell count
B. Decreased sodium level
C. Decreased white cell count
D. Increased calcium level
A. Increased red cell count
B. Decreased sodium level
C. Decreased white cell count
D. Increased calcium level
728.
A client receiving chemotherapy for breast cancer has an order for
Zofran (ondansetron) 8mg PO to be given 30 minutes before induction of
the chemotherapy. The purpose of the medication is to:
A. Prevent anemia
B. Promote relaxation
C. Prevent nausea
D. Increase neutrophil counts
A. Prevent anemia
B. Promote relaxation
C. Prevent nausea
D. Increase neutrophil counts
729. The physician has ordered Cortisporin ear drops for a two-year-old. To administer the ear drops, the nurse should:
A. Pull the ear down and back.
B. Pull the ear straight out.
C. Pull the ear up and back.
D. Leave the ear undisturbed.
A. Pull the ear down and back.
B. Pull the ear straight out.
C. Pull the ear up and back.
D. Leave the ear undisturbed.
730.
A client with Lyme’s disease is being treated with Achromycin
(tetracycline HCl). The nurse should tell the client that the medication
will be rendered ineffective if taken with:
A. Antacids
B. Salicylates
C. Antihistamines
D. Sedative-hypnotics
A. Antacids
B. Salicylates
C. Antihistamines
D. Sedative-hypnotics
731.
A client with schizophrenia has been taking Thorazine (chlorpromazine)
200mg four times a day. Which finding should be reported to the doctor
immediately?
A. The client complains of thirst.
B. The client has gained four pounds in the past two months.
C. The client complains of a sore throat and fever.
D. The client naps throughout the day.
A. The client complains of thirst.
B. The client has gained four pounds in the past two months.
C. The client complains of a sore throat and fever.
D. The client naps throughout the day.
732.
The doctor has prescribed Claritin (loratidine) for a client with
seasonal allergies. The feature that separates Claritin from other
antihistamines such as Benadryl (diphenhydramine) is that the
medication:
A. Is nonsedating
B. Stimulates appetite
C. Is used for motion sickness
D. Is less expensive
A. Is nonsedating
B. Stimulates appetite
C. Is used for motion sickness
D. Is less expensive
733.
A six-month-old is being treated for thrush with Nystatin (mycostatin)
oral suspension. The nurse should administer the medication by:
A. Placing it in a small amount of applesauce
B. Using a cotton-tipped swab
C. Adding it to the infant’s formula
D. Placing it in 2–3oz. of water
A. Placing it in a small amount of applesauce
B. Using a cotton-tipped swab
C. Adding it to the infant’s formula
D. Placing it in 2–3oz. of water
734.
A client with iron-deficiency anemia is taking an oral iron supplement.
The nurse should tell the client to take the medication with:
A. Orange juice
B. Water only
C. Milk
D. Apple juice
A. Orange juice
B. Water only
C. Milk
D. Apple juice
735.
A child is admitted to the emergency room following ingestion of a
bottle of medication containing acetaminophen. The antidote for
acetaminophen is:
A. Acetylcysteine
B. Deferoxamine
C. Edetate calcium disodium
D. Activated charcoal
A. Acetylcysteine
B. Deferoxamine
C. Edetate calcium disodium
D. Activated charcoal
736.
The nurse knows that a client with right-sided hemiplegia understands
teaching regarding ambulation with a cane if she states:
A. I will hold the cane in my right hand.
B. I will advance my cane and my right leg at the same time.
C. I will be able to walk only by using a walker.
D. I will hold the cane in my left hand.”
A. I will hold the cane in my right hand.
B. I will advance my cane and my right leg at the same time.
C. I will be able to walk only by using a walker.
D. I will hold the cane in my left hand.”
737.
A nursing assistant assigned to care for a client receiving linear
accelerator radium therapy for laryngeal cancer states, “I don’t want to
be assigned to that radioactive patient.” The best response by the
nurse is to:
A. Tell the nursing assistant that the client is not radioactive.
B. Tell the nursing assistant to wear a radiation badge to detect the amount of radiation that she is receiving.
C. Instruct her regarding the use of a lead-lined apron.
D. Ask a co-worker to care for the client.
A. Tell the nursing assistant that the client is not radioactive.
B. Tell the nursing assistant to wear a radiation badge to detect the amount of radiation that she is receiving.
C. Instruct her regarding the use of a lead-lined apron.
D. Ask a co-worker to care for the client.
738.
The nurse caring for a client scheduled for an angiogram should prepare
the client for the procedure by telling him to expect:
A. Dizziness as the dye is injected
B. Nausea and vomiting after the procedure is completed
C. A decreased heart rate for several hours after the procedure is completed
D. A warm sensation as the dye is injected
A. Dizziness as the dye is injected
B. Nausea and vomiting after the procedure is completed
C. A decreased heart rate for several hours after the procedure is completed
D. A warm sensation as the dye is injected
739.
A client with Parkinson’s disease complains of “choking” when he
swallows. Which intervention will improve the client’s ability to
swallow?
A. Withholding liquids until after meals
B. Providing semi-liquids when possible
C. Providing a full liquid diet
D. Offering small, more frequent meals
A. Withholding liquids until after meals
B. Providing semi-liquids when possible
C. Providing a full liquid diet
D. Offering small, more frequent meals
740.
Which of the following statements best explains the rationale for
placing the client in Trendelenburg position during the insertion of a
central line catheter?
A. It will facilitate catheter insertion.
B. It will make the client more comfortable during the insertion.
C. It will prevent the occurrence of ventricular tachycardia.
D. It will prevent the development of pulmonary embolus.
A. It will facilitate catheter insertion.
B. It will make the client more comfortable during the insertion.
C. It will prevent the occurrence of ventricular tachycardia.
D. It will prevent the development of pulmonary embolus.
741.
The doctor has ordered the removal of a Davol drain. Which of the
following instructions should the nurse give to the client before
removing the drain?
A. The client should be told to breathe normally.
B. The client should be told to take two or three deep breaths as the drain is being removed.
C. The client should be told to hold his breath as the drain is being removed.
D. The client should breathe slowly as the drain is being removed.
A. The client should be told to breathe normally.
B. The client should be told to take two or three deep breaths as the drain is being removed.
C. The client should be told to hold his breath as the drain is being removed.
D. The client should breathe slowly as the drain is being removed.
742. Which of the following findings is associated with right-sided heart failure?
A. Shortness of breath
B. Nocturnal polyuria
C. Daytime oliguria
D. Crackles in the lungs
A. Shortness of breath
B. Nocturnal polyuria
C. Daytime oliguria
D. Crackles in the lungs
743.
A client returns from surgery with a total knee replacement. Which of
the following findings requires immediate nursing intervention?
A. Bloody drainage of 30mL from the Davol drain is present.
B. The CPM is set on 90° flexion.
C. The client is unable to ambulate to the bathroom.
D. The client is complaining of muscle spasms.
A. Bloody drainage of 30mL from the Davol drain is present.
B. The CPM is set on 90° flexion.
C. The client is unable to ambulate to the bathroom.
D. The client is complaining of muscle spasms.
744. Which of the following postpartal clients is at greatest risk for hemorrhage?
A. A gravida 1 para 1 with an uncomplicated delivery of a 7-pound infant
B. A gravida 1 para 0 with a history of polycystic ovarian disease
C. A gravida 3 para 3 with a history of low–birth weight infants
D. A gravida 4 para 3 with a Caesarean section
A. A gravida 1 para 1 with an uncomplicated delivery of a 7-pound infant
B. A gravida 1 para 0 with a history of polycystic ovarian disease
C. A gravida 3 para 3 with a history of low–birth weight infants
D. A gravida 4 para 3 with a Caesarean section
745.
An infant with a ventricular septal defect is discharged with a
prescription for Lanoxin (digoxin) elixir 0.01mg PO q 12hrs. The bottle
is labeled 0.10mg per 1/2 tsp. The nurse should instruct the mother to:
A. Administer the medication using a nipple.
B. Administer the medication using the calibrated dropper in the bottle.
C. Administer the medication using a plastic baby spoon.
D. Administer the medication in a baby bottle with 1oz. of water.
A. Administer the medication using a nipple.
B. Administer the medication using the calibrated dropper in the bottle.
C. Administer the medication using a plastic baby spoon.
D. Administer the medication in a baby bottle with 1oz. of water.
746. An elderly client with glaucoma is scheduled for a cholecystectomy. Which medication order should the nurse question?
A. Demerol (meperidine)
B. Tagamet (cimetadine)
C. Atropine (atropine)
D. Phenergan (promethazine)
A. Demerol (meperidine)
B. Tagamet (cimetadine)
C. Atropine (atropine)
D. Phenergan (promethazine)
747. Which instruction would not be included in the discharge teaching of the client receiving Thorazine (chlorpromazine)?
A. You will need to wear protective clothing or a sunscreen when you are outside.
B. You will need to avoid eating aged cheese.
C. You should carry hard candy with you to decrease dryness of the mouth.
D. You should report a sign of infection immediately.
A. You will need to wear protective clothing or a sunscreen when you are outside.
B. You will need to avoid eating aged cheese.
C. You should carry hard candy with you to decrease dryness of the mouth.
D. You should report a sign of infection immediately.
748.
An elderly client who experiences nighttime confusion wanders from his
room into the room of another client. The nurse can best help with
decreasing the client’s confusion by:
A. Assigning a nursing assistant to sit with him until he falls asleep
B. Allowing the client to room with another elderly client
C. Administering a bedtime sedative
D. Leaving a nightlight on during the evening and night shifts
A. Assigning a nursing assistant to sit with him until he falls asleep
B. Allowing the client to room with another elderly client
C. Administering a bedtime sedative
D. Leaving a nightlight on during the evening and night shifts
749.
A four-year-old is scheduled for a routine tonsillectomy. Which of the
following lab findings should be reported to the doctor?
A. A hemoglobin of 12Gm
B. A platelet count of 200,000
C. A white blood cell count of 16,000
D. A urine specific gravity of 1.010
A. A hemoglobin of 12Gm
B. A platelet count of 200,000
C. A white blood cell count of 16,000
D. A urine specific gravity of 1.010
750.
A client with psychotic depression is receiving Haldol (haloperidol).
Which one of the following adverse effects is associated with the use of
haloperidol?
A. Akathisia
B. Cataracts
C. Diaphoresis
D. Polyuria
A. Akathisia
B. Cataracts
C. Diaphoresis
D. Polyuria
751.
A client is admitted to the emergency room with a gunshot wound to the
right arm. After dressing the wound and administering the prescribed
antibiotic, the nurse should:
A. Ask the client if he has any medication allergies.
B. Check the client’s immunization record.
C. Apply a splint to immobilize the arm.
D. Administer medication for pain.
A. Ask the client if he has any medication allergies.
B. Check the client’s immunization record.
C. Apply a splint to immobilize the arm.
D. Administer medication for pain.
752. The nurse is caring for a client with suspected endometrial cancer. Which symptom is associated with endometrial cancer?
A. Frothy vaginal discharge
B. Thick, white vaginal discharge
C. Purulent vaginal discharge
D. Watery vaginal discharge
A. Frothy vaginal discharge
B. Thick, white vaginal discharge
C. Purulent vaginal discharge
D. Watery vaginal discharge
753.
A client with Parkinson’s disease is scheduled for stereotactic
surgery. Which finding indicates that the surgery had its intended
effect?
A. The client no longer has intractable tremors.
B. The client has sufficient production of dopamine.
C. The client no longer requires any medication.
D. The client will have increased production of serotonin.
A. The client no longer has intractable tremors.
B. The client has sufficient production of dopamine.
C. The client no longer requires any medication.
D. The client will have increased production of serotonin.
754.
A client with AIDS asks the nurse why he cannot have a pitcher of water
left at his bedside. The nurse should tell the client that:
A. It would be best for him to drink ice water.
B. He should drink several glasses of juice instead.
C. It makes it easier to keep a record of his intake.
D. He should not drink water that has been sitting for a period of time.
A. It would be best for him to drink ice water.
B. He should drink several glasses of juice instead.
C. It makes it easier to keep a record of his intake.
D. He should not drink water that has been sitting for a period of time.
755.
An elderly client is diagnosed with interstitial cystitis. Which
finding differentiates interstitial cystitis from other forms of
cystitis?
A. The client is asymptomatic.
B. The urine is free of bacteria.
C. The urine contains blood.
D. Males are affected more often.
A. The client is asymptomatic.
B. The urine is free of bacteria.
C. The urine contains blood.
D. Males are affected more often.
756.
The mother of a male child with cystic fibrosis tells the nurse that
she hopes her son’s children won’t have the disease. The nurse is aware
that:
A. There is a 25% chance that his children will have cystic fibrosis.
B. Most of the males with cystic fibrosis are sterile.
C. There is a 50% chance that his children will be carriers.
D. Most males with cystic fibrosis are capable of having children, so genetic counseling is advised.
A. There is a 25% chance that his children will have cystic fibrosis.
B. Most of the males with cystic fibrosis are sterile.
C. There is a 50% chance that his children will be carriers.
D. Most males with cystic fibrosis are capable of having children, so genetic counseling is advised.
757.
A six-month-old is hospitalized with symptoms of botulism. What aspect
of the infant’s history is associated with Clostridium botulinum
infection?
A. The infant sucks on his fingers and toes.
B. The mother sweetens the infant’s cereal with honey.
C. The infant was switched to soy-based formula.
D. The father recently purchased an aquarium.
A. The infant sucks on his fingers and toes.
B. The mother sweetens the infant’s cereal with honey.
C. The infant was switched to soy-based formula.
D. The father recently purchased an aquarium.
758.
The mother of a six-year-old with autistic disorder tells the nurse
that her son has been much more difficult to care for since the birth of
his sister. The best explanation for changes in the child’s behavior
is:
A. The child did not want a sibling.
B. The child was not adequately prepared for the baby’s arrival.
C. The child’s daily routine has been upset by the birth of his sister.
D. The child is just trying to get the parent’s attention.
A. The child did not want a sibling.
B. The child was not adequately prepared for the baby’s arrival.
C. The child’s daily routine has been upset by the birth of his sister.
D. The child is just trying to get the parent’s attention.
759.
The parents of a child with cystic fibrosis ask what determines the
prognosis of the disease. The nurse knows that the greatest determinant
of the prognosis is:
A. The degree of pulmonary involvement
B. The ability to maintain an ideal weight
C. The secretion of lipase by the pancreas
D. The regulation of sodium and chloride excretion
A. The degree of pulmonary involvement
B. The ability to maintain an ideal weight
C. The secretion of lipase by the pancreas
D. The regulation of sodium and chloride excretion
760.
The nurse is assessing a client hospitalized with a duodenal ulcer.
Which finding should be reported to the doctor immediately?
A. BP 82/60, pulse 120
B. Pulse 68, respirations 24
C. BP 110/88, pulse 56
D. Pulse 82, respirations 16
A. BP 82/60, pulse 120
B. Pulse 68, respirations 24
C. BP 110/88, pulse 56
D. Pulse 82, respirations 16
761.
While caring for a client in the second stage of labor, the nurse
notices a pattern of early decelerations. The nurse should:
A. Notify the physician immediately.
B. Turn the client on her left side.
C. Apply oxygen via a tight face mask.
D. Document the finding on the flow sheet.
A. Notify the physician immediately.
B. Turn the client on her left side.
C. Apply oxygen via a tight face mask.
D. Document the finding on the flow sheet.
762.
The nurse is teaching the client with AIDS regarding needed changes in
food preparation. Which statement indicates that the client understands
the nurse’s teaching?
A. Adding fresh ground pepper to my food will improve the flavor.
B. Meat should be thoroughly cooked to the proper temperature.
C. Eating cheese and yogurt will prevent AIDS-related diarrhea.
D. It is important to eat four to five servings of fresh fruits and vegetables a day.
A. Adding fresh ground pepper to my food will improve the flavor.
B. Meat should be thoroughly cooked to the proper temperature.
C. Eating cheese and yogurt will prevent AIDS-related diarrhea.
D. It is important to eat four to five servings of fresh fruits and vegetables a day.
763.
The sputum of a client remains positive for the tubercle bacillus even
though the client has been taking Laniazid (isoniazid) in combination
with other antituberculars. The nurse recognizes that the client taking
isoniazid should have a negative sputum culture within:
A. Two weeks
B. Six weeks
C. Two months
D. Three months
A. Two weeks
B. Six weeks
C. Two months
D. Three months
764. Which person is at greatest risk for developing Lyme disease?
A. Computer programmer
B. Elementary teacher
C. Veterinarian
D. Landscaper
A. Computer programmer
B. Elementary teacher
C. Veterinarian
D. Landscaper
765.
The mother of a one-year-old wants to know when she should begin
toilet-training her child. The nurse’s response is based on the
knowledge that sufficient sphincter control for toilet training is
present by:
A. 12–15 months of age
B. 18–24 months of age
C. 26–30 months of age
D. 32–36 months of age
A. 12–15 months of age
B. 18–24 months of age
C. 26–30 months of age
D. 32–36 months of age
766.
The nurse is developing a plan of care for a client with a newly
created ileostomy. The priority nursing diagnosis for this client is:
A. Risk for deficient fluid volume related to excessive fluid loss from ostomy
B. Disturbed body image related to presence of ostomy
C. Risk for impaired skin integrity related to irritation from ostomy appliance
D. Deficient knowledge of ostomy care related to unfamiliarity with information resources
A. Risk for deficient fluid volume related to excessive fluid loss from ostomy
B. Disturbed body image related to presence of ostomy
C. Risk for impaired skin integrity related to irritation from ostomy appliance
D. Deficient knowledge of ostomy care related to unfamiliarity with information resources
767.
The physician has prescribed Cobex (cyanocobalamin) for a client
following a gastric resection. Which lab result indicates that the
medication is having its intended effect?
A. Neutrophil count of 4500cu mm
B. Hgb of 14.2g/dL
C. Platelet count of 250,000cu mm
D. Eosinophil count of 200cu mm
A. Neutrophil count of 4500cu mm
B. Hgb of 14.2g/dL
C. Platelet count of 250,000cu mm
D. Eosinophil count of 200cu mm
768.
A behavior-modification program has been started for an adolescent with
oppositional defiant disorder. Which statement describes the use of
behavior modification?
A. Distractors are used to interrupt repetitive or unpleasant thoughts.
B. Techniques using stressors and exercise are used to increase awareness of body defenses.
C. A system of tokens and rewards is used as positive reinforcement.
D. Appropriate behavior is learned through observing the action of models.
A. Distractors are used to interrupt repetitive or unpleasant thoughts.
B. Techniques using stressors and exercise are used to increase awareness of body defenses.
C. A system of tokens and rewards is used as positive reinforcement.
D. Appropriate behavior is learned through observing the action of models.
769. Following eruption of the primary teeth, the mother can promote chewing by giving the toddler:
A. Pieces of hot dog
B. Carrot sticks
C. Pieces of cereal
D. Raisins
A. Pieces of hot dog
B. Carrot sticks
C. Pieces of cereal
D. Raisins
770.
The nurse is infusing total parenteral nutrition (TPN). The primary
purpose for closely monitoring the client’s intake and output is:
A. To determine how quickly the client is metabolizing the solution
B. To determine whether the client’s oral intake is sufficient
C. To detect the development of hypovolemia
D. To decrease the risk of fluid overload
A. To determine how quickly the client is metabolizing the solution
B. To determine whether the client’s oral intake is sufficient
C. To detect the development of hypovolemia
D. To decrease the risk of fluid overload
771.
An obstetrical client with diabetes has an amniocentesis at 28 weeks
gestation. Which test indicates the degree of fetal lung maturity?
A. Alpha-fetoprotein
B. Estriol level
C. Indirect Coombs
D. Lecithin sphingomyelin ratio
A. Alpha-fetoprotein
B. Estriol level
C. Indirect Coombs
D. Lecithin sphingomyelin ratio
772. Which nursing assessment indicates that involutional changes have occurred in a client who is three days postpartum?
A. The fundus is firm and three finger widths below the umbilicus.
B. The client has a moderate amount of lochia serosa.
C. The fundus is firm and even with the umbilicus.
D. The uterus is approximately the size of a small grapefruit.
A. The fundus is firm and three finger widths below the umbilicus.
B. The client has a moderate amount of lochia serosa.
C. The fundus is firm and even with the umbilicus.
D. The uterus is approximately the size of a small grapefruit.
773.
When administering total parenteral nutrition, the nurse should assess
the client for signs of rebound hypoglycemia. The nurse knows that
rebound hypoglycemia occurs when:
A. The infusion rate is too rapid.
B. The infusion is discontinued without tapering.
C. The solution is infused through a peripheral line.
D. The infusion is administered without a filter.
A. The infusion rate is too rapid.
B. The infusion is discontinued without tapering.
C. The solution is infused through a peripheral line.
D. The infusion is administered without a filter.
774.
A client scheduled for disc surgery tells the nurse that she frequently
uses the herbal supplement kava-kava (piper methysticum). The nurse
should notify the doctor because kava-kava:
A. Increases the effects of anesthesia and post-operative analgesia
B. Eliminates the need for antimicrobial therapy following surgery
C. Increases urinary output, so a urinary catheter will be needed post-operatively
D. Depresses the immune system, so infection is more of a problem
A. Increases the effects of anesthesia and post-operative analgesia
B. Eliminates the need for antimicrobial therapy following surgery
C. Increases urinary output, so a urinary catheter will be needed post-operatively
D. Depresses the immune system, so infection is more of a problem
775.
The physician has ordered 50mEq of potassium chloride for a client with
a potassium level of 2.5mEq/L. The nurse should administer the
medication:
A. Slow, continuous IV push over 10 minutes
B. Continuous infusion over 30 minutes
C. Controlled infusion over five hours
D. Continuous infusion over 24 hours
A. Slow, continuous IV push over 10 minutes
B. Continuous infusion over 30 minutes
C. Controlled infusion over five hours
D. Continuous infusion over 24 hours
776.
The nurse reviewing the lab results of a client receiving Cytoxan
(cyclophosphamide) for Hodgkin’s lymphoma finds the following: WBC
4,200, RBC 3,800,000, platelets 25,000, and serum creatinine 1.0mg. The
nurse recognizes that the greatest risk for the client at this time is:
A. Overwhelming infection
B. Bleeding
C. Anemia
D. Renal failure
A. Overwhelming infection
B. Bleeding
C. Anemia
D. Renal failure
777. Which of the following is an adverse effect associated with the use of Adriamycin (doxorubicin)?
A. Ventricular arrhythmias
B. Alopecia
C. Leukopenia
D. Stomatitis
A. Ventricular arrhythmias
B. Alopecia
C. Leukopenia
D. Stomatitis
778.
A client with cervical cancer has a radioactive implant. Which
statement indicates that the client understands the nurse’s teaching
regarding radioactive implants?
A. I won’t be able to have visitors while getting radiation therapy.
B. I will have a urinary catheter while the implant is in place.
C. I can be up to the bedside commode while the implant is in place.
D. I won’t have any side effects from this type of therapy.
A. I won’t be able to have visitors while getting radiation therapy.
B. I will have a urinary catheter while the implant is in place.
C. I can be up to the bedside commode while the implant is in place.
D. I won’t have any side effects from this type of therapy.
779.
The nurse is teaching circumcision care to the mother of a newborn.
Which statement indicates that the mother needs further teaching?
A. I will apply a petroleum gauze to the area with each diaper change.
B. I will clean the area carefully with each diaper change.
C. I can place a heat lamp to the area to speed up the healing process.
D. I should carefully observe the area for signs of infection.
A. I will apply a petroleum gauze to the area with each diaper change.
B. I will clean the area carefully with each diaper change.
C. I can place a heat lamp to the area to speed up the healing process.
D. I should carefully observe the area for signs of infection.
780.
A client admitted for treatment of bacterial pneumonia has an order for
intravenous ampicillin. Which specimen should be obtained prior to
administering the medication?
A. Routine urinalysis
B. Complete blood count
C. Serum electrolytes
D. Sputum for culture and sensitivity
A. Routine urinalysis
B. Complete blood count
C. Serum electrolytes
D. Sputum for culture and sensitivity
781.
While obtaining information about the client’s current medication use,
the nurse learns that the client takes ginkgo to improve mental
alertness. The nurse should tell the client to:
A. Report signs of bruising or bleeding to the doctor.
B. Avoid sun exposure while using the herbal supplement.
C. Purchase only those brands with FDA approval.
D. Increase daily intake of vitamin E.
A. Report signs of bruising or bleeding to the doctor.
B. Avoid sun exposure while using the herbal supplement.
C. Purchase only those brands with FDA approval.
D. Increase daily intake of vitamin E.
782. A client with Hodgkin’s lymphoma is receiving Platinol (cisplatin). To help prevent nephrotoxicity, the nurse should:
A. Slow the infusion rate.
B. Make sure the client is well hydrated.
C. Record the intake and output every shift.
D. Tell the client to report ringing in the ears.
A. Slow the infusion rate.
B. Make sure the client is well hydrated.
C. Record the intake and output every shift.
D. Tell the client to report ringing in the ears.
783.
The chart of a client hospitalized for a total hip repair reveals that
the client is colonized with MRSA. The nurse understands that the
client:
A. Will not display symptoms of infection
B. Is less likely to have an infection
C. Can be placed in the room with others
D. Cannot colonize others with MRSA
A. Will not display symptoms of infection
B. Is less likely to have an infection
C. Can be placed in the room with others
D. Cannot colonize others with MRSA
784.
A client receiving Vancocin (vancomycin) has a serum level of 20mcg/mL.
The nurse knows that the therapeutic range for vancomycin is:
A. 5–10mcg/mL
B. 10–25mcg/mL
C. 25–40mcg/mL
D. 40–60mcg/mL
A. 5–10mcg/mL
B. 10–25mcg/mL
C. 25–40mcg/mL
D. 40–60mcg/mL
785. A client is admitted with symptoms of pseudomembranous colitis. Which finding is associated with Clostridium difficile?
A. Diarrhea containing blood and mucus
B. Cough, fever, and shortness of breath
C. Anorexia, weight loss, and fever
D. Development of ulcers on the lower extremities
A. Diarrhea containing blood and mucus
B. Cough, fever, and shortness of breath
C. Anorexia, weight loss, and fever
D. Development of ulcers on the lower extremities
786. Which vitamin should be administered with INH (isoniazid) in order to prevent possible nervous system side effects?
A. Thiamine
B. Niacin
C. Pyridoxine
D. Riboflavin
A. Thiamine
B. Niacin
C. Pyridoxine
D. Riboflavin
787.
A client is admitted with suspected Legionnaires’ disease. Which factor
increases the risk of developing Legionnaires’ disease?
A. Treatment of arthritis with steroids
B. Foreign travel
C. Eating fresh shellfish twice a week
D. Doing volunteer work at the local hospital
A. Treatment of arthritis with steroids
B. Foreign travel
C. Eating fresh shellfish twice a week
D. Doing volunteer work at the local hospital
788.
A client who uses a respiratory inhaler asks the nurse to explain how
he can know when half his medication is empty so that he can refill his
prescription. The nurse should tell the client to:
A. Shake the inhaler and listen for the contents.
B. Drop the inhaler in water to see if it floats.
C. Check for a hissing sound as the inhaler is used.
D. Press the inhaler and watch for the mist.
A. Shake the inhaler and listen for the contents.
B. Drop the inhaler in water to see if it floats.
C. Check for a hissing sound as the inhaler is used.
D. Press the inhaler and watch for the mist.
789. The nurse is caring for a client following a right nephrolithotomy. Post-operatively, the client should be positioned:
A. On the right side
B. Supine
C. On the left side
D. Prone
A. On the right side
B. Supine
C. On the left side
D. Prone
790. A client is admitted with sickle cell crises and sequestration. Upon assessing the client, the nurse would expect to find:
A. Decreased blood pressure
B. Moist mucus membranes
C. Decreased respirations
D. Increased blood pressure
A. Decreased blood pressure
B. Moist mucus membranes
C. Decreased respirations
D. Increased blood pressure
791.
A healthcare worker is referred to the nursing office with a suspected
latex allergy. The first symptom of latex allergy is usually:
A. Oral itching after eating bananas
B. Swelling of the eyes and mouth
C. Difficulty in breathing
D. Swelling and itching of the hands
A. Oral itching after eating bananas
B. Swelling of the eyes and mouth
C. Difficulty in breathing
D. Swelling and itching of the hands
792.
A client is admitted with disseminated herpes zoster (shingles).
According to the Centers for Disease Control Guidelines for Infection
Control:
A. Airborne precautions will be needed.
B. No special precautions will be needed.
C. Only contact precautions will be needed.
D. Droplet precautions will be needed.
A. Airborne precautions will be needed.
B. No special precautions will be needed.
C. Only contact precautions will be needed.
D. Droplet precautions will be needed.
793.
Acticoat (silver nitrate) dressings are applied to the legs of a client
with deep partial thickness burns. The nurse should:
A. Change the dressings once per shift.
B. Moisten the dressing with sterile water.
C. Change the dressings only when they become soiled.
D. Moisten the dressing with normal saline.
A. Change the dressings once per shift.
B. Moisten the dressing with sterile water.
C. Change the dressings only when they become soiled.
D. Moisten the dressing with normal saline.
794.
The nurse is preparing to administer an injection to a six-month-old
when she notices a white dot in the infant’s right pupil. The nurse
should:
A. Report the finding to the physician immediately.
B. Record the finding and give the infant’s injection.
C. Recognize that the finding is a variation of normal.
D. Check both eyes for the presence of the red reflex.
A. Report the finding to the physician immediately.
B. Record the finding and give the infant’s injection.
C. Recognize that the finding is a variation of normal.
D. Check both eyes for the presence of the red reflex.
795. A client is diagnosed with stage II Hodgkin’s lymphoma. The nurse recognizes that the client has involvement:
A. In a single lymph node or single site
B. In more than one node or single organ on the same side of the diaphragm
C. In lymph nodes on both sides of the diaphragm
D. In disseminated organs and tissues
A. In a single lymph node or single site
B. In more than one node or single organ on the same side of the diaphragm
C. In lymph nodes on both sides of the diaphragm
D. In disseminated organs and tissues
796.
A client has been receiving Rheumatrex (methotrexate) for severe
rheumatoid arthritis. The nurse should tell the client to avoid taking:
A. Aspirin
B. Multivitamins
C. Omega 3 fish oils
D. Acetaminophen
A. Aspirin
B. Multivitamins
C. Omega 3 fish oils
D. Acetaminophen
797.
The physician has ordered a low-residue diet for a client with Crohn’s
disease. Which food is not permitted in a low-residue diet?
A. Mashed potatoes
B. Smooth peanut butter
C. Fried fish
D. Rice
A. Mashed potatoes
B. Smooth peanut butter
C. Fried fish
D. Rice
798.
A client hospitalized with cirrhosis has developed abdominal ascites.
The nurse should provide the client with snacks that provide additional:
A. Sodium
B. Potassium
C. Protein
D. Fat
A. Sodium
B. Potassium
C. Protein
D. Fat
799.
A diagnosis of multiple sclerosis is often delayed because of the
varied symptoms experienced by those affected with the disease. Which
symptom is most common in those with multiple sclerosis?
A. Resting tremors
B. Double vision
C. Flaccid paralysis
D. “Pill-rolling” tremors
A. Resting tremors
B. Double vision
C. Flaccid paralysis
D. “Pill-rolling” tremors
800.
After attending a company picnic, several clients are admitted to the
emergency room with E. coli food poisoning. The most likely source of
infection is:
A. Hamburger
B. Hot dog
C. Potato salad
D. Baked beans
A. Hamburger
B. Hot dog
C. Potato salad
D. Baked beans
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