RENRAPR2017MCKREW

Patrick McKenzie

1. A nursing professional development specialist, who is coordinating a seminar for National Nurses Week,
contacts a nationally known speaker to deliver the keynote address. Early in the planning stage of the
seminar, the nursing professional development specialist seeks to:
a. develop a staffing plan with the nurse manager to promote attendance.
b. obtain a written agreement from the speaker confirming attendance
c. generate collaborative agreements with other agencies.
d. request copies of the speaker's book from the publisher.

2. Which statement indicates an accurate assessment of a learning need?

a. “Due to an increase in the Parish tuberculosis case rates, a learning activity on tuberculosis
transmission is required."
b. “Our quality review identifies 10 medication errors this month, indicating a need for a class on
medication administration."
c. “The nurses on this unit state that they have never worked with unlicensed assistive personnel
before, and need a class on appropriate delegation skills."
d. “We must teach the staff to use the patient care assignment sheets at the beginning of each shift."

3. Six months after an educational activity on documentation, a nursing professional development specialist
performs an audit of patient charts. Which type of evaluation does the audit reflect?
a. Content
b. Impact
c. Outcome
d. Process

4. To integrate research findings into practice, the nursing professional development specialist's first action
is to:
a. critique a research article with staff.
b. demonstrate the process by example.
c. identify barriers to implementing the research results.
d. design an instructional unit about evidence-based practice.

5. A unit report identifies staff members who are non-adherent in consistently documenting patient care.
The nursing professional development specialist's next action is to:
a. build documentation requirements into annual staff competencies.
b. facilitate a group of staff members to clarify the contributing factors
c. collaborate with the nurse manager regarding counseling non-adherent staff.
d. develop a training program about staff documentation in the deficient areas.

6. A nursing professional development specialist works with the infection preventionist to involve staff in the
selection of a new hand hygiene product. The nursing professional development specialist facilitates
selection by using the decision-making technique of:
a. brainstorming.
b. consensus.
c. convergent thinking.
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d. Group think.
7. A nursing professional development specialist has been asked by the nurse manager to work with the new
nurse residents who are having difficulty recognizing the early signs and symptoms of sepsis. The nursing
professional development specialist chooses to incorporate a high-fidelity simulated clinical experiences
approach. The educational advantages of simulation opportunities for learners include:
a. engaging a large number of staff in a single learning activity.
b. validating the transfer of knowledge from classroom to clinical practice.
c. improving skill performance, critical thinking, and clinical decision-making.
d. exercising time-saving approaches to enhance complex patient management conditions.

8. A process within the nursing professional development model is:

a. patient safety.
b. staff orientation.
c. the quality of care
d. the learning environment.

9. The credit awarded by the Nursing Council of Jamaica for continuing education for relicensure is:
a. contact hours.
b. certificates of attendance.
c. continuing education units.
d. continuing education recognition.

10. Which is an accurate statement about certification in nursing professional development?

a. Certification measures the nurse's level of education.
b. Certification guarantees that standards of care will be met.
c. Certification is a means of licensure and public protection.
d. Certification measures the nurse's knowledge of the specialty.

11. Which comparison of verbal and nonverbal communication is accurate?

a. Both verbal and nonverbal communication are formally taught.
b. The setting is more restricted in nonverbal communications.
c. The sender has more control over verbal communication.
d. More channels are used for verbal communication.

12. A 4-month-old with meningococcal meningitis has just been admitted to the pediatric unit. Which nursing
intervention has the highest priority?
a. Administering acetaminophen (Tylenol)
b. Obtaining history information from the parents
c. Orienting the parents to the pediatric unit
d. Instituting droplet precautions
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13. The charge nurse observes a new staff nurse who is changing a dressing on a surgical wound. After
carefully washing her hands the nurse dons sterile gloves to remove the old dressing. After removing the
dirty dressing, the nurse removes the gloves and dons a new pair of sterile gloves in preparation for
cleaning and redressing the wound. The most appropriate action for the charge nurse is to:
a. interrupt the procedure to inform the staff nurse that sterile gloves are not needed to remove the old
dressing.
b. discuss dressing change technique with the nurse at a later date.
c. Whisper in the staff nurse’s ear the correct procedure.
d. congratulate the nurse on the use of good technique.

14. The parents of a child, age 6, who will begin school in the fall ask the nurse for anticipatory guidance. The
nurse should explain that a child of this age:
a. Rebels against scheduled activities
b. Is highly sensitive to criticism
c. Still depends on the parents
d. Will engage in solitary play

15. Several clients are admitted to an adult medical unit. The nurse would ensure airborne precautions for a
client with which of the following medical conditions?
a. Advanced carcinoma of the lung
b. A diagnosis of AIDS and cytomegalovirus
c. A tentative diagnosis of viral pneumonia
d. A positive tuberculin test with an abnormal chest x-ray

16. A young adult is being treated for second and third degree burns over 25% of his body and is now ready
for discharge. The nurse evaluates his understanding of discharge instructions relating to wound care and
is satisfied that he is prepared for home care when he makes which statement?
a. “I will need to take sponge baths at home to avoid exposing the wounds to unsterile bath water.”
b. “If any healed areas break open I should first cover them with a sterile dressing and then report it.”
c. “I must wear my Jobst elastic garment all day and can only remove it when I’m going to bed.”
d. “I can expect occasional periods of low-grade fever and can take Tylenol every 4 hours.”

17. The nurse in charge is evaluating the infection control procedures on the unit. Which finding indicates a
break in technique and the need for education of staff?
a. The nurse aide is not wearing gloves when feeding an elderly client.
b. A nurse with open, weeping lesions of the hands puts on gloves before giving direct client care.
c. The nurse puts on a mask, a gown, and gloves before entering the room of a client on strict isolation.
d. A client with active tuberculosis is asked to wear a mask when he leaves his room to go to another
department for testing.
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18. Which question is least useful in the assessment of a client with AIDS?
a. Are you a drug user?
b. Do you have many sex partners?
c. What is your method of birth control?
d. How old were you when you became sexually active?

19. A client was admitted to the hospital with client chest pain and shortness of breath. Arterial blood gases
were: pH=7.52, pCO2= 27, HCO3= 22. These values indicate:
a. Respiratory alkalosis
b. Respiratory acidosis
c. Metabolic alkalosis
d. Metabolic acidosis

20. Before starting on Isoniazid (INH), nurses priority would be:

a. AST and ALT
b. BUN, serum creatinine
c. Serum glucose level
d. Blood uric acid level

21. Which of the following would be considered most normal in the water - seal chamber within the first 24
hours postoperatively with a two-bottle water-seal drainage?
a. Bright-red blood bloody drainage
b. No fluctuation in the water - seal tube
c. Continuous bubbling in the water-seal tube
d. Intermittent, slight bubbling from the water-seal tube

22. A 19-year old client comes to the emergency department with acute asthma. His respiratory rate is 44
bpm and he appears in acute respiratory distress. Which of the following actions should be taken first?
a. Take a full nursing history
b. Administer oxygen 6L/m
c. Administer bronchodilator by nebulizer
d. Provide emotional support to the client

23. A client with emphysema is observed to have labored breathing and exhibits slow, shallow respiration.
The nurse assesses the client’s lab results for which of the following?
a. Respiratory alkalosis
b. Respiratory acidosis
c. Metabolic alkalosis
d. Metabolic acidosis
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24. A nurse is describing the process of fetal circulation to a client during a prenatal visit. The nurse accurately
tells the client that fetal circulation consists of:
a. Two umbilical veins and one umbilical artery
b. Two umbilical arteries and one umbilical vein
c. Arteries carrying oxygenated blood to the fetus
d. Veins carrying deoxygenated blood to the fetus

25. During a prenatal visit at 38 weeks, a nurse assesses the fetal heart rate. The nurse determines that the
fetal heart rate is normal if which of the following is noted?
a. 80 BPM
b. 100 BPM
c. 150 BPM
d. 180 BPM

26. A client arrives at a prenatal clinic for the first prenatal assessment. The client tells a nurse that the first
day of her last menstrual period was September 19th, 2013. Using Naegele’s rule, the nurse determines
the estimated date of confinement as:
a. July 26, 2013
b. June 12, 2014
c. June 26, 2014
d. July 12, 2014

27. A nurse is assisting in performing an assessment on a client who suspects that she is pregnant and is
checking the client for probable signs of pregnancy. Select all that apply.
i. Fetal heart rate detected by nonelectric device
ii. Outline of the fetus via radiography or ultrasound
iii. Chadwick’s sign
iv. Ballottement
a. ii iii
b. I ii
c. I iv
d. iii iv

28. A pregnant client in the last trimester has been admitted to the hospital with a diagnosis of severe
preeclampsia. A nurse monitors for complications associated with the diagnosis and assesses the client
for:
a. Any bleeding, such as in the gums, petechiae, and purpura.
b. Periods of fetal movement followed by quiet periods
c. Complaints of feeling hot when the room is cool
d. Enlargement of the breasts
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29. A client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been
experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instructs the client
regarding management of care. Which statement, if made by the client, indicates a need for further
education?
a. “I will maintain strict bedrest throughout the remainder of pregnancy.”
b. “I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks following the last
evidence of bleeding.”
c. “I will count the number of perineal pads used on a daily basis and note the amount and color of
blood on the pad.”
d. “I will watch for the evidence of the passage of tissue.”

30. A nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational
diabetes. Which statement if made by the client indicates a need for further education?
a. “I need to stay on the diabetic diet.”
b. “I will perform glucose monitoring at home.”
c. “I need to avoid exercise because of the negative effects of insulin production.”
d. “I need to be aware of any infections and report signs of infection immediately to my health care
provider.”

Mr. George Brown, a 22-year old patient, was admitted to the Medical Unit with a history of pleuritic
chest pain aggravated on inspection and coughing. Assessment findings include nasal flaring, use of
accessory muscles of respiration, sudden onset of chills and rapid rise in temperature of 101.4F-103F,
38.5C-39.5C. He was evaluated by the doctor who made a diagnosis of Pneumonia.

31. Which of the following investigations would Mr. Brown’s doctor request? SELECT ALL
THAT APPLY
i. Bronchoscopy
ii. Chest x-ray for diagnosis and location of lesion
iii. Gram stain, culture and sensitivity of sputum
iv. Chest x-ray to show present extent of pulmonary disease
a. i, ii
b. i, iv
c. ii, iii
d. ii, iv
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32. Mr. Brown’s medical management will include: SELECT ALL THAT APPLY

i. oxygen therapy.
ii. broncho dilators.
iii. antimicrobial therapy.
iv. clearing the obstructed airway.
a. i, ii, iii
b. i, ii, iv
c. i, iii, iv
d. ii, iii, iv

33. In preparing a nursing care plan for Mr. Brown, which of the following nursing diagnoses
would be utilized? SELECT ALL THAT APPLY

i. Pain related to inflammatory process and dyspnea

ii. Altered nutrition, less than body requirement related to poor appetite
iii. Ineffective airway clearance related to excessive trachea-bronchial secretions
iv. Impaired gas exchange related to decreased ventilation secondary to inflammation and
infection involving distal airspaces

a. i, ii, iii
b. i, ii, iv
c. i, iii, iv
d. ii, iii, iv

34. When providing care for Mr. Brown to improve gas exchange, the nurse will do which of
the following? SELECT ALL THAT APPLY

i. Administer oxygen
ii. Auscultate lungs for crackles
iii. Place him in semi fowler’s position
iv. Observe for cyanosis, dyspnea and hypoxia

a. i, ii, iii
b. i, ii, iv
c. ii, iii, iv
d. i, ii, iii, iv
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35. In an effort to enhance Mr. Brown’s airway clearance the nurse should: SELECT ALL
THAT APPLY

i. administer oxygen.
ii. encourage fluid intake.
iii. encourage deep breathing and coughing.
iv. employ chest wall percussion and postural drainage.

a. i, ii, iii
b. i, ii, iv
c. i, iii, iv
d. ii, iii, iv

36. To relieve Mr. Brown’s pleuritic pain the nurse will: SELECT ALL THAT APPLY

i. administer prescribed analgesics.

ii. splint the chest while coughing.
iii. avoid suppressing productive cough.
iv. encourage bed rest during febrile periods.

a. i, ii, iii
b. i, ii, iv
c. i, iii, iv
d. ii, iii, iv

37. A student nurse is developing a plan of care for a paranoid client with a nursing diagnosis of
Disturbed thought processes. The registered nurse reviews the interventions developed by the
student and suggests revising the plan if the student has documented which intervention?

a. Display a non-judgmental attitude

b. sit with the client and hold the client's hand
c. use simple and clear language when speaking to the client
d. diffuse angry and hostile verbal attacks with non-defensive stand

38. A benzodiazepine anxiolytic has been prescribed for a client for the management of anxiety, and
a student nurse prepares to provide instructions to the client regarding the administration of
the medication. The registered nurse who is supervising the student intervenes if the student
plans to tell the client which of the following?
a. avoid driving or other activities requiring alertness until the response to the medication
b. do not skip medication doses and do not double up on missed doses
c. avoid the use of alcohol while taking the medication
d. double a dose if a dose was missed
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39. A nurse is told that the nursing model used in the nursing facility is a functional nursing
approach. The nurse understands that planning care delivery will be based on which
characteristic of this type of nursing model of practice?
a. a single registered nurse (RN) is responsible for providing nursing care to a group of clients
b. nursing personnel are led by a RN in providing care to a group of clients
c. managed care concepts and tools are used in providing client care
d. a task approach methods is used to provide care to clients

40. A nurse manager has implemented a change in the method of documenting nursing care. A
nurse who has been at the facility for several years is resistant to the change and is not taking an
active part in facilitating the process of change. Which of the following would be the best
approach in dealing with the nurse?
a. ignore the resistance
b. tell the nurse that she must comply with the change
c. tell the nurse the charge nurse will do all of the documentation
d. confront the nurse, and encourage verbalization of feelings regarding the change

41. A nurse is caring for four clients and is preparing to do her initial rounds. Which client should the
nurse assess first? A client:

a. diabetes being discharged today

b. with tracheostomy and copious secretions
c. scheduled for physical therapy this morning
d. with a pressure ulcer that needs dressing change

42. A nurse preceptor is working with a new nurse and notes that the new nurse is reluctant to
delegate tasks to members of the care team. The nurse preceptor recognizes that this
reluctance most likely is due to:
a. the philosophy of the new nurse's school of nursing
b. role modeling behaviors of the preceptor
c. the orientation provided to the new nurse
d. lack of trust in the team members

43. Which of the following guidelines should a nurse include in the teaching plan for a patient who
has osteoarthritis?
a. increase daily calcium intake to 1500 mg
b. sleep at least 10 hours each day
c. achieve ideal body weight
d. maintain a high fiber diet
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44. A client diagnosed with schizophrenia is prescribed Haldol. For which of the following should the
nurse be most concerned?

a. Client report nightmares

b. Client reports dry mouth
c. White blood cell count decrease
d. Body temperature of 99F

45. A primary care provider's orders indicated that a surgical consent form needs to be signed. Since
the nurse was not present when the primary care provider discussed the surgical procedure,
which statement "best" illustrates the nurse fulfilling the client advocate role?

a. "The doctor has asked that you sign the consent form."
b. "Do you have any questions about the procedure?"
c. "What were you told about the procedure you are going to have?"
d. "Remember that you can change your mind and cancel the procedure."

46. Although the client refused the procedure, the nurse insisted and inserted a nasogastric tube in
the right nostril. The administrator of the hospital decides to settle the lawsuit because the
nurse is most likely to be found guilty of which of the following?
a. An unintentional tort
b. Assault
c. Invasion of Privacy
d. Battery

47. Nurses agree to be advocates for their patients. Practice of advocacy calls for the nurse to:
a. Seek out the nursing supervisor in conflicting situations
b. Work to understand the law as it applies to the client's clinical condition.
c. Assess the client's point of view and prepare to articulate this point of view.
d. Document all clinical changes in the medical record in a timely manner.

48. The doctor prescribes one tablet, but the nurse accidentally administers two. After notifying the
doctor, the nurse monitors the client carefully for untoward effects of which there are none. Is
the client likely to be successful in suing the nurse for malpractice?
a. No, the client was not harmed
b. No, the nurse notified the primary care provider
c. Yes, a breach of duty exists
d. Yes, foreseeability is present

49. The nurse is discharging a patient with hepatitis B. Which statement by the patient suggest
understanding?

a. “Now I can never get hepatitis again.”

b. “I can safely give blood after 3 months.”
c. “I’ll never have a problem with my liver again, even if I drink alcohol.”
d. “My family knows that if I get tired and start vomiting, I may be getting sick again.”
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50. A component that separates occupations from professions is commitment. Which of the
following is the BEST way that nurses can show commitment to each other?

a. Reporting substandard practice by unlicensed care assistants

b. Reading the professional literature
c. Mentoring nursing students and novice nurses
d. Making a financial contribution to a professional organization

51. The nurse has determined that a client does not understand the implications of a surgical
procedure scheduled for the next day. The nurse will not ask the client to sign the informed
consent form until the surgeon provides further explanations, and the client verbalizes
understanding. The professional nursing ethical principle applicable in this situation is.

a. Autonomy.
b. Confidentiality.
c. Fidelity.
d. Veracity

52. The code of ethics serves which of the following purposes?

a. Establishes standardized curricula for nursing educational programs.
b. Set formal guidelines and standards for professional nursing conduct.
c. Ensures that nurses provide client care based on scientific principles.
d. Determines qualifications for advanced practice nurses.

Mrs. Jane Thomas, a 46-year old housewife and mother of three boys ages 15, 13 and 9
was admitted to the drug rehabilitation center for treatment due to alcohol abuse. Her husband works
full time and is seldom at home. The family is disorganized, and conflicts frequently arise as 13-year old
Johnny has become a social deviant. Mrs. Thomas complained that she cannot cope with the situation.
53. Substance abusers are defined as persons who:
A usually use several category of drugs
B use excessive amount of harmful substance
C use drugs to cope with the stress of daily living
D restrict themselves to only one category of drugs

54. Which of the following factors is LEAST likely to contribute to substance abuse?
A Genetic factors
B Relief of anxiety
C Recreational use
D Strong emotional conflict

55. Which of the following behaviors is NOT suggestive of substances abuse?

A The use of substances to deal with personal problems
B The use of smaller quantities of the substances to maintain effect
C The use of chemical substance beyond the point of voluntary control
D The use of very defensive behavior when criticized about use of substance.
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56. In order to help this client to cope with the present situation, the nurse should:
i maintain a non-judgmental attitude
ii encourage her to join a support group
iii encourage her to ventilate her feelings about the problem
iv give her books to read concerning the problems alcohol creates.
A i, ii, iii B i, ii, iv C i, iii, iv D ii, iii, iv

57. In assisting the family to solve its conflicts, the nurse does all of the following EXCEPT
A assists family to develop impulse control
B refers family to a psychiatric social worker
C encourages family to ventilate their feelings
D encourages family to join a social network therapy group

58. The MOST appropriate assistance the nurse can offer this client concerning her problems is to:
A assist her in finding a job
B promise her more financial aid for her family
C refer her to an alcoholic rehabilitation program
D suggest that she uses her will power and act like a woman

59. The MOST likely cause for Johnny’s deviant behavior is:
i lack of parental control
ii poor hereditary background
iii inability to adjust to the family situation
iv lack of warm significant relationship with parents
A i, ii, iii
B i, ii, iv
C i, iii, iv
D ii, iii, iv

60. The nurse, by adhering to an Agency's policies and procedures, demonstrates her accountability to which
of the following?
Manager
Institution
Regulatory Body
Nurses' Association