RENR REVIEW PRACTICE TEST 3

1. Managed care is one of the fundamental principles involved in the distribution of

healthcare services. What is one of the goals of managed care?
a. Preventing illness through screening and promotion of health activities
b. Improving training of healthcare professionals
c. Eliminating health disparities between segments of the population
d. Providing hospice or home hospice care

2. According to the nurse's Code of Ethics, the hallmark of nursing practice is

a. autonomy.
b. accountability.
c. evidence-based practice.
d altruism.

3. The nurse plans and implements care for a patient based on nursing knowledge and
skills. The nurse is functioning within which role?
a. Caregiver
b. Advocate
c. Educator
d. Leader

4. The nurse is planning care for a patient and reflects upon a previous similar situation to
identify care approaches. Which mechanism is this nurse using to acquire knowledge?
a. Personal experience
b. Inductive reasoning
c. Trial and error
d. Authority

5. The nurse is focusing on the process when conducting nursing research. What is the
nurse doing at this time?
a. Verifying a belief
b. Carrying out research in a precise and organized manner
c. Following a planned series of steps to gather and analyze information
d. Testing practice theories by applying them to a specific clinical problem

6. The nurse is implementing an evidence-based guideline when planning the care of a

patient with a stage 4 pressure ulcer. What is this nurse doing?
a. Writing orders for medications to apply to the wound
b. Applying research findings to clinical practice
c. Acquiring funding for a research study
d. Designing a research study

1
 7. For which route of parenteral drug administration does the nurse use a 3/8-inch 25-gauge
needle?
a. Intracardiac
b. Subcutaneous
c. Intramuscular
d. Intravenous

8. The nurse is caring for four clients on a medical–surgical unit. The ward clerk gives the
nurse the morning labs. Which of the following labs would require that the nurse call the
physician and inform the healthcare provider about the client’s abnormalities?
a. WBC 14,600 mm3
b. Serum protein 6.9 g/dL
c. I & D (incision and drainage) showing no growth for the last 24 hours
d. Albumin 4.2 g/dL

9. The admitting department alerts the nurse on a medical–surgical unit that a client with
active tuberculosis (TB) is being admitted to the unit. Which type of isolation is appropriate
based on the client’s diagnosis?
a. Standard precautions
b. Airborne precautions
c. Droplet precautions
d. Contact precautions

10. The nurse needs to change a dressing on the client’s abdomen. Which of the following
techniques should be implemented?
a. Contact precautions
b. Standard precautions
c. Droplet precautions
d. Airborne precautions

11. Which of the following manifestations indicates a systemic reaction associated with an
inflammatory response?
a. Erythema
b. Pain
c. Tachypnea (RR 26)
d. Edema

12. The nurse is assessing a client’s wound for signs and symptoms of inflammation. Which of
the following would alert the nurse that the client is exhibiting signs of inflammation?
I. Leg edema
II. Leg cool to touch
III. Severe pain from swelling
IV. Severe erythema of leg
a. I, II, III
b. I, II, IV
c. I, III, IV
d. I, II, III, IV

2
13. A client is receiving a narcotic for severe acute pain. Which of the following should the
nurse encourage the client to consume on a greater level due to the pain medication?
a. Vitamin D
b. Fiber
c. Protein
d. Carbohydrates

14. Clients experiencing a fluid volume deficit would most likely exhibit which of the following
lab results?
I. Increased serum potassium
II. Decreased serum sodium
III. Increased hemoglobin
IV. Increased hematocrit
a. I only
b. II and III
c. III and IV
d. IV only

15. A nursing student is studying the functions of the skin. Which statement by the nursing
student indicates the need for further teaching?
a. “The epidermis protects tissues from physical, chemical, and biologic damage.”
b. “The dermis regulates body temperature by dilating and constricting capillaries.”
c. “The eccrine sweat glands regulate body heat by excretion of perspiration.”
d. “The apocrine sweat glands cushion the scalp and provide insulation in cold weather.”

16. A nurse is completing an assessment of a client who has a gastric ulcer. All of the following
are expected findings EXCEPT?
a. Client reports pain relieved by eating.
b. Client reports a sensation of bloating.
c. Client states that pain occurs ½ to 1 hr after a meal.
d. Client experiences pain upon palpation of the epigastric region.

17. A nurse is teaching a client who has a new diagnosis of pernicious anemia due to chronic
gastritis. Which of the following should be included in the teaching?
A. Cells producing gastric acid have been damaged.
B. A monthly injection of medication is required.
C. Vitamin K supplements will be administered.
D. Increased production of intrinsic factor is occurring.

3
18. A nurse is caring for a client who has chronic gastritis and is scheduled for a selective
vagotomy. The purpose of this procedure is to
A. Increase Duodenal Gastric Emptying.
B. Reduce Gastric Acid Secretions.
C. Increase Gastric Mucus Secretion.
D. Reduce Histamine Secretion.

19. The 39-year-old daughter of a client with a terminal illness tells the nurse that she thinks
something is wrong with her because she frequently cries, is often sad, and can’t imagine losing
her mother. The nurse assures the daughter that these are normal feelings associated with:
a. Bereavement-related depression
b. Complicated grief
c. Anticipatory grief
d. Caregiver grief

20. A patient has been complaining of abdominal cramping and gas; the nurse notes that his
abdomen is slightly distended. Which sound does the nurse expect to hear during percussion of
this patient’s abdomen?
a. Flatness
b. Dullness
c. Resonance
d. Tympany

.21. Which if the following teaching theorists would encourage a client’s active participation?
a. B.F.Skinner
b. Jerome Brunner
c. Jean Piaget
d. Ivan Pavlov

22.. What occurs as a result of an inadequate secretion of insulin?

a. Protein synthesis is increased.
b. Increased fat breakdown leads to ketonemia.
c. Serum glucose levels are markedly decreased.
d. More rapid conversion and storage of carbohydrates to glucose occurs.

23. The newly admitted client has burns on both legs. The burned areas appear white and leather-
like. No blisters or bleeding are present, and the client states that he or she has little pain. How
should this injury be categorized?
A. Superficial
B. Partial-thickness superficial
C. Partial-thickness deep
D. Full thickness

4
24. At what point after a burn injury should the nurse be most alert for the complication of
hypokalemia?
A. Immediately following the injury
B. During the fluid shift
C. During fluid remobilization
D. During the late acute phase

25. What is the priority nursing diagnosis during the first 24 hours for a client with full-thickness
chemical burns on the anterior neck, chest, and all surfaces of the left arm?
A. Risk for Ineffective Breathing Pattern
B. Decreased Tissue Perfusion
C. Risk for Disuse Syndrome
D. Disturbed Body Image

26. A male client is admitted to the substance abuse unit for alcohol detoxification. Which of the
following medications is Nurse Alice most likely to administer to reduce the symptoms of alcohol
withdrawal?
A. naloxone (Narcan)
B. haloperidol (Haldol)
C. magnesium sulfate
D. chlordiazepoxide (Librium)

27. A male client admitted to the psychiatric unit for treatment of substance abuse says to the
nurse, “It felt so wonderful to get high.” Which of the following is the most appropriate response?
A. “If you continue to talk like that, I’m going to stop speaking to you.”
B. “You told me you got fired from your last job for missing too many days after taking drugs all night.”
C. “Tell me more about how it felt to get high.”
D. “Don’t you know it’s illegal to use drugs?”

28. A 39 year old mother with obsessive-compulsive disorder has become immobilized by her
elaborate hand washing and walking rituals. Nurse Trish recognizes that the basis of O.C. disorder
is often:
A. Problems with being too conscientious
B. Problems with anger and remorse
C. Feelings of guilt and inadequacy
D. Feeling of unworthiness and hopelessness

29.. Mario is complaining to other clients about not being allowed by staff to keep food in his room.
Which of the following interventions would be most appropriate?
A. Allowing a snack to be kept in his room
B. Reprimanding the client
C. Ignoring the clients behavior
D. Setting limits on the behavior

5
30. Joey a client with antisocial personality disorder belches loudly. A staff member asks Joey, “Do
you know why people find you repulsive?” this statement most likely would elicit which of the
following client reaction?
A. Defensiveness
B. Embarrassment
C. Shame
D. Remorsefulness

31. A client, age 41, visits the gynaecologist. After examining her, the physician suspects cervical
cancer. The nurse reviews the client’s history for risk factors for this disease. Which history finding
is a risk factor for cervical cancer?
A. Onset of sporadic sexual activity at age 17
B. Spontaneous abortion at age 19
C. Pregnancy complicated with eclampsia at age 27
D. Human papillomavirus infection at age 32

32. Neoplasm can be classified as either benign or malignant. The following are characteristics
of malignant tumour apart from:
A. Metastasis
B. Infiltrates surrounding tissues
C. Encapsulated
D. Poorly differentiated cells

33. On a clinic visit a client who has a relative with cancer, is asking about the warning signs
that may relate to cancer. The nurse correctly identifies the warning signs of cancer by
responding:
A. “If a sore healing took a month or more to heal, cancer should be suspected.”
B. “Presence of dry cough is one of the warning signs of cancer.”
C. “A lump located only in the breast area may suggest the presence of cancer.”
D. “Sudden weight loss of unexplained aetiology can be a warning sign of cancer.”

34. In staging and grading neoplasm TNM system is used. TNM stands for:
A. Time, neoplasm, mode of growth
B. Tumour, node, metastasis
C. Tumour, neoplasm, mode of growth
D. Time, node, metastasis

35. Breast self- examination (BSE) is one of the ways to detect breast cancer earlier. The nurse
is conducting a health teaching to female clients in a clinic. During evaluation the clients are

6
asked to state what they learned. Which of the following statement made by a client needs
further teaching about BSE?
A. “BSE is done after menstruation.”
B. “BSE palpation is done by starting at the centre going to the periphery in a circular motion.”
C. “BSE can be done in either supine or standing position.”
D. “BSE should start from age 20.”

36. Jordon is a client with jaundice who is experiencing pruritus. Which nursing intervention
would be included in the care plan for the client?
A. Administering vitamin K subcutaneously
B. Applying pressure when giving I.M. injections
C. Decreasing the client’s dietary protein intake
D. Keeping the client’s fingernails short and smooth

37. Marie, a 51-year-old woman, is diagnosed with cholecystitis. Which diet, when selected by
the client, indicates that the nurse’s teaching has been successful?
A. 4-6 small meals of low-carbohydrate foods daily
B. High-fat, high-carbohydrate meals
C. Low-fat, high-carbohydrate meals
D. High-fat, low protein meals

38. When planning home care for a client with hepatitis A, which preventive measure should be
emphasized to protect the client’s family?
A. Keeping the client in complete isolation
B. Using good sanitation with dishes and shared bathrooms
C. Avoiding contact with blood-soiled clothing or dressing
D. Forbidding the sharing of needles or syringes

39. Which clinical manifestation would the nurse expect a client diagnosed with acute
cholecystitis to exhibit?
A. Jaundice, dark urine, and steatorrhea
B. Acute right lower quadrant (RLQ) pain, diarrhoea, and dehydration
C. Ecchymosis petechiae, and coffee-ground emesis
D. Nausea, vomiting, and anorexia

40. You’re assessing the stoma of a patient with a healthy, well-healed colostomy. You expect
the stoma to appear:
A. Pale, pink and moist
B. Red and moist
C. Dark or purple colored
D. Dry and black

41. You’re caring for a patient with a sigmoid colostomy. The stool from this colostomy is:
A. Formed

7
B. Semisolid
C. Semiliquid
D. Watery

42. You’re advising a 21 year old with a colostomy who reports problems with flatus. What
food should you recommend?
A. Peas
B. Cabbage
C. Broccoli
D. Yogurt

43. A nurse is inserting a nasogastric tube in an adult male client. During the procedure, the
client begins to cough and has difficulty breathing. Which of the following is the appropriate
nursing action?
A. Quickly insert the tube
B. Notify the physician immediately
C. Remove the tube and reinsert when the respiratory distress subsides
D. Pull back on the tube and wait until the respiratory distress subsides

44. Nurse Ryan is assessing for correct placement of a nasogastric tube. The nurse aspirates the
stomach contents and check the contents for pH. The nurse verifies correct tube placement if
which pH value is noted?
A. 3.5
B. 7.0
C. 7.35
D. 7.5

45. A physician’s orders indicate that a surgical consent needs to be signed. The nurse was not
present when the surgeon discussed the surgical procedure with the client. Which statement by the
nurse best illustrates fulfillment of the client’s advocate role?
A. “The doctor has asked that you sign this 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 likely to be found guilty of which of the following?
A. Unintentional tort

8
 B. Assault
C. Invasion of privacy
D. Battery

47. Which of the following applies in the planning of nursing for the patient whom the physician
has written a Do Not Resuscitate (DNT) order?
A. The client may no longer make decisions regarding his or her own health care.
B. The client and family know that the client will most likely die within the next 48 hours.
C. The nurse will continue to implement all treatments focused on comfort and symptom
management.
D. A DNR from the previous admission is valid for the current admission.

48. The nurse conducts an assessment on a 45 year old woman who states that during the interview
“I’m so tired all the time and have been having mood swings and hot flushes.” Which of the
following body systems would the nurse use to conduct a more in-depth assessment?
A. Respiratory and nervous.
B. Reproductive and endocrine.
C. Nervous and cardiovascular.
D. Cardiovascular and endocrine.

49. After the nurse evaluated the instructions given to a client with pulmonary embolism who is
being discharged from the hospital, it was determined that additional teaching was required when
the client made which of the following statements?
A. “I will limit my daily fluid intake.”
B. “I will sit down whenever possible.”
C. “I will continue to wear supportive hose.”
D. “I will only cross my legs at the ankle and not at the knees.”

50. The oncologist examines a client in the clinic with severe bone marrow depression and
subsequently admits him to the hospital. The client’s therapy includes radiation and
chemotherapy. Which of the following nursing diagnosis takes PRIORITY in the client’s care
plan?
A. Imbalanced nutrition less than body requirements.
B. Risk for infection.
C. Pain.
D. Risk for injury.