‫بيت التمريض‬ PALNURSE YOUR ACCESS TO SUCCESS

1. In directing emergency care until the ambulance arrives, it is most important

that the school nurse
A. place a small makeshift pillow under his head
B. check to see if he can move all of his extremities
C. keep him flat and immobilized in a natural position
D. cover him with a blanket

2. A primary goal of nursing care when John is brought into the emergency room
will be
A. prevention of spinal shock
B. maintenance of respiration
C. maintenance of orientation D provision for pain relief
Situation: Crutchfield tongs are used to apply traction to realign the spinal cord.

3. A nursing measure for john while he is in cervical traction should be to

A. massage the back of his head
B. position him from side to side
C. remove the weights at least once a shift
D. encourage involvement in his own care
Situation: John is found to have a temperature of 36°C (96.8°F).
4. The most appropriate initial nursing measure for John in response to his
hypothermia would be to
A. cover him with additional blankets
B. place a hot-water bottle at his feet
C. check for signs of shock
D. notify his physician
Situation: John has a tracheostomy performed and is on assisted ventilation.

5. The alarm on the ventilator sounds. The initial response by the nurse should be
to quickly
A. notify the respiratory therapist
B. check all connections from the respirator
C. notify the respiratory therapist to come immediately
D. use a self-inflating bag to ventilate John
6. When suctioning John, the nurse should
A. ensure that he is able to take a breath between insertions of the catheter
B. suction him for at least 30 seconds with each catheter insertion
E. apply suction and gently rotate the catheter while inserting it into the bronchial
bifurcation
F. use clean technique during the suction procedure

7. John suddenly becomes diaphoretic, his blood pressure rises to 190/110, and he
complains of a headache. The nurse should assess the patient for signs of
A. increased intracranial pressure
B. spinal meningitis
C. pulmonary congestion
D. fecal impaction

8. Upon admission John had a complete loss of motor ability. Within 48 hours he is
noted to be having muscle spasms. His family becomes very excited when they
notice these movements. Which of the following choices would be the most
appropriate response by the nurse?
A. A. at this stage, muscle spasms are expected, but it is too soon to evaluate the
extent of the injury or its permanent effects
B. I can understand your excitement. These movements are a good sign that he is
making progress
C. these movements are an indication that he is trying to move and that his will is
very strong
D. these movements are reflex activities that indicate that his spinal cord is intact
Situation: Mark Richards has a compound fracture of the temporal bone.

9. The nurse notices bleeding from the orifice of the ear. Which of the following
actions
by the nurse can be safely used to determine if the drainage contains
cerebrospinal fluid
(CSF)? The nurse should
A. swab the orifice of the ear with sterile applicator and send the specimen to the
laboratory
B. blot the drainage with a sterile gauze pad and look for a clear halo or ring around
the spot of blood
C. gently suction the ear an send the specimen to the laboratory
D. test the CSF with a Tes-Tape and get a negative reading for sugar
‫بيت التمريض‬ PALNURSE YOUR ACCESS TO SUCCESS

10.The nursing care plans states "Observe for early signs of increased intracranial
pressure (IIP)." Early symptoms of IIP include
A. widening pulse pressure and dilated pupils
B. rising blood pressure and bradycardia
C. elevated temperature and decerebrate posturing
D. nausea, vomiting, and restlessness

11.During the initial period after a head injury, nursing intervention for Mr.
Richards should include
A. packing the ear with cotton balls to stop bleeding
B. awakening the patient every 2 hours to determine his level of consciousness
C. placing the patient in Trendelenburg's position
D. forcing fluids to restore hydration

12.Before discharge, a computerized axial tomogram will be performed to rule out

any intracranial or extracranial bleeding. Mr. Richards should be told that
A. the procedure is noninvasive and he will not feel any pain
B. he will experience a burning sensation as the dye is being injected
C. the procedure is done in the operating room under anesthesia
D. local anesthetic is used before injecting air into the ventricles of the brain via the
spinal canal

Situation: Tonnie Miccio is a 43-year old divorced man who has been rushed to the
emergency room with an acute gouty arthritis.

13.While admitting Mr. Miccio to the hospital, the nurse should recognize those
factors that can precipitate an acute attack. They include
A. excessive smoking
B. large alcohol intake
C. emotional stress
D. improper rest

14.A serum uric acid level is performed by the hospital laboratory. In acute gout,
the uric acid level is approximately
A. 1.0 mg/100 ml
B. 2.1 mg/100 ml
C. 6.5 mg/100 ml
D. 10 mg/100 ml

15.Colchicine is the standard drug used to treat acute gout: The physician orders
colchicines, 1.0 mg every 2 hours. After receiving the third dose, the patient
complains of nausea, vomiting, and diarrhea. The nurse should recognize that this
is
A. a transient side effect and give the next dose
B. a sign of toxicity and withhold the medication
C. an allergic response to the drug and notify the physician
D. a psychogenic response to the severe pain

16.The expected outcome for colchicine is to

A. reduce uric acid levels
B. relieve joint pain and inflammation
C. increase blood flow to the kidney
D. detoxify purines in the liver

17.During the night, Mr. Miccio complains of severe pain in his toe and asks the
nurse for 2 aspirin tablets. The nurse should
A. give the patient the 2 aspirin tablets
B. elevate the foot on a pillow
C. notify the physician
D. offer the patient a cup of tea
18.Some physicians prescribe an alkali-ash diet to enhance the effect of the
medications. Which of the following foods are allowed?
A. liver, shellfish, and fats
B. cranberries, cheese, and whole grain cereals
C. milk, vegetables, and most fruits
D. eggs, milk, prunes, and plums

19.After the acute attack subsides, the physician orders allopurinol (Zyloprim), 300
mg/day. The expected outcome for this drug is to
A. lower the plasma and urinary uric acid level
‫بيت التمريض‬ PALNURSE YOUR ACCESS TO SUCCESS

B. reduce inflammation of the affected joints

C. produce diuresis
D. relieve pain

20.A teaching program for Mr. Miccio should include

A. emphasizing that aspirin is contraindicated in patient's taking allopurinol
B. restricting fluid intake to 1,000 ml/day
C. explaining that acute gouty attacks often occur during initiation of allopurinol
therapy
D. D. stating that a low-purine diet should be followed while taking allopurinol

21.About 2 months after taking the allopurinol, Mr. Miccio develops a skin rash.
The nurse should
A. recognize this as a minor side effect that will subside
B. ask the patient if he has been taking any aspirin while taking the allopurinol
C. recognize this is an indication to discontinue the drug
D. be aware that concomitant use of colchicines with allopurinol causes this reaction
22.One day, Jennifer asks her roommate, Erin, how her scoliosis was first
recognized. Erin replies, "The school health nurse told me that there may be a
problem after all the girls in my class were asked to stand erect while she
examined our backs." The nurse suspected scoliosis when she observed that Erin's
shoulder on one side was elevated and her
A. head appeared aligned to the opposite side
B. leg on the same side appeared shorter
C. hip on the opposite side appeared prominent
D. arm on the same side appeared longer

23.When Erin's scoliosis was diagnosed after x-ray examination of her spine, she
was fitted with a Milwaukee brace. Erin asks the nurse when it could be removed
each day. Which of the following would be the best response?
A. only when you are lying flat, either resting or sleeping
B. for 1 hour a day when you bathe, shower, or go swimming
C. only for special occasions, such as a party
D. for 3 hours a day: one in the morning, one in the afternoon, and one in the
evening
Situation: Erin's admission to the hospital for spinal fusion was necessary because
hr scoliosis did not respond to the Milwaukee brace.

24.Preoperative preparation for Erin includes explaining that for 2 weeks after
surgery she will be positioned
A. on either side or prone
B. sitting upright
C. flat and will be logrolled
D. on her back

25.When Erin is told that after surgery she will wear a body cast for about 1 year,
she begins to sob. She tells the nurse she will look like a football player, not a girl.
Which of the following is the best response the nurse can make?
A.the people who really care about you won't even notice your cast
B. it only will be for a year. You're mature enough to wait
C. just ignore any comments that people make
D.a pretty hairstyle and some loose peasant blouses will keep you looking feminine

26.After surgery, the nurse applies slight pressure to Erin's toes and asks Erin is he
can feel her foot being touched. Erin replies, "No, I don't feel anything." The nurse
should then
A. wait 1 hour and supply pressure again
B. record Erin's expected response
C. ask Erin if her toes feel cold
D. report Erin's response to the surgeon

Situation: Virginia K is a 25- year old woman who works as a lifeguard at the local
beach. On her way to work she is in an automobile accident and is rushed to the
hospital by ambulance. A diagnosis of complete transaction of the spinal cord at
the third lumbar (L3) level is made.

27.While assess Ms. K for neurologic function, the nurse can expect she will be
unable to
A. shrug her shoulders
B. tighten her abdominal muscles
C. bend her elbow
D. straighten her legs
‫بيت التمريض‬ PALNURSE YOUR ACCESS TO SUCCESS

28.Long-term goals for Ms. K include developing skills in

A. performing wheelchair ambulation
B. activating an electric wheelchair
C. walking with leg braces and crutches
D. walking without aids

29.observing for symptoms of which of the following is the priority of care for Ms.
K in the acute stages of complete transaction of the lumbar cord?
A. spinal shock
B. respiratory insufficiency
C. autonomic hyperreflexia
D. hypertensive crisis

30.To prevent the complication of urinary tract infections, which of the following
measures should be included in the nursing care plan?
A. encouraging extra fluid intake
B. offering at least two servings of citrus fruit juice per day
C. telling the patient to avoid fruit juices such as plum, prune, and cranberry
D. notifying the dietician to include a container of milk at all meals

Situation: Jim, a 17-year old senior in high school, has sustained a simple fracture
of the mandible after falling from his motorbike.

31.Upon admission to the emergency room, which of the following choices should
the nurse expect to observe?
A. bleeding in the external auditory canal
B. dropped prominence of the cheek on the affected side
C. edema of the eyes and cheeks
D. teeth unevenly lined up
Situation: An open reduction with wiring of the lower jaw to the upper jaw has
been done by the surgeon.

32.In anticipating the postoperative needs o the patient, which of the following
actions has the priority for Jim?
A. placing paper and pencil at the bedside
B. providing a tracheostomy set for tracheostomy care
C. taping a wire cutter to the head of the bed
D. inserting a gauze wick in the inside of the cheek

33.While teaching Jim mouth care the nurse should

A. show him how to use moistened gauze sponges to clean his mouth and tongue
B. demonstrate how an oral irrigation can be performed by inserting the catheter
along the inside of the mouth between the teeth and the cheek
C. explain to him that mouth care should not be done until the wires are removed
D. tell him to use an astringent mouthwash to remove all the debris

Mrs. Marian H is a 50-year old woman who has a spinal cord lesion at the fourth
thoracic (T4) vertebra.

34. When there are lesions above T4 and T6, the patient may experience
autonomic hyperreflexia. This condition can be prevented by
A. avoiding bladder distention
B. changing the patient's position hourly
C. wearing supportive elastic hose
D. doing a neurologic check

35.Mrs. H complains of severe headache and is extremely anxious. The nurse

checks her blood pressure and finds it is 210/110. The nurse should then
A. check the patency of the urinary catheter
B. apply ice packs to her head
C. place the patient in a flat position
D. sit with the patient until the symptoms subside
Situation: Dorothy C, RN, age 35, is at work. After moving a particularly heavy
patient, she suddenly develops severe pain in the lumbosacral area that radiates
down her right leg. The preliminary diagnosis is rupture of an intervertebral disk.

36.Proper body mechanics may have prevented this injury to Ms. C. If she had
adhered to the correct method of turning a patient from the supine position to the
left side, she would have crossed the patient's right arm over chest, and crossed
the right leg over the left leg. Then, while standing with her feet
‫بيت التمريض‬ PALNURSE YOUR ACCESS TO SUCCESS

A. together at the patient's right side, she would gently turn the patient by pushing
at the shoulder and sacral areas
B. apart at the right side of the bed, she would turn the patient by gently pushing at
the shoulder and center of the back
C. apart at the left side of the bed, she would gently roll the patient toward her
while keeping her legs straight
D. apart at the left side of the bed, she would gently roll the patient toward her
while flexing her knees

37.Instructions for Ms. C's recuperation at home should include the use of a bed
board, firm mattress, and rest in which of the following positions?
A. completely flat in bed
B. head elevated on a pillow, and knees and feet elevated with pillows
C. head elevated with several pillows, and her legs flat
D. Head elevated with several pillows, and several pillows under her knees

38.Ms. C should be reminded that if she is turning on her side, it is best if she

A. grasps a chair leg by the side of the bed, and slowly pulls herself over, flexing the
uppermost knee

B. keeps her legs extended while crossing them to the side to which she is turning,
and then uses her
arms to help turn the upper portion of her body
C. crosses her arms, flexes the uppermost knee toward the side to which she is
turning, and then rolls over
D. crosses her arms, crosses her legs while they are extended to the side toward
which she is turning,
and then rolls over

39.The physician gives Ms. C a prescription for methocarbamol (Robaxin). Because

of her nursing background, Ms. C will know that the mediation is having the
desired effects if which of the following occurs?
A. She feels drowsy, and is sleeping more
B. she has a feeling of euphoria
C. there is a decrease in muscle spasms
D. there is an increase in the knee-jerk reflex

Situation: After a week of bed rest at home, Ms. C's condition remains about the
same. She is admitted to the hospital for further treatment and diagnostic tests.

40.Phenylbutazone (Butazolidin) is ordered for Ms. C. Planning for the

administration of this medication should include directions to
A. administer it immediately before or after eating
B. avoid administering it with dairy products
C. administer it at least 2 hours after eating
D. administer it at specific time intervals, without regard to meals

41.In addition to the order for phenylbutazone, Ms. C is placed on bed rest and in
pelvic traction. To diminish adverse responses to this treatment, the nurse should
request an order for
A. acetylsalicylic acid (aspirin)
B. diphenoxylate hydrochloride (Lomotil)
C. prochlorpeazine (Compazine)
D. dioctyl sodium sulosuccinate (Colace)
42.A myelogram is performed on Mrs. C with a water-soluble contrast medium.
Care after this procedure should include
A. limiting fluid intake and elevating the head of the bed to 15 to 30 degrees
B. not allowing anything by mouth and keeping the bed flat
C. encouraging fluid intake and keeping the bed flat
D. encouraging fluid intake and raising the head of the bed to 15 to 30 degrees
43.Ms. C has a laminectomy. Postoperatively, she complains that the pain is no
different now than it was before surgery. The nurse should
A. administer analgesics as ordered, and explain that the pain is to be expected
because of the edema that results from the surgery
B. administer the analgesics as ordered, but request that the physician check the
patient immediately
C. withhold the analgesic and notify the physician
D. administer the analgesics as ordered, and tell Ms. C it will give her relief shortly
‫بيت التمريض‬ PALNURSE YOUR ACCESS TO SUCCESS

44.Rehabilitation will be facilitated if Ms. C is encouraged to do which of the

following?
A. sleep in prone position
B. sit up for at least part of he day
C. perform abdominal-strengthening exercise
D. perform full trunk range-of-motion exercises

Situation: Martha S is a 27-year old patient who has experienced increasing

generalized stiffness, especially in the morning, fatigue, general malaise, and
swelling and pain in the finger joints. She has a tentative diagnosis of rheumatoid
arthritis.

45.Upon admission, Mrs. S is noted to have a rectal temperature of 37.7°C (100°F).

A white blood count is ordered, and the report comes back at 8,500/mm 3. The
nurse should recognize this as being consistent with rheumatoid arthritis because
it is
A. within normal limits
B. evidence of leukopenia
C. only slightly elevated
D. indicative of a generalized infectious process
46.Which of the following blood-analysis tests would be consistent with diagnosis
of rheumatoid arthritis?
A. an elevated erythrocyte sedimentation rate and negative C-reactive protein
B. an elevated erythrocyte sedimentation rate and positive C-reactive protein
C. a low erythrocyte sedimentation rate and negative C-reactive protein
D. a low erythrocyte sedimentation rate and positive C-reactive protein

47.The primary goal of nursing care for Mrs. S during this initial acute phase of
rheumatoid arthritis should be to
A. prevent deformity and reduce inflammation
B. prevent the spread of the inflammation to other joints
C. provide for comfort and relief of pain
D. assist her to accept the fact that rheumatoid arthritis is a log-term illness
48.During hospitalization, the nurse should explain to Mrs. Samuel that analgesics
of choice would be
A. codeine
B. acetylsalicylic acid (aspirin)
C. C. acetaminophen (Tylenol)
D. D. proppoxyphene hydrochloride (Darvon)

49.During the acute phase of Mrs. S's illness, which of the following measures
would be the most appropriate?
A. frequent periods of active exercises
B. frequent periods of bed rest
C. rest for he affected joints only
D. encouragement to perform activities of daily living independently

50.The nurse understands that the main nursing goal in helping Mrs. S adapt to
her chronic illness and plan is to
A. provide the care she is unable to give herself
B. provide guidance so that she will not repress her illness
C. plan for social contacts so that she will not feel alone
D. arrange for her after-care with the home health aide

51.Mrs. S is given instructions for using paraffin for her hands. The nurse should
include the fact that the dips will be most effective if they are performed
A. before exercising her hands
B. after exercising her hands
C. instead of exercising her fingers
D. while exercising her fingers

52.Whenever Mrs. S feels pain from her arthritis, she tells the nurse she feels not
only the pain but that her "whole body feels threatened." Which response by the
nurse is the most therapeutic?
A. I will have someone stay with you so you won't harm yourself
B. I will teach you some relaxing exercises so you won't be so tense
C. you must have some medication to help you gain control D. arthritic pain will
lessen if you try to grin and bear it

53.When Mrs. S is discharged, she is instructed to take aspirin at home. It is

important that she be told to take the drug
A. on a regular basis throughout the day
B. only when other measures are not effective
C. upon arising and again at bedtime
‫بيت التمريض‬ PALNURSE YOUR ACCESS TO SUCCESS

D. between meals to promote its absorption

54.When Mrs. S is discharged, the nursing staff refers her to a nurse therapist who
will assist her in dealing with the anxiety over her arthritis and the changes it has
made in her life. The nursing team recognizes that the role of the nurse therapist is
to
A. work in conjunction with a psychiatrist
B. provide individual nursing psychotherapy
C. lead groups in therapy for those with similar problems
D. give family nursing psychotherapy

Situation: Twenty years after Mrs. S was first diagnosed with rheumatoid arthritis,
she is admitted for a right total hip replacement. She has experienced severe right
hip pain that has not responded to treatment for several years, and has had
increasing difficulty moving about because of damage to the right hip joint.

55.Preoperative teaching for Mrs. S should include

A. isometric exercises of the quadriceps and gluteal muscles
B. instructions on the necessity for keeping the right leg perfectly straight after
surgery
C. the need to flex the involved hip postoperatively to maintain mobility
D. the avoidance of aspirin for 4 days prior to surgery

56.Which of the following should the nurse consider to be most significant if noted
when checking Mrs. S 3 days postoperatively?
A. pain in the operative site
B. swelling of the operative sites
C. pain and tenderness in the calf
D. orthostatic hypotension

57.The physical therapist orders exercises of Mrs. S's right hip, knee, and foot to
gradually increase range of motion to the right hip. The nurse can best assist Mrs.
S by
A. administering an analgesic before the exercises
B. stopping the exercises if Mrs. S experiences pain
C. performing the exercises for Mrs. S
D. observing Mrs. S's ability to perform the exercises

58.Mrs. S should be instructed to avoid

A. adduction of her right leg
B. abduction of hr right leg
C. bearing any weight on her right leg
D. the prone position in bed

59.The nurse and Mrs. S plan for her rehabilitation. Mrs. S asks the nurse, "What
do I have to do in therapy?" Which reply by the nurse most accurately describes
the task of the patient in rehabilitation? To
A. follow the instructions of the rehabilitation team
B. regain some function that was lost
C. prevent further loss of your ability to function
D. learn to deal realistically with your disability

60.When the rehabilitation therapist tells Mrs. S that the outcome of her therapy
depends on "the ability of the nursing staff" as well as on her motivation, Mrs. S
questions the nurse on the meaning of this phrase. The nurse should reply that
"the nurse's role in rehabilitation is to
A. make the patient as comfortable as possible
B. follow the directions of the rehabilitation therapist
C. supervise the patient's therapy appointments and exercise program
D. assist the patient in establishing therapy priorities and goals

61.Mrs. S asks the nurse if her new joint will function normally. The nurse can best
answer this by saying that
A. the new joint will be stronger than the old one
B. the new joint won't function as well as a normal joint, but it will be better than
the arthritic joint
C. the new joint will function almost as well as a normal joint, particularly if you
perform your exercise faithfully
D. the doctor will be able to assess your limitations in 6 weeks and then explain
them to you

Situation: Mr. Lee is a 20-year-old patient who sustains a compound fracture of

the right shaft of the femur and a simple fracture of the ulna in a motorcycle
accident.
‫بيت التمريض‬ PALNURSE YOUR ACCESS TO SUCCESS

62.While serving as a member of a first aid squad, Mary V, RN, reaches the scene
of the motorcycle accident and administers emergency treatment, which includes
the application of a splint. It is important that the splint
A. be applied while the limb is in good alignment
B. be applied to the limb in the position in which it is found
C. extend from the fracture site downward
D. extend from the fracture site upward

63.While Mr. Lee is being transported in the ambulance to the hospital, he should
be positioned with the affected limbs
A. elevated
B. in a flat position
C. lower than his heart
D. slightly abducted

64.While taking a history from the patient, the nurse determines that his last
booster injection for tetanus immunization was 5 years ago. The nurse should
recognize that this information is important because it
means that he should receive
A. a full tetanus immunization program
B. nothing, because he is sufficiently immunized against tetanus
C. an additional booster injection
D. human tetanus immune globulin

Situation: Mr. Lee is taken to the operating room and the wound caused by the
fracture of the femur is cleansed and debrided. The fracture is then reduced, and a
Steinmann pin for skeletal traction is inserted. A closed reduction of the ulna is
performed, and a cast is applied.

65.The most important nursing measure in the immediate postoperative period

will be
A. encouragement of isometric exercises
B. cleansing of the area around the Steinmann pin
C. careful observation of vital signs
D. massage of pressure areas
66.After Mr. Lee returns to his room, he complains of pain in his right arm. The
initial action of the nurse should be to
A. administer analgesics as ordered
B. check his fingers
C. notify his physician immediately
D. pad the edges of the cast

67.To maintain proper alignment and immobilization of the femur, the physician
has ordered skeletal traction with a Thomas splint. While caring for Mr. Lee, the
nurse should explain to him that he
A. cannot turn or sit up
B. cannot turn but can sit up
C. can turn but cannot sit up
D. can turn and can sit up
68.In dealing with the weights that are applying the traction, the nurse should
A. allow them to hang freely in place
B. hold them up if the patient is shifting position in bed
C. remove them if the patient is being moved up in bed
D. lighten them for short periods if the patient complains of pain

69.Mr. Lee has a Thomas knee splint in place. In addition to the usual measures for
a patient in traction, it will be important that the nurse observe
A. the groin area for pressure
B. for constipation
C. his skin for sings of decubiti
D. for signs of hypostatic pneumonia

70.If Mr. Lee should show an increase in blood pressure and signs of confusion and
increased restlessness, the nurse should suspect
A. a concussion
B. impending shock
C. fat emboli
D. anxiety

71.Because of the nature of Mr. Lee's wound and the insertion of a Steinmann pin,
it is especially important that the nurse observe for
A. a foul odor
B. foot drop
C. pulmonary congestion
D. fecal impaction
‫بيت التمريض‬ PALNURSE YOUR ACCESS TO SUCCESS

72.Mr. Lee develops an acute localized osteomyelitis. He is placed on intravenous

antibiotic therapy. The wound is incised and drained, and neomycin irrigations are
ordered four times a day. It is important that these irrigations be performed
A. with strict aseptic techniques
B. with a warm solution
C. for at least 5 minutes
D. at equal time intervals

Situation: Maria Alfredo is a 30-year old married woman who has systemic lupus
erythematosus (SLE).

73.While doing as nursing history on Mrs. Alfredo, the nurse should recognize that
the most common initial symptoms of SLE are
A. petechiae in the skin, nosebleeds, and pallor
B. hematuria, increased blood pressure, and edema
C. tachycardia, tremors, and loss of weight
D. painful muscles and joints, stiffness, and inflammation of joints

74.Mrs. Afredo is instituted on long-term prednisone therapy. Her daily

maintenance dose is 5 mg/day. In the instructions to Mrs. Alfredo, the nurse
should emphasize that
A. once the symptoms of SLE subside, the medication will be discontinued gradually
B. a weight gain 2 pounds per week should be reported to the physician
C. the maintenance dose will be the lowest dose that controls symptoms
D. if adrenal atrophy occurs, adrenocorticotropic hormone (ACTH) will have to be
prescribed

75.Mrs. Alfredo questions the nurse about family planning and birth control.
Which of the following choices should the nurse include in her answer?
A. oral contraceptives can precipitate an acute exacerbation of your condition
B. Intrauterine devices are the recommended brithcontrol measures
C. there are no contraindications for pregnancy, as long as the disease is being
treated
D. studies indicate that the corticosteroids produce fetal damage

76.The nursing care plan states, "Observe for signs of Raynaud's phenomenon."
The nurse should recognize that this phenomenon
A. occurs as a side effect of prednisone
B. is aggravated by smoking
C. is relieved by application of cold compresses to the hands
D. is the priority care
77.Although many abnormal laboratory findings are found in SLE, there is no one
specific diagnostic test. The test that is positive in over 95 percent of all patients
with SLE is the blood test for
A. the lupus erythematosus (LE) factor
B. the rheumatoid factor
C. antinuclear antibodies (ANA)
D. C-reactive protein (CRP)
78.The teaching program for Mrs. Alfredo planned by the nurse should include
emphasis on which of the following?
A. once the symptoms are controlled, the corticosteroids will be discontinued
B. if hair loss occurs, it is irreversible
C. overexposure to the sun can produce an exacerbation of symptoms
D. a low-potassium, low-protein diet is recommended

79.Mrs. Alfredo tells the nurse that she has had black, tarry stools. The nurse
should
A. reassure the patient that this is a minor side effect of prednisone
B. tell the patient that if she takes the prednisone with milk, black, tarry stools will
be avoided
C. tell the patient that she will ask the physician to prescribe aluminum hydroxide
D. notify the physician because black, tarry stools can be an indication of bleeding
peptic ulcer

80.Mrs. Alfredo calls the physician's office and complains that she has chills, a
fever, and a cough. The nurse should
A. advise that she remain in bed, drink extra fluids, and take aspirin every 4 hours
B. recommended that she increase her dose of prednisone until her temperature is
normal
C. recommended that she come to the office to be examined by the physician
D. tell Mrs. Alfredo to call for an appointment when she is feeling better
‫بيت التمريض‬ PALNURSE YOUR ACCESS TO SUCCESS

Situation: Irene P is being treated in the emergency room for an acute attack of
Meniere's syndrome

81.The nurse should recognize that the triad of symptoms associated with
Meniere's syndrome is
A. nystagmus, arthralgia, and vertigo
B. nausea, vomiting, and arthralgia
C. syncope, headache, and hearing loss
D. hearing loss, vertigo, and tinnitus

82.Patient teaching for Mrs. P includes helping her to recognize that

A. Meniere's syndrome is psychogenic and is brought on by stress
B. most patients can be successfully treated with a low-salt diet and diuretics
C. acute infection can precipitate an attack
D. a labyrinthectomy is the preferred treatment for relieving symptoms and
restoring hearing

83.Nursing intervention during an acute attack includes

A. encouraging the patient to walk
B. placing the patient in a semi-Fowler's position
C. Having the patient lie flat
D. placing the patient in Trendelenburg's position

Situation: Mrs. C, 30 years old, has symptoms of diplopia, fatigue, slight vertigo,
and a lack of coordination. After a neurological work-up she is diagnosed as having
multiple sclerosis.

84.The main goal of nursing care for Mrs. C during the acute phase of the disease
should be to
A. promotes rest
B. prevent constipation
C. maintain normal functioning
D. encourage activities of daily living
85.Mrs. C is note d to be having mood swings. In deciding what approach to use
with her, the nursing staff should recognize that this
A. is probably the result of an underlying mental disorder
B. indicates that Mrs. C is having difficulty accepting her diagnosis
C. may be a result of pathology and involvement of the limbic system in the disease
D. indicates that Mrs. C's intellectual capacity has been compromised

86.Mrs. C questions the nurse concerning the usual course of multiple sclerosis.
Which would be the best reply by the nurse?
A. each individual is very different; we cannot tell what will happen
B. I know you are worried, but it is too soon to predict what will happen
C. usually, acute episodes like this are followed by remissions, which may last a long
time
D. the future will take care of itself; let's concentrate on the present

87. As Mrs. C's condition improves, it is most important that she be given
guidance in
A. developing a program of exercise
B. learning to handle stressful situations
C. seeking vocational rehabilitation
D. limiting her activities to those that are absolutely necessary

Situation: Barbara is a 23-year-old woman who lives with her mother, sister, and
brother in a private residence. She is attending the neurological out-patient clinic
for the first time. Her health history includes two grand mal seizures./ A diagnosis
of idiopathic epilepsy has been made. The physician has ordered an
electroencephalogram (EEG) and phenytoin sodium (Dilantin), 300 mg/day

88.While doing a nursing history on Barbara, the nurse should recognize that
A. persons with idiopathic epilepsy have a lower intelligence level
B. grand mal seizures do not cause mental deterioration
C. a common characteristic of idiopathic epilepsy is committing acts of violence
D. idiopathic epilepsy is a form of mental illness

89.To prepare Barbara for EEG, the nurse should explain that
A. during the test she will experience small electric shocks that feels like pin pricks
B. the test measures mental status as well as electrical brain waves
C. during the hyperventilation portion of the test, she may experience dizziness
‫بيت التمريض‬ PALNURSE YOUR ACCESS TO SUCCESS

D. she will be unconscious during the test

90.Health teaching for Barbara includes ensuring that she understands that
A. proper prophylactic medication can control the incidence of seizures
B. moderate use of alcohol is permitted
C. forcing fluids helps to reduce the incidence of seizures
D. the incidence of seizures is related to hyperglycemia

91.During a follow-up clinic visit, Barbara tells the nurse that her urine has had a
reddish-brown color. The nurse should
A. reassure Barabara that this is a harmless side effect of phenytoin sodium
(Dilantin)
B. tell Barbara that this is a sign of hepatic toxicity
C. recommend that Barbara go to the laboratory for a serum Dilantin concentration
test
D. notify the physician that Barbara has hematuria

92.A long-term goal for Barbara is to minimize the gingival hyperplasia associated
with Dilantin therapy. The nurse should recognize that
A. another anticonvulsant will be prescribed if it occurs
B. the physician will reduce the dosage at the first sign of hyperplasia
C. a regular plan of good oral hygiene is essential
D. vitamin C should be taken daily with the Dilantin

93.Barbara's serum concentration level Dilantin is 15 ug/ml. The nurse should

recognize this as
A. a desired therapeutic serum level
B. below the desired therapeutic level
C. above the recommended serum level
D. a toxic serum level
94.Family members should be instructed about caring Barbara during a grand mal
seizure. Immediate care during a seizure should include
A. restraining Barbara's arms and legs
B. forcing the mouth open to insert an airway
C. giving orange juice before the clonic stage begins
D. turning Barbara's head to the side
95.The nurse explains to Barbara that safety precautions can be taken by those
who have warning symptoms before the seizure. (These symptoms are not part of
the seizure, as the aura is.) What warning symptoms should the nurse tell Barbara
to be aware of?
A. Hot and cold sensations, gastrointestinal problems, anxiety, and mood changes
B. Muscle twitching, lapse of consciousness, anxiety, and gastrointestinal problems
C. tingling in a local region, anxiety, and lapse of consciousness
D. increased tonicity of muscles and autonomic behavior

96.The nurse should tell Barbara's family that after a seizure she will be in a
confused state and will need some supervision. It is most important for the caring
one to be calm because the confused state of the epileptic is considered to be
A. One mood swings and a feeling of general inadequacy and fatigue that result in a
decrease of interest
B. an adaptive period, when one slowly learns to cope with the devastating insults
to one's psychological and physical integrity
C. a gross impairment in social and intellectual functioning with crude, tactless, and
impulsive
behavior
a helpless state, with intellectual deterioration, difficulty in communication,
and regression to the infantile state

97.Barbara asks the nurse if it is true that there is an "epileptic personality."

Which of the following choices would be the nurse's best response/
A. the person must be aware that anxiety over anticipation of a seizure may cause
personality problems
B. No, deviation in personality is caused by restrictions imposed by society
C. Yes, one may learn to induce seizures as a way of getting attention from others
D. the person may take on a sick role if mismanaged at home or in the community

Situation: Ms. R, a 35-year old woman, has myasthenia gravis. She has been
referred to the neurology clinic by her physician.

98.While doing a nursing history on Ms. R, the nurse should expect her to
complain of which of the following symptoms?
A. passive tremors, cogwheel rigidity, and drooling
B. spastic weakness of the limbs, intention tremors, and incontinence
C. diplopia, ptosis, and fatigue
D. nystagmus, ataxia, and tinnitus
‫بيت التمريض‬ PALNURSE YOUR ACCESS TO SUCCESS

99.In preparing a teaching plan for Ms. R, the nurse should emphasize that
A. the anticholinesterase medications cause fewer side effects when taken on an
empty stomach
B. physical activity should be planned for the late afternoon early evening
C. a member of the family should be taught how to use suction for emergency use
D. edrophonium chloride (Tensilon) is the drug of choice in the treatment of
myasthenia gravis
E.

100.Respiratory distress is common in people with myasthenic crisis? Marked

improvement of respirations occurs after the administration of intravenous
A. diazepam (Valium)
B. hydrocortisone
C. atropine sulfate
D. edrophonium chloride (Tensilon)

101.The medication used to treat cholinergic crisis

A. atropine sulfate
B. neostigmine (Prostigmin)
C. aminophylline
D. hydrocortisone
102.The physician has prescribed pyridostigmine (Mestinon), 180 mg/day. Ms. R
tells the nurse that each time she takes the medication she feels nauseated. The
nurse should tell Ms. R to
A. crush the tablet before taking it
B. take the tablet with food or milk
C. take the tablet on an empty stomach
D. not to take the medication until she notifies the physician

Mr. Go, who has had Parkinsosn's disease for 4 years, visits his wife daily during
her hospital stay. His illness is being treated with levodopa (L-dopa).

103.When Mr. Go visits his wife, he is observed to be walking rather slowly. The
nurse should recognize that Mr. Go is
A. exhibiting a long-range side effect of L-dopa
B. exhibiting a symptom that is characteristic of stage II Parkinson's disease
C. beginning to experience atrophy of the cerebral cortex and cellular changes
D. probably doing this on purpose as a way of

104.The nurse can help him to be more comfortable by

A. discussing this problem and how he handles it, and discussing hygiene measures
with him
B. opening the windows and providing as much ventilation as possible while he is
visiting
C. suggesting that he is probably dressing too warmly for the hospital environment
D. explaining that this is a side effect of his medication, and encouraging increased
intake of fluids

Situation: Mr. go has a sudden exacerbation of symptoms. He develops

tachycardia, a respiratory rate of 40, and appears extremely anxious. He is
hospitalized with a diagnosis of parkinsonian crisis.
105. Planning for Mr. Go's care should include measures to
A. provide a quiet, restful environment
B. maintain joint range of motion
C. decrease social isolation
D. improve his nutritional status

106.Mr. Go responds to treatment, and his condition gradually improves.

However, he complains that he feels dizzy whenever he tries to stand up from a
lying position. The nurse should
A. explain that this is just part of his illness
B. tell him that his doctor will be notified of this symptom
C. encourage him to change his position slowly
D. discuss his feelings about his wife's hospitalization

107.Mr. Go has problems in dressing himself as a result of tremors, but he refuses

all assistance. Which of the following is the best initial action by the nurse in
response to this complaint?
A. tell him he needs assistance, and gradually help him
B. give him more time and encouragement to dress himself
C. suggest that for the present he wear only the hospital gown
D. listen to his refusal, but give him assistance as needed
‫بيت التمريض‬ PALNURSE YOUR ACCESS TO SUCCESS

108.Mr. Go discusses his work as an accountant with the nurse. He states that he
his glad that he will be able to continue working. An appropriate initial response
would be based on the nurse's recognition that he
A. should be encouraged to be active
B. should be cautioned against overfatigue
C. is being unrealistic about his future
D. needs to recognize that his situation is unique
109.Mr. Go tells the nurse that someone told him that people with Parkinson's
disease develop early senility. In response, the nurse should explain that
A. Parkinson's disease progresses very slowly over a period of years, and it is only in
the late stages that any mental changes might take place
B. his information is false, because Parkinson's disease does not cause any changes
in the individual's
intellectual capacities
C. he does not have to worry about senility because he is responding so well to
treatment
D. although Parkinson's disease does cause mental confusion, this condition is
clinically different from senility
E. 1 C 2B 3A 4A 5B 6A 7D 8A 9B
10 D
F. 11 B 12 A 13 B 14 D 15 B 16 B 17 C 18 C 19
A 20 C
G.21 C 22 C 23 B 24 C 25 D 26 D 27 D 28 C 29
A 30 A
H.31 D 32 C 33 B 34 A 35 A 36 D 37 B 38 C 39
C 40 A
‫بيت التمريض‬ PALNURSE YOUR ACCESS TO SUCCESS

I. 41 D 42 D 43 A 44 C 45 A 46 B 47 A 48 B 49
B 50 B
J. 51 A 52 B 53 A 54 B 55 A 56 C 57 A 58 C 59
D 60 D
K.61 C 62 B 63 A 64 C 65 C 66 B 67 D 68 A 69
A 70 C
L. 71 A 72 A 73 D 74 C 75 A 76 B 77 C 78 C 79
D 80 C
M.81 D 82 B 83 C 84 A 85 C 86 C 87 B 88 B 89
C 90 A
N.91 A 92 C 93 A 94 D 95 A 96 B 97 D 98 C 99
C 100 D
O.101 A 102 B 103 B 104 A 105 A 106 C 107 B 108 A
109 A