IPI NURSING EXAM PART 2

250. The school nurse is teaching the faculty is the most effective methods to prevent
the spread of lice (Pediculus250. The school nurse is teaching the faculty the most effective
methods to prevent the spread of lice (pediculus Humanus Capitis) in the school. The
information that would be most important to include is reflected in which of these statements?
A. “The treatment medication requires reapplication in 8 to 10 days.”
B. “Bedding and clothing can be boiled or steamed to kill lice.”
C. “Children should not share hats, scarves, and combs.”
D. “Nit combs are necessary to comb lice eggs (nits) out of the children’s hair.”

251. A nurse is reinforcing teaching with a client about compromised host precautions. The
client is receiving filgrastim (Neupogen) for neutropenia. Which lunch selection suggests the
client has learned about necessary dietary changes?
A. Grilled chicken sandwich and skim milk.
B. Roast beef, mashed potatoes, and green beans
C. Peanut butter, sandwich, banana, and iced tea
D. Barbeque beef, baked beans, and coleslaw.

252. A school nurse has a 10 year old child with a history of epilepsy with tonic-clonic seizures
attending classes regularly. The school nurse should inform the teacher that if the child
experiences a seizure in the classroom, the most important action to take during the seizure
would be to
A. Move any chairs or desks at least 3 feet away from the child
B. Note the sentence of movements with the time lapse of the event
C. Provide privacy as much as possible to minimize frightening the other children.
D. Place the hands or a folded blanket under the head of the child.

253. Which of these clients is the priority for the nurse to report to the public health department
within the next 24 hours?
A. An infant with a positive culture of stool for shigella
A. An elderly factory worker with a lab report that is positive history for acid-fast bacillus
smear
B. A young adult commercial pilot with a positive pathological examination from an induced
sputum for Pneumocystis carinii.
C. A middle aged nurse with a history of varicella zoster virus and with crops of vesicles on
an erythematous base that appear on the skin.

254. When screening children for scoliosis, at what time of development would the nurse expect
early signs to appear?
A. Prenatally on ultrasound
B. In early infancy
C. When the child begins to bear weight
D. During the pre adolescent growth spurt
255. The nurse is teaching the client to select foods rich in potassium to help prevent digitalis
toxicity. Which choice indicates the client understands dietary needs?
A. Three apricots
B. Medium banana
C. Navel orange
D. Baked potato

256.When administering enteral feeding to a client via a jejunostomy tube, the nurse should
administer the formula
A. Every four to six hours
B. Continuously
C. In a bolus
D. Every hour

257. In providing care for a client with pain from a sickle cell crisis, which one of the following
medication orders for pain control should be questioned by the nurse?
A. Demerol ‘
B. Morphine
C. Methadone
D. Codeine

258.The health care provider orders an IV aminophylline infusion at 30 mg/hr. The pharmacy
sends a 1,000 ml bag containing 500 mg of aminophylline. In order to administer 30 mg per
hour, the RN will set the infusion rate at:
A. 20 ml per hour
B. 30 ml per hour
C. 50 ml per hour
D. 60 ml per hour

259. A client with bipolar disorder is taking lithium (LithanE…. What should the nurse emphasize
when teaching about this medication?
A. Take the medication before meals
B. Maintain adequate daily salt intake
C. Reduce fluid intake to minimize diuresis
D. Use antacids to prevent heartburn

260. A 4 year old child is admitted with burns on his legs and lower abdomen. When assessing
the child’s hydration status, which of the following indicates a less than adequate fluid
replacement?
A. Decreasing hematocrit increasing urine volume
B. Rising hematocrit and increasing urine volume
C. Falling hematocrit and decreasing urine volume
D. Stable hematocrit and increasing urine volume

261.A newly diagnosed with Type 1 diabetes Mellitus asks the purpose of the test measuring
glycosylated hemoglobin. The nurse should explain the purpose of this test is to determine:
A. The presence of anemia often associated with Diabetes
B. The oxygen carrying capacity of the client’s red cells.
C. The average blood glucose for the past 2-3 months
D. The client’s risk for cardiac complications
262.The nurse is teaching a client with chronic renal failure (CRF) about medications. The client
questions of the purpose of aluminum hydroxide (Amphojel) in her medication regimen. What is
the best explanation for the nurse to give the client about the therapeutic effects of this
medication?
A. It decrease serum phosphate
B. It will reduce serum calcium
C. Amphojel increases urine output
D. The drug is taken to control gastric acid and secretion

263. A client with testicular cancer has had an orchiectomy. Prior to discharge the client
expresses his fears related to his prognosis. Which principle should the nurse base the
response on?
A. Testicular cancer has a cure rate of 90% with early diagnosis
B. Testicular cancer has a cure rate of 50% with early diagnosis
C. Intensive chemotherapy is the treatment of choice
D. Testicular cancer is usually fatal

264.A client has a history of chronic obstructive pulmonary disease (COPD...As the nurse enters
the client’s room, his oxygen is running at 6 liters per minute, his color is flushed and his
respirations are per minute. What should the nurse do first?
A. Obtain a 12 lead EKG
B. Place client in high Fowler’s position
C. Lower the oxygen rate
D. Take baseline vital signs

265. The nurse is caring for a client who requires a mechanical ventilator for breathing. The high
pressure alarm goes off on the ventilator. What is the first action the nurse should perform?
A. Disconnect the client from the ventilator and use a manual resuscitation bag
B. Perform a quick assessment of the client’s condition
C. Call the respiratory therapist for help
D. Press the alarm reset button on the ventilator

266.The provider orders reads “Aspirate nasogastric (NG) feeding tube every 4 hours and check
pH of aspirate.” The pH of the aspirate is 10. Which action should the nurse take?

A. Hold the tube feeding and notify the provider

B. Administer the tube feeding as scheduled
C. Irrigate the tube with diet cola soda
D. Apply intermittent suction to the feeding tube

267. A patient has returned to the floor after undergoing a transurethral resection of the prostate
(TURP). The patient has a continuous bladder irrigation system in place. The patient tells you he
is experiencing bladder spasms and asks what you can do to relieve his discomfort. What is the
most appropriate nursing action to relieve the discomfort of the patient?
A. Apply a cold compress to the public area
B. Notify the urologist
C. Irrigate the catheter with 30 to 50 mL of normal saline as ordered
 D. Administer a narcotic as ordered.

268. The nursing instructor is talking with the junior nursing class about male reproductive
issues. The instructor tells the students that organic causes of erectile dysfunction include
what? (Mark all that apply.)
A. Cirrhosis
B. Multiple sclerosis
C. Tadalafil
D. Phosphodiesterase - 5 inhibitors
E. Parkinsonism

279. The nursing instructor is discussing the different types of immunity with the Level 1 nursing
students. The instructor gives an example of a patient given a vaccination for rubella; what will
the healthy patient develop?
A. Natural Immunity
B. Active acquired immunity
C. The disease rubella
D. Hypersensitivity

280.You are performing an admission on a patient newly admitted with cancer. The patient has
just finished a course of chemotherapy. Which assessments would you make that might indicate
that the patient is possibly experiencing immune dysfunction (Mark all that apply.)
A. Cardiovascular
B. Respiratory
C. Neurosensory
D. Hematologic
E. Endocrine

281. A 16 year old has been brought to the emergency department by his parents after falling
through the glass of a storm door. The fall resulted in a 6 cm laceration of the right antecubital.
The nurse caring for the patient knows that the site of the injury will have an invasion of what?
A. Interferon
B. Phagocytic cells
C. Apoptosis
D. Cytokines

282. When the nurse assesses her patient’ laboratory studies, the nurse notes in an increase in
several cell counts on the complete blood count. The nurse would expect an increase in what
cell count due to the fact that these are cells to arrive at the site where inflammation occurs?
A. Eosinophils
B. Red blood cell
C. Lymphocytes
D. Neutrophils
283. You are a home health caring for a patient who has an immunodeficiency. What is most
important for you to do to help ensure successful outcomes and a favorable prognosis?
A. Encourage the patient and family to be active partners in the management of the
immunodeficiency.
B. Encourage the patient and family to be knowledgeable about the treatment regimen
C. Make sure the patient and family understand the patient teaching
D. Make sure the patient and family understand the medications used in treatment
284. You are a home health nurse reinforcing patient teaching with a patient who is
immunosuppressed and his family. You know that the patient understands the teaching when he
states what?
A. “My family needs to understand what to do i get an infection.”
B. “I need to know how to treat any infection that i get.”
C. “I need to understand how to give my infusions.”
D. “My family and I need to understand that these are life long things i need to do.”

285. The nursing caring for patients on the immunocompromised unit knows that a major role
for her is what?
A. To reinforce teaching knowledge for the family
B. To develop and maintain a knowledge base in the evolving treatment modalities
C. To teach the patient to stay away from crowds
D. To help the patient and family understand the adverse effects

286. A patient with immunodeficiency disease needs a lot of patient education to understand his
or her disease process and to learn self-care for when they are at home. What areas of patient
education do these patients need?
A. How to manage stress
B. Physiologic safety
C. Psychological stability
D. Healthy nutrition
E. How to strengthen immune system function .

287. In one primary immunodeficiency disease white blood cells cannot initiate an inflammatory
response to infection organisms. What disease is it?
A. Chronic granulomatous disease
B. wiskott -Aldrich syndrome
C. Hyperimmunoglobulinemia E syndrome
D. Common variable immunodeficiency

288. A new AIDS patient is being admitted to your unit. While you are doing the admission
assessment you are aware that you need to include what (Mark all that apply)
A. Patient’s physical status
B. Identification of potential risk factors
C. All factors affecting immune system functioning
D. The patient’s biophysical profile
E. History of sexual practices.

289. You are agreed to work with an AIDS patient who is very anxious. What should be an
appropriate nursing intervention to aid this patient in decreasing her level of anxiety?

A. Teach the patient guided imagery

B. Instruct the patient in planning activities interspersed with periods of rest
C. Increase activity level by walking with patient
D. Give cymbalta as ordered
290. An AIDS patient is admitted to the hospital with AIDS related anorexia. What drug has been
found to promote significant weight gain in AIDS by increasing body fat stores?
A. Adversa
B. Momordica Charantia
C. Megestrol
D. Dronabinol

291.A patient with H.I.V. is admitted to the hospital because of chronic severe diarrhea. As the
nurse caring for this patient you would expect physician to order what drug for the management
of the patient’s diarrhea?

A. Zithromax
B. Sandostatin
C. Levaquin
D. Biaxin

292. The clinic nurse is caring for a patient diagnosed with rheumatoid arthritis. The patient tells
you she has not been taking medication because she cannot get the medicine bottle open. The
patient says it is too hard to get the child proof tops off the bottle. What suggestion could you
make that would be the most helpful to your patient, aiding her in being more complaint with her
medication treatment regimen?
A. Have a neighbor come over and open the bottles for you
B. Have a family member come and open the bottles for you
C. Take your medicine bottles back to the pharmacy and have them put tops on them that
are not child proof
D. Get a 7 day pill holder and have someone fill it for you each week.

293. You are preparing plan for a patient newly diagnosed with rheumatoid arthritis. The nurse is
planning subject the nurse needs to teach this patient?
A. Diet
B. Activity limitations
C. Signs and symptoms
D. The side effects of the medications

294. A 25 year old mother of a 6 month old has just diagnosed with rheumatoid arthritis. The
nurse is planning the teaching for this patient. What willing the teaching focus on? (Mark all that
apply)
A. Physical limitations and adaptations
B. Nutrition and weight maintenance
C. The disorder itself
D. Possible changes related to the disorder
E. Patient safety in the home

295. A patient in the rehabilitation phase of the burn injury is setting goals with the nurse. What
goals would be appropriate at this time? Mark all that apply.
A. Increased participation in activities of daily living
B. Increased understanding of the planned follow up care
C. Increased control of treatment
D. Adjustment to alterations in lifestyle
E. Recognition of complications
296. A burn patient is transitioning from the acute phase of the injury to the rehabilitation phase.
The patient tells the nurse. “I can wait to have surgery to reconstruct my face so I took normal
again.” What would be the nurse’s best response?
A. “You know, nothing can be done until your scars mature. It is something the doctor will
talk to you about in the first few years after discharge.”
B. “That is something for you to talk to your doctor about.”
C. “I know that is really important to you, but you have to realize that no one can make you
look like you used to.”
D. “You will have most of these scars for the rest of your life.”
297. What is a priority in the rehabilitation phase of the burn injury?
A. Monitoring fluid and electrolyte imbalances
B. Patient and family education
C. Assessing wound healing
D. Document family support

298. Your patient is in the acute phase of a burn injury. One of the nursing diagnosis on the plan
of care is ineffective coping due to burn injury and altered body image. What interventions can
you institute to help his patient cope more effectively? (Mark all that apply.)
A. Monitoring fluid and electrolyte
B. Patient and family education
C. Assessing wound healing
D. Documenting family support

299. The causes of acquired seizures include what? (Mark apply that)
A. Cerebrovascular disease
B. Metabolic and toxic conditions
C. Hypernatremia
D. Brain tumor
E. Drug and alcohol.

300. A nurse is caring for a patient admitted with cluster headaches. The nurse knows that in the
early phase of a cluster headache what is required?
A. Dim lightning
B. Abortive medication therapy
C. Quiet
D. Rest

301. You are discharging a patient home after supratenorial removal of a pituitary
mass. What medication would expect to have ordered prophylactically for this
patient?

A. Prednisone
B. Dexamethasone
C. Cafergot
 D. Phentoin

302. During their pathophysiology class the nursing students study seizures. How
might the instructor best describe the cause of a seizure?

A. Uncontrolled normal electrical charges throughout the brain

B. A drysrthymia in the motor strip of the brain
C. A dysrthymia in the nerve cells in one section of the brain
D. Abnormal, recurring controlled electrical charges in the brain

303. You are caring for a patient who has had transspheniodal surgery. You know
that when a patient has transsphenoidal surgery it is generally for a problem with
what?

A. Pituitary
B. Thalamus
C. Hypothalamus
D. Foreamenvole

304. The nursing instructor is teaching her students about monitoring a patient with
increased ICP. What is a trend of ICP measurements over time an important
indication of?

A. Patient’s level of consciousness

B. Patient’s ultimate prognosis
C. Whether or not the patient’s brainstem is going to herniated
D. Patient’s underlying status

305. A patient is considered terminal after being involved in a motor vehicle

accident in which they received massive trauma to the head. As the patient’s ICP
increases and condition worsens, the family asks you what indications of
approaching death will be there be. What would be your best response?

A. “There is a change in the pattern of their respirations.”

B. “Projectile vomiting and hemiplegia usually occur just before death.”
C. “Posturing may develop as pressure on the brain steam increases.”
D. “Loss of brain steam reflexes is a sign of approaching death.”
306. The nurse is caring for a patient with a brain tumor. What drug would the
nurse expect the nurse to be ordered to reduce the edema surrounding the tumor?

A. Solumedrol
B. Dextromethrorphan
C. Dexamethasone
D. Mannitol

307. A patient with suspected head injury following an assault is being transported
to the emergency department. What would the nurse expect the physician to order
to aid in preventing secondary injury?

A. PET
B. CBC
C. ABG
D. MRI

308. The nurse for a patient with a spinal cord injury notes that the patient is
having autonomic dysreflexia. What is the priority nursing action at this time?

A. Irrigate the catheter

B. Check the rectum for a fecal mass
C. Place the patient in a sitting position
D. A topical anesthesia is inserted into the rectum

309. A patient you are caring is noted that a 6 year old is in transit with a suspected
brain injury after being involved in a pedestrian /motor vehicle accident. The child
is unresponsive at this time. Vital signs are within normal limits. What will the
therapy used on this child be directed towards?

A. A distended bladder
B. A fecal mass
C. Abrupt onset of fever
D. Sudden hypothermia
310. The emergency department is notified that a 6 year old is in transit with a
suspected brain injury after being involved in a pedestrian/motor vehicle accident.
The child is unresponsive at this time. Vital signs are within normal limits. What
will the therapy used on this child be directed towards?

A. Maintain the child’s airway

B. Decreasing the ICP
C. Assessing secondary brain injury
D. Preserving brain homeostasis

311. A patient with a T-2 injury is in spinal shock. The nurse will expect to observe
what assessment finding?

A. Absence of reflexes along with flaccid extremities

B. Positive Babinski’s reflex along with spastic extremities
C. Hyperreflexia along with spastic extremities
D. Spasticity of all four extremities

312. A patient presents at the clinic complaining of pain and weakness in her
hands. On assessment in the nurse notes diminished reflexes in the upper
extremities bilaterally and bilateral loss of sensation. The nurse knows that these
findings are indicative of what?

A. Guillain-Barre’ Syndrome
B. Myasthenia gravis
C. Trigeminal neuralgia
D. Peripheral nerve disorder

313. A 35 year old woman is diagnosed with a peripheral neuropathy. When

making her plan of care, the nurse knows to include what in patient teaching (Mark
all that apply)

A. Inspect the lower extremities for skin breakdown

B. Footwear needs to be accurately sixed
C. The disease has a genetic component
D. Assistive devices may be needed to reduce the risk of falls
 E. Ask others for assistance

314. A diabetic patient presents to the clinic and is diagnosed with a

mononeuropathy. What does the nursing care for this patient involve?

A. Protection of the affected limb from injury

B. Exercises for the affected limb
C. Information on support groups
D. Assistive devices to prevent foot drop

315. You are the nurse caring for a patient with myasthenia gravis. You know that
patient/family education is major part of the care for this patient because most of
her care is given on an patient basis. When developing the teaching plan for this
patient/ family you would know that apriority factor in your education plan should
be what?

A. Medication management
B. Fatigue and rest
C. Coping
D. Exacerbation management

316. You are the nursing caring for a 67 year old female with multiple sclerosis
(MS). She tells you that she is very concerned about the progress of her disease
and what the future holds. You know that elderly patients with MS are particularly
concerned about what? (Mark all that apply.)

A. Possible nursing placement

B. Fatigue
C. Increased disability
D. Martial concern
E. Social isolation

317. A 33 year old nurse parents at the clinic with complaints of weakness, in
coordination, dizziness, and loss of balance. The patient is hospitalized and
diagnosed with multiple sclerosis (MS). What sign or symptom, revealed during
the initial assessment, is typical of MS?
 A. Diplopia, history, of increased fatigue, and decreased or absent deep tendon
reflexes
B. Flexor spasms, clonus, and negative Babinski’s reflex.
C. Blurred vision, intention tremor, and urinary hesitancy
D. Hyperactive abdominal reflexes and history of unsteady gait and episodic
paresthesia in both legs

318. The nurse is preparing to teach a patient recently diagnosed with myasthenia
gravis about the disease. What should the nurse teach the patient that myasthenia
gravis is caused by?

A. Genetic dysfunction
B. Upper and lower motor neuron lesions
C. Decreased conduction of impulses in an upper motor neuron lesion
D. A lower motor neuron lesion

319. A male patient presents to the patient is guarding his neck and tells the nurse
that the has stiffness in the neck area. The nurse suspects the patient may have
meningitis. What is another well- recognized sign of this infection?

A. Negative Brudzinski’s sign

B. Positive Kernig ‘s sign
C. Hyperpatellar reflex
D. Sluggish pupil reaction

320.A patient presents to the emergency department complaining of severe

headaches, nosebleeds and anxiety. What might the nurse suspect is the problem
with this patient?

A. Hypertensive emergency
B. Hypertensive crisis
C. Hypertension
D. Hypertensive urgency

321. A patient is sent to the emergency department by her primary care physician
in a hypertensive urgency. How would the nurse expect this patient to be treated?

A. Diuretic
 B. Beta-blocker
C. Calcium channel blocker
D. Alpha inhibitor

322. A patient in hypertensive urgency is admitted to the CUU. What is the global
of treatment for a patient in hypertensive urgency?

A. Normalizing blood pressure within 12 to 24 hours

B. Obtaining a blood pressure of at least 140/90 in 36 hours
C. Obtaining a blood pressure of at least 120/80 is 36 hours
D. Normalizing blood pressure within 24 to 48 hours

323. Patients in hypertensive crisis can have a preciptitous drop in blood pressure.
This can be a life-threatening event if immediate action is not taken. What should
be done to restore blood pressure to an accepting level?

A. Infuse plasma expanders

B. Withhold all medications until blood pressure stabilizers
C. Infuse normal saline
D. Withhold anti-hypertensive until blood stabilizers

324. A patient in hypertensive emergency is being cared for in the intensive care
unit. The patient has become hypovolemic secondary to natriuresis. What could be
the IV fluid of choice for volume replacement?

A. D5W
B. 0.45 normal saline
C. D10
D. Normal saline

326. A critical care nurse is caring for a patient in a hypertensive emergency . what
medication would you expect the physician to order for this patient?

A. Lisinopril
B. Coreg
C. Sodium nitroprusside
D. Hydrochlorothiazide
327. You are caring for a client with uncontrolled hypertension. The patient ask
you can happen if the hypertension isn’t brought under control. What could be a
consequence of uncontrolled hypertension (Mark all that apply.)

A. Transient ischemic attacks

B. Cerebrovascular accident
C. Retinal hemorrhage
D. Venous insufficiency
E. Right ventricular hypertrophy

328. You are a clinic nurse caring for a patient with hypertension. You are
developing a care plan for this patient. What might be a priority nursing diagnosis
for this patient’s plan of care?

A. Deficient knowledge regarding the relation between the treatment regimen

and the medication ordered
B. Noncompliance with therapeutic regimen related to side effects of
prescribed therapy.
C. Deficient knowledge regarding the relation between the prescribed
medication and patient’s symptoms
D. Noncompliance with treatment regimen related to quality of life

329.The student nurse is doing clinical hours in a walk in clinic. A patient with
primary hypertension, and who has not been adhering to the prescribed dietary
regimen, comes in for a follow-up appointment. The student is asked to develop a
Nursing Care Plan for this patient. What is one of the measurable patient outcomes
the student may include?

A. Patient will reduce Na intake to no more than 2.4 kg of sodium

B. Patient will have a stable BUN and serum creatine levels
C. Patient will abstain from fat intake and reduce calories
D. Patient will maintain a normal body weight

330. A patient with a new diagnosis of hypertension is being assessed by the nurse.
Why would the nurse question the patient about decreased visual acuity?
 A. It may indicate retinopathy
B. It may indicate peripheral arterial disease
C. It may indicate nephropathy
D. It may indicate left ventricular hypertpathy

331. You are caring for a patient admitted to the orthopedic unit skeletal traction.
You know that this patient is at increased risk for DVT. What would you do to
decrease the risk of DVT in this patient?

A. Pretend to ride a bicycle while you lay in bed

B. Allow the patient to assist range of motion exercises
C. Encourage the patient to perform active ROM exercises on the affected
D. Do foot and ankle exercises every 1 to 2 hours while awake

332. What does plantar flexion demonstrate?

A. Function of the plantar nerve

B. Function of the tibial nerve
C. Function of the radial nerve
D. Function of the personal nerve

333. You are working with a student nurse to set up traction on a patient with
Buck’s traction. How often do you need to assess circulation to the affected leg?

A. Within 30 minutes, then every 1 to 2 hours

B. Within 30 minutes, then every 4 hours
C. Within 30 minutes, then every 8 hours
D. Within 30 minutes, then every shift

334. A patient is scheduled for a total knee replacement. The surgeon explains the
technique of creating a “bloodless” field for the surgery to the patient. What does
this entail?

A. Intermittent auto transfusion

B. Postoperative blood salvage
C. Intraoperative blood salvage with reinfusion
D. Use of a pneumatic tourniquet
335. You are caring for a patient who is in skeletal traction. What is most important
to do frequently when caring for a patient in skeletal traction to maintain effective
traction?

A. Check the traction apparatus to see that the ropes are in the wheel grooves of
the pulleys
B. Make sure that the weighs hang freely
C. Make sure that the knots in the rope are tied securely
D. Evaluate patient’s position, because slipping down in bed results in
ineffective traction

336. A nurse is caring for a patient who just had skeletal traction removed and a
brace applied to their leg. What is a brace used for (Mar all that apply.)

A. Prevent additional injury

B. Align body part
C. Provide support
D. Control movement
E. Prevent deformity

337.The nurse is preparing instructions for a patient who is going home with a cast
on his leg. What teaching point is most critical to emphasize in the teaching
session?

A. Using crutches properly

B. Exercising joints above and below the cast, as ordered
C. Avoiding walking on a leg cast without the physician’s permitted
D. Reporting signs of impaired circulation

338. A patient who underwent a total hip replacement is being routinely turned.
What should the nurse and other caregivers do to prevent dislocation of the new
prosthesis?

A. Keep the affected leg in position of abduction

B. Use measures other than turning to prevent pressure ulcers
C. Prevent internal rotation of the affected leg
D. Keep the hip flexed by placing pillows under the patient’s knee
339. A patient is admitted to the unit in traction for a fractured proximal femur.
What is the most appropriate type of traction to apply to a fractured proximal
femur?

A. Russell’s traction
B. Dunlop’s traction
C. Buck’s extension traction
D. Cervical head halter

340. A patient has come to the clinic for a routine annual physical. The Nurse
Practitioner notes a large projection of bone at the shoulder. The Nurse Practitioner
knows that this is most likely what?

A. An osterosacroma
B. An osteochondroma
C. An osteoblast
D. An osteitis

341. You are preparing a patient who underwent foot surgery for discharge. You
are discussing the use of assistive devices for a portion of your rehabilitation with
the patient and their family. What does the choice of assistive devices depend on?

A. Patient’s general condition, balance, and weight-bearing prescription

B. Patient’s general condition, strength, and weight restrictions
C. Patient’s motivation, balance, and weight-bearing prescriptions
D. Patient’s weight-bearing prescriptions, motivation and balance

342. You are precepting a new graduate nurse who has just started working on the
orthopedic unit. Today the two of you are providing care for a patient who has just
returned from having foot surgery with percutaneous pins. The graduate nurse is
discussing the potential for infection in patients who undergo foot surgery. What
would you tell the graduate nurse about the potential for infection?

A. Dressing changes are done under strict sterile technique

B. Surgical site can be soaked in hot bath water for up to 10 minutes
C. Use soap and Clorox to clean pin sites
D. Care must be taken to protect the surgical wound from dirt and
moisture
343. What is the drug of choice used to treat osteomyelitis?

A. Calcitonin
B. Mithracin
C. Alkaline phosphate
D. Potassium hydrochloride

344. A 42 year old man presents at the clinic complaining of pain in his heel so bad
it inhibits his ability to walk. The patient is diagnosed with plantar fasciitis. Patient
teaching provided by the nurse would include what instructions to decrease the
pain associated with this condition?

A. Wrapping the affected area in lamb’s wool or gauze

B. Gently stretching the foot and the Achilles tendon
C. Wearing open-toed shoes
D. Application of keratolyic ointment

345. The nurse is providing a class on osteoporosis at the local senior citizens
center. Which of the following statements related to osteoporosis is correct?

A. Osteoporosis is a disease of the elderly

B. A non-modifiable risk factor for osteoporosis is a person’s level of activity
C. Secondary osteoporosis occurs in women after menopause
D. Slow discontinuation of your corticosteroid therapy will halt the progression
of the osteoporosis, but not restore the lost bone mass

346. The nursing instructor is discussing osteomalacia with her nursing students.
The instructor gives the student the assignment of planning a day’s menu for a
patient with osteomalacia. What would be the best choice for breakfast for a patient
with ostemalacia?

A. Cereal with milk, a scrambled egg and grapefruit

B. Fresh fruit with granola sprinkled on the fruit
C. Waffles with fresh strawberries and powdered sugar
D. A bagel topped with vegetable cream cheese and a side of grapes
347. The nurse is providing a class on osteoporosis at the local senior citizens
center. Which of the following statements related to osteoporosis is corrected?

A. Osteoporosis is a disease of the elderly

B. A non-modifiable risk factor for osteoporosis is a person’s level of activity
C. Secondary osteoporosis occurs in women after menopause
D. Slow discontinuation of your corticosteroid will halt the progression of the
osteoporosis, but not restore the lost bone mass

348. The patient was placed in a long arm cast after fracturing her humerus.
Twelve hours after the application of the cast, the patient tells the nurse arm hurts.
Analgesics do not relieve the pain. What would be the most appropriate nursing
action?

A. Preparing the patient for cast removal or bivalving of the cast.

B. Obtaining an order for a difference pain and medication
C. Encouraging the patient to wiggle and move the fingers
D. Petaling the edges of his cast

349. You are caring for a patient who has had an amputation. What nursing action
would you be least likely to perform with this type of patient?

A. Teaching the patient self-care activities

B. Placing the residual limb on a pillow
C. Promoting mobility
D. Teaching the patient how to wrap the stump

350. You are caring for a patient diagnosed with Ebola virus. What would it be
important for you to monitor closely?

A. Airway
B. ABGs
C. Pain response
D. Level of consciousness

351. The pharmacist at the hospital is presenting a talk to the nursing staff. The
pharmacist at the hospital is presenting a talk to the nursing staff. The pharmacist is
talking about emerging infectious diseases might the pharmacist talk about ( Mark
all that apply)

A. Breakdown in public health measures

B. Population growth ‘
C. Decreasing human resistance
D. Aging population
E. Ecologic changes

352. A mother brings her 12 month son into the clinic for his MMR vaccination.
What would the clinic nurse advise the mother about the MMR vaccine?

A. The mother should be advised that photophobia and hives might occur.
B. The mother should be advised that there are no documented reactions to an
MMR.
C. The mother should be advised that fever and hypersentivity reaction might
occur
D. The mother should be advised that hypothermia might occur.

353. A patient on your unit is found to have pulmonary tuberculosis(TB. What is

the most appropriate precaution for the staff to take to prevent transmission of TB?

A. Standard precautions only

B. Standard and droplet precautions
C. Standard and contact precautions
D. Standard and airborne precautions

354. The nurse places a patient in isolation. Isolation techniques attempt to break
the chain of infection by interfering with:

A. Transmission mode
B. Agent
C. Susceptible host
D. Portal of entry

355. A 73 year old male is brought in by ambulance from a long-term care faculty.
The patient’s symptoms are weakness, lethargy, incontinence, and a change in
mental status. The nurse knows that emergencies in the elderly may be more
difficult to manage. Why would this be true?

A. Elderly people may have an altered response to treatment

B. Elderly people may have less risk of developing complications
C. Elderly people have difficulty giving a history.
D. Elderly people may perceive the trip to the ED as the end of their
dependence

356. Which breakfast option indicates to the nurse that the client with coronary
artery disease requires further diet instruction?

A. Orange juice, shredded wheat, skim milk, toast with jelly

B. Grapefruit juice, oatmeal, 1% milk, bagel with jelly
C. Canned peaches, egg omelet, whole milk, fruited yogurt
D. Applesauce, bagel with margarine, egg-white omelet, skim milk

357. The nurse would encourage the new mother to use which breastfeeding
position to enable optimal control of the newborn’s head while giving the mother a
full view of the infant’s checks and jaw?

A. Lying-down position
B. Cradle position
C. Clutch (football) position
D. Across the lap position

358. The medical-surgical nursing unit is short-staffed for the shift for the shift
and a registered nurse (RN) from the pediatric unit has been floated to the nursing
unit. Which client should the nurse assign to the float nurse?

A. A 32 year old client newly diagnose with diabetes who needs dietary and
medication teaching
 B. A 56 year old client newly admitted with Guillain-Barre syndrome who has
severe leg weakness
C. An 88 year old client with dementia who will be transferred to a skilled
nursing faculty during the shift
D. A 59 year old client who will be returning from surgery following
transurethral resection of the prostate

359. A client has experienced a near-drowning event in salt water. The nurse
anticipates that the client may experience which complication of this trauma?

A. Heart block
B. Renal failure
C. Pulmonary edema
D. Respiratory alkalosis
360. The nurse suspects that hepatotoxcity is developing in a dark-skinned client
who is on an antibiotic. In what area of the body should the nurse assess for
jaundice?

A. Palms of the hands or soles of the feet

B. Hard palate of oral cavity
C. Sclera
D. Conjustivae

361. A client who is 20 weeks’ gestation is concerned about how to tell her 3 year
old son about her pregnancy. Which statement by the nurse would be best when
counseling this client?

A. “If he is not pleased with the news of the new baby, you should tell him that
you are disappointed in him.”
B. “Tell him that the he is going to have a lot of responsibilities in helping care
for the baby.”
 C. “Try to provide extra attention to him and include him in plans for the baby.”
D. “Tell him that he will have to stay with his grandparents when the baby is
born because you will be busy the baby.”
362. When assessing the chest tube drainage system of a client, the nurse observes
a slight rise and fall in the water level in the water seal. The nurse should take
which action?

A. Notify the physician immediately

B. Have the client cough
C. Continue to monitor the system
D. Reposition the chest tube

363. A client with cancer has calcium level of 11.8 mg/dL. Which symptoms would
indicate a need for the nurse to call the physician for treatment orders?

A. Increased gastric motility

B. Peaked T- waves on 12 leave ECG
C. Muscle spasms
D. Muscle weakness

364. The nurse noted the following on the ECG monitor. The nurse would evaluate
the cardiac arrhythmia as :
 A. Atrial flutter
B. A sinus rhythm
C. Ventricular tachycardia
D. Atrial fibrillation
365. The nurse is caring for the client who is recovering from partial thickness
burns. Which choice of breakfast items indicates the client understands the
recommended diet?

A. Two slices of toast with butter, orange juice, skim milk

B. Two poached eggs, hash brown potatoes, whole milk
C. Three pancakes with syrup, two slices of bacon, apple juice
D. One cup of oatmeal with skim milk, ½ grapefruit, coffee
366. Following the administration of a diphtheria/pertussis/ tetanus (DPT
immunization the nurse notes that the infant has insipiratory stride. The nurse
should take which action?

A. Administer epinephrine as per protocol orders

B. Evaluate for pulmonary edema
C. Inspect for peripheral edema
D. Assess the baby again in 15 minutes
367. A young athlete injures his knee in practice. The doctor prescribes Ibuprofen
(Advil) for pain and to reduce inflammation. Following three weeks of therapy the
patient develops petechiae, and Platelet count is 9,000mm3. The nurse can expect
that

A. The patient will able to continue therapy with this medication

B. The dosage will be reduced from 3 to2 tablets a day
C. The medication will be determined, and an alternative great will be
prescribed.
D. The lab studies will be repeated as they are likely an error.
368. A 22 year old woman tells a clinic nurse that her last menstrual period was 3
months ago, which began on 11/21. She has a positive urine pregnancy test. Using
Nagele’s rule, which date should the nurse calculate to be the woman’s estimated
date of confinement (EDC.?

A. 8/28
B. 1/28
C. 8/15
D. 1/15
369. A nurse is caring for a 24 year old client whose pregnancy history is as
follows: elective termination in 1998, spontaneous abortion in 2001, term vaginal
delivery in 2003, and currently pregnant again. Which documentation by the nurse
of the client’s gravity and parity is correct?

A. G4P1
B. G4P2
C. G4P1
D. G2P1
370. A pregnant client tells a nurse that she thinks she is carrying twins. In
reviewing the client’s history and medical records, the nurse should determine that
which factors are associated with multiple gestation? Select all that apply.
 A. Elevated serum alph-fetoprotein
B. Use of reproductive technology
C. Maternal age greater than 40
D. Family history
E. Elevated hemoglobin
371. At an inpatient psychiatric unit, a 40 year old woman insists on staying in her
room and repeatedly comments to the nurse: “Special agents are here. Maybe you
are one.” Which of the following responses, if made by the nurse, is BEST?

1. “You can trust me. There are no agents here.”

2. “You must feel afraid if you believe that, but there are no agents here.”
3. “No one here will hurt you. They are here to help you.”
4. “Agents? Tell me more about what you mean.”
372.A postoperative client has returned to his room from the surgical recovery
area. The client is sleeping, and the nurse noted the client is disoriented when
aroused. Which of the following actions, if taken by the nurse, is BEST?

1. Place the call bell within the client’s reach.

2. Stay with the client until he is totally oriented
3. Restrain all four extremities until the client is oriented
4. Elevate the side rails until the client is fully awake.
373. The nurse is caring for a patient with second-third-degree burns. The client is
receiving morphine sulfate 15 mg IV. The nurse noted a decrease in bowel sounds
and slight abdominal distention. Which of the following actions, if taken by the
nurse, is BEST?

1. Recommend that the morphine dose is decreased

2. Withhold the pain medication
3. Administer the medication by another route
4. Explore alternative pain management techniques.
374. The visiting nurse evaluates the progress of a client recently diagnosed with
insulin dependent diabetes mellitus (IDDM). As part of the treatment plan, the
client receives Humulin N 32 units and Humulin R 8 units each morning. Which of
the following actions, if performed by the client while preparing the morning
insulin injection, would require an intervention by the nurse?

1. After the client draws up 8 units of Humulin R, she adds Humulin N to the
syringe for a total of 40 units.
2. The client draws up 32 units of the clear insulin followed by 8 units of
cloudy insulin for a total of 40 units
3. Initially, the client injects air into the Humulin N vital without drawing up
any insulin
4. The client injects air into each bottle of insulin equal to the amount of
insulin to be withdrawn.
375. The clinic nurse is obtaining a throat culture from a client with pharyngitis. It
is MOST important for the nurse to do which of the following?

1. Quickly rub a cotton swab over both tonsillar areas and the posterior
pharynx
2. Obtain a sputum container for the client to use
3. Irrigate with warm saline, and then swab the pharynx
4. Hyperextend the client’s head and neck for the procedure
376. During the first 24 hours after total parenteral nutrition ( TPN) therapy is
started, the nurse should

1. Monitor vital signs every two hours

2. Determine urinalysis results
3. Evaluate blood glucose levels
4. Compare weight with previous readings
377. The nurse is caring for an 85 year old woman recovering from a fractured
pelvis in a long term care facility. The woman’s activity orders reads: ambulate
with walker bid. After the nurse implements the order, which of the following
charting entries is BEST?

1. “Patient ambulated well with walker. States has no c/o stiffness or pain. Did
not appear fatigued.”
2. “Ambulated without difficulty for 20 minutes. Vital; signs remained stable.
Color good.”
3. “Walked full length of hall with walker. No difficulty with balance. Using
walker correctly.”
4. “Patient ambulated 60 feet independently with walker. Respirations 14 and
unlabored.”
378. The nurse receives a phone call from a nursing assistant who states that her
five year old child has developed chickenpox. It would be MOST important for the
nurse to ask which of the following questions?

1. “Have your other children had chickenpox.”

2. “Does your child have a temperature.”
3. “Have you had the chickenpox?”
4. “Do you have someone to watch your child?”
379. The nurse knows that which of the following plans would be a priority for an
infant with a positive PKU blood test?

1. Place the infant on Lofenlac formula

2. Administer medium –chain triglyceride (MCT) oil with each feeding.
3. Provide genetic counseling for the family
4. Place the infant on Lorenzo’s oil treatments
380. A man is seen in the outpatient clinic for treatment of hypertension. The client
expresses concern to the nurse that his wife has been unemployed for more than six
months. He is afraid that soon they will
 1. “These things always have a way of working themselves out.”
2. “It’s important for your health that you not worry too much.”
3. “You’re worried that you won’t be able to pay the rent?”
4. “A social worker might be able to help you with this problem.”
381. The nurse cares for a 19 year old woman after delivery of a 7 lb oz baby boy.
The patient has decided bottle-feed her infant. The nurse should encourage the
patient to

1. Use the manual breast pump to relieve breast engorgement

2. Apply warm packs to the breast to relieve discomfort
3. Massage the breasts to reduce engorgement and discomfort
4. Wear a well supportive bra and take Tylenol for discomfort

382.The nurse is caring for clients in the postanesthesia care unit (PACU). Which
of the following clients require IMMEDIATE attention by the nurse?

1. A client with a new tracheotomy with a small amount of serosanguineous

drainage on the dressing
2. A client who is responsive with a moderate amount of clear fluid draining
from the NG tube
3. A client with a chest tube and dark red drainage in the collection chamber
4. A client who is unresponsive to verbal stimuli with the oral airway out of
place

383. A 57 year old man admitted with metastatic cancer has been receiving
chemotherapy for 3 months. His lab values include: RBC 3.8 million/mm3,WBC
3,000/mm3,Hgb 9.3g/dL, platelets 50,000/mm3. The nurse would expect the
patient to exhibit which of the following symptoms?
 1. BP 120/70, pulse 100, respirations 16.
2. Ankle edema and ascites
3. Flushed face and light stools
4. Nausea, anorexia, and vomiting
384. A staff member informs the nurse that his six year old child has heard lice. It
is MOST important for the nurse to take which of the following actions?

1. Inspect the staff member’s head for louse and nits

2. Inform the staff member that he cannot care for clients until further notice
3. Request that the staff member to contact his physician
4. Instruct the staff member about how to use Kwell
385. Which of the following is a priority nursing goal in the plan of care for a
client with paralysis from a cerebrovascular accident (CVA.?

1. Maintain adduction of the affected shoulder

2. Prevent flexion of the affected extremities
3. Observe active range of motion (ROM) daily to all extremities
4. Maintain external rotation of the affected hip.
386. Which of the following statements, if made by the parents of a nine year old
client with anostomy, would indicate to the nurse that they are providing quality
home care?

1. “We change the bag at least once a week, and we carefully inspect the stoma
at that time.”
2. “We change the bag every day so that can inspect the stoma and the skin.”
3. “We encourage our daughter to watch TV while we change her ostomy bag.”
4. “We only have to change the ostomy bag every ten days.”
387. A child comes to the school nurse with a honey-colored crusted lesion below
her right nostril. Which of the following actions should the nurse take FIRST?

1. Remove the scab

 2. Apply a wet cloth to the lesion
3. Notify the child’s parents
4. Contact the health department
388. The nurse would identify which of the following clients as being the highest
risk for developing a pulmonary embolus?

1. A 19 year old four days postpartum with an obstetrical history of placenta

previa.
2. An obsess 40 year old man with multiple pelvic fractures from an auto
accident two days
3. A 65 year old woman who had a fractured hip repaired 10 days ago and who
is in physical therapy daily.
4. A 22 year old leukemic client with a platelet count of 120,000/mm3 and a
hemoglobin level of 9.0 g.
389. The nurse is supervising a student nurse administer a tube feeding to a client
via Levin tube. Which of the following actions, if performed by the student nurse,
indicates a proper understanding of the correct procedure?

1. The Levin tube remains unclamped for 30 minutes after the feeding
2. Sterile equipment is used to administer the feeding
3. The amount of the feeding is varied according to the patient’s tolerance
4. The tube feeding is given at room temperature
390. The nurse is caring for a client with deep vein thrombosis (Thrombophlebits)
of the left leg. Which of the following would be an appropriate nursing goal for
this client?

1. Decrease inflammatory response in the affected extremity and prevent

embolus formation
2. Increase peripheral circulation and oxygenation of the affected extremity
3. Prepare the client and family for anticipated vascular surgery on the affected
extremity
 4. Prevent hypoxia associated with the development of a pulmonary embolus
391. A client is scheduled to have left kidney removed due to hypertension and
renal disease and an intravenous pyelogram (IVP) is ordered. Which of the
following nursing actions has the highest priority the evening prior to the IVP?

1. Administer a cathartic enema to cleanse the bowel

2. Obtain information about client allergies
3. Instruct the client to be NPO after midnight
4. Teach the client that x-rays will be taken at multiple intervals
392. The nurse is assisting a 58 year old woman from the bed to the chair for the
first time since a right total hip replacement. Which action is MOST important for
the nurse to take?

1. Assist the patient to stand on her right leg and pivot to a low soft chair,
keeping her hip straight
2. Assist the patient to stand on her leg and pivot to a straight-backed chair,
flexing her hips slightly
3. Ask the patient to bear weight equally on both legs, bend at the waist, and sit
in a low soft chair
4. Assist the patient to stand on both legs and take a few steps to a straight
backed chair
393. The nurse is preparing a 56 year old woman for a paracentesis procedure.
Which action is MOST important for the nurse to take which of the following
actions?

1. Keep the woman NPO 12 hours before the procedure

2. Have the woman void just before the procedure
3. Initiate a bowel preparation program 24 hours before the procedure
4. Place the woman supine during the procedure
394. Which sign or symptom indicates that a client’s abdominal aortic aneurysm
(AAA. is extending?
 A. Increased abdominal
B. Decreased pulse rate and blood pressure
C. Restrosternal back pain radiating to the left arm
D. Elevated blood pressure and rapid respirations
395. Your patient has just returned from the PACU following left tibia ORIF. The
patient his complaining of pain, and you are preparing to administer a first dose of
meperidine . Prior to administering the drug you would assess for the patient’s

A. Electrolyte values
B. Blood pressure
C. Allergies to any medications
D. Hydration status

396. Your patient is 12 hours post ORIF right ankle. The patient is asking for pain
medication. The pain-medication orders are written as a combination of a narcotic
analgesic and a nonsteriodal anti-inflammatory (NSAID. given together. What us
the rationale for administering pain medication in this manner?

A. To prevent respiratory depression from the narcotic

B. To eliminate the need for additional medication during the night
C. To combine the medications more effectively and relieve the patient’s pain
with fewer narcotics
D. To eliminate toxic effects of the narcotic
397. A nursing assistant (NA. reports to the nurse that a postsurgical patients is
complaining of pain that she rated as an eight on a ten point scale. The NA tells the
nurse that she thinks the patient is exaggerating and does not need pain medication.
What is the nurse’s best response?

A. “Pain often comes and goes with postsurgical patients. Please ask her about
pain again in about 30 minutes.”
 B. “We need to provide pain medications because it’s the lae, and we must
always follow the law.”
C. “professionally, I believe pain is whatever the patient says it is.”
D. “
Patients often misreport pain to get our attention when we are busy.”
398.The wife of a patient you are caring for asks to speak with you. She tells you
that she is concerned because her husband’s is requiring more and more pain
medication. She states, “He was in pain long before he got cancer because he broke
his back about 20 years ago. His pain medicine wasn’t just raised and raised for
that pain.” What should be the nurse’s best response?

A. “I didn’t know that I will speak to the doctor about your husband’s pain
control.”
B. “Cancer pain be either acute or chronic. Most cancer pain is used by tumor
involvement and needs to be treated in a way that brings the patient relief.”
C. “Cancer is an acute kind of pain so the more it hurts the patient, the more
medicine we give the patient until it doesn’t hurt anymore.”
D. “Does the increasing medication dosage concern you?”

399. You are caring for a patient admitted to the medical surgical unit after falling
from a horse. The patient states “I hurt so bad. I suffer from chronic pain anyway,
and now it is so much worse.” As a nurse, what should you understand about
chronic pain? (Mark all that apply.)

A. How it affects patients and families

B. Where the resources are to assist the patient with pain management
C. How to cope with acute pain
D. What pain-relief strategies are available
E. The difference between acute and intermittent pain
400. You are assessing an 86 year old postoperative patient who is very stoic.
When you enter the room, the patient is curled into the fetal position, and he is
moaning. His vital signs are elevated and he is perspiring. You ask the patient what
his pain level is on a zero to ten scales that you did patient education on with this
patient prior to surgery. The patient indicates a pain level of two to three. You
review your pain management orders and find that all medications are ordered
PRN. How would you treat this patient’s pain?

A. Treat the clinical symptoms you see

B. Call the physician for new orders because it is obvious that the pain
medicine is not working
C. Believe what the patient says
D. Ask the family what they think and treat accordingly

401. The hospital staff educator is presenting education on transcultural nursing to

a group of the graduate nurses. What would the staff educator best explain as the
underlying focus of transcultural nursing?

A. The underlying focus on transcultural nursing is to promote the well-being

of institutions
B. The underlying focus of transcultural nursing is to promote the health of
communities
C. The underlying focus of transcultural nursing is to provide culture-specific
and culture-universal care
D. The underlying focus of transcultural nursing is to promote the well-being of
groups.
402. You are a student preparing a paper for your class in community health. You
cite key health care indicators in the United States. What do these key indicators
reveal?
 A. A significant gap in health status between the overall population and people
of specific ethnic backgrounds
B. A significant gap in health care delivery between the overall population and
subgroups of the minority populations
C. A significant gap in health status between the Hispanic population and the
Native American population
D. A significant gap in health care delivery between the Asian American
population and the Pacific Islander population
403. You are caring for a patient with a secondary diagnosis of hypermagnesemia.
What would you assess this patient for?

A. Hypertension
B. Kussmaul respirations
C. Increased DTRs
D. Shallow respirations

404. Metabolic acidosis can be divided clinically into forms: normal anion gap
acidosis and high anion gap acidosis. What causes normal gap acidosis?

A. Constipation
B. Small bowel fistulas
C. Late renal insufficiency
D. Excessive administration of chloride
405. Isotonic IV fluids are fluids with a total osmolaity close to that of the ECF.
Most IV fluids contain either dextrose or electrolytes in water. When would you
infuse electrolyte-free water intravenously?

A. Never, it rapidly enters red blood cells, causing them to rupture

B. When the patient is severely dehydrated
 C. When the patient is in an excess of an electrolyte, i.e. hypercalcemia
D. When the patient is in a deficit of an electrolyte, i.e. hypocalcemia
406. The nurse in the medical ICU is caring for a patient who is in respiratory
acidosis due to inadequate ventilation. What diagnosis could the patient have that
could cause inadequate ventilation?

A. Insomnia
B. Multiple myloma
C. Guillain-Barre’ syndrome
D. Overdose of amphetamines
407. As the ICU nurse caring for a patient with multiple traumas from an ATV
accident, you draw arterial blood gas (ABGs) every 4 hours. what are you
assessing in this patient with ABGs?

A. The bicarbonate-carbonic acid buffer system

B. The patient’s oxygen status
C. The patient’s intracellular buffer systems
D. Metabolic acidosis status
408. The nurse is preparing to send an arterial blood gas (ABG) specimen to the
laboratory. The nurse should be sure to document which item on the laboratory
requisition form before sending the specimen?

A. The client’s temperature

B. The client’s blood pressure
C. If pain medication was given to the client
D. What the client ate at the meal before the blood draw
409. A 73 year old man comes into the emergency department (ED. by ambulance
after slipping on a small carpet in his home. The patient fell on his hip with a
resultant fracture. He is alert and oriented; PERLA is intact. His heart rate elevated,
he is anxious and thirsty, a Foley catheter is placed, and 40 mL of urine is present.
What is the nurse’s most likely explanation for the urine output?
 A. The man urinated prior to his arrival to the ED and will probably not need to
have the Foley catheter kept in place
B. The man has a brain injury, lacks ADH, and needs vasopressin
C. The man is in heart failure and is releasing atrial natriuretic peptide that
results in decreased urine output
D. He is having a sympathetic reaction, has stimulated the renin-angiotensin-
aldosterone system that results in diminished urine output
410. Research has identified the key processes of mourning. What are they? (Mark
all that apply)

A. Anger at the deceased

B. Reinvestment
C. Re-experiencing the relationship
D. Relinquishing old attachments
E. Readjustments to adapt to the new world by forgetting the old.
411. You are the nurse caring for an 87 year old Mexican-American female patient
who is in end-stage renal disease. The physician has just been in to see the patient
and her family to tell them that nothing more can be done for the patient and that
death is not far off. The physician offers to discharge the patient home to hospice
care. The patient and family refuse. After the physician leaves, the patient’s
daughter approached you and asks what hospice care is. What would this lack of
knowledge about hospice care perceived as?

A. Lack of American education of the patient and her family

B. A language barrier to hospice care for this patient
C. A barrier to hospice care for this patient
D. Inability to grasp American concepts of health care
412. Your patient is a 42 year old mother of two children with a diagnosis of
ovarian cancer is terminal. She begins her rage at God and the clergy. When you
told admitted this patient, you did a spiritual assessment. What would it have been
very important for you to assess?
 A. Is she able to tell her family of negative test results?
B. Does she have a sense of peace of mind and a purpose to her life?
C. Can she let go of her husband so he can make a new life?
D. Does she need time and space to bargain with God for a cure
413. You are caring for a 71 year old patient who is 4 days postoperative for
bilateral inguinal hernias. The patient has a history of congestive heart failure and
peptic ulcer disease. The patient is refusing to ambulate and will not drink fluids
expect for the hot tea with her meals. The nurse’s aide reports to you that this
patient’s vital signs are slightly elevated and she has a nonproductive cough. When
you assess the patient, you find that are crackles at the base of the lungs. What
would you suspect is wrong with your patient?

A. Flash pulmonary edema

B. Pneumonia
C. Hypostatic pulmonary congestion
D. Right-sided heart failure
414. You are the nurse writing a plan of care for a patient who is status post-
surgery for a broken femur. What is the most important goal for this patient?

A. Relief of pain
B. Optimal respiratory function
C. Optimal cardiovascular function
D. Unimpaired wound healing
415. The nursing instructor is discussing the difference between ambulatory
surgical centers and hospital-based surgical units. A student ask why some patients
have surgery in the hospital and others are sent to ambulatory centers. What is the
instructor’s best response?

A. “Patients who go to ambulatory surgery centers have more family support

than patients admitted to the hospital.”
B. “Patients admitted to the hospital for surgery have multiple needs.”
 C. “Only emergency and trauma patients are admitted to the hospital.”
D. Patients who have surgery in the hospital can’t afford the added expense of
ambulatory surgery centers.”
416. You are the nurse caring for a patient who just had surgery. What is your
highest priority?

A. Assessing for hemorrhage

B. Maintain a patient airway
C. Managing the patient’s pain
D. Assessing vital signs every 15 minutes
417.A 38 year old patient has just been admitted to the PACU following abdominal
surgery. As the patient begins to awaken, he is restless and asking for “drink of
water.” The nurse checks his skin and it is cold, moist, and pale. What is the nurse
concerned the patient may be at risk for?

A. Hemorrhage and shock

B. Loss of airway and hypotension
C. Pain and anxiety
D. Hypertension and dryshythmias
418. You are caring for a patient who is scheduled for a laryngectomy. You are
preparing the patient’s care plan. Which nursing diagnoses should receive the
highest priority for this surgery?

A. Anxiety related to diagnosis of cancer

B. Altered nutrition related to swallowing difficulties
C. Ineffective airway clearance related to surgical alterations in the airway
D. Impaired verbal communication related to removal of the larynx
419. The nurse is caring for a patient who needs education on his medication
therapy for allergic rhinitis. The patient is to take cromolyn (Nasalcrom) daily. In
providing educational interventions regarding this medication, what is the most
important instruction the nurse can give on the action of the medication?
 A. It inhibits the release of histamine and other chemicals
B. It is used to treat atrial and ventricular dyrrythmias
C. It competitively inhibits the rate-limiting enzyme in the liver
D. It leads to bronchodilation and relaxes smooth muscle in the bronchi

420. A 42 year old patient is admitted to the emergency department (ED. following
being mugged. The patient received blunt trauma to the face and has clear fluid
draining from the right nostril. What does the ED nurse know to assess this fluid
for?

A. Sodium
B. Protein
C. Calcium
D. Glucose
421. As an asthma educator, you are teaching a patient newly diagnosed with
asthma and her family about the use of a peak flow meter. What does a peak flow
meter measure?

A. Highest airflow during a forced inspiration

B. Highest airflow during a forced expiration
C. Highest airflow during a normal inspiration
D. Highest airflow during a normal expiration
422. You are caring for a post operative patient on the medical-surgical unit.
During each patient assessment, you evaluate your patient for infection. Which
sign or symptom would be most indicative of infection?

A. Presence of an indwelling urinary catheter

B. Rectal temperature of 100 F. (37.8 C
C. Red, warm, tender incision
D. White blood cell (WBC. Count of 8,000/mL
423. You admit a patient to the postanesthesia care unit with a blood pressure of
130/90 and pulse of 68 beats per minute. After 30 minutes, the patient’s blood
pressure is 120/65, and the pulse is 100. You document the patient’s skin as cold,
moist and pale. What is the patient showing sign of?

A. Hypothermia
B. Hypovolemic shock
C. Neurogenic shock
D. Malignant hypothermia
424. You are the nurse caring for 82 year old women in the PACU. The woman
begins to awaken and responds to her name but is confused, restless and agitated.
What are you aware of?

A. Postoperative confusion is an indication of an oxygen problem or possibly a

stroke during surgery.
B. Confusion, restlessness, and agitation are normal postoperative findings and
will diminish in time
C. Postoperative confusion is common in the elderly, but it could also indicate a
significant blood loss
D. Confusion, restlessness, and agitation indicate inadequate pain management,
and analgesics will help/
425. You admit a patient to the postanesthesia care unit with a blood pressure of
130/90 and a pulse of 68 per minute. After 30 minutes, the patient’s blood pressure
is 120/65, and pulse is 100. You document the patient’s skin as cold and pale. What
patient showing signs of?

A. Hypothermia
B. Hypovolemic shock
C. Neurogenic shock
D. Malignant hypothermia
426. You are caring for a postoperative patient on the medical-surgical unit. During
each patient assessment, you evaluate for patient for infection. Which signor
symptom would be most indicative of infection?

A. Presence of an indwelling urinary catheter

B. Rectal temperature of 100 degree F ( 37.8 degree C
C. Red, warm, tender incision
D. White blood cell (WBC. count of 8,000 mL
427. You admit a patient to the PACU who has undergone a surgical procedure that
required the use of general anesthesia. What is the patient most at risk for
following general anesthesia?

A. Atlectasis
B. Anemia
C. Dehydration
D. Peripheral edema
428. The registered nurse had just admitted a client with severe depression. What
domain should be the priority focus as the nurse identifies the nursing diagnoses?

A. Nutrition
B. Elimination
C. Activity
D. Safety

430. The nurse is caring for a client in the coronary care unit. The display on the
cardiac monitor indicates ventricular fibrillation. What should the nurse do first?

A. Perform defibrillation
B. Administer epinephrine as ordered
C. Assess for presence of pulse
 D. Institute CPR
431. Which of the following conditions assessed by the nurse would contraindicate
the use of benztropine (Cogentin)?

A. Neuro malignant syndrome

B. Acute extrapyramidal syndrome
C. Glaucoma, prostatic hypertrophy
D. Parkinson’s disease, atypical tremors
432. The nurse is caring for a post-op colostomy client. The client begins to cry,
saying “I’ll never be attractive again with this ugly red thing. “What should the
first action taken by the nurse?

A. Arrange a consultation with a sex therapist experienced in working with

colostomy clients
B. Suggest sexual positions that hide the colostomy
C. Invite the partner to participate in colostomy care after viewing an
instructional video
D. Encourage the client to discuss her feelings about the colostomy
433. A schizophrenic client talks animatedly but the staff are unable to understand
what the client is communicating. The client is observed mumbling to herself and
speaking to the radio. A desirable outcome for this client’s care will be

A. Expresses feelings appropriate through interactions

B. Accurately interprets events and behaviors of others
C. Demonstrates improved social relationships
D. Engages in meaningful and understandable verbal communications
434. The caring for a client with benign prostatic hypertrophy ( BPH). Which of
the following assessments would the nurse anticipate finding?

A. Large volume of urinary output with each voiding

B. Involuntary voiding with coughing and sneezing
 C. Frequent urination
D. Urine is dark and concentrated
435. A client complaining of severe shortness of breath is diagnosed with
congestive heart failure. The nurse observes a falling pulse oximetry. The client’s
color changes to gray and she expectorates large amounts of pink frothy sputum.
The first action of the nurse would be which of the following?

A. Call the health care provider

B. Check vital signs
C. Position in high Fowler’s
D. Administer oxygen
436. Which of the following nursing assessment findings require immediate
discontinuance of an antipsychotic medication?

A. Involuntary rhythmic stereotypic movements and tongue protrusion ‘

B. Cheek puffing, involuntary movements of extremities and trunk
C. Agitation, constant state of motion
D. Hyperpyrexia, severe muscle rigidity, malignant hypertension
437. A 3 year old is treated in the emergency department after ingestion of 1 ounce
of a liquid narcotic. What action should the nurse perform first?

A. Provide the ordered humidified oxygen via mask

B. Suction the mouth and the nose
C. Check the mouth and radial pulse
D. Start the ordered intravenous fluids
438. Which of the following statements describes what the nurse must know in
order to provide anticipatory guidance to parents of a toddler about readiness for
toilet training?

A. The child learns voluntary sphincter control through repetition

B. Myelination of the spinal cord is completed by this age
 C. Neuronal impulses are interrupted at the base of the ganglia
D. The toddler can understand cause and effect
439. The nurse is caring for a 14 month old just diagnosed with cystic fibrosis. The
parents state this is the first child in wither family with this disease, and ask about
the risk to future children. What is the best response by the nurse?

A. 1 in 4 chance for each child to carry that trait

B. 1 in 4 risk for each child to have the disease
C. 1 in 2 chance of avoiding the trait and disease
D. 1 in 2 chance that each child will have the disease
440. During seizure activity which observation is the priority to enhance further
direction of treatment?

A. Observe the sequence or types of movement

B. Note the time from beginning to end
C. Identify the pattern of breathing
D. Determine if loss of bowel or bladder control occurs.
441. The nurse is preparing to perform a physical examination on an 8-month old
who is sitting contently on his mother’s lap. Which of the following should the
nurse do first?

A. Elicit reflexes
B. Measure height and weight
C. Ausculate heart and lungs
D. Examine the ears
442. A client is unconscious following a tonic-clonic seizure. What should the
nurse do first?

A. Check the pulse

B. Administer valium
C. Place the client in a side-lying position
 D. Place a tongue blade in the mouth
443. When counseling parents of a child who has recently been diagnosed with
hemophilia, what must the nurse know about the offspring father and a carrier
mother?

A. It is likely that all sons are affected

B. There is a 50% probability that sons will have the disease
C. Every daughter is likely to be a carrier
D. There is a 25% chance a daughter will be a carrier
444. The nurses on a unit are planning for stoma care for clients who have a stoma
for fecal diversion. Which stomal diverionposes the highest for skin breakdown

A. Illeostomy
B. Transverse colostomy
C. Illeal conduit
D. Sigmoid colostomy
445. The nurse is assessing a client with delayed wound healing. Which of the
following risk factors is most important in this situation?

A. Glucose level of 120

B. History of myocardial infarction
C. Long term steroid usage
D. Diet high in carbohydrates
446. In assessing the healing of a client wound during a home visit, which of the
following is the best indicator of good healing?

A. White patches
B. Green drainage
C. Reddened tissue
D. Eschar development
447. The nurse is caring for 2 children who have had surgical repair of congenital
heart defects. For which defect is it a priority to assess for findings of her heart
conduction disturbance?

A. Aterial septal defect

B. Patent ductusarterious
C. Aortic stenosis
D. Ventricular septal defect
448. When an autistic client begins to eat with her hands, the nurse can best handle
the problem by

A. Placing the spoon in the client’s hand and stating, “Use the spoon to eat your
food.”
B. Commenting, “I believe you know better than to eat with your hand.”
C. Jokingly stating, “Well I guess fingers sometimes work better than spoons.”
D. Removing the food and stating, “You can’t have anymore food until you use
the spoon.”
449. The nurse asks a client with a history of alcoholism about recent drinking
behavior. The client states “I didn’t hurt anyone. I just like to have a good time,
and drinking helps me to relax.” The client is using which defense mechanism?

A. Denial
B. Projection
C. Intellectualization
D. Rationalization
450. When assessing a client who has just undergone a cardioversion, the practical
nurse (LPN) finds the respirations are 12/minute. Which action should the nurse
take first?

A. Try to vigorously stimulate normal breathing

B. Ask the RN to assess the vital signs
 C. Measure the pulse oximetry
D. Continue to monitor respirations
451. Following a cocaine high, the user commonly experiences an extremely
unpleasant feeling called

A. Craving
B. Crashing
C. Outward bound
D. Nodding out

452. Which of the following should the nurse obtain from a client prior to having
electroconvulsive therapy (ECT)?

A. Permission to videotape
B. Salivary pH
C. Mini-mental status exam
D. Pre-anesthesia work-up
453. The nurse detects blood-tinged fluid leaking from the nose and ears of a head
trauma client. What is the appropriate is nursing action?

A. Pack the nose and ears with sterile gauze

B. Apply pressure to the injury site
C. Apply bulky, loose dressing to nose and ears
D. Apply an ice to the back of the neck
454. The nurse is caring for a client with increased intracranial pressure ( ICP)
understands that which condition(s) can cause problem? Select all that apply.

A. Edema
B. Trauma
C. Tumors
 D. Migraines
E. Hemorrhages
F. Hydrocephalus
456. The nurse understands that which are risk factor(s) for the development of
breast cancer? Select all that apply.

A. Age
B. Obesity
C. Multiparity
D. Family history
E. Early menarche
F. Early menopause
457. The nurse is instructing a client with diabetes mellitus in measures to prevent
the chronic complication of diabetic nephropathy. Which statement by the client
indicates a need for further instruction?

A. “I should increase my dietary protein, sodium, and potassium.”

B. “I need to be sure to avoid any medications that may harm my kidneys.”
C. “I will have to have routine laboratory work done to monitor kidney
function.”
D. “If the condition develops, it may be necessary to undergo dialysis or
transplant.”
458. The nurse is caring for a client who has diagnosed with suspected acute
pancreatitis. When reviewing the client’s laboratory results, the nurse determines
that which finding will support the diagnosis?

A. Elevated cholesterol
B. Elevated serum amylase
C. Decreased serum amylase
D. Decreased serum bilirubin
459. The nurse working in the community health center is conducting a teaching
session on the risk factors for colorectal cancer. The nurse includes which item(s)
in the teaching session? Select all that apply.

A. History of breast cancer

B. Age older than 50 years
C. History of ovarian cancer
D. History of bladder cancer
E. History of chronic inflammatory bowel disease

460. The client is caring for a client following thyroidectomy. The nurse most
appropriately places the client in which position following this procedure?

A. Prone
B. Fowler’s
C. Side-lying
D. Reverse Trendelenburg’s
461. The client who underwent which procedure is most likely to have the least
amount of water in the stool?

A. Ilesostomy
B. Ascending colostomy
C. Transverse colostomy
D. Descending colostomy
462.The nurse is reviewing laboratory test results for the client with liver disease
and notes that the client’s albumin level is low. Which assessment is focused on the
consequence of low albumin levels?

A. Evaluating for asterxis

B. Inspecting for petechiae
 C. Palpating for peripheral edema
D. Evaluating for decreased level of consciousness
463. The nurse is performing an eye examination on a client using an Ishiara chart.
The nurse presents the first slide to the client, and the client is unable to identify
the numbers. The nurse understands that this is suggestive of which finding?

A. A problem with color vision

B. A problem with visual acuity
C. A problem with accommodation
D. A problem with performing the test
464. The nurse is caring for a client in the post procedure period following cardiac
catherization. Which priority assessment should the nurse conduct on a routine
basis?

A. Skin turgor
B. Peripheral pulses
C. Intake and output
D. Neurological checks
465. Which reproductive structure is responsive for the transportation of the ova
from the ovaries to uterus?

A. Cervix
B. Vagina
C. Endometruim
D. Fallopian tubes
466. The nurse is caring for a client who has been diagnosed with secondary
cataracts. The nurse understands that which disease(s) can cause secondary
cataracts? Select all that apply.

A. Heart failure
B. Hyotension
 C. Severe myopia
D. Maternal rubella
E. Diabetes mellitus
F. Ultraviolet light exposure
467. The nurse working in the newborn nursery has to draw a heel-stick blood
sample before an infant’s discharge. What can the nurse do to decrease the pain in
the infant feels from this procedure? Select all that apply.

A. Wrap the heel in a warm, damp cloth

B. Use EMLA before doing the stick
C. Swaddling the infant
D. Have the infant do non-nutritive sucking
E. Do the stick while the infant is asleep
468. A child on the nurse’s floor is having a polysomnogram. The parent wants to
know what types of data are obtained from the sleep study. The nurse knows that
which data can be provided? Select all that apply.

A. Heart rate and respirations

B. Brain waves
C. Eye and body movements
D. Cyanosis or plethora
E. End-tidal carbon dioxide
469. Parents express concern about their 5 year old who started having more
temper tantrums. The parents want to know if this is normal for this age. What
should the nurse ask the parents about the tantrums? Select all that apply.

A. “Does the child do anything right in front of you?”

B. “Are the tantrums related to one specific aspect of life.”
C. “Are the tantrums causing any harm to self or others?”
D. “Have you consulted the internet for any suggestions?
 E. “How do you handle your child during a tantrum.”
470. A 17-month-old is brought into the clinic, and the nurse notes the toddler has
tooth decay on the maxillary upper incisors. The toddler is holding a bottle of juice,
and the parent says the child cannot seem to be weaned from the bottle. The nurse
could suggest which of the following tactics to assist the parent in weaning the
toddler? Select all that apply.

A. Hide the bottle, and tell the toddler that it is not needed anymore
B. Put only tap water in the bottle
C. Give the bottle only at night
D. Give the toddler a pacifier and take the bottle away
471. Parents are interested in switching their child from a booster seat to a regular
seatbelt. The child is 7 years ago and weighs 51 Ib. what can the nurse tell the
parents about switching the child to seat belt? Select all the apply.

A. The safest place to ride in the car is in the front seat

B. The child needs to weigh 60 Ib and be 8 years old to qualify legally for a
seat belt
C. The seat belt should be worn low on the hips
D. Tether straps are optional
472. The nurse goes to kindergarten classroom to evaluate a rash. A 5 year old has
patches of vesicles on the chest and face rather than on the arms and legs. The
child says it is very itchy. The teacher tells the nurse the child had a runny nose a
couple of days ago. The nurse suspects that the rash is caused by which virus?

A. Fifth disease (erythema infectiosum)

B. Roseola (exanthema subitum)
C. Scarlet fever ( group A-B hemolytic streptococcus)
D. Chickenpox (varicella zoster)
473. The clinic is doing a lead something program for children in a low-income
Hispanic community. The nurse working in the program wants to tell the parents
the reasons to have their children screened for lead poisoning. Select all the
following reasons that apply.

A. Young children absorb 10% of the lead to which they are exposed
B. Homes built between 1900 and 1950 may contain lead-based paint
C. The blood level of lead should be below 12.8 mcg/Dl
D. Lead can affect any part of the body, but the brain and kidneys are at greatest
risk
E. Foods such as fruit, candy, and antacids contain level
474. Gullian-Barre’ is a progressive motor weakness secondary to an autoimmune
response from a viral illness or immunizations Gullian-Barre ’shows which of the
following symptoms? Select all that apply.

A. Always fatal after 18 to 24 months

B. Progresses cephalocaudally
C. Complications are associated with immobility
D. Respiratory support is a nursing priority
E. Tube feedings or total parental nutrition may become necessary
475. As a component of discharge teaching, the nurse knows that treatment
regimen for a 15 year old with systemic lupus erythematosus include which of the
following? Select all that apply

A. High protein diet

B. Low salt intake
C. Exposure to the sun
D. Killed-virus vaccines
E. Systemic corticosteroids
F. Antimalarials
476. A 12 year old cut a hand while climbing a barb-wired fence. What should the
nurse discuss with the parents regarding need for tetanus vaccine? Select all that
apply.

A. No tetanus vaccine is necessary; it is too soon

B. Tetanus is a potentially fatal disease
C. Puncture wounds are less susceptible to tetanus
D. There will be mild soreness at the injection site
E. Tdap should be administered
F. Td should be administered
477. A parent calls the nurse for doing information for Pepto-Bismol and aspirin
for children who are 8 and 9 years old and are ill. The nurse states which of the
following? Select all that apply.

A. 1 tbs of Pepto-Bismol after every diarrhea stool

B. 81-mg baby aspirin every 4 hours
C. No medications are necessary
D. Pepto-Bismol contains aspirin
E. Diet as tolerated
F. Reye syndrome is associated
478. The nurse is doing discharge teaching for a 3 month old with a new shunt that
was placed for hydrocephalus. Which of the following are signs and symptoms of
hydrocephalus that the parents may see if the shunt malfunctions? Select all that
apply.

A. Vomiting
B. Irritability
C. Poor feeding
D. Headache
E. Sunken fontanel
 F. Seizures
G. Inability to wake up infant
H. Hyperactivity
479. The nurse detects blood-tinged fluid leaking from the nose and ears of a head
trauma client. What is the appropriate nursing action?

A. Pack the nose and ears with sterile gauze

B. Apply pressure to the injury site
C. Apply bulky, loose dressing to nose and ears
D. Apply an ice pack to the back of the neck
480. A female client talks to the nurse in the provider’s office about uterine fibroid,
also called leiomyomas or myomas. What statement by the woman indicates more
education is needed?

A. “I am the one out of every 4 women that get fibroids, and of women my age-
between the 30s and 40s, fibroids occur more frequently.”
B. “My fibroids occur are noncancerous tumors that grow slowly.”
C. “My associated problems I have had are pelvic pressure and pain, urinary
incontinence, and constipated
D. “Fibroids that cause no problems still need to be taken out.”
481. While caring for a client who was admitted with myocardial infarction (MI) 2
days ago, the nurse notes today’s temperature is 101.1 degrees Fahrenhelt (38.5
degrees Celsius) The appropriate nursing intervention is to

A. Call the health care provider immediately

B. Administer acetaminophen as ordered as this is normal at this time
C. Send blood, urine and sputum for culture
482. The client with infective endocarditis must be assessed frequently by the
home health nurse. Which findings suggest that antibiotic therapy is not effective,
and must be reported by the nurse immediately to the provider?
 A. Nausea and vomiting
B. Fever of 103 degrees F. (39.5 degrees C._
C. Diffuse macular rash
D. Muscle tenderness
483. A client has viral pneumonia affecting 2/3 of the right lung. What would be
the best position to teach the client to lie in every other hour during first hours after
admission?

A. Side-lying on the left with the head elevated 10 degrees

B. Side-lying on the left with head elevated 35 degrees
C. Side-lying on the right with the head elevated 10 degrees
D. Side-lying on the right with the head elevated 35 degrees
484. A client who is to have antineoplastic chemotherapy tells the nurses of a fear
of being sick all the time and indicates a wish to try acupuncture. Which of these
beliefs stated by the client would be incorrect about acupuncture?

A. “some needles go as deep as 3 inches, depending on where they’re placed in

the body and what the treatment is for. The needles usually are left in for 15
to 30 minutes.”
B. “In traditional Chinese medicine, imbalances in the basic energetic flow of
life—known as qi or chi—are thought to to cause illness.”
C. “The flow of life is believed to flow through major pathways called nerve
cluster in your body.”
D. “By inserting extremely fine needles into some of the over 400 acupuncture
points in various combinations it is believed that energy flow will rebalance
to allow the body’s natural healing mechanisms to take over.”
485. A nurse is observing a client during an excretory urogram. Which of these
observations indicate a complication is occurring?

A. “The client complains of a salty taste in the mouth when the dye is injected.”
B. “The client’s entire body turns a bright red color.”
 C. “The client states “I have a feeling of getting warm.”
D. “The client gags and complains “I am getting sick.”
486. If a client has ataxia, the MOST important nursing action would be to

A. Supervise ambulation
B. Measure the intake and output accurately
C. Consult the speech therapist
D. Elevate the foot of the bed
487. The nurse knows which of the following would have the greatest impact on an
elderly client’s ability to complete activities of daily loving (ADLs)

A. Preservation
B. Aphasia
C. Mnemonic disturbances
D. Apraxia

488. In planning diet teaching for a child in the early stages of nephritic syndrome,
the nurse should discuss with the parents which of the following dietary changes?

A. Adequate protein intake, low sodium

B. Low-protein, low –potassium intake
C. Low-protein potassium, low-calorie intake
D. Limited-protein, high-carbohydrate intake
489. Several days after the delivery of a stillborn, the parents say, “We wish we
could talk with other couples who have go through this trauma. “Which of the
following nursing responses would be BEST?

A. “SIDS will provide you with this opportunity.”

B. “SHARE will provide you with opportunity.”
C. “RESOLVE will provide you with this opportunity.”
 D. CANDLELIGHTERS will provide you with this opportunity.”
490. The mother of a child with chickenpox asks the physician’s office nurse why
her child will not come down with chickenpox again if exposed to the virus at
school at a later date. The nurse’s responses should be based on the information
that

A. Natural passive immunity occurs because the child receives antibodies from
outside the body.
B. Artificial active immunity occurs because the child receives specific
antigens against the chicken pox virus
C. Natural active immunity occurs because the child’s body actively makes
antibodies against chicken pox virus
D. Artificial passive immunity occurs because of the inflammatory process of
chicken pox.
491. A toddler with lead poisoning is admitted to the pediatric unit. There is an
order to encourage fluids. Which of the following fluids would be the best for the
nurse to offer to the child?

A. Milk
B. Water
C. Orange juice
D. Fruit punch
492. The nurse is leading an in-service education class on legal issues. Which of
the following acts constitutes battery?

A. The nurse restrains an agitated, confusion patient in the Emergency Room

with a physician’s order
B. The nurse chases a patient who tries to run away while outside for a walk.
C. The nurse holds the arm of a manic patient who struck her while calling for
assistance
D. The nurse administers an injection to a schizophrenic patient who refuses to
take the medication by mouth because he believes it is poison
493. In caring for a client with a nursing diagnosis of rape trauma syndrome, acute
phase, the nurse should consider the MOST important initial goal to be that

A. Within three to five months , the client will state that the memory of the
event is less vivid and distressing
B. The client will indicate a willingness to keep to a follow-up appointment
with a rape crisis counselor
C. The client will be able to describe the results of the physical examination
that was completed in the emergency room
D. The client will begin to express her reactions and feelings about the assault
before leaving the emergency room
494. Which of the following symptoms are MOST likely to be observed by the
nurse when the client is withdrawing from heroin?

A. Severe cravings, depression, fatigue, hypersomina

B. Depression, disturbed, sleep, restlessness, disorientation
C. Nausea and vomiting, tachycardia, coarse tremors, seizures
D. Runny nose, yawning, fever, muscle and joint pain, diarrhea
495The nurse is caring for client in the Emergency Department of an acute facility.
Four clients have been admitted in the last 10 minutes. Which of the following
admissions should the nurse see FIRST?

A. Performing activities one at a time

B. Documentation at the end of the workday
C. Addressing all nonessential activities as they are
D. Deciding on the most important tasks to complete first

497. The nurse is using concepts of time management to organize the workday.
Which action will assist the nurse to effectively implement time management
strategies?

A. Complete nonessential activities first to reduce interruptions

 B. Plan the day so that all time is accounted for in task completion
C. Identify tasks that must be completed within a specific time frame
D. Assist others in the completion of their assigned tasks when asked
498. The nurse is taking a course on ethics as part of continuing education
requirements in the state in which the nurse is employed. The nurse understands
that respect for an individual’s right to self-determination is identified by which
term?

A. Justice
B. Fidelity
C. Veracity
D. Autonomy
499. The nurse understands that an ethical dilemma exists in which scenario?

A. No correct decision exists

B. A satisfactory alternative is present
C. The right answer is always obvious
D. One ethical principal takes procedure over others
500. Which are example(s) of a negligent act? Select all that apply.

A. Medication errors resulting in inquiry

B. Failure to monitor an intravenous flow rate resulting in injury
C. A decline in client’s condition resulting in a longer hospital stay
D. A fall that occurs as a result of failure to provide safety measures to a client
E. Failure to report a change in a client’s condition to the health care provider
(HCP)