ONCOLOGY 1
A female client with cancer is scheduled for
radiation therapy. The nurse knows that radiation at
any treatment site may cause a certain adverse
effect. Therefore, the nurse should prepare the
client to expect:
A vomiting
B hair loss.
C stomatitis
D fatigue
Nurse April is teaching a group of women to
perform breast self-examination. The nurse should
explain that the purpose of performing the
examination is to discover:
A areas of thickness or fullness.
B cancerous lumps.
C fibrocystic masses.
D changes from previous self-examinations.
Jeovina, with advanced breast cancer is prescribed
tamoxifen (Nolvadex). When teaching the client
about this drug, the nurse should emphasize the
importance of reporting which adverse reaction
immediately?
A anorexia
B Vision changes
C Hearing loss
D Headache
A male client is in isolation after receiving an
internal radioactive implant to treat cancer. Two
hours later, the nurse discovers the implant in the
bed linens. What should the nurse do first?
A Put the implant back in place, using
forceps and a shield for self-protection, and call for
help.
B Leave the room and notify the radiation
therapy department immediately.
C Stand as far away from the implant as
possible and call for help.
D Pick up the implant with long-handled
forceps and place it in a lead-lined container.
A female client has an abnormal result on a
Papanicolaou test. After admitting, she read his
chart while the nurse was out of the room, the
client asks what dysplasia means. Which definition
should the nurse provide?
A Alteration in the size, shape, and
organization of differentiated cells
B Increase in the number of normal cells in a
normal arrangement in a tissue or an organ
C Replacement of one type of fully
differentiated cell by another in tissues where the
second type normally isn’t found
D Presence of completely undifferentiated
tumor cells that don’t resemble cells of the tissues
of their origin
A female client with cancer is being evaluated for
possible metastasis. Which of the following is one of
the most common metastasis sites for cancer cells?
A Colon
B Reproductive tract
C White blood cells (WBCs)
D Liver
What should a male client over age 52 do to help
ensure early identification of prostate cancer?
A Have a complete blood count (CBC) and
blood urea nitrogen (BUN) and creatinine levels
checked yearly.
B Perform monthly testicular self-
examinations, especially after age 50.
C Have a transrectal ultrasound every 5
years.
D Have a digital rectal examination and
prostate-specific antigen (PSA) test done yearly.
For a female client newly diagnosed with radiation-
induced thrombocytopenia, the nurse should
include which intervention in the plan of care?
A Placing the client in strict isolation
B Administering aspirin if the temperature
exceeds 102° F (38.8° C)
C Inspecting the skin for petechiae once
every shift
D Providing for frequent rest periods
Nurse Brian is developing a plan of care for marrow
suppression, the major dose-limiting adverse
reaction to floxuridine (FUDR). How long after drug
administration does bone marrow suppression
become noticeable?
A 7 to 14 days
B 2 to 4 days
C 24 hours
D 21 to 28 days
A 35 years old client with ovarian cancer is
prescribed hydroxyurea (Hydrea), an antimetabolite
drug. Antimetabolites are a diverse group of
antineoplastic agents that interfere with various
metabolic actions of the cell. The mechanism of
action of antimetabolites interferes with:
A the chemical structure of deoxyribonucleic
acid (DNA) and chemical binding between DNA
molecules (cell cycle–nonspecific)
B normal cellular processes during the S
phase of the cell cycle.
C one or more stages of ribonucleic acid
(RNA) synthesis, DNA synthesis, or both (cell cycle–
nonspecific).
D cell division or mitosis during the M phase
of the cell cycle
For a female client with newly diagnosed cancer, the
nurse formulates a nursing diagnosis of Anxiety
related to the threat of death secondary to cancer
diagnosis. Which expected outcome would be
appropriate for this client?
A “Client verbalizes feelings of anxiety.”
B “Client stops seeking information.”
C “Client uses any effective method to
reduce tension.”
D “Client doesn’t guess at prognosis.”
Nurse April is teaching a client who suspects that
she has a lump in her breast. The nurse instructs the
client that a diagnosis of breast cancer is confirmed
by:
A breast self-examination.
B chest X-ray.
C fine needle aspiration.
D mammography
Nurse Lucia is providing breast cancer education at a
community facility. The American Cancer Society
recommends that women get mammograms:
A after the first menstrual period and
annually thereafter
B yearly after age 40.
C every 3 years between ages 20 and 40 and
annually thereafter.
D after the birth of the first child and every 2
years thereafter.
A female client is receiving chemotherapy to treat
breast cancer. Which assessment finding indicates a
fluid and electrolyte imbalance induced by
chemotherapy?
A Dry oral mucous membranes and cracked
lips
B Blood pressure of 120/64 to 130/72 mm
Hg
C Urine output of 400 ml in 8 hours
D Serum potassium level of 3.6 mEq/L
When caring for a male client diagnosed with a
brain tumor of the parietal lobe, the nurse expects
to assess:
A seizures
B short-term memory impairment.
C tactile agnosia.
D contralateral homonymous hemianopia.
A client, age 41, visits the gynecologist. After
examining her, the physician suspects cervical
cancer. The nurse reviews the client’s history for risk
factors for this disease. Which history finding is a
risk factor for cervical cancer?
A Pregnancy complicated with eclampsia at
age 27
B Spontaneous abortion at age 19
C Human papillomavirus infection at age 32
D Onset of sporadic sexual activity at age 17
A male client undergoes a laryngectomy to treat
laryngeal cancer. When teaching the client how to
care for the neck stoma, the nurse should include
which instruction?
A “Have a family member perform stoma
care initially until you get used to the procedure.”
B “Keep the stoma dry.”
C “Keep the stoma uncovered.”
D “Keep the stoma moist.
The nurse is interviewing a male client about his
past medical history. Which preexisting condition
may lead the nurse to suspect that a client has
colorectal cancer?
A Hemorrhoids
B Weight gain
C Duodenal ulcers
D Polyps
A male client with a nagging cough makes an
appointment to see the physician after reading that
this symptom is one of the seven warning signs of
cancer. What is another warning sign of cancer?
A Persistent nausea
B Indigestion
C Rash
D Chronic ache or pain
The nurse is preparing for a female client for
magnetic resonance imaging (MRI) to confirm or
rule out a spinal cord lesion. During the MRI scan,
which of the following would pose a threat to the
client?
A The client lies still.
B The client wears a watch and wedding
band.
C The client hears thumping sounds.
D The client asks questions.
A female client is undergoing tests for multiple
myeloma. Diagnostic study findings in multiple
myeloma include:
A Bence Jones protein in the urine.
B a decreased serum creatinine level
C a low serum protein level.
D hypocalcemia
Nurse Amy is speaking to a group of women about
early detection of breast cancer. The average age of
the women in the group is 47. Following the
American Cancer Society guidelines, the nurse
should recommend that the women:
A perform breast self-examination annually.
B have a physician conduct a clinical
examination every 2 years.
C have a mammogram annually.
D have a hormonal receptor assay annually.
The ABCD method offers one way to assess skin
lesions for possible skin cancer. What does the A
stand for?
A Actinic
B Asymmetry
C Arcus
D Assessment
A 34-year-old female client is requesting
information about mammograms and breast cancer.
She isn’t considered at high risk for breast cancer.
What should the nurse tell this client?
A When she begins having yearly
mammograms, breast self-examinations will no
longer be necessary.
B She should eat a low-fat diet to further
decrease her risk of breast cancer.
C She should have had a baseline
mammogram before age 30.
D She should perform breast self-
examination during the first 5 days of each
menstrual cycle.
A male client complains of sporadic epigastric pain,
yellow skin, nausea, vomiting, weight loss, and
fatigue. Suspecting gallbladder disease, the
physician orders a diagnostic workup, which reveals
gallbladder cancer. Which nursing diagnosis may be
appropriate for this client?
A Chronic low self-esteem
B Disturbed body image
C Anticipatory grieving
D Impaired swallowing
Which intervention is appropriate for the nurse
caring for a male client in severe pain receiving a
continuous I.V. infusion of morphine?
A Assisting with a naloxone challenge test
before therapy begins
B Discontinuing the drug immediately if
signs of dependence appear
C Obtaining baseline vital signs before
administering the first dose
D Changing the administration route to P.O.
if the client can tolerate fluids
A 35 years old client has been receiving
chemotherapy to treat cancer. Which assessment
finding suggests that the client has developed
stomatitis (inflammation of the mouth)?
A Yellow tooth discoloration
B Rust-colored sputum
C Red, open sores on the oral mucosa
D White, cottage cheese–like patches on the
tongue
A male client with a cerebellar brain tumor is
admitted to an acute care facility. The nurse
formulates a nursing diagnosis of Risk for injury.
Which “related-to” phrase should the nurse add to
complete the nursing diagnosis statement?
A Related to impaired balance
B Related to psychomotor seizures
C Related to difficulty swallowing
D Related to visual field deficits
A female client is receiving methotrexate (Mexate),
12 g/m2 I.V., to treat osteogenic carcinoma. During
methotrexate therapy, the nurse expects the client
to receive which other drug to protect normal cells?
A leucovorin (citrovorum factor or folinic
acid [Wellcovorin])
B cytarabine (ara-C, cytosine arabinoside
[Cytosar-U]
C probenecid (Benemid)
D thioguanine (6-thioguanine, 6-TG)
During chemotherapy, an oncology client has a
nursing diagnosis of impaired oral mucous
membrane related to decreased nutrition and
immunosuppression secondary to the cytotoxic
effects of chemotherapy. Which nursing
intervention is most likely to decrease the pain of
stomatitis?
A Providing a solution of hydrogen
peroxide and water for use as a mouth rinse
B Monitoring the client’s platelet and
leukocyte counts
C Checking regularly for signs and symptoms
of stomatitis
D Recommending that the client discontinue
chemotherapy
ONCOLOGY 2
The removal of entire breast, pectoralis major and
minor muscles and neck lymph nodes which is
followed by skin grafting is a procedure called:
A Simple mastectomy
B Modified radical mastectomy
C Radiation therapy
D Radical mastectomy
Sarah, a hospice nurse visits a client dying of ovarian
cancer. During the visit, the client expresses that “If
I can just live long enough to attend my daughter’s
graduation, I’ll be ready to die.” Which phrase of
coping is this client experiencing?
A Anger
B Denial
C Bargaining
D Depression
The nurse is instructing the 35 year old client to
perform a testicular self-examination. The nurse
tells the client:
A To examine the testicles while lying down
B That the best time for the examination is
after a shower
C To gently feel the testicle with one finger
to feel for a growth
D That testicular self-examination should be
done at least every 6 months
Rian, a community health nurse is instructing a
group of female clients about breast self-
examination. The nurse instructs the client to
perform the examination:
A At the onset of menstruation
B Every month during ovulation
C Weekly at the same time of day
D 1 week after menstruation begins
A client is taking Cyclophosphamide (Cytoxan) for
the treatment of lymphoma. The nurse is very
cautious in administering the medication because
this drug poses the fatal side effect of:
A Alopecia
B Myeloma
C CNS toxicity
D Hemorrhagic cystitis
The home health care nurse is caring for a male
client with cancer and the client is complaining of
acute pain. The appropriate nursing assessment of
the client’s pain would include which of the
following?
A The client’s pain rating
B Nonverbal cues from the client
C The nurse’s impression of the client’s pain
D Pain relief after appropriate nursing
intervention
A client had undergone radiation therapy (external).
The expected side effects include the following
apart from:
A Hair loss
B Ulceration of oral mucous membranes
C Constipation
D Headache
The female client who has been receiving radiation
therapy for bladder cancer tells the nurse that it
feels as if she is voiding through the vagina. The
nurse interprets that the client may be
experiencing:
A Rupture of the bladder
B The development of a vesicovaginal
fistula
C Extreme stress caused by the diagnosis of
cancer
D Altered perineal sensation as a side effect
of radiation therapy
The following are teaching guidelines regarding
radiation therapy except:
A The therapy is painless
B To promote safety, the client is assisted
by therapy personnel while the machine is in
operation.
C The client may communicate all his
concerns or needs or discomforts while the machine
is operating.
D Safety precautions are necessary only
during the time of actual irradiation.
The nurse is preparing Cyclophosphamide (Cytoxan).
Safe handling of the drug should be implemented to
protect the nurse from injury. Which of the
following action by the nurse should be corrected?
A The nurse should wear mask and gloves.
B Air bubbles should be expelled on wet
cotton.
C Label the hanging IV bottle with
“ANTINEOPLASTIC CHEMOTHERAPY” sign.
D Vent vials after mixing.
Skin reactions are common in radiation therapy.
Nursing responsibilities on promoting skin integrity
should be promoted apart from:
A Avoiding the use of ointments, powders
and lotion to the area
B Using soft cotton fabrics for clothing
C Washing the area with a mild soap and
water and patting it dry not rubbing it.
D Avoiding direct sunshine or cold.
A male client is receiving the cell cycle–nonspecific
alkylating agent thiotepa (Thioplex), 60 mg weekly
for 4 weeks by bladder instillation as part of a
chemotherapeutic regimen to treat bladder cancer.
The client asks the nurse how the drug works. How
does thiotepa exert its therapeutic effects?
A It interferes with deoxyribonucleic acid
(DNA) replication only.
B It interferes with ribonucleic acid (RNA)
transcription only.
C It interferes with DNA replication and
RNA transcription.
D It destroys the cell membrane, causing
lysis
Cytarabine (Ara-C) is an antimetabolite that can
cause a common cytarabine syndrome which
includes the following apart from:
A Fever
B Myalgia
C Chest pain
D Diarrhea
A cervical radiation implant is placed in the client for
treatment of cervical cancer. The nurse initiates
what most appropriate activity order for this client?
A Bed rest
B Out of bed ad lib
C Out of bed in a chair only
D Ambulation to the bathroom only
Nurse Kate is reviewing the complications of
colonization with a client who has microinvasive
cervical cancer. Which complication, if identified by
the client, indicates a need for further teaching?
A Infection
B Hemorrhage
C Cervical stenosis
D Ovarian perforation
Vanessa, a community health nurse conducts a
health promotion program regarding testicular
cancer to community members. The nurse
determines that further information needs to be
provided if a community member states that which
of the following is a sign of testicular cancer?
A Alopecia
B Back pain
C Painless testicular swelling
D Heavy sensation in the scrotum
A male client is admitted to the hospital with a
suspected diagnosis of Hodgkin’s disease. Which
assessment findings would the nurse expect to note
specifically in the client?
A Fatigue
B Weakness
C Weight gain
D Enlarged lymph nodes
Nurse Farah is caring for a client following a
mastectomy. Which assessment finding indicates
that the client is experiencing a complication related
to the surgery?
A Pain at the incisional site
B Arm edema on the operative side
C Sanguineous drainage in the Jackson-Pratt
drain
D Complaints of decreased sensation near
the operative site
Rhea, has malignant lymphoma. As part of her
chemotherapy, the physician prescribes
chlorambucil (Leukeran), 10 mg by mouth daily.
When caring for the client, the nurse teaches her
about adverse reactions to chlorambucil, such as
alopecia. How soon after the first administration of
chlorambucil might this reaction occur?
A Immediately
B 1 week
C 2 to 3 weeks
D 1 month
Nurse Mickey is caring for a client who is
postoperative following a pelvic exenteration and
the physician changes the client’s diet from NPO
status to clear liquids. The nurse makes which
priority assessment before administering the diet?
A Bowel sounds
B Ability to ambulate
C Incision appearance
D Urine specific gravity
On a clinic visit a client who has a relative with
cancer, is asking about the warning signs that may
relate to cancer. The nurse correctly identifies the
warning signs of cancer by responding:
A “If a sore healing took a month or more to
heal, cancer should be suspected.”
B “Presence of dry cough is one of the
warning signs of cancer.”
C “A lump located only in the breast area
may suggest the presence of cancer.”
D “Sudden weight loss of unexplained
etiology can be a warning sign of cancer.”
Breast self examination (BSE) is one of the ways to
detect breast cancer earlier. The nurse is conducting
a health teaching to female clients in a clinic. During
evaluation the clients are asked to state what they
learned. Which of the following statement made by
a client needs further teaching about BSE?
A “BSE is done after menstruation.”
B “BSE palpation is done by starting at the
center going to the periphery in a circular motion.”
C “BSE can be done in either supine or
standing position.”
D “BSE should start from age 20.”
Nurse Cecilia is caring for a client who has
undergone a vaginal hysterectomy. The nurse avoids
which of the following in the care of this client?
A Elevating the knee gatch on the bed
B Assisting with range-of-motion leg
exercises
C Removal of antiembolism stockings twice
daily
D Checking placement of pneumatic
compression boots
The nurse is caring for a female client experiencing
neutropenia as a result of chemotherapy and
develops a plan of care for the client. The nurse
plans to:
A Restrict all visitors
B Restrict fluid intake
C Teach the client and family about the
need for hand hygiene
D Insert an indwelling urinary catheter to
prevent skin breakdown
The nurse is admitting a male client with laryngeal
cancer to the nursing unit. The nurse assesses for
which most common risk factor for this type of
cancer?
A Alcohol abuse
B Cigarette smoking
C Use of chewing tobacco
D Exposure to air pollutants
During the admission assessment of a 35 year old
client with advanced ovarian cancer, the nurse
recognizes which symptom as typical of the disease?
A Diarrhea
B Hypermenorrhea
C Abdominal bleeding
D Abdominal distention
A client is diagnosed with breast cancer. The tumor
size is up to 5 cm with axillary and neck lymph node
involvement. The client is in what stage of breast
cancer?
A Stage I
B Stage II
C Stage III
D Stage IV
Chemotherapy is one of the therapeutic modalities
for cancer. This treatment is contraindicated to
which of the following conditions?
A Recent surgery
B Pregnancy
C Bone marrow depression
D All of the above
The male client is receiving external radiation to the
neck for cancer of the larynx. The most likely side
effect to be expected is:
A Dyspnea
B Diarrhea
C Sore throat
D Constipation
Nausea and vomiting is an expected side effect of
chemotherapeutic drug use. Which of the following
drug should be administered to a client on
chemotherapy to prevent nausea and vomiting?
A Metochlopramide (Metozol)
B Succimer (Chemet)
C Anastrazole (Arimidex)
D Busulfan (Myleran)
The client with leukemia is receiving busulfan
(Myleran) and allopurinol (Zyloprim). The nurse tells
the client that the purpose if the allopurinol is to
prevent:
A Nausea
B Alopecia
C Vomiting
D Hyperuricemia
Nurse Janet is assigned in the oncology section of
the hospital. Which of the following orders should
the nurse question if a client is on radiation
therapy?
A analgesics before meals
B Saline rinses every 2 hours
C Aspirin every 4 hours
D Bland diet
Nurse Joy is caring for a client with an internal
radiation implant. When caring for the client, the
nurse should observe which of the following
principles?
A Limit the time with the client to 1 hour per
shift
B Do not allow pregnant women into the
client’s room
C Remove the dosimeter badge when
entering the client’s room
D Individuals younger than 16 years old may
be allowed to go in the room as long as they are 6
feet away from the client
Nurse Meredith is instructing a premenopausal
woman about breast self-examination. The nurse
should tell the client to do her self-examination:
A at the end of her menstrual cycle.
B on the same day each month.
C on the 1st day of the menstrual cycle.
D immediately after her menstrual period.
A client is diagnosed with progressive prostate
cancer. The nurse expects which drug is given?
A Anstrazole (arimidex)
B Estramustine (Emcyt)
C Paclitaxel (Taxol)
D Irinotecan (Camptosar)
Neoplasm can be classified as either benign or
malignant. The following are characteristics of
malignant tumor apart from:
A Metastasis
B Infiltrates surrounding tissues
C Encapsulated
D Poorly differentiated cells
Nurse Bea is reviewing the laboratory results of a
client diagnosed with multiple myeloma. Which of
the following would the nurse expect to note
specifically in this disorder?
A Increased calcium
B Increased white blood cells
C Decreased blood urea nitrogen level
D Decreased number of plasma cells in the
bone marrow
A female client is hospitalized for insertion of an
internal cervical radiation implant. While giving
care, the nurse finds the radiation implant in the
bed. The initial action by the nurse is to:
A Call the physician
B Reinsert the implant into the vagina
immediately
C Pick up the implant with gloved hands and
flush it down the toilet
D Pick up the implant with long-handled
forceps and place it in a lead container.
The classic symptoms that define breast cancer
includes the following except:
A “pink peel” skin
B Solitary, irregularly shaped mass
C Firm, nontender, nonmobile mass
D Abnormal discharge from the nipple
Nina, an oncology nurse educator is speaking to a
women’s group about breast cancer. Questions and
comments from the audience reveal a
misunderstanding of some aspects of the disease.
Various members of the audience have made all of
the following statements. Which one is accurate?
A Mammography is the most reliable
method for detecting breast cancer.
B Breast cancer is the leading killer of
women of childbearing age.
C Breast cancer requires a mastectomy.
D Men can develop breast cancer.
Specific classification of the chemotherapeutic
agent, Vincristine (Oncovin) is:
A Hormone modulator
B Mitotic inhibitor
C Antineoplastic antibiotic
D Antimetabolite
A male client is diagnosed as having a bowel tumor
and several diagnostic tests are prescribed. The
nurse understands that which test will confirm the
diagnosis of malignancy?
A Biopsy of the tumor
B Abdominal ultrasound
C Magnetic resonance imaging
D Computerized tomography scan

A female client with cancer is receiving
chemotherapy and develops thrombocytopenia. The
nurse identifies which intervention as the highest
priority in the nursing plan of care?
A Monitoring temperature
B Ambulation three times daily
C Monitoring the platelet count
D Monitoring for pathological fractures
Radiation protection is very important to implement
when performing nursing procedures. When the
nurse is not performing any nursing procedures
what distance should be maintained from the
client?
A 1 feet
B 2 feet
C 2.5 feet
D 3 feet
Contact of client on radiation therapy should be
limited only to how many minutes to promote
safety of the therapy personnel?
A 1 minute
B 3 minutes
C 5 minutes
D 10 minutes
Mina, who is suspected of an ovarian tumor is
scheduled for a pelvic ultrasound. The nurse
provides which preprocedure instruction to the
client?
A Eat a light breakfast only
B Maintain an NPO status before the
procedure
C Wear comfortable clothing and shoes for
the procedure
D Drink six to eight glasses of water
without voiding before the test
Nurse Kent is teaching a male client to perform
monthly testicular self-examinations. Which of the
following points would be appropriate to make?
A Testicular cancer is a highly curable type
of cancer
B Testicular cancer is very difficult to
diagnose.
C Testicular cancer is the number one cause
of cancer deaths in males.
D Testicular cancer is more common in older
men.
A client taking a chemotherapeutic agent
understands the effects of therapy by stating:
A “I will avoid eating hot and spicy foods.”
B “I should stay in my room all the time.”
C “I should limit my fluid intake to about
500 ml per day.”
D “I should notify the physician immediately
if a urine color change is observed.”
In staging and grading neoplasm TNM system is
used. TNM stands for:
A Time, neoplasm, mode of growth
B Tumor, node, metastasis
C Tumor, neoplasm, mode of growth
D Time, node, metastasis
Chemotherapeutic agents have different specific
classifications. The following medications are
antineoplastic antibiotics except:
A Doxorubicin (Adriamycin)
B Fluorouracil (Adrucil)
C Mitoxantrone (Novantrone)
D Bleomycin (Blenoxane)
A 25 year old patient is inquiring about the methods
or ways to detect cancer earlier. The nurse least
likely identify this method by stating:
A Annual chest x-ray.
B Annual Pap smear for sexually active
women only.
C Annual digital rectal examination for
persons over age 40.
D Yearly physical and blood examination
A female client diagnosed with multiple myeloma
and the client asks the nurse about the diagnosis.
The nurse bases the response on which description
of this disorder?
A Altered red blood cell production
B Altered production of lymph nodes
C Malignant exacerbation in the number of
leukocytes
D Malignant proliferation of plasma cells
within the bone
Surgical procedure to treat breast cancer involves
the removal of the entire breast, pectoralis major
muscle and the axillary lymph nodes is:
A Simple mastectomy
B Modified radical mastectomy
C Halstead Surgery
D Radical mastectomy
To provide relief from the cytarabine syndrome,
which drug is given?
A Analgesic
B Aspirin
C Steroids
D Allopurinol
Mr. Miller has been diagnosed with bone cancer.
You know this type of cancer is classified as:
A lymphoma
B carcinoma
C melanoma
D sarcoma
ONCOLOGY 3
The client with which of the following types of lung
cancer has the best prognosis?
A Adenocarcinoma
B Oat cell
C Squamous cell
D Small cell
The client with cancer is receiving chemotherapy
and develops thrombocytopenia. The nurse
identifies which intervention as the highest priority
in the nursing plan of care?
A Ambulation three times a day
B Monitoring temperature
C Monitoring the platelet count
D Monitoring for pathological factors
The nurse is reviewing the laboratory results of a
client diagnosed with multiple myeloma. Which of
the following would the nurse expect to note
specifically in this disorder?
A Decreased number of plasma cells in the
bone marrow.
B Increased WBC’s
C Increased calcium levels
D Decreased blood urea nitrogen
Which of the following nursing interventions would
be most helpful in making the respiratory effort of a
client with metastatic lung cancer more efficient?
A Teaching the client diaphragmatic
breathing techniques
B Administering cough suppressants as
ordered
C Teaching and encouraging pursed-lip
breathing
D Placing the client in a low semi-Fowlers
position
A nurse is providing education in a community
setting about general measures to avoid excessive
sun exposure. Which of the following
recommendations is appropriate?
A Apply sunscreen only after going in the
water.
B Avoid peak exposure hours from 9am to
1pm
C Wear loosely woven clothing for added
ventilation
D Apply sunscreen with a sun protection
factor (SPF) of 15 or more before sun exposure.
The nurse is developing a plan of care for the client
with multiple myeloma. The nurse includes which
priority intervention in the plan of care?
A Coughing and deep breathing
B Encouraging fluids
C Monitoring red blood cell count
D Providing frequent oral care
A 36-year-old man with lymphoma presents with
signs of impending septic shock 9 days after
chemotherapy. The nurse could expect which of the
following to be present?
A Flushing, decreased oxygen saturation,
mild hypotension
B Low-grade fever, chills, tachycardia
C Elevated temperature, oliguria,
hypotension
D High-grade fever, normal blood pressure,
increased respirations
At the time of diagnosis of Hodgkin’s lymphoma,
which of the following areas is often involved?
A Back
B Chest
C Groin
D Neck
A 56-year-old woman is currently receiving radiation
therapy to the chest wall for recurrent breast
cancer. She calls her health care provider to report
that she has pain while swallowing and burning and
tightness in her chest. Which of the following
complications of radiation therapy is most likely
responsible for her symptoms?
A Hiatal hernia
B Stomatitis
C Radiation enteritis
D Esophagitis
The nurse is caring for a client following a modified
radical mastectomy. Which assessment finding
would indicate that the client is experiencing a
complication related to this surgery?
A Sanguineous drainage in the Jackson-Pratt
drain
B Pain at the incisional site
C Complaints of decreased sensation near
the operative site
D Arm edema on the operative side
When a client has a lobectomy, what fills the space
where the lobe was?
A The space stays empty.
B The surgeon fills the space with gel
C The lung space fills up with serous fluid
D The remaining lobe or lobes overexpand
to fill the space
A 32-year-old woman meets with the nurse on her
first office visit since undergoing a left mastectomy.
When asked how she is doing, the woman states her
appetite is still not good, she is not getting much
sleep because she doesn’t go to bed until her
husband is asleep, and she is really anxious to get
back to work. Which of the following nursing
interventions should the nurse explore to support
the client’s current needs?
A Call the physician to discuss allowing the
client to return to work earlier.
B Suggest that the client learn relaxation
techniques to help with her insomnia
C Perform a nutritional assessment to assess
for anorexia
D Ask open-ended questions about
sexuality issues related to her mastectomy
Which of the following laboratory values is expected
for a client just diagnosed with chronic lymphocytic
leukemia?
A Elevated sedimentation rate
B Uncontrolled proliferation of granulocytes
C Thrombocytopenia and increased
lymphocytes
D Elevated aspartate aminotransferase and
alanine aminotransferase levels.
One of the most serious blood coagulation
complications for individuals with cancer and for
those undergoing cancer treatments is disseminated
intravascular coagulation (DIC). The most common
cause of this bleeding disorder is:
A Underlying liver disease
B Brain metastasis
C Intravenous heparin therapy
D Sepsis
Which of the following assessment findings in a
client with leukemia would indicate that the cancer
has invaded the brain?
A Headache and vomiting.
B Restlessness and tachycardia
C Hypervigilant and anxious behavior
D Increased heart rate and decreased blood
pressure
For which of the following conditions is a client with
multiple myeloma (MM) monitored?
A Hypercalcemia
B Hyperkalemia
C Hypernatremia
D Hypermagnesemia
In which of the following diseases would bone
marrow transplantation not be indicated in a newly
diagnosed client?
A Acute lymphocytic leukemia
B Chronic myeloid leukemia
C Severe aplastic anemia
D Severe combined immunodeficiency
Which of the following conditions is not a
complication of Hodgkin’s disease?
A Anemia
B Infection
C Myocardial Infarction
D Nausea
Which of the following complications are three main
consequences of leukemia?
A Bone deformities, spherocytosis, and
infection.
B Anemia, infection, and bleeding
tendencies
C Lymphocytopoesis, growth delays, and
hirsutism
D Polycythemia, decreased clotting time,
and infection.
Which of the following is the primary goal for
surgical resection of lung cancer?
A To remove the tumor and all surrounding
tissue.
B To remove the tumor and as little
surrounding tissue as possible.
C To remove all of the tumor and any
collapsed alveoli in the same region.
D To remove as much as the tumor as
possible, without removing any alveoli.
If the client with lung cancer also has preexisting
pulmonary disease, which of the following
statements best describes how the extent of that
can be performed?
A It doesn’t affect it.
B It may require a whole lung to be
removed.
C The entire tumor may not be able to be
removed
D It may prevent surgery if the client can’t
tolerate lung tissue removal.
During a routine physical examination, a firm mass is
palpated in the right breast of a 35-year-old woman.
Which of the following findings or client history
would suggest cancer of the breast as opposed to
fibrocystic disease?
A History of early menarche
B Cyclic changes in mass size
C History of anovulatory cycles
D Increased vascularity of the breast
A 58-year-old man is going to have chemotherapy
for lung cancer. He asks the nurse how the
chemotherapeutic drugs will work. The most
accurate explanation the nurse can give is which of
the following?
A “Chemotherapy affects all rapidly
dividing cells.”
B “The molecular structure of the DNA is
altered.”
C “Cancer cells are susceptible to drug
toxins.”
D “Chemotherapy encourages cancer cells
to divide.”
When caring for a client with a central venous line,
which of the following nursing actions should be
implemented in the plan of care for chemotherapy
administration? Select all that apply.
A Verify patency of the line by the presence
of a blood return at regular intervals.
B Inspect the insertion site for swelling,
erythema, or drainage.
C Administer a cytotoxic agent to keep the
regimen on schedule even if blood return is not
present.
D If unable to aspirate blood, reposition the
client and encourage the client to cough.
E Contact the health care provider about
verifying placement if the status is questionable.
The oncology nurse specialist provides an
educational session to nursing staff regarding the
characteristics of Hodgkin’s disease. The nurse
determines that further education is needed if a
nursing staff member states that which of the
following is characteristic of the disease?
A Presence of Reed-Sternberg cells
B Involvement of lymph nodes, spleen, and
liver
C Occurs most often in the older client
D Prognosis depends on the stage of the
disease
Which of the following tests in performed on a
client with leukemia before initiation of therapy to
evaluate the child’s ability to metabolize
chemotherapeutic agents?
A Lumbar puncture
B Liver function studies
C Complete blood count (CBC)
D Peripheral blood smear
Which of the following immunizations should not be
given to a 4-month-old sibling of a client with
leukemia?
A Diphtheria and tetanus and pertussis
(DPT) vaccine.
B Hepatitis B vaccine
C Haemophilus influenza type b vaccines
(Hib)
D Oral poliovirus vaccine (OPV)
What are the three most important prognostic
factors in determining long-term survival for
children with acute leukemia?
A Histologic type of disease, initial platelet
count, and type of treatment
B Type of treatment and client’s sex
C Histologic type of disease, initial WBC
count, and client’s age at diagnosis
D Progression of illness, WBC at the time of
diagnosis, and client’s age at the time of diagnosis.
A centrally located tumor would produce which of
the following symptoms?
A Coughing
B Hemoptysis
C Pleuritic pain
D Shoulder pain
A child is seen in the pediatrician’s office for
complaints of bone and joint pain. Which of the
following other assessment findings may suggest
leukemia?
A Abdominal pain
B Increased activity level
C Increased appetite
D Petechiae
Which of the following clients is most at risk for
developing multiple myeloma?
A A 20-year-old Asian woman
B A 30-year-old White man
C A 50-year-old Hispanic woman
D A 60-year-old Black man
A pneumonectomy is a surgical procedure
sometimes indicated for treatment of non-small-cell
lung cancer. A pneumonectomy involves removal of:
A An entire lung field
B A small, wedge-shaped lung surface
C One lobe of a lung
D One or more segments of a lung lobe
Which of the following statements is correct about
the rate of cell growth in relation to chemotherapy?
A Faster growing cells are less susceptible to
chemotherapy.
B Non-dividing cells are more susceptible to
chemotherapy
C Faster growing cells are more susceptible
to chemotherapy
D Slower growing cells are more susceptible
to chemotherapy.
Which of the following is the reason to perform a
spinal tap on a client newly diagnosed with
leukemia?
A To rule out meningitis
B To decrease intracranial pressure
C To aid in classification of the leukemia
D To assess for central nervous system
infiltration
Which of the following interventions is the key to
increasing the survival rates of clients with lung
cancer?
A Early bronchoscopy
B Early detection
C High-dose chemotherapy
D Smoking cessation
Giving instructions for breast self-examination is
particularly important for clients with which of the
following medical problems?
A Cervical dysplasia
B A dermoid cyst
C Endometrial polyps
D Ovarian cancer
The community nurse is conducting a health
promotion program at a local school and is
discussing the risk factors associated with cancer.
Which of the following, if identified by the client as
a risk factor, indicates a need for further
instructions?
A Viral factors
B Stress
C Low-fat and high-fiber diets
D Exposure to radiation
Parents of pediatric clients who undergo irradiation
involving the central nervous system should be
warned about postirradiation somnolence. When
does this neurologic syndrome usually occur?
A Immediately
B Within 1 to 2 weeks
C Within 5 to 8 weeks
D Within 3 to 6 months
Which of the following treatment measures should
be implemented for a child with leukemia who has
been exposed to the chickenpox?
A No treatment is indicated.
B Acyclovir (Zovirax) should be started on
exposure
C Varicella-zoster immune globin (VZIG)
should be given with the evidence of disease
D VZIG should be given within 72 hours of
exposure
Nausea and vomiting are common adverse effects of
radiation and chemotherapy. When should a nurse
administer antiemetics?
A 30 minutes before the initiation of
therapy.
B With the administration of therapy.
C Immediately after nausea begins.
D Immediately after nausea begins
A client has been diagnosed with lung cancer and
requires a wedge resection. How much of the lung is
removed?
A One entire lung
B A lobe of the lung
C A small, localized area near the surface of
the lung.
D A segment of the lung, including a
bronchiole and its alveoli
The client with a benign lung tumor is treated in
which of the following ways?
A The tumor is treated with radiation only.
B The tumor is treated with chemotherapy
only.
C The tumor is left alone unless symptoms
are present.
D The tumor is removed, involving the least
possible amount of tissue
A client with leukemia has neutropenia. Which of
the following functions must be frequently
assessed?
A Blood pressure
B Bowel sounds
C Heart sounds
D Breath sounds
Which of the following types of leukemia carries the
best prognosis?
A Acute lymphoblastic leukemia
B Acute myelogenous leukemia
C Basophillic leukemia
D Eosinophillic leukemia
Which of the following represents the most
appropriate nursing intervention for a client with
pruritis caused by cancer or the treatments?
A Administration of antihistamines
B Steroids
C Silk sheets
D Medicated cool baths
The nurse is reviewing the laboratory results of a
client receiving chemotherapy. The platelet count is
10,000 cells/mm. Based on this laboratory value,
the priority nursing assessment is which of the
following?
A Assess level of consciousness
B Assess temperature
C Assess bowel sounds
D Assess skin turgor
A client with stomach cancer is admitted to the
oncology unit after vomiting for 3 days. Physical
assessment findings include irregular pulse, muscle
twitching, and complaints of prickling sensations in
the fingers and hands. Laboratory results include a
potassium level of 2.9 mEq/L, a pH of 7.46, and a
bicarbonate level of 29 mEq/L. The client is
experiencing:
A Respiratory alkalosis
B Respiratory acidosis
C Metabolic alkalosis
D Metabolic acidosis
Warning signs and symptoms of lung cancer include
persistent cough, bloody sputum, dyspnea, and
which of the other following symptoms?
A Dizziness
B Generalized weakness
C Hypotension
D Recurrent pleural effusion
The nurse is teaching a 17-year old client and the
client’s family about what to expect with high-dose
chemotherapy and the effects of neutropenia. What
should the nurse teach as the most reliable early
indicator of infection in a neutropenic client?
A Fever
B Chills
C Tachycardia
D Dyspnea
Which of the following foods should a client with
leukemia avoid?
A White bread
B Carrot sticks
C Stewed apples
D Medium rare steak
Which of the following medications usually is given
to a client with leukemia as prophylaxis against P.
carinii pneumonia?
A Bactrim
B Oral nystatin suspension
C Prednisone
D Vincristine (Oncovin)
Which of the following substances has abnormal
values early in the course of multiple myeloma
(MM)?
A Immunoglobulins
B Platelets
C Red blood cells
D White blood cells
According to a standard staging classification of
Hodgkin’s disease, which of the following criteria
reflects stage II?
A Involvement of extralymphatic organs or
tissues
B Involvement of single lymph node region
or structure
C Involvement of two or more lymph node
regions or structures.
D Involvement of lymph node regions or
structures on both sides of the diaphragm.
In the client with terminal lung cancer, the focus of
nursing care is on which of the following nursing
interventions?
A Provide emotional support
B Provide nutritional support
C Provide pain control
D Prepare the client’s will
CANCER
In assigning patients with alterations related to
gastrointestinal (GI) cancer, which would be the
most appropriate nursing care tasks to assign to the
LPN/LVN, under supervision of the team leader RN?
A A patient who needs enemas and
antibiotics to control GI bacteria
B A patient who needs central line insertion
for chemotherapy
C A patient with severe anemia secondary
to GI bleeding
D A patient who needs pre-op teaching for
bowel resection surgery
Persons at risk are the greater target population for
cancer screening programs. Which asymptomatic
patient(s) needs extra encouragement to participate
in cancer screening? (Choose all that apply).
A A 19-year-old white-American female C. Intensification
who is sexually inactive for a Pap smear D. Consolidation
B A 35-year-old white-American female for A B,A,C,D
an annual mammogram B B,D,C,A
C A 49year-old African-American male for an C A,B,C,D
annual fecal occult blood test D B, C, D, A
D A 45-year-old African-American male for
an annual prostate-specific antigen For a patient on the chemotherapeutic drug
vincristine (Oncovin), which of the following side
In monitoring patients who are at risk for spinal cord effects should be reported to the physician?
compression related to tumor growth, what is the A Nausea and vomiting
most likely early manifestation? B Fatigue
A Constipation C Paresthesia
B Motor loss D Anorexia
C Urinary hesitancy
D Sudden-onset back pain For a patient who is experiencing side effects of
When assigning staff to patients who are receiving radiation therapy, which task would be the most
chemotherapy, what is the major consideration appropriate to delegate to the nursing assistant?
about chemotherapeutic drugs? A Report the amount and type of food
A Chemotherapeutics are frequently given consumed from the tray.
through central nervous access devices. B Check the skin for redness and irritation
B During preparation, drugs may be after the treatment.
absorbed through the skin or inhaled. C Assist the patient to identify patterns of
C Oral and venous routes are the most fatigue.
common. D Recommend participation in a walking
D Many chemotherapeutics are vesicants program
What do you tell patients is the most important risk You are caring for a patient with esophageal cancer.
factor for lung cancer when you are teaching about Which task could be delegated to the nursing
lung cancer prevention? assistant?
A Exposure to environmental/occupational A Initiate daily weights.
carcinogens B Observe the patient’s response to
B Cigarette smoking feedings
C Pipe or cigar smoking C Facilitate expression of grief or anxiety.
D Exposure to environmental tobacco D Assist the patient with oral hygiene
smoke (ETS)
For a patient who is receiving chemotherapy, which
Chemotherapeutic treatment of acute leukemia is laboratory result is of particular importance?
done in four phases. Place these phases in the A WBC
correct order. B Electrolytes
A. Maintenance C PT and PTT
B. Induction D BUN

For care of a patient who has oral cancer, which task
would be appropriate to delegate to the LPN/LVN?
A Explain when brushing and flossing are
contraindicated.
B Give antacids and sucralfate suspension
as ordered.
C Assist the patient to brush and floss.
D Recommend saliva substitutes.
You have just received the morning report from the
night shift nurses. List the order of priority for
assessing and caring for these patients.
A. A patient who developed tumor lysis
syndrome around 5:00 AM
B. A patient with frequent reports of break-
through pain over the past 24 hours
C. A patient scheduled for exploratory
laparotomy this morning
D. A patient with anticipatory nausea and
vomiting for the past 24 hours
A A, C, B, D
B A,B,C,D
C A,C,D,B
D A,D,B,C
A community health center is preparing a
presentation on the prevention and detection of
cancer. Which health care professional should be
assigned to address the explaining, screening exams
and diagnostic testing for common cancers ?
A LPN/LVN
B nutritionist
C RN
D nurse practitioner
A patient with lung cancer develops syndrome of
inappropriate antidiuretic hormone secretion
(SIADH). After reporting symptoms of weight gain,
weakness, and nausea and vomiting to the
physician, you would anticipate which initial order
for the treatment of this patient?
A Fluid restrictions as ordered
B Urinalysis as ordered
C A fluid bolus as ordered
D Sodium-restricted diet as ordered
In caring for a patient with neutropenia, what tasks
can be delegated to the nursing assistant? (Choose
all that apply).
A Gather the supplies to prepare the room
for protective isolation.
B Practice good handwashing technique.
C Take vital signs every 4 hours
D Assess for sore throat, cough, or burning
with urination.
E Report temperature elevation >100.4o F
F Report superinfections, such as candidiasis
Following chemotherapy, a patient is being closely
monitored for tumor lysis syndrome. Which
laboratory value requires particular attention?
A Hematocrit
B Electrolytes
C Hemoglobin
D Platelet count
Which of the following cancer patients could
potentially be placed together as roommates?
(Choose the answers that apply).
A A patient with a neutrophil count of
1000/mm3
B A patient who underwent debulking of a
tumor to relieve pressure
C A patient receiving high-dose
chemotherapy after a bone marrow harvest
D A patient who is post-op laminectomy for
spinal cord compression
A 56-year-old patient comes to the walk-in clinic for
scant rectal bleeding and intermittent diarrhea and
constipation for the past several months. There is a
history of polyps and a family history for colorectal
cancer. While you are trying to teach about
colonoscopy, the patient becomes angry and
threatens to leave. What is the priority diagnosis?
A Diarrhea/Constipation related to altered
bowel patterns
B Knowledge Deficit related to disease
process and diagnostic procedure
C Risk for Fluid Volume Deficit related to
rectal bleeding and diarrhea
D Anxiety related to unknown outcomes
and perceive threat to body integrity
A primary nursing responsibility is the prevention of
lung cancer by assisting patients in smoking/tobacco
cessation. Which tasks would be appropriate to
delegate to the LPN/LVN?
A Discuss strategies to avoid relapse
B Explain the application of a nicotine
patch
C Suggest ways to deal with urges for a
tobacco
D Develop a “quit plan”
For a patient with osteogenic sarcoma, you would
be particularly vigilant for elevations in which
laboratory value?
A Hematocrit
B Sodium
C Calcium
D Potassium
The physician tells the patient that there will be an
initial course of treatment with continued
maintenance treatments and ongoing observation
for signs and symptoms over a prolonged period of
time. You can help the patient by reinforcing that
the primary goal for this type of treatment is:
A Palliation
B Cure
C Permanent remission
D Control
Which patient is at greatest risk for pancreatic
cancer?
A A young, white obese female with no
known health issues
B An elderly white female with a history of
pancreatitis
C An elderly black male with a history of
smoking and alcohol use
D A young black male with juvenile onset
diabetes
The disease progress of cancers, such as cervical or
Hodgkin’s, can be classified according to a clinical
staging system. Place the description of stages 0-IV
in the correct order.
A. Metastasis
B. Limited local spread
C. Cancer in situ
D. Tumor limited to tissue of origin
E. Extensive local and regional spread
A A,B,C,D,E
B C, D, B, E, A
C C, D, E, B, A
D D,C,E,A,B
Which set of classification values indicates the most
extensive and progressed cancer?
A Tis N0 M0
B T1 N0 M0
C T1 N1 M0
D T4 N3 M1
BLADDER CANCER
A male patient suffering from bladder cancer has
undergone a bladder removal and an ileal conduit
has been created for urine diversion. Upon changing
this patient's pouch, the nurse notes that the area
surrounding the stoma is reddened, oozing, and
causing the patient discomfort. What should Nurse
Katrina infer from this observation?
A. There has been no dilation of the stoma.
B. The faceplate of the pouch isn't fitting the stoma Which grade corresponds to a very low level of
properly. malignancy in a tumor?
C. The skin wasn't properly lubricated prior to the A. Grade 3
application of the pouch. B. Grade 4
D. The skin barrier has been correctly installed. C. Grade 2
D. Grade 1
Which tumor grade is characterized by a complete
non-responsiveness to radiation? A male patient, post-radium implant for bladder
A. Grade 2 cancer, is to be admitted to the nursing ward. What
B. Grade 3 would be the most critical action for the head nurse
C. Grade 1 to take in managing this patient's care?
D. Grade 4 A. Advocate for the patient to have regular rest
periods.
How do tricyclic antidepressants impact the urinary B. Order sedative medications for the patient to
system? reduce anxiety.
A. Medications that amplify resistance at the C. Implement protective reverse isolation for the
bladder outlet. patient.
B. Medications that trigger detrusor muscle D. Assign the patient to a solitary room.
contractility and facilitate bladder emptying.
C. Medications that reduce the resistance at the What proportion of bladder cancers is represented
bladder outlet. by squamous cell carcinoma?
D. Medications that suppress contractility and A. 3% of cases
foster urine retention. B. 5% of cases
C. 50% of cases
Which category of drugs is known to suppress D. 95% of cases
contractility and encourage the retention of urine?
A. Beta-adrenergic medications. The statement that occupational exposure to
B. Antispasmodic agents. aromatic amines does not lead to cancer is:
C. Relaxants for the external sphincter/striated A. Inaccurate
muscle. B. Accurate
D. Cholinergic medications.
The decision to administer chemotherapy hinges on
When treating superficial bladder cancer, mitomycin the overall health status of the patient. Is this
(Mutamycin), an antineoplastic antibiotic, can be statement:
directly instilled. What is the name for this A. Inaccurate
procedure? B. Accurate
A. Intraarterial administration.
B. Intraventricular administration. Is it accurate to assert that there's a connection
C. Intrathecal administration. between aniline dyes and the onset of cancer?
D. Intravesical administration. A. Certainly, that's the case.
B. No, that's not correct.
Which variety of bladder cancer is most frequently D. Medications that trigger detrusor muscle
diagnosed? What is the total number of recognized grades for contractility and aid in bladder emptying.
A. Carcinoma of transitional cells. categorizing cancer?
B. Carcinoma of squamous cells. A. 5 grades What defines alpha-adrenergic medications?
C. Hyperplasia of epithelial cells. B. 3 grades A. Drugs that augment bladder outlet resistance.
D. Carcinoma of cuboidal cells. C. 4 grades B. Drugs that suppress contractility and encourage
D. 6 grades urine retention.
The statement that artificial sweeteners, pelvic C. Drugs that trigger detrusor muscle contractility
irradiation, and chronic cystitis cannot lead to Mr. Canelo, who has been diagnosed with bladder and facilitate bladder emptying.
cancer is: cancer, is due for a cystectomy along with the D. Drugs that lessen the resistance of the bladder
A. Accurate formation of an ileal conduit the following morning. outlet.
B. Inaccurate He's noticed to be pacing the floor and anxiously
wringing his hands as the nurse enters his room. What circumstance would signal the need to employ
Which grade corresponds to a high degree of What's the most appropriate response? chemotherapy?
malignancy, typically associated with anaplastic A. "Mr. Canelo, I notice you seem anxious. Could A. Persistent reflux.
carcinoma? you share your feelings about tomorrow's B. Recurrence of Carcinoma in situ (CIS).
A. Grade 4 procedure?" C. Excessive fatigue.
B. Grade 3 B. "Mr. Canelo, I understand you must be filled with D. The positioning of the tumor.
C. Grade 2 worry. I'll leave you alone with your thoughts." How is Transitional Cell Carcinoma (TCC) best
D. Grade 1 C. "Good evening, Mr. Canelo. It was quite a described?
pleasant day today, wasn't it?" A. A malignancy that originates from the urothelial
Where does bladder cancer rank in terms of the D. "Mr. Canelo, at this rate, you'll exhaust both lining of the urinary tract.
most frequently diagnosed genitourinary (GU) yourself and the hospital floors." B. A cancerous development causing deterioration
cancers in adults? of the bladder wall and its urothelium.
A. It holds the 4th position. A patient suffering from bladder cancer is C. A benign expansion of the urothelium triggered
B. It secured 2nd place. undergoing treatment via iridium seed implants. by inflammation or irritation.
C. It's at the top, the 1st place. What important advice should the nurse emphasize D. An aggressive form of bladder cancer with poor
D. It's positioned 8th. in the discharge instructions for this client? prognosis.
A. Inform about any changes in urinary frequency.
Which tumor grade is typically known to exhibit B. Limit bowel movements. Besides recurring UTI, nausea/vomiting, and
resistance? C. Ramp up his consumption of fluids. leukopenia, which of the following is also a known
A. Grade 3 tumor D. Refrain from sitting for extended periods. adverse reaction to chemotherapy?
B. Grade 2 tumor A. Glaucoma
C. Grade 4 tumor What is the primary action of cholinergic B. Nephrotoxicity
D. Grade 1 tumor medications within the urinary system? C. Fistula
A. Medications that enhance resistance at the D. Benign Prostatic Hyperplasia (BPH)
Which grade of tumor typically shows a poor bladder outlet.
response to radiation therapy? B. Medications that relax the internal sphincter Which medication category is known to lessen the
A. Grade 4 muscle. resistance of the bladder outlet?
B. Grade 3 C. Medications that reduce resistance at the bladder A. Hormones such as estrogens.
C. Grade 1 outlet. B. Medications that block alpha-adrenergic
D. Grade 2 receptors.
C. Agents that stimulate beta-adrenergic receptors.
D. Medications that stimulate alpha-adrenergic
receptors.
Is there evidence suggesting a correlation between
exposure to the process of pizza making in one's
occupation and the development of bladder cancer?
A. Absolutely, there is.
B. Not at all, there isn't.
Which tumor grade signifies the least degree of
malignancy?
A. Grade 4 tumor
B. Grade 1 tumor
C. Grade 3 tumor
D. Grade 2 tumor
What is an accurate characterization of beta-
adrenergics?
A. Medications that promote bladder emptying.
B. Medications that promote detrusor contractility
and facilitate bladder emptying.
C. Medications that increase the resistance at the
bladder outlet.
D. Medications that suppress contractility and
foster urine storage.
What is the most common initial symptom
associated with bladder cancer?
A. Frequent urination.
B. Constipation.
C. Pain in the flank due to a blockage in the ureter
or a pelvic mass.
D. Painless blood in the urine.
What is the primary purpose of conducting a
random bladder biopsy?
A. To investigate smaller tumors.
B. To verify the stage and grade of the tumor.
C. To study invasive characteristics.
D. To confirm stages T1-T4.
A male patient is undergoing a chemotherapy
regimen to treat bladder cancer, which includes a
weekly 60 mg dose of the cell cycle–nonspecific
alkylating agent thiotepa (Thioplex) for four weeks
via bladder installation. When he asks the nurse
how the medication works, what would be the
correct explanation for thiotepa's therapeutic
effects?
A. It solely disrupts the replication of
deoxyribonucleic acid (DNA).
B. It changes the metabolic activity of cancer cells.
C. It disrupts both DNA replication and RNA
transcription processes.
D. It solely interferes with the transcription of
ribonucleic acid (RNA).
What description accurately characterizes
anticholinergics?
A. Medications that lessen the resistance at the
bladder outlet.
B. Medications that encourage detrusor contractility
and facilitate bladder emptying.
C. Medications that enhance the resistance at the
bladder outlet.
D. Medications that reduce contractility and aid in
urine retention.
A patient has been diagnosed with bladder cancer,
and preparations are being made for a cystectomy
and an ileal conduit. What is the appropriate
preoperative plan that the nurse should arrange?
A. Arrange for cleansing enemas and laxatives as
prescribed.
B. Educate the patient about the stoma irrigation
procedure.
C. Instruct the patient on muscle-tightening
exercises.
D. Restrict the intake of fluids for the next 24 hours.
BREAST CANCER
A client receiving chemotherapy for breast cancer
has an order for Zofran (ondansetron) 8mg PO to be
given 30 minutes before induction of the
chemotherapy. The purpose of the medication is to:
A Prevent anemia
B Promote relaxation
C Prevent nausea
D Increase neutrophil counts
The community health nurse implemented a new
program about effective breast cancer screening
technique for the female personnel of the health
department of Valenzuela. Which of the following
technique should the nurse consider to be of the
lowest priority?
A Yearly breast exam by a trained
professional
B Detailed health history to identify
women at risk
C Screening mammogram every year for
women over age 50
D Screening mammogram every 1-2 years
for women over age of 40
Which of the following are used in diagnosing breast
cancer?
A Mammogram
B Ultrasound
C MRI
D Biopsy
E All of the above
What does regional refer to in relation to breast
cancer?
A Metastases
B Lymph nodes
C A tumor within the breast
D A tumor is within both breasts
The 2000 NIH Consensus Development Conference
Statement states that what percentage of women
with invasive breast cancer should consider the
option of systemic chemotherapy, not just women
whose tumors are greater than 1cm in size?
A 100% (all)
B 75%
C 50%
D 25%
Hormonal agents are used to treat some cancers. An
example would be:
A Thyroxine to treat thyroid cancer.
B ACTH to treat adrenal carcinoma.
C Estrogen antagonists to treat breast
cancer.
D Glucagon to treat pancreatic carcinoma
1 in ____ women get Breast Cancer.
A 7
B 2
C 8
D 4
Ductal lavage is used for
A women at higher risk for benign
proliferative breast disease.
B women at low risk for breast cancer.
C screening women over age 65.
D women with breast implants.
Can men get breast cancer?
A Yes, always
B No, never
C Yes, but not likely
D I don't know
Which of the following terms is used to describe
removal of the breast tissue and an axillary lymph
node dissection leaving muscular structure intact as
surgical treatment of breast cancer?
A Modified radical mastectomy
B Segmental mastectomy
C Total mastectomy
D Radical mastectomy
A 52 yr-old female tells the nurse that she has found
a painless lump in her right breast during her
monthly self-examination. Which assessment
finding would strongly suggest that this client’s
lump is cancerous?
A eversion of the right nipple and a mobile
mass
B nonmobile mass with irregular edges
C mobile mass that is oft and easily
delineated
D nonpalpable right axillary lymph nodes
The statistics decrease for getting breast cancer as
one gets older in age.
A True
B False
What does local breast cancer refer to?
A Metastases
B The chest wall
C The breast
D Lymph nodes
What is the percentage of breast tissue that can be
removed and rearranged to have the breast still
looking like a breast?
A 60%
B 15%
C 30%
D 45%
Noninvasive Breast Cancer is when..
A the cancer cells have stayed from their
origin and have not spread
B the cancer cells have spread to other parts
of your body
During a breast examination, which finding most
strongly suggests that the Luz has breast cancer?
A Slight asymmetry of the breasts.
B A fixed nodular mass with dimpling of the
overlying skin
C Bloody discharge from the nipple
D Multiple firm, round, freely movable
masses that change with the menstrual cycle
What is a symptom of Breast Cancer?
A Itchy throat
B Lump in underarm or breast area.
C Pain in the arm
What is the purpose of using hormonal therapy for
patients with breast cancer cells?
A To replace the hormones and add
testosterone.
B To produce more hormones by adding
testosterone along with estrogen and progesterone.
C To block the supply of estrogen or
pregesterone to the cells
The nurse recognizes which of the following
statements as accurately reflecting a risk factor for
breast cancer?
A Multiparity
B No alcohol consumption
C Mother affected by cancer before 60
years of age
D Onset of menses before 14 years of age
The nurse is teaching the client about breast self-
examination. Which observation should the client
be taught to recognize when doing the examination
for detection of breast cancer?
A tender, movable lump
B pain on breast self-examination
C round, well-defined lump
D dimpling of the breast tissue
Maria Sison, 40 years old, single, was admitted to
the hospital with a diagnosis of Breast Cancer. She
was scheduled for radical mastectomy. Nursing care
during the preoperative period should consist of
A assuring Maria that she will be cured of
cancer
B assessing Maria’s expectations and
doubts
C maintaining a cheerful and optimistic
environment
D keeping Maria’s visitors to a minimum so
she can have time for herself
Can family history of breast cancer increase the
chances of the family members?
A No
B Yes
C Only from the mother's side
D Only from the dad's side
A female client was diagnosed with breast cancer. It
is found to be stage IV, and a modified mastectomy
is performed. After the procedure, what behaviors
could the nurse expects the client to display?
A Denial of the possibility of carcinoma.
B Signs of grief reaction.
C Relief that the operation is over.
D Signs of deep depression.
What is Breast Cancer?
A A tumor that developes in the breast area
B A very common disease among women
C A deadly disease
D All of the above
Breast reconstruction is done
after_____________surgery.
A Lumpectomy
B Mastectomy
Breast Cancer is the most common reason for death
in what ages?
A 0-4
B 85-99
C 55-84
D 15-54
Can a mammography detect breast cancer before A Breast cancer
you can even see it. B Lung cancer
A Yes C Brain cancer
B No D Colon and rectal cancer
C Sometimes
D What is a mammography? Is early detection of breast cancer your best chance
of survival?
Maria refuses to acknowledge that her breast was A No
removed. She believes that her breast is intact B Yes
under the dressing. The nurse should C Sometimes
A call the MD to change the dressing so D I Don't Know
Kathy can see the incision
B recognize that Kathy is experiencing GASTRIC CANCER
denial, a normal stage of the grieving process The diagnosis of stomach cancer may not be
C reinforce Kathy’s belief for several days accompanied by noticeable symptoms for an
until her body can adjust to stress of surgery. extended period.
D remind Kathy that she needs to accept her A. Correct
diagnosis so that she can begin rehabilitation B. Incorrect
exercises.
A client with breast cancer is returned to the room What other symptoms might be indicative of
following a right total mastectomy. The nurse stomach cancer?
should: A. All of the symptoms provided.
A Elevate the client’s right arm on pillows B. Feeling persistently bloated after meals.
B Place the client’s right arm in a dependent C. Unaccounted for stomach pain.
sling D. Vomiting or finding blood in the stools.
C Keep the client’s right arm on the bed
beside her Which of the following could potentially increase
D Place the client’s right arm across her the likelihood of developing stomach cancer?
body A. Progressing age.
B. All of the choices.
Breast Cancer is most likely to spread to your C. Overconsumption of salted or pickled foods.
____________area. D. Habitual cigarette smoking.
A Face
B Stomach What signs might a person initially exhibit if they are
C Underarm developing stomach cancer?
D Leg A. All of the choices.
B. Digestive issues such as indigestion, discomfort in
A 37-year-old client with uterine cancer asks the the stomach, or heartburn.
nurse, "Which is the most common type of cancer in C. Persistent feelings of fatigue.
women?" The nurse replies that it's breast cancer. D. Feelings of nausea or a decreased desire to eat.
Which type of cancer causes the most deaths in
women?
Is it possible to prevent the onset of stomach
cancer?
A. Negative
B. Affirmative
A male patient, diagnosed with a Peptic ulcer,
presents with a high concentration of Helicobacter
pylori bacteria as revealed by laboratory tests. Can
you identify the most accurate interpretation of this
information?
A. This finding points to the organism inducing
gastric carcinoma.
B. The ulcer will likely heal on its own without any
medical intervention.
C. The patient's management plan will likely
incorporate both ranitidine and antibiotic therapy.
D. An operation is necessitated by these findings.
Which symptom might suggest that an enlarging
cancer is causing stomach drainage?
A. Unexplained weight loss.
B. Intense feelings of nausea followed by vomiting.
C. Pain in the abdomen.
D. Change in bowel habits, such as constipation or
diarrhea.
A patient suffering from persistent indigestion is
hospitalized and later diagnosed with stomach
cancer. Which item from the following list is
associated with a heightened risk of developing this
type of cancer?
A. Consuming high amounts of fruit on a daily basis.
B. Processed meats, such as those often used in
sandwiches.
C. Processed sugars.
D. Fizzy drinks.
In reference to gastric cancer, can you determine
which statement holds true?
A. The majority of gastric cancer fatalities are
reported in individuals under the age of 40.
B. Women are more frequently diagnosed with
stomach cancers than men.
C. The rate of stomach cancer cases has been
consistently falling in the United States.
D. A diet abundant in smoked foods and lacking in
fruits and vegetables could potentially reduce the
risk of stomach cancer.
Which type of cancer is believed to have a
connection with the bacterium Helicobacter pylori?
A. Cancer of the vagina.
B. Kidney cancer.
C. Cancer of the stomach.
D. Prostate cancer.
LUNG CANCER
What is the most common reason for
bronchoscopes not being able to reach a tumor
within the lung?
A Scar tissue
B Malformations of the lung
C The tumor is too small
D Due to small bronchi
Of the four basic cell types of lung cancer listed
below, which is always associated with smoking?
A adenocarcinoma
B squamous cell carcinoma (epidermoid)
C undifferenciated carcinoma
D bronchoalveolar carcinoma
A 67-year-old client who is receiving chemotherapy
for lung cancer is admitted to the hospital with
thrombocytopenia. While you are taking the
admission history, the client makes these
statements. Which statement is of most concern?
A “I’ve noticed that I bruise more easily
since the chemotherapy started.”
B “My bowel movements are soft and dark
brown in color.”
C “I take one aspirin every morning
because of my history of angina.”
D “My appetite has decreased since the
chemotherapy strated.
What percentage of lung cancer is caused by
smoking?
A 50%
B 63%
C 87%
D 94%
What is the benefit of a navigational bronchoscopy?
A Performs biopsies
B Delivers High Dose Radiation (HDR)
C Explains the distance that the
bronchoscope can travel into the lung.
D All of the above
Antonio with lung cancer develops Horner's
syndrome when the tumor invades the ribs and
affects the sympathetic nerve ganglia. When
assessing for signs and symptoms of this syndrome,
the nurse should note:
A miosis, partial eyelid ptosis, and
anhidrosis on the affected side of the face.
B chest pain, dyspnea, cough, weight loss,
and fever.
C arm and shoulder pain and atrophy of arm
and hand muscles, both on the affected side.
D hoarseness and dysphagia
A client with lung cancer is admitted in the nursing
care unit. The husband wants to know the condition
of his wife. How should the nurse respond to the
husband?
A Find out what information he already
has.
B Suggest that he discuss it with his wife.
C Refer him to the doctor.
D Refer him to the nurse in charge
In terms of lung cancer, what is intratumoral
chemotherapy used for?
A Small Cell Lung Cancer
B Non-Small Cell Lung Cancer
A client with lung cancer has received oxycodone 10
mg orally for pain. When the student nurse assesses
the client, which finding should you instruct the
student to report immediately?
A Respiratory rate of 8 to 10 per minute
B Pain level decreased from 6/10 to 2/10
C Client requests room door be closed.
D Heart rate 90-100 per minute
What is true about interventional pulmonology?
A Looks at reasons for shortness of breath.
This is not only used for lung cancer; it can be used
for breast cancer, colon cancer, renal cancer and
melanoma.
B This increases the likelihood for cure by
29%.
C CTCA was the first to combine
interventional pulmonology with various
treatments.
Which of the following symptoms is most
characteristic of a client with a cancer of the lung?
A air hunger
B exertional dyspnea
C cough with night sweats
D persistent changing cough
Which of the following types of lung cancer is
characterized as fast growing and tending to arise
peripherally?
A Large cell carcinoma
B Bronchioalveolar carcinoma
C Adenocarcinoma
D Squamous cell carcinoma
Which of the following types of lung cancer is the
most prevalent carcinoma of the lung for both men
and women?
A Adenocarcinoma
B Large cell carcinoma
C Squamous cell carcinoma
D Small cell carcinoma
A 56-year-old man is worried about his risk of
developing lung cancer. He has no medical
problems, but he does report having smoked one
pack of cigarettes a day for 4 years while in college.
He stopped smoking more than 30 years ago. Of the
following which is the most accurate statement
regarding this patient's risk of developing lung
cancer?
A It is equal to someone who has never
smoked
B In any age group, the risk of developing
lung cancer declines after stopping smoking
C The annual lung cancer mortality of
smokers is 10 times that of nonsmokers
D His risk of developing lung cancer is only
slightly greater than that of a non-smoker
What does an Endobronchial Ultrasound help do
and how does it work?
A An Endobronchial Ultrasound helps with
the staging of a tumor. A bronchoscope is inserted
into the lung with an ultrasound on the tip. There
is a slot that houses a needle to biopsy the lymph
nodes.
B An Endobronchial Ultrasound helps take
images of the lung. A long scope is inserted directly
into the chest cavity. The scope takes 30 images
with a 360 degree rotation. The images are sent to a
computer where the oncologist is able to examine
the images.
C An Endobronchial Ultrasound helps with
the placement of fiducial markers. An x-ray is taken
of the lung and lymph nodes, the endobronchial
ultrasound is then inserted in the area of the
tumor(s) for implantation of fiducial markers.
The most common lethal cancer in males between
their fifth and seventh decades is:
A cancer of the prostate
B cancer of the lung
C cancer of the pancreas
D cancer of the bowel
A 62-year-old woman presents to your clinic for a
regularly scheduled examination. She has no new
complaints, but she is concerned about her risk of
developing lung cancer. She has smoked one pack of
cigarettes a day since she was 18 years old. She asks
whether she should be given any tests to screen for
lung cancer. For this patient, which of the following
statements is true?
A Chest x-rays are a cost-effective and
accurate way to screen for lung cancer
B Spiral computed tomography scanning is
currently recommended for screening in
asymptomatic patients
C Benign nodules are rarely seen on spiral
CT, making it ideal for cancer screening
D At present, there are no recommended
radiographic studies to screen for lung cancer
The nurse is conducting an education session for a
group of smokers in a “stop smoking” class. Which
finding would the nurse state as a common
symptom of lung cancer? :
A Dyspnea on exertion
B Foamy, blood-tinged sputum
C Wheezing sound on inspiration
D Cough or change in a chronic cough
A 64-year-old woman returns to your clinic for
continued evaluation of a chronic cough, which she
has been experiencing for the past 2 months. A
chest x-ray obtained yesterday shows a spiculated
right middle lobe mass with mediastinal
lymphadenopathy. In addition, today the patient
reports right leg pain of new onset. You are
concerned about metastatic disease. For this
patient, which of the following approaches to
diagnostic imaging would be most appropriate for
the evaluation of possible metastatic disease?
A CT scan of the chest
B CT scan of the chest, head, and adrenal
glands
C CT scan of the chest, head, and adrenal
glands, and a bone scan
D CT scan of the chest and head, and a bone
scan
Chemotherapy may be used in combination with
surgery in the treatment of lung cancer. Special
nursing considerations with chemotherapy include
all but which of the following?
A Helping the client deal with depression
secondary to the diagnosis and its treatment
B Explaining that the reactions to
chemotherapy are minimal
C Careful observation of the IV site of the
administration of the drugs
D Careful attention to blood count results
Gina, a home health nurse is visiting a home care
client with advanced lung cancer. Upon assessing
the client, the nurse discovers wheezing,
bradycardia, and a respiratory rate of 10
breaths/minute. These signs are associated with
which condition?
A Hypoxia
B Delirium
C Hyperventilation
D Semiconsciousness
Which of the following is the most common type of
lung cancer?
A Large cell
B Adenocarcinoma
C Oat cell
D Squamous cell
Lung cancer is the top killer of cancer.
A True
B False
A 37-year-old client with uterine cancer asks the
nurse, "Which is the most common type of cancer in
women?" The nurse replies that it's breast cancer.
Which type of cancer causes the most deaths in
women?
A Breast cancer
B Lung cancer
C Brain cancer
D Colon and rectal cancer
A patient is scheduled for a magnetic resonance
imaging (MRI) scan for suspected lung cancer.
Which of the following is a contraindication to the
study for this patient?
A The patient is allergic to shellfish.
B The patient has a pacemaker.
C The patient suffers from claustrophobia.
D The patient takes anti-psychotic
medication.
When a patient in the terminal stages of lung cancer
begins to exhibit loss of consciousness, a major
nursing priority is to:
A Protect the patient from injury
B Insert an airway
C Elevate the head of the bed
D Withdraw all pain medications
What is an autofluorescence bronchoscopy?
A This shows where treatment is being
delivered to within the lung.
B This lights up cancer cells and it can show
cells that haven't grown into a tumor yet.
C This lights up the path that a
bronchoscope can follow.
ACUTE RESPIRATORY DISTRESS SYNDROME
In a critical care unit, Nurse Sophie is attending to a
male patient suffering from acute respiratory
distress syndrome resulting from shock. His
condition rapidly worsens, necessitating
endotracheal (ET) intubation and mechanical
ventilation. When the high-pressure alarm on the
mechanical ventilator suddenly rings out, Sophie
swiftly initiates a check to identify the cause.
What condition would most likely trigger the high-
pressure alarm on the ventilator?
A. Is it possible that an ET cuff leak has occurred?
B. Could it be due to an alteration in the oxygen
concentration without resetting the oxygen level
alarm?
C. Might it be due to the kinking of the ventilator
tubing?
D. Or could it be due to a disconnected ventilator
tube?
At Hope General Hospital, Nurse Rebecca is
responsible for a female patient who has sustained
multiple traumas. Aware of the risk of the patient
developing acute respiratory distress syndrome
(ARDS), Rebecca is on high alert for early signs of
this serious condition.
What should she consider as the earliest indicator of
ARDS?
A. An escalated respiratory rate.
B. Bilateral wheezing during respiration.
C. The appearance of intercostal retractions.
D. The presence of inspiratory crackles.
At Haven County Hospital, medical professionals,
including seasoned respiratory therapist David, are
constantly working to manage various conditions
affecting their patients. One such condition is acute
respiratory distress syndrome (ARDS), a severe and
often life-threatening disorder.
David reflects on his years of practice and thinks
about the following statement: "Management of
ARDS is largely supportive, with limited options
available to reverse the process." Is this statement
accurate or misleading?
A. Accurate
B. Misleading
Matthew, a dedicated nurse, was attending to a
male patient who had been admitted following a
major car accident. The patient suffered from chest
trauma and was promptly intubated. Suddenly, the
high-pressure alarm on the ventilator blares,
grabbing Matthew's immediate attention. He rushes
over to check the patient and finds an absence of
breath sounds in the right upper lobe of the
patient's lung.
Matthew's mind instantly races, trying to identify
what other signs he should be on the lookout for to
pinpoint the cause of this alarming development.
What could this situation indicate?
A. The development of a right pneumothorax.
B. The onset of acute respiratory distress syndrome.
C. The presence of a pulmonary embolism.
D. A misplaced endotracheal tube.
At Mercy General Hospital, Nurse Benjamin is
attending to an African American male patient who
came in with an asthma attack, now experiencing
acute respiratory distress. Benjamin knows that
detecting cyanosis, a sign of poor oxygenation, can
be more challenging in individuals with darker skin.
Given this situation, where should Nurse Benjamin
focus his inspection to identify cyanosis in this
patient?
A. The earlobes.
B. The lips.
C. The nail beds.
D. The mucous membranes.
In a bustling intensive care unit, Nurse Martin is
taking care of an ARDS patient, Mr. Thompson,
who's now moving into the fibrotic phase of the
syndrome. Martin, with a meticulous eye for detail,
takes note of the various developments that this
stage brings. How would you describe this fibrotic
phase of ARDS?
A. Is it the phase where the lung initiates self-repair,
marking the point where the patient either starts to
improve or the condition begins to decline?
B. Could it be the stage where fibrous tissue begins
to form, making the lungs less flexible, thus
increasing the effort to breathe, and consequently,
the oxygen demand?
C. Or, is this the phase where fluids infiltrate the
alveoli, leading to the collapse of alveoli and
bronchi, and resulting in decreased lung
compliance?
Amid the hustle and bustle of City General Hospital,
Registered Nurse Joshua is providing care to a
patient suffering from acute respiratory distress
syndrome (ARDS). Joshua knows that understanding
the different phases of ARDS is critical for effective
care.
When thinking about the Acute Exudative Phase of
ARDS, how would Joshua describe it?
A. Or, is this the stage where the lung begins to
repair itself, and it’s the turning point where the
patient starts to improve or their condition
worsens?
B. Does it involve fluids shifting into the alveoli,
leading to the collapse of the alveoli and bronchi,
and resulting in a loss of lung compliance?
C. Is this the phase where fibrous tissue begins to
form, the lungs don’t expand well, and increased
effort to breathe escalates the demand for oxygen?
Nurse Lauren, a seasoned professional, is at the
helm of the ICU in a bustling city hospital. Tonight,
she is attending to a male patient who has been
diagnosed with acute respiratory distress syndrome.
Part of her role involves taking measurements via a
pulmonary artery catheter.
In her latest reading, she notes that the pulmonary
capillary wedge pressure (PCWP) is at 12mm Hg. As
an experienced practitioner, how should Nurse
Lauren interpret this finding?
A. As a value that is uncertain and not anticipated.
B. As a typical and anticipated value.
C. As an unusually low and unexpected value.
D. As a high value that was to be expected.
In the bustling trauma unit of St. Luke's Hospital,
Nurse Emily diligently cares for a patient who has
recently suffered a right femur fracture. Given the
nature of the injury, Emily is watchful for any signs
that may hint at a fat embolism, a potential
complication in such cases.
What symptoms should she be on the lookout for
that might suggest the development of a fat
embolism?
A. Might it be muscle spasms in the right thigh?
B. Is it a series of migraine-like headaches?
C. Or could it be the onset of acute respiratory
distress syndrome?
D. Could it be numbness in the right leg?
In a small town fire department, firefighter Jack had
a challenging call responding to a massive house
fire. His dedication to his job meant he was right in
the thick of it, battling the flames, and
unfortunately, he ended up inhaling a significant
amount of smoke.
Two days later, a severe lack of oxygen triggered
complications. Jack's condition worsened so much
that he required an artificial airway and a ventilator
to assist with his breathing. Given this situation,
what medical condition do you think Jack has most
probably developed?
A. Bronchitis, inflammation of the lining of the
bronchial tubes.
B. Atelectasis, partial or complete collapse of the
entire lung.
C. Acute respiratory distress syndrome (ARDS), a
life-threatening condition that prevents enough
oxygen from getting to the lungs and into the
blood.
D. Pneumonia, an infection that inflames the air sacs
in one or both lungs.
HEMATOLOGIC PROBLEMS
After receiving change-of-shift report about all of
these clients, which one will you assess first?
A A 26-year-old with thalassemia major who
has a short-stay admission for a blood transfusion
B A 50-year-old with newly diagnosed stage
IV non-Hodgskin’s lymphoma who is crying and
stating “I’m not ready to die.”
C A 69-year-old with chemotherapy-
induced neutropenia who has an elevated oral
temperature
D A 44-year-old who was admitted 3 days
previously with a sickle cell crisis and has orders for
a CT scan
A client with acute myelogenous leukemia is
receiving induction phase chemotherapy. Which
assessment information is of most concern?
A Ecchymoses present on anterior trunk
B Inflammation and redness of oral mucosa
C Urine output less than intake by 400 mL
D Serum potassium level of 7.8 mEq/L
The primary purpose of the Schilling test is to
measure the client’s ability to:
A Store vitamin B12
B Absorb vitamin B12
C Produce vitamin B12
D Digest vitamin B12
A client is admitted to the intensive car unit (ICU)
with disseminated intravascular coagulation (DIC)
associated with a gram-negative infection. Which
assessment information has the most immediate
implications for the client’s care?
A The client complains of chest pain.
B There is mottling of the hands and feet.
C There is no palpable radial or pedal pulse.
D The client’s oxygen saturation is 87%
The physician has ordered several laboratory tests
to help diagnose an infant’s bleeding disorder.
Which of the following tests, if abnormal, would the
nurse interpret as most likely to indicate
hemophilia?
A Clot retraction test
B Partial thromboplastin time (PTT)
C Tourniquet test
D Bleeding time
The nurse implements which of the following for the
client who is starting a Schilling test?
A Starting a 24- to 48 hour urine specimen
collection
B Starting a 72 hour stool specimen
collection
C Maintaining NPO status
D Administering methylcellulose (Citrucel)
The nurse is preparing to teach a client with
microcytic hypochromic anemia about the diet to
follow after discharge. Which of the following foods
should be included in the diet?
A Lettuce
B Eggs
C Cheese
D Citrus fruits
When comparing the hematocrit levels of a post-op
client, the nurse notes that the hematocrit
decreased from 36% to 34% on the third day even
though the RBC and hemoglobin values remained
stable at 4.5 million and 11.9 g/dL, respectively.
Which nursing intervention is most appropriate?
A Check the dressing and drains for frank
bleeding
B Continue to monitor vital signs
C Call the physician
D Start oxygen at 2L/min per NC
A client with microcytic anemia is having trouble
selecting food items from the hospital menu. Which
food is best for the nurse to suggest for satisfying
the client’s nutritional needs and personal
preferences?
A Brown rice
B Egg yolks
C Vegetables
D Tea
A client comes into the health clinic 3 years after
undergoing a resection of the terminal ileum
complaining of weakness, shortness of breath, and a
sore tongue. Which client statement indicates a
need for intervention and client teaching?
A “I take a vitamin B12 tablet every day.”
B “I have 3 to 4 loose stools per day.”
C “I have been gargling with warm salt
water for my sore tongue.”
D “I have been drinking plenty of fluids.”
A clinic nurse instructs the mother of a child with
sickle cell disease about the precipitating factors
related to pain crisis. Which of the following, if
identified by the mother as a precipitating factor,
indicates the need for further instructions?
A Stress
B Fluid overload
C Trauma
D Infection
Which of the following blood components is
decreased in anemia?
A Erythrocytes
B Leukocytes
C Platelets
D Granulocytes
A vegetarian client was referred to a dietician for
nutritional counseling for anemia. Which client
outcome indicates that the client does not
understand nutritional counseling? The client:
A Adds vitamin C to all meals
B Adds dried fruit to cereal and baked goods
C Drinks coffee or tea with meals
D Cooks tomato-based foods in iron pots
Which of the following nursing assessments is a late
symptom of polycythemia vera?
A Shortness of breath
B Headache
C Pruritus
D Dizziness
Laboratory studies are performed for a child
suspected of having iron deficiency anemia. The
nurse reviews the laboratory results, knowing that
which of the following results would indicate this
type of anemia?
A A decreased reticulocyte count
B An elevated RBC count
C Red blood cells that are microcytic and
hypochromic
D An elevated hemoglobin level
A child suspected of having sickle cell disease is seen
in a clinic, and laboratory studies are performed. A
nurse checks the lab results, knowing that which of
the following would be increased in this disease?
A Platelet count
B Reticulocyte count
C Hemoglobin level
D Hematocrit level
Which statements by the mother of a toddler would
lead the nurse to suspect that the child has iron-
deficiency anemia? Select all that apply.
A “He sleeps 12 hours every night and take a
2-hour nap.”
B “He doesn’t like meat, but he will eat
small amounts of it.”
C “He drinks over 3 cups of milk per day.”
D “I can’t keep enough apple juice in the
house; he must drink over 10 ounces per day.”
E “He refuses to eat more than 2 different
kinds of vegetables.”
As charge nurse, you are making the daily
assignments on the medical-surgical unit. Which
client is best assigned to a nurse who has floated
from the post-anesthesia care unit (PACU)?
A A 43-year-old client with multiple
myeloma who needs discharge teaching
B A 52-year-old client with chronic
gastrointestinal bleeding who has returned to the
unit after a colonoscopy
C A 65-year-old client with pernicious
anemia who has just been admitted to the unit
D A 30-year-old client with thalassemia
major who has an order for subcutaneous infusion
of deferoxamine (Desferal)
As home health nurse, you are taking an admission
history for a client who has a deep vein thrombosis
and is taking warfarin (Coumadin) 2 mg daily. Which
statement by the client is the best indicator that
additional teaching about warfarin may be needed?
A “The doctor said that it is important to
avoid becoming constipated.”
B “I will need to have some blood testing
done once or twice a week.”
C “Coumadin makes me feel a little
nauseated unless I take it with food.”
D “I have started to eat more healthy foods
like green salads and fruit.”
A 78-year-old client admitted to the hospital with
chronic anemia caused by possible gastrointestinal
bleeding has all of these activities included in the
care plan. Which activity is best delegated to an
experienced nursing assistant (NA)?
A Use Hemoccult slides to obtain stool
specimens.
B Have the client sign a colonoscopy
consent form.
C Check for allergies to contrast dye or
shellfish.
D Administer PEG-ES (GoLYTELY) bowel
preparation
You are transferring a client with newly diagnosed
chronic myeloid leukemia to a long-term-care (LTC)
facility. Which information is most important to the
LTC charge nurse prior to transferring the client?
A The Philadelphia chromosome is present
in the blood smear
B The client’s chemotherapy has resulted in
neutropenia
C There has been a 20-pound weight loss
over the past year
D Glucose is elevated as a result of
prednisone therapy
A new RN is preparing to administer packed red
blood cells (PRBCs) to a client whose anemia was
caused by blood loss after surgery. Which action by
the new RN requires that you, as charge nurse,
intervene immediately?
A The new RN tells the client that the PRBCs
may cause a serious transfusion reaction.
B The new RN starts an intravenous line for
the transfusion using a 22-gauge catheter.
C The new RN waits 20 minutes after
obtaining the PRBCs before starting the infusion.
D The new RN primes the transfusion set
using 5% dextrose in lactated Ringer’s solution.
Which of the following cells is the precursor to the
red blood cell (RBC)?
A Macrophage
B Stem cell
C T cell
D B cell

Which of the following assessments in a child with
hemophilia would lead the nurse to suspect early
hemarthrosis?
A Instability of a long bone in passive
movement
B Eccymosis formation around a joint
C Cool, pale, clammy extremity
D Child’s reluctance to move a body part
A client who has been receiving cyclosporine
following an organ transplant is experiencing these
symptoms. Which one is of most concern?
A Bleeding of the gums while brushing the
teeth
B Occasional nausea after taking the
medication
C Numbness and tingling of the feet
D Non-tender swelling in the right groin
A client with pernicious anemia asks why she must
take vitamin B12 injections for the rest of her life.
What is the nurse’s best response?
A “The reason for your vitamin deficiency is
an increased requirement for the vitamin because
of rapid red blood cell production.”
B “The reason for your vitamin deficiency is
an inability to absorb the vitamin because the
stomach is not producing sufficient intrinsic
factor.”
C “The reason for your vitamin deficiency is
an inability to absorb the vitamin because the
stomach is not producing sufficient acid.”
D “The reason for your vitamin deficiency is
an excessive excretion of the vitamin because of
kidney dysfunction.”
Which of the following foods would the nurse
encourage the mother to offer to her child with iron
deficiency anemia?
A Potato, peas, and chicken
B Rice cereal, whole milk, and yellow
vegetables
C Macaroni, cheese, and ham
D Pudding, green vegetables, and rice
You are reviewing the complete blood count (CBC)
for a client who has been admitted for knee
arthroscopy. Which value is most important to
report to the physician prior to surgery?
A Hemoglobin 10.9 g/dL
B Hematocrit 33%
C Platelet count 426,000/ mm3
D White blood cell count 16,000/mm3
A 22-year-old with stage I Hodgkin’s disease is
admitted to the oncology unit for radiation therapy.
During the initial assessment, the client tells you,
“Sometimes I am afraid of dying.” Which response is
most appropriate at this time?
A “Most people with stage I Hodgkin’s
disease survive.”
B “Tell me a little bit more about your fear
of dying.”
C “Perhaps you should ask the doctor about
medication.”
D “Many individuals with this diagnosis have
some fears.”
A 32-year-old client with a history of sickle cell
anemia is admitted to the hospital during a sickle
cell crisis. The physician orders all of these
interventions. Which order will you implement first?
A Start a large-gauge IV line and infuse
normal saline at 200 mL/hour.
B Immunize with Pneumovax and
Haemophilus influenzae vaccines.
C Give morphine sulfate 4-8 mg IV every
hour as needed.
D Administer oxygen at an F102 of 100%
per non-rebreather mask.
Because of the risks associated with administration
of factor VIII concentrate, the nurse would teach the
client’s family to recognize and report which of the
following?
A Puffiness around the eyes
B Constipation
C Abdominal distention
D Yellowing of the skin
A client with graft-versus-host disease (GVHD) after
a bone marrow transplant is being cared for on the
medical unit. Which of these nursing activities is
best delegated to a newly graduated RN who has
had a 6-week orientation to the unit?
A Infusion of D5.45% normal saline at 125
mL/hour to the client
B Assessment of the client for signs of
infection caused by GVHD
C Administration of methotrexate and
cyclosporine to the client
D Education of the client about ways to
prevent infection
A client states that she is afraid of receiving vitamin
B12 injections because of the potential toxic
reactions. What is the nurse’s best response to
relieve these fears?
A “Vitamin B12 may cause mild nausea but
nothing toxic.”
B “Vitamin B12 will cause ringing in the eats
before a toxic level is reached.”
C “Vitamin B12 may cause a very mild skin
rash initially.”
D “Vitamin B12 is generally free of toxicity
because it is water soluble.”
The nurse understands that the client with
pernicious anemia will have which distinguishing
laboratory findings?
A Sedimentation rate, 16 mm/hour
B Schilling’s test, elevated
C RBCs 5.0 million
D Intrinsic factor, absent
Which of the following would the nurse identify as
the priority nursing diagnosis during a toddler’s
vasoocclusive sickle cell crisis?
A Decreased cardiac output related to
abnormal hemoglobin formation
B Pain related to tissue anoxia
C Excess fluid volume related to infection
D Ineffective coping related to the presence
of a life-threatening disease
A client admitted to the hospital with a sickle cell
crisis complains of severe abdominal, hip, and knee
pain. You observe an LPN accomplishing these client
care tasks. Which one requires that you, as charge
nurse, intervene immediately?
A The LPN positions cold packs on the
client’s knees.
B The LPN encourages the client to use the
ordered PCA.
C The LPN checks the client’s temperature
every 2 hours.
D The LPN places a “No Visitors” sign on the
client’s door.
You are the charge nurse in an oncology unit. A
client with an absolute neutrophil count (ANC) of
300/mm3 is placed in protective isolation. Which
staff member should you assign to provide care for
this client, under the supervision of an experienced
oncology RN?
A An LPN with 2 years of experience on the
oncology unit
B An LPN who has floated from the same-
day-surgery unit
C An RN who transferred recently from the
ED
D An RN from the float pool who usually
works on the surgical unit
A client with iron deficiency anemia is scheduled for
discharge. Which instruction about prescribed
ferrous gluconate therapy should the nurse include
in the teaching plan?
A “Take the medication with a glass of milk.”
B “Take the medication with cereal.”
C “Take the medication on an empty
stomach.”
D “Take the medication with an antacid.”
A client with macrocytic anemia has a burn on her
foot and states that she had been watching
television while lying on a heating pad. What is the
nurse’s first response?
A Assess for potential abuse
B Check for diminished sensations
C Clean and dress the area
D Document the findings
You obtain the following data about a client
admitted with multiple myeloma. Which
information has the most immediate implications
for the client’s care?
A The client complains of chronic bone pain.
B The 24 hour urine shows Bence-Jones
protein.
C The client is unable to plantarflex the
feet.
D The blood uric acid level is very elevated
A client with anemia may be tired due to a tissue
deficiency of which of the following substances?
A Oxygen
B Carbon dioxide
C Factor VIII
D T-cell antibodies
The mothers asks the nurse why her child’s
hemoglobin was normal at birth but now the child
has S hemoglobin. Which of the following responses
by the nurse is most appropriate?
A “The placenta bars passage of the
hemoglobin S from the mother to the fetus.”
B “Antibodies transmitted from you to the
fetus provide the newborn with temporary
immunity.”
C “The red bone marrow does not begin to
produce hemoglobin S until several months after
birth.”
D “The newborn has a high concentration
of fetal hemoglobin in the blood for some time
after birth.”
The nurse would instruct the client to eat which of
the following foods to obtain the best supply of
vitamin B12?
A Green leafy vegetables
B Meats and dairy products
C Broccoli and Brussels sprouts
D Whole grains
The nurse in the outpatient clinic is assessing a 22-
year-old with a history of a recent splenectomy after
a motor vehicle accident. Which information
obtained during the assessment will be of most
immediate concern to the nurse?
A The client admits to occasional marijuana
use.
B The client engages in unprotected sex.
C The client has abdominal pain with light
palpation.
D The client has an oral temperature of
99.7o F
The nurse is assessing a client’s activity intolerance
by having the client walk on a treadmill for 5
minutes. Which of the following indicates an
abnormal response?
A Pulse rate increased by 20 bpm
immediately after the activity
B Respiratory rate decreased by 5
breaths/minute
C Diastolic blood pressure increased by 7
mm Hg
D Pulse rate within 6 bpm of resting phase
after 3 minutes of rest
Which of the following diagnostic findings are most
likely for a client with aplastic anemia?
A Decreased production of T-helper cells
B Reed-Sternberg cells and lymph node
enlargement
C Increased levels of WBCs, RBCs, and
platelets
D Decreased levels of white blood cells, red
blood cells, and platelets
After receiving the change-of-shift report, which
client will you assess first?
A A 38-year-old with aplastic anemia who
needs teaching about decreasing infection risk prior
to discharge
B A 20-year-old with possible acute
myelogenous leukemia who has just arrived on the
medical unit
C A 60-year-old with non-Hodgkin’s
lymphoma who is refusing the ordered
chemotherapy regimen
D A 40-year-old with lymphedema who
requests help to put on compression stockings
before getting out of bed
A 67-year-old client who is receiving chemotherapy
for lung cancer is admitted to the hospital with
thrombocytopenia. While you are taking the
admission history, the client makes these
statements. Which statement is of most concern?
A “I take one aspirin every morning
because of my history of angina.”
B “My bowel movements are soft and dark
brown in color.”
C “My appetite has decreased since the
chemotherapy strated.”
D “I’ve noticed that I bruise more easily
since the chemotherapy started.”
You are making a room assignment for a newly
arrived client whose laboratory testing indicates
pancytopenia. All of these clients are already on the
nursing unit. Which one will be the best roommate
for the new client?
A The client with viral pneumonia
B The client with shingles
C The client with cellulitis
D The client with digoxin toxicity
The nurse is teaching a client with polycythemia
vera about potential complications from this
disease. Which manifestations would the nurse
include in the client’s teaching plan? Select all that
apply.
A Headache
B Gout
C Orthopnea
D Visual disturbance
E Weight loss
F Hearing loss
A pediatric nurse health educator provides a
teaching session to the nursing staff regarding
hemophilia. Which of the following information
regarding this disorder would the nurse plan to
include in the discussion?
A Hemophilia is a Y linked hereditary
disorder
B Hemophilia A results from a deficiency of
factor VIII
C Males inherit hemophilia from their
fathers
D Females inherit hemophilia from their
mothers
A long-term-care client with chronic lymphocytic
leukemia has a nursing diagnosis of Activity
Intolerance related to weakness and anemia. Which
of these nursing activities is most appropriate for
you, as the charge nurse, to delegate to a nursing
assistant?
A Evaluate the client’s response to normal
activities of daily living.
B Assist the client in choosing a diet that will
improve strength.
C Check the client’s blood pressure and
pulse rate after ambulation.
D Determine which self-care activities the
client can do independently
You have developed the nursing diagnosis Risk for
Impaired Tissue Integrity related to effects of
radiation for a client with Hodgkin’s lymphoma who
is receiving radiation to the groin area. Which
nursing activity is best delegated to a nursing
assistant caring for the client?
A Check the skin for signs of redness or
peeling.
B Apply alcohol-free lotion to the area after
cleaning.
C Explain good skin care to the client and
family.
D Clean the skin over daily with a mild
soap.
A mother asks the nurse if her child’s iron deficiency
anemia is related to the child’s frequent infections.
The nurse responds based on the understanding of
which of the following?
A Children with iron deficiency anemia are
more susceptible to infection than are other
children.
B Children with iron-deficiency anemia are
less susceptible to infection than are other children.
C Little is known about iron-deficiency
anemia and its relationship to infection in children.
D Children with iron-deficient anemia are
equally as susceptible to infection as are other
children.
A client was admitted with iron deficiency anemia
and blood-streaked emesis. Which question is most
appropriate for the nurse to ask in determining the
extent of the client’s activity intolerance?
A “How long have you had this problem?”
B “Have you been able to keep up with all
your usual activities?”
C “What activities were you able to do 6
months ago compared with the present?”
D “Are you more tired now than you used to
be?”
A client is to receive epoetin (Epogen) injections.
What laboratory value should the nurse assess
before giving the injection?
A Partial thromboplastin time
B Prothrombin time
C Hemoglobin concentration
D Hematocrit
A group of clients is assigned to an RN-LPN/LVN
team. The LPN/LVN is most likely to be assigned to
provide client care and administer medications to
which of these clients?
A A 36-year-old client with chronic renal
failure who will need a subcutaneous injection of
epoetin (Procrit)
B A 50-year-old client with newly diagnosed
polycythemia vera who is scheduled for phlebotomy
C A 55-year-old client with a history of stem
cell transplantation who will have a bone marrow
aspiration
D A 39-year-old client with hemophilia B
who has been admitted for a blood transfusion
A transfusion of PRBCs has been infusing for 5
minutes when the client becomes flushed and
tachypneic and says, “I am having chills. Please get
me a blanket.” Which action should you take first?
A Administer oxygen.
B Obtain a warm blanket for the client.
C Check the client’s oral temperature.
D Stop the medication.
The nurse explains to the parents of a 1-year-old
child admitted to the hospital in a sickle cell crisis
that the local tissue damage the child has on
admission is caused by which of the following?
A Elevated serum bilirubin concentration.
B Lack of oxygen in the red blood cells
C Autoimmune reaction complicated by
hypoxia
D Obstruction to circulation
The nurse has just admitted a 35-year-old female
client who has a serum B12 concentration of 800
pg/ml. Which of the following laboratory findings
would cue the nurse to focus the client history on
specific drug or alcohol abuse?
A Serum creatinine, 0.5 mg/dL
B Total bilirubin, 0.3 mg/dL
C Folate, 1.5 ng/mL
D Hemoglobin, 16 g/Dl
Following a car accident, a client with a Medic-Alert
bracelet indicating hemophilia A is admitted to the
emergency department (ED). Which physician order
should you implement first?
A Infuse normal saline at 250 mL/hour.
B Type and cross-match for 4 units RBCs.
C Transfuse Factor VII concentrate.
D Transport to radiology for C-spine x-rays.
When a client is diagnosed with aplastic anemia, the
nurse monitors for changes in which of the
following physiological functions?
A Bleeding tendencies
B Peripheral sensation
C Bowel function
D Intake and output
Which of the following disorders results from a
deficiency of factor VIII?
A Hemophilia B
B Sickle cell disease
C Christmas disease
D Hemophilia A
Which of the following symptoms is expected with
hemoglobin of 10 g/dl?
A None
B Palpitations
C Pallor
D Shortness of breath
The nurse devises a teaching plan for the patient
with aplastic anemia. Which of the following is the
most important concept to teach for health
maintenance?
A Practice yoga and meditation to decrease
stress and anxiety
B Eat animal protein and dark leafy
vegetables each day
C Get 8 hours of sleep at night and take
naps during the day
D Avoid exposure to others with acute
infection
HEMATOLOGIC SYSTEM
During a high-stakes surgery, Dr. Allison, who is an
experienced vascular surgeon, takes a moment to
educate the surgical interns. As she navigates the
abdominal aorta, she queries them about its major
branches, asking: Which of these arteries is not
typically counted as a significant branch of the
abdominal aorta?
A. The artery referred to as the Phrenic artery.
B. The artery known as the Common iliac artery.
C. The artery named the Gonadal artery.
D. The artery labeled the Mediastinal artery.
In the middle of a busy night shift, Nurse Peters is
brushing up on her knowledge of the cardiovascular
system in between patient rounds. As she examines
an anatomical chart, she wonders which among the
following is not typically classified as a primary
branch emerging from the descending thoracic
aorta?
A. Renal artery
B. Bronchial artery
C. Mediastinal artery
D. Posterior intercostals artery
While attending to Mr. Johnson, a patient with a
history of cardiovascular issues, nurse Jane noticed
certain symptoms pointing to pulmonary edema -
shortness of breath, a persistent cough, and fatigue.
She started wondering which part of the heart, if it
were to fail, might be most responsible for this
condition.
"Which cardiac chamber's failure is most commonly
associated with the onset of pulmonary edema?"
A. The left atrium.
B. The right ventricle.
C. The left ventricle.
D. The right atrium.
In the midst of her daily tasks, nurse Jane found
herself explaining to a newly diagnosed heart failure
patient the fundamentals of cardiac performance.
She attempted to simplify the concept of cardiac
output, causing her to reflect:
"What two components are multiplied together to
calculate cardiac output?"
A. Heart rate and diastolic blood pressure.
B. Heart rate and ejection fraction.
C. Diastolic and systolic blood pressure.
D. Heart rate and stroke volume.
Amidst the steady rhythm of beeping monitors and
soft shuffling in the cardiac ward, Nurse Sullivan
finds herself in a thoughtful moment, studying a
model of the heart's intricate vascular network. She
ponders: which among these is the primary branch
springing forth directly from the aortic arch?
A. Common Carotid artery
B. Right Subclavian artery
C. Brachiocephalic artery
D. Thoracic artery
Identify the type of nerves that establish a
connection between the SA and AV nodes within
the heart's intricate system.
A. Accelerator nerves
B. Gastric nerves
C. Phrenic nerves
D. Thoracic nerves
During a clinical neurology rotation, Nurse Mark
uses a 3D model of the brain to explain the vascular
supply to the medical students. He focuses on the
vertebral arteries and their union, then questions: In
the confines of the cranial cavity, the vertebral
arteries merge to form which artery?
A. The artery known as the PCA.
B. The artery named the MCA.
C. The artery labeled the Common Carotid.
D. The artery referred to as the Basilar.
In the anatomy lab, Nurse John is demonstrating the
intricate network of arteries of the lower extremity,
using a life-like model. He poses an intriguing
question: Which of these arteries does not typically
branch off from the femoral artery?
A. The artery labeled as the Deep circumflex iliac
artery.
B. The artery called the Superficial pudendal artery.
C. The artery referred to as the Superficial
circumflex iliac artery.
D. The artery known as the Deep external pudendal
arteries.
As Nurse Avery continues her rounds, she spots a
complex cardiovascular chart on the wall of the
ward. She contemplates the journey of blood,
noting the passage from the heart's muscular
arteries into the thin-walled cardiac veins. In the
intricate maze of the cardiovascular system, where
does the blood that flows into these cardiac veins
head to next?
A. The Left Ventricle
B. The Right Ventricle
C. The Left Atrium
D. The Coronary Sinus
While performing a comprehensive cardiac
examination, Nurse Jane knew the precise
auscultation sites were critical for accurate
detection of heart sounds. When it came to the
tricuspid valve, she wondered:
"Where should I position my stethoscope for
optimal detection of the tricuspid valve's sounds?"
A. To the right side of the sternum.
B. To the left of the sternum, near the midpoint of
the sixth rib.
C. Roughly three inches from the xiphoid process.
D. Along the left lower sternal border.
While deep in study, nursing student Liam
contemplates the role of angiotensin in the body's
intricate homeostasis mechanisms. He recalls that
angiotensin can directly stimulate the adrenal
cortex, leading to the release of a certain hormone.
But which one was it?
A. It could be responsible for Aldosterone
production.
B. It induces the release of Renin.
C. It causes the secretion of Thyroxine.
D. It triggers the release of Calcitonin.
In the hustle and bustle of a busy hospital ward,
Nurse Thompson is currently caring for a patient
who's just undergone a cardiovascular procedure.
As part of his postoperative review, she needs to
refresh her knowledge of key arterial structures. She
remembers clearly that the brachiocephalic artery
branches out to form the right common carotid
artery and also the ____ artery.
A. Right subclavian artery.
B. Left subclavian artery.
C. Left common carotid artery.
D. Right thoracic artery.
Amidst the hum of monitors and the smell of sterile
linens, Nurse Avery finds herself in the cardiac ward
of the hospital. During her shift, she observes a
variety of heart-related cases. As she reviews a
patient's angiogram, she muses about the structure
of the coronary arteries. One specific artery, the
right coronary artery, she knows, splits off into the
posterior interventricular artery and which other
artery?
A. The Right Ventricle Circumflex (RVC)
B. The Marginal Artery
C. The Left Ventricle Circumflex (LVC)
D. The Left Anterior Descending (LAD)
During a round in the intensive care unit, Nurse
Mary uses an educational moment to explain liver
physiology to her fellow nurses. She questions them
about the vascular system, asking: Which of these
veins is typically not counted among the tributaries
of the portal vein?
A. The vein known as the Left gastric vein.
B. The vein labeled the Inferior mesenteric vein.
C. The vein referred to as the Splenic vein.
D. The vein named the Subclavian vein.
While conducting a health check-up for a patient,
Nurse Mark takes the time to explain some vital
signs and their importance to the medical interns.
He ponders over a concept, asking: What is the
pulse pressure (pp) generally considered to be?
A. The difference between the systolic and diastolic
pressure.
B. The sum of the systolic and diastolic pressure.
C. The inverse of the blood pressure.
D. The half of the systolic pressure.
In the hustle and bustle of a teaching hospital,
Nurse Jane prepares a learning session for her
students about the complex arterial system. As she
displays a detailed model of the human anatomy,
she questions which artery gives rise to the left
splenic, hepatic, and gastric arteries.
A. The artery termed as the Suprarenal artery.
B. The artery labeled as the Celiac artery.
C. The artery referred to as the Left sacral artery.
D. The artery known as the Phrenic artery.
After a day full of practice on the cardiac ward,
Nurse Jackson decides to refresh the trainee nurses'
understanding of the heart's intricate dance of
rhythms and pressure changes. Turning the
discussion to the period of relaxation for the heart's
lower chambers, she asks:
Can anyone shed light on what transpires during the
phase of ventricular diastole?
A. Appearance of the T wave.
B. Surge in aortic pressure.
C. Generation of the "lub" heart sound.
D. Increase of ventricular volume.
As a nurse on a bustling cardiac floor, Jane observed
a critical part of her duty was interpreting the
plethora of rhythmic heart sounds and intricate
details from the EKG monitor. One day, while
pondering about the dynamics of the heart's
contractions and relaxations, she wondered:
"During the period of ventricular contraction, also
known as ventricular systole, what phenomenon is
likely to occur?"
A. An augmentation of pressure within the aorta.
B. The EKG representation is known as the P wave.
C. A surge in the ventricular chamber's volume.
D. The heart sound is typically referred to as 'Dup'.
ANTICOAGULANTS
As part of her patient rounds, Nurse Amelia was
explaining the importance of maintaining a balance
with Warfarin dosage to Mr. Collins. She mentioned
that there is an INR value above which Warfarin
doesn't offer extra therapeutic benefits to most
patients, but instead increases the risk of bleeding.
That value is:
A. 1.5
B. 3.0
C. 2.5
D. 2.0
Late in her night shift, Nurse Adrienne faced a
critical situation with a patient who had an
excessive anticoagulant effect from Heparin. She
knew she needed to act fast to reverse this effect.
Which of the following would she utilize for rapid
reversal?
A. Platelets
B. Packed red blood cells
C. Infusion of vitamin K dependent coagulation
factors.
D. Protamine
Late in the evening, Nurse Rebecca was engaged in
a lively discussion with her colleagues about various
medications. The topic of Warfarin came up, and
one of the new nurses was curious about its
mechanism. Rebecca mentioned that Warfarin:
A. Acts as a vitamin K antagonist.
B. Serves as a thrombin inhibitor.
C. Works by activating fibrinolysis.
D. Binds to antithrombin III as part of its action.
Nurse Grayson was educating a patient about her
new medication, Warfarin. The patient was curious
about how soon they could expect to see an
anticoagulant effect. Grayson explained that the
time taken for observable anticoagulant effect of
Warfarin is:
A. Typically 24-36 hours.
B. Generally within 2-7 days.
C. As short as 6-12 hours.
D. Usually between 8-10 days.
As Nurse Sarah settled into her day shift, she had a
new task to set a monitoring schedule for Mr.
Johnson, who recently started on Warfarin. Sarah
carefully planned the most suitable frequency of INR
monitoring for a patient in this situation, which
would be:
A. To start with daily checks, then move to weekly,
and eventually to monthly.
B. To begin with twice daily, then daily, move to
weekly, and eventually to monthly.
C. To start with three times daily, then reduce to
twice daily, then to daily, then to weekly, and
eventually to monthly.
D. To begin with twice a week, then weekly, move
to every two or three weeks, and finally to
monthly.
Nurse Leona was counseling a newly pregnant
patient with a history of clotting disorders. She
carefully considered which anticoagulant
medications are generally avoided during
pregnancy. Which of the following anticoagulants
fell into this category?
A. Low molecular weight heparins (LMWHs)
B. Warfarin
C. Unfractionated heparin
D. All of the choices provided.
Nurse Edwards was reviewing the treatment
protocol for a patient who was on low molecular
weight heparins (LMWHs). He knew these usually
didn't require monitoring. However, in certain
situations, monitoring might be necessary. He
pondered over which of the following would be
measured in such cases:
A. Activated partial thromboplastin time (APTT).
B. Anti-factor Xa level.
C. Thrombin time.
D. Prothrombin time.
Nurse David found himself facing a challenging
scenario with a patient on Warfarin who was at a
high risk of thromboembolism and scheduled for a
surgery associated with a high risk of bleeding.
David knew the best course of anticoagulation
strategy would involve:
A. Beginning full dose of either unfractionated
heparin or LMWH 2-3 days prior to the operation.
B. Resuming the regular Warfarin regimen after the
surgical procedure, once satisfactory haemostasis
has been established.
C. Discontinuing Warfarin 4-5 days before the
scheduled surgery.
D. All of the actions stated.
During her morning rounds, Nurse Jennifer
encounters Mrs. Lawrence, an 85-year-old woman
with a complex medication regime. Among the
prescriptions, she notes Warfarin. Jennifer reflects
on the approved clinical applications of this drug.
Which one below is not recognized as an approved
indication for Warfarin?
A. Atrial fibrillation management.
B. Treatment of Peripheral artery disease.
C. Management of Deep vein thrombosis.
D. Post Heart valve replacement prophylaxis.
In preparing a patient on Warfarin for a surgery with
a low risk of bleeding, Nurse Elliot reviewed the
correct protocols. Which of the following did his
review confirm as the correct approach?
A. Move over to heparin five days before the
surgery and resume warfarin post-surgery.
B. Continue warfarin, but ensure INR is checked
prior to the surgical procedure.
C. Transition to heparin seven days before the
surgery and recommence warfarin post-surgery.
D. Transfer to heparin two days prior to the surgery
and restart warfarin after the surgery.
In a group discussion about anticoagulant therapy,
Nurse Isaac was asked to provide some insights
about Heparin. He mentioned that regarding
Heparin, the following statement(s) are correct:
A. Heparin shows varying anticoagulant responses.
B. Heparin achieves its anticoagulant effect by
binding to antithrombin III.
C. All the statements are accurate.
D. Monitoring of Heparin therapy is done with
activated partial thromboplastin time (APTT).
During a staff meeting, Nurse Thompson was asked
to share the advantages of low molecular weight
heparin (LMWH) over unfractionated heparin, based
on her experiences. Thompson stated that LMWH:
A. Does not necessitate the monitoring of activated
partial thromboplastin time.
B. All of the choices.
C. Exhibits a superior bioavailability.
D. Can be given subcutaneously, hence, can be
administered even outside of a hospital setting.
Nurse Martinez, keen on ensuring optimal patient
care, was explaining to a patient on oral
anticoagulant therapy the need for regular tests to
monitor the drug's effects. He pointed out that the
recommended test to keep track of the efficacy of
oral anticoagulant therapy is:
A. Partial thromboplastin time (PTT).
B. Thrombin time.
C. The International normalized ratio (INR).
D. Bleeding time.
While briefing her team, Nurse Amelia emphasized
that certain patients might require anticoagulant
therapy for an indefinite period. Which conditions
would necessitate this long-term approach?
A. Venous thromboembolism.
B. Atrial fibrillation.
C. High risk of myocardial infarction.
D. Each of the conditions listed.
Nurse Benedict was part of a critical care team
responding to a patient with life-threatening
bleeding from excessive warfarin. In such
circumstances, he knew the urgency of reversing
the anticoagulant effect of warfarin. Which of the
following would be used for this purpose?
A. Vitamin K or Vitamin K dependent coagulation
factors.
B. Protamine
C. Any of the options stated.
D. Platelets.
HODGKIN’S DISEASE
A newly admitted client is diagnosed with Hodgkin’s
disease undergoes an excisional cervical lymph node
biopsy under local anesthesia. What does the nurse
assess first after the procedure?
A Airway
B Level of consciousness
C Vital signs
D Incision site
A 21-year-old male with Hodgkin’s lymphoma is a
senior at the local university. He is engaged to be
married and is to begin a new job upon graduation.
Which of the following diagnoses would be a
priority for this client?
A Fatigue related to chemotherapy
B Anticipatory grieving related to terminal
illness
C Tissue integrity related to prolonged bed
rest
D Sexual dysfunction related to radiation
therapy
A patient is admitted to the oncology unit for
diagnosis of suspected Hodgkin's disease. Which of
the following symptoms is typical of Hodgkin's
disease?
A Nausea and vomiting.
B Painful cervical lymph nodes.
C Weight gain.
D Night sweats and fatigue. A False
B True
People infected with HIV are more likely to develop
lymphatic disease. Hodgkin lymphoma may be cured with
A True chemotherapy with almost no incidence of
B False secondary acute nonlymphocytic leukemia within 10
years.
Hodgkin lymphoma, named for Thomas Hodgkin, is A True
an American physician who identified it in 1832. B False
A False
B True The Hodgkin's disease patient described in the
question above undergoes a lymph node biopsy for
The two main groups of lymphoma in humans are definitive diagnosis. If the diagnosis of Hodgkin's
Hodgkin lymphoma and the non-Hodgkin disease were correct, which of the following cells
Lymphomas (NHL). would the pathologist expect to find?
A True A Lymphoblastic cells.
B False B Gaucher's cells.
C Reed-Sternberg cells.
The nurse is aware that the following symptoms is D Rieder's cells
most commonly an early indication of stage 1
Hodgkin’s disease? The nurse understands that Hodgkin’s disease is
A Splenomegaly suspected when a client presents with a painless,
B Night sweat swollen lymph node. Hodgkin’s disease typically
C Persistent hypothermia affects people in which age group?
D Pericarditis A Young adults (ages 21-40 years)
B Older adults (ages 41-50 years)
One of the symptoms for lymphatic disease is C Children (ages 6-12 years)
swelling of the lymph nodes; however, this D Teenagers (ages 13-20 years)
symptom may be easily overlooked because the
enlargement does not cause any pain. Non-Hodgkin lymphoma can spread to almost any
A True part of the body, including the liver, bone marrow,
B False and spleen.
A True
Sex is one of the risk factors for developing NHL, but B False
race is not.
A False A client admitted with newly diagnosed with
B True Hodgkin’s disease. Which of the following would the
nurse expect the client to report?
Hodgkin lymphoma only occurs in a group of lymph A Weight gain
nodes, not in a single lymph node or in other parts B Night sweats
of the lymphatic system, such as the bone marrow C Headache
and spleen. D Lymph node pain

ACUTE LEUKEMIA
The laboratory results of the client with leukemia
indicate bone marrow depression. The nurse should
encourage the client to:
A Increase his activity level and ambulate
frequently
B Sleep with the head of his bed slightly
elevated
C Drink citrus juices frequently for
nourishment
D Use a soft toothbrush and electric razor
A client jokes about his leukemia even though he is
becoming sicker and weaker. The nurse’s most
therapeutic response would be:
A “Your laugher is a cover for your fear.”
B “He who laughs on the outside, cries on
the inside.”
C “Why are you always laughing?”
D “Does it help you to joke about your
illness?”
The treatment for patients with leukemia is bone
marrow transplantation. Which statement about
bone marrow transplantation is not correct?
A The patient is under local anesthesia
during the procedure
B The aspirated bone marrow is mixed with
heparin.
C The aspiration site is the posterior or
anterior iliac crest.
D The recipient receives cyclophosphamide
(Cytoxan) for 4 consecutive days before the
procedure.
A 68-year-old woman is diagnosed with
thrombocytopenia due to acute lymphocytic
leukemia. She is admitted to the hospital for
treatment. The nurse should assign the patient
A to a private room so she will not infect
other patients and health care workers.
B to a private room so she will not be
infected by other patients and health care workers. The treatment protocol for a client with acute
C to a semiprivate room so she will have lymphatic leukemia includes prednisone,
stimulation during her hospitalization. methotrexate, and cimetadine. The purpose of the
D to a semiprivate room so she will have the cimetadine is to:
opportunity to express her feelings about her A Decrease the secretion of pancreatic
illness. enzymes
B Enhance the effectiveness of
A 22-year-old man is admitted to the hospital with methotrexate
complaints of fatigue and weight loss. Physical C Promote peristalsis
examination reveals pallor and multiple bruises on D Prevent a common side effect of
his arms and legs. The results of the patients tests prednisone
reveal acute lymphocytic leukemia and
thrombocytopenia. Which of the following nursing Francis with leukemia has neutropenia. Which of
diagnoses MOST accurately reflects his condition? the following functions must frequently assessed?
A Potential for injury. A Blood pressure
B Self-care deficit B Bowel sounds
C Potential for self-harm. C Heart sounds
D Alteration in comfort. D Breath sounds
A leukemia patient has a relative who wants to Which of the following would the nurse identify as
donate blood for transfusion. Which of the following the initial priority for a child with acute lymphocytic
donor medical conditions would prevent this? leukemia?
A A history of hepatitis C five years A Instituting infection control precautions
previously. B Encouraging adequate intake of iron-rich
B Cholecystitis requiring cholecystectomy foods
one year previously. C Assisting with coping with chronic illness
C Asymptomatic diverticulosis. D Administering medications via IM
D Crohn's disease in remission. injections
A child with leukemia is being discharged after A patient is undergoing the induction stage of
beginning chemotherapy. What instructions will the treatment for leukemia. The nurse teaches family
nurse include in the teaching plan for the parents of members about infectious precautions. Which of
this child? the following statements by family members
A Provide a diet low in protein and high in indicates that the family needs more education?
carbohydrates A We will bring in books and magazines for
B Avoid fresh vegetables that are not entertainment.
cooked or peeled B We will bring in personal care items for
C Notify the M.D. if the child’s temperature comfort.
exceeds 101F (39C) C We will bring in fresh flowers to brighten
D Increase the use of humidifiers the room.
throughout the house
D We will bring in family pictures and get
well cards
Marie with acute lymphocytic leukemia suffers from
nausea and headache. These clinical manifestations
may indicate all of the following except
A effects of radiation
B chemotherapy side effects
C meningeal irritation
D gastric distension
A client with acute leukemia is admitted to the
oncology unit. Which of the following would be
most important for the nurse to inquire?
A "Have you noticed a change in sleeping
habits recently?"
B "Have you had a respiratory infection in
the last 6 months?"
C "Have you lost weight recently?"
D "Have you noticed changes in your
alertness?"
An African American client is admitted with acute
leukemia. The nurse is assessing for signs and
symptoms of bleeding. Where is the best site for
examining for the presence of petechiae?
A The abdomen
B The thorax
C The earlobes
D The soles of the feet
The nurse is reviewing the laboratory report of a
client who underwent a bone marrow biopsy. The
finding that would most strongly support a diagnosis
of acute leukemia is the existence of a large number
of immature:
A lymphocytes
B thrombocytes
C reticulocytes
D leukocytes
What is the peak age range in acquiring acute
lymphocytic leukemia (ALL)?
A 4 to 12 years.
B 20 to 30 years
C 40 to 50 years
D 60 to 70 years
A child is undergoing remission induction therapy to
treat leukemia. Allopurinol is included in the
regimen. The main reason for administering
allopurinol as part of the client’s chemotherapy
regimen is to:
A Prevent metabolic breakdown of
xanthine to uric acid
B Prevent uric acid from precipitating in the
ureters
C Enhance the production of uric acid to
ensure adequate excretion of urine
D Ensure that the chemotherapy doesn’t
adversely affect the bone marrow
A 33-year-old male is being evaluated for possible
acute leukemia. Which of the following would the
nurse inquire about as a part of the assessment?
A The client collects stamps as a hobby.
B The client recently lost his job as a postal
worker.
C The client had radiation for treatment of
Hodgkin’s disease as a teenager.
D The client’s brother had leukemia as a
child.
The client with leukemia is receiving busulfan
(Myleran) and allopurinol (Zyloprim). The nurse tells
the client that the purpose if the allopurinol is to
prevent:
A Nausea
B Alopecia
C Vomiting
D Hyperuricemia
The patient receiving mitoxantrone (Novantrone)
for treatment of secondary progressive multiple
sclerosis (MS) is closely monitored for
A leukopenia and cardiac toxicity.
B mood changes and fluid and electrolyte
alterations.
C renal insufficiency.
D hypoxia.
A patient with leukemia is receiving chemotherapy
that is known to depress bone marrow. A CBC
(complete blood count) reveals a platelet count of
25,000/microliter. Which of the following actions
related specifically to the platelet count should be
included on the nursing care plan?
A Monitor for fever every 4 hours.
B Require visitors to wear respiratory masks
and protective clothing.
C Consider transfusion of packed red blood
cells.
D Check for signs of bleeding, including
examination of urine and stool for blood.
A nurse is caring for a patient with acute
lymphoblastic leukemia (ALL). Which of the
following is the most likely age range of the patient?
A 3-10 years.
B 25-35 years.
C 45-55 years.
D over 60 years
A 4-year-old is admitted with acute leukemia. It will
be most important to monitor the child for:
A Abdominal pain and anorexia
B Fatigue and bruising
C Bleeding and pallor
D Petechiae and mucosal ulcers
Which of the following would be the priority nursing
diagnosis for the adult client with acute leukemia?
A Oral mucous membrane, altered related
to chemotherapy
B Risk for injury related to
thrombocytopenia
C Fatigue related to the disease process
D Interrupted family processes related to
life-threatening illness of a family member
Situation: Stacy is diagnosed with acute lymphoid
leukemia (ALL) and beginning chemotherapy.Stacy is
discharged from the hospital following her
chemotherapy treatments. Which statement of
Stacy’s mother indicated that she understands when
she will contact the physician?
A “I should contact the physician if Stacy has
difficulty in sleeping”.
B “I will call my doctor if Stacy has
persistent vomiting and diarrhea”.
C “My physician should be called if Stacy is
irritable and unhappy”.
D “Should Stacy have continued hair loss, I
need to call the doctor”.
During chemotherapy for lymphocytic leukemia,
Mathew develops abdominal pain, fever, and "horse
barn" smelling diarrhea. It would be most important
for the nurse to advise the physician to order:
A enzyme-linked immunosuppressant assay
(ELISA) test.
B electrolyte panel and hemogram.
C stool for Clostridium difficile test.
D flat plate X-ray of the abdomen.
COLOSTOMY
A client with colostomy refuses to allow his wife to
see the incision or stoma and ignores most of his
dietary instructions. The nurse on assessing this
data, can assume that the client is experiencing:
A A reaction formation to his recent altered
body image.
B A difficult time accepting reality and is in
a state of denial.
C Impotency due to the surgery and needs
sexual counseling
D Suicide thoughts and should be seen by
psychiatrist
The nurse plans to teach Michiel about colostomy
irrigation. As the nurse prepares the materials
needed, which of the following item indicates that
the nurse needs further instruction?
A Plain NSS / Normal Saline
B K-Y Jelly
C Tap water
D Irrigation sleeve
When doing colostomy irrigation at home, a client
with colostomy should be instructed to report to his
physician :
A Abdominal cramps during fluid inflow
B Difficulty in inserting the irrigating tube
C Passage of flatus during expulsion of feces
D Inability to complete the procedure in half
an hour
The nurse teaches the patient whose surgery will
result in a sigmoid colostomy that the feces expelled
through the colostomy will be
A solid.
B semi-mushy.
C mushy.
D fluid.
Michiel asked the nurse, what foods will help lessen
the odor of his colostomy. The nurse best response
would be
A Eat eggs
B Eat cucumbers
C Eat beet greens and parsley
D Eat broccoli and spinach
Which of the following is TRUE in colostomy
feeding?
A Hold the syringe 18 inches above the
stoma and administer the feeding slowly
B Pour 30 ml of water before and after
feeding administration
C Insert the ostomy feeding tube 1 inch
towards the stoma
D A Pink stoma means that circulation
towards the stoma is all well
The nurse is caring for a client with a colostomy. The
client tells the nurse that he makes small pin holes
in the drainage bag to help relieve gas. The nurse
should teach him that this action:
A destroys the odor-proof seal
B wont affect the colostomy system
C is appropriate for relieving the gas in a
colostomy system
D destroys the moisture barrier seal
Before discharge, the nurse scheduled the client
who had a colostomy for colorectal cancer for
discharge instruction about resuming activities. The
nurse should plan to help the client understands
that:
A After surgery, changes in activities must
be made to accommodate for the physiologic
changes caused by the operation.
B Most sports activities, except for
swimming, can be resumed based on the client’s
overall physical condition.
C With counseling and medical guidance, a
near normal lifestyle, including complete sexual
function is possible.
D Activities of daily living should be resumed
as quickly as possible to avoid depression and
further dependency.
The nurse knew that the normal color of Michiel’s
stoma should be
A Brick Red
B Gray
C Blue
D Pale Pink
Which of the following behavior of the client
indicates the best initial step in learning to care for
his colostomy?
A Ask to defer colostomy care to another
individual
B Promises he will begin to listen the next
day
C Agrees to look at the colostomy
D States that colostomy care is the function
of the nurse while he is in the hospital
A 58-year-old male client tells the office nurse that
his wife does not let him change his colostomy bag
himself. Which response by the nurse indicates as
understanding of the situation?
A "Your wife's need to help you is a reality
you should accept"
B "Do you think your wife might benefit
from counseling?"
C "You feel you need privacy when
changing your colostomy?"
D "Have you discussed the situation with
your doctor?"
The nurse is teaching a female client how to
perform a colostomy irrigation. To enhance the
effectiveness of the irrigation and fecal returns,
what measure should the nurse instruct the client to
do?
A Increase fluid intake
B Place heat on the abdomen
C Perform the irrigation in the evening
D Reduce the amount of irrigation solution
A client is scheduled to undergo an abdominal
perineal resection with a permanent colostomy.
Which of the following measures would be an
anticipated part of the client’s preoperative care?
A Keep the client NPO for 24 hrs before
surgery
B Administer neomycin sulfate the evening
before surgery
C Inform the client that total parenteral
nutrition will likely be implemented after surgery
D Advise the client to limit physical activity
A male client with bladder cancer has had the
bladder removed and an ileal conduit created for
urine diversion. While changing this client’s pouch,
the nurse observes that the area around the stoma
is red, weeping, and painful. What should nurse
Katrina conclude?
A The skin wasn’t lubricated before the
pouch was applied.
B The pouch faceplate doesn’t fit the
stoma.
C A skin barrier was applied properly.
D Stoma dilation wasn’t performed.
A temporary colostomy is performed on the client
with colon cancer. The nurse is aware that the
proximal end of a double barrel colostomy:
A Is the opening on the client’s left side
B Is the opening on the distal end on the
client’s left side
C Is the opening on the client’s right side
D Is the opening on the distal right side
Arthur Cruz, a 45 year old artist, has recently had an
abdominoperineal resection and colostomy. Mr.
Cruz accuses the nurse of being uncomfortable
during a dressing change, because his “wound looks
terrible.” The nurse recognizes that the client is
using the defense mechanism known as:
A Reaction Formation
B Sublimation
C Intellectualization
D Projection
The client who had transverse colostomy asks the
nurse about the possible effect of the surgery on
future sexual relationship. What would be the best
nursing response?
A The surgery will temporarily decrease the
client’s sexual impulses.
B Sexual relationships must be curtailed for
several weeks.
C The partner should be told about the
surgery before any sexual activity.
D The client will be able to resume normal
sexual relationships.
While irrigating the client’s colostomy, Michiel
suddenly complains of severe cramping. Initially, the
nurse would
A Stop the irrigation by clamping the tube
B Slow down the irrigation
C Tell the client that cramping will subside
and is normal
D Notify the physician
The nurse should insert the colostomy tube for
irrigation at approximately
A 1-2 inches
B 3-4 inches
C 6-8 inches
D 12-18 inches
The maximum height of irrigation solution for
colostomy is ( Choose 2 answer)
A 5 inches
B 12 inches
C 18 inches
D 24 inches
When preparing to teach a client with colostomy
how to irrigate his colostomy, the nurse should plan
to perform the procedure:
A When the client would have normally
had a bowel movement
B After the client accepts he had a bowel
movement
C Before breakfast and morning care
D At least 2 hours before visitors arrive
When irrigating a colostomy, the nurse lubricates
the catheter and gently inserts it into the stoma no
more than _______ inches
A 3”
B 2”
C 4”
D 5”
The nurse will start to teach Michiel about the
techniques for colostomy irrigation. Which of the
following should be included in the nurse’s teaching
plan?
A Use 500 ml to 1,000 ml NSS
B Suspend the irrigant 45 cm above the
stoma
C Insert the cone 4 cm in the stoma
D If cramping occurs, slow the irrigation
The nurse is performing a colostomy irrigation on a
male client. During the irrigation, the client begins
to complain of abdominal cramps. What is the
appropriate nursing action?
A Notify the physician
B Stop the irrigation temporarily
C Increase the height of the irrigation
D Medicate for pain and resume the
irrigation
The nurse would know that dietary teaching had
been effective for a client with colostomy when he
states that he will eat:
A Food low in fiber so that there is less stool
B Everything he ate before the operation
but will avoid those foods that cause gas
C Bland foods so that his intestines do not
become irritated
D Soft foods that are more easily digested
and absorbed by the large intestines
When observing an ostomate do a return
demonstration of the colostomy irrigation, the
nurse notes that he needs more teaching if he:
A Stops the flow of fluid when he feels
uncomfortable
B Lubricates the tip of the catheter before
inserting it into the stoma
C Hangs the bag on a clothes hook on the
bathroom door during fluid insertion
D Discontinues the insertion of fluid after
only 500 ml of fluid has been instilled
The nurse is caring for a male client postoperatively
following creation of a colostomy. Which nursing
diagnosis should the nurse include in the plan of
care?
A Sexual dysfunction
B Body image, disturbed
C Fear related to poor prognosis
D Nutrition: more than body requirements,
imbalanced
The first day after, surgery the nurse finds no
measurable fecal drainage from a patient’s
colostomy stoma. What is the most appropriate
nursing intervention?
A Call the doctor immediately.
B Obtain an order to irrigate the stoma.
C Place the patient on bed rest and call the
doctor.
D Continue the current plan of care.
A client is scheduled to have a descending
colostomy. He’s very anxious and has many
questions regarding the surgical procedure, care of
stoma, and lifestyle changes. It would be most
appropriate for the nurse to make a referral to
which member of the health care team?
A Social worker
B Registered Dietician
C Occupational Therapist
D Enterostomal Nurse Therapist
SITUATION: Michiel, A male patient diagnosed with
colon cancer was newly put in colostomy. Michiel
shows the BEST adaptation with the new colostomy
if he shows which of the following?
A Look at the ostomy site
B Participate with the nurse in his daily
ostomy care
C Ask for leaflets and contact numbers of
ostomy support groups
D Talk about his ostomy openly to the nurse
and friends
Nurse Michelle should know that the drainage is
normal 4 days after a sigmoid colostomy when the
stool is:
A Green liquid
B Solid formed
C Loose, bloody
D Semiformed
The next day, the nurse will assess Michiel’s stoma.
The nurse noticed that a prolapsed stoma is evident
if she sees which of the following?
A A sunken and hidden stoma
B A dusky and bluish stoma
C A narrow and flattened stoma
D Protruding stoma with swollen
appearance
Discharge instructions for a patient who has been
operated on for colorectal cancer include irrigating
the colostomy. The nurse knows her teaching is
effective when the patient states he’ll contact the
doctor if:
A He experiences abdominal cramping while
the irrigant is infusing
B He has difficulty inserting the irrigation
tube into the stoma
C He expels flatus while the return is
running out
D He’s unable to complete the procedure in
1 hour
Tony returns form surgery with permanent
colostomy. During the first 24 hours the colostomy
does not drain. The nurse should be aware that:
A Proper functioning of nasogastric suction
B Presurgical decrease in fluid intake
C Absence of gastrointestinal motility
D Intestinal edema following surgery
COLORECTAL CANCER
When teaching a client about the signs of colorectal
cancer, Nurse Trish stresses that the most common
complaint of persons with colorectal cancer is:
A Change in bowel habits
B Abdominal pain
C Change in caliber of stools
D Hemorrhoids
When teaching a client about the signs of colorectal
cancer, Nurse Trish stresses that the most common
complaint of persons with colorectal cancer is:
A Hemorrhoids
B Change in caliber of stools
C Abdominal pain
D Change in bowel habits
Which of the following characteristics are risk
factors for colorectal cancer?
A History of skin cancer
B Age younger than 40
C Familial polyposis
D Low fat, low protein, high fiber diet
You must rearrange the room assignment for
several clients. Which two clients would best suited
to put in the same room? (Choose the letter that
applies).
A A 43-year-old female second day post-
operative cholecystectomy
B A 35-year-old female with copious,
intractable diarrhea and vomiting
C A 62-year-old female with colon cancer
receiving chemotherapy and radiation
D A 53-year-old female with pain related to
alcohol-associated pancreatitis
Before discharge, the nurse scheduled the client
who had a colostomy for colorectal cancer for
discharge instruction about resuming activities. The
nurse should plan to help the client understands
that:
A After surgery, changes in activities must
be made to accommodate for the physiologic
changes caused by the operation.
B With counseling and medical guidance, a
near normal lifestyle, including complete sexual
function is possible.
C Activities of daily living should be resumed
as quickly as possible to avoid depression and
further dependency.
D Most sports activities, except for
swimming, can be resumed based on the client’s
overall physical condition.
A temporary colostomy is performed on the client
with colon cancer. The nurse is aware that the
proximal end of a double barrel colostomy:
A Is the opening on the distal end on the
client’s left side
B Is the opening on the client’s left side
C Is the opening on the distal right side
D Is the opening on the client’s right side
The client has a good understanding of the means to
reduce the chances of colon cancer when he states:
A “I will exercise daily.”
B “I will include more fresh fruits and
vegetables in my diet.”
C “I will include more red meat in my diet.”
D “I will have an annual chest x-ray.”
A nurse assigned to the emergency department
evaluates a patient who underwent fiberoptic
colonoscopy 18 hours previously. The patient
reports increasing abdominal pain, fever, and chills.
Which of the following conditions poses the most
immediate concern?
A Bowel perforation.
B Colon cancer.
C Viral gastroenteritis.
D Diverticulitis
A patient received surgery and chemotherapy for
colon cancer, completing therapy 3 months
previously, and she is now in remission. At a follow-
up appointment, she complains of fatigue following
activity and difficulty with concentration at her
weekly bridge games. Which of the following
explanations could account for her symptoms?
A The patient may be immunosuppressed.
B The symptoms may be the result of
anemia caused by chemotherapy.
C The patient may be depressed.
D The patient may be dehydrated.
A client is being evaluated for cancer of the colon. In
preparing the client for barium enema, the nurse
should:
A Place the client on CBR a day before the
study
B Render an oil retention enema and give
laxative the night before
C Instruct the client to swallow 6
radiopaque tablets the evening before the study
D Give laxative the night before and a
cleansing enema in the morning before the test
Which of the follow statements provides accurate
information regarding cancer of the colon and
rectum?
A Rectal cancer affects more than twice as
many people as colon cancer.
B The incidence of colon and rectal cancer
decreases with age.
C Cancer of the colon and rectum is the
second most common type of internal cancer in the
United States.
D There is no hereditary component to
colon cancer
Which diet is associated with an increased risk of
colorectal cancer?
A Low protein, complex carbohydrates
B High fat, refined carbohydrates
C Low carbohydrates, complex proteins
D High protein, simple carbohydrates
Discharge instructions for a patient who has been
operated on for colorectal cancer include irrigating
the colostomy. The nurse knows her teaching is
effective when the patient states he’ll contact the
doctor if:
A He experiences abdominal cramping while
the irrigant is infusing
B He’s unable to complete the procedure in
1 hour
C He expels flatus while the return is
running out
D He has difficulty inserting the irrigation
tube into the stoma
RENAL DISORDERS 1
An 18-year-old college student is admitted to the
hospital presenting with dark urine, fever, and flank
pain. After diagnostic tests, the student is diagnosed
with acute glomerulonephritis. What health history
factor is most likely to be present in this student's
case?
A. Previous renal trauma.
B. A recent episode of a sore throat.
C. Family history of acute glomerulonephritis.
D. History of renal calculi (kidney stones).
Nurse Emily is providing education to a 22-year-old
patient with diabetic nephropathy. The patient
expresses the belief that since they are young and
have two kidneys, sticking to their insulin schedule
will prevent kidney damage. What is the best
response that Nurse Emily should give?
A. "As long as your kidneys continue to produce
urine, you have minimal concern."
B. "You should consult with your physician; statistics
suggest your viewpoint may be too optimistic."
C. "Your statement would hold true if diabetes could
solely be managed through insulin."
D. "Despite following your insulin schedule, the
risk of kidney damage remains a concern."
Nurse Sarah is caring for a paraplegic patient who
has been diagnosed with renal calculi. Sarah is trying
to understand the contributing factors that led to
the formation of these calculi. Which factor is likely
to have contributed to the development of renal
calculi in this patient?
A. Enhanced loss of calcium from the skeletal
system.
B. Elevated fluid consumption.
C. Reduced renal function.
D. Lowered dietary calcium intake.
While attending to Mrs. Jones, who is currently in
the oliguric phase of renal failure, Nurse Rebecca
wonders what level of 24-hour urine output she
should expect to be below for this patient.
A. Not exceeding 1000 milliliters.
B. Under 800 milliliters.
C. Less than 400 milliliters.
D. Below 200 milliliters.
Nurse James is crafting a care plan focused on the
nursing diagnosis of "risk for infection" for his
patient who has recently undergone a kidney
transplant. What would be an appropriate goal to
set for this patient?
A. Work toward ceasing the use of cyclosporine
(Neoral) as expediently as safe.
B. Resume usual fluid consumption within a 48 to
72-hour timeframe.
C. Maintain a normal body temperature and have
cultures that show no infection.
D. Return to regular employment within a period of
2 to 3 weeks post-surgery.
Nurse Sarah is caring for a patient with end-stage
renal disease (ESRD) who has an arteriovenous
fistula in the left arm for hemodialysis. What
intervention should be included in the patient's plan
of care?
A. Apply consistent pressure to the needle
insertion site upon ceasing hemodialysis.
B. Keep the left arm completely dry.
C. Maintain the head of the bed at a 45-degree
elevation.
D. Elevate the left arm on an arm board for a
minimum of 30 minutes.
Nurse Karen is caring for a patient who has just
been wheeled back from the operating theater
following a repair of an abdominal aortic aneurysm.
She's vigilant for signs of potential complications,
particularly acute renal failure. What symptom
should alert Nurse Karen to the possibility of acute
renal failure in this postoperative patient?
A. Complete absence of urine.
B. Oliguria
C. Frequent bowel movements.
D. Nausea and vomiting.
Nurse Megan is attending a continuing education
seminar on preventing urinary tract infections (UTIs)
in hospitalized patients. The speaker asks the
audience which factor is primarily responsible for
the majority of UTIs in hospitalized settings. What is
the most likely answer?
A. Inadequate fluid intake.
B. Immunosuppressed state of the patient.
C. The use of invasive procedures.
D. Insufficient perineal hygiene.
Nurse Sarah is reviewing the care plan for Mr.
Anderson, a patient with chronic renal failure who is
complaining about persistent itching or pruritus.
What instruction should Nurse Sarah include in Mr.
Anderson's teaching plan to manage this symptom?
A. Take baths frequently to keep the skin clean.
B. Maintain short, clean fingernails.
C. Utilize alcohol-based emollients for skin moisture.
D. Vigorously rub the affected skin areas with a
towel.
Nurse Laura is preparing a teaching care plan for a
patient diagnosed with cystitis, who is being treated
with phenazopyridine (Pyridium). Laura wants to
include essential guidance for the safe and effective
use of this medication. What instruction should
Nurse Laura include in the care plan for this patient?
A. Cease taking phenazopyridine as soon as
symptoms of painful urination subside.
B. Administer phenazopyridine immediately prior to
urinating to alleviate discomfort.
C. Contact the physician if your urine becomes
orange-red in color.
D. Stop the course of prescribed antibiotics once the
painful urination is alleviated.
Nurse William is setting up for the urinary
catheterization of a patient who has recently
suffered from a traumatic injury. As he gets ready,
William notices that there's blood present at the
opening of the urethra (urethral meatus). What
should be William's priority action in this situation?
A. Postpone the catheterization and alert the
physician.
B. Analyze the discharge for hidden blood prior to
inserting the catheter.
C. Thoroughly rinse and clean the urethral opening
before proceeding with catheterization.
D. Generously apply lubrication to the catheter
before insertion.
While administering peritoneal dialysis to Mr.
Thompson in the dialysis unit, Nurse Emily notes
that the return fluid is draining more slowly than
usual. What is Nurse Emily's most appropriate
immediate course of action to address the slow
drainage of return fluid during Mr. Thompson's
peritoneal dialysis?
A. Inspect the outflow tubing for any kinks or
obstructions.
B. Request Mr. Thompson to perform a cough.
C. Elevate the drainage bag higher than Mr.
Thompson's abdomen.
D. Adjust Mr. Thompson's bed to a reverse
Trendelenburg position.
Nurse Jennifer is preparing discharge instructions
for a patient who was diagnosed with sepsis
stemming from a urinary tract infection (UTI). What
key point should Nurse Jennifer include in her
patient's discharge teaching plan?
A. Refrain from using tampons.
B. Abstain from engaging in sexual activity.
C. Consume 8 to 10 eight-ounce glasses of water
each day.
D. Take cool baths to manage symptoms.
Nurse David is developing a care plan for Ms. Garcia,
who has been diagnosed with renal calculi. What
intervention should Nurse David include in the care
plan to best manage Ms. Garcia's condition?
A. Encourage a diet high in purines.
B. Advise the patient to maintain complete bed rest.
C. Limit fluid intake to reduce urine output.
D. Instruct the patient to strain all urine.
During a session of hemodialysis, Nurse Alex notices
that her patient, Mrs. Wilson, starts to complain
about experiencing muscle cramps. What should
Nurse Alex do immediately to effectively relieve
Mrs. Wilson's muscle cramps?
A. Accelerate the rate of the ongoing hemodialysis
treatment.
B. Urge Mrs. Wilson to perform active range-of-
motion exercises.
C. Infuse a normal saline solution intravenously.
D. Administer a 5% dextrose solution intravenously.
Nurse Emily is responsible for a patient who recently
had an arteriovenous fistula placed for
hemodialysis. She knows it's crucial to regularly
assess for patency. What is the best method for
Emily to check the patency of this arteriovenous
fistula?
A. Compress the fistula and observe the rate of
refilling upon release.
B. Aspirate blood from the fistula using a needle and
syringe.
C. Evaluate capillary refill time in the nail beds of the
same arm.
D. Palpate along the entire length of the fistula for
the presence of a thrill.
Nurse Ethan is reviewing the medical history of Mrs.
Clark, who reports that she leaks urine whenever
she coughs, sneezes, or lifts heavy items. Based on
this description, what type of urinary incontinence is
Mrs. Clark likely experiencing?
A. Overflow Incontinence.
B. Reflex Incontinence.
C. Urge Incontinence.
D. Stress Incontinence.
Nurse Laura is caring for Mr. Harris, who has been
recently diagnosed with acute glomerulonephritis.
Based on the diagnosis, what clinical manifestations
would Nurse Laura expect to see in Mr. Harris?
A. Increased thirst and frequent urination.
B. Painful urination and low blood pressure.
C. Chills and pain in the area between the ribs and
hip.
D. Reduced urine output and generalized swelling.
David, a dialysis nurse, is preparing a 54-year-old
patient for hemodialysis. The patient has a
functioning arteriovenous (AV) fistula in place. What
should David prioritize to ensure the patency of the
AV fistula before initiating hemodialysis?
A. Elevate the extremity with the AV fistula above
heart level.
B. Auscultate the AV fistula for bruit and palpate
for thrill.
C. Apply a warm compress to the AV fistula site.
D. Administer a bolus of saline through the AV
fistula.
Nurse Melissa is caring for a patient with renal
failure and has orders to administer Polystyrene
sulfonate (Kayexalate). She understands that this
medication has a specific role in managing the
complications associated with renal failure. What is
the primary purpose of using Polystyrene sulfonate
(Kayexalate) in patients with renal failure?
A. To counteract constipation resulting from sorbitol
usage.
B. To swap potassium ions for sodium ions.
C. To rectify acid-base imbalances.
D. To lower elevated serum phosphate
concentrations.
Nurse Olivia is monitoring a postoperative patient
who has been back from surgery for six hours. The
patient has an indwelling urinary catheter, which
was empty upon return but now shows only 120ml
of urine. Olivia confirms that the drainage system is
not obstructed. What is Olivia's priority intervention
in this situation?
A. Administer a 500ml bolus of isotonic saline
solution.
B. Position the patient for shock management and
alert the surgical team.
C. Irrigate the urinary catheter with sterile saline or
water.
D. Assess the patient's circulatory status and vital
signs.
Nurse Emily is closely monitoring the cardiac status
of a patient with end-stage renal disease. The
cardiac monitor starts showing frequent PVCs
(Premature Ventricular Contractions). What is the
priority nursing intervention for this situation?
A. Ready the equipment for potential defibrillation
of the patient.
B. Contact the healthcare provider immediately.
C. Administer intravenous lidocaine (Xylocaine) to
the patient.
D. Review the most recent laboratory results for
the patient's potassium level.
Nurse John is formulating a care plan for a patient
who is in end-stage renal disease. Among the
various aspects of patient care that need to be
addressed, what would be the priority nursing
diagnosis for this patient?
A. Excess fluid volume.
B. Elevated risk for physical harm.
C. Nutritional imbalance: insufficient dietary intake.
D. Reduced tolerance for physical activity.
Nurse Emily is attending to Lisa, a 30-year-old
woman who is undergoing hemodialysis treatment.
Lisa has an internal arteriovenous fistula in her arm
for vascular access. Emily wants to take measures to
minimize the risk of complications associated with
the arteriovenous fistula. What action should Emily
take to prevent complications related to this
vascular access device?
A. Establish intravenous lines proximal to the
location of the arteriovenous fistula.
B. Notify the healthcare provider if a bruit or thrill is
detected over the arteriovenous fistula.
C. Refrain from measuring blood pressure on the
arm containing the arteriovenous fistula.
D. Feel for pulses distal to the arteriovenous fistula
site.
Nurse Isabella is working with a patient who may
need to transition to continuous peritoneal dialysis.
Before making any recommendations, she needs to
evaluate whether the patient meets certain criteria
to be eligible for this treatment option. What is a
required criterion for a patient to be considered for
continuous peritoneal dialysis?
A. The patient's vascular access point needs to be
fully healed.
B. Previous attempts at hemodialysis must have
been unsuccessful.
C. The patient must have severe pulmonary edema.
D. The patient needs to have stable hemodynamic
parameters.
Nurse Ethan is reviewing the medical histories of
two different patients: one with renal failure and
another with prerenal failure. Ethan aims to
differentiate the two conditions based on treatment
responsiveness. Which statement accurately
distinguishes prerenal failure from renal failure?
A. In prerenal failure, blood urea nitrogen (BUN)
levels can be lowered through hemodialysis.
B. In prerenal failure, vasoactive agents such as
dopamine (Intropin) elevate blood pressure levels.
C. In prerenal failure, administering an intravenous
infusion of isotonic saline enhances urine
production.
D. In prerenal failure, diuretics like furosemide
(Lasix) are less effective in eliciting a response.
Nurse William is speaking to a men's health group
about the importance of screening for prostate
cancer. One of the attendees asks him what is the
most indicative diagnostic test for detecting
prostate cancer. What should Nurse William reply?
A. Testing for prostate-specific antigen (PSA) levels.
B. An in-depth digital rectal examination.
C. Excretory urography as a diagnostic measure.
D. The use of magnetic resonance imaging (MRI).
Nurse Olivia is caring for a 32-year-old patient and is
reviewing the patient's medical chart. Based on the
symptoms exhibited, what would lead Nurse Olivia
to suspect the patient may have acute
glomerulonephritis?
A. Symptoms of fever, chills, and pain in the right
upper quadrant radiating to the back.
B. Symptoms of painful urination, frequent
urination, and a sense of urgency.
C. Complaints of back pain accompanied by nausea
and vomiting.
D. Elevated blood pressure, reduced urine output,
and complaints of fatigue.
Nurse Zachary is preparing medication education for
a patient diagnosed with a urinary tract infection
(UTI) and prescribed phenazopyridine (Pyridium).
What important information should Nurse Zachary
include in the patient's medication teaching?
A. "Expect your urine to possibly change to a bright
orange color."
B. "You must complete this antibiotic course for a
total of 7 days."
C. "Administer this medication between your meals
and at bedtime."
D. "Avoid this drug if you have a penicillin allergy."
Nurse Lauren is caring for a patient, Mr. Patel, who
has been admitted with acute renal calculi and is
experiencing significant pain. What type of
medication is generally indicated for the
management of pain related to acute renal calculi?
A. Narcotic analgesics.
B. Salicylates
C. Nonsteroidal anti-inflammatory drugs (NSAIDs).
D. Muscle relaxants.
Nurse David is overseeing the hemodialysis
treatment of a patient when he notices that she
starts to become agitated. She complains of a
headache and mentions feeling nauseous. David
needs to identify the likely complication that could
be manifesting. What complication should Nurse
David suspect based on the patient's symptoms
during hemodialysis?
A. Acute hemolysis.
B. Disequilibrium syndrome.
C. Entrapment of air in the bloodstream.
D. Bacterial or viral infection.
You're caring for a patient who recently underwent
a kidney transplant. You become concerned about
the possibility of kidney transplant rejection. Which
symptoms would arouse your suspicion?
A. Elevated body temperature, an increase in
weight, and reduced urine production.
B. Reduced urine production accompanied by low
blood pressure.
C. Discomfort at the surgical site, overall feeling of
weakness, and signs of depression.
D. Discomfort at the surgical site, overall malaise,
and low blood pressure.
Nurse Jake is monitoring a patient who has just
completed their first session of hemodialysis.
Shortly afterward, the patient starts to experience a
headache, elevated blood pressure, restlessness,
mental confusion, nausea, and vomiting. What
condition is most likely indicated by these
symptoms?
A. Disequilibrium Syndrome
B. Peritonitis
C. Hypervolemia
D. Respiratory Distress
Nurse Anthony is on his rounds when he checks on
Mrs. Smith, who has recently been diagnosed with
acute pyelonephritis. Based on her diagnosis, which
symptoms would Nurse Anthony expect to observe
in Mrs. Smith?
A. Jaundice and pain in the flank area.
B. Tenderness at the costovertebral angle along
with chills.
C. Increased frequency of urination and urination at
night.
D. A burning sensation during urination.
Nurse Emily is assessing a patient who presents with
intense pain on the right side of his lower back,
nausea, vomiting, and restlessness. The patient also
appears somewhat pale and is sweating. His vital
signs are: BP 140/90 mmHg, Pulse 118 beats/min.,
Respirations 33 breaths/min., and Temperature
98.0°F. Based on the subjective data, which
symptom most strongly suggests the diagnosis of
renal calculi (kidney stones)?
A. Pain that extends toward the right upper
abdominal area.
B. Urine that is dark in color and produced in low
amounts.
C. Vomiting that resembles coffee grounds in color.
D. A history of experiencing mild symptoms of the
flu the previous week.
Nurse Maya is working on a rehabilitation plan for a
patient who has a neurogenic bladder. Which action
should be considered the most critical when
undertaking bladder training for this patient?
A. Promote the practice of Kegel exercises.
B. Establish designated times for bladder emptying.
C. Suggest the continued use of an indwelling
urinary catheter.
D. Advocate for increased fluid intake.
Nurse Anthony is taking care of a patient who has
been diagnosed with end-stage renal disease. What
should be the priority nursing diagnosis for this
patient?
A. Excess Fluid Volume.
B. Deficit in Patient Knowledge.
C. Intolerance to Physical Activity.
D. Experience of Pain.
Nurse Anna is evaluating a patient who may be
suffering from a urinary tract infection (UTI). To
further confirm the diagnosis, Anna pays close
attention to the patient's subjective symptoms.
Which statement from the patient would most likely
indicate the presence of a UTI?
A. "I experience a burning sensation during
urination."
B. "There's a sweet odor coming from my urine."
C. "I can go for long stretches without feeling the
need to urinate."
D. "I've been urinating quite frequently."
Nurse Laura is assessing a patient suspected of
progressing through the stages of acute renal
failure. What sign would indicate to her that the
patient is in the second phase of acute renal failure?
A. A daily urine output that doubles, reaching 4 to
5 liters per day.
B. A daily urine output of less than 100 ml.
C. Stabilization of kidney function.
D. Urine production is less than 400 ml per day.
Nurse Olivia is caring for a patient who has diabetes
mellitus and has recently started hemodialysis due
to renal failure. What would be the most
appropriate dietary recommendation for this
patient on the days between dialysis treatments?
A. A diet devoid of protein, along with the use of a
salt substitute.
B. A low-protein diet with a physician-prescribed
amount of water intake.
C. No dietary restrictions whatsoever.
D. A low-protein diet with no restrictions on water
intake.
Nurse Olivia is caring for a patient who has recently
undergone a kidney transplant. She understands the
importance of immunosuppressive therapy to
prevent rejection of the new organ. For how long is
immunosuppression generally continued following a
kidney transplantation?
A. For the initial 24 hours following the transplant.
B. Only for one week post-transplant.
C. Indefinitely, for the duration of the patient's life.
D. Until there are no further signs of kidney
rejection.
Nurse Alex is discussing dietary modifications with a
patient who has both diabetes and a longstanding
history of multiple renal stones. Now facing chronic
renal failure, which nutritional component needs to
be notably decreased in this patient's meal plan?
A. Protein sources
B. Dietary fats
C. Carbohydrate intake
D. Ascorbic acid (Vitamin C)
Nurse Emily is caring for a patient who recently
underwent surgery to create an arteriovenous
fistula for hemodialysis. What key information
should Nurse Emily keep in mind when providing
care for this patient?
A. The patient should not experience pain during
the initiation of dialysis.
B. Auscultating the fistula with a stethoscope is not
advised.
C. The patient generally feels at their best
immediately following dialysis treatment.
D. Measuring blood pressure on the arm with the
arteriovenous fistula can lead to clot formation.
Nurse Amanda is responsible for caring for Mr.
Johnson, who has just undergone a prostatectomy.
What complication requires immediate and priority
assessment in Mr. Johnson's post-operative care?
A. Signs of hemorrhaging or excessive bleeding.
B. Early indications of pneumonia.
C. The onset of deep vein thrombosis symptoms.
D. Symptoms of urine retention.
Nurse Jane is closely monitoring a patient who has
been diagnosed with nephritic syndrome. Jane is
eager to identify any positive indicators that would
suggest her patient is on the path to recovery. What
change would signify that the patient with nephritic
syndrome is recovering?
A. An increase in overall body weight.
B. Complete absence of protein in the urine.
C. Decreased levels of serum albumin.
D. Elevated levels of lipids in the blood serum.
Nurse Anthony is caring for a patient diagnosed with
acute renal failure. He notes that the patient is also
experiencing elevated blood pressure levels.
Anthony wants to identify the most prevalent cause
of hypertension in the context of acute renal failure.
What is the most common cause of hypertension in
cases of acute renal failure?
A. Low levels of red blood cells.
B. Insufficient fluid volume in the body.
C. Excessive fluid volume in the body.
D. Fluid accumulation in the lungs.
Nurse Sarah is conducting a follow-up visit in the
outpatient clinic for a patient who recently received
a kidney transplant. The patient reports discovering
a lump in her breast. What should Nurse Sarah
consider regarding transplant recipients?
A. Overwhelmed with anxiety post the life-altering
kidney transplant experience.
B. At a lower likelihood for developing cancer, thus
the lump is probably non-malignant.
C. More prone to tumor formation directly due to
the kidney transplant.
D. At a heightened risk for cancer development
because of immunosuppressive therapy with
cyclosporine (Neoral).
Nurse Emma is caring for a 60-year-old patient
diagnosed with pyelonephritis and suspected
septicemia. The patient has had recurrent UTIs, is
sleep-deprived, and has lost weight due to frequent
urination, including at night. The patient's lab results
indicate sodium levels of 154 mEq/L, osmolarity at
340 mOsm/L, glucose at 127 mg/dl, and potassium
at 3.9 mEq/L. What is the priority nursing diagnosis
for this patient?
A. Fluid Volume Deficit related to the inability to
conserve water.
B. Fluid Volume Deficit related to osmotic diuresis
triggered by hyponatremia.
C. Altered Nutrition: Less Than Body Requirements
related to a hypermetabolic state.
D. Altered Nutrition: Less Than Body Requirements
related to the catabolic effects of insulin deficiency.
Nurse Brian is reviewing the medical history of
several patients admitted to the general medical
floor. Based on their profiles, which patient is at the
greatest risk for developing a urinary tract infection
(UTI)?
A. A 28-year-old individual diagnosed with angina.
B. A 35-year-old woman who has a fractured wrist.
C. A 50-year-old postmenopausal woman.
D. A 20-year-old woman diagnosed with asthma.
Nurse Olivia is conducting an educational session on
the early signs of kidney disease for a group of
nursing students. She poses a question: What is the
most frequently observed early sign of kidney
disease?
A. Elevated blood pressure.
B. Proteinuria.
C. Blood in the urine.
D. Excessive thirst and hunger.
ACUTE RENAL FAILURE
Nurse Ethan is advising a patient suffering from
chronic renal failure on the importance of keeping
track of weight changes. He wants to make sure the
patient knows when it's essential to report any
weight changes to the doctor. Which of the
following scenarios should he highlight as a crucial
one for notifying the physician?
A. A weight decrease of 2 pounds within a span of 5
days.
B. A weight increase of 2 pounds over a 2-day
duration.
C. An increase of 5 pounds within a short period of
2 days.
D. A reduction of 5 pounds over a 5-day period.
In a health class, Nurse Amelia is teaching about the
kidney's role in water balance. She challenges her
students with a question, "Could you tell me
approximately how much water healthy kidneys
typically excrete in a day?"
A. 3-4 liters of water.
B. 5-6 liters of water.
C. 1-2 liters of water.
D. 7-8 liters of water.
Nurse Williams is educating her patient about
kidney functions as part of a wellness check-up. She
mentions the kidneys' role in managing salt levels in
the body. On average, how much salt do healthy
kidneys eliminate each day?
A. 3-4 grams
B. 6-8 grams
C. 1-2 milligrams
D. 5 grams
Nurse Andrew is presenting a lecture on urinary
system health to his patients. One topic of interest
is the acidity of urine. He poses the following
question to his audience, "What is the typical acidity
level of urine?"
A. Extremely acidic, with a pH below 3.
B. Alkaline, with a pH greater than 7.
C. Neutral, with a pH of around 7.
D. Slightly acidic, with a pH range of 6-7.
During a meeting with her team, Nurse Samantha
discusses a case of a patient with suspected fluid
volume imbalance and potential malnutrition. She
asks her team, "Does an increase or decrease in the
Blood Urea Nitrogen (BUN) to Creatinine ratio signal
issues such as fluid volume excess or malnutrition?"
A. Increase
B. Decrease
Nurse Benjamin is explaining to a group of nursing
students about a type of renal failure characterized
by a gradual, stealthy process of kidney destruction,
often remaining unnoticed for years while nephrons
are damaged and the renal mass decreases. Is he
discussing:
A. Chronic renal failure
B. Acute renal failure
Nurse Jacob is explaining to a group of nursing
students about a therapeutic process for renal
failure. This process entails the continuous
circulation of blood, either from artery to vein or
vein to vein, wherein excess water and solutes are
filtered out and directed into a collection device. As
necessary, fluid can be supplemented with a
balanced electrolyte solution during the treatment.
What is the term for this procedure?
A. Continuous Ambulatory Peritoneal Dialysis
(CAPD)
B. Continuous Renal Replacement Therapy (CRRT)
C. Continuous Cyclic Peritoneal Dialysis (CCPD)
D. Hemodialysis (HD)
During a lively discussion at the University Hospital
nursing station, Nurse Davis ponders on a
physiology-related query. She asks, "On an average
day, how much potassium chloride (KCL) do healthy
kidneys manage to eliminate?"
A. 1 gram
B. 6 to 8 milligrams
C. 6 to 8 grams
D. 3 milligrams
Nurse Elizabeth is advising a patient with renal
failure on dietary modifications. Keeping in mind the
condition of the patient's kidneys, which kind of diet
should she recommend?
A. High protein, high carbohydrate, low calorie.
B. Sufficient calories, high carbohydrate, restricted
protein.
C. Restricted protein, low carbohydrate, sufficient
calories.
D. Low calorie, restricted protein, low carbohydrate.
At Springfield Clinic, Nurse Johnson is overseeing a
patient who's been prescribed continuous
ambulatory peritoneal dialysis (CAPD). She
questions, "In the context of CAPD, after how many
hours does the patient need to empty their
peritoneal cavity and refresh the dialysate?"
A. 4-6 hours
B. 24 hours
C. 6-8 hours
D. 48 hours
In the midst of her bustling shift, Nurse Madison has
to administer medication to a patient who is going
to have their serum creatinine levels tested. She has
to ensure that the medication she gives will not
tamper with either the secretion of creatinine or the
assay used to gauge its serum concentration. Which
medication can she safely administer from the
following options?
A. An antibiotic frequently used, Cefoxitin.
B. A medication often utilized in combination with
others to fight bacterial infections, Trimethoprim.
C. The commonly used pain reliever and anti-
inflammatory, Ibuprofen.
D. The medication famously known as a stomach
acid reducer, Cimetidine.
Nurse Julia is taking care of a male patient who is in
the oliguric phase of acute renal failure (ARF).
Among her nursing interventions, which one should
she prioritize the most?
A. Restricting fluid intake.
B. Encouraging consumption of carbohydrates.
C. Promoting coughing and deep breathing
exercises.
D. Implementing measures to relieve pain.
Nurse Matthew is reviewing the medical history of a
new patient, noticing a past infection caused by
group A beta-hemolytic streptococci. He's aware of
the potential renal complications associated with
this type of infection. He asks a colleague, "Can you
remind me which renal disorder is often linked with
a history of infection by group A beta-hemolytic
streptococci?"
A. Acute glomerulonephritis
B. Chronic renal failure
C. Acute renal failure
D. Nephrotic syndrome
Nurse James is providing education to his patient,
Mr. Thompson, who has recently been diagnosed
with kidney disease. James is explaining the
potential complications of the disease, specifically
serious electrolyte imbalances. He asks Mr.
Thompson, "Can you recall which electrolyte
disorder I mentioned as being particularly severe in
connection with kidney disease?"
A. Hyperkalemia
B. Hyponatremia
C. Metabolic acidosis
D. Hypermagnesemia
Nurse Parker is instructing her nursing students
about various factors that can cause damage to
kidney tissue. She asks her students if they can
recall the name of these damaging agents. Which
term is she referring to?
A. Nephrons
B. Nephrotoxins
C. Enterotoxic Agents
D. Immune Response Elements
At City Cross Hospital, Nurse Mitchell is evaluating a
patient suspected of producing dilute urine. She
considers, "Which tests and their corresponding
results can confirm the presence of dilute urine?"
A. Glomerular Filtration Rate (GFR) of (100 ml/min),
and/or Specific Gravity (1.030).
B. Consistent Specific Gravity (1.010), and/or
constant osmolality (300 mOsm/l).
C. Increased urine osmolality (>300 mOsm/l) and
high urine specific gravity (>1.010).
D. Serum Creatinine level of (1.5 mg/dl).
Nurse Aiden is preparing to educate a group of
student nurses about renal failure. He wants to
highlight a type of renal failure that is characterized
by a sudden and sharp deterioration in kidney
function. Which type of renal failure is he referring
to?
A. Chronic Renal Failure
B. Acute Renal Failure
Nurse Isabel is caring for a patient with chronic renal
failure. The patient's kidneys now possess too few
nephrons to efficiently excrete metabolic waste and
manage fluid and electrolyte balance. This advanced
stage of chronic renal failure is referred to as what?
A. Acute tubular necrosis
B. Dialysis stage
C. End-stage renal disease (ESRD)
D. Renal insufficiency
Nurse Thomas is educating a patient who has
recently undergone a kidney transplant. He wants to
ensure that the patient is aware of the signs and
symptoms of acute kidney rejection. Which of the
following symptoms should he advise the patient to
watch out for?
A. Severe low blood pressure and weight loss.
B. Fever and discomfort at the transplant site.
C. Rapid heart rate and headaches.
D. Recurring urinary tract infections and oral yeast
infections.
Nurse Mia is conducting a teaching session about
the renal system for her junior colleagues. She's
explaining the complex mechanism by which the
kidneys regulate sodium (Na+) and potassium (K+)
levels. Which option best captures the process Mia
is describing?
A. The kidneys trigger the release of aldosterone,
which in turn controls renin. Renin then initiates the
release of angiotensin, which governs Na+ and K+
levels.
B. The kidneys incite the release of renin, which
governs angiotensin. The angiotensin then
influences aldosterone, which in turn regulates the
levels of Na+ and K+.
C. The kidneys stimulate the release of renin, which
manages K+. They also release angiotensin,
prompting the secretion of Na+.
Nurse Liam was conducting a health teaching
session for patients at risk of kidney disease. He
explained how some initial signs could be subtle and
easily overlooked. One of the potential early
indicators was a decrease in the ability to
concentrate, alongside alterations in urine
concentration and volume. He then posed a
question to his audience, "Is it accurate to say that
early signs of kidney disease often include a reduced
ability in the concentration and dilution of urine?"
A. True
B. False
In a busy morning shift, Nurse Wilson finds himself
managing a patient exhibiting symptoms such as
fluid volume excess, edema due to salt and water
retention, hypertension, Azotemia, hyperkalemia,
muscle weakness, nausea, diarrhea, and high serum
creatinine and BUN levels. As he analyzes the case,
he wonders which phase of Acute Renal Failure his
patient could be in. Which phase is it?
A. Initiation Phase
B. Maintenance Phase
C. Recovery Phase
D. Intrarenal Phase
Nurse William is caring for a female patient who was
admitted with a diagnosis of acute renal failure. The
patient is conscious, aware, and complaining of
intense back pain, along with nausea, vomiting, and
abdominal discomfort. Her vital statistics are blood
pressure at 100/70 mm Hg, pulse rate at 110,
respiration rate at 30, and an oral temperature of
100.4°F (38°C). Her electrolyte results show sodium
levels at 120 mEq/L and potassium at 5.2 mEq/L,
and she has only produced 50 ml of urine over the
past 8 hours. What kind of electrolyte imbalance
does the patient's condition suggest?
A. Hyperphosphatemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Nurse Mason is sharing an example with his
students about a particular type of renal failure. He
explains that this form of failure is brought about by
an obstruction in the flow of urine, potentially due
to an enlarged prostate or a tumor blocking the
urethra, or even by calculi obstructing the ureter or
kidney pelvis. Can the students identify the type of
renal failure he is describing?
A. Intrarenal Failure
B. Postrenal Failure
C. Perirenal Failure
D. Prerenal Failure
During her shift, Nurse Lily is closely monitoring the
urine output of her patients. She needs to recognize
if the urine output drops below a certain threshold,
which is considered the minimum normal output
per hour. What is this value?
A. 35 ml/hr
B. 40 ml/hr
C. 45 ml/hr
D. 30 ml/hr
During her regular shift at the hospital, Nurse
Stevens reviews lab results for her patients. She's
analyzing the Blood Urea Nitrogen (BUN) values as
part of her assessments. What is considered a
typical range for BUN levels?
A. 250-500 milligrams per deciliter.
B. 40-70 milligrams per deciliter.
C. 5-20 milligrams per deciliter.
D. 0.5-1.1 milligrams per deciliter.
Nurse Sara has been given the responsibility of
caring for a patient who has just been transferred to
her unit after undergoing a left nephrectomy. Sara
knows she needs to prioritize certain aspects of care
for her patient's well-being. She considers, "What
would be my topmost priority in providing care for
my patient following a left nephrectomy?"
A. Regularly checking the patient's temperature.
B. Making sure the patient is able to turn from side
to side.
C. Ensuring the patient is able to sip clear liquids.
D. Monitoring the patient's urine output on an
hourly basis.
Nurse Collins is attending to a patient suffering from
acute renal failure. Suddenly, the patient's urinary
output spikes to 150 ml/hr, leading Nurse Collins to
deduce that the patient has transitioned into the
second phase of acute renal failure. During this
phase, what signs and symptoms should she be
vigilant about?
A. Insufficient fluid volume, erratic changes in
serum sodium and potassium levels.
B. Excessive fluid volume, high potassium levels, and
high sodium levels.
C. Excessive fluid volume, low potassium levels, and
high sodium levels.
D. Insufficient fluid volume, no significant changes in
serum sodium and potassium levels.
During a lecture to nursing students, Nurse
Annabelle is discussing the serious consequences of
kidney failure. She mentions that one particular
condition stands as the leading cause of death when
kidneys fail. Which condition is she referring to?
A. Low sodium levels (hyponatremia)
B. Elevated sodium levels (hypernatremia)
C. Elevated potassium levels (hyperkalemia)
D. Low potassium levels (hypokalemia)
While caring for a patient with advanced renal
disease at Riverside General Hospital, Nurse Bennett
ponders over the severity of end-stage renal disease
(ESRD). She questions, "What is the glomerular
filtration rate (GFR) threshold in milliliters per
minute that defines the occurrence of ESRD?"
A. Less than 10 ml.
B. Less than 15 ml.
C. Less than 5 ml.
D. Less than 25 ml.
During her shift at Evergreen Hospital, Nurse
Patterson encounters a patient with a suspected
buildup of toxins in their blood. She ponders, "What
is the medical term for the accumulation of toxins in
one's bloodstream?"
A. Urethrorrhea
B. Urethritis
C. Uremia
D. Urticaria
Nurse Ava is conducting a seminar on renal function
assessment for a group of trainee nurses. She poses
a question to them, "Can you tell me, which renal
function test is typically considered the most crucial
one in clinical practice?"
A. Blood Urea Nitrogen (BUN)
B. Osmolarity
C. Serum Creatinine
D. Glomerular Filtration Rate (GFR)
As Nurse Miranda is discussing potential
complications of hemodialysis with her team, she
highlights the most common issue they need to
anticipate. Which of these complications is typically
the most frequent during hemodialysis?
A. Infections
B. Hypertension
C. Hemorrhage
D. Dialysis-induced dementia
Nurse Hannah is teaching her patients about chronic
kidney disease. She explains the purpose of anti-
hypertensive therapy for those suffering from this
condition. What is the primary goal of this
treatment in the context of chronic renal disease?
A. To safeguard the cardiovascular system.
B. To provide dual protection for the renal and
cardiovascular systems.
C. None of the choices apply.
D. To shield the renal system.
Nurse Anna is educating a group of nursing students
about the common causes of end-stage renal
disease (ESRD). She poses a question to the group,
"What chronic condition is considered the primary
cause of ESRD among patients?"
A. Anemia
B. Long-term presence of Diabetes Mellitus.
C. History of prostate cancer.
D. Persistent low blood pressure.
In the tranquility of a home-care setting, Nurse
Wilson assists a patient undergoing peritoneal
dialysis. The patient remarks that the dialysate in
the collection bag appears cloudy. Nurse Wilson
considers, "What could be the potential explanation
for the cloudiness observed in the dialysate
collection bag?"
A. The patient might be suffering from an infection,
possibly peritonitis.
B. Medication has been added to the dialysate.
C. The patient requires a kidney transplant.
D. The patient needs to switch their dialysate.
Nurse Avery is attending to a female patient
suffering from end-stage renal disease (ESRD). The
patient expresses mixed feelings, stating she resents
being dependent on the dialysis machine, yet feels
relieved about starting dialysis as it will allow her to
consume whatever she wishes. Drawing from this
dialogue, which nursing diagnosis should Avery
identify for her patient?
A. Self-esteem disturbance stemming from
dependence on dialysis.
B. Anxiety related to the perceived threat to her
health status and role functioning.
C. A risk for imbalanced nutrition, leaning towards
an excess, due to an increased dietary intake.
D. Ineffective management of the therapeutic
regimen due to a lack of understanding about the
treatment plan.
After an intensive hemodialysis session at Sunshine
Care Dialysis Center, Nurse Gray finds her patient
writhing in discomfort. The patient laments a
throbbing headache, waves of nausea, and an
unshakeable restlessness. Prompted by these
symptoms, she considers, "What would be the most
suitable course of action to take under such
circumstances?"
A. Adjust the bed to elevate the patient's head.
B. Contact the attending physician promptly.
C. Administer anti-nausea medication to the patient.
D. Keep a close observation of the patient.
Nurse Jackson is assisting a patient advancing
speedily toward End-Stage Renal Disease (ESRD).
The patient, anxious about his condition, inquires
about the possibility of a kidney transplant.
Considering the potential contraindications, Nurse
Jackson knows that the patient's eligibility for a
kidney transplant might be compromised by:
A. Slight hearing loss.
B. Prior appendectomy.
C. Recent diagnosis of severe heart disease.
D. Uncomplicated past orthopedic surgery.
As Nurse Tristan attends to a male patient grappling
with acute renal failure, he knows to anticipate
specific treatments. In this case, he should expect
the use of hypertonic glucose, insulin infusions, and
sodium bicarbonate to alleviate which of the
following conditions?
A. An abnormally high level of calcium in the blood,
known as Hypercalcemia.
B. An overly high sodium level in the blood, termed
Hypernatremia.
C. A deficiency of potassium in the blood, referred
to as Hypokalemia.
D. An excessive level of potassium in the blood,
otherwise known as Hyperkalemia.
Nurse Jane was assisting a patient who had been
recently diagnosed with acute renal failure. The
patient, having done some research, wanted to
understand the complications associated with his
condition better. He asked Jane, "What is the most
significant complication that I should be aware of as
someone suffering from acute renal failure?"
A. Severe Constipation
B. Occurrence of Infections
C. Dysfunction of Platelets
D. Development of Anemia
In the hospital's renal unit, Nurse Robert has been
caring for Marina, a patient with acute renal failure.
After a week of treatment, Marina transitions into
the diuretic phase. Robert knows this stage requires
vigilant monitoring for certain conditions. He
discusses with a junior nurse, "What potential
condition should we carefully watch for during
Marina's diuretic phase?"
A. An imbalance of the body's pH due to excessive
acid.
B. Further progression of kidney failure.
C. High levels of potassium in the blood.
D. Low volume of circulating body fluids.
During a health education session, Nurse Emily is
explaining to her patient about the composition of
urine. She poses a question to her patient, "Can you
tell me which component forms the majority of
urine's composition?"
A. Water
B. Urea, a waste product from protein metabolism.
C. Potassium chloride
D. Sodium chloride, commonly known as salt.
During a seminar at Central City Hospital, Nurse
Baker learns about the severity of end-stage renal
disease. She recalls, "What is the threshold
glomerular filtration rate (GFR) - in ml/min per
1.73m2 - that defines end-stage renal disease?"
A. Less than 10.
B. Less than 15.
C. Less than 45.
D. Less than 30.
While caring for a patient with acute renal failure at
Harmony Medical Center, Nurse Anderson reviews
the various phases of the condition. She recalls,
"During which phase of acute renal failure does
oliguria occur, rendering the kidneys unable to
effectively remove metabolic wastes, water,
electrolytes, and acids?"
A. Initiation phase
B. Recycle phase
C. Maintenance phase
D. Recovery phase
Nurse Samantha was deep in conversation with a
colleague about one of her patients. The patient, a
middle-aged man, had been exhibiting signs of
lethargy, confusion, anorexia, and nausea.
As Samantha listed out the patient's symptoms, she
highlighted that these conditions are often
associated with the metabolic disruptions brought
on by a certain medical state. She asked her
colleague, "What's the medical term we use when
these metabolic impairments, including
Hyperkalemia, Acidosis, Hyperlipidemia,
Hyperuricemia, and malnutrition, come into play?"
A. Development of Oliguria.
B. Uremic Syndrome.
C. Exposure to Nephrotoxic Agents.
D. Presence of Hematuria.
Nurse Olivia is attending to a patient who has
recently undergone a renal biopsy. Among her post-
procedure care actions, which one should she
ideally refrain from doing?
A. Helping the patient walk around the room and
hallway for brief periods.
B. Urging the patient to consume at least 3 liters of
fluids in the first 24 hours.
C. Checking successive urine samples for hidden
blood using dipsticks.
D. Giving narcotics for pain management as
required.
Working in the renal unit, Nurse David often has to
explain complex kidney functions to his patients. He
is currently discussing with a patient, Mrs. Lewis, the
significance of assessing her kidney's filtration
capabilities. David wants Mrs. Lewis to understand
which test is most often monitored to evaluate
glomerular filtration rate and overall kidney
function. He asks her, "Mrs. Lewis, can you recall
which diagnostic test we use to keep track of your
kidneys' filtration performance and overall health?"
A. Sampling of kidney tissue for examination.
B. Test measuring the creatinine clearance.
C. Blood test for serum creatinine and blood urea
nitrogen (BUN).
D. Analysis of urine components.
Nurse Olivia, with her years of expertise, is vigilantly
attending to a female patient who is experiencing
her inaugural session of dialysis due to acute renal
failure. Olivia knows that she must keep a close eye
out for dialysis equilibrium syndrome, a
complication that often occurs during the initial
dialysis treatments. If this syndrome manifests,
what signs and symptoms can Olivia expect to
observe in her patient?
A. Patient report sudden bone pain and display signs
of confusion.
B. Patient show signs of confusion, complain of a
headache, or even experience seizures.
C. Patient exhibit weakness, express feelings of
tingling, and develop abnormal heart rhythms.
D. A drop in blood pressure, a rapid heart rate, and
rapid breathing.
A week into treating a patient with acute renal
failure, Nurse Alex notices that the patient has
transitioned into the diuretic phase. As he continues
to provide care, which condition should he be
particularly watchful for during this phase?
A. Metabolic acidosis
B. Progression to chronic renal failure.
C. Fluid volume deficit.
D. Elevated potassium levels.
While caring for a patient with compromised kidney
function at Serenity Medical Center, Nurse
Thompson reflects on her pharmacology knowledge.
She considers, "Which among these medications is
known to be potentially harmful to the kidneys,
exhibiting nephrotoxic properties?"
A. Diuretics
B. Nonsteroidal anti-inflammatory drugs (NSAIDs)
C. Angiotensin-converting enzyme (ACE) inhibitors
D. Sodium bicarbonate or Potassium bicarbonate
Nurse Benjamin is conducting a workshop on
Chronic Kidney Disease (CKD) for a team of
healthcare professionals. He asks the team,
"According to the Kidney Disease Outcomes Quality
Initiative (K/DOQI), CKD is defined as evidence of
structural or functional kidney abnormalities,
demonstrated by abnormal urinalysis, imaging
studies, or histology, that persist for at least how
many months, irrespective of whether the
Glomerular Filtration Rate is decreased?"
A. 3 months
B. 1 month
C. 6 months
D. 2 months
Nurse Liam is examining the latest lab results for a
patient with acute renal failure. As he pores over
the data, one particular result grabs his attention,
prompting him to immediately report it to the
physician. Which result is he most likely concerned
about?
A. Serum potassium concentration at 6 mEq/L.
B. Hemoglobin level of 10.3 mg/dl.
C. Blood urea nitrogen (BUN) at 50 mg/dl.
D. Venous blood pH at 7.30
While conducting a urinalysis at Heartland Regional
Medical Center, Nurse Benson comes across a
quandary concerning the standard components of
urine. She muses, "Which of the following
substances is typically not detected in urine?"
A. Proteins
B. Urea
C. Ammonia
D. Sodium
In the renal unit, Nurse Sarah is meticulously
examining the lab results of a patient with acute
renal failure. She realizes that one particular result
needs immediate reporting to the physician. She
discusses with a fellow nurse, "Among these results,
which one do you think should be flagged to the
doctor right away?"
A. Hemoglobin concentration measured at 10.3
mg/dl.
B. Potassium level in the blood at 6 mEq/L.
C. Blood urea nitrogen reading at 50 mg/dl.
D. Acidity of the venous blood with a pH of 7.30.
Nurse Victoria is working with a patient whose
kidneys are struggling to regulate fluid and
electrolyte balance and to eliminate metabolic
waste products effectively. Given these conditions,
what should the approach be towards the patient's
fluid and sodium intake?
A. It should be restricted.
B. It should be mixed.
C. It should be encouraged.
D. It should be compensated.
Nurse Lisa is caring for a patient in acute renal
failure who has been identified as a suitable
candidate for continuous renal replacement therapy
(CRRT). Lisa is discussing with a medical student
about the primary reason for recommending CRRT.
She asks, "Could you tell me what's the most typical
indication for implementing CRRT in patients?"
A. Inflammation of the pericardium.
B. High levels of nitrogen waste in the blood.
C. Overabundance of fluid in the body.
D. Excessive levels of potassium in the blood.
At Meadowland General Hospital, Nurse Philips
admits a patient diagnosed with early stage chronic
renal failure. As she carries out her assessment, she
wonders, "Which of these symptoms is typically
associated with a patient in the early stages of
chronic renal failure?"
A. Reduced urine output, known as oliguria.
B. Increased thirst, known as polydipsia.
C. Complete cessation of urine output, known as
anuria.
D. Excessive urination, known as polyuria.
Nurse Michael was providing education to a group
of nursing students during their clinical rotation in
the nephrology unit. One of his patients had
recently suffered a sudden loss in kidney function
due to a combination of severe hypertension,
exposure to harmful substances, and muscle tissue
breakdown from a heatstroke. He asked his
students, "This patient's condition involves acute
damage to renal tissue and nephrons, as well as
acute tubular necrosis, leading to a drastic drop in
tubular and glomerular function. What type of renal
failure are we dealing with here?"
A. Prerenal Failure
B. Perirenal Failure
C. Intrarenal Failure
D. Postrenal Failure
As Nurse John is discussing urinary composition with
his fellow healthcare workers, he poses a true-or-
false question to stimulate discussion, "Are we to
believe that the presence of creatinine, phosphate,
sulfates, and uric acid in urine is abnormal and
indicative of renal failure?"
A. False
B. True
As part of her daily rounds, Nurse Ava is discussing
with her patient, Mr. Johnson, about the
significance of electrolytes in the body and how
some of them are excreted via urine. She wants to
educate him about the specific electrolytes typically
found in urine. She asks him, "Mr. Johnson, do you
remember which electrolytes we discussed are
typically present in urine?"
A. All mentioned options.
B. Chloride ions
C. Bicarbonate ions
D. Sodium ions
Nurse Mark is caring for a patient, Mr. Brown, who
is showing signs of renal dysfunction due to
decreased blood flow to his kidneys from heart
failure. Mark explains to Mr. Brown that there are
different types of renal failure and the one he is
most likely suffering from is due to an impaired
supply of blood to the kidney, which can result from
fluid volume deficit, hemorrhage, heart failure, or
shock. Mark asks Mr. Brown, "Can you recall the
type of renal failure we talked about that occurs due
to an impaired blood supply to the kidneys?"
A. Postrenal
B. Intrarenal
C. Prerenal
D. Perirenal
As a newly graduated Registered Nurse, you are
tasked with the care of a patient suffering from
acute renal failure and hypernatremia. The charge
nurse instructs you to delegate some tasks to the
nursing assistant on your team. You ponder, "Which
of these patient care activities can I safely delegate
to the nursing assistant?"
A. Administering 0.45% saline via the patient's IV
line.
B. Observing for signs of dehydration in the patient.
C. Tracking the patient's daily weight for trends.
D. Providing oral care to the patient every 3-4
hours.
In a teaching session, Nurse Laura is explaining to
her fellow nurses about certain renal conditions that
can arise due to a combination of ischemia and
exposure to nephrotoxins. She quizzes her
colleagues, "Which renal condition is most likely to
develop when a patient experiences both ischemia
and exposure to a nephrotoxin simultaneously?"
A. Infection of the urinary tract.
B. Acute Glomerulonephritis
C. Acute Tubular Necrosis Or Tubular Necrosis
D. Progressive loss of kidney function over time.
During a tutoring session, Nurse Jack is helping a
nursing student understand the body's fluid
regulation mechanisms. He asks her a question,
"Can you tell me which hormone plays a crucial role
in controlling the absorption of water in our body?"
A. Antidiuretic Hormone (Vasopressin)
B. Thyroxine
C. Prolactin
D. Melanin
KIDNEY STONES, BLADDER CANCER, PROSTATE
DISORDERS
A client underwent a TURP, and a large three way
catheter was inserted in the bladder with
continuous bladder irrigation. In which of the
following circumstances would the nurse increase
the flow rate of the continuous bladder irrigation?
A When the drainage is continuous but slow
B When the drainage appears cloudy and
dark yellow
C When there is no drainage of urine and
irrigating solution
D When the drainage becomes bright red
Which of the following assessment data would most
likely be related to a client’s current complaint of
stress incontinence?
A The client’s intake of 2 to 3 L of fluid per
day.
B The client’s history of competitive
swimming
C The client’s age of 45 years
D The client’s history of three full-term
pregnancies
The client is admitted to the ER following a MVA.
The client was wearing a lap seat belt when the
accident occurred. The client has hematuria and
lower abdominal pain. To determine further
whether the pain is due to bladder trauma, the
nurse asks the client if the pain is referred to which
of the following areas?
A Umbilicus
B Costovertebral angle
C Hip
D Shoulder
A client is receiving a radiation implant for the
treatment of bladder cancer. Which of the following
interventions is appropriate?
A Restrict the client’s fluid intake
B Monitor the client for signs and
symptoms of cystitis
C Place the client in a semi-private room
D Flush all urine down the toilet
A week after kidney transplantation the client
develops a temperature of 101, the blood pressure
is elevated, and the kidney is tender. The x-ray
results the transplanted kidney is enlarged. Based
on these assessment findings, the nurse would
suspect which of the following?
A Kidney obstruction
B Chronic rejection
C Kidney infection
D Acute rejection

The client complains of fever, perineal pain, and
urinary urgency, frequency, and dysuria. To assess
whether the client’s problem is related to bacterial
prostatitis, the nurse would look at the results of
the prostate examination, which should reveal that
the prostate gland is:
A Soft and swollen
B Tender, indurated, and warm to the
touch
C Tender and edematous with ecchymosis
D Reddened, swollen, and boggy.
The client passes a urinary stone, and lab analysis of
the stone indicates that it is composed of calcium
oxalate. Based on this analysis, which of the
following would the nurse specifically include in the
dietary instructions?
A Avoid green, leafy vegetables such as
spinach.
B Increase intake of dairy products.
C Increase intake of meat, fish, plums, and
cranberries
D Avoid citrus fruits and citrus juices
The client is admitted to the hospital with BPH, and
a transurethral resection of the prostate is
performed. Four hours after surgery the nurse takes
the client’s VS and empties the urinary drainage
bag. Which of the following assessment findings
would indicate the need to notify the physician?
A Red bloody urine
B Blood pressure of 100/50 and pulse 130.
C Urinary output of 200 ml greater than
intake
D Pain related to bladder spasms.
A 72-year old male client is brought to the
emergency room by his son. The client is extremely
uncomfortable and has been unable to void for the
past 12 hours. He has known for some time that he
has an enlarged prostate but has wanted to avoid
surgery. The best method for the nurse to use when
assessing for bladder distention in a male client is to
check for:
A Rebound tenderness below the symphysis
B Urine discharge from the urethral meatus
C Dullness in the lower left quadrant
D A rounded swelling above the pubis
A 27-year old client, who became paraplegic after a
swimming accident, is experiencing autonomic
dysreflexia. Which condition is the most common
cause of autonomic dysrelexia?
A Bladder distention
B Incontinence
C Diarrhea
D Upper respiratory infection
A client who has been diagnosed with bladder
cancer is scheduled for an ileal conduit.
Preoperatively, the nurse reinforces the client’s
understanding of the surgical procedure by
explaining that an ileal conduit:
A Is a temporary procedure that can be
reversed later.
B Conveys urine from the ureters to a
stoma opening in the abdomen.
C Creates an opening in the bladder that
allows urine to drain into an external pouch.
D Diverts urine into the sigmoid colon,
where it is expelled through the rectum.
The nurse is caring for a client following a kidney
transplant. The client develops oliguria. Which of
the following would the nurse anticipate to be
prescribed as the treatment of oliguria?
A Irrigation of foley catheter
B Encourage fluid intake
C Administration of diuretics
D Restricting fluids
Which of the following symptoms indicate acute
rejection of a transplanted kidney?
A Edema, nausea
B Increased WBC count, pain with voiding
C Weight gain, pain at graft site
D Fever, anorexia
Adverse reactions of prednisone therapy include
which of the following conditions?
A Acne and bleeding gums
B Sodium retention and constipation
C Increased blood glucose levels and
decreased wound healing.
D Mood swings and increased temperature
The client is to undergo kidney transplantation with
a living donor. Which of the following preoperative
assessments is important?
A Signs and symptoms of rejection
B Signs of graft rejection
C Urine output
D Client’s support system and
understanding of lifestyle changes
When teaching the client to care for an ileal conduit,
the nurse instructs the client to empty the appliance
frequently, primarily to prevent which of the
following problems?
A Separation of the appliance from the skin
B Rupture of the ileal conduit
C Interruption of urine production
D Development of odor
The nurse is assessing the urine of a client who has
had an ileal conduit and notes that the urine is
yellow with a moderate amount of mucus. Based on
the assessment data, which of the following nursing
interventions would be most appropriate at this
time?
A Encourage a high fluid intake
B Change the appliance bag
C Obtain a urine specimen for culture
D Notify the physician
A client has a ureteral catheter in place after renal
surgery. A priority nursing action for care of the
ureteral catheter would be to:
A Irrigate the catheter with 30 ml of normal
saline every 8 hours
B Ensure that the catheter is draining freely
C Ensure that the catheter drains at least 30
ml an hour
D Clamp the catheter every 2 hours for 30
minutes
A client has passed a renal calculus. The nurse sends
the specimen to the laboratory so it can be analyzed
for which of the following factors?
A Type of infection
B Size and number of calculi
C Composition of calculus
D Antibodies
The client has a clinic appointment scheduled 10
days after discharge. Which laboratory finding at
that time would indicate that allopurinol (Zyloprim)
has had a therapeutic effect?
A Increased urinary calcium excretion
B Decreased serum uric acid level
C Increased serum calcium level
D Decreased urinary alkaline phosphatase
level
After surgery for an ileal conduit, the nurse should
closely evaluate the client for the occurrence of
which of the following complications related to
pelvic surgery?
A Inguinal hernia
B Ascites
C Thrombophlebitis
D Peritonitis
A client has just received a renal transplant and has
started cyclosporine therapy to prevent graft
rejection. Which of the following conditions is a
major complication of this drug therapy?
A Hemorrhage
B Depression
C Peptic ulcer disease
D Infection
A priority nursing diagnosis for the client who is
being discharged t home 3 days after a TURP would
be:
A Deficient fluid volume
B Impaired Tissue Integrity
C Imbalanced Nutrition: Less than Body
Requirements
D Ineffective Airway Clearance
The client with urolithiasis has a history of chronic
urinary tract infections. The nurse concludes that
this client most likely has which of the following
types of urinary stones?
A Cystine
B Calcium oxalate
C Uric acid
D Struvite
Mr. Roberto was readmitted to the hospital with
acute graft rejection. Which of the following
assessment finding would be expected?
A Hypotension
B Elevated BUN and Creatinine
C Decreased WBC
D Normal Body Temperature
A client is admitted with a diagnosis of
hydronephrosis secondary to calculi. The calculi
have been removed and postobstructive diuresis is
occurring. Which of the following interventions
should be done?
A Monitor the client’s electrolyte levels.
B Assess for urine output every shift
C Weigh the client every other day
D Take vital signs every 8 hours
The client with BPH undergoes a transurethral
resection of the prostate. Postoperatively, the client
is receiving continuous bladder irrigations. The
nurse assesses the client for signs of transurethral
resection syndrome. Which of the following
assessment data would indicate the onset of this
syndrome?
A Increased urinary output and anemia
B Tachycardia and diarrhea
C Decreased urinary output and bladder
spasms
D Bradycardia and confusion
The nurse is taking the history of a client who has
had benign prostatic hyperplasia in the past. To
determine whether the client currently is
experiencing difficulty, the nurse asks the client
about the presence of which of the following early
symptoms?
A Urge incontinence
B Urinary retention
C Decreased force in the stream of urine
D Nocturia
The nurse suspects that a client with polyuria is
experiencing water diuresis. Which laboratory value
suggests water diuresis?
A Normal to low urine specific gravity
B High urine specific gravity
C High urine osmolarity
D Elevated urine Ph
A client who has been diagnosed with calculi reports
that the pain is intermittent and less colicky. Which
of the following nursing actions is most important at
this time?
A Apply warm compresses to the flank area
B Strain the urine carefully
C Administer meperidine (Demerol) every 3
hours
D Report hematuria to the physician
A client with BPH is being treated with terazosin
(Hytrin) 2mg at bedtime. The nurse should monitor
the client’s:
A Urinary nitrites
B Blood pressure
C White blood cell count
D Pulse
The client with an ileal conduit will be using a
reusable appliance at home. The nurse should teach
the client to clean the appliance routinely with what
product?
A Soap
B Baking soda
C Hydrogen peroxide
D Alcohol
Which of the following symptoms is the most
common clinical finding associated with bladder
cancer?
A Dysuria
B Urinary retention
C Painless hematuria
D Suprapubic pain
The nurse is developing a teaching plan for a client
with stress incontinence. Which of the following
instructions should be included?
A Do not wear a girdle
B Avoid activities that are stressful and
upsetting
C Avoid caffeine and alcohol
D Limit physical exertion
The nurse is preparing to care for the client
following a renal scan. Which of the following would
the nurse include in the plan of care?
A No special precautions except to wear
gloves if in contact with the client’s urine.
B Limit contact with the client to 20 minutes
per hour.
C Save all urine in a radiation safe container
for 18 hours
D Place the client on radiation precautions
for 18 hours
A client had a transurethral prostatectomy for
benign prostatic hypertrophy. He’s currently being
treated with a continuous bladder irrigation and is
complaining of an increase in severity of bladder
spasms. Which of the interventions should be done
first?
A Administer a belladonna and opium
suppository as ordered by the physician.
B Stop the irrigation and call the physician
C Check for the presence of clots, and make
sure the catheter is draining properly.
D Administer an oral analgesic
The nurse is receiving in transfer from the
postanesthesia care unit a client who has had a
percutaneous ultrasonic lithrotripsy for calculuses in
the renal pelvis. The nurse anticipates that the
client’s care will involve monitoring which of the
following?
A Suprapubic tube
B Nephrostomy tube
C Jackson-Pratt drain
D Urethral stent
The nurse is reviewing a medication history of a
client with BPH. Which medication should be
recognized as likely to aggravate BPH?
A Buspirone (BuSpar)
B Metformin (Glucophage)
C Inhaled ipratropium (Atrovent)
D Ophthalmic timolol (Timoptic)
Steroids, if used following kidney transplantation
would cause which of the following side effects?
A Alopecia
B Orthostatic Hypotension
C Increase Cholesterol Level
D Increase Blood Glucose Level
During a client’s urinary bladder catherization, the
bladder is emptied gradually. The best rationale for
the nurse’s action is that completely emptying an
overdistended bladder at one time tends to cause:
A Abdominal cramping
B Renal failure
C Possible shock
D Atrophy of bladder musculature
Because a client’s renal stone was found to be
composed to uric acid, a low-purine, alkaline-ash
diet was ordered. Incorporation of which of the
following food items into the home diet would
indicate that the client understands the necessary
diet modifications?
A Grapes, corn, cereals, and liver.
B Milk, apples, tomatoes, and corn
C Eggs, spinach, dried peas, and gravy.
D Salmon, chicken, caviar, and asparagus
Allopurinol (Zyloprim), 200 mg/day, is prescribed for
the client with renal calculi to take home. The nurse
should teach the client about which of the following
side effects of this medication?
A Retinopathy
B Dizziness
C Nasal congestion
D Maculopapular rash
The client returns to the nursing unit following a
pyelolithotomy for removal of a kidney stone. A
Penrose drain is in place. Which of the following
would the nurse include on the client’s
postoperative care?
A Frequent dressing changes around the
Penrose drain
B Weighing the dressings
C Sterile irrigation of the Penrose drain
D Maintaining the client’s position on the
affected side
A client is diagnosed with prostate cancer. Which
test is used to monitor progression of this disease?
A Complete blood cell count (CBC)
B Serum creatinine
C Prostate specific antigen (PSA)
D Serum potassium
The primary reason for taping an indwelling
catheter laterally to the thigh of a male client is to:
A Allow the client to turn without kinking
the catheter
B Prevent the catheter from kinking in the
urethra
C Prevent accidental catheter removal
D Eliminate pressure at the penoscrotal
angle
A client has urge incontinence. Which of the
following signs and symptoms would the nurse
expect to find in this client?
A Frequent dribbling of urine
B Inability to empty the bladder
C Loss of urine when coughing
D Involuntary urination with minimal
warning
The primary function of the prostate gland is:
A To secrete a hormone that stimulates the
production and maturation of sperm
B To produce a secretion that aids in the
nourishment and passage of sperm
C To regulate the acidity and alkalinity of the
environment for proper sperm development.
D To store underdeveloped sperm before
ejaculation
When providing discharge teaching for a client with
uric acid calculi, the nurse should an instruction to
avoid which type of diet?
A High-purine
B Low-calcium
C High-oxalate
D Low-oxalate
The nurse teaches the client with a urinary diversion
to attach the appliance to a standard urine
collection bag at night. The most important reason
for doing this is to prevent:
A The need to restrict fluids
B Urine leakage
C Appliance separation
D Urine reflux into the stoma
When developing a plan of care for the client with
stress incontinence, the nurse should take into
consideration that stress incontinence is best
defined as the involuntary loss of urine associated
with:
A Activities that increase abdominal
pressure
B Overdistention of the bladder
C A strong urge to urinate
D Obstruction of the urethra
A client received a kidney transplant 2 months ago.
He’s admitted to the hospital with the diagnosis of
acute rejection. Which of the following assessment
findings would be expected?
A Elevated BUN and creatinine levels
B Decreased WBC count
C Normal body temperature
D Hypotension
A client is scheduled to undergo a transurethral
resection of the prostate gland (TURP). The
procedure is to be done under spinal anesthesia.
Postoperatively, the nurse should be particularly
alert for early signs of:
A Respiratory paralysis
B Renal shutdown
C Cardiac arrest
D Convulsions
The nurse is conducting a postoperative assessment
of a client on the first day after renal surgery. Which
of the following findings would be most important
for the nurse to report to the physician?
A Temperature, 99.8
B A 2×2 inch area of serous sanguineous
drainage on the flank dressing.
C Absence of bowel sounds
D Urine output, 20 ml/hour
A client is complaining of severe flank and
abdominal pain. A flat plate of the abdomen shows
urolithiasis. Which of the following interventions is
important?
A Encourage a high calcium diet
B Enforce strict bed rest
C Limit fluid intake
D Strain all urine
A female client with a urinary diversion tells the
nurse, “This urinary pouch is embarrassing.
Everyone will know that I’m not normal. I don’t see
how I can go out in public anymore.” The most
appropriate nursing diagnosis for this patient is:
A Deficient Knowledge about how to care
for the urinary diversion.
B Disturbed Body Image related to creation
of a urinary diversion.
C Low Self-Esteem related to feelings of
worthlessness
D Anxiety related to the presence of urinary
diversion.
The nurse is evaluating the discharge teaching for a
client who has an ileal conduit. Which of the
following statements indicates that the client has
correctly understood the teaching? Select all that
apply.
A “I can usually keep my ostomy pouch on
for 3 to 7 days before changing it.”
B “I should empty my ostomy pouch of urine
when it is full.”
C “If I limit my fluid intake I will not have to
empty my ostomy pouch as often.”
D “I can place an aspirin tablet in my pouch
to decrease odor.”
E “I must use a skin barrier to protect my
skin from urine.”
Which of the following interventions would be most
appropriate for preventing the development of a
paralytic ileus in a client who has undergone renal
surgery?
A Encourage the client to ambulate every 2
to 4 hours
B Offer 3 to 4 ounces of a carbonated
beverage periodically.
C Encourage use of a stool softener
D Continue intravenous fluid therapy
If a client’s prostate enlargement is caused by a
malignancy, which of the following blood
examinations should the nurse anticipate to assess
whether metastasis has occurred?
A Endogenous creatinine clearance time
B Serum creatinine level
C Total nonprotein nitrogen level
D Serum acid phosphatase level
The client who has a cold is seen in the emergency
room with inability to void. Because the client has a
history of BPH, the nurse determines that the client
should be questioned about the use of which of the
following medications?
A Antitussives
B Antibiotics
C Diuretics
D Decongestants
The nurse teaches the client with an ileal conduit
measures to prevent a UTI. Which of the following
measures would be most effective?
A Use sterile technique to change the
appliance
B Irrigate the stoma daily.
C Avoid people with respiratory tract
infections
D Maintain a daily fluid intake of 2,000 to
3,000 ml
RENAL FAILURE AND DIALYSIS
A client newly diagnosed with renal failure is
receiving peritoneal dialysis. During the infusion of
the dialysate the client complains of abdominal
pain. Which action by the nurse is most
appropriate?
A Slow the infusion
B Decrease the amount to be infused
C Stop the dialysis
D Explain that the pain will subside after
the first few exchanges
Which of the following nursing interventions should
be included in the client’s care plan during dialysis
therapy?
A Keep the client NPO.
B Limit the client’s visitors
C Pad the side rails of the bed
D Monitor the client’s blood pressure
The dialysis solution is warmed before use in
peritoneal dialysis primarily to:
A Add extra warmth into the body.
B Encourage the removal of serum urea.
C Promote abdominal muscle relaxation.
D Force potassium back into the cells
The client with an arteriovenous shunt in place for
hemodialysis is at risk for bleeding. The nurse would
do which of the following as a priority action to
prevent this complication from occurring?
A Ensure that small clamps are attached to
the AV shunt dressing.
B Check the results of the PT time as they
are ordered.
C Check the shunt for the presence of a
bruit and thrill
D Observe the site once per shift
Which of the following factors causes the nausea
associated with renal failure?
A Oliguria
B Accumulation of waste products
C Electrolyte imbalances
D Gastric ulcers
What is the primary disadvantage of using
peritoneal dialysis for long term management of
chronic renal failure?
A It cannot correct severe imbalances.
B It is a time consuming method of
treatment.
C The danger of hemorrhage is high.
D The risk of contacting hepatitis is high.
The main indicator of the need for hemodialysis is:
A Hypertension
B Acidosis
C Ascites
D Hyperkalemia
A nurse is assessing the patency of an arteriovenous
fistula in the left arm of a client who is receiving
hemodialysis for the treatment of chronic renal
failure. Which finding indicates that the fistula is
patent?
A Absence of bruit on auscultation of the
fistula.
B Capillary refill time less than 3 seconds in
the nail beds of the fingers on the left hand.
C Palpation of a thrill over the fistula
D Presence of a radial pulse in the left wrist
The nurse is instructing a client with diabetes
mellitus about peritoneal dialysis. The nurse tells
the client that it is important to maintain the dwell
time for the dialysis at the prescribed time because
of the risk of:
A Hyperglycemia
B Fluid overload
C Disequilibrium syndrome
D Infection
The client with chronic renal failure is at risk of
developing dementia related to excessive
absorption of aluminum. The nurse teaches that this
is the reason that the client is being prescribed
which of the following phosphate binding agents?
A Alu-cap (aluminum hydroxide)
B Tums (calcium carbonate)
C Amphojel (aluminum hydroxide)
D Basaljel (aluminum hydroxide)
The nurse is reviewing a list of components
contained in the peritoneal dialysis solution with the
client. The client asks the nurse about the purpose
of the glucose contained in the solution. The nurse
bases the response knowing that the glucose:
A Prevents disequilibrium syndrome
B Decreases risk of peritonitis.
C Prevents excess glucose from being
removed from the client.
D Increases osmotic pressure to produce
ultrafiltration
The nurse has completed client teaching with the
hemodialysis client about self-monitoring between
hemodialysis treatments. The nurse determines that
the client best understands the information given if
the client states to record the daily:
A Pulse and respiratory rate
B Activity log
C BUN and creatinine levels
D Intake, output, and weight
The client with acute renal failure has a serum
potassium level of 5.8 mEq/L. The nurse would plan
which of the following as a priority action?
A Check the sodium level
B Allow an extra 500 ml of fluid intake to
dilute the electrolyte concentration.
C Place the client on a cardiac monitor
D Encourage increased vegetables in the
diet
The nurse is assisting a client on a low-potassium
diet to select food items from the menu. Which of
the following food items, if selected by the client,
would indicate an understanding of this dietary
restriction?
A Strawberries
B Spinach
C Cantaloupe
D Lima beans
The nurse helps the client with chronic renal failure
develop a home diet plan with the goal of helping
the client maintain adequate nutritional intake.
Which of the following diets would be most
appropriate for a client with chronic renal failure?
A High calcium, high potassium, high protein
B High carbohydrate, high protein
C Low protein, high potassium
D Low protein, low sodium, low potassium
The client with chronic renal failure has an
indwelling catheter for peritoneal dialysis in the
abdomen. The client spills water on the catheter
dressing while bathing. The nurse should
immediately:
A Change the dressing
B Reinforce the dressing
C Flush the peritoneal dialysis catheter
D Scrub the catheter with providone-iodine
Dialysis allows for the exchange of particles across a
semipermeable membrane by which of the
following actions?
A Osmosis and diffusion
B Allowing the passage of blood cells and
protein molecules through it.
C Passage of fluid toward a solution with a
lower solute concentration
D Passage of solute particles toward a
solution with a higher concentration.
In planning teaching strategies for the client with
chronic renal failure, the nurse must keep in mind
the neurologic impact of uremia. Which teaching
strategy would be most appropriate?
A Conducting a one-on-one session with the
client.
B Validating frequently the client’s
understanding of the material.
C Providing all needed teaching in one
extended session.
D Using videotapes to reinforce the material
as needed
The client being hemodialyzed suddenly becomes
short of breath and complains of chest pain. The
client is tachycardic, pale, and anxious. The nurse
suspects air embolism. The nurse should:
A Discontinue dialysis and notify the
physician
B Continue the dialysis at a slower rate after
checking the lines for air
C Monitor vital signs every 15 minutes for
the next hour
D Bolus the client with 500 ml of normal
saline to break up the air embolism
The nurse assesses the client who has chronic renal
failure and notes the following: crackles in the lung
bases, elevated blood pressure, and weight gain of 2
pounds in one day. Based on these data, which of
the following nursing diagnoses is appropriate?
A Ineffective tissue perfusion related to
interrupted arterial blood flow.
B Ineffective therapeutic Regimen
Management related to lack of knowledge about
therapy.
C Excess fluid volume related to the
kidney’s inability to maintain fluid balance.
D Increased cardiac output related to fluid
overload
Aluminum hydroxide gel (Amphojel) is prescribed
for the client with chronic renal failure to take at
home. What is the purpose of giving this drug to a
client with chronic renal failure?
A To reverse metabolic acidosis.
B To prevent Curling’s stress ulcers
C To relieve the pain of gastric hyperacidity
D To bind phosphorus in the intestine
The nurse is monitoring a client receiving peritoneal
dialysis and nurse notes that a client’s outflow is less
than the inflow. Select actions that the nurse should
take.
A Check the peritoneal dialysis system for
kinks
B Reposition the client to his or her side.
C Check the level of the drainage bag
D Contact the physician
E Place the client in good body alignment
When caring for Mr. Roberto’s AV shunt on his right
arm, you should:
A Notify the physician if a bruit and thrill are
present
B Take the blood pressure on the right arm
instead
C Cover the entire cannula with an elastic
bandage
D User surgical aseptic technique when
giving shunt care
The nurse is preparing to care for a client receiving
peritoneal dialysis. Which of the following would be
included in the nursing plan of care to prevent the
major complication associated with peritoneal
dialysis?
A Change the catheter site dressing daily
B Monitor the clients level of consciousness
C Maintain strict aseptic technique
D Add heparin to the dialysate solution
In a client in renal failure, which assessment finding
may indicate hypocalcemia?
A Increased blood coagulation
B Headache
C Diarrhea
D Serum calcium level of 5 mEq/L
Which of the following clients is at greatest risk for
developing acute renal failure?
A A pregnant woman who has a fractured
femur
B A teenager who has an appendectomy
C A client with diabetes who has a heart
catherization
D A dialysis client who gets influenza
To gain access to the vein and artery, an AV shunt
was used for Mr. Roberto. The most serious
problem with regards to the AV shunt is:
A Clot formation
B Vessel sclerosis
C Septicemia
D Exsanguination
A client with chronic renal failure has asked to be
evaluated for a home continuous ambulatory
peritoneal dialysis (CAPD) program. The nurse
should explain that the major advantage of this
approach is that it:
A Is faster and more efficient than standard
peritoneal dialysis
B Has fewer potential complications than
standard peritoneal dialysis
C Allows the client to be more independent
D Is relatively low in cost
The nurse teaches the client with chronic renal
failure when to take the aluminum hydroxide gel.
Which of the following statements would indicate
that the client understands the teaching?
A “I’ll take it every 4 hours around the
clock.”
B “I’ll take it when I have a sour stomach.”
C “I’ll take it with meals and bedtime
snacks.”
D “I’ll take it between meals and at bedtime.
The client with chronic renal failure tells the nurse
he takes magnesium hydroxide (milk of magnesium)
at home for constipation. The nurse suggests that
the client switch to psyllium hydrophilic mucilloid
(Metamucil) because:
A MOM is high in sodium
B Metamucil is more palatable
C MOM can cause magnesium toxicity
D MOM is too harsh on the bowel
The client newly diagnosed with chronic renal
failure recently has begun hemodialysis. Knowing
that the client is at risk for disequilibrium syndrome,
the nurse assesses the client during dialysis for:
A Hypertension, tachycardia, and fever
B Headache, deteriorating level of
consciousness, and twitching.
C restlessness, irritability, and generalized
weakness
D Hypotension, bradycardia, and
hypothermia
A client has a history of chronic renal failure and
received hemodialysis treatments three times per
week through an arteriovenous (AV) fistula in the
left arm. Which of the following interventions is
included in this client’s plan of care?
A Take the blood pressure in the left arm
B Keep the AV fistula site dry.
C Keep the AV fistula wrapped in gauze.
D Assess the AV fistula for a bruit and thrill
The nurse is performing an assessment on a client
who has returned from the dialysis unit following
hemodialysis. The client is complaining of a
headache and nausea and is extremely restless.
Which of the following is the most appropriate
nursing action?
A Medicate the client for nausea
B Notify the physician
C Elevate the head of the bed
D Monitor the client
A client with chronic renal failure has completed a
hemodialysis treatment. The nurse would use which
of the following standard indicators to evaluate the
client’s status after dialysis?
A VS and BUN
B Potassium level and weight
C VS and weight.
D BUN and creatinine levels
Which of the following is the most significant sign of
peritoneal infection?
A Cloudy dialysate fluid
B Swelling in the legs
C Redness at the catheter insertion site
D Poor drainage of the dialysate fluid
During the client’s dialysis, the nurse observes that
the solution draining from the abdomen is
consistently blood tinged. The client has a
permanent peritoneal catheter in place. Which
interpretation of this observation would be correct?
A Bleeding can indicate kidney damage.
B Bleeding is caused by too-rapid infusion of
the dialysate.
C Bleeding is expected with a permanent
peritoneal catheter
D Bleeding indicates abdominal blood
vessel damage
A client is diagnosed with chronic renal failure and
told she must start hemodialysis. Client teaching
would include which of the following instructions?
A There will be a few changes in your
lifestyle.
B Follow a high potassium diet
C Strictly follow the hemodialysis schedule
D Use alcohol on the skin and clean it due to
integumentary changes.
The hemodialysis client with a left arm fistula is at
risk for steal syndrome. The nurse assesses this
client for which of the following clinical
manifestations?
A Aching pain, pallor, and edema in the left
arm.
B Pallor, diminished pulse, and pain in the
left hand.
C Warmth, redness, and pain in the left
hand.
D Edema and reddish discoloration of the
left arm
A client receiving hemodialysis treatment arrives at
the hospital with a blood pressure of 200/100, a
heart rate of 110, and a respiratory rate of 36.
Oxygen saturation on room air is 89%. He complains
of shortness of breath, and +2 pedal edema is
noted. His last hemodialysis treatment was
yesterday. Which of the following interventions
should be done first?
A Restrict the client’s fluids
B Prepare the client for hemodialysis.
C Administer oxygen
D Elevate the foot of the bed
A client is undergoing peritoneal dialysis. The
dialysate dwell time is completed, and the dwell
clamp is opened to allow the dialysate to drain. The
nurse notes that the drainage has stopped and only
500 ml has drained; the amount the dialysate
instilled was 1,500 ml. Which of the following
interventions would be done first?
A Call the physician.
B Clamp the catheter and instill more
dialysate at the next exchange time.
C Change the client’s position.
D Check the catheter for kinks or
obstruction.
The client with chronic renal failure who is
scheduled for hemodialysis this morning is due to
receive a daily dose of enalapril (Vasotec). The nurse
should plan to administer this medication:
A On return from dialysis
B The day after dialysis
C During dialysis
D Just before dialysis
A client is admitted to the hospital and has a
diagnosis of early stage chronic renal failure. Which
of the following would the nurse expect to note on
assessment of the client?
A Polyuria
B Polydipsia
C Oliguria
D Anuria
The client with chronic renal failure returns to the
nursing unit following a hemodialysis treatment. On
assessment the nurse notes that the client’s
temperature is 100.2. Which of the following is the
most appropriate nursing action?
A Continue to monitor vital signs
B Monitor the site of the shunt for infection
C Encourage fluids
D Notify the physician
The client asks whether her diet would change on
CAPD. Which of the following would be the nurse’s
best response?
A “Diet restrictions with CAPD are fewer
than with standard peritoneal dialysis because CAPD
works more quickly.”
B “Diet restrictions are more rigid with CAPD
because standard peritoneal dialysis is a more
effective technique.”
C “Diet restrictions are the same for both
CAPD and standard peritoneal dialysis.”
D “Diet restrictions with CAPD are fewer
than with standard peritoneal dialysis because
dialysis is constant.”
The nurse is caring for a hospitalized client who has
chronic renal failure. Which of the following nursing
diagnoses are most appropriate for this client?
Select all that apply.
A Imbalanced Nutrition; Less than Body
Requirements
B Excess Fluid Volume
C Impaired Gas Exchange
D Pain.
E Activity Intolerance
BURNS
1) The burned client on admission is drooling and
having difficulty swallowing. What is the nurse’s
best first action?
A. Assess level of consciousness and pupillary
reactions.
B. Ask the client at what time food or liquid
was last consumed.
C. Auscultate breath sounds over the
trachea and mainstem bronchi.
D. Measure abdominal girth and auscultate
bowel sounds in all four quadrants.
2) When should ambulation be initiated in the client
who has sustained a major burn?
A. When all full-thickness areas have been
closed with skin grafts
B. When the client’s temperature has
remained normal for 24 hours
C. As soon as possible after wound
debridement is complete
D. As soon as possible after resolution of the
fluid shift
3) Which information obtained by assessment
ensures that the client’s respiratory efforts are
currently adequate?
A. The client is able to talk.
B. The client is alert and oriented.
C. The client’s oxygen saturation is 97%.
D. The client’s chest movements are
uninhibited
4) A client with a solar burn of the chest, back, face,
and arms is seen in urgent care. The nurse’s primary
concern should be:
A. fluid resuscitation
B. infection
C. body image
D. pain management
5) Which vitamin deficiency is most likely to be a
long-term consequence of a full-thickness burn
injury?
A. Vitamin A
B. Vitamin B
C. Vitamin C
D. Vitamin D
6) In a female client with burns on the legs, which
nursing intervention helps prevent contractures?
A. Applying knee splints
B. Elevating the foot of the bed
C. Hyperextending the client’s palms
D. Performing shoulder range-of-motion
exercises
7) The client, who is 2 weeks postburn with a 40%
deep partial-thickness injury, still has open wounds.
On taking the morning vital signs, the client is found
to have a below-normal temperature, is
hypotensive, and has diarrhea. What is the nurse’s
best action?
A. Nothing, because the findings are normal
for clients during the acute phase of
recovery.
B. Increase the temperature in the room and
increase the IV infusion rate.
C. Assess the client’s airway and oxygen
saturation.
D. Notify the burn emergency team.
8) Which statement made by the client with facial
burns who has been prescribed to wear a facial
mask pressure garment indicates correct
understanding of the purpose of this treatment?
A. “After this treatment, my ears will not
stick out.”
B. “The mask will help protect my skin from
sun damage.”
C. “Using this mask will prevent scars from
being permanent.”
D. “My facial scars should be less severe
with the use of this mask.”
9) A female client with second- and third-degree
burns on the arms receives autografts. Two days
later, the nurse finds the client doing arm exercises.
The nurse knows that this client should avoid
exercise because it may:
A. dislodge the autografts.
B. increase edema in the arms.
C. increase the amount of scarring.
D. decrease circulation to the fingers.
10) A client is admitted to the hospital following a
burn injury to the left hand and arm. The client’s
burn is described as white and leathery with no
blisters. Which degree of severity is this burn?
A. first-degree burn
B. second-degree burn
C. third-degree burn
D. fourth-degree burn
11) Which of the following statements reflect the
nursing management of the patient with a white
phosphorus chemical burn?
A. Do not apply water to the burn.
B. Immediately drench the skin with running
water from a shower, hose or faucet.
 C. Alternate applications of water and ice to
the burn.
D. Wash off the chemical using warm water,
then flush the skin with cool water.
12) Which clinical manifestation indicates that the
burned client is moving into the fluid remobilization
phase of recovery?
A. Increased urine output, decreased urine
specific gravity
B. Increased peripheral edema, decreased
blood pressure
C. Decreased peripheral pulses, slow
capillary refill
D. Decreased serum sodium level, increased
hematocrit
13) The nurse is assessing a male client admitted
with second- and third-degree burns on the face,
arms, and chest. Which finding indicates a potential
problem?
A. Partial pressure of arterial oxygen (PaO2)
value of 80 mm Hg
B. Urine output of 20 ml/hour
C. White pulmonary secretions
D. Rectal temperature of 100.6° F (38° C)
14) What clinical manifestation should alert the
nurse to possible carbon monoxide poisoning in a
client who experienced a burn injury during a house
fire?
A. Pulse oximetry reading of 80%
B. Expiratory stridor and nasal flaring
C. Cherry red color to the mucous
membranes
D. Presence of carbonaceous particles in the
sputum
15) During the acute phase, the nurse applied
gentamicin sulfate (topical antibiotic) to the burn
before dressing the wound. The client has all the
following manifestations. Which manifestation
indicates that the client is having an adverse
reaction to this topical agent?
A. Increased wound pain 30 to 40 minutes
after drug application
B. Presence of small, pale pink bumps in the
wound beds
C. Decreased white blood cell count
D. Increased serum creatinine level
16) A 30-year-old homemaker fell asleep while
smoking a cigarette. She sustained severe burns of
the face,neck, anterior chest, and both arms and
hands. Using the rule of nines, which is the best
estimate of total body-surface area burned?
A. 18%
B. 22%
C. 31%
D. 40%
17) In an industrial accident, client who weighs 155
lb (70.3 kg) sustained full-thickness burns over 40%
of his body. He’s in the burn unit receiving fluid
resuscitation. Which observation shows that the
fluid resuscitation is benefiting the client?
A. A urine output consistently above 100
ml/hour.
B. A weight gain of 4 lb (1.8 kg) in 24 hours.
C. Body temperature readings all within
normal limits
D. An electrocardiogram (ECG) showing no
arrhythmias.
18) A client received burns to his entire back and left
arm. Using the Rule of Nines, the nurse can
calculate that he has sustained burns on what
percentage of his body?
A. 9%
B. 18%
C. 27%
D. 36%
19) What is the priority nursing diagnosis for a client
in the rehabilitative phase of recovery from a burn
injury?
A. Acute Pain
B. Impaired Adjustment
C. Deficient Diversional Activity
D. Imbalanced Nutrition: Less than Body
Requirements
20) Following a full-thickness (third-degree) burn of
his left arm, a male client is treated with artificial
skin. The client understands postoperative care of
artificial skin when he states that during the first 7
days after the procedure, he will restrict:
A. range of motion.
B. protein intake.
C. going outdoors.
D. fluid ingestion.
21) Which information obtained by assessment
ensures that the client’s respiratory efforts are
currently adequate?
A. The client is able to talk.
B. The client is alert and oriented.
C. The client’s oxygen saturation is 97%.
D. The client’s chest movements are
uninhibited
22) The burned client’s family ask at what point the
client will no longer be at increased risk for
infection. What is the nurse’s best response?
A. “When fluid remobilization has started.”
B. “When the burn wounds are closed.”
C. “When IV fluids are discontinued.”
D. “When body weight is normal.”
23) Twelve hours after the client was initially
burned, bowel sounds are absent in all four
abdominal quadrants. What is the nurse’s best
action?
A. Reposition the client onto the right side.
B. Document the finding as the only action.
C. Notify the emergency team.
D. Increase the IV flow rate.
24) The newly admitted client has burns on both
legs. The burned areas appear white and leather-
like. No blisters or bleeding are present, and the
client states that he or she has little pain. How
should this injury be categorized?
A. Full thickness
B. Partial-thickness deep
C. Partial-thickness superficial
D. Superficial
25) The nurse is caring for client with a new donor
site that was harvested to treat a new burn. The
nurse position the client to:
A. allow ventilation of the site
B. make the site dependent
C. avoid pressure on the site
D. keep the site fully covered
26)All of the following laboratory test results on a
burned client’s blood are present during the
emergent phase. Which result should the nurse
report to the physician immediately?
A. Serum sodium elevated to 131 mmol/L
(mEq/L)
B. Serum potassium 7.5 mmol/L (mEq/L)
C. Arterial pH is 7.32
D. Hematocrit is 52%
27) Which client factors should alert the nurse to
potential increased complications with a burn
injury?
A. The client is a 26-year-old male.
B. The client has had a burn injury in the
past.
C. The burned areas include the hands and
perineum.
D. The burn took place in an open field and
ignited the client’s clothing.
28) The client has severe burns around the right hip.
Which position is most important to be emphasized
by the nurse that the client maintain to retain
maximum function of this joint?
A. Hip maintained in 30-degree flexion, no
knee flexion
B. Hip flexed 90 degrees and knee flexed 90
degrees
C. Hip, knee, and ankle all at maximum
flexion
D. Hip at zero flexion with leg flat
29) Which intervention is most important for the
nurse to use to prevent infection by cross-
contamination in the client who has open burn
wounds?
A. Handwashing on entering the client’s
room
B. Encouraging the client to cough and deep
breathe
C. Administering the prescribed tetanus
toxoid vaccine
D. Changing gloves between cleansing
different burn areas
30) Ten hours after the client with 50% burns is
admitted, her blood glucose level is 90 mg/dL. What
is the nurse’s best action?
A. Notify the emergency team.
B. Document the finding as the only action.
C. Ask the client if anyone in her family has
diabetes mellitus.
D. Slow the intravenous infusion of dextrose
5% in Ringer’s lactate.
31) Nurse Jane formulates a nursing diagnosis of
Impaired physical mobility for a client with third-
degree burns on the lower portions of both legs. To
complete the nursing diagnosis statement, the
nurse should add which “related-to” phrase?
A. Related to fat emboli
B. Related to infection
C. Related to femoral artery occlusion
D. Related to circumferential eschar
32) A male client comes to the physician’s office for
treatment of severe sunburn. The nurse takes this
opportunity to discuss the importance of protecting
the skin from the sun’s damaging rays. Which
instruction would best prevent skin damage?
A. “Minimize sun exposure from 1 to 4 p.m.
when the sun is strongest.”
B. “Use a sunscreen with a sun protection
factor of 6 or higher.”
C. “Apply sunscreen even on overcast
days.”
D. “When at the beach, sit in the shade to
prevent sunburn.”
33) When assessing a client with partial thickness
burns over 60% of the body, which of the following
should the nurse report immediately?
A. Complaints of intense thirst
B. Moderate to severe pain
C. Urine output of 70 ml the 1st hour
D. Hoarseness of the voice
34) What clinical manifestation indicates that an
escharotomy is needed on a circumferential
extremity burn?
A. The burn is full thickness rather than
partial thickness.
B. The client is unable to fully pronate and
supinate the extremity.
C. Capillary refill is slow in the digits and the
distal pulse is absent.
D. The client cannot distinguish the sensation
of sharp versus dull in the extremity.
35) On admission to the emergency department the
burned client’s blood pressure is 90/60, with an
apical pulse rate of 122. These findings are an
expected result of what thermal injury–related
response?
A. Fluid shift
B. Intense pain
C. Hemorrhage
D. Carbon monoxide poisoning
36) The client with a dressing covering the neck is
experiencing some respiratory difficulty. What is the
nurse’s best first action?
A. Administer oxygen.
B. Loosen the dressing.
C. Notify the emergency team.
D. Document the observation as the only
action.
37) The client has a deep partial-thickness injury to
the posterior neck. Which intervention is most
important to use during the acute phase to prevent
contractures associated with this injury?
A. Place a towel roll under the client’s neck
or shoulder.
B. Keep the client in a supine position
without the use of pillows.
C. Have the client turn the head from side
to side 90 degrees every hour while
awake.
D. Keep the client in a semi-Fowler’s position
and actively raise the arms above the
head every hour while awake.
38) The burned client is ordered to receive
intravenous cimetidine, an H2 histamine blocking
agent, during the emergent phase. When the
client’s family asks why this drug is being given,
what is the nurse’s best response?
A. “To increase the urine output and prevent
kidney damage.”
B. “To stimulate intestinal movement and
prevent abdominal bloating.”
C. “To decrease hydrochloric acid
production in the stomach and prevent
ulcers.”
D. “To inhibit loss of fluid from the
circulatory system and prevent
hypovolemic shock.”
39) During the acute phase of a burn, the nurse in-
charge should assess which of the following?
A. Client’s lifestyle
B. Alcohol use
C. Tobacco use
D. Circulatory status
40) At what point after a burn injury should the
nurse be most alert for the complication of
hypokalemia?
A. Immediately following the injury
B. During the fluid shift
C. During fluid remobilization
D. During the late acute phase
41) The burned client relates the following history of
previous health problems. Which one should alert
the nurse to the need for alteration of the fluid
resuscitation plan?
A. Seasonal asthma
B. Hepatitis B 10 years ago
C. Myocardial infarction 1 year ago
D. Kidney stones within the last 6 month
42) What statement by the client indicates the need
for further discussion regarding the outcome of skin
grafting (allografting) procedures?
A. “For the first few days after surgery, the
donor sites will be painful.”
B. “Because the graft is my own skin, there
is no chance it won’t ‘take’.”
C. “I will have some scarring in the area
when the skin is removed for grafting.”
D. “Once all grafting is completed, my risk for
infection is the same as it was before I was
burned.”
43) The burned client newly arrived from an
accident scene is prescribed to receive 4 mg of
morphine sulfate by IV push. What is the most
important reason to administer the opioid analgesic
to this client by the intravenous route?
A. The medication will be effective more
quickly than if given intramuscularly.
B. It is less likely to interfere with the client’s
breathing and oxygenation.
C. The danger of an overdose during fluid
remobilization is reduced.
D. The client delayed gastric emptying.
44) In assessing the client’s potential for an
inhalation injury as a result of a flame burn, what is
the most important question to ask the client on
admission?
A. “Are you a smoker?”
B. “When was your last chest x-ray?”
C. “Have you ever had asthma or any other
lung problem?”
D. “In what exact place or space were you
when you were burned?”
45) What additional laboratory test should be
performed on any African American client who
sustains a serious burn injury?
A. Total protein
B. Tissue type antigens
C. Prostate specific antigen
D. Hemoglobin S electrophoresis
46) In an industrial accident, a male client that
weighs 155 lb (70 kg) sustained full-thickness burns
over 40% of his body. He’s in the burn unit receiving
fluid resuscitation. Which observation shows that
the fluid resuscitation is benefiting the client?
A. A urine output consistently above 100
ml/hour
B. A weight gain of 4 lb (2 kg) in 24 hours
C. Body temperature readings all within
normal limits
D. An electrocardiogram (ECG) showing no
arrhythmias
47) Nursing care planning is based on the
knowledge that the first 24-48 hours post-burn are
characterized by:
A. An increase in the total volume of
intracranial plasma
B. Excessive renal perfusion with diuresis
C. Fluid shift from interstitial space
D. Fluid shift from intravascular space to the
interstitial space
48) In reviewing the burned client’s laboratory
report of white blood cell count with differential, all
the following results are listed. Which laboratory
finding indicates the possibility of sepsis?
A. The total white blood cell count is
9000/mm3.
B. The lymphocytes outnumber the
basophils.
C. The “bands” outnumber the “segs.”
D. The monocyte count is 1,800/mm3.
49) The newly admitted client has a large burned
area on the right arm. The burned area appears red,
has blisters, and is very painful. How should this
injury be categorized?
 A. Full thickness
B. Partial-thickness deep
C. Partial-thickness superficial
D. Superficial
50) The client has experienced an electrical injury,
with the entrance site on the left hand and the exit
site on the left foot. What are the priority
assessment data to obtain from this client on
admission?
A. Airway patency
B. Heart rate and rhythm
C. Orientation to time, place, and person
D. Current range of motion in all extremities
51) The client who experienced an inhalation injury
6 hours ago has been wheezing. When the client is
assessed, wheezes are no longer heard. What is the
nurse’s best action?
A. Raise the head of the bed.
B. Notify the emergency team.
C. Loosen the dressings on the chest.
D. Document the findings as the only action.
52) Which statement by the client indicates correct
understanding of rehabilitation after burn injury?
A. “I will never be fully recovered from the
burn.”
B. “I am considered fully recovered when all
the wounds are closed.”
C. “I will be fully recovered when I am able to
perform all the activities I did before my
injury.”
D. “I will be fully recovered when I achieve
the highest possible level of functioning
that I can.”
53) A female client is brought to the emergency
department with second- and third-degree burns on
the left arm, left anterior leg, and anterior trunk.
Using the Rule of Nines, what is the total body
surface area that has been burned?
A. 18%
B. 27%
C. 30%
D. 36%
54) If a client has severe bums on the upper torso,
which item would be a primary concern?
A. Debriding and covering the wounds
B. Administering antibiotics
C. Frequently observing for hoarseness,
stridor, and dyspnea
D. Establishing a patent IV line for fluid
replacement
55) Contractures are among the most serious long-
term complications of severe burns. If a burn is
located on the upper torso, which nursing measure
would be least effective to help prevent
contractures?
A. Changing the location of the bed or the TV
set, or both, daily
B. Encouraging the client to chew gum and
blow up balloons
C. Avoiding the use of a pillow for sleep, or
placing the head in a position of
hyperextension
D. Helping the client to rest in the position
of maximal comfort
56) Which intervention is most important to use to
prevent infection by autocontamination in the
burned client during the acute phase of recovery?
A. Changing gloves between wound care on
different parts of the client’s body.
B. Avoiding sharing equipment such as blood
pressure cuffs between clients.
C. Using the closed method of burn wound
management.
D. Using proper and consistent handwashing.
57) Which type of fluid should the nurse expect to
prepare and administer as fluid resuscitation during
the emergent phase of burn recovery?
A. Colloids
B. Crystalloids
C. Fresh-frozen plasma
D. Packed red blood cells
58) An adult is receiving Total Parenteral Nutrition
(TPN). Which of the following assessment is
essential?
A. evaluation of the peripheral IV site
B. confirmation that the tube is in the
stomach
C. assess the bowel sound
D. fluid and electrolyte monitoring
59) When planning care for a male client with burns
on the upper torso, which nursing diagnosis should
take the highest priority?
A. Ineffective airway clearance related to
edema of the respiratory passages
B. Impaired physical mobility related to the
disease process
C. Disturbed sleep pattern related to facility
environment
D. Risk for infection related to breaks in the
skin
60) What is the priority nursing diagnosis during the
first 24 hours for a client with full-thickness
chemical burns on the anterior neck, chest, and all
surfaces of the left arm?
A. Risk for Ineffective Breathing Pattern
B. Decreased Tissue Perfusion
C. Risk for Disuse Syndrome
D. Disturbed Body Image
61. A client who has had a full-thickness burn is
being discharged from the hospital. Which
information is most important for the nurse to
provide prior to discharge?
A. How to maintain home smoke detectors
B. Joining a community reintegration
program
C. Learning to perform dressing changes
D. Options available for scar removal
62. A client who is admitted after a thermal burn
injury has the following vital signs: blood pressure,
70/40; heart rate, 140 beats/min; respiratory rate,
25/min. He is pale in color and it is difficult to find
pedal pulses. Which action will the nurse take first?
A. Begin intravenous fluids.
B. Check the pulses with a Doppler device.
C. Obtain a complete blood count (CBC).
D. Obtain an electrocardiogram (ECG).
63. A client who was burned has crackles and a
respiratory rate of 40/min, and is coughing up
blood-tinged sputum. What action will the nurse
take first?
A. Administer digoxin
B. Perform chest physiotherapy
C. Monitor urine output
D. Place the client in an upright position
64. How will the nurse position a client with a burn
wound to the posterior neck to prevent
contractures?
A. Have the client turn the head from side
to side.
B. Keep the client in a supine position
without the use of pillows.
C. Keep the client in a semi-Fowler’s position
with her or his arms elevated.
D. Place a towel roll under the client’s neck
or shoulder.
65. On assessment, the nurse notes that the client
has burns inside the mouth and is wheezing. Several
hours later, the wheezing is no longer heard. What
is the nurse’s next action?
A. Documenting the findings
B. Loosening any dressings on the chest
C. Raising the head of the bed
D. Preparing for intubation
66. Ten hours after the client with 50% burns is
admitted, her blood glucose level is 140 mg/dL.
What is the nurse’s best action?
A. Documents the finding
B. Obtains a family history for diabetes
C. Repeats the glucose measurement
D. Stops IV fluids containing dextrose
67. The client has a large burned area on the right
arm. The burned area appears pink, has blisters, and
is very painful. How will the nurse categorize this
injury?
A. Full-thickness
B. Partial-thickness superficial
C. Partial-thickness deep
D. Superficial
68. The client has burns on both legs. These areas
appear white and leather-like. No blisters or
bleeding are present, and there is just a “small
amount of pain.” How will the nurse categorize this
injury?
A. Full-thickness
B. Partial-thickness superficial
C. Partial-thickness deep
D. Superficial
69. The client has experienced an electrical injury of
the lower extremities. Which are the priority
assessment data to obtain from this client?
A. Current range of motion in all extremities
B. Heart rate and rhythm
C. Respiratory rate and pulse oximetry
reading
D. Orientation to time, place, and person
70. The client has severe burns around the right hip.
Which position is most important to use to maintain
maximum function of this joint?
A. Hip maintained in 30-degree flexion
B. Hip at zero flexion with leg flat
C. Knee flexed at 30-degree angle
D. Leg abducted with foam wedge
71. The client who is burned is drooling and having
difficulty swallowing. Which action will the nurse
take first?
A. Assesses level of consciousness and
pupillary reactions
B. Ascertains the time food or liquid was last
consumed
C. Auscultates breath sounds over the
trachea and mainstem bronchi
D. Measures abdominal girth and auscultates
bowel sounds
72. The client with a full-thickness burn is being
discharged to home after a month in the hospital.
His wounds are minimally opened and he will be
receiving home care. Which nursing diagnosis has
the highest priority?
A. Acute Pain
B. Deficient Diversional Activity
C. Impaired Adjustment
D. Imbalanced Nutrition: Less than Body
Requirements
73. The client with a new burn injury asks the nurse
why he is receiving intravenous cimetidine
(Tagamet). What is the nurse’s best response?
A. “Tagamet will stimulate intestinal
movement.”
B. “Tagamet can help prevent hypovolemic
shock.”
C. “This will help prevent stomach ulcers.”
D. “This drug will help prevent kidney
damage.”
74. The client with facial burns asks the nurse if he
will ever look the same. Which response is best for
the nurse to provide?
A. “With reconstructive surgery, you can look
the same.”
B. “We can remove the scars with the use of
a pressure dressing.”
C. “You will not look exactly the same.”
D. “You shouldn’t start worrying about your
appearance right now.”
75. The client with open burn wounds begins to
have diarrhea. The client is found to have a below-
normal temperature, with a white blood cell count
of 4000/mm3. Which is the nurse’s best action?
A. Continuing to monitor the client
B. Increasing the temperature in the room
C. Increasing the rate of the intravenous
fluids
D. Preparing to do a workup for sepsis
76. The family of a client who has been burned asks
at what point the client will no longer be at greater
risk for infection. What is the nurse’s best response?
A. “As soon as he finishes his antibiotic
prescription.”
B. “As soon as his albumin level returns to
normal.”
C. “When fluid remobilization has started.”
D. “When the burn wounds are closed.”
77. The nurse is conducting a home safety class. It is
most important for the nurse to include which
information in the teaching plan?
A. Have chimneys swept every 2 years.
B. Keep a smoke detector in each bedroom.
C. Use space heaters instead of gas heaters.
D. Use carbon monoxide detectors only in
the garage.
78. The nurse provides wound care for a client 48
hours after a burn injury. To achieve the desired
outcome of the procedure, which nursing action will
be carried out first?
A. Applies silver sulfadiazine (Silvadene)
ointment
B. Covers the area with an elastic wrap
C. Places a synthetic dressing over the area
D. Removes loose nonviable tissue
79. The nurse should teach the community that a
minor burn injury could be caused by what common
occurrence?
A. Chimney sweeping every year
B. Cooking with a microwave oven
C. Use of sunscreen agents
D. Use of space heaters
80. The nurse uses topical gentamicin sulfate
(Garamycin) on a client’s burn injury. Which
laboratory value will the nurse monitor?
A. Creatinine
B. Red blood cells
C. Sodium
D. Magnesium level
81. The RN has assigned a client who has an open
burn wound to the LPN. Which instruction is most
important for the RN to provide the LPN?
A. Administer the prescribed tetanus toxoid
vaccine.
B. Assess wounds for signs of infection.
C. Encourage the client to cough and breathe
deeply.
D. Wash hands on entering the client’s
room.
82. Three days after a burn injury, the client
develops a temperature of 100° F, white blood cell
count of 15,000/mm3, and a white, foul-smelling
discharge from the wound. The nurse recognizes
that the client is most likely exhibiting symptoms of
which condition?
A. Acute phase of the injury
B. Autodigestion of collagen
C. Granulation of burned tissue
D. Wound infection
83. Twelve hours after the client was initially
burned, bowel sounds are absent in all four
abdominal quadrants. Which is the nurse’s best
action?
A. Administers a laxative
B. Documents the finding
C. Increases the IV flow rate
D. Repositions the client onto the right side
84. What intervention will the nurse implement to
reduce a client’s pain after a burn injury?
A. Administering morphine 4 mg
intravenously.
B. Administering hydromorphone (Dilaudid)
4 mg intramuscularly.
C. Applying ice to the burned area
D. Avoiding tactile stimulation
85. What statement indicates the client needs
further education regarding the skin grafting
(allografting)?
A. “Because the graft is my own skin, there
is no chance it won’t ‘take.’”
B. “For the first few days after surgery, the
donor sites will be painful.”
C. “I will have some scarring in the area
when the skin is removed for grafting.”
D. “I am still at risk for infection after the
procedure.”
86. When providing care for a client with an acute
burn injury, which nursing intervention is most
important to prevent infection by
autocontamination?
A. Avoiding sharing equipment such as blood
pressure cuffs between clients
B. Changing gloves between wound care on
different parts of the client’s body
C. Using the closed method of burn wound
management
D. Using proper and consistent handwashing
87. Which assessment finding assists the nurse in
confirming inhalation injury?
A. Brassy cough
B. Decreased blood pressure
C. Nausea
D. Headache
88. Which finding indicates that fluid resuscitation
has been successful for a client with a burn injury?
A. Hematocrit = 60%
B. Heart rate = 130 beats/min
C. Increased peripheral edema
D. Urine output = 50 mL/hr
89. Which finding indicates to the nurse that a client
with a burn injury has a positive perception of his
appearance?
A. Allowing family members to change his
dressings
B. Discussing future surgical reconstruction
C. Performing his own morning care
D. Wearing the pressure dressings as ordered
90. Which finding indicates to the nurse that the
client understands the psychosocial impact of his
severe burn injury?
A. “It is normal to feel depressed.”
B. “I will be able to go back to work
immediately.”
C. “I will not feel anger about my situation.”
D. “Once I get home, things will be normal.”
91. Which finding is characteristic during the
emergent period after a deep full thickness burn
injury?
A. Blood pressure of 170/100 mm Hg
B. Foul-smelling discharge from wound
C. Pain at site of injury
D. Urine output of 10 mL/hr
92. Which is the priority nursing diagnosis during
the first 24 hours for a client with chemical burns to
the legs and arms that are red in color, edematous,
and without pain?
A. Decreased Tissue Perfusion
B. Disturbed Body Image
C. Risk for Disuse Syndrome
D. Risk for Ineffective Breathing Pattern
93. Which laboratory result, obtained on a client 24
hours post-burn injury, will the nurse report to the
physician immediately?
A. Arterial pH, 7.32
B. Hematocrit, 52%
C. Serum potassium,7.5 mmol/L (mEq/L)
D. Serum sodium, 131 mmol/L (mEq/L)
94. Which nursing intervention is likely to be most
helpful in providing adequate nutrition while the
client is recovering from a thermal burn injury?
A. Allowing the client to eat whenever he or
she wants
B. Beginning parenteral nutrition high in
calories
C. Limiting calories to 3000 kcal/day
D. Providing a low-protein, high-fat diet
95. Which statement best exemplifies the client’s
understanding of rehabilitation after a full-thickness
burn injury?
A. “I am fully recovered when all the wounds
are closed.”
B. “I will eventually be able to perform all my
former activities.”
C. “My goal is to achieve the highest level of
functioning that I can.”
D. “There is never full recovery from a major
burn injury.”
96. Which statement indicates that a client with
facial burns understands the need to wear a facial
pressure garment?
A. “My facial scars should be less severe
with the use of this mask.”
B. “The mask will help protect my skin from
sun damage.”
C. “This treatment will help prevent
infection.”
D. “Using this mask will prevent scars from
being permanent.”
97. The client with a dressing covering the neck is
experiencing some respiratory difficulty. What is the
nurse’s best first action?
A. Administer oxygen.
B. Loosen the dressing.
C. Notify the emergency team.
D. Document the observation as the only
action.
98. During the acute phase, the nurse applied
gentamicin sulfate (topical antibiotic) to the burn
before dressing the wound. The client has all the
following manifestations. Which manifestation
indicates that the client is having an adverse
reaction to this topical agent?
A. Increased wound pain 30 to 40 minutes
after drug application
B. Presence of small, pale pink bumps in the
wound beds
C. Decreased white blood cell count
D. Increased serum creatinine level
99. Which intervention is most important to use to
prevent infection by autocontamination in the
burned client during the acute phase of recovery?
A. Changing gloves between wound care on
different parts of the client’s body.
B. Avoiding sharing equipment such as blood
pressure cuffs between clients.
C. Using the closed method of burn wound
management.
D. Using proper and consistent handwashing.
100. The burned client relates the following history
of previous health problems. Which one should alert
the nurse to the need for alteration of the fluid
resuscitation plan?
A. Seasonal asthma
B. Hepatitis B 10 years ago
C. Myocardial infarction 1 year ago
D. Kidney stones within the last 6 month