PLT College Inc.

Bayombong Nueva Vizcaya

NCM 116 Midterm Examination

Name: ________________________________________ Year and section: ____________

INSTRUCTIONS: Write the correct answer before the number. Erasure means WRONG!

1. Nurse Nadine should stop the transfusion of packed RBC when she has the following
assessment finding EXCEPT.

a. Bibasilar rales or crackles c. Low back pain

b. Anuria d. fever and skin rashes

2. Sulfasalazine (Azulfidine) is prescribed for Mr. Jigs a client with ulcerative colitis. Nurse
Toni instruct the client about the medication. Which statement when made by the client
indicates that he understands the teaching about the medication?

a. I should avoid exposure to sunlight

b. This medication will cause constipation
c. This medication should be taken with meals
d. This medication should be taken as prescribed

3. What medication does Nurse Ella expect to be prescribed for a client with adrenal
insufficiency?

a. Epinephrine c. Cyclophosphamide
b. Hydrocort d. Amphogel

4. Which of the following should nurse Amor assess in a client receiving steroid?

a. Hyponatremia c. Hyperglycemia
b. Hyperkalemia d. Weight loss

5. In patients with Diabetes Insipidus, what would be our nursing priority?

a. Acute pain c. Imbalanced nutrition less than body

requirements
b. Fluid volume excess d. Fluid volume deficit

6. Nurse John Paul is teaching a diabetic patient how to prevent hyperglycemia. The most
important food for the client to avoid is.

a. Coffee c. Sweetened juice

b. Skim milk d. Bread

7. The patient is experiencing hypovolemic shock. What are the signs and symptoms of
hypovolemic shock?

a. Hypertension, bradypnea, tachycardia

b. Hypotension, bradycardia, bradypnea
 c. Hypotension, tachycardia, tachypnea
d. Hypertension, tachycardia

8. Which of the following beverages has the lowest sodium content?

a. Low fat milk c. Carrot juice

b. Fresh coconut juice d. Canned tomato juice

9. Which of the following findings is a characteristic manifestation of a client with SIADH?

a. Edema, oliguria, weight gain

b. Polyuria, weight loss and edema
c. Constipated, cold intolerance and fever
d. Tremors, diarrhea and heat intolerance

10. Which of the following findings in a client with DM should be given highest priority by
the nurse?

a. Blood glucose level of 240 mg/dL

b. Serum potassium of 3.2 mEq/L
c. Blood pH of 7.2
d. Serum sodium of 130 mEq/L

11. A client has been diagnose to have DI. He has been receiving intranasal vasopressin.
Which of the following indicates effectiveness of the medication?

a. Urine output of more than 200ml/hr

b. Blood pressure of 90/50 mmHg
c. Pulse rate of 126bpm
d. Fluid intake less than 85 oz (2,500 mL) in 24 hours.

12. The patient is receiving heparin. The client develops bright red urine. Which of the
following actions should the nurse do first?

a. Decrease the heparin infusion rate

b. Monitor the partial thromboplastin time (PTT)
c. Prepare to administer Vit. K
d. Prepare to administer protamine sulfate

13. Which of the following foods is lowest in calcium?

a. Cheese c. Taho
b. Oyster d. Egg yolk

14. The client has been diagnosed to have pyelonephritis. Upon assessment, the nurse notes
which of the following?

a. Epigastric pain c. Suprapubic discomfort

b. Costovertebral angle tenderness d. Rebound tenderness
15. Which of the following statements of a client with a family history of DM indicates that
he understands teachings on how to decrease the risk of having the disease?

a. I will not eat sweet foods c. I will exercise regularly

b. I ill eat foods rich in protein d. I will take vitamin supplements

16. The client who has DM called the clinic and states that he is feeling dizzy. The nurse
should advise the client to do which of the following?

a. Inject yourself the prescribed dose of insulin

b. Drink half cup of apple juice
c. Come to the clinic immediately
d. Drink a glass of skim milk

17. The client has been diagnosed to have glomerulonephritis. He is experiencing oliguria.
Which of the following foods may be included in the client’s diet?

a. Apple slices c. Carrot cake

b. Sandwich with ketchup d. Ripe mango

18. The patient has been diagnosed to have hyperthyroidism. The nurse is aware that the
early sign of hypocalcemia is

a. Paresthesia c. Tachycardia
b. Optic neuritis d. Respiratory distress

19. The client has been diagnosed to have hyperthyroidism. Which of the following nursing
intervention should be included in the nursing care plan?

a. Instill NS eyedrops c. Increased fluid intake

b. Keep environment warm d. None of the above

20. The client has hypothyroidism. His pulse rate is 112 bpm. Which of the following is
appropriate nursing action?

a. Administer prescribed medication

b. Hold the prescribed medication and notify the physician
c. Delay giving the clients medication
d. Administer the medication during the night

21. A client with diabetes mellitus had self-injected regular insulin. She omitted her breakfast
because she was already late for her work. Which of the following assessments are
indicative of hypoglycemia?

a. Weakness, altered LOC, fruity odor of breath

b. Glycosuria, abdominal pain, excessive nurse
c. Dry, flushed skin, excessive urination
d. Pallor, diaphoresis, tremors

22. Immediately following thyroidectomy, Mrs. Eduvina should should be monitored for the
following signs of post-op complications?
 a. Increased BP c. laryngospasm
b. Bleeding d. all of the above

23. Mr. Crawford has been diagnosed to have Adrenal Insufficiency. He is on

Fludrocortisone therapy. Which of the following statements needs intervention by the
RN?

a. I need to monitor my blood pressure

b. I need to take my Ca supplement
c. I need to stop taking the pill if I gain to much weight
d. I need to include fruits and vegetables in my diet

24. Mr. Labitoria had been diagnosed to have Grave’s disease. The nurse monitor the client
for which of the following signs and symptoms?

a. Fatigue, dray hair and brittle nails

b. Hypertension, weight loss and anorexia
c. Obesity, HPN, tachycardia
d. Hypocalcemia, exophthalmos, increased appetite to eat

25. Which of the following is a potential side effect of Codeine?

a. Constipation c. Hypertension
b. Headache d. Restlessness

26. A patient is taking Lanoxin. As a nurse your nursing responsibility before administering
the medication will be?

a. Check the respiratory rate c. Check the temperature

b. Check the heart rate d. Check the liver enzymes

27. Mr. Milby’s serum calcium level is 3.5 mEq/L. which of the following assessment data
will the nurse consider to be LEAST related to the lab result?

a. Muscle weakness
b. Tingling sensations on the face and around the mouth
c. Abdominal cramping
d. Decreased blood pressure

28. Mrs. Geronimo, a client with DM has a blood glucose level of 60 mg/dL. Which of the
following signs and symptoms does the nurse observe in the client?

a. Deep rapid breathing

b. Warm, flushed dry skin
c. Impaired mental alertness, dizziness
d. Urine output of 300 ml in 2 hours.

29. Mr. M had been diagnosed to have SIADH. Which of the following nursing interventions
is appropriate for the client?
 a. Increased oral fluid intake c. Decreased fluid intake
b. Administer desmopressin d. Na-free IV fluids

30. Which of the following laboratory values is expected in patients with SIADH?

a. Serum magnesium of 1.3 mEq/L

b. Serum potassium of 3.2 mEq/L
c. Serum calcium of 4 mEq/L
d. Serum sodium of 118 mEq/L

31. The patient is taking aspirin. What is the side effect of this medication?

a. Hypertension c. Tachycardia
b. Bleeding d. Respiratory distress

32. Which of the following below diseases is a major risk for chronic kidney disease?

a. Dental disorder c. Degenerative disease

b. Diabetes d. metabolic disorders

33. 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 c. Limit fluid intake

b. Enforce strict bed rest d. Strain all urine

34. Adverse reactions of prednisone therapy include which of the following conditions?

a. Acne and gum bleeding c. Sodium retention and constipation

b. Mood swings d. increased blood glucose and decreased wound healing

35. When providing discharge teaching for a client with uric acid calculi, the nurse should an
instruction to avoid which type of diet?

a. Low oxalate c. High purine

b. High oxalate d. Low calcium

36. A nurse provides instructions to a client regarding the administration of the prednisone
and instructs the client that the best time to take the medication is during?

a. After breakfast c. Evening

b. Before breakfast d. Before bedtime

37. A client with diabetes insipidus is taking antidiuretic hormone. Which of the following
symptoms would alert the need to decrease the dosage?

a. Diarrhea c. Jaundice
b. Drowsiness d. Alopecia
38. Which of the following medications decreases their action while taking thyroid hormone?

a. Metformin c. Zoloft
b. Warfarin d. Epinephrine

39. A patient with CKD has a low erythropoietin (EPO) level. The patient is at risk for?

A. Hypercalcemia c. Blood clots

B. Hyperuricemia d. Anemia

40. A patient with stage 4 chronic kidney disease asks what type of diet they should follow.
You explain the patient should follow a:
a. Low protein, low sodium, low potassium, low phosphate diet
b. High protein, low sodium, low potassium, high phosphate diet
c. Low protein, high sodium, high potassium, high phosphate diet
d. Low protein, low sodium, low potassium, high phosphate diet

41. Which patient below is NOT at risk for developing chronic kidney disease?

a. A 58 year old female with uncontrolled hypertension.

b. A 69 year old male with diabetes mellitus.

c. A 45 year old female with polycystic ovarian disease.

d. A 78 year old female with an intrarenal injury.
42. The kidneys are responsible for performing all the following functions EXCEPT?

A. Activating Vit. D C. Secreting Erythropoietin

B. Secreting Renin D. Maintaining cortisol production

43. You have a patient that might have a urinary tract infection (UTI). Which statement by
the patient suggests that a UTI is likely?

a. “I pee a lot” c. “It burns when I pee”

b. “My pee smells sweet” d. ‘’I go hours without the urge to pee”

44. Which instructions do you include in the teaching care plan for a patient with cystitis
receiving phenazopyridine (Pyridium)?

a. If the urine turns orange-red, call the doctor.

b. Take phenazopyridine just before urination to relieve pain.
c. Once painful urination is relieved, discontinue prescribed antibiotics.
d. After painful urination is relieved, stop taking phenazopyridine.

45. Which patient is at greatest risk for developing a urinary tract infection (UTI)?

a. A 35 y.o. woman with a fractured wrist

b. A 50 y.o postmenopausal woman
c. A 20 y.o. woman with asthma
d. A 28 y.o. with angina
46. Your patient with chronic renal failure reports pruritus. Which instruction should you
include in this patient’s teaching plan?

a. Keep fingernails short and clean.

b. Rub the skin vigorously with a towel.
c. Take frequent baths.
d. Apply alcohol-based emollients to the skin.

47. An 18 y.o. student is admitted with dark urine, fever, and flank pain and is diagnosed
with acute glomerulonephritis. Which would most likely be in this student’s health
history?

a. Renal calculi c. Recent sore throat

b. Renal trauma d. Family history of acute glomerulonephritis

48. Clinical manifestations of acute glomerulonephritis include which of the following?

a. Chills and flank pain c. Hematuria and proteinuria

b. Oliguria and generalized edema d. Dysuria and hypotension

49. You’re planning your medication teaching for your patient with a UTI prescribed
phenazopyridine (Pyridium). What do you include?

a. “Take this drug between meals and at bedtime.”

b. ‘’You need to take this antibiotic for 7 days.”
c. “Don’t take this drug if you’re allergic to penicillin.”
d. ‘’Your urine might turn bright orange’’

50. Which finding leads you to suspect acute glomerulonephritis in your 32 y.o. patient?

a. Dysuria, frequency, and urgency

b. Hypertension, oliguria, and fatigue
c. Back pain, nausea, and vomiting
d. Fever, chills, and right upper quadrant pain radiating to the back

51. What is the priority nursing diagnosis with your patient diagnosed with end-stage renal
disease?

a. Activity intolerance c. Knowledge deficit

b. Fluid volume excess d. Pain

52. Your 60 y.o. patient with pyelonephritis and possible septicemia has had five UTIs over
the past two years. She is fatigued from lack of sleep, has lost weight, and urinates
frequently even in the night. Her labs show: sodium, 154 mEq/L; osmolarity 340
mOsm/L; glucose, 127 mg/dl; and potassium, 3.9 mEq/L. Which nursing diagnosis is a
priority?

A. Fluid volume deficit related to inability to conserve water

B. Fluid volume deficit related to osmotic diuresis induced by hyponatremia
C. Altered nutrition: Less than body requirements related to hypermetabolic state
 D. Altered nutrition: Less than body requirements related to catabolic effects of insulin
deficiency

53. A patient with diabetes has had many renal calculi over the past 20 years and now has
chronic renal failure. Which substance must be reduced in this patient’s diet?

a. Carbohydrates c. Protein
b. Fats d. Vitamin C.

54. What is the most important nursing diagnosis for a patient in end-stage renal disease?

a. Risk for injury c. Altered nutrition: less than body requirements

b. Fluid volume excess d. Activity intolerance

55. Nurse Celine is caring for a client with clinical depression who is receiving an MAO
inhibitor. When providing instructions about precautions with this medication, the nurse
should instruct the client to:

a. Avoid chocolate and cheese c. Take the medicine with milk

b. Take frequent naps d. Avoid walking without assistance

56. While providing home care to a client with congestive heart failure, the nurse is asked
how long diuretics must be taken. The best response to this client should be:

a. “As you urinate more, you will need less medication to control fluid.”
b. “You will have to take this medication for about a year.”
c. “The medication must be continued so the fluid problem is controlled.”
d. “Please talk to your physician about medications and treatments.”