1. Which among the following patients has a high risk of having multiple sclerosis?

 A. 45-year-old Irish female whose mother has multiple sclerosis

 B. 46-year-old Canadian male who is currently diagnosed with hyperthyroidism
 C. 63-year-old Korean male who experienced hemorrhagic stroke and has left-sided
hemiplegia
 D. 21-year-old American female who smokes at least 1 pack of cigarettes a day
 E. 54-year-old Australian female who has Type-1 Diabetes Mellitus
2. A client is post thyroidectomy. Which of the following conditions may indicate thyroid crisis as
a complication?
 A. Elevated temperature
 B. Bradycardia
 C. Nausea
 D. Delirium
 E. Lethargy
 F. Hoarseness
 G. Congestive heart failure
3. In a parenting conference, the parents of which of the following children must be referred to a
geneticist?
 A. Cystic fibrosis
 B. Wilm’s tumor
 C. Marfan’s Syndrome
 D. Infectious mononucleosis
 E. Retinoblastoma
 F. Alzheimer’s disease
4. The charge nurse is making patient assignments for the day. Which of the following patients
should not be delegated to both LPNs and UAP?
 A. A 45-year-old patient, complaining of stomach pain relieved by vomiting after meals
 B. A 56-year-old patient with an esophageal tamponade
 C. A 52-year-old patient with flapping tremors
 D. A 72-year-old patient with left-sided body weakness secondary to stroke
 E. A 61-year-old patient with COPD with an oxygen saturation of 85%
 F. A 65-year-old patient with unstable angina
 G. A 60-year-old patient, complaining of chest pain, unrelieved after three doses of
nitroglycerine
 H. A 50-year-old patient, receiving chemotherapy with a temperature of 102°F
5. The patient admitted for hypercholesterolemia is ordered to receive cholestyramine. Which of
the following parameters should the nurse be alarmed with its occurrence?
 A. Abdominal discomfort
 B. Seizure
 C. Constipation
 D. Diarrhea
 E. Nausea
 F. Foul-smelling stools
 G. Easy bruising
 H. Black, tarry stools
 I. Dry mouth
  J. Muscle spasms
6. Which signs and symptoms are most likely indicative of syndrome of inappropriate antidiuretic
hormone (SIADH) secretion?
 A. Seizure
 B. Confusion
 C. Nausea
 D. Irritability
 E. Decreased level of consciousness
7. If the nurse thinks she is duty-bound to tell the truth about the client, this is an ethical dilemma of
autonomy versus what?
 A. Veracity
 B. Beneficence
 C. Non-maleficence
 D. Justice
8. A nurse is assigned to a client with intentional tremors. Which drugs will the doctor most likely
order for this client?
 A. Corticosteroids
 B. Antihypertensives
 C. Opioid analgesics
 D. Antipsychotics
 E. Immunosuppressant
 F. Muscle relaxant
9. A nurse is going to administer prescribed dopamine to a newly delivered neonate suffering from
perinatal asphyxia. What parameters should the nurse note in computing for the dose of
dopamine?
 A. Weight of patient in kg
 B. Height of patient in cm
 C. BMI
 D. Ordered dose in mcg/kg/min
 E. Volume of the medication
 F. Stock weight of the medication
 G. Time in 60 min/hr
 H. Infusion rate in mL/hr
 I. Drop factor of 15 drops/ml
10. Which laboratory tests should be monitored in a client taking entacapone (Comtan) due to
Parkinson’s disease?
 A. CBC
 B. Serum creatinine
 C. Hemoglobin
 D. Hematocrit
 E. BP

11. The nurse is caring for a 67-year-old patient diagnosed with atrial fibrillation. The patient
has been receiving digoxin, an inotropic anti-dysrhythmic, as ordered by the physician.
Knowing that this medication has adverse effects, which of the following should the
nurse closely monitor for and report to the healthcare provider?
  A. Headache
 B. Heart rate of 54 beats per minute
 C. Heart rate of 120 beats per minute
 D. Blood pressure of 80/60 mmHg
 E. Blood pressure of 140/90 mmHg
 F. Blurred vision
 G. Patient says: “The TV has a weird color.”
 H. Patient says: “I see two of every object.”
12. A child who weighs 15 kg needs how many cc of intravenous fluid replacement?
 Enter your answer: __________
13. The nurse admits the following schizophrenic clients. Which one needs the nurse’s attention
first?
 A. A client with weird actions and mumbling in front of the television
 B. A client who had a heated argument with a family member and is pacing continuously
 C. A client who has been seated on the chair for the last 2 hours looking out the window
 D. A client who is confused but is coherent
14. Which of the following toys is appropriate for a preschooler?
 A. Patty cake
 B. Bright colored mobiles
 C. Playhouse
 D. Rattle
 E. Tricycle
 F. Cooking play set
15. Which of the following clients should be assigned to the registered nurse?
 A. A 3-year-old child who sustained burns to the face characterized by redness, scalding
and letheary skin near the eyebrows and high-pitched crowing sound while breathing
 B. A pregnant client with burns to the anterior torso with rapid breathing and weeping
blisters on the neck
 C. A 40-year-old client with burns to the anterior thigh characterized by redness,
blistering and edema of the distal toes
 D. A 10-year-old boy with burns on the chest and neck characterized by redness with a
blood pressure of 100/85
16. The nurse and unlicensed assistive personnel (UAP) are caring for patients on a vascular unit.
Which task is least appropriate to delegate to the unlicensed assistive personnel (UAP)?
 A. Provide indwelling catheter care to a patient on bed rest
 B. Evaluate the patient’s 8-hour intake and output
 C. Give a bath to a patient who is third-spacing
 D. Administer a cation-exchange resin enema to a patient
 E. Assist a patient to ambulate
17. An obstetric-trained registered nurse is floated to the medical-surgical unit from the obstetrics
unit. Which two adult clients will you assign to the obstetric-trained registered nurse? The clients
who are:
 A. Post hysterectomy and post cone biopsy with spotting, their third day in the hospital
 B. With cervical fracture and acute glomerulonephritis, their first day in the hospital
 C. Diagnosed with amyotrophic lateral sclerosis (ALS) with ventilator and bacterial
pneumonia, their first day in the hospital
  D. With heart failure and Guillain-Barre syndrome (GBS), their first day in the hospital
18. A client with hypersecretion of glucocorticoids and mineralocorticoids will most likely manifest
which of the following?
 A. Trunkal obesity
 B. Menorrhagia
 C. Hypoglycemia
 D. Fatigue
 E. Increased sexual desire
 F. Mood swings
19. The charge nurse is making patient assignments to registered nurses (RNs), licensed practical
nurses (LPNs), and unlicensed assistive personnel (UAP). Which of the following tasks can be
delegated to licensed practical nurses (LPNs)?
 A. Administering IV push medications
 B. Administering intravenous piggyback (IVPB) medications
 C. Performing morning care such as bathing the patient
 D. Assessing a patient, diagnosed with stage IV heart failure
 E. Feeding the patient who has an IV access in both forearms
 F. Teaching a patient about coronary artery disease
 G. Admitting a patient with supraventricular tachycardia
 H. Inserting an indwelling catheter on a patient
 I. Writing a care plan
 J. Discharging the patient post-cardiac catheterization
20. Arrange the correct sequence of using crutches when a client is going up the stairs.
 A. Bring the affected leg to the next step
 B. Bring the crutches up to the next step
 C. With a crutch under each arm, come up close to the stair
 D. Bring your good leg up to the next step
21. A charge nurse in the emergency room is conducting patient assignments with her staff
members, which consist of registered nurses (RNs), licensed practical nurses (LPNs), and
unlicensed assistive personnel (UAP). Which of the following patients should not be delegated to
LPNs and UAPs?
 A. A 35-year-old patient, ready for discharge to a rehabilitation center
 B. A 65-year-old patient who is a newly diagnosed diabetic, complaining of diminished
vision
 C. A 55-year-old patient with lacerated left leg
 D. A 25-year-old patient with a 2-day history of diarrhea
 E. A 58-year-old patient with shortness of breath
 F. A 25-year-old patient, exhibiting stridor after being stung by a wasp
 G. A 48-year-old patient with violent behavior and is in panic
 H. A 59-year-old patient with sinus tachycardia and complaining of nausea, vomiting,
and diarrhea in the last 3 days
22. The nurse is assigned to a client hooked to an intracranial pressure monitoring. The monitor
shows a sustained intracranial pressure of 25 mm Hg. The nurse knows that the client will most
probably experience which of the following symptoms?
 A. Tachycardia
 B. Tachypnea
  C. Decreased LOC
 D. Narrowed pulse pressure
 E. Decreased diastolic pressure
23. A client is diagnosed with osteoporosis. Which statements should the nurse include when
teaching the client about the disease?
 A. “It’s common in females after menopause.”
 B. “It’s a degenerative disease characterized by a decrease in bone density.”
 C. “It’s a congenital disease caused by poor dietary intake of milk products.”
 D. “It can cause pain and injury.”
 E. “Passive range-of-motion exercises can promote bone growth.”
 F. “Weight-bearing exercise should be avoided.”
24. Which of the following assessment methods for a specific symptom is incorrect?
 A. Palpation of crepitus in osteoarthritis
 B. Percussion of hyperresonance in children
 C. Inspection of the sclera for jaundice
 D. Auscultation for a bruit in abdominal aneurysm
25. Which of the following is considered a risk factor for insulin-dependent diabetes mellitus?
 A. Age below 35
 B. Viral infection
 C. Obesity
 D. Presence of human leukocyte antigen (HLA)
 E. Oral contraceptive use
 F. Autoimmune reaction
26. Which of the following is a manifestation of serotonin toxicity?
 A. Muscle rigidity
 B. Diaphoresis
 C. High fever
 D. Hypotension
 E. Bradycardia
 F. Diarrhea
27. Which of the following foods is appropriate for a client taking warfarin sodium (Coumadin)
based on the old protocol?
 A. Spinach
 B. Squash
 C. Lettuce
 D. Arugula
 E. Ice cream
28. Which of the following is a manifestation of neuroleptic malignant syndrome?
 A. Temperature of 38.9°C
 B. Muscle rigidity
 C. Sore throat
 D. Pill-rolling tremors
 E. Diaphoresis
 F. Stooped posture
29. The nurse is assisting a client with diverticulosis to select appropriate foods. Which foods, if
selected by the client, indicate an understanding of the implications of the condition to the diet?
  A. Bran
 B. Fresh peaches
 C. Cucumber salad
 D. Yeast rolls
 E. Beans
 F. Nuts
 G. Large canned peas
 H. White bread
 I. Wheat bread
30. Adequate nutrition is vital for good health and healing. In assisting a client with colostomy in
choosing an appropriate menu two weeks postoperatively, the nurse would encourage the client
to choose which of the following?
 A. Whole wheat bread, mashed potatoes, peeled stewed tomatoes
 B. Broiled pork chop, boiled potato, corn on the cob
 C. Broiled trout, mashed potatoes, spinach
 D. Barbecue on a white bun, coleslaw, French fries
31. The presence of allergy from specific types of medications and food components are
considered contraindications to some vaccines. Which of the following vaccines is
contraindicated in the presence of allergies to both egg protein and antibiotics?
A. MMR
B. Varivax
C. Influenza
D. Inactivated polio vaccine
E. Pneumovax
32. Which of the following symptoms indicates sleep deprivation due to obstructive sleep apnea?
A. Elevated blood pressure
B. Confusion
C. Irritability
D. Loss of concentration
E. Rapid respirations
F. Decreased temperature
G. Talkativeness
33. Which of the following should be referred immediately for cancer screening tests?
A. 55-year-old African client with a history of frequent urinary tract infection, late onset of first
menstruation, and have yet to experience menopause
B. 68-year-old African client who had her first baby at age 37
C. 40-year-old Jewish menopausal client with vague abdominal discomfort and hot flashes
D. 20-year-old smoker who works as a prostitute and whose Pap smear in the past 2 years have
yielded negative results