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PRACTICE TEST QUESTIONS

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1. The nurse would evaluate that the client understands his home care
instructions after scleral buckling for a detached retina if he says his
activity should include:
a. Avoiding abrupt movements of the head
b. Exercising the eye muscles each day
c. Turning the entire head rather than just the eyes for sight
d. Avoiding activities requiring good depth perception

2. Lomotil has been prescribed to treat a client’s diarrhea. The nurse should
teach the client to report which of the following common side effects?
a. Urinary retention
b. Diaphoresis
c. Hypotension
d. Lethargy

3. Nitroglycerin is also available in ointment or paste form. Before applying


nitroglycerin ointment, the nurse should:
a. Cleanse the skin with alcohol where the ointment will be placed.
b. Obtain the client’s pulse rate and rhythm
c. Remove the ointment previously applied
d. Instruct the client to expect pain relief in the next 15 minutes

4. While a client with hypertension is being assessed, he says to the nurse, “I


really don’t know why I am here. I feel fine and haven’t had any
symptoms.” The nurse would explain to the client that symptoms of
hypertension:
a. Are often not present
b. Signify a high risk of stroke
c. Occur only with malignant hypertension
d. Appear after irreversible kidney damage has occurred

5. For a neurologically injured client, the nurse would best assess motor
strength by:
a. Comparing equality of hand grasps
b. Observing spontaneous movements
c. Observing the client feed himself
d. Asking him to signal if he feels pressure applied to his feet
6. Morphine 8 mg IM has been ordered for a client. The ampule label reads 15
mg/mL. How many milliliters will the nurse give?
a. 0.45 mL
b. 0.53 mL
c. 0.66 mL
d. 0.75 mL

7. The correct procedure for auscultating the client’s abdomen for bowel
sounds would include:
a. Palpating the abdomen first to determine correct stethoscope
placement
b. Encouraging the client to cough to stimulate movement of fluid and
air through the abdomen
c. Placing the client on the left side to aid auscultation
d. Listening for 5minutes in all four quadrants to confirm
absence of bowel sound

8. A client is admitted to the hospital with a diagnosis of a right hip fracture.


She complains of right hip pain and cannot move her right leg. Which of
the following assessments made by the nurse indicates that the client has
a typical sign of hip fracture? The client’s right leg is:
a. Rotated internally
b. Held in a flexed position
c. Adducted
d. Shorter than the leg on the unaffected side

9. The nurse assesses the client’s understanding of the relationship between


body position and gastroesophageal reflux. Which response would indicate
that the client understands measures to avoid problems with reflux while
sleeping?
a. I can elevate the foot of the bed 4 to 6 inches
b. I can sleep on my stomach with my head turned to the left
c. I can sleep on my back without a pillow under my head
d. I can elevate the head of the bed 4 to 6 inches

10. Which of the following would be an appropriate nursing diagnosis for a


hospitalized client with bacterial pneumonia and shortness of breath?
a. Ineffective cardiopulmonary tissue perfusion related to myocardial
damage
b. Risk for self-care deficit related to fatigue
c. Deficient fluid volume related to nausea and vomiting
d. Disturbed thought processes related to inadequate relief of chest pain

11. Theophylline ethylenediamide is administered to a client with COPD to:


a. Reduce bronchial secretions
b. Relax bronchial smooth muscle
c. Strengthen myocardial contractions
d. Decrease alveolar elasticity

12. Which of the following lab results would be unexpected in a client with
chronic renal failure?
a. Serum potassium 6.0 mEq/L
b. Serum creatinine 9 mg/dL
c. BUN 15 mg/dL
d. Serum phosphate 5.2 mg/dL.

13. Which of the following criteria are acceptable for a rescuer to


discontinue CPR?
a. When it is obvious that the victim will not survive
b. When the rescuer is exhausted
c. After 30 minutes of CPR without a pulse rate
d. When the family requests discontinuation

14. 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

15. The nurse notes that the client’s urinary appliance contains yellow urine
with large amounts of mucus. How would the nurse best interpret these
data?
a. The client is developing an infection of the urinary tract
b. The mucus is caused by elevated levels of glucose in the urine
c. These findings are normal for a client with an ileal conduit
d. There is irritation of the stoma

16. Which of the following assessments would be important for the nurse to
make to determine whether or not a client is recovering as expected from
spinal anesthesia?
a. Level of consciousness
b. Rate and depth of respirations
c. Rate of capillary refill in the toes
d. Degree of response to pinpricks in the legs and toes

17. A client with iron-deficiency anemia is prescribed liquid iron


supplements. The nurse evaluates the client’s understanding of how to take
this drug. Which of the following statements indicates the client has
adequate knowledge?
a. I can use antidiarrheal drugs if I develop diarrhea
b. I will report any black stools to the physician
c. I will check my gums for any bleeding
d. I will dilute the medication and drink it with a straw

18. The nurse has instructed the client about the correct positioning of his
leg and hip following hip replacement surgery. Which of the following
statements indicate that the client has understood these instructions?
a. I may cross my legs as long as I keep my knees extended
b. I should avoid bending over to tie my shoes
c. I can sit in any chair that I find comfortable
d. I should avoid any unnecessary walking for about 3 months after my
surgery

19. Clients with diabetes mellitus require frequent vision assessment. The
nurse should instruct the client about which of the following eye problems
most likely to be associated with diabetes mellitus?
a. Cataracts
b. Retinopathy
c. Astigmatism
d. Glaucoma

20. An autograft is taken from the client’s left leg. The nurse should care
for the donor site by:
a. Covering it with an occlusive dry dressing
b. Keeping the site clean and dry
c. Applying a pressure dressing
d. Wrapping the extremity with an elastic bandage

21. Which of the following categories of medications would the nurse


anticipate being included in the conservative management of a client with a
herniated lumbar disk?
a. Muscle relaxant
b. Sedatives
c. Tranquilizers
d. Parenteral analgesics

22. The client has a nursing diagnosis of Constipation related to decreased


mobility secondary to traction. A care plan that incorporates which of the
following breakfasts would be most helpful in reestablishing a normal bowel
routine?
a. Eggs and bacon, buttered white toast, orange juice and coffee
b. Corn flakes with sliced banana, milk and English muffin with jelly
c. Orange juice, breakfast pastries (doughnut and Danish) and coffee
d. An orange, raisin bran and milk, and wheat toast with butter
23. A client has been placed on levodopa to treat Parkinson’s disease.
Which of the following is a common side effects of levodopa that the nurse
should include in the client’s teaching plan?
a. Pancytopenia
b. Peptic ulcer
c. Postural hypotension
d. Weight loss

24. The client would be experiencing a typical symptom of Meniere’s


disease if, before an attack, he experienced:
a. A severe headache
b. Blurred vision
c. Nausea
d. A feeling of inner ear fullness

25. Which of the following observations should the postanesthesia care unit
(PACU) nurse plan to make first when the client who has had a modified
radical mastectomy returns from the operating room?
a. Obtaining and recording vital signs
b. Observing that drainage tubes are patent and functioning
c. Ensuring that the client’s airway is free of obstruction
d. Checking the client’s dressings for drainage

26. The classic signs and symptoms of rheumatoid arthritis include which of
the following?
a. Pain on weight-bearing, rash and low-grade fever
b. Joint swelling, joint stiffness in the morning and bilateral joint
movement
c. Crepitus, development of Heberden’s nodes and anemia
d. Fatigue, leucopenia and joint pain

27. Nursing measures for the client who has had an MI include helping the
client to avoid activity that results in Valsalva’s maneuver. Valsalva’s
maneuver may cause cardiac dysrhythmias, increased venous pressure,
increased intrathoracic pressure and thrombi dislodgement. Which of the
following actions would help prevent Valsalva’s maneuver? Have the client:
a. Assume a side-lying position
b. Clench her teeth while moving in bed
c. Drink fluids through a straw
d. Avoid holding her breath during activity

28. A client is scheduled for radical neck surgery and a total laryngectomy.
During the preoperative teaching, the nurse should prepare the client for
which of the following postoperative possibilities?
a. Endotracheal intubation
b. Insertion of laryngectomy tube
c. Immediate speech therapy
d. Gastrostomy tube

29. The client is being taught to self-administer insulin. Learning goals


most likely will be attained when they are established by the:
a. Nurse and client because both need to be responsible for teaching
b. Physician and client because the physician is the manager of care
and the client is the main participant
c. Client because the client is best able to identify his or her own needs
and how to meet those needs
d. Client, nurse and physician so the client can participate in
planning care with the nurse and physician

30. Which statement by the client with rheumatoid arthritis would indicate
that she needs additional teaching to safely receive the maximum benefit
of her aspirin therapy?
a. I always take aspirin with food to protect my stomach
b. Once I learned to take aspirin with meals, I was able to start using
the inexpensive generic brand
c. I always watch for bleeding gums or blood in my stool
d. I try to take aspirin only on days when the pain seems
particularly bad

31. A client has stress incontinence has been given a pamphlet that
describes Kegel exercises. Which of the following statements indicates to
the nurse that the client has understood the instructions contained in the
pamphlet?
a. I should perform these exercises every evening
b. It will probably take a year before the exercises are effective
c. I can do these exercises sitting up, lying down or standing
d. I need to tighten my abdominal muscles to do these exercises
correctly

32. The development of laryngeal cancer is most clearly linked to which of


the following factors?
a. High-fat, low-fiber diet
b. Alcohol and tobacco use
c. Low socioeconomic status
d. Overuse of artificial sweeteners

33. Oxtriphylline (Choledyl SA) 0.2 g has been ordered. Available tablets
are 100mg. How many tablets should be given?
a. 0.5 tablets
b. 2.0 tablets
c. 2.5 tablets
d. 5.0 tablets

34. The most common causes of megaloblastic, macrocytic anemias are:


a. Folate or vitamin B deficiency
b. Chronic disease
c. Iron deficiency
d. Infection

35. Which of the following nutrients provides a little over half of the energy
needed during sleep?
a. Protein
b. Carbohydrate
c. Fat
d. Water

36. An anticipated outcome for the client after cataract removal surgery
would include which of the following?
a. The client states her vision is clear
b. The client states her infection is under control
c. The client describes methods to prevent an increase in
intraocular pressure
d. The client states she is able to administer parenteral pain medication

37. The nurse understands that Hodgkin’s disease is suspected when a


client presents with a painless, swollen lymph node. Hodgkin’s disease
typically affects people in which age group?
a. Children (ages 6-12 years)
b. Teenagers (ages 13-20 years)
c. Young adults (ages 21-40 years)
d. Older adults (ages 41-50 years)

38. The nurse notes the following assessment findings regarding the client’s
peripheral vascular status: cramping leg pain relieved by rest; cool, pale
feet; and delayed capillary refilling. Based on these data, the nurse would
make a nursing diagnosis of:
a. Impaired skin integrity
b. Impaired gas exchange
c. Ineffective peripheral tissue perfusion
d. Impaired physical mobility

39. The client with urinary tract infection is given a prescription for
trimethoprim (Bactrim-DS) for her infection. Which of the following
statements would indicate that she understands the principles of antibiotic
therapy?
a. I’ll take the pills until I feel better and keep the rest for recurrences
b. I’ll take all the pills then return to my doctor
c. I’ll take the pills until the symptoms go away then reduce the dose to
one pill a day
d. I’ll take all the pills then have the prescription renewed once
40. Which of the following clients would the nurse expect to be at highest
risk for developing a urinary tract infection?
a. Woman who has delivered two children vaginally
b. Man with an indwelling urinary catheter for incontinence
c. Man with a past medical history of renal calculi
d. Woman with well-controlled diabetes mellitus

41. When bandaging the burned client’s hand, the nurse should make
certain that:
a. The bandage is free of elastic
b. The hand and finger surfaces do not touch
c. The hand and fingers are not elevated above heart level
d. The bandage material is moistened with sterile normal saline solution

42. The nurse is caring for a client who has a history of aplastic anemia.
Which of the following data from the nursing history indicates that the
anemia is not being managed effectively?
a. Pallor of skin and mucous membranes
b. Heart rate of 68 bpm, bounding pulse
c. Blood pressure of 146/90 mm Hg
d. Poor skin turgor

43. A client is learning about caring for her ileostomy. Which of the
following statements would indicate that she understands how to care for
her ileostomy pouch?
a. I’ll empty my pouch when it’s about one-third full
b. I can take my pouch off at night
c. I should change my pouch immediately after lunch
d. I must apply a new pouch system every day

44. A client’s laboratory tests indicate that the client has hypocalcemia.
Which of the following symptoms should the nurse look for in the client?
a. Flushed skin
b. Depressed reflexes
c. Tingling in extremities
d. Diarrhea

45. Which of the following symptoms would the nurse most likely observe
in a client with cholecystitis from cholelithiasis?
a. Black stools
b. Nausea after ingestion of high fat foods
c. Elevated temperature of 103 F (39.4 C)
d. Decreased WBC count

46. Pain control is an important nursing goal for the client with pancreatitis.
Which of the following medications would the nurse plan to administer in
this situation?
a. Meperidine hydrochloride (Demerol)
b. Cimetidine (Tagamet)
c. Morphine sulfate
d. Codeine sulfate

47. A client is recovering from a gastric resection for peptic ulcer disease.
Which of the following outcomes indicates that the goal of adequate
nutritional intake is being achieved 3 weeks following surgery?
a. Increases food intake and tolerance gradually
b. Experiences occasional episodes of nausea and vomiting
c. Drinks 2000 mL/day of water
d. Experiences a rapid weight gain within 1 week

48. What would be the most important nursing intervention in caring for
the client’s residual limb during the first 24 hrs after amputation of the left
leg?
a. Keeping the residual limb flat on the bed
b. Abducting the residual limb on a scheduled basis
c. Applying traction to the residual limb
d. Elevating the residual limb on a pillow

49. After the client returns from surgery for a deviated nasal septum, the
nurse would anticipate placing her in what position?
a. Supine
b. Left side-lying
c. Semi-Fowler’s
d. Reverse Trendelenburg’s

50. While suctioning a client’s laryngectomy tube, the nurse insert the
catheter:
a. About 1-2 inches
b. As the client exhales
c. Until resistance is met, then withdraw it 1-2 cm
d. Until the client begins coughing

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