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101.  If  the  school-age  child  is  not  given  the  opportunity  to  engage  in tasks  and  activities  he  can  carry  through  to  completion,  he  is likely to develop feelings of: 

❍ A.  Guilt  
❍ B.  Shame  
❍ C.  Stagnation  
❍ D.  Inferiority  

102.  The  physician  has  ordered  2  units  of  whole  blood  for  a  client following surgery. To provide for client safety, the nurse should:  
❍ A.  Obtain a signed permit for each unit of blood  
❍ B.  Use a new administration set for each unit transfused  
❍ C.  Administer the blood using a Y connector  
❍  D.  Check  the  blood  type  and  Rh  factor  three  times  before initiat-ing  the  transfusion   

103.  A  client  with  B  positive  blood  is  scheduled  for  a  transfusion of whole blood. Which finding requires nursing intervention?  
❍ A.  The available blood has been banked for 2 weeks.  
❍ B.  The blood available for transfusion is Rh negative.  
❍ C.  The client has a peripheral IV of D5 1/2 normal saline.  

❍ D.  The blood available for transfusion is type O positive.  

104.  The  nurse  is  reviewing  the  lab  results  of  a  client’s  arterial  blood gases. The PaCO2 indicates effective functioning of the: ❍ A.  Kidneys  
❍ B.  Pancreas  
❍ C.  Lungs 
❍ D.  Liver  

105.  The  autopsy  results  in  SIDS-related  death  will  show  the  following consis-tent findings:  
❍ A.  Abnormal central nervous system development 
❍ B.  Abnormal cardiovascular development ❍ C.  Intraventricular hemorrhage and cerebral edema  
❍ D.  Pulmonary edema and intrathoracic hemorrhages


106.  The  nurse  is  caring  for a  newborn  who  is  on  strict  intake  and output.  The  used  diaper weighs  73.5gm.  The  diaper’s  dry  weight was 62gm. The newborn’s urine output is: ❍ A.  10ml  
❍ B.  11.5ml  
❍ C.  10gm  
❍ D.  12gm  

107.  The  nurse  is  teaching  the  parents  of  an  infant  with  osteogenesis imper-fecta. The nurse should explain the need for:  
❍ A.  Additional calcium in the infant’s diet  
❍ B.  Careful handling to prevent fractures  
❍ C.  Providing extra sensorimotor stimulation  
❍ D.  Frequent testing of visual function  

108.  A  newborn  is  diagnosed  with  respiratory  distress  syndrome (RDS). Which position is best for maintaining an open airway?  
❍ A.  Prone, with his head turned to one side  
❍ B.  Side-lying, with a towel beneath his shoulders ❍ C.  Supine, with his neck slightly flexed  
❍ D.  Supine, with his neck slightly extended  



109.   A  client  with  bipolar  disorder is  discharged  with  a  prescription  for Depakote (divalproex sodium). The  nurse should remind the client  of  the need  for: 


A. Frequent  dental  visits B.Frequent  lab  work 
C. Additional  fluids 
D. Additional  sodium 


110.The  physician’s notes state that a  client  with cocaine  addiction  has formication.  The  nurse  recognizes  that  the  client  has: 
A.Tactile  hallucinations B.Irregular heart  rate C.Paranoid  delusions D.Methadone  tolerance


111.The  nurse  is  preparing  a client  with  gastroesophageal  reflux  disease  (GERD) for discharge.  The  nurse  should  tell  the  client  to: 
❍ A.  Eat a small snack before bedtime  
❍ B.  Sleep on his right side ❍ C.  Avoid carbonated beverages  
❍ D.  Increase his intake of citrus fruits  

112. A client with a C3 spinal cord injury experiences autonomic hyperreflexia.  After placing  the  client  in  high  Fowler’s  position,  the  nurse’s  next  action should be to: 
❍  A.  Notify the physician ❍  B.  Make sure the catheter is patent 
❍  C.  Administer an antihypertensive 
❍  D.  Provide supplemental oxygen 

113.  A  client  is  to  receive  Dilantin  (phenytoin)  via  a  nasogastric  (NG)  tube. When  giving  the medication,  the  nurse  should: 
❍  A.  Flush  the  NG  tube  with  2–4mL  of  water  before giving the medication  
❍  B.  Administer  the  medication,  flush  with  5mL  of water, and clamp the NG tube  
❍  C.  Flush  the  NG  tube  with  5mL  of  normal  saline  and administer the medication  
❍  D.  Flush  the  NG  tube  with  2–4oz  of  water  before  and  after giving  the  medication 




114.  When assessing the client with acute arterial occlusion, the nurse would   expect to find:  
❍ A.  Peripheral edema in the affected extremity   
❍ B.  Minute blackened areas on the toes   
❍ C.  Pain above the level of occlusion   
❍ D.  Redness and warmth over the affected area   

115. The nurse is assessing a client following the removal of a pituitary tumor. The nurse notes that the urinary output has increased and that the urine is very dilute. The nurse should give priority to:  
❍ A. Notifying the doctor immediately  
❍ B. Documenting the finding in the chart  
❍ C. Decreasing the rate of IV fluids  
❍  D.  Administering vasopressive medication 


116.  The physician has ordered Coumadin (sodium warfarin) for a client with  a history of clots. The nurse should tell the client to avoid which of the following vegetables?  

❍ A. Lettuce  
❍ B. Cauliflower  
❍ C. Beets  
❍ D.  Carrots  


117.  The nurse is caring for a child in a plaster-of-Paris hip spica cast. To facilitate drying, the nurse should: 
❍ A. Use a small hand-held hair dryer set on medium heat  
❍ B. Place a small heater near the child’s bed  
❍ C. Turn the child at least every 2 hours  
❍  D.  Allow one side to dry before changing positions 

118.  The local health clinic recommends vaccination against influenza for all  its employees. The influenza vaccine is given annually in: 
❍ A. November  
❍ B. December  
❍ C. January  
❍ D. February   


119.  A  client  is  admitted  with  suspected  Hodgkin’s  lymphoma.  The diagnosis is confirmed by the:  
❍ A.  Overproliferation of immature white cells  
❍ B.  Presence of Reed-Sternberg cells  
❍ C.  Increased incidence of microcytosis  
❍ D.  Reduction in the number of platelets  


120.  The  nurse  is  caring  for  a  client  following  a  laryngectomy.  The nurse can best help the client with communication by:  
❍ A.  Providing a pad and pencil  
❍ B.  Checking on him every 30 minutes  
❍ C.  Telling him to use the call light  
❍ D.  Teaching the client simple sign language  


121.  A  client  has  recently  been  diagnosed  with  open-angle glaucoma. The nurse should tell the client to avoid taking:  
❍ A.  Aleve (naprosyn)  
❍ B.  Benadryl (diphenhydramine)  
❍ C.  Tylenol (acetaminophen)  
❍ D.  Robitussin (guaifenesin)  


122.  The  nurse  is  caring  for  a  client  with  an  endemic  goiter.  The nurse recog-nizes that the client’s condition is related to:  
❍ A.  Living in an area where the soil is depleted of iodine  
❍ B.  Eating foods that decrease the thyroxine level ❍ C.  Using aluminum cookware to prepare the family’s meals  
❍ D.  Taking medications that decrease the thyroxine level  



123.  A  client  with  a  history  of  schizophrenia  is  seen  in  the  local health  clinic  for  medication  follow-up.  To  maintain  a  therapeutic level of medication, the nurse should tell the client to avoid:  
❍ A.  Taking over-the-counter allergy medication ❍ B.  Eating cheese and pickled foods  
❍ C.  Eating salty foods  
❍  D.   Taking  over-the-counter pain  relievers


124.  The  nurse  is  formulating  a  plan  of  care  for  a  client  with  a  goiter. The pri-ority nursing diagnosis for the client with a goiter is:  
❍ A.  Body image disturbance related to swelling of neck  
❍ B.  Anxiety-related changes in body image  
❍  C.  Altered  nutrition,  less  than  body  requirements,  related to dif-ficulty in swallowing  
❍  D.  Risk  for  ineffective  airway  clearance  related  to pressure on the trachea


125.  Upon  arrival  in  the  nursery,  erythomycin  eyedrops  are  applied  to  the newborn’s eyes. The nurse understands that the medication will:  
❍ A.  Make the eyes less sensitive to light  
❍ B.  Help prevent neonatal blindness  
❍ C.  Strengthen the muscles of the eyes  
❍ D.  Improve accommodation to near objects  


126.  A  client  has  a  diagnosis  of  discoid  lupus  erythematosus  (DLE). The  nurse  recognizes  that  discoid  lupus  differs  from  systemic lupus erythematosus because it: 
❍ A.  Produces changes in the kidneys  
❍ B.  Is confined to changes in the skin  
❍ C.  Results in damage to the heart and lungs  
❍ D.  Affects both joints and muscles  



127.  A  client  sustained  a  severe  head  injury  to  the  occipital  lobe. The nurse should carefully assess the client for:  
❍ A.  Changes in vision  
❍ B.  Difficulty in speaking ❍ C.  Impaired judgment  
❍ D.  Hearing impairment 


128.  The  nurse  observes  a  group  of  toddlers  at  daycare.  Which  of  the follow-ing play situations exhibits the characteristics of parallel play?  
❍ A.  Lindie and Laura sharing clay to make cookies  
❍ B.  Nick and Matt playing beside each other with trucks  
❍ C.  Adrienne working a puzzle with Meredith and Ryan  
❍ D.  Ashley playing with a busy box while sitting in her crib  


129.  Which of the following statements is true regarding language development of young children?
❍ A.  Infants can discriminate speech from other patterns of sound.   
❍ B. Boys are more advanced in language development than girls of the same age.   
❍ C. Second-born children develop language earlier than first-born or only children.   
❍ D. Using single words for an entire sentence suggests delayed speech development.   

130.  A mother tells the nurse that her daughter has become quite a collector filling her room with Beanie babies, dolls, and stuffed animals. The nurse  recognizes that the child is developing:  
❍  A. Object permanence  
❍  B. Post-conventional thinking  
❍  C. Concrete operational thinking  
❍  D.  Pre-operational thinking  




131.  According to Erikson, the developmental task of the infant is to establish trust. Parents and caregivers foster a sense of trust by: 
❍  A. Holding the infant during feedings  
❍  B. Speaking quietly to the infant  
❍  C. Providing sensory stimulation  
❍  D.  Consistently responding to needs  


132.  The nurse is preparing to walk the postpartum client for the first time since delivery. Before walking the client, the nurse should: 
❍ A.  Give the client pain medication   
❍ B.  Assist the client in dangling her legs   
❍ C.  Have the client breathe deeply   
❍ D.  Provide the client additional fluids   


133. To minimize confusion in the elderly hospitalized client, the nurse should 
❍ A. Provide sensory stimulation by varying the daily routine 
❍ B. Keep the room brightly lit and the television on to provide     orientation to time   
❍ C. Encourage visitors to limit visitation to phone calls to avoid     overstimulation   
❍  D.  Provide explanations in a calm, caring manner to minimize     anxiety   


134.  A  client  diagnosed with  tuberculosis  asks  the  nurse  when  he can return to work. The nurse should tell the client that:  
❍  A.  He  can  return  to  work  when  he  has  three  negative sputum cultures. ❍ B.  He can return to work as soon as he feels well enough.  
❍  C.  He  can  return  to  work  after  a  week  of  being on the medication.  
❍  D.  He  should  think  about  applying  for  disability  because he will no longer be able to work. 


135.  The  physician  has  ordered  lab  work  for  a  client  with  suspected dissemi-nated  intravascular  coagulation  (DIC).  Which  lab  finding would provide a definitive diagnosis of DIC?  
❍ A.  Elevated erythrocyte sedimentation rate  
❍ B.  Prolonged clotting time  
❍ C.  Presence of fibrin split compound  
❍ D.  Elevated white cell count  




136.  The  nurse  is  caring  for  a  client  with  rheumatoid  arthritis.  The  nurse knows that the client’s symptoms will be most improved by:  
❍ A.  Taking a warm shower upon awakening  
❍ B.  Applying ice packs to the joints  
❍ C.  Taking two aspirin before going to bed  
❍ D.  Going for an early morning walk  


137.  A  client  with  schizophrenia  has  been  taking  Clozaril  (clozapine) for  the  past  6  months.  This  morning  the  client’s  temperature  was elevated to 102°F. The nurse should give priority to:  
❍ A.  Placing a note in the chart for the doctor  
❍ B.  Rechecking the temperature in 4 hours  
❍ C.  Notifying the physician immediately  
❍ D.  Asking the client if he has been feeling sick  

138.  Which  one  of  the  following  clients  is  most  likely  to  develop  acute respira-tory distress syndrome?  
❍ A.  A 20-year-old with fractures of the tibia  
❍ B.  A 36-year-old who is HIV positive  
❍ C.  A 40-year-old with duodenal ulcers  
❍ D.  A 32-year-old with barbiturate overdose

139.  The  complete  blood  count  of  a  client  admitted  with  anemia reveals  that  the  red  blood  cells  are  hypochromic  and microcytic. The nurse recog-nizes that the client has:  
❍ A.  Aplastic anemia  
❍ B.  Iron-deficiency anemia  
❍ C.  Pernicious anemia  
❍ D.  Hemolytic anemia 


140.  While  performing  a  neurological  assessment  on  a  client  with  a  closed head injury, the nurse notes a positive Babinski reflex. The nurse should: 
❍ A.  Recognize that the client’s condition is improving  
❍ B.  Reposition the client and check reflexes again  
❍ C.  Do nothing because the finding is an expected one  
❍ D.  Notify the physician of the finding  


141.  The  doctor  has  ordered  neurological  checks  every  30  minutes  for a  client  injured  in  a  biking  accident.  Which  finding  indicates  that the client’s con-dition is satisfactory?  
❍ A.  A score of 13 on the Glascow coma scale  
❍ B.  The presence of doll’s eye movement  
❍ C.  The absence of deep tendon reflexes  
❍ D.  Decerebrate posturing 


142.  The  nurse  is  developing  a  plan  for bowel  and  bladder retraining for a  client  with  paraplegia.  The  primary  goal  of  a  bowel  and bladder retraining program is:  
❍ A.  Optimal restoration of the client’s elimination pattern  
❍ B.  Restoration of the client’s neurosensory function  
❍ C.  Prevention of complications from impaired elimination  
❍ D.  Promotion of a positive body image  

143.  When  checking  patellar  reflexes,  the  nurse  is  unable  to  elicit  a knee-jerk  response.  To  facilitate  checking  the  patellar reflex,  the nurse should tell the client to:  
❍ A.  Pull against her interlocked fingers  
❍ B.  Shrug her shoulders and hold for a count of five ❍ C.  Close her eyes tightly and resist opening  
❍  D.   Cross  her  legs  at  the  ankles   

144. The  nurse  is  performing  a  physical  assessment  on  a client.  The  last  step  in  the  physical  assessment  is: 
❍ A.  Inspection  
❍ B.  Auscultation  
❍ C.  Percussion  
❍ D.  Palpation  


145.A  client  with  schizophrenia  spends  much  of his  time  pacing  the  floor, rocking  back and forth,  and  moving  from  one foot to another.  The  client’s behaviors  are  an  example  of: 
A. Dystonia 
B.Tardive  dyskinesia C.Akathisia 
D.Oculogyric crisis 


146.The  nurse  is  assessing  a  recently  admitted  newborn.  Which  finding should  be  reported  to  the  physician? 
❍ A.  The umbilical cord contains three vessels.  
❍ B.  The newborn has a temperature of 98°F.  
❍ C.  The feet and hands are bluish in color.  
❍ D.  A large, soft swelling crosses the suture line. 




147. Which statement is true regarding the infant’s susceptibility to pertussis?   A.If  the  mother had  pertussis,  the  infant  will  have immunity. passive
B.Most  infants  and  children  are  highly  susceptible  from  birth.
C.The  newborn  will  be  immune  to  pertussis  for  the  first  few months  of  life. 
D.Infants  under 1  year  of  age  seldom  get pertussis. 


148.A  client in  labor  has  been given  epidural anesthesia  with  Marcaine (bupivacaine).  To  reverse  the  hypotension  associated  with  epidural  anesthesia, the  nurse  should  have  which  medication 
❍ A.  Narcan (naloxone)  
❍ B.  Dobutrex (dobutamine)  
❍ C.  Romazicon (flumazenil)  

❍  D.   Adrenalin  (epinephrine)    

149.  The  physician  has  prescribed  Gantrisin  (sulfasoxazole) 1g  in divided  doses  for a  client  with  a  urinary  tract  infection.  The  nurse should admin-ister the medication:  

❍ A.  With meals or a snack ❍ B.  30 minutes before meals  
❍ C.  30 minutes after meals ❍ D.  At bedtime  


150.  A  client  with  a  history  of  depression  is  treated  with  Parnate (tranyl-cypromine),  an  MAO  inhibitor.  Ingestion  of  foods containing tyramine while taking an MAO inhibitor can result in: ❍ A.  Extreme elevations in blood pressure  

❍ B.  Rapidly rising temperature  
❍ C.  Abnormal movement and muscle spasms  
❍ D.  Damage to the eighth cranial nerve  

151.  A  client  is  admitted  to  the  emergency  room  after  falling  down  a flight  of  stairs.  Initial  assessment  reveals  a  large  bump  on  the front  of  the  head  and  a  2-inch  laceration  above  the  right  eye. Which finding is consistent with injury to the frontal lobe?  

❍ A.  Complaints of blindness  
❍ B.  Decreased respiratory rate and depth  
❍ C.  Failure to recognize touch  
❍ D.  Inability to identify sweet taste  

152.  The  nurse  is  evaluating  the  intake  and  output  of  a  client  for  the first  12  hours  following  an  abdominal  cholecystectomy.  Which finding should be reported to the physician?  

❍ A.  Output of 10mL from the Jackson-Pratt drain  
❍ B.  Foley catheter output of 285mL  
❍ C.  Nasogastric tube output of 150mL  
❍ D.  Absence of stool  


153.  A community  health  nurse  is  teaching  healthful  lifestyles  to  a group  of  senior citizens.  The  nurse  knows  that  the  leading cause of death in per-sons 65 and older is:  

❍ A.  Chronic pulmonary disease  
❍ B.  Diabetes mellitus  
❍ C.  Pneumonia  
❍  D.   Heart  disease   

154.  A client  suspected  of  having  Alzheimer’s  disease  is  evaluated  using  the Mini-Mental  State  Examination.  At  the  beginning  of  the  evaluation,  the examiner  names  three  objects.  Later  in  the  evaluation,  he  asks  the  client to name the same three objects. The examiner is testing the client’s:  

❍ A.  Attention  
❍ B.  Orientation  
❍ C.  Recall  
❍ D.  Registration  


155.  A  client  with  end  stage  renal  disease  is  being  managed  with peritoneal  dialysis.  If  the  dialysate  return  is  slowed  the  nurse should tell the client to:  

❍ A.  Irrigate the dialyzing catheter with saline  
❍ B.  Skip the next scheduled infusion  
❍ C.  Gently retract the dialyzing catheter  
❍ D.  Change position or turn side to side  



156.  The  nurse  is  the  first  person  to  arrive  at  the  scene  of  a  motor vehicle  accident.  When  rendering  aid  to  the  victim,  the  nurse should give priority to:  

❍ A.  Establishing a patent airway  
❍ B.  Checking the quality of respirations  
❍ C.  Observing for signs of active bleeding  
❍ D.  Determining the level of consciousness  

157.  A client  hospitalized  with  renal  calculi  complains  of  severe  pain in  the  right  flank.  In  addition  to  complaints  of  pain,  the  nurse  can expect to see changes in the client’s vital signs that include:  

❍ A.  Decreased pulse rate ❍ B.  Increased blood pressure  
❍ C.  Decreased respiratory rate  
❍ D.  Increased temperature  


158.  The  nurse  is  using  the  Glascow  coma  scale  to  assess  the  client’s motor  response.  The  nurse  places  pressure  at  the  base  of  the client’s  fingernail  for  20  seconds.  The  client’s  only  response  is withdrawal of his hand. The nurse interprets the client’s response as:  

❍ A.  A score of 6 because he follows commands  
❍ B.  A score of 5 because he localizes pain  
❍ C.  A score of 4 because he uses flexion  
❍ D.  A score of 3 because he uses extension  

159.  A 4-year-old  is  admitted  to  the  hospital  for treatment  of Kawasaki’s  dis-ease.  The  medication  commonly  prescribed  for the treatment of Kawasaki’s disease is:  

❍ A.  Aspirin (acetylsalicylic acid)  
❍ B.  Benadryl (diphenhydramine)  
❍ C.  Polycillin (ampicillin) ❍ D.  Betaseron (interferon beta)  


160.  The  nurse  is  caring  for  a  client  with  bulimia  nervosa.  The  nurse recog-nizes  that  the  major  difference  in  the  client  with  anorexia nervosa and the client with bulimia nervosa is the client with bulimia:  

❍ A.  Is usually grossly overweight.  
❍ B.  Has a distorted body image.  
❍ C.  Recognizes that she has an eating disorder.  
❍ D.  Struggles with issues of dependence versus independence.  

 161.  The  Mantoux  text  is  used  to  determine  whether  a  person  has  been exposed to tuberculosis. If the test is positive, the nurse will find a:  

❍ A.  Fluid-filled vesicle  
❍ B.  Sharply demarcated erythema  
❍ C.  Central area of induration  
❍ D.  Circular blanched area  


162.  The  physician  has  ordered  continuous  bladder  irrigation  for  a client fol-lowing a prostatectomy. The nurse should:  

❍ A.  Hang the solution 2–3 feet above the client’s abdomen  
❍ B.  Allow air from the solution tubing to flow into the catheter  
❍  C.  Use  a  clean  technique  when  attaching  the  solution tubing to the catheter  
❍  D.  Clamp  the  solution  tubing  periodically  to  prevent bladder dis-tention  

163.  A pediatric  client  is  admitted  to  the  hospital  for treatment  of diarrhea  caused  by  an  infection  with  salmonella.  Which  of  the following most like-ly contributed to the child’s illness?  

❍ A.  Brushing the family dog  
❍ B.  Playing with a turtle 
❍ C.  Taking a pony ride  
❍  D.   Feeding  the  family  cat   

164.  Which  one  of  the  following  infants  needs  a  further assessment of growth?  

❍ A.  4-month-old: birth weight 7lb, 6oz; current weight 14lb, 4oz  
❍ B.  2-week-old: birth weight 6lb, 10oz; current weight 6lb, 12oz  
❍ C.  6-month-old: birth weight 8lb, 8oz; current weight 15lb  
❍ D.  2-month-old: birth weight 7lb, 2oz; current weight 9lb, 6oz  



165.  The  physician  has  ordered  Pyridium  (phenazopyridine)  for  a client with urinary urgency. The nurse should tell the client that:  

❍ A.  The urine will have a strong odor of ammonia.  
❍ B.  The urinary output will increase in amount.  
❍ C.  The urine will have a red–orange color.  
❍ D.  The urinary output will decrease in amount. 


166.  The  nurse  is  teaching  the  mother  of  an  infant  with  eczema.  Which  of  the following instructions should be included in the nurse’s teaching?  

❍ A.  Dress the infant warmly to prevent undue chilling  
❍ B.  Cut the infant’s fingernails and toenails regularly  
❍ C.  Use bubble bath instead of soap for bathing
❍  D.  Wash  the  infant’s  clothes  with  mild  detergent  and fabric softener  


167.  Skeletal  traction  is  applied  to  the  right  femur  of  a  client  injured in a fall. The primary purpose of the skeletal traction is to:  

❍ A.  Realign the tibia and fibula  
❍ B.  Provide traction on the muscles  
❍ C.  Provide traction on the ligaments  
❍ D.  Realign femoral bone fragments  


168.  The  home  health  nurse  is  visiting  a  client  with  an  exacerbation of  rheumatoid  arthritis.  To  prevent  deformities  of  the  knee  joints, the nurse should:  

❍ A.  Tell the client to walk without bending the knees ❍ B.  Encourage movement within the limits of pain  
❍ C.  Instruct the client to sit only in a recliner  
❍ D.  Remain in bed as long as the joints are painful


169.  The  physician  has  ordered  Dextrose  5%  in  normal  saline  for  an infant  admitted  with  gastroenteritis.  The  advantage  of administering the infant’s IV through a scalp vein is: 

❍ A.  The infant can be held and comforted more easily. ❍ B.  Dextrose is best absorbed from the scalp veins.  
❍ C.  Scalp veins do not infiltrate like peripheral veins.  
❍ D.  There are few pain receptors in the infant’s scalp.  


170.  A newborn  diagnosed  with  bilateral  choanal  atresia  is  scheduled for sur-gery  soon  after  delivery.  The  nurse  recognizes  the immediate need for surgery because the newborn:  

❍ A.  Will have difficulty swallowing  
❍ B.  Will be unable to pass meconium  
❍ C.  Will regurgitate his feedings  
❍ D.  Will be unable to breathe through his nose  

171.  The  most  appropriate  means  of  rehydration  of  a  7-month-old with diar-rhea and mild dehydration is:  

❍ A.  Oral rehydration therapy with an electrolyte solution  
❍ B.  Replacing milk-based formula with a lactose-free formula  
❍ C.  Administering intraveneous Dextrose 5% 1⁄4 normal saline  

❍ D.  Offering bananas, rice, and applesauce along with oral fluids  


172.  The  nurse  is  caring  for  an  infant  receiving  intravenous  fluid. Signs of fluid overload in an infant include:  

❍ A.  Swelling of the hands and increased temperature ❍ B.  Increased heart rate and increased blood pressure  
❍ C.  Swelling of the feet and increased temperature ❍ D.  Decreased heart rate and decreased blood pressure  

173.  The  nurse  is  providing  care  for  a  10-month-old  diagnosed  with Wilms  tumor.  Most  parents  of  infants  with  Wilms  tumor report finding the mass when:  

❍ A.  The infant is diapered or bathed  
❍ B.  The infant is unable to use his arms  
❍ C.  The infant is unable to follow a moving object  
❍  D.   The  infant  is  unable  to  vocalize  sounds   

174.  An  obstetrical  client  has  just  been  diagnosed  with  cardiac disease. The nurse should give priority to:  

❍ A.  Instructing the client to remain on strict bed rest ❍ B.  Telling the client to monitor her pulse and respirations  
❍ C.  Instructing the client to check her temperature in the evening  
❍ D.  Telling the client to weigh herself monthly  


175.  The  nurse  is  caring  for  a  client  receiving  supplemental  oxygen. The effec-tiveness of the oxygen therapy is best determined by:  

❍ A.  The rate of respirations  
❍ B.  The absence of cyanosis  
❍ C.  Arterial blood gases  
❍ D.  The level of consciousness  


176.  A  client  having  a  colonoscopy  is  medicated  with  Versed (midazolam). The nurse recognizes that the client:  

❍ A.  Will be able to remember the procedure within 2–3 hours  
❍ B.  Will not be able to remember having the procedure done  
❍ C.  Will be able to remember the procedure within 2–3 days  
❍  D.  Will  not  be  able  to  remember  what  occurred  before the pro-cedure  

177.  The  nurse  is  assessing  a  client  with  an  altered  level  of  consciousness. One of the first signs of altered level of consciousness is:  

❍ A.  Inability to perform motor activities  
❍ B.  Complaints of double vision  
❍ C.  Restlessness  
❍ D.  Unequal pupil size 


178.  Four  clients  are  to  receive  medication.  Which  client  should receive med-ication first?  

❍  A.  A  client  with  an  apical  pulse  of  72  receiving Lanoxin (digoxin) PO daily  
❍  B.  A  client  with  abdominal  surgery  receiving Phenergan  (promethazine)  IM  every  4  hours PRN for nausea and vomiting  
❍  C.  A  client  with  labored  respirations  receiving  a  stat dose of IV Lasix (furosemide)  
❍  D.  A  client  with  pneumonia  receiving  Polycillin  (ampicillin) IVPB every 6 hours  


179.  The  nurse  is  caring  for  a  cognitively  impaired  client  who  begins to  pull  at  the  tape  securing  his  IV  site.  To  prevent  the  client  from removing the IV, the nurse should:  

❍  A.  Place  tape  completely  around  the  extremity,  with tape ends out of the client’s vision  
❍ B.  Tell him that if he pulls out the IV, it will have to be  restarted 
❍ C.  Slap the client’s hand when he reaches toward the IV site  
❍ D.  Apply clove hitch restraints to the client’s hands  


180.  A  client  is  admitted  to  the  emergency  room  with  complaints  of subster-nal  chest  pain  radiating  to  the  left  jaw.  Which  ECG finding is suggestive of acute myocardial infarction?  

❍ A.  Peaked P wave  
❍ B.  Changes in ST segment ❍ C.  Minimal QRS wave  
❍ D.  Prominent U wav 

181.  The  nurse  is  assessing  a  client  with  a  closed  reduction  of  a  fractured femur. Which finding should the nurse report to the physician?  

❍ A.  Chest pain and shortness of breath.  
❍ B.  Ecchymosis on the side of the injured leg.  
❍ C.  Oral temperature of 99.2°F.  
❍ D.  Complaints of level two pain on a scale of five. 


182.  According  to  the  American  Heart  Association  (2005)  guidelines the com-pression-to-ventilation cardiopulmonary resuscita-tion is:  

❍ A.  10:1  
❍ B.  20:2  
❍ C.  30:2  
❍ D.   40:1   


183.  A  client  is  admitted  with  a  diagnosis  of  renal  calculi.  The  nurse should give priority to:  

❍ A.  Initiating an intraveneous infusion  
❍ B.  Encouraging oral fluids  
❍ C.  Administering pain medication  
❍ D.  Straining the urine 


184.  The  Joint  Commission  for Accreditation  of  Hospital  Organizations (JCAHO) specifies  that  two  client  identifiers  are  to  be  used before  admin-istering  medication.  Which  method  is  best  for identifying patients using two patient identifiers?  

❍  A. Take  the  medication  administration  record  (MAR) to  the  room  and  compare  it  with  the  name  and medical number recorded on the armband. ❍  B.  Compare  the  medication  administration  record  (MAR)  with the client’s room number and name on the armband.  
❍  C.  Request  that  a  family  member  identify  the  client  and then ask the client to state his name.  
❍  D.  Ask  the  client  to  state  his  full  name  and  then  to  write his full name.  


185.  A client  complains  of  sharp,  stabbing  pain  in  the  right  lower quadrant  that  is  graded  as  level  8  on  a  scale  of  10.  The  nurse knows that pain of this severity can best be managed using:  

❍ A.  Aleve (naproxen sodium)  
❍ B.  Tylenol with codeine (acetaminophen with codeine)  
❍ C.  Toradol (ketorolac)  
❍ D.  Morphine sulfate (morphine sulfate)  

186.  A  client  has  had  diarrhea  for  the  past  3  days.  Which  acid/base imbalance would the nurse expect the client to have?  

❍ A.  Respiratory alkalosis ❍ B.  Metabolic acidosis  
❍ C.  Metabolic alkalosis  
❍ D.  Respiratory acidosis


187.  A home  health  nurse  finds  the  client  lying  unconscious  in  the doorway  of  her bathroom.  The  nurse  checks  for responsiveness by  gently  shaking  the  client  and  calling  her name.  When  it  is determined that the client is nonresponsive, the nurse should:  

❍ A.  Start cardiac compression  
❍ B.  Give two slow, deep breaths  
❍ C.  Open the airway using head-tilt, chin-lift maneuver ❍ D.  Call for help  

188.  The  nurse  is  reviewing  the  lab  reports  of  a  client  who  is  HIV positive.  Which  lab  report  provides  information  regarding  the effectiveness of the client’s medication regimen?  

❍ A.  ELISA  
❍ B.  Western Blot  
❍ C.  Viral load  
❍ D.  CD4 count  


189.  A  client  with  AIDS-related  cytomegalovirus  is  started  on  Cytovene  (ganciclovir). The nurse should tell the client that the medication will be needed:  

❍ A.  Until the infection clears  
❍ B.  For 6 months to a year ❍ C.  Until the cultures are normal  
❍ D.  For the remainder of life  

190.  The  nurse  is  caring  for  a  client  with  suspected  AIDS  dementia complex. The first sign of dementia in the client with AIDS is:  

❍ A.  Changes in gait  
❍ B.  Loss of concentration ❍ C.  Problems with speech ❍ D.  Seizures  


191.  The  physician  has  ordered  Activase  (alteplase)  for  a  client  admitted with a myocardial infarction. The desired effect of Activase is:  

❍ A.  Prevention of congestive heart failure  
❍ B.  Stabilization of the clot ❍ C.  Increased tissue oxygenation  
❍  D.   Destruction  of  the  clot   



192.  The  mother  of  a  2-year-old  asks  the  nurse  when  she  should  schedule  her son’s  first  dental  visit.  The  nurse’s  response  is  based  on  the  knowledge that most children have all their deciduous teeth by:  

❍ A.  15 months  
❍ B.  18 months  
❍ C.  24 months  
❍ D.  30 months  


193.  The  nurse  is  caring  for  a  child  with  Down  syndrome.  Which  characteristics are commonly found in the child with Down syndrome? ❍ A.  Fragile bones, blue sclera, and brittle teeth  

❍ B.  Epicanthal folds, broad hands, and transpalmar creases  
❍ C.  Low posterior hairline, webbed neck, and short stature  
❍ D.  Developmental regression and cherry-red macula  


194.  After several  hospitalizations  for respiratory  ailments,  a  6-monthold  has  been  diagnosed  as  having  HIV.  The  infant’s  respiratory ailments were most likely due to:  

❍ A.  Pneumocystis carinii ❍ B.  Cytomegalovirus  
❍ C.  Cryptosporidiosis  
❍ D.  Herpes simplex  


195.  A  client  has  returned  from  having  a  bronchoscopy.  Before  offering the client sips of water, the nurse should assess the client’s:  

❍ A.  Blood pressure  
❍ B.  Pupilary response  
❍ C.  Gag reflex  
❍ D.  Pulse rate  

196.  The  physician  has  ordered  injections  of  Neumega  (oprellvekin)  for a  client  receiving  chemotherapy  for  prostate  cancer.  Which  finding suggests that the medication is having its desired effect? ❍ A.  Hct 12.8g  

❍ B.  Platelets 250,000mm3 ❍ C.  Neutrophils 4,000mm3 ❍ D.  RBC 4.7 million  


197.  A  child  suspected  of  having  cystic  fibrosis  is  scheduled  for  a quantitative  sweat  test.  The  nurse  knows  that  the  quantitative sweat test will be ana-lyzed using:  

❍ A.  Pilocarpine iontophoresis  
❍ B.  Choloride iontophoresis  
❍ C.  Sodium iontophoresis ❍ D.  Potassium iontophoresis  


198.  The  nurse  is  caring  for  a  client  with  a  Brown-Sequard  spinal cord injury. The nurse should expect the client to have:  

❍ A.  Total loss of motor, sensory, and reflex activity ❍ B.  Incomplete loss of motor function  
❍ C.  Loss of sensory function with potential for recovery  
❍ D.  Loss of sensation on the side opposite the injury


199.  A  client  with  cirrhosis  has  developed  signs  of  heptorenal  syndrome. Which diet is most appropriate for the client at this time?  

❍ A.  High protein, moderate sodium  
❍ B.  High carbohydrate, moderate sodium  
❍ C.  Low protein, low sodium  
❍ D.  Low carbohydrate, high protein  





200.  The  nurse  is  caring  for  a  client  with  a  basal  cell  epithelioma.  The primary cause of basal cell epithelioma is:  

❍ A.  Sun exposure  
❍ B.  Smoking  
❍ C.  Ingestion of alcohol  
❍ D.  Food preservatives  




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