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❍ A. Guilt
❍ D. The blood available for transfusion is type O positive.
❍ A. Lettuce
127. A client sustained a severe head injury to the occipital lobe. The nurse should carefully assess the client for:
❍ 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