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                [Q.NO.101-200 ]

101.  The  physician  has  prescribed  tranylcypromine  sulfate  (Parnate) 10mg  bid.  The  nurse  should  teach  the  client  to  refrain  from eating foods con-taining tyramine because it may cause:  

❍ A.  Hypertension  
❍B. Hyperthermia  
❍C.  Hypotension  
❍D.Urinary retention  

102.  The  client  is  admitted  to  the  emergency  room  with  shortness  of breath,  anxiety,  and  tachycardia.  His  ECG  reveals  atrial fibrillation  with  a  ventric-ular response  rate  of  130  beats  per minute.  The  doctor orders  quinidine  sulfate.  While  he  is receiving quinidine, the nurse should monitor his ECG for:  

❍ A.  Peaked P wave  
❍ B.  Elevated ST segment  
❍ C.  Inverted T wave  
❍D.Prolonged QT interval  

103. Lidocaine is a medication frequently ordered for the client experiencing:  
❍A.  Atrial tachycardia  
❍ B.  Ventricular tachycardia  
❍ C.  Heart block  
❍ D.  Ventricular brachycardia  

104.  The  doctor  orders  2%  nitroglycerin  ointment  in  a  1-inch  dose  every 12 hours. Proper application of nitroglycerin ointment includes:  

❍ A.  Rotating application sites  
❍ B.  Limiting applications to the chest  
❍ C.  Rubbing it into the skin  
❍ D.  Covering it with a gauze dressing  

105.  The  physician  prescribes  captopril  (Capoten)  25mg  po  tid  for the  client  with  hypertension.  Which  of  the  following  adverse reactions can occur with administration of Capoten?  

❍ A.  Tinnitus  
❍ B.  Persistent cough  
❍C.  Muscle weakness  
❍ D.  Diarrhea  

106.  The  client  is  admitted  with  a  BP of  210/100.  Her  doctor orders furosemide  (Lasix) 40mg  IV  stat.  How  should  the  nurse administer the prescribed furosemide to this client?  

❍ A.  By giving it over 1–2 minutes  
❍ B.  By hanging it IV piggyback  
❍ C.  With normal saline only  
❍ D.  With a filter  

107.  The  client  is  receiving  heparin  for  thrombophlebitis  of  the  left  lower extremity. Which of the following drugs reverses the effects of heparin?  

❍B.Protamine sulfate  
❍ C.  Streptokinase  
❍ D.  Sodium warfarin  

108.  The  nurse  is  making  assignments  for  the  day.  Which  client should be assigned to the pregnant nurse?  

❍  A.  The  client  receiving  linear  accelerator  radiation therapy for lung cancer  
❍ B.  The client with a radium implant for cervical cancer  
❍  C.  The  client  who  has  just  been  administered soluble brachytherapy for thyroid cancer  
❍  D.  The  client  who  returned  from  placement  of  iridium seeds for prostate cancer  

109.  The  nurse  is  planning  room  assignments  for the  day.  Which  client should be assigned to a private room if only one is available?  

❍ A.  The client with Cushing’s disease  
❍ B.  The client with diabetes  
❍ C.  The client with acromegaly  
❍ D.  The client with myxedema  

110.  The  charge  nurse  witnesses  the  nursing  assistant  hitting  the  client  in  the long-term care facility. The nursing assistant can be charged with:  

❍ A.  Negligence  
❍ B.  Tort  
❍ C.  Assault  

111. Which assignment should not be performed by the licensed practical nurse?  

❍ A.  Inserting a Foley catheter  
❍ B.  Discontinuing a nasogastric tube  
❍ C.  Obtaining a sputum specimen 
❍ D.  Starting a blood transfusion 

 112.  The  client  returns  to  the  unit  from  surgery  with  a  blood pressure  of  90/50,  pulse  132,  respirations  30.  Which  action by the nurse should receive priority?  

❍ A.  Continue to monitor the vital signs  
❍ B.  Contact the physician  
❍ C.  Ask the client how he feels  
❍ D.  Ask the LPN to continue the post-op care  

113.  The  nurse  is  caring  for  a  client  with  B-Thalassemia  major.  Which therapy is used to treat Thalassemia?  

❍ A.  IV fluids  
❍ B.  Frequent blood transfusions  
❍ C.  Oxygen therapy  
❍ D.  Iron therapy  

114.  The  child  with  a  history  of  respiratory  infections  has  an  order  for  a  sweat test to be done. Which finding would be positive for cystic fibrosis?  

❍ A.  A serum sodium of 135meq/L  
❍ B.  A sweat analysis of 69 meq/L  
❍ C.  A potassium of 4.5meq/L  
❍ D.  A calcium of 8mg/dL  

115.  The  nurse  caring  for  the  child  with  a  large  meningomylocele  is aware that the priority care for this client is to:  

❍ A.  Cover the defect with a moist, sterile saline gauze  
❍ B.  Place the infant in a supine position  
❍ C.  Feed the infant slowly  
❍ D.  Measure the intake and output

  116.  The  nurse  is  caring  for  an  infant  admitted  from  the  delivery  room. Which finding should be reported?  
❍ A.  Acyanosis  
❍ B.  Acrocyanosis  
❍ C.  Halequin sign  
❍ D.  Absent femoral pulses 

 117.  The  nurse  is  aware  that  a  common  mode  of  transmission  of clostridium difficile is:  

❍ A.  Use of unsterile surgical equipment  
❍ B.  Contamination with sputum  
❍ C.  Through the urinary catheter  
❍ D.  Contamination with stool  

118.  The  nurse  has  just  received  the  change  of  shift  report. Which client should the nurse assess first?

 ❍ A.  A client 2 hours post-lobectomy with 150ml drainage  
❍ B.  A client 2 days post-gastrectomy with scant drainage  
❍ C.  A client with pneumonia with an oral temperature of 102°F  
❍ D.  A client with a fractured hip in Buck’s traction  

119.  A  client  has  been  receiving  cyanocobalamine  (B12)  injections  for the  past  six  weeks.  Which  laboratory  finding  indicates  that  the medication is hav-ing the desired effect?  

❍ A.  Neutrophil count of 60%  
❍ B.  Basophil count of 0.5%  
❍ C.  Monocyte count of 2%  
❍ D.  Reticulocyte count of 1%  

120.  The  nurse  is  providing  discharge  teaching  for  a  client  taking  dissulfiram (Antabuse). The nurse should instruct the client to avoid eating:  

❍ A.  Peanuts, dates, raisins  
❍ B.  Figs, chocolate, eggplant  
❍ C.  Pickles, salad with vinaigrette dressing, beef  
❍ D.  Milk, cottage cheese, ice cream 

 121.  A  70-year-old  male  who  is  recovering  from  a  stroke  exhibits  signs  of  unilateral neglect. Which behavior is suggestive of unilateral neglect?  

❍ A.  The client is observed shaving only one side of his face.  
❍  B.  The  client  is  unable  to  distinguish  between  two  tactile stimuli presented simultaneously.  
❍  C.  The  client  is  unable  to  complete  a  range  of  vision without turning his head side to side.  
❍  D.  The  client  is  unable  to  carry  out  cognitive  and  motor activity  at  the  same  time.   

122.  A  client  with  acute  leukemia  develops  a  low  white  blood  cell count. In addition to the institution of isolation, the nurse should:  
❍ A.  Request that foods be served with disposable utensils  
❍ B.  Ask the client to wear a mask when visitors are present  
❍ C.  Prep IV sites with mild soap and water and alcohol  
❍ D.  Provide foods in sealed, single-serving packages  

123.  A  new nursing  graduate  indicates  in  charting  entries  that  he  is  a  licensed registered  nurse,  although  he  has  not  yet  received  the  results  of  the licensing exam. The graduate’s action can result in a charge of:  
❍ A.  Fraud  
❍ B.  Tort  
❍ C.  Malpractice  
❍ D.  Negligence 

 124.  The  nurse  is  assigning  staff  for  the  day.  Which  client  should  be assigned to the nursing assistant?  
❍A.  A 5-month-old with bronchiolitis ❍B.A 10-year-old 2-day post-appendectomy  
❍ C.  A 2-year-old with periorbital cellulitis  
❍ D.  A 1-year-old with a fractured tibia  

125.  During  the  change  of  shift,  the  oncoming  nurse  notes  a  discrepancy  in the  number  of  percocette  listed  and  the  number  present  in  the  narcotic drawer. The nurse’s first action should be to:  

❍ A.  Notify the hospital pharmacist ❍ B.  Notify the nursing supervisor  ❍ C.  Notify the Board of Nursing  
>❍ D.  Notify the director of nursing 

 126.  Due  to  a  high  census,  it  has  been  necessary  for a  number  of clients  to  be  transferred  to  other units  within  the  hospital.  Which client should be transferred to the postpartum unit?  

❍ A.  A 66-year-old female with gastroenteritis  
❍ B.  A 40-year-old female with a hysterectomy  
❍ C.  A 27-year-old male with severe depression  
❍ D.  A 28-year-old male with ulcerative colitis  

127.  A  client  with  glomerulonephritis  is  placed  on  a  low-sodium  diet.  Which  of the following snacks is suitable for the client with sodium restriction?  

❍ A.  Peanut butter cookies  
❍ B.  Grilled cheese sandwich  
❍ C.  Cottage cheese and fruit  
❍ D.  Fresh peach  

128.  A  home  health  nurse  is  making  preparations  for  morning  visits. Which one of the following clients should the nurse visit first?  

❍ A.  A client with a stroke with tube feedings  
❍  B.  A  client  with  congestive  heart  failure  complaining  of night-time dyspnea  
❍ C.  A client with a thoracotomy six months ago  
❍ D.  A client with Parkinson’s disease  

129.  A client  with  cancer  develops  xerostomia.  The  nurse  can  help  alleviate the discomfort the client is experiencing associated with xerostomia by:  

❍ A.  Offering hard candy  
❍ B.  Administering analgesic medications  
❍ C.  Splinting swollen joints  
❍ D.  Providing saliva substitute  

130.  The  nurse  is  making  assignments  for the  day.  The  staff consists  of  an  RN, an  LPN, and  a  nursing  assistant.  Which client could the nursing assistant care for?  

❍ A. A client with Alzheimer’s disease ❍ B.  A client with pneumonia  
❍ C.  A client with appendicitis  
❍ D.  A client with thrombophlebitis  

131.  The  nurse  is  caring  for  a  client  with  cerebral  palsy.  The  nurse should pro-vide frequent rest periods because:  
❍  A.  Grimacing  and  writhing  movements  decrease  with relaxation and rest.  
❍ B.  Hypoactive deep tendon reflexes become more active  with rest. 
❍ C.  Stretch reflexes are increased with rest.  
❍  D.   Fine  motor  movements  are  improved  by  rest.   

132.  The  physician  has  ordered  a  culture  for the  client  with  suspected gonor-rhea. The nurse should D size culture of:  

❍ A.  Blood  
❍ B.  Nasopharyngeal secretions  
❍ C.  Stool  
❍ D.  Genital secretions  

133.  Which  of  the  following  post-operative  diets  is  most  appropriate for the client who has had a hemorrhoidectomy?  

❍ A.  High-fiber  
❍ B.  Lactose free  
❍ C.  Bland  
❍ D.  Clear-liquid  

134.  The  client  delivered  a  9-pound  infant  two  days  ago.  An  effective means of managing discomfort from an episiotomy is:  

❍ A.  Medicated suppository  
❍ B.  Taking showers  
❍ C.  Sitz baths  
❍ D.  Ice packs  

135.  The  nurse  is  assessing  the  client  recently  returned  from  surgery. The nurse is aware that the best way to assess pain is to:  

❍ A.  Take the blood pressure, pulse, and temperature  
❍ B.  Ask the client to rate his pain on a scale of 0–5  
❍ C.  Watch the client’s facial expression  
❍ D.  Ask the client if he is in pain 

 136.  The  client  is  admitted  with  chronic  obstructive  pulmonary disease.  Blood  gases  reveal  pH  7.36,  CO2  45,  O2  84,  bicarb  28. The nurse would assess the client to be in:  
❍ A.  Uncompensated acidosis  
❍ B.  Compensated alkalosis  
❍ C.  Compensated respiratory acidosis  
❍ D.  Uncompensated metabolic acidosis  

137.  The  schizophrenic  client  has  become  disruptive  and  requires seclusion. Which staff member can institute seclusion?  

❍ A.  The security guard  
❍ B.  The registered nurse  
❍ C.  The licensed practical nurse  
❍ D.  The nursing assistant 

 138.  The  physician  has  ordered  sodium  warfarin  for  the  client  with  thrombophlebitis. The order should be entered to administer the medication at:  

❍ A.  0900  
❍ B.  1200  
❍ C.  1700  
❍ D.  2100  

139.  A  25-year-old  male  is  brought  to  the  emergency  room  with  a  piece  of metal in his eye. The first action the nurse should take is:  

❍ A.  Use a magnet to remove the object.  
❍ B.  Rinse the eye thoroughly with saline.  
❍ C.  Cover both eyes with paper cups.  
❍ D.  Patch the affected eye.  

140.  To  ensure  safety  while  administering  a  nitroglycerine  patch, the nurse should:  

❍ A.  Wear gloves while applying the patch.  
❍ B.  Shave the area where the patch will be applied.  
❍ C.  Wash the area thoroughly with soap and rinse with hot water.  
❍ D.  Apply the patch to the buttocks. 

 141.  The  client  with  Cirrhosis  is  scheduled  for  a  pericentesis.  Which instruc-tion should be given to the client before the exam?  

❍ A.  ―You will need to lay flat during the exam.‖  
❍ B.  ―You need to empty your bladder before the procedure.‖  
❍ C.  ―You will be asleep during the procedure.‖  
❍  D.  ―The  doctor will  inject  a  medication  to  treat  your illness dur-ing the procedure.‖  

142.  The  client  is  scheduled  for  a  Tensilon  test  to  check  for  Myasthenia Gravis. Which medication should be kept available during the test?  

❍ A.  Atropine sulfate  
❍ B.  Furosemide  
❍ C.  Prostigmin  
❍  D.   Promethazine  

143.  The  first  exercise  that  should  be  performed  by  the  client  who  had a mas-tectomy 1 day earlier is: 

❍ A.  Walking the hand up the wall 
❍ B.  Sweeping the floor  
❍ C.  Combing her hair  
❍ D.  Squeezing a ball  

144. Which woman is not a candidate for RhoGam?  

❍ A.  A gravida 4 para 3 that is Rh negative with an Rh-positive baby  
❍ B.  A gravida 1 para 1 that is Rh negative with an Rh-positive baby  
❍  C.  A  gravida  II  para  0  that  is  Rh  negative  admitted  after  a stillbirth delivery  
❍ D.  A gravida 4 para 2 that is Rh negative with an Rh-negative baby  

145.  Which  laboratory  test  would  be  the  least  effective  in  making  the diagno-sis of a myocardial infarction?  

❍ A.  AST  
❍ B.  Troponin  
❍ C.  CK-MB  
❍ D.  Myoglobin  

146.  The  client  with  a  myocardial  infarction  comes  to  the  nurse’s  station stat-ing  that  he  is  ready  to  go  home  because  there  is  nothing  wrong with him. Which defense mechanism is the client using?  

❍ A.  Rationalization  
❍ B.  Denial  
❍ C.  Projection  
❍ D.  Conversion reaction 

 147.  The  client  is  receiving  total  parenteral  nutrition  (TPN).  Which  lab test should be evaluated while the client is receiving TPN?  
❍ A.  Hemoglobin  
❍ B.  Creatinine  
❍ C.  Blood glucose  
❍ D.  White blood cell count   

148.  The  client  with  diabetes  is  preparing  for  discharge.  During discharge  teaching,  the  nurse  assesses  the  client’s  ability  to  care for himself.  Which  statement  made  by  the  client  would  indicate  a need for follow-up after discharge?  

❍ A.  ―I live by myself.‖  
❍ B.  ―I have trouble seeing.‖  
❍ C.  ―I have a cat in the house with me.‖  
❍ D.  ―I usually drive myself to the doctor.‖  

149.  The  client  with  cirrhosis  of  the  liver  is  receiving  Lactulose.  The nurse is aware that the rationale for the order for Lactulose is:  

❍ A.  To lower the blood glucose level ❍ B.  To lower the uric acid level  
❍ C.  To lower the ammonia level  
❍ D.  To lower the creatinine level 

150.  The  client  is  receiving  peritoneal  dialysis.  If  the  dialysate  returns cloudy, the nurse should:  

❍ A.  Document the finding  
❍ B.  Send a specimen to the lab  
❍ C.  Strain the urine  
❍ D.  Obtain a complete blood count  

151.  The  nurse  employed  in  the  emergency  room  is  responsible  for triage  of  four  clients  injured  in  a  motor  vehicle  accident.  Which of the following clients should receive priority in care?  

❍ A.  A 10-year-old with lacerations of the face 
❍ B.  A 15-year-old with sternal bruises  
❍ C.  A 34-year-old with a fractured femur  
❍ D.  A 50-year-old with dislocation of the elbow  

152.  Which  of  the  following  roommates  would  be  most  suitable  for the client with myasthenia gravis?  

❍ A.  A client with hypothyroidism  
❍ B.  A client with Crohn’s disease  
❍ C.  A client with pylonephritis  
❍  D.   A client  with  bronchitis  

 153.  The  nurse  is  observing  a  graduate  nurse  as  she  assesses  the central  venous  pressure.  Which  observation  would  indicate that the graduate needs further teaching?  

❍  A.  The  graduate  places  the  client  in  a  supine  position  to read the manometer.  
❍  B.  The  graduate  turns  the  stop-cock  to  the  off  position from the IV fluid to the client.  
❍  C.  The  graduate  instructs  the  client  to  perform  the Valsalva maneuver during the CVP reading.  
❍ D.  The graduate notes the level at the top of the meniscus.  

154.  The  nurse  is  working  with  another  nurse  and  a  patient  care  assistant. Which of the following clients should be assigned to the registered nurse?  

❍ A.  A client 2 days post-appendectomy  
❍ B.  A client 1 week post-thyroidectomy  
❍ C.  A client 3 days post-splenectomy ❍ D.  A client 2 days post-thoracotomy  

155.  Which  of  the  following  roommates  would  be  best  for  the  client newly admitted with gastric resection? 

 ❍ A.  A client with Crohn’s disease  
❍ B.  A client with pneumonia  
❍ C.  A client with gastritis  
❍ D.  A client with phlebitis  

156.  The  nurse  is  preparing  a  client  for  mammography.  To  prepare the client for a mammogram, the nurse should tell the client:  

❍ A.  To restrict her fat intake for 1 week before the test  
❍ B.  To omit creams, powders, or deodorants before the exam  
❍ C.  That mammography replaces the need for self-breast exams  
❍  D.  That  mammography  requires  a  higher  dose  of radiation than x-rays  

157. Which action by the novice nurse indicates a need for further teaching?  

❍ A.  The nurse fails to wear gloves to remove a dressing.  
❍ B.  The nurse applies an oxygen saturation monitor to the  ear lobe. 
❍  C.  The 

158.  The  graduate  nurse  is  assigned  to  care  for  the  client  on  ventilator  support, pending organ donation. Which goal should receive priority?  

❍  A.  Maintaining  the  client’s  systolic  blood  pressure  at 70mmHg or greater  
❍  B.  Maintaining  the  client’s  urinary  output  greater  than 300cc per hour  
❍  C.  Maintaining  the  client’s  body  temperature  of greater than 33°F rectal  
❍ D.  Maintaining the client’s hematocrit at less than 30%  

159.  The  nurse  is  assigned  to  care  for  an  infant  with  physiologic  jaundice. Which action by the nurse would facilitate elimination of the bilirubin?  

❍ A.  Increasing the infant’s fluid intake  
❍ B.  Maintaining the infant’s body temperature at 98.6°F  
❍ C.  Minimizing tactile stimulation ❍ D.  Decreasing caloric intake  

160.  A  home  health  nurse  is  planning  for  her  daily  visits.  Which  client should the home health nurse visit first?  

❍ A.  A client with AIDS being treated with Foscarnet  
❍ B.  A client with a fractured femur in a long leg cast  
❍ C.  A client with laryngeal cancer with a laryngectomy  
❍ D.  A client with diabetic ulcers to the left foot  

161.  The  charge  nurse  overhears  the  patient  care  assistant  speaking harshly to the client with dementia. The charge nurse should:  
❍ A.  Change the nursing assistant’s assignment  
❍ B.  Explore the interaction with the nursing assistant  
❍ C.  Discuss the matter with the client’s family  

❍ D.  Initiate a group session with the nursing assistant  

162.  The  nurse  notes  the  patient  care  assistant  looking  through  the personal  items  of  the  client  with  cancer.  Which  action  should  be taken by the reg-istered nurse?  

❍ A.  Notify the police department as a robbery  
❍ B.  Report this behavior to the charge nurse  
❍ C.  Monitor the situation and note whether any items are missing  
❍  D.   Ignore  the  situation  until  items  are  reported  missing   nurse  elevates  the  head  of  the  bed  to  check  the blood pressure.  
❍  D.  The  nurse  places  the  extremity  in  a  dependent position to acquire a peripheral blood sample.  

163. Which client can best be assigned to the newly licensed nurse? 

❍ A.  The client receiving chemotherapy  
❍ B.  The client post–coronary bypass ❍ C.  The client with a TURP  
❍ D.  The client with diverticulitis  

164.  The  nurse  has  an  order  for  medication  to  be  administered intrathecally.  The  nurse  is  aware  that  medications  will  be administered by which method?  

❍ A.  Intravenously  
❍ B.  Rectally  
❍ C.  Intramuscularly  
❍ D.  Into the cerebrospinal fluid  

165.  The  client  is  admitted  to  the  unit  after  a  cholescystectomy. Montgomery  straps  are  utilized  with  this  client.  The  nurse  is  aware that Montgomery straps are utilized on this client because:  

❍ A.  The client is at risk for evisceration.  
❍ B.  The client will require frequent dressing changes.  
❍  C.  The  straps  provide  support  for  drains  that  are inserted into the incision. 
 ❍ D.  No sutures or clips are used to secure the incision.  

166.  A  client  with  pancreatitis  has  been  transferred  to  the  intensive care unit. Which order would the nurse anticipate?  

❍ A.  Blood pressure every 15 minutes  
❍ B.  Insertion of a Levine tube  
❍ C.  Cardiac monitoring  
❍ D.  Dressing changes two times per day  

167.  The  nurse  is  caring  for  a  client  with  a  diagnosis  of  hepatitis  who is  expe-riencing  pruritis.  Which  would  be  the  most  appropriate nursing interven-tion?  

❍ A.  Suggest that the client take warm showers two times per day  
❍ B.  Add baby oil to the client’s bath water  
❍ C.  Apply powder to the client’s skin  
❍ D.  Suggest a hot-water rinse after bathing 

 168.  The  nurse  recognizes  that  which  of  the  following  would  be  most  appropriate to wear when providing direct care to a client with a cough?  

❍ A.  Mask  
❍ B.  Gown  
❍ C.  Gloves  
❍ D.  Shoe covers  

169.  A  client  visits  the  clinic  after  the  death  of  a  parent.  Which  statement made by the client’s sister signifies abnormal grieving?  

❍  A.  ―My  sister  still  has  episodes  of  crying,  and  it’s  been three months since Daddy died.‖  
❍  B.  ―Sally  seems  to  have  forgotten  the  bad  things  that Daddy did in his lifetime.‖  
❍  C.  ―She  really  had  a  hard  time  after  Daddy’s  funeral. She said that she had a sense of longing.‖  
❍  D.  ―She  has  not  been  saddened  at  all  by  Daddy’s  death. She acts like nothing has happened.‖  

170.  The  nurse  is  obtaining  a  history  on  an  80-year-old  client. Which  state-ment  made  by  the  client  might  indicate  a  potential for fluid and elec-trolyte imbalance?  

❍ A.  ―My skin is always so dry.‖  
❍ B.  ―I often use laxatives.‖  
❍ C.  ―I have always liked to drink a lot of ice tea.‖  
❍ D.  ―I sometimes have a problem with dribbling urine.‖  

171.  A client  is  admitted  to  the  acute  care  unit.  Initial  laboratory values  reveal  serum  sodium  of  170meq/L.  What  behavior changes would be most common for this client?  

❍ A.  Anger  
❍ B.  Mania  
❍ C.  Depression  
❍ D.  Psychosis  

172.  When  assessing  a  client  for  risk  of  hyperphosphatemia,  which piece of information is most important for the nurse to obtain?  

❍ A.  A history of radiation treatment in the neck region  
❍ B.  Any history of recent orthopedic surgery  
❍ C.  A history of minimal physical activity  
❍  D.   A history  of  the  client’s  food  intake   

173.  The  nurse  on  the  3–11  shift  is  assessing  the  chart  of  a  client  with an  abdominal  aneurysm  scheduled  for surgery  in  the  morning and  finds  that  the  consent  form  has  been  signed,  but  the  client  is unclear about  the  surgery  and  possible  complications.  Which  is the most appropriate action?  
❍  A.  Call  the  surgeon  and  ask  him  or  her  to  see  the client to clarify the information  
❍ B.  Explain the procedure and complications to the client  
❍  C.  Check  in  the  physician’s  progress  notes  to  see  if understand-ing has been documented 
❍  D.  Check  with  the  client’s  family  to  see  if  they understand the procedure fully  

174.  The  nurse  is  preparing  a  client  for  surgery.  Which  item  is  most important to remove before sending the client to surgery?  

❍ A.  Hearing aid  
❍ B.  Contact lenses  
❍ C.  Wedding ring  
❍ D.  Artificial eye  

175.  A client  is  2  days  post-operative  colon  resection.  After a coughing  episode,  the  client’s  wound  eviscerates.  Which nursing action is most appropriate? 

❍ A.  Reinsert the protruding organ and cover with 44s  
❍ B.  Cover the wound with a sterile 44 and ABD dressing  
❍ C.  Cover the wound with a sterile saline-soaked dressing  
❍ D.  Apply an abdominal binder and manual pressure to  the wound 

176.  The  nurse  is  caring  for  a  client  with  a  malignancy.  The  classification  of the primary tumor is Tis. The nurse should plan care for a tumor:  

❍ A.  That cannot be assessed  
❍ B.  That is in situ  
❍ C.  With increasing lymph node involvement  
❍ D.  With distant metastasis  

177.  A  client  with  cancer  is  to  undergo  an  intravenous  pyelogram. The nurse should:  

❍ A.  Force fluids 24 hours before the procedure  
❍ B.  Ask the client to void immediately before the study  
❍  C.  Hold  medication  that  affects  the  central  nervous system for 12 hours pre- and post-test  
❍ D.  Cover the client’s reproductive organs with an x-ray shield.  

178.  A  client  arrives  in  the  emergency  room  with  a  possible fractured femur. The nurse should anticipate an order for:  

❍ A.  Trendelenburg position  
❍ B.  Ice to the entire extremity  
❍ C.  Buck’s traction  
❍ D.  An abduction pillow 

 179.  The  nurse  is  performing  an  assessment  on  a  client  with  possible perni-cious anemia. Which data would support this diagnosis?  

❍ A.  A weight loss of 10 pounds in 2 weeks  
❍ B.  Complaints of numbness and tingling in the extremities 
❍ C.  A red, beefy tongue  
❍ D.  A hemoglobin level of 12.0gm/dL  

180.  A  client  with  suspected  renal  disease  is  to  undergo  a  renal  biopsy.  The nurse plans to include which statement in the teaching session?  

❍ A.  ―You will be sitting for the examination procedure.‖  
❍ B.  ―Portions of the procedure will cause pain or discomfort.‖  
❍ C.  ―You will be asleep during the procedure.‖  
❍  D.  ―You  will  not  be  able  to  drink  fluids  for  24  hours following the study.‖  

181.  The  nurse  is  caring  for  a  client  scheduled  for  a  surgical  repair  of a  sacu-lar  abdominal  aortic  aneurysm.  Which  assessment  is most crucial during the preoperative period?  

❍ A.  Assessment of the client’s level of anxiety  
❍ B.  Evaluation of the client’s exercise tolerance  
❍ C.  Identification of peripheral pulses  
❍  D.   Assessment  of  bowel  sounds  and  activity  

 182.  A client  in  the  cardiac  step-down  unit  requires  suctioning  for excess  mucous  secretions.  The  dysrhythmia  most  commonly seen during suc-tioning is:  

❍ A.  Bradycardia  
❍ B.  Tachycardia  
❍ C.  Premature ventricular beats  
❍ D.  Heart block  

183.  The  nurse  is  performing  discharge  instruction  to  a  client  with  an implantable defibrillator. What discharge instruction is essential?  

❍ A.  ―You cannot eat food prepared in a microwave.‖  
❍  B.  ―You  should  avoid  moving  the  shoulder  on  the  side of the pacemaker site for 6 weeks.‖  
❍ C.  ―You should use your cell phone on your right side.‖  
❍  D.  ―You  will  not  be  able  to  fly  on  a  commercial  airliner with the defibrillator in place.‖  

184.  Six  hours  after  birth,  the  infant  is  found  to  have  an  area  of swelling  over the  right  parietal  area  that  does  not  cross  the suture line. The nurse should chart this finding as:  

❍ A.  A cephalhematoma  
❍ B.  Molding  
❍ C.  Subdural hematoma  
❍ D.  Caput succedaneum  

185.  A  removal  of  the  left  lower  lobe  of  the  lung  is  performed  on  a client  with  lung  cancer.  Which  post-operative  measure  would usually be included in the plan?  

❍ A.  Closed chest drainage  
❍ B.  A tracheostomy  
❍ C.  A Swan Ganz Monitor  
❍ D.  Percussion vibration and drainage

186.  The  nurse  is  caring  for  a  client  with  laryngeal  cancer.  Which  finding  ascertained in the health history would not be common for this diagnosis?  

❍ A.  Foul breath  
❍ B.  Dysphagia  
❍ C.  Diarrhea  
❍ D.  Chronic hiccups  

187.  The  nurse  is  caring  for  a  new  mother.  The  mother  asks  why  her  baby  has lost weight since he was born. The best explanation of the weight loss is:  

❍ A.  The baby is dehydrated.  
❍ B.  The baby is hypoglycemic.  
❍ C.  The baby is allergic to the formula the mother is giving him.  
❍  D.  A  loss  of  10%  is  normal  in  the  first  week  due  to meconium stools.  

188.  The  nurse  is  performing  discharge  teaching  on  a  client  with diverticulitis  who  has  been  placed  on  a  low-roughage  diet. Which food would have to be eliminated from this client’s diet?  

❍ A.  Roasted chicken  
❍ B.  Noodles  
❍ C.  Cooked broccoli  
❍ D.  Custard  

189.  A client  has  rectal  cancer and  is  scheduled  for  an  abdominal perineal  resection.  What  should  be  the  priority  nursing  care during the post-op period?  

❍ A.  Teaching how to irrigate the illeostomy  
❍ B.  Stopping electrolyte loss in the incisional area  
❍ C.  Encouraging a high-fiber diet  
❍ D.  Facilitating perineal wound drainage  

190.  The  nurse  is  assisting  a  client  with  diverticulosis  to  select appropriate foods. Which food should be avoided? 

❍ A.  Bran  
❍ B.  Fresh peaches  
❍ C.  Cucumber salad  
❍ D.  Yeast rolls  

191.  A 6-month-old  client  is  admitted  with  possible  intussuception. Which  question  during  the  nursing  history  is  least  helpful  in obtaining informa-tion regarding this diagnosis?  

❍ A.  ―Tell me about his pain.‖  
❍ B.  ―What does his vomit look like?‖  
❍ C.  ―Describe his usual diet.‖  
❍  D.   ―Have  you  noticed  changes  in  his  abdominal  size?

192.  The  nurse  is  caring  for a  client  with  epilepsy  who  is  being treated  with  carbamazepine  (Tegretol).  Which  laboratory  value might indicate a seri-ous side effect of this drug?  

❍ A.  Uric acid of 5mg/dL  
❍ B.  Hematocrit of 33%  
❍ C.  WBC 2000 per cubic millimeter  
❍ D.  Platelets 150,000 per cubic millimeter  

193.  A  client  is  admitted  with  a  Ewing’s  sarcoma.  Which  symptoms would be expected due to this tumor’s location?  

❍ A.  Hemiplegia  
❍ B.  Aphasia  
❍ C.  Nausea  
❍ D.  Bone pain  

194.  A  infant  weighs  7  pounds  at  birth.  The  expected  weight  by  1 year should be:  

❍ A.  10 pounds  
❍ B.  12 pounds  
❍ C.  18 pounds  
❍ D.  21 pounds  

195.  The  nurse  is  making  initial  rounds  on  a  client  with  a  C5  fracture  and crutchfield tongs. Which equipment should be kept at the bedside?  

❍ A.  A pair of forceps  
❍ B.  A torque wrench  
❍ C.  A pair of wire cutters  
❍ D.  A screwdriver 

 196.  The  nurse  is  visiting  a  home  health  client  with  osteoporosis. The  client  has  a  new  prescription  for  alendronate  (Fosamax). Which instruction should be given to the client?  

❍ A.  Rest in bed after taking the medication for at least  30 minutes.  
❍ B.  Avoid rapid movements after taking the medication.  
❍ C.  Take the medication with water only.  
❍  D.  Allow  at  least  1  hour  between  taking  the  medicine  and taking other medications.  

197.  The  nurse  is  working  in  the  emergency  room  when  a  client arrives  with  severe  burns  of  the  left  arm,  hands,  face,  and  neck. Which action should receive priority?  

❍ A.  Starting an IV  
❍ B.  Applying oxygen  
❍ C.  Obtaining blood gases  
❍ D.  Medicating the client for pain 

 198.  A  24-year-old  female  client  is  scheduled  for  surgery  in  the  morning. Which of the following is the primary responsibility of the nurse? 

❍ A.  Taking the vital signs  
❍ B.  Obtaining the permit  
❍ C.  Explaining the procedure  
❍ D.  Checking the lab work 

 199.  A client  with  cancer is  admitted  to  the  oncology  unit.  Stat  lab values  reveal  Hgb  12.6,  WBC  6500,  K+  1.9,  uric  acid  7.0,  Na+ 136,  and  platelets  178,000.  The  nurse  evaluates  that  the  client  is experiencing which of the following? 
❍ A.  Hypernatremia  
❍ B.  Hypokalemia  
❍ C.  Myelosuppression  
❍ D.  Leukocytosis  

200.  The  nurse  is  caring  for  a  client  scheduled  for  removal  of  the pituitary gland. The nurse should be particularly alert for:  

❍ A.  Nasal congestion  
❍ B.  Abdominal tenderness  
❍ C.  Muscle tetany  
❍ D.  Oliguria  






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