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The nurse performs a home visit for a 32 year-old woman who had given birth to her first infant three days before. The
mother has concerns about breastfeeding and the nurse observes the infant feeding. The mother sits supported upright
with cushions and the infant positioned in a cradle hold. The infant's head and body are aligned against the mother's
abdomen. The infant sucks intermittently with the lips turned outwards and the nipple In the mouth.
Which intervention is most appropriate?
A. Reposition the Infant

B. Assist the infant to turn I, inwards

C. Ensure the latch includes areola

D. Stimulate the infant to %tic k constant

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A 43 year-old man is 30 hours post-operative following placement of a partial thickness skin autograft for a burn injury on
the lower anterior leg. During a routine assessment, the nurse observes the wound is bleeding continuously. What is the
priority nursing action?
A. Use a pen to outline and monitor the area

B. Perform a wound swab for laboratory analysis

C. Incise and drain fluid, from the wound bed

D. Apply firm and direct pressure for 10 minutes

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A patient is preparing for a scheduled hip replacement. Which lab value should be reported to the physician?


Normal Values



134 - 146 mmol/L



3.5 5.1 mmol/L



2.15 - 2.62 mmol/L



1.2 - 2 mmol/L

A. Sodium

B. Calcium

C. Potassium

D. Magnesium

Paper code ( M. D. A)
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A 52 year-old woman is scheduled to undergo an abdominal-perineal resection in three days for removal of a cancer of
the rectum. The nurse reviews the care plan with the patient. The patient will receive prophylactic antibiotics and will be
given a mechanical bowel preparation the day before.
Which additional preparation should the patient undertake at this time,
A. Wear pressure stockings

B. Perform leg strengthening exercises

C. Maintain high-protein, low-residue diet

D. Take daily ferrous iron tablet,

A five year-old child girl had presented with tiredness, headache and petechiae. She was pale and complains of joint pain.
On palpation, there was an enlarged spleen, liver, and lymph nodes. A lumbar puncture showed central nervous system
involvement. The child underwent chemotherapy treatment and is now attended by the nurse for regular routine
Which condition would require more attention from the nurses?
A. Increase leukocytres

B. Lack of muscle coordination

C. bleeding wile brushing teeth

D. Occasional nausea and vomiting

A nurse is admitting a six month-old infant with pneumonia. Which of the following interventions supports this infant's
emotional needs?
A. Allow the parents to leave the room during painful procedures
B. Encourage parents to distract the infant from crying
C. Interview the parents to learn the infant's comforting habits
D. Enforce strict visiting schedules and routines

Paper code ( M. D. A)
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During an evaluation at a community clinic, the patient completes the medical history.
Which of the following is NOT a risk fader for an acute myocardial infarction?
A. Coronary artery disease

B. Smoking

C. Hemophilia

D. Hyperlipidemia

While caring for a patient in the post-anesthesia care unit (PACU) who has developed Hypovolemic Shock, a nurse should
position the patient:
A. Flat with legs elevated

B. In trendelenburg position

C. With the head of the bed 45 degrees

D. Completely flat

A patient visits the clinic for a 2-week check up after a corneal transplantation (keratoplasty). The nurse observes the
patient's sclera is red and the patient complains of the eye feeling irritated. The nurse suspects the patient may have a(n):
A. Infection

B. Hemorrhage

C. Graft rejection

D. Post operative glaucoma

A post-operative patient has returning the nursing diagnosis of ineffective tissue perfusion. To assess for tissue perfusion,
the nurse should check all the following EXCEPT!
A. Skin and nail bed color

B. Temperature of extremities

C. Respiratory rate

D. Peripheral pulses

Paper code ( M. D. A)
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During immediate postoperative period, a patient reveals an oxygen saturation level of 91%. The nurse should:
A. Position the patient on the left side

B. Administer supplemental oxygen

C. Continue to provide supportive care

D. Lower the temperature of the room

The nurse is assessing a patient who has surgery under general anesthesia. The patient's respiration rate is 4 per minute
and O2 saturation on 3L per minute of oxygen via nasal cannula is 84%.
The nurse is awaiting the results of an arterial blood gas (ABG) and anticipates that which of the following will be
A. Arterial oxygen saturation (SaO2)

B. Hydrogen ion concentration (pH)

C. Partial pressure of arterial oxygen (PaO2)

D. Partial pressure of arterial carbon dioxide (PaCO2)

A 32 year-old woman with a motor neuron disease has progressive weakness of cranial nervous V, ix and xii. She has
recently been experiencing sudden outbursts of crying and laughing . Both stroke and myasthenia gravity have been
ruled out.
Which voluntary muscle activity would be most significantly impacted?
A. Walking

B. Swallowing

C. Breathing

D. Smelling

The nurse performs an assessment of a 23 year-old man who believes that people are saying on him. During the
interview, he keeps his eyes to the floor and answers q awkwardly. He has never had an intimate relationships and avoids
contact with his family members. He has never been employed and tells the nurse that he is not looking for a job. The
urse o siders Erikso s theory of psy hoso ial develop e t.
Which stage is this patient most likely experiencing?

Paper code ( M. D. A)
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A. Autonomy versus shame and doubt

B initiative versus guilt

C. Trust versus mistrust

D. Identity versus confusion is.

A 65 year-old man presents with a resting tremor in the right forearm. An assessment of gait reveals decreased arm
swinging and slight dragging body movements are slow. He has not been sleeping well at night for the past six months
due to leg pain and says that he feels constantly tired and weak. He reports that he has not suffered any recent fall and
that the symptoms seem to be slowly worsening.
Which medication is most likely to be administer?
A. Levodopa

B. Haloperidol

C. Phenytoin

D. Benzodiazepine

A four year-old girl was playing outside in a park when she came running to her mottle) crying and holding her right upper
arm. Two hours later they presented to the Emergency Department. There was swelling over the upper right arm, with
pain and itching at the site as well as swelling of the oral mucosa. The child seems anxious.
What is the next most appropriate step in management?
A. Administer subcutaneous epinephrine

B. Maintain patent airway

C. Administer oral diphenhydramine

D. Prepare intubation equipment

When panning discharge teaching for the parent of an infant with bronchiolitis, the nurses should EMPHASIZE:
A. Use of supplemental oxygen at night

B. Frequent hand washing

C. Sleeping in the supine position

D. Rice-thickened formula during night-time feedings

Paper code ( M. D. A)
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A home care nurse visits a diabetic patient who was started an insulin injections. Upon examination, the nurse observes
small lumps and dents on the right upper arm where the patient has injected insulin.
What is the BEST nursing intervention?
A. Refer the patient to a dermatologist for diabetic cellulitis
B. Instruct patient to rotate the sites of injection
C. Refer the patient to an endocrinologist for better control of glucose level
D. Instruct the patient to inject the muscular area instead of the subcutaneous area.

A patient has an order for 1000 milliliters (ml) of intravenous (IV) fluid to infuse over eight hours. The available IV tubing
hall drip factor of 10 gtts/ml.
Which of the following rate is correct?
A. 125 ml/hour

B. 125 drops/minute

C. 21 drops/ minute

D. 21 ml/hour

The nurse is preparing a discharge plan for a 65 year-old man with a new diagnosis of congestive heart failure. The
discharge orders include furosemide 40 milligrams by mouth twice per day. The nurse recommends foods to reduce
unwanted medication side effects.
Which of the following foods would be most appropriate to include in teaching plan?
A Green and leafy vegetables

B. Bananas and oranges

C. Chicken and fish

D Whole wheat grains

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A 70 year-old woman presents with increasing dyspnoea on exertion. She feels breathless and realest while performing
household tasks such as making the bed and sweeping the floor. Her previous medical history includes a myocardial
infarction at 57 years old. She sleeps with her bed elevated on three pillows. Examination reveals bilateral basal crackles
and cold, damp skin.
Blood pressure 172/94 mmHg

Heart rate 94/min

Respiratory rate 36/min

Temperature 37.1 C

Oxygen Saturation 90% on room air

Which heart chamber most likely failed first?
A. Right atrial

B. Right Ventricle

C. Left Ventricle

D. Left atrial

A. 40 year-old woman suffered an automobile accident one month ago. The accident resulted in a
C-4 spinal cord injury. Her preventive care includes independent daily performance of coughing and deep breathing.
Which range of motion exercises would be most beneficial for this patient?
A. Active

B. Passive

C. Combined

D. Resistive

A child conies into the clinic with several lesions to the scalp. The round lesions have dandruff like scaling with hair loss.
What Is the MOST likely diagnosis for this skin condition?
A. Impetigo

B. Ringworm (tinea capitis)

C. Pediculosis capitis

D. Scabies

Paper code ( M. D. A)
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Which nursing diagnosis takes priority for a newly diagnosed patient with a left-sided stroke?
A. Risk for impaired swallowing related to absence of gag reflex
B. Risk for impaired integrity related to immobility
C. Risk for infection related to invasive line placement
D. Risk for Impaired speech related to left sided stroke

A nine year-old girl has ousting diagnosis of Alter. Body Image related to changes in appearance secondary to varicella
Infection. The child's body is covered with a rash and many large, weeping pustules. The nurse provides counseling to the
mother who is concerned that the child will develop scarring.
Which intervention is most appropriate?
A. Keep the skin out of direct sunlight

B. Apply calamine lotion to skin every two hours

C. Wash pustules with soap and keep dry

D. Soak in colloidal oatmeal bath three times daily

The nurse is caring for a patient with a deep vein thrombosis (DVT). The patient's heparin sodium infusion has been
discontinued and the patient is receiving prescribed warfarin sodium (Coumadin).
The nurse should advise the patient that which of the following needs to be continued?
A. Daily complete blood count (CBC)

B. Laboratory tests for partial thrombopalstin time (PTT)

C. Strict bed rest

D. Wearing elasticized support stockings

Paper code ( M. D. A)
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A patient has blood glucose level of 60 mg/dI. The patient is to receive 15 g of carbohydrate if the blood glucose is less
than 70 mg/dI.
How many mIs of orange juice should the patient receive?
A. 120 ml

B. 90 ml

C. 60 ml

D. 30 ml

A Patient is scheduled for a pneumonectomy in the morning. Which of the following diagnosis is the MOST likely
indication for this type of surgery?
A. Lung carcinoma

B. Pulmonary tuberculosis

C. Benign pulmonary nodules

D. Mediastinal shift

A patient receiving total parenteral nutrition through a central line suddenly has difficulty breathing and is restless. Chest
auscultation reveals a heart murmur.
Blood pressure 90/60 mmHg

Heart rate 120/min

Respiratory rate 22/min

Temperature 37.1 C

Oxygen Saturation 90% on room air

What is the most appropriate initial nursing action?
A. Notify the physician

B. Administer 100% oxygen by face mask

C. Place patient in the left side Decubitus

D. Obtain stat blood glucose measurement

Paper code ( M. D. A)
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A 16 year-old boy fractured his right tibia and fibula during a football match. Eight weeks later, the fractures were
successfully healed and the cast was removed.
Which range of motion exercises would be most beneficial?
A. Active

B. Passive

C. Combined

D. Resistive

The nurse is teaching a patient who was recently diagnosed with rheumatoid arthritis affecting the hands.
Which of the following treatments should the nurse discuss with the patient at this time?
A. Transcuataneous electric stimulation (TENS)

B. lontophoresis

C. Nonsteroidal anti-inflammatory drugs (NSAIDs)

D. Synovectomy

A 65 year-old woman who has diagnosed with hypothyroidism at the age of 45 is brought to the clinic by ambulance. On
arrival, she had a severely decreased level of consciousness. Her breathing is shallow and irregular. The skin is cool, thy
and pale. There is generalized non-pitting edema of all extremities and the face.
Blood pressure 70/40 mmHg

Heart Rate 60/min

Respiratory rate 12/min

Body temperature 35.5 C tympanic

What is the most appropriate method to re-warm this patient?

A. Warmed intravenous isotonic fluids

B. Place the patient in a warm bath

C. Apply heat packs to the head and neck

D. Cover the patient with hospital blankets

Paper code ( M. D. A)
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The patient will

Altered tissue perfusion related to hypertension

Maintain blood pressure below 130/50 mmHg

Fluid volume excess related to lower extremity edema

Not have signs of edema or unexpected weight gain

Knowledge deficit related to disease process

Alternation in comfort related to chronic diseases

Verbalize understanding of diseases process,

symptoms and medication management
Report an absence of headaches each week

A patient has come to the clinic for follow up one week after being discharged from the hospital for treatment of a
hypertensive crisis. Blood pressure stabilized at 124/78 mmHG. The patient reports feeling well, has no edema, and no
longer has daily headaches. Blood pressure is 156/90 mmHg. During evaluation the patient admits to having stopped
taking medication that had been ordered because headaches are no longer present. Unless the symptoms return, the
patient states they will not be returning to the clinic.
What should the nurse do?
A. Resolve and discontinue the entire care plan per patient request, suggest psychology consult.
B. Resolve B and D, continue A and C
C. Continue entire care plan as written
D. Add a new problem to the care plan , non-compliance and interventions to determine potential reasons.

A 34 year-old quadriplegia patient reside at home with his wife in order to prevent contractures of all extremities , the
community care nurse will instruct the patient's wife in the performance of :
A. Active range of motion exercise
B. Passive range of motion exercise
C. Active assistive range of motion exercise
D. Resistive range of motion exercise

Paper code ( M. D. A)
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A 40 year old woman presents with right hip pain. Palpation of the pelvic girdle is normal. An x-ray shows bone with
deformities with osteolytic lesions and bone enlargement. The patient has not suffered any trauma and has been
generally healthy. which serum laboratory analysis would be most useful?
A. Prothrombin time
B. Alkaline phosphates
C. Acid phosphates
D. Parathyroid hormone

A six year-old patient has presented to clinic with fever, malaise and anorexia . The patient was treated 2 weeks ago for
a streptococcal infection. The nurse should expect the physician to order what test?
A. Electrocardiogram

B. Jones Test

C. Spinal tap

D. Heart biopsy

A 32 year-old Woman with diabetes mellitus type 1 underwent a cholecystectomy and is now on day two of recovery. The
patient's bowel sounds have returned and has resumed normal diet but has been finishing less than half of each meal on
the tray. The nurse enters the room to perform a routine assessment and finds the patient confused
Blood pressure 110/60 mmHg

Heart Rate 96/min

Respiratory rate 22/min

Temperature 37.0 C

What is the most appropriate initial intervention?

A. Administer glucagon

B. Notify the physician

C. Give an insulin injection

D. offer a glass of juice

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A 33 year-old woman with diabetes type 1 presents to the clinic with fatigue, blurred vision and loss appetite. Her breath
smell like fruit and she leaves the room twice during the examination to use the toilet. She has brought a liter bottle of
water with her that she finish while at the clinic. She reports that she has had a cold for the past three days, but has not
taken additional insulin during the illness:
Blood pressure 130/76mmHg

Heart rate 90/min

Respiratory rate 20/min

Body temperature 38.0 C

What is the most appropriate intervention?

A. Risk for impaired skin integrity related to circulation.

B. Deficient knowledge related to illness management

C. Risk for fluid volume excess related to fluid intake

D. Imbalanced nutrition related to decreased appetite

A 12 year-old patient had a cast removed from the left-leg after-wearing for eight weeks. The patient wants to resume
sports as soon as possible. In order to regain muscle strength lost while wearing the cast, the nurse will instruct the
patient in the performance of:
A. Resistive range of motion exercises to left leg .
B. Passive range of motion exercises to right leg .
C. Active assistive range of motion exercise to right leg .
D. Active range of motion exercises to both legs .

The parent of a child with chronic asthma is hesitant to discipline because the child often doesn't feel well. The nurse
should encourage the parent to:
A. Set consistent behaviour limits

B. Be more lenient during times of illness

C. Cherish the limited time the child has to live

D. Avoid upsetting the child with limit-setting

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A patient presents to the office for a physical examination. The patient is found to be healthy and fit but occasionally
drinks alcohol and has unprotected sex. What is the BEST nursing diagnosis?
A. Health seeking behaviour

B. Knowledge dame risk behaviors

C. Low self-esteem

D. Altered thought process

A 55 old woman presents with pain in the joint softie hands she feels generally tired and has had a low grade fever for the
past week. On examination, the joints of the fingers on both hands are symmetrically swollen.
Blood pressure 120/70 mmHg

Heart rate 82/min

Respiratory rate 18/min

Temperature 38.0 C

Oxygen saturation 99% on room air

Which type arthritis most likely?
A. Rheumatoid

B. Septic

C. Psoriatic

D. Osteoarthritis

A nurse is admitting a two year old child with an umbilical hernia. Which of the following interventions does not meet s
A. Allowing the child to make choices when possible
B. Providing rooming in and unlimited visitation
C. Attempting to continue rituals used at home
D. Maintaining strict bed rest

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A seven year-old child presents to the emergency room with a fracture of the right arm. What would be the long term
goal for this patient?
A. Patient verbalizes decreased pain level
B. Nurse notes neurovascular checks are within normal limits
C. Nurse notes decreased swelling of right arm
D. Patient performs activities of daily living without difficulty

A home reviews the second follow up laboratory test results of a patient care nurse with iron deficiency anemia. The
nurse compares the recent laboratory results taken 3 months ago. The patient has been eating foods rich in iron as
prescribed by the nutritionist,
What can be inferred about the progress of the treatment by comparing the two laboratory values?
Laboratory values Three Months Prior
Blood Urea Nitrogen

34-56 g/L
3.5-6.5 mmol/L
120-140 g/L
2.8-8.9 nnol/L
58-145 umol/L

Current Laboratory Values

Blood Urea Nitrogen

34-56 g/L
3.5-6.5 mmol/L
120-140 g/L
2.8-8.9 nnol/L
58-145 umol/L


A. Patient uptake of iron by diet is sufficient, and no additional intervention is necessary.

B. Patient's uptake of iron by diet is sufficient but additional intervention is necessary
C. Patient's uptake of iron by diet is insufficient, and additional intervention is necessary.
D. Patient's uptake of iron by diet is insufficient, and the physician's immediate attention is necessary.

Paper code ( M. D. A)
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A first time mother of a three week-old breastfed baby brings the infant to the clinic and complains that her child has
been forcefully vomiting after feeding. He was born at 40 weeks gestation, weighing 3.6 kilograms. He is constantly
hungry and irritable. Examination reveals a swollen abdomen and a palpable mass in the middle upper right quadrant.
What is the most likely health problem?
A. Intussusceptions

B. Pyloric stenosis

C. Gastroesophageal reflux

D. Diaphragmatic hernia

A six year-old child type 1 diabetes has an uncontrolled blood glucose level. The child has been given regular insulin with
minimal change in glucose level in the first 30 minutes.
Which type of insulin has an onset of 15 minutes and duration of no more than 4 hours?
A. Aspart (Novolog)

B. Lipspro (Humalog)

C. Semdente

D. Neutral Protamine Hagedorn (NPH)

A patient with cerebrovascular accident, left-sided hemiplegia, and aphasia has a nursing diagnosis of risk for aspiration
related to swallowing difficulties with a short-term goal that the patient will not aspirate. The patient has undergone
insertion of a percutaneous gastric endoscopy and has all the nutrition and fluids administered through the tube. The
nurse should:
A. Continue the care plan as written
B. Discontinue the risk for aspiration diagnosis
C. Revise the goals and interventions for diagnosis
D. Add a nursing diagnosis of ineffective health maintenance

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A three year-old child is admitted to the postoperative care unit following a heart transplant. The nurse administers
cyclosporine by intravenous infusion. Fifteen minutes later the child has difficulty in breathing, his skin feels cold and
clammy and he appears restless. Which of the following is the most appropriate action?
A. Ensure airway patency

B. Administer oxygen therapy

C. Discontinue intravenous infusion

D. Administer intramuscular epinephrine

A nurse is evaluating a patient 5 days after a right total hip replacement Which of the following goals is appropriate for
the patient?
A. Maintain hip abduction without dislocation

B. Rest with leg elevated while sitting

C. Tie shoes and put on undergarments without assistive device

D. Perform scissor-like leg exercise only

A 50 year-old woman presents with poor balance and coordination. She says that she has developed pain on the outer
aspect of the thighs and the inner side of the arch of the foot. The nurse wishes to examine the integrity of the affected
lumber spinal nerve root and performs a deep tendon reflex examination.
Which reflex would most likely be diminished?
A. Plantar

B. Brachioradialis

C. Patellar

D. Achilles tendon

A 40 year-old woman is a gravid 2, para 2 and is currently trying to conceive. Her previous pregnancy resulted in the birth
of a baby with a cleft lip and palate. The patient is anxious and concerned about the future pregnancies and the nurse
provides genetic counseling and reassurance.
Which foods would be most effectively prevent recurrence?
A. Green vegetables and citrus foods

B. Eggs, milk and dairy products

C. Wheat, corn, rice, oats, rye

D. Beef, chicken and yellow vegetables

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In what position should a dyspneic patient to be placed?
A. Prone

B. Recumbent

C. Semi-Fowlers

D. Trendelenburg

A 66 year-old woman is admitted to the hospital with a history of hypertension. She presents with breathing d1Hiculties
that worsen with activity and while sleeping. She is generally weak and feels that her heart misses bedts and that
sometimes beats loudly. An electrocardiogram shows atrial fibrillation, right ventricular atrophy end deviation towards
the right
Which nursing Intervention is most appropriate?
A. Provide a bedside commode (Portable toilet)

B. Place in right side lying position

C. Encourage family and friends to visit

D. Encourage independent hygienic activities

A community health nurse is teaching a health class about infectious disease processes.
The nurse instruct the class that class that rabies would be considered which of the following types of infection?
A. Viral

B. Protozoan

C. Fungal

D. Bacterial

A nurse is caring for a 3 week-old infant who was just admitted to the hospital. Which of the following nursing
interventions does not support this infant's basic emotional and social needs?
A. Provide for continual contact between parents and infant
B. Actively involve parents in caring for infant

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C. Keep the infant's environment quiet, dim and free of sensory stimulation
D. Foster infant-sibling relationships as appropriate

The patient is receiving mechanical ventilation set at fraction of inspired oxygen (Fi0) 100%.
The nurse should understand that which of the following can improve this patient's oxygenation?
A. Adding positive end expiratory pressure (PEEP)

B. Placing the patient in Trendelenburg position

C. increasing the FO2

D. Suctioning the patient hourly

A baby girl was born prematurely at 11 weeks gestation duo placenta abruption. She is now two months old and has a
potential hearing deficit. In the neonatal intensive care unit INICUI she had passed the initial screening tests for hearing
but has significant risk factors that suggest further evaluation
Which automatic reflex should be further evaluated?
A. Moro

B. Babinski

C. Pupullary

D. Tonic neck

A 65 year-old woman presents to her care provider with complaints of bright red blood in the stool, a loss of appetite, a
feeling of fullness and fatigue, She has lost five kilograms in the past three weeks without dieting. A faecal occult blood
test is positive and the patient is scheduled for an additional screening test, Which screening test is most likely for this
A. Barium enema

B. colonoscopy

C. Endoscopy

D. Computed tomography

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The nurse assigned to care for a patient with a diagnosis of thrombotic stroke, The nurse knows that this type of stroke is
MOST LIKELY caused by:
A. Blockage of large vessels as a result of atherosclerosis
B. Emboli produce from valvular heart disease
C. Decreased cerebral blood flow due to circulatory failure
D. A temporary disruption in oxygenation of the brain
A home care patient with chronic obstructive pulmonary disease (COPD) reports an upset stomach. The patient taking
theophylline (Theo-Dur) and triamoinolone acetonide (Azmacort). The nurse should instruct the patient to take:
A. Theo-Dur on an empty stomach

B. Theo-Dur and Azmacort at the same time

C. Theo Dur and Azmacort 12 hours apart

D. Theo-Dur with milk or crackers

A 30 year-old woman has been prescribed albuterol PRN and prophylactic inhaled corticosteroid taken once per day. She
has been taking the prophylactic as prescribed nut has needed to use the albuterol more often than usual. She has a
chronic cough and often has air hunger.
Which intervention is initially most appropriate?
A. Refer for a chest X-ray

B. Administer magnesium sulphate

C. Assess peak flow measurement

D. perform atrial oxygenation

A 3 week-old infant is hospitalized with jaundice. When considering the fluid needs relative to body size of the infant as
compared to the fluid needs of an adult, the nurse knows this infant requires:
A. Less fluids

B. More fluids

C. Same amount of fluids

D. Much less fluid

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A child is treated for superficial (first-degree) thermal burns to the thigh. The child is in great discomfort and does not eat.
Which of the following diagnoses should receive PRIORITY?
A. Altered nutrition

B. impaired skin integrity

C. Risk for infection

D. Acute pain

A pediatric nurse is providing medication instructions to the mother of a 13 year-old boy who is starting anti-depressant
therapy. the mother appears unfocused, agitated and confused and asks the nurse to repeat the instructions several
times. She tells the nurse that she is concerned that she might administer the medication incorrectly. The nurse is
concerned that the mother is not following the instructions. Which intervention would be most appropriate?
A. Reassure her that doubts are normal

B. Reinforce the importance of correct dosage

C. Refocus the teaching with printed material

D. Take a small break and then continue

A patient is preparing for a total knee replacement. During the preoperative interview process the patient reports allergic
reaction to penicillin.
Which of the following is considered a side effect and not a true allergy to medication?
A. Shortness of breath

B. Tingling ups and tongue

C. Rash

D Upset stomach


150-200 mg dl
2 units
201-250 mg/dl
4 units
251.300 mg/dl
6 units
301.350 mg/dl
8 units
351.400 mg/dl
10 units
> 401 mg/dl
Call the physician
67.The blood glucose level of a patient with diabetes mellitus is 302 mg/dl before lunch. The nurse should administer
how many units of Insulin?
A. 4

B. 6

C. 8

D. 10

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To minimize a toddler from scratching and picking at a healing skin graft site, the nurse should utilize:
A. Mild sedatives

B. Hand mittens

C. Punishment for picking

D. Distraction

A patient with heart failure has the following vital signs: Which of the following vital signs should be reported to the
physician prior to administering the next dose of digoxin?
Blood pressure 136/84 mmHg

Heart rate 48/min

Respiratory rate 20/min

Temperature 37.1 C

A. Blood pressure

B. Pulse

C. Temperature

D. Respiratory rate

A 50 year-old male presents to the medical office 3 weeks after cardiac surgery with complaints of a feeling of weakness,
difficulty breathing and joint pains. Upon examination the nurse finds a fever and a friction rub on auscultation of the
chest. The nurse should recognize that the MOST likely surgical complication is:
A. Neuropsychological dysfunction

B. Postpericardiotomy syndrome

C. Cardiac Tamponade

D. Phrenic nerve damage

A 55 year-old man presents to the clinic with complaints of numbness and tingling In his feet for the past three months.
He appears thin and his skin is pale. Examination confirms the loss of vibration sense. He also has altered proprioception.
He had a subtotal gastectomy two years ago (see lab results)


1.45 2.01 fmol/cell
0.41 0.50
81-97 fl
0.5% - 2.5%

A. Iron

B. B12

C. Folate

D. Acid

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Which of the following nursing diagnosis is a PRIORITY for a patient admitted to the critical care unit with diabetic
A. Deficient fluid volume secondary to hyperglycemia
B. Risk for infection secondary to weakened immune system
C. Deficient knowledge of cause and prevention
D. Imbalanced nutrition related to hyperglycaemic state
A 55 year-old man presents to the clinic with complaints of numbness and tingling in his feet for the past three months.
He appears thin and his skin is pale. Examination confirms the loss of vibration sense. He also has altered proprioception.
He had a subtotal gastrectomy two years ago (see lab results)


1.45-2.01 fmol/cell
0.41-0. 0.50
81-97 fl
0.5% 2.5%

A Iron

B. B12

C. Folate

D. Acid

As identified by Dr. Elizabeth Kubler-Ross, which stage of dying is characterized y the tra sitio fro ,

o, ot

e' to

Yes, me, but".

A. Anger

B Depression

C Acceptance

D. Bargaining

The nurse is measuring the chest tubes drainage of a patient who had open heart surgery 4 hours ago. Which of the
following is the MAXIMUM hourly amount of chest tube drainage that is expected in this time frame?
A. 100 ml

B. 200 ml

C. 300 ml

D. 400 ml

Paper code ( M. D. A)
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11.88 %
3.75 %

15 %
11.88 %


7.81 %

Which of the following statements is most accurate?

A. Girls have more ADHD than asthma
B. Boys are more frequently diagnosed with chronic illnesses
C. Boys are les, frequently diagnosed with chronic illnesses
D. Girls have more other chronic Illnesses than ADHD

A patient is being followed in the clinic for hypertension, adult onset diabetes, a. obesity. The patient is apathetic about
learning about nutritional guidelines to reach the goals of weight loss and consumption of a healthy diet. The patient
admitted to eati g Whatever is put i fro t of

e .

Which of the following actions would the nurse take,

A. Collaborate with patient to set goals
B. Add a nursing diagnosis of non-compliance
C. Refer for psychiatric screening for depression
D. Discuss nutritional interventions with the spouse

A nurse is caring for a three year-old child with a fractured arm.
Which of the following interventions is the MOST appropriate for pain management
A. Administer analgesics when necessary

B. Assess pain once a shift

C. Anticipate pain and intervene early

D. Encourage the use of self-quieting techniques

Paper code ( M. D. A)
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After hearing restoration operation, a patient has no signs of complications and soon recover.
Which of the following is an expected outcome 5 days after the hearing restoration surgery?
A. Regain full hearing

B. Minimal facial nerve paralysis

C. Minimal urinary incontinence

D. Ambulates without difficulty


Goals- for the next three months, the patient will:

Not have any migraine headaches
Decrease the number of migraine headache
Learn to tolerate her migraine headaches
Continue to take prescribed preventative medications daily
Initiate complementary pain management strategies as needed
Wean self from all pain medications
Keep a pain diary and recognize triggers and auras before migraine headaches commence

An adolescent patient with a history of migraine headaches for the past year has been followed for pain management.
The headaches have decreased in severity and now occur only occasionally What are the BEST three long term goals?
A. A, D, F

B. B, D, F

C. C, E, F

D. D, E, G

A community health nurse visits a patient who had a cerebrovascular accident. The patient is at risk for deficient fluid
volume due to voluntary reduction of fluid intake to avoid the use of the bathroom. The nurse educates the patient on
the importance of drinking fluids and maintaining hydration.
Which of the following Indicates the efficacy of the nursing intervention?
A. Amber color urine

B. Respiration

C. Tachycardia

D. Moist mucous membrane

Paper code ( M. D. A)
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A patient with diabetes mellitus and multiple sclerosis has been prescribed bacofen The nurse knows this medication may
result in?
A. Increase insulin needs

B. Renal Failure

C. optic neuritis

D. Muscle tremor

Which instruction take priority in reducing anxiety related to surgery?
A. Surgical procedure and postoperative exercises

B. Risk of infection after surgery

C. Advance directives and what it means

D. Pre-operative laboratory result and what to expect on it


Nursing Diagnosis
Impaired physical mobility
Activity intolerance
Alteration in comfort
Risk for alteration in skin integrity
Knowledge deficit
Decrease cardiac output

84. A patient with Alzheimer's disease and severe cardiomyopathy presents to the hospital with a fractured left hip. The
patient is on bed rest until a cardiologist clears the patient to have surge,. Which nursing diagnoses have the highest
A. E and F

B. D and C

C. C and F

D. A and B

Paper code ( M. D. A)
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A 19 year-old woman telephones the nurse and complains of difficulty breathing. The symptoms developed while
exercising that morning. She has it productive cough with thick mucous secretions and wheezing. The nurse hears that
the breathing problems do not interfere with talking on the phone. The woman plans to attend the clinic but must wait
for two hours before she can be driven there. Which treatment should be recommended first by the physician?
A. Pursed-lip breathing
B. Deep breathing and coughing
C. Decrease physical activity
D. B2 Agonist administration
Prior to providing care for a hospitalized infant, the nurse who focuses on preventive measures must:
A. Introduce self to parent
B. perform hand hygiene
C. Have a witness present
D. Assess the child's developmental level