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Directions :

In this section you will read several passages. Each passage is followed by questions about it. Choose the
one best answer : (A(,(B),(C), or (D) for each question. Then, on your answer sheet find the number of
the question and fill in the oval that corresponds to the letter of your answer choice. Answer all
questions based on what is staled or implied in the passage.
1. A child who has acute lymphocytic leukemia is receiving chemotherapeutic drugs and has an
order for allopurinol (Zyloprim). The nurse should recognize that the purpose of Zyloprim for the
child is to
a. Stimulate erythropoletic activity
b. Promote the deposit of calcium in the long bones
c. Interfere with the production of leukemic cells
d. Inhibit uric acid production

2. A teenager with acne says to the nurse in the physicians office, Look at my face, I still get
pimples. The nurse should explain to the teenager that a contributing cause of acne in
adolescents is
a. Eating a large amount of foods high in fat
b. Eating foods that are high in complex carbohydrates
c. An increase in secretions of the sebaceous glands
d. An increase in secretions of the adrenal glands

3. When assessing a six month old baby girl, the nurse should expect the infant to exhibit which of
the following abilities indicative of normal development?
a. Creeping on her hands and knees
b. Pulling herself to a standing position
c. Waving bye-bye
d. Turning over completely

4. A mother makes all of the following comments about her 14-month-old sons behavior. Which
behavior should the nurse discourage?
a. My son loves to feed himself slices of peeled apple
b. My son takes his favorite blanket with him whenever he leaves the house
c. My son gets up on his knees and rocks himself to sleep
d. My son takes a bottle of juice to bed with him and sucks on it if he wakes during the night

5. A nurse would instruct a patient who has had an ileostomy to avoid which of the following
a. Potatoes
b. Beef
c. Popcorn
d. Yogurt

6. A 12-years-old girl has a long leg cast applied to her left leg. She is being instructed in crutch-
walking no weight bearing on her left leg. Which of the following observations indicates that the
girl needs further teaching?
a. She is using the three point gait
b. Her elbows are slightly flexed
c. She places the crutches approximately six to eight inches in front of her each step
d. She is supporting her weight on the weight on the axillary bars and hand places of the

7. A 26-years-old woman is brought to the psychiatric unit because of suicidal thoughts. To

determine if one to one observation is indicated for the woman, the nurse should determine if
a. Anyone in the womans family has attempted suicide
b. The woman has a plan for suicide
c. The woman has had a recent loss
d. The woman has a social support system

8. In which of the following ways should the nurse intervene when a patient repeatedly talks about
the past?
a. Help the patient to establish goals for the future
b. Give the patient a diversional activity
c. Ask the patient to drink of recent pleasures
d. Encourage the patient to share memories

9. A patient who has begun taking a tricyclic antidepressant is given instructions regarding its use.
Which of the following comments would indicate that the patient understands the information?
a. I like active exercise, but I wont be able to do it while Im on this medicine, but I guess I can
tolerate that
b. This medicine will make my ears ring, but I guess I can tolerate that
c. I wont eat cheese if one of my visitors brings me some
d. I dont feel any better, but Ive only been taking the medicine for a week

10. A woman who is dependent on alcohol is admitted to the detocxification unit. The answer to
which of the following questions is essential for the nurse to obtain from the patient
a. How does her husband react to her problem?
b. When did she have her last drink?
c. How old she was when she began to drink?
d. What did she eat in the past four hours?

11. When discussing methods of stress reduction with a patient, the nurse should use which of the
following approaches first?
a. Explain to the patient the physiological effects stress
b. Teach the patient relaxation techniques that reduce stress
c. Determine if the patient is able to identify sources of stress
d. Describe to the patient the benefits of active exercise in coping with stress

12. In the immediate postoperative period following a hip replacement, the patient should be
assisted to perform which of the following exercises on the affected extremity?
a. Leg raising
b. Dorsiflexion and extension of the foot
c. Flexion and extension of the knee
d. Quadriceps setting
13. Diazepam is prescribed for a patient with low back pain. The desired therapeutic action of valium
in this situation is to
a. Reduce anxiety levels
b. Eliminate pain sensation
c. Suppress the inflammatory process
d. Lessen muscle spasticity

14. A patient admitted to the hospital with a diagnosis of the chronic renal failure should be
assessed for which of the following manifestations?
a. Hypotension
b. Fatigue
c. Flushed skin
d. Painful urination

15. Following a prostatectomy, the pathology report reveals that the patient has cancer of the
prostate. Which of the following blood test results would support this diagnosis?
a. Decreased uric acid
b. Decreased creatinine
c. Elevated bicarbonate
d. Elevated acid phosphatase

16. Which of the following plans is particularly important in the care of a patient who has
Alzheimers disease?
a. Using behavior modification techniques
b. Assessing the patients abilities on an on-going basis
c. Helping the patient explore emotional conflicts
d. Implementing a bowel-training program

17. A patient who has a spinal cord transaction is in spinal shock. On assessment, the nurse would
expect the patient to describe which of the following findings in the lower extremities?
a. Loss of sensation
b. Complaints of tingling
c. Excessive diaphoresis
d. Constant tremors

18. Which of the following observations of a patient who has pernicious anemia would indicate that
the goal of care has been achieved?
a. The patients skin has no petechiae
b. The patients tongue has lost its beefy red color
c. The patient has no dependent edema
d. The patient has a good appetite

19. To screen for the presence of neural tube defect in the fetus, a nurse would expect a pregnant
woman to have which of the following test performed?
a. Serum alpha-fetoprotein
b. Biophysical profile
c. Amniocentesis
d. TORCH titers
20. If a four-years-old childs growth and development is age-appropriate, a nurse would expect to
observe which of the following behaviors?
a. Talking with an imaginary playmate
b. Drawing a stick figure with at least six parts
c. Walking down stairs, one step at a time
d. Counting backwards from the number 10

21. An elderly man who has Alzheimers disease calls the nurse by his wifes name. Which of the
following measures by the nurse would be appropriate?
a. Responding to whatever name he calls the nurse
b. Asking him to remember the nurses name
c. Stating the nurses name at each contact with him
d. Allowing him extra time in which to remember the nurses name

22. A nurse would expect a patient to describe the symptoms of arterial insufficiency in the lower
extremities in which of the following ways?
a. My legs feel weak when I get up to walk.
b. My legs hurt when I walk, but they feel better when I sit down.
c. My feet and ankles become swollen after walking.
d. My feet burn if I walk on a hard surface.

23. A patient who has a borderline personality disorder asks the nurse on a psychiatric unit if she
may stay up beyond the designated bedtime. When the nurse says no, the patient says, The
nurse on duty last night let me stay up late. Which of the following responses by the nurse
would be therapeutic?
a. You shouldnt have been given that privilege.
b. Everyone is required to go to bed now.
c. You can stay up for one more hour.
d. Why do you want to stay up?

24. When a women who is at 34 weeks gestation has non-reactive results to successtive non stress
tests, a nurse would prepare the woman for
a. An emergency cesarean delivery
b. Induction of labor
c. Internal fetal monitoring
d. A biophysical profile

25. A six-year-old child who is admitted to a hospital for suspected sexual molestation tells a nurse,
I do not like it when my stepdad takes a bath with me. Based on this information, which of the
following actions should the nurse take?
a. Ask the child to explain to you what takes place during bath time
b. Interview the child further by using anatomically correct dolls
c. Contact the facilitys designated child abuse interviewer
d. Approach the stepfather to clarity the childs statement

26. Which of the following comments would a patient with an antisocial personality be most likely to
a. The police are always arresting me for nothing.
b. Im feeling guilty because Ive disappointed my family.
c. Im becoming very anxious.
d. Ive learned my lesson, and Ill never do that again.

27. A patient who has ulcerative colitis does not respond to the prescribed therapy and is admitted
to the hospital for a total colectomy and creation of an ileostomy. Which of the following
measures should be given priority in the patients preoperative care plan?
a. Promoting the patients acceptance of an ileostomy
b. Monitoring the patients emotional state
c. Preventing the patient from developing pressure sores
d. Correcting the patients fluid imbalance

28. A patient is to be transfused with a unit of whole blood. If the patient were to develop an allergic
reaction, the nurse would expect to administer which of the following drugs?
a. Diphenhydramine hydrochloride (Benadryl)
b. Chlorpheniramine maleate (Chlortrimeton)
c. Pseudoephedrine hydrochloride (Sudafed)
d. Promethazine hydrochloride maleate (Phenergan)

29. A patient who has had an ileostomy says to the nurse, I will have to be isolated for the rest of
my life because no one will be able to stand this terrible odor. Which of the following responses
by the nurse would most likely be reassuring?
a. The odor will gradually become less noticeable.
b. I can understand your concern, but remaining in isolation does not reduce odor.
c. There are techniques that can reduce odor.
d. The odor is a normal part of your condition and will not offend people.

30. A patient who has been given prescription for daily thyroid extract also should be given which of
the following instruction?
a. You may have a skin irritation due to the medication.
b. You may become sluggish if the medication disage is too high.
c. You will take the medication for the rest of your life.
d. You will need to take the medication with food.

31. A nurse should recognize that cardiac arrest in a previously healthy infant is usually preceded by
a. Ventricular arrhythmias
b. Respiratory failure
c. Generalized seizures
d. Distributive shock
32. Because a woman is receiving magnesium sulfate for pregnancy-induced hypertension, it is
essential for the nurse to assess the womans
a. Urine chemistry
b. Platelet count
c. Apical heart rate
d. Respiratory rate
33. A patient has a laryngectomy with a laryngeal tube in place. When suctioning the laryngeal tube,
which of the following measures is correct?
a. Suctioning the laryngeal tube for about 10 seconds
b. Using a clean technique when suctioning the tube
c. Applying suction while inserting the catheter into the tube
d. Turning the patients head to suction one side and then the other side
34. While a patient who has Hodgkins disease is receiving chemotherapy, it is important to assess
the patient for symptoms of.
a. Thrombus formation
b. Ascites
c. Infection
d. Splenomegaly
35. When a patient who has diabetes mellitus experiences peripheral neuropathy, the priority
nursing diagnosis should be..
a. Altered health maintenance
b. Altered urinary elimination
c. Risk for impaired skin integrity
d. Noncompliance
36. Which of the following approaches would a nurse take first when preparing to insert an
intravenous catheter into an eight-year-old boy?
a. Have an assistant restrain the boy for the procedure
b. Reguest that the parents leave the room during the procedure
c. Explain to the boy what he will feel during the procedure
d. Reassure the boy that the procedure will be over quickly
37. Following a subtotal gastrectomy, a patient has a nasogastric tube attached to low, intermittent
suction. Eight hours after surgery, the patient complains of being nauseated. The nurse should
take which of the following actions first?
a. Instruct the patient to take deep breaths
b. Apply a cool cloth to the patients forehead
c. Administer antiemetic medication to the patient
d. Determine the patency of the patients nasogastric tube
38. A patient is to receive heparin sodium 20,000 units in 1000 ml of solution intravenously. The
fluid is to be regulated to deliver 50 ml of solution each hour. At this rate, the patient should
receive how many units of heparin each hour?
a. 500
b. 1000
c. 1500
d. 2000
39. A nurse suspects that a six-month-old infant has cystic fibrosis. Which of the diagnosis?
a. Quantitative collection of stool for fecal fat
b. Pulmonary function studies
c. Serum sample for human leukocyte antigen
d. Sweat chloride analysis
40. A woman who is in preterm labor is receiving magnesium sulfate for which of the following
a. To enhance fetal lung maturity
b. To prevent seizures
c. To improve urine output
d. To control uterine contraction patterns
41. A 27 years old man is admitted to the psychiatric unit after striking his wife with a cooking
utensil. He is hyperactive and is in handcuffs. Which of the following behaviors would indicate
that the patient needs continued restraints?
a. He pushes the attendant out of his way
b. He shouts curses at the nurse
c. He tears up his chart
d. He makes obscene gestures
42. A patient is brought to the psychiatric unit. Which of the following activities would be performed
by the registered nurse rather than the licensed practical nurse?
a. Administering a stat dose of lorazepam (ativan) 2 mg intramuscularly (IM)
b. Admitting the patient to the psychiatric unit
c. Asking the patient whether he hears voices other people do not hear
d. Drawing a blood sample for a lithium level