RENR PRACTICE TEST 3

1. During a class for teens, a participant states she frequently “overindulges” in numerous activities, including
eating. She questions her likelihood for becoming addicted to alcohol as a result of her “addictive
personality.” What information should be provided to the client?
a. There are no data to support the existence of an addictive personality, although individuals who become
addicted to substances frequently display an affinity for engaging in risky behaviors.
b. It is true the addictive personality does have a greater incidence of becoming addicted to a variety of
substances.
c. There is no relationship between addiction and personalities who are prone to “overindulgence.”
d. The client is not at an advanced enough age to make this determination.

2. After surgery, the nurse notes a client is unable to achieve pain relief from the analgesics prescribed. A
review of the client’s medical records reveals a history of alcohol abuse. What inferences can the nurse make?
a. The client has an unreported addiction to the pain medication being prescribed.
b. The client has a history of using this medication at home.
c. The client is likely cross-tolerant to the prescribed analgesic.
d. The client has a dual diagnosis relating to alcohol and drug addiction.

3. A client is being treated for alcohol dependency. During the treatment, the client reports having been treated
and undergone detoxification three times in the past. The client states that this time has been more difficult than
the previous detoxification experiences. What information can be provided to the client?
a. Aging can impact the ability of the body to handle detoxification from alcohol and drugs.
b. Increased difficulty with alcohol detoxification is likely the result of an addiction to another substance at
the same time.
c. The dependency might have been greater this time.
d. With each subsequent episode, detoxification becomes more difficult.

4. During a routine physical, the nurse asks the client about alcohol use. The client denies alcohol use. The
client reports having alcoholic parents, and wonders about the likelihood of becoming an alcoholic as well.
What response by the nurse is most correct?
a. “You are right to avoid alcohol use.”
b. “You will likely become an alcoholic.”
c. “There are studies that support a genetic link for developing alcoholism.”
d. “You should be fine to drink.”

A 25 year old man is admitted to a medical ward accompanied by his family, following a generalized seizure. After
medical assessment, a diagnosis of epilepsy is made. His family is concerned about how they should care for him
should this situation re occur. Questions 5 - 7

5. The client says to the nurse, “I always see flashing lights just before my seizure.” The nurse understands this
to be
a. Pre seizure
b. Aura
c. Pre-ictal
d. Onset of a seizure

6. Which of the following nursing interventions is PRIORITY for this client immediately following his
seizure?
a. Administer oxygen via face mask
b. Assess the air way
c. Remove any hazards from the area
d. Turn to internal position

7. The nurse when educating the client on the adverse effects of phenytoin (dilantin), tells him to report which
of the following to the health care provider?
a. Gingival hyperplasia
b. Abdominal pain
c. Loss of balance
d. Irregular heart beat
_____________________________________________________________________
8. The nurse is collecting data from a client regarding past alcohol use history. What question will provide the
greatest amount of information?
a. Are you a heavy drinker?
b. How often do you use alcohol?
c. Drinking doesn’t cause any problems for you, does it?
d. Is alcohol use a concern for you?

9. The client with a history of alcohol abuse is being discharged. The physician has prescribed disulfiram
(Antabuse). The client asks about the action of the medication. Which of the following statements by the nurse
is most correct?
a. “The medication will help curb your craving for alcohol.”
b. “The medication will reduce the anxiety you might experience during this difficult time.”
c. “The medication will prevent seizures and other symptoms of withdrawal.”
d. “The medication will prevent your body from breaking down alcohol.”

10. A nurse is concerned about potential substance abuse by a coworker. Which of the following behaviors
warrants further investigation?
a. The nurse in question frequently requests the largest patient care assignment for the shift.
b. The nurse in question prefers not to be the “medication nurse” on the shift.
c. The nurse in question declines to take scheduled breaks.
d. The nurse in question frequently wastes medications.

11. A formerly homeless client has been treated for alcoholism. The client’s physical examination reveals the
client is underweight and malnourished. Which of the following medications prescribed by the physician is
intended to manage the client’s nutritional status?
a. Folic acid
b. Magnesium sulfate
c. Methadone
d. Sertraline (Zoloft)

12. During an admission assessment, a nurse asks both physiological and psychosocial questions. The client
angrily responds “I’m here for my heart, not my head problems.” Which is the nurse’s best response?
a. It’s just a routine part of our assessment. All clients are asked these same questions.
b. Why are you concerned about these types of questions?
c. Psychological factors, like excessive stress, have been found to affect medical conditions.
d. We can skip these questions, if you like. It isn’t imperative that we complete this section.

13. A client is being evaluated in the Emergency Department after suffering severe burns to his torso and upper
extremities. The nurse notes edema at the burned areas. Which of the following best describes the underlying
cause for this manifestation?
a. Reduced vascular permeability at the site of the burned area
b. Decreased osmotic pressure in the burned tissue
c. Increased fluids in the extracellular compartment
d. Inability of the damaged capillaries to maintain fluids in the cell walls

14. The client having severe burns over more than half of his body has an indwelling catheter. When evaluating
the client’s intake and output, which of the following should be taken into consideration?
a. The amount of urine output will be greatest in the first 24 hours after the burn injury.
b. The amount of urine will be reduced during the first 8 hours of the burn injury and will then increase as
the diuresis begins.
c. The amount of urine will be reduced in the first 24–48 hours, and will then increase.
d. The amount of urine will be elevated due to the amount of intravenous fluids administered during the
initial phases of treatment.
15. A client has presented with a burn injury. The injury site is pale and waxy with large flat blisters. The client
asks questions about the severity of the injury and how long it will take for this injury to heal. Based upon your
knowledge, what information should be provided to the client?
a. The wound is a partial-thickness burn, and could take up to two weeks to heal.
b. The wound is a superficial burn, and will take up to three weeks to heal.
c. The wound is a deep partial-thickness burn, and will take more than three weeks to heal.
d. Wound healing is individualized.

16. The nurse is reviewing the laboratory results of the renal system for a client who experienced a major burn
event on 45% of the body 24 hours ago. Which of the following results would the nurse expect to see?
i. Creatinine clearance reduced
ii. BUN reduced
iii. GFR reduced
iv. Specific gravity elevated
a. i only
b. i, ii, iii
c. iii and iv
d. iv only

17. The client with diabetes mellitus reports having difficulty cutting his toenails. The nurse assesses the
toenails and notes the nails are thick and ingrown. Which of the following recommendations should be provided
to the client?
a. Cut the nails straight across with a clipper after the bath.
b. Make an appointment with a nail shop for a pedicure.
c. Make an appointment with a podiatrist.
d. Offer to file the tops of the nails to reduce thickness after cutting.

18. The diabetic client reports the presence of corns, and asks for information about preventing the condition.
What is the best response by the nurse to the client’s inquiry?
a. “You will need to make sure that you select shoes that are appropriately fitted.”
b. “You can use corn pads to gradually remove the growths.”
c. “Corns are best treated by shaving them off.”
d. “You can use a mild abrasive soap to scrub the area to remove them.”

19. A client at risk for the development of type 2 diabetes mellitus asks why weight loss will reduce risk of the
condition. Which of the following responses by the nurse is most correct?
a. “The amount of foods taken in require more insulin to adequately metabolize them, resulting in
diabetes.”
b. “Excess body weight impairs the body’s release of insulin.”
c. “Thin people are less likely to become diabetic.”
d. “The physical inactivity associated with obesity causes a reduced ability by the body to produce
insulin.”

20. A client has been recently diagnosed with type 1 diabetes mellitus. The client is making statements that
signal denial of the problem. The client states, “I am thin and eat all of the time, how can this mean I have
diabetes?”
Which of the following responses by the nurse is most appropriate?
a. “Thin people are diabetic too.”
b. “Your condition makes it impossible for you to gain weight.”
c. “You are eating large quantities because your condition makes it difficult for your body to obtain energy
from the foods taken in.”
d. “Your lab tests indicate the presence of diabetes.”
.
21. The nurse notes the laboratory testing performed on a 78-year-old client reveal a serum glucose level of 130
mg/dL. The nurse performs an assessment on the client and notes the absence of polyuria, polydipsia, or
polyphagia. Which of the following impressions by the nurse is most correct?
a. The client might have eaten a meal with high sugar content prior to the testing.
b. The laboratory results might be erroneous.
c. The client has type 1 diabetes mellitus.
d. The client will need to be assessed for other manifestations.
22. A nurse is acting as a preceptor for a new graduate nurse. One of the patients assigned to their care is a 41-
year-old client whose laboratory test results reveal a fasting serum blood glucose level of 125 mg/dL. The
graduate nurse asks the nurse what this means. Which of the following statements by the nurse is most correct?
a. “These results must be called to the physician.”
b. “This client has diabetes.”
c. “These results are normal.”
d. “The results are consistent with prediabetes.”

23. A client who experiences a transient ischemic attack (TIA) is placed on Warfarin (Coumadin). The
laboratory reports MOST likely reflect a drug therapeutic range of?
a. Prothrombin time (PT) 35 seconds, control normal 20 seconds; INR 2
b. Partial thromboplastin time (PTT) 30 seconds; control (normal) 30 second
c. Prothrombin time (PT) 45 seconds; control (normal) 20 seconds; INR 4
d. Partial thromboplastin time (PTT) 52 second; control (normal) 30 second

24. A client found unconscious at home is taken to the emergency room. Physical examination shows cherry red
mucous membranes, nail beds and skin. Which of the following is the MOST likely cause of his condition?
a. Spider bite
b. Aspirin ingestion
c. Hydrocarbon ingestion
d. Carbon monoxide poisoning

25. A nurse is teaching a client about a newly prescribed drug. Which if the following would MOST likely
cause a geriatric patient to have difficulty retaining knowledge about prescribed medications?
a. Decreased plasma drug levels
b. Sensory deficits
c. Lack of family support
d. History of Tourette syndrome

26. A 64-year-old client reports feeling weak. The physical assessment notes that the client is slightly pale. The
physician diagnoses the client as begin mildly anemic. The physician recommends dietary changes. During the
counseling session, the client reports frustration, as she feels she regularly eats a balanced diet. What response
by the nurse is indicated?
a. “You might not be eating as well as you think.”
b. “This happens as you get older.”
c. “As we age, the amount of iron absorbed by your body is decreased.”
d. “Menopause is responsible for these changes.”

27. During the assessment of the client’s abdomen, frequent pulsations are noted. What action by the nurse is
indicated?
a. Document the findings as hyperactive bowel sounds.
b. Review the client’s medical records for signs and symptoms of cirrhosis, as these findings are indicative
of ascites.
c. Assess the time when the client last voided, as the bladder is apparently full and becoming distended.
d. Notify the physician related to potential signs consistent with an aortic aneurysm.

28. The client presents with a diagnosis of acute diverticulitis. During the assessment, which of the following
findings will most support this diagnosis?
a. Right lower quadrant pain
b. Left lower quadrant pain
c. Upper middle abdominal pain
d. Back pain and tenderness

29. A client presents with pain, nausea, and vomiting. The assessment reveals the discomfort is in the mid-upper
abdomen. After completion of the assessment, which of the following diagnoses can the nurse likely anticipate?
a. Appendicitis
b. Peritonitis
c. Pancreatitis
d. Crohn’s disease
30. An unconscious client is brought to the Emergency Department. The assessment reveals the client has a
scaphoid abdomen. Based upon your knowledge, what information can you make about the client?
a. The client likely has type 2 diabetes mellitus.
b. The client likely suffers from Crohn’s disease.
c. The client is malnourished.
d. The client is likely suffering from diverticulosis.

31. The nurse is providing teaching to the client planning to have a small bowel series. Which of the following
statements by the client indicates the need for further education?
a. “I might experience constipation for a few days after the procedure.”
b. “I will need to increase my fluid intake the first few days after the procedure.”
c. “I might have a laxative prescribed after the procedure.”
d. “The barium will be inserted through my rectum.”

32. The physician suspects the presence of an abdominal mass in a client. An abdominal ultrasound is ordered.
Which of the following should be included in instructions provided to the client prior to the procedure?
a. Advise the technician if you suspect you are pregnant.
b. Drink 1–2 quarts one hour before the procedure.
c. Do not eat or drink anything 8–12 hours before the procedure.
d. Take a laxative the evening before the procedure.

33. During data collection, the client reports concerns with constipation. Which of the following findings could
signal a source of the problem being reported?
a. Vicodin (hydrocodone) taken twice daily for a recent back injury
b. Acetaminophen used daily for a recent back injury
c. Infrequent use of over-the-counter medications to manage insomnia
d. The use of oral contraceptives to regulate the menstrual cycle

34. A client with several episodes of urinary calculi has been found through analysis to have stones composed of
calcium phosphate. The nurse teaches this client to reduce intake of which of the following foods?
a. Flour, milk, and milk products
b. Organ meats, sardines, and seafood
c. Tomatoes, fruits, and nuts
d. Chicken, beef, and ham products

35. A newly admitted client to the medical–surgical unit is found to have ureteral calculi. The nursing diagnosis
having priority is which of the following?
a. Pain, Acute
b. Fluid Volume, Deficient
c. Knowledge, Deficient
d. Skin Integrity, Risk for Impaired

36. The nurse assessing a client newly admitted to the medical–surgical unit with glomerulonephritis expects to
find which of the following classic manifestations of this disorder?
a. Acute flank pain, nausea, and vomiting
b. Hematuria, proteinuria, and edema
c. Headache, fever, dehydration
d. Weight loss, anemia, and fatigue

37. The nursing diagnosis established for a client with acute glomerulonephritis is Fluid Volume, Excess related
to plasma protein deficit and sodium and water retention. Which of the following assessments provides the most
accurate indication of fluid balance for this client?
a. Daily weight
b. Intake and output records
c. Serum sodium levels
d. Vital signs
 38. A client returns to the medical–surgical unit following a right nephrectomy, and is receiving oxygen via
nasal cannula at a rate of 2 l/minute. The nurse assesses the following: respiratory rate 12/minute, shallow
breathing with inadequate lung expansion, and client complaint of shortness of breath.
Which nursing intervention has the highest priority at this time?
a. Continue to monitor vital signs and respiratory status.
b. Encourage the client to deep-breathe and use an incentive spirometer.
c. Increase oxygen flow rate to at least 5 l/minute.
d. Position the client with head of bed elevated 15 degrees.

39. Which of the following laboratory data does the nurse anticipate for the client with chronic renal failure prior
to hemodialysis?
a. Increased urine osmolality
b. Decreased phosphorus
c. Decreased potassium
d. Increased creatinine

40. The nurse administering calcium acetate two tablets p.o. with each meal to the client with chronic renal
failure understands the rationale for this treatment as which of the following?
a. Decreases serum creatinine.
b. Lowers serum phosphate.
c. Neutralizes gastric acid.
d. Stimulates appetite.

During natural disasters, nursing skills are of paramount importance in preventing loss of life, injuries and
paralysis through application of the nursing process. During Hurricane Andrew, several roads became
impassable and the night shift staffs were asked to continue working for another 16 hours. The staffs were
sparsely assigned among the wards and the Accident and Emergency Department.
Questions 41 - 45

41. As is customary, prior to the hurricane the doctor on duty sought to discharge some of the less critically ill
clients. Which of the following clients would the nurse NOT advocate to remain on the ward?
a. 40 year old woman with Type 2 diabetes and a GMR of 20 mmol/L
b. 50 year old man with two days post operative hernia repair
c. 35 year old man with shortness of breath and cough
d. 24 year old woman with low grade fever and a new onset of cough

42. Several clients arrive at the Accident and Emergency Department. Which of the following clients would
the nurse assess as PRIORITY?
a. A two year with pupils fixed and agonal gasps
b. 43 year old male with shallow cuts and minor bruises to chest and face
c. 50 years old man with head injury but no loss of consciousness
d. 20 year old male with profuse bleeding from an amputated leg

43. During disaster management the nurse establishes the need for immediate emergency measures to save and
sustain the lives of survivors. Which phase of the nursing process is this function carried out?
a. Evaluation
b. Diagnosing
c. Assessment
d. Planning

44. After the hurricane, the nurse’s immediate PRIORITY is to

i. Determine life threatening cases
ii. Document the number of casualties
iii. Assess cardiopulmonary function
iv. Keep channels of communication
a. i, ii and iii
b. i, iii and iv
c. ii, iii and iv
d. i, ii, iii and iv
45. Due to the number of casualties, the nurse manager has to request additional staff. What function of
management is the manger utilizing?
a. Planning
b. Organizing
c. Controlling
d. Evaluating
____________________________________________________________

46. The nurse notes the presence of a cloudy dialysate return for a client in acute renal failure receiving
peritoneal dialysis. Which of the following actions does the nurse initiate after notifying the physician?
a. Culture the dialysate return.
b. Chart the cloudy dialysate.
c. Measure abdominal girth.
d. Slow dialysate instillation.

47. The nurse plans to reinforce dietary teaching for the client in renal failure, emphasizing that protein foods
selected should be those that are complete proteins, having high biological value. Which of the following
foods will the nurse explain meet this criterion?
a. Eggs
b. Legumes
c. Nuts
d. Vegetables

A 79 year old client, resident at the senior citizens home, is admitted to a medical ward in the general hospital.
Assessment reveals that he is experiencing shortness of breath, dyspnea, productive cough and activity
intolerance; he is also having difficulty eating and sleeping. The client who is a chronic smoker has been
diagnosed as having chronic airflow limitation, formerly call COPD.
Questions 48 - 53

48. The client is prescribed Ipratropium Bromide (Atrovent) as part of a treatment. The nurse assesses the
medication to be effective when there is
a. Increased wheezing
b. Decreased wheezing
c. Increased sputum production
d. Increased frequency of coughing

49. The charge nurse assesses the notes of the admitting nurse. Which of the following statements would cause
the charge nurse to be most concerned?
a. Place client in high fowler’s position
b. A line drawn through a sentence and marked error
c. Anxiety related to fear of impending doom
d. Client produced frothy blood-tinged sputum

50. The doctor prescribed several treatments for the client. Which of the following orders would cause
concern?
a. Humidified oxygen 4 L via nasal cannula
b. Nebulize normal saline
c. Nebulize ventolin
d. Theophylline 2 ml IV

51. Which of the following best describes emphysema?

a. Enlarge alveolar spaces due to entrapped air
b. Chronic upper airway disorder
c. A condition mostly caused by smoking
d. Mucous accumulation due to decreased cilia activity
 52. The MAIN immune modulator in the trigger of asthma is?
a. IgA
b. igE
c. igG
d. igD

53. The lab results for the client reveals the following: pH 7.30, HCOᴣ 30 mEq/L, PCO₂ 50mm Hg, PaO₂ 80.
The nurse interprets the findings as
a. respiratory acidosis compensating
b. respiratory alkalosis compensating
c. metabolic acidosis compensating
d. metabolic alkalosis compensating
________________________________________________________________

54. Which statement should a nurse identify as correct regarding a clients right to refuse treatment?
a. Clients can refuse pharmacological but not psychological treatment.
b. Clients can refuse any treatment at any time.
c. Clients can refuse only electroconvulsive therapy (ECT).
d. Professionals can override treatment refusal by an actively suicidal or homicidal client.

55. The primary purpose of nursing research is to:

a. Bring prestige to the discipline.
b. Fund nursing education.
c. Generate scientific knowledge to guide nursing practice.
d. Promote the importance of nursing in society.

56. A research study investigating the benefits of ambulation after cesarean section would be an example of
which type of research evidence?
. a. Control
b. Description
c. Explanation
d. Prediction

57. A research study validates the positive effect that a nursing intervention, patient journaling, has on decreasing
spiritual distress during cancer recovery. This would be an example of which type of research evidence?
a. Control
b. Description
c. Explanation
d. Prediction

58. A nurse who reads research articles and incorporates research findings into nursing practice would
demonstrate which of the following research roles?
a. Collaborator
b. Consumer
c. Primary investigator
d. Producer

59. Florence Nightingale is most noted for which of the following contributions to nursing research?
a. Case study approach to research
b. Data collection and analysis
c. Framework and model development
d. Quasi-experimental study design

60. Scientific knowledge is generated through:

a. Authorities.
b. Borrowing from other disciplines.
c. Personal experience.
d. Research.

61. Quantitative and qualitative research approaches are particularly useful in nursing
because they:
 a. Are easy to implement.
b. Are process oriented.
c. Provide different views.
d. Require few resources.

62. Patricia Benner (1984) emphasizes the importance of acquiring clinical knowledge and expertise through:
a. Authorities.
b. Borrowing from other disciplines.
c. Personal experience.
d. Research.

63. An example of inductive reasoning is:

a. Going from a single diabetic patient to all diabetic patients.
b. Moving from all chronically ill patients to a single chronically ill patient.
c. Using a standard nursing care plan to care for a specific patient.
d. Using a computerized nursing care plan to care for insulin-dependent diabetic patients.

64. Outcomes research in health care is oriented toward establishing:

a. Characteristics and description of nursing phenomena.
b. Critical indicators.
c. Predictive relationships.
d. Quality and effectiveness.

65. What knowledge is required to fully define nursing research?

a. An exhaustive list of the research that has already been conducted in nursing
b. Ways to perform the major descriptive and inferential statistics needed for analysis
c. Research studies well received by other disciplines for collaborative projects
d. A determination of what nurses need to know to provide the best patient care

66. Which of the following leadership styles is BEST, if there is time to make decision?
a. Situational
b. Autocratic
c. Democratic
d. Laissez-faire

67. Which of the following assessments would be MOST appropriate for the nurse to make while the
dialysis solution is dwelling within the client’s abdomen?
a. Assess for urticaria
b. Observe respiratory status
c. Check capillary refill time
d. Monitor electrolyte

68. The nurse asks a patient to breathe into a paper bag in order to correct the problem of hyperventilation.
This is done because
a. CO2 content in the blood will be reduced
b. This leads to a reduction of oxygen, causing the diaphragm to relax
c. It facilitates an increase in the oxygen saturation level of the blood
d. It increases CO2 which stimulates the brain and causes depression of the respiratory system

69. All of the following objectives are CRITICAL to the development of patient education programmes
EXCEPT:
a. Reduction in the cost of patient care
b. Improvement in the standard of health care
c. Facilitation of the development of self-care skills
d. Encouragement of active participation in planning his care

70. Which of the following seating arrangements is MOST appropriate for a counseling session?
a. The counsellor sits at her desk with the counselee lying on a couch
b. The counsellor sits at her desk with the counselee on the opposite side of the desk
c. The counsellor and the counselee sit at one side of the desk half facing each other
d. The counsellor and the counselee sit away from the desk, at an angle, facing each other
71. The nurse finds a client lying on the floor next to the bed. After returning the client to bed, assessing for
injury and notifying the primary care provider, the nurse fills out an incident report. Which of the following
is the nurse’s NEXT action?
a. Give the incident report to the nurse-manager
b. Place the incident report on the chart
c. Call the family to inform them
d. Omit mentioning the fall in the chart documentation

72. The student knows that for any organization to function effectively its members need to understand the
a. Functions of the manager
b. Mission of the organization
c. Management tends to be used
d. Resources available to the organization

73. Which of the following interventions should the Nurse implement before beginning a teaching session with
the patient?
i. Seat the patient comfortably
ii. State specific objectives for the talk
iii. Set a specific time limit for the talk
iv. Encourage the patient to verbalize her needs
a. i, ii, iii
b. i, ii, iv
c. i, iii, iv
d. ii, iii, iv

74. Which of the following characteristics of primary health care are identified by the World Health
Organization?
i. Accessible
ii. Affordable
iii. Adaptable
iv. Acceptable
a. i, ii, iii
b. i, ii, iv
c. i, iii, iv
d. ii, iii, iv

75. Which of the following would be important to include in the teaching plan for the client who wants more
information on ovulation and fertility management?
a. The ovum survives for 96 hours after ovulation, making conception possible during this time
b. The basal body temperature falls at least 0.2 F (0.17 C) after ovulation has occurred
c. Ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the next menstrual cycle
d. Most women can tell they have ovulated because of severe pain and thick, scant cervical mucus

Scenario- A 16 year old admitted with sickle cell crisis

Questions 76 - 77

76. Which of the following is not a symptom of sickle cell disease?

a. Fever
b. Pain
c. Dyspnea and cough
d. Nausea and vomiting

77. What is the highest priority nursing care treatment during the sickle cell crisis?
a. Blood transfusion and iron supplement
b. Transfusion of WBCs treated to decrease immunogenicity
c. Aggressive pain medication and oxygen therapy
d. Platelet concentrated transfusion and albumin
 _________________________________________________________________

78. The formation of the red blood cells production are stimulated from
a. Granulocytes
b. Leukocytes
c. Erythropoietin
d. Hemolysis

79. A child with a diagnosis of a hernia has been scheduled for a surgical repair in 2 weeks. The nurse
reinforces instructions to the parents about the signs of possible hernia strangulation. The nurse tells the parents
that which manifestation requires the health care provider notification by the parents?
a. Fever
b. Diarrhea
c. Vomiting
d. Constipation

80. A nurse preparing the environment on the ward discovers an expensive watch. What should the nurse do
next?
a. Contact the last patient who occupied the bed
b. Give the nurse manager the watch
c. Ask the nurse manager if any patient reported a loss watch
d. Place the watch in a bag and in the cupboard

81. A new RN was assigned a new procedure by the nurse manager. The RN never did the procedure, which
was not the scope of her practice. What is the RN response to this?
a. Ask a nurse to demonstrate the procedure
b. Read the procedure manual then ask for supervision while doing it
c. Observe another nurse do the procedure
d. Try the procedure on her own

82. A patient on digoxin 0.125mg for 3 months. As the nurse is about to administer the drug, the patient gets
confuse with tremors. What is the priority nursing care?
a. Take the patient pulse
b. Call the doctor
c. Withhold the drug
d. Take vital signs

83. A 36 year old patient admitted with acute asthma exacerbation. What is best treatment when caring for this
hospitalized patient?
a. Antibiotics
b. Antitussins
c. Rescue Inhalers
d. Corticosteroids

84. What is the typical ECG changes seen during a myocardial Infarction?
a. Q wave, ST segment depression and normal QRS
b. T wave inversion, elevated ST segment and abnormal QRS
c. Peak P wave and elevated ST segment and emergent U wave
d. Tall T wave, elevated ST segment and abnormal QRS

85. What is the initial post operative nursing intervention for a patient immediately following a permanent
pacemaker?
a. Check the patient vital signs
b. Assess the patient respiration
c. Check the site for bleeding
 d. Check the patient’s heart rate

86. A patient admitted with a sprain ankle over 12 hours. He asks the nurse for a heating pad to place on his
ankle. What is the priority for the nurse to implement?
a. Give the patient the heating pad
b. Administer prescribe antipyretic
c. Give the patient a cold pack
d. Alternate heat pad and then the cold pack

87. According to Erikson, the psychosocial task of adolescence is developing:

a. intimacy.
b. identity.
c. initiative.
d. independence.

88. Which of the following will be used to treat jaundice?

a. Sunlight
b. Bili blanket
c. Phototherapy
d. Breastfeeding

89. A primigravida is breastfeeding her newly born infant. She asked the nurse, “How will I know if my baby
is getting enough feed?” The nurse response to this will be
a. The infant will have 6-8 wet diapers per day
b. The infant will fall asleep while breastfeeding
c. The infant will wake up every 4-6 hours between feedings
d. The infant will pass stool twice per day

90. What is one of the major physical characteristics of the child with Down syndrome?
a. Excessive height
b. Spots on the palms
c. Inflexibility of the joints
d. Hypotonic musculature

91. A goiter is an enlargement or hypertrophy of which gland?

a. Thyroid
b. Adrenal
c. Anterior pituitary
d. Posterior pituitary

Senario
A 40 year old married woman with two teenage daughters has a history of fibroids and is admitted to the ward
for hysterectomy the following day. The client’s husband is her health care proxy and he is very tearful.
Questions 92 - 97

92. After administering the pre operation medication the nurse realizes that the consent form is not signed by the
client. The nurse’s PRIORITY action would be to
a. Have the client sign the consent from since she just got the medication
b. Inform the doctor that the surgery should be postponed until the medication wears off
c. Have the husband sign the consent form
d. Have the surgeon sign the consent form

93. The nurse teaches the client deep breathing and coughing exercises prior to surgery. The PRIORITY reason
for teaching deep breathing and coughing is to:
a. Increase excretion of anesthesia postoperatively
b. Prevent post operative respiratory complication
 c. Strengthen the thoracic muscles
d. Mobilize secretions

94. Which of the following is NOT a risk factor for the development of uterine fibroids?
a. Reproductive age
b. Unoccupied uterus
c. Menopause
d. Multiparity

95. The client tells the nurse, “I am a failure. My husband will not find me attractive anymore”. Which if the
following response is MOST therapeutic?
a. “It’s just a fibroid, it will not show on you.”
b. “I hear your concern but you have nothing to worry about.”
c. “You said your husband will not find you attractive anymore?”
d. ‘Whatever concern you have you can discuss with your doctor.”

96. The client tells the nurse that her doctor prescribed Medroxyprogesterone acetate (depoprevera). Which of
the following statements by the client indicates to the nurse that she understands the adverse effects of the drug?
a. I am concerned about the thrombus I had in the past
b. I should monitor my blood pressure
c. This drug does not cause sterility
d. I should take this drug with food

97. When administering Heparin anticoagulant therapy, the nurse needs to monitor the clotting time to make
certain that it is within the therapeutic range of
a. One to two times the normal control
b. Two to three times the normal control
c. 3.5 times the normal control
d. 4.5 times the normal control
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98. The nurse notes that a patient who us a vegetarian has an abnormal number of megaloblasts. The nurse
suspects a deficiency in
a. Iron
b. Zinc
c. Vitamin c
d. Vitamin b12

99. A female client is prescribed Spironolactone (Aldactone), 50mg once daily. The nurse comprehends that
Spironolactone?
a. Blocks the reabsorption of sodium, thereby increasing urinary output
b. Inhibits renal vasoconstriction, which prevents the release of rennin
c. Interferes with fluid retention by inhibiting aldosterone
d. Prevent the secretion of epinephrine form the adrenal medulla

100. The doctor orders Gentamycin for a child. Which of the following should be the INITIAL action by the
nurse?
a. Check the child’s ID bracelet
b. Assess the lab results of the liver enzymes
c. Review BUN and creatinine results
d. Assess the child for a fever