NP 4 1. A client is admitted to the emergency room with a gunshot wound to the right arm.

After dressing the wound and administering the prescribed antibiotic, the nurse should: A.Ask the client if he has any medication allergies B.Check the clients immunization record C.Apply a splint to immobilize the arm D.Administer medication for pain 2. The nurse is caring for a client with suspected endometrial cancer. Which symptom is associated with endometrial cancer? A.Frothy vaginal discharge B.Thick, white vaginal discharge C.Purulent vaginal discharge D.Watery vaginal discharge 3. A client with Parkinsons disease is scheduled for stereotactic surgery. Which finding indicates that the surgery had its intended effect? A.The client no longer has intractable tremors. B.The client has sufficient production of dopamine. C.The client no longer requires any medication. D.The client will have increased production of serotonin. 4. A client with AIDS asks the nurse why he cannot have a pitcher of water left at his bedside. The nurse should tell the client that: A.It would be best for him to drink ice water. B.He should drink several glasses of juice instead. C.It makes it easier to keep a record of his intake. D.He should drink only freshly run water. 5. An elderly client is diagnosed with interstitial cystitis. Which finding differentiates interstitial cystitis from other forms of cystitis? A.The client is asymptomatic. B.The urine is free of bacteria. C.The urine contains blood. D.Males are affected more often. 6. The mother of a male child with cystic fibrosis tells the nurse that she hopes her sons children wont have the disease. The nurse is aware that: A.There is a 25% chance that his children will have cystic fibrosis. B.Most of the males with cystic fibrosis are sterile. C.There is a 50% chance that his children will be carriers. D.Most males with cystic fibrosis are capable of having children, so genetic counseling is advised. 7. A 6-month-old is hospitalized with symptoms of botulism. What aspect of the infants history is associated with Clostridium botulinum infection? A.The infant sucks on his fingers and toes. B.The mother sweetens the infants cereal with honey. C.The infant was switched to soy-based formula. D.The father recently purchased an aquarium.

8. The mother of a 6-year-old with autistic disorder tells the nurse that her son has been much more difficult to care for since the birth of his sister. The best explanation for changes in the childs behavior is: A.The child did not want a sibling. B.The child was not adequately prepared for the babys arrival. C.The childs daily routine has been upset by the birth of his sister. D.The child is just trying to get the parents attention. 9. The parents of a child with cystic fibrosis ask what determines the prognosis of the disease. The nurse knows that the greatest determinant of the prognosis is: A.The degree of pulmonary involvement B.The ability to maintain an ideal weight C.The secretion of lipase by the pancreas D.The regulation of sodium and chloride excretion 10. The nurse is assessing a client hospitalized with duodenal ulcer. Which finding should be reported to the doctor immediately? A.BP 82/60, pulse 120 B.Pulse 68, respirations 24 C.BP 110/88, pulse 56 D.Pulse 82, respirations 16 . 11. While caring for a client in the second stage of labor, the nurse notices a pattern of early decelerations. The nurse should: A.Notify the physician immediately B.Turn the client on her left side C.Apply oxygen via a tight face mask D.Document the finding on the flow sheet 12. The nurse is teaching the client with AIDS regarding needed changes in food preparation. Which statement indicates that the client understands the nurses teaching? A.Adding fresh ground pepper to my food will improve the flavor. B.Meat should be thoroughly cooked to the proper temperature. C.Eating cheese and yogurt will prevent AIDSrelated diarrhea. D.It is important to eat four to five servings of fresh fruits and vegetables a day. 13. The sputum of a client remains positive for the tubercle bacillus even though the client has been taking Laniazid (isoniazid). The nurse recognizes that the client should have a negative sputum culture within: A.2 weeks B.6 weeks C.8 weeks D.12 weeks 14. Which person is at greatest risk for developing Lymes disease? A.Computer programmer B.Elementary teacher C.Veterinarian

D.Landscaper 15. The mother of a 1-year-old wants to know when she should begin toilet-training her child. The nurses response is based on the knowledge that sufficient sphincter control for toilet training is present by: A.1215 months of age B.1824 months of age C.2630 months of age D.3236 months of age 16. The nurse is developing a plan of care for a client with an ileostomy. The priority nursing diagnosis is: A.Fluid volume deficit B.Alteration in body image C.Impaired oxygen exchange D.Alteration in elimination 17. The physician has prescribed Cobex (cyanocobalamin) for a client following a gastric resection. Which lab result indicates that the medication is having its intended effect? A.Neutrophil count of 4500 B.Hgb of 14.2g C.Platelet count of 250,000 D.Eosinophil count of 200 18. A behavior-modification program has been started for an adolescent with oppositional defiant disorder. Which statement describes the use of behavior modification? A.Distractors are used to interrupt repetitive or unpleasant thoughts. B.Techniques using stressors and exercise are used to increase awareness of body defenses. C.A system of tokens and rewards is used as positive reinforcement. D.Appropriate behavior is learned through observing the action of models. 19. Following eruption of the primary teeth, the mother can promote chewing by giving the toddler: A.Pieces of hot dog B.Carrot sticks C.Pieces of cereal D.Raisins 20. The nurse is infusing total parenteral nutrition (TPN). The primary purpose for closely monitoring the clients intake and output is: A.To determine how quickly the client is metabolizing the solution B.To determine whether the clients oral intake is sufficient C.To detect the development of hypovolemia D.To decrease the risk of fluid overload 21. An obstetrical client with diabetes has an amniocentesis at 28 weeks gestation. Which test indicates the degree of fetal lung maturity? A.Alpha-fetoprotein B.Estriol level C.Indirect Coombs D.Lecithin sphingomyelin ratio 22. Which nursing assessment indicates that involutional changes have occurred in a client who is 3 days postpartum? A.The fundus is firm and 3 finger widths below the umbilicus. B.The client has a moderate amount of lochia serosa. C.The fundus is firm and even with the umbilicus. D.The uterus is approximately the size of a small grapefruit. 23. When administering total parenteral nutrition, the nurse should assess the client for signs of rebound hypoglycemia. The nurse knows that rebound hypoglycemia occurs when: A.The infusion rate is too rapid. B.The infusion is discontinued without tapering. C.The solution is infused through a peripheral line. D.The infusion is administered without a filter. 24. A client scheduled for disc surgery tells the nurse that she frequently uses the herbal supplement kava-kava (piper methysticum). The nurse should notify the doctor because kava-kava: A.Increases the effects of anesthesia and postoperative analgesia B.Eliminates the need for antimicrobial therapy following surgery C.Increases urinary output, so a urinary catheter will be needed post-operatively D.Depresses the immune system, so infection is more of a problem 25. The physician has ordered 50mEq of potassium chloride for a client with a potassium level of 2.5mEq. The nurse should administer the medication: A.Slow, continuous IV push over 10 minutes B.Continuous infusion over 30 minutes C.Controlled infusion over 5 hours D.Continuous infusion over 24 hours 26. The nurse reviewing the lab results of a client receiving Cytoxan (cyclophasphamide) for Hodgkins lymphoma finds the following: WBC 4,200, RBC 3,800,000, platelets 25,000, and serum creatinine 1.0mg. The nurse recognizes that the greatest risk for the client at this time is: A.Overwhelming infection B.Bleeding C.Anemia D.Renal failure 27. While administering a chemotherapeutic vesicant, the nurse notes that there is a lack of blood return from the IV catheter. The nurse should: A.Stop the medication from infusing B.Flush the IV catheter with normal saline C.Apply a tourniquet and call the doctor D.Continue the IV and assess the site for edema 28. A client with cervical cancer has a radioactive implant. Which statement indicates that the client understands the nurses teaching regarding radioactive implants?

A.I wont be able to have visitors while getting radiation therapy. B.I will have a urinary catheter while the implant is in place. C.I can be up to the bedside commode while the implant is in place. D.I wont have any side effects from this type of therapy. 29. The nurse is teaching circumcision care to the mother of a newborn. Which statement indicates that the mother needs further teaching? A.I will apply a petroleum gauze to the area with each diaper change. B.I will clean the area carefully with each diaper change. C.I can place a heat lamp to the area to speed up the healing process. D."I should carefully observe the area for signs of infection. 30. A client admitted for treatment of bacterial pneumonia has an order for intravenous ampicillin. Which specimen should be obtained prior to administering the medication? A.Routine urinalysis B.Complete blood count C.Serum electrolytes D.Sputum for culture and sensitivity 31. While obtaining information about the clients current medication use, the nurse learns that the client takes ginkgo to improve mental alertness. The nurse should tell the client to: A.Report signs of bruising or bleeding to the doctor B.Avoid sun exposure while using the herbal C.Purchase only those brands with FDA approval D.Increase daily intake of vitamin E 32. A client with Hodgkins lymphoma is receiving Platinol (cisplatin). To help prevent nephrotoxicity, the nurse should: A.Slow the infusion rate B.Make sure the client is well hydrated C.Record the intake and output every shift D.Tell the client to report ringing in the ears 33. The chart of a client hospitalized for a total hip repair reveals that the client is colonized with MRSA. The nurse understands that the client: A.Will not display symptoms of infection B.Is less likely to have an infection C.Can be placed in the room with others D.Cannot colonize others with MRSA 34. A client receiving Vancocin (vancomycin) has a serum level of 20mcg/mL. The nurse knows that the therapeutic range for vancomycin is: A.510mcg/mL B.1025mcg/mL C.2540mcg/mL D.4060mcg/mL

35. A client is admitted with symptoms of pseudomembranous colitis. Which finding is associated with Clostridium difficile? A.Diarrhea containing blood and mucus B.Cough, fever, and shortness of breath C.Anorexia, weight loss, and fever D.Development of ulcers on the lower extremities 36. Which vitamin should be administered with INH (isoniazid) in order to prevent possible nervous system side effects? A.Thiamine B.Niacin C.Pyridoxine D.Riboflavin . 37. A client is admitted with suspected Legionnaires disease. Which factor increases the risk of developing Legionnaires disease? A.Treatment of arthritis with steroids B.Foreign travel C.Eating fresh shellfish twice a week D.Doing volunteer work at the local hospital 38. A client who uses a respiratory inhaler asks the nurse to explain how he can know when half his medication is empty so that he can refill his prescription. The nurse should tell the client to: A.Shake the inhaler and listen for the contents B.Drop the inhaler in water to see if it floats C.Check for a hissing sound as the inhaler is used D.Press the inhaler and watch for the mist 39. The nurse is caring for a client following a right nephrolithotomy. Post-operatively, the client should be positioned: A.On the right side B.Supine C.On the left side D.Prone 40. A client is admitted with sickle cell crises and sequestration. Upon assessing the client, the nurse would expect to find: A.Decreased blood pressure B.Moist mucus membranes C.Decreased respirations D.Increased blood pressure 41. A healthcare worker is referred to the nursing office with a suspected latex allergy. The first symptom of latex allergy is usually: A.Oral itching after eating bananas B.Swelling of the eyes and mouth C.Difficulty in breathing D.Swelling and itching of the hands 42. A client is admitted with disseminated herpes zoster. According to the Centers for Disease Control Guidelines for Infection Control: A.Airborne precautions will be needed. B.No special precautions will be needed. C.Contact precautions will be needed. D.Droplet precautions will be needed.

D.Pill-rolling tremors 43. Acticoat (silver nitrate) dressings are applied to the legs of a client with deep partial thickness burns. The nurse should: A.Change the dressings once per shift B.Moisten the dressing with sterile water C.Change the dressings only when they become soiled D.Moisten the dressing with normal saline Answer B is correct. Acticoat, a commercially prepared dressing, should be moistened with sterile water. Answers A and C are incorrect because Acticoat dressings remain in place up to 5 days. Answer D is incorrect because normal saline should not be used to moisten the dressing 44. The nurse is preparing to administer an injection to a 6-month-old when she notices a white dot in the infants right pupil. The nurse should: A.Report the finding to the physician immediately B.Record the finding and give the infants injection C.Recognize that the finding is a variation of normal D.Check both eyes for the presence of the red reflex 45. A client is diagnosed with stage II Hodgkins lymphoma. The nurse recognizes that the client has involvement: A.In a single lymph node or single site B.In more than one node or single organ on the same side of the diaphragm C.In lymph nodes on both sides of the diaphragm D.In disseminated organs and tissues 46. A client has been receiving Rheumatrex (methotrexate) for severe rheumatoid arthritis. The nurse should tell the client to avoid taking: A.Aspirin B.Multivitamins C.Omega 3 fish oils D.Acetaminophen 47. The physician has ordered a low-residue diet for a client with Crohns disease. Which food is not permitted in a low-residue diet? A.Mashed potatoes B.Smooth peanut butter C.Fried fish D.Rice 48. A client hospitalized with cirrhosis has developed abdominal ascites. The nurse should provide the client with snacks that provide additional: A.Sodium B.Potassium C.Protein D.Fat 49. A diagnosis of multiple sclerosis is often delayed because of the varied symptoms experienced by those affected with the disease. Which symptom is most common in those with multiple sclerosis? A.Resting tremors B.Double vision C.Flaccid paralysis 50. After attending a company picnic, several clients are admitted to the emergency room with E. coli food poisoning. The most likely source of infection is: A.Hamburger B.Hot dog C.Potato salad D.Baked beans