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TEST 1
Multiple Choice
- While assessing a client with diabetes mellitus, the nurse observes an absence of
hair growth on the client's legs. What additional assessment provides further
data to support this finding?
a. Palpate for the presence of femoral pulses bilaterally.
b. Assess for the presence of a positive Homan's sign.
c. Observe the appearance of the skin on the client's legs.
d. Watch the client's posture and balance during ambulation.
- The healthcare provider prescribes 15 mg/kg of Streptomycin for an infant
weighing 4 pounds.
The drug is diluted in 25 ml of D 5 W to run over 8 hours. How much
Streptomycin will the infant receive?
a. 9 mg.
b. 18 mg.
c. 27 mg.
d. 36 mg.
- In assessing a client with preeclampsia who is receiving magnesium sulfate, the
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nurse determines that her deep tendon reflexes are 1+; respiratory rate is 12
breaths/minute; urinary output is 90 ml in 4 hours; magnesium sulfate level is 9
mg/dl. Based on these findings, what intervention should the nurse implement?
a. Continue the magnesium sulfate infusion as prescribed.
b. Decrease the magnesium sulfate infusion by one-half.
c. Stop the magnesium sulfate infusion immediately.
d. Administer calcium gluconate immediately.
- A client is on a mechanical ventilator. Which client response indicates that the
neuromuscular blocker tubocurarine chloride (Tubarine) is effective?
a. The client’s expremities are paralyzed.
b. The peripheral nerve stimulator causes twitching.
c. The client clinches fist upon command.
d. The client’s Glagow Coma Scale score is 14.
- An elderly female client comes to the clinic for a regular check-up. The client
tells the nurse that she has increased her daily doses of acetaminophen
(Tylenol) for the past month to control joint pain. Based on this client's
comment, what previous lab values should the nurse compare with today's lab
report?
a. Look at last quarter's hemoglobin and hematocrit, expecting an
increase today due to dehydration.
b. Look for an increase in today's LDH compared to the previous
one to assess for possible liver damage.
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- Aspirin is prescribed for a 9-year-old child with rheumatic fever to control the
inflammatory process, promote comfort, and reduce fever. What intervention
is most important for the nurse to implement?
a. Instruct the parents to hold the aspirin until the child has first
had a tepid sponge bath.
b. Administer the aspirin with at least two ounces of water or juice.
c. Notify the healthcare provider if the child complains of ringing in the ears.
d. Advise the parents to question the child about seeing yellow halos around
objects.
- Which signs or symptoms are characteristic of an adult client diagnosed
with Cushing's syndrome?
a. Husky voice and complaints of hoarseness.
b. Warm, soft, moist, salmon-colored skin.
c. Visible swelling of the neck, with no pain.
d. Central-type obesity, with thin extremities.
- A charge nurse agrees to cover another nurse’s assignment during a lunch
break. Based on the status report provided by the nurse who is leaving for
lunch, which client should be checked first by the charge nurse? The client
a. admitted yesterday with diabetec ketoacidosis whose blood
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glucose level is now 195 mg/dl.
b. with an ileal conduit created two days ago with a scant amount
of blood in the drainage pouch.
c. post-triple coronary bypass four days ago who has
serosanguinous drainage in the chest tube.
d. with a pneumothorax secondary to a gunshot wound with a
current pulse oximeter reading of 90%.
- An outcome for treatment of peripheral vascular disease is, "The client will
have decreased venous congestion." What client behavior would indicate to
the nurse that this outcome has been met?
a. Avoids prolonged sitting or standing.
b. Avoids trauma and irritation to skin.
c. Wears protective shoes.
d. Quits smoking.
- The healthcare provider performs a paracentesis on a client with ascites and 3
liters of fluid are removed. Which assessment parameter is most critical for the
nurse to monitor following the procedure?
a. Pedal pulses.
b. Breath sounds.
c. Gag reflex.
d. Vital signs.
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b. Total parenteral nutrition to be infused at 125 ml/hour.
c. Nasogastric tube connected to low intermittent suction.
d. Metoclopramide (Reglan) intermittent piggyback.
- A client's telemetry monitor indicates the sudden onset of ventricular
fibrillation. Which assessment finding should the nurse anticipate?
a. Bounding erratic pulse.
b. Regularly irregular pulse.
c. Thready irregular pulse.
d. No palpable pulse.
- In assessing a 70-year-old female client with Alzheimer's disease, the nurse notes
that she has deep inflamed cracks at the corners of her mouth. What
intervention should the nurse include in this client's plan of care?
a. Scrub the lesions with warm soapy water.
b. Encourage the client to drink orange juice for added vitamin C.
c. Notify the healthcare provider of the need for oral antibiotics.
d. Ensure that the client gets adequate B vitamins in foods or supplements.
- A young adult female client is seen in the emergency department for a minor
injury following a motor vehicle collision. She states she is very angry at the
person who hit her car. What is the best nursing response?
a. "You are lucky to be alive. Be grateful no one was killed."
b. "I understand your car was not seriously damaged."
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c. "You are upset that this incident has brought you here."
d. "Have you ever been in the emergency department before?"
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- In evaluating teaching of a client about wearing a Holter monitor, which
statement made by the client would indicate to the nurse that the client
understands the procedure?
a. “I must record any symptoms occurring with my activity.”
b. “I am not looking forward to staying in bed for 24 hours.”
c. “I really am dreading the frequent blood drawing.”
d. “I know that I shouldn’t get close to my microwave oven.”
- A 9-year-old female client was recently diagnosed with diabetes mellitus.
Which symptom will her parents most likely report?
a. Refuses to eat her favorite meals at home.
b. Drinks more soft drinks than previously.
c. Voids only one or two times per day.
d. Gained 10 pounds within one month.
- The nurse is caring for four clients: Client A, who has emphysema and whose
oxygen saturation is 94%; Client B, with a postoperative hemoglobin of 8.
mg/dl; Client C, newly admitted with a potassium level of 3.8 mEq/L; and
Client D, scheduled for an appendectomy who has a white blood cell count of
15,000 mm
. What intervention should the nurse implement?
a. Increase Client A's oxygen to 4 liters per minute via nasal cannula.
b. Determine if Client B has two units of packed cells available in the blood bank.
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c. Ask the dietician to add a banana to Client C's breakfast tray.
d. Inform Client D that surgery is likely to be delayed until the infection is
treated.
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- A nurse is completing the health history for a 25-year-old male client who
reports that he is allergic to penicillin. Which question should the nurse ask
after receiving this information?
a. "Are you allergic to any other medications?"
b. "How often have you taken penicillin in the past?"
c. "Is anyone else in your family allergic to penicillin?"
d. "What happens to you when you take penicillin?"
- A 10-year-old child with meningitis is suspected of having diabetes insipidus. In
evaluating the child's laboratory values, which finding is indicative of diabetes
insipidus?
a. Decreased urine specific gravity.
b. Elevated urine glucose.
c. Decreased serum potassium.
d. Increased serum sodium.
- A client with myelogenous leukemia is receiving an autologous bone marrow
transplantation (BMT). What is the priority intervention that the nurse
should implement when the bone marrow is repopulating?
a. Administer sargramostim (Leukine, Prokine).
b. Infuse PRBC and platelet transfusions.
c. Give parental prophylactic antibiotics.
d. Maintain a protective isolation environment.
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- A 38-year-old male client collapsed at his outside construction job in Texas in
July. His admitting vital signs to ICU are, BP 82/70, heart rate 140
beats/minute, urine output 10 ml/hr, skin cool to the touch. Pulmonary artery
(PA) pressures are, PAWP 1, PAP 8/2, RAP -1, SVR 1600. What nursing action
has the highest priority?
a. Apply a hypothermia unit to stabilize core temperature.
b. Increase the client's IV fluid rate to 200 ml/hr.
c. Call the hospital chaplain to counsel the family.
d. Draw blood cultures x 3 to detect infection.
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c. Measure the child's abdominal girth weekly.
d. Weigh the child's wet diapers.
- The mother of a 9-month-old who was diagnosed with respiratory syncytial
virus (RSV) yesterday calls the clinic to inquire if it will be all right to take her
infant to the first birthday party of a friend's child the following day. What
response should the nurse provide this mother?
a. The child can be around other children but should wear a mask at all times.
b. The child will no longer be contagious, no need to take any further
precautions.
c. Make sure there are no children under the age of 6 months
around the infected child.
d. Do not expose other children. RSV is very contagious even
without direct oral contact.
- A client from a nursing home is admitted with urinary sepsis and has a single-
lumen, peripherally-inserted central catheter (PICC). Four medications are
prescribed for 9:00 a.m. and the nurse is running behind schedule. Which
medication should the nurse administer first?
a. Piperacillin/tazobactam (Zosyn) in 100 ml D 5 W, IV over 30 minutes q8 hours.
b. Vancomycin (Vancocin) 1 gm in 250 ml D 5 W, IV over 90 minutes q12 hours.
c. Pantoprazole (Protonix) 40 mg PO daily
d. Enoxaparin (Lovenox) 40 mg subq q24 hours.
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- Which action should the nurse implement to reduce the risk of vesicant
extravasation in the client who is receiving intravenous chemotherapy?
a. Administer an antiemetic before starting the chemotherapy.
b. Instruct the client to drink plenty of fluids during the treatment.
c. Keep the head of the bed elevated until the treatment is completed.
d. Monitor the client's intravenous site hourly during the treatment.
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today and had 160 mg/dl yesterday.
c. A client with hepatitis who is jaundiced and has a bilirubin
level that is 4 times the normal value.
d. A client with cancer who has an absolute count of neutrophils
< 500 today and had 2,000 yesterday.
- In planning the turning schedule for a bedfast client, it is most important
for the nurse to consider what assessment finding?
a. 4+ pitting edema of both lower extremities.
b. A Braden risk assessment scale rating score of ten.
c. Warm, dry skin with a fever of 100° F.
d. Hypoactive bowel sounds with infrequent bowel movements.
- The healthcare provider prescribes naproxen (Naprosyn) 500 mg PO twice a
day for a client with osteoarthritis. During a follow-up visit one month later,
the client tells the nurse, "The pills don't seem to be working. They are not
helping the pain at all." Which factor should influence the nurse's response?
a. Noncompliance is probably affecting optimum medication effectiveness.
b. Drug dosage is inadequate and needs to be increased to four times a day.
c. The drug needs 4 to 6 weeks to reach therapeutic levels in the bloodstream.
d. NSAID response is variable and another NSAID may be more effective.
- A nurse is interested in studying the incidence of infant death in a particular
city and wants to compare that city's rate to the state's rate. What state
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resource is most likely to provide this information?
a. Disease registry.
b. Department of Health.
c. Bureau of Vital Statistics.
d. Census data.
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