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1. The usual sequence for physical assessment skills is *
a) auscultation; inspection; palpation; percussion b) inspection; auscultation; palpation; percussion c) inspection; palpation; percussion; auscultation d) palpation; percussion; inspection; auscultation
2. When performing a physical exam, the most important criterion the nurse should inspect for is: *
a) sensation b) symmetry c) rigidity d) range of motion
3. When teaching patients it is important for the nurse to remember that: *
a) a needs assessment precedes the teaching plan b) resistance factors are based on developmental tasks c) talking is the most effective way to teach d) the teaching plan procedes the needs assessment
4. The FIRST action to be taken by the nurse when a patient has collapsed is: *
a) establish an open airway b) determine if patient is unconscious c) check the carotid pulse d) assess patient for bleeding
5. Which of the following should be done when assessing the patient in pain? *
a) the patient should be asked to describe in writing his experience so that details wil be clear b) the family should be asked about the patient\\\'s pain so the patient wil not be disturbed c) the nurse should ask the patient to rate his pain on a scale of 0-10 (none to worst) d) the physician should verify the nurse\\\'s assessment of the patient
6. Nursing management of the patient with an epidural catheter should include: *
a) careful identification of the epidural catheter b) frequent monitoring of patient vital signs c) assessment of sensation and motor function d) all of the above
7. When an abnormal cardiac rhythm is identified or supsected the nurse should assess: *
a) blood pressure b) mentation c) presence or absence of chest pain d) all of the above
8. A patient is admitted with a diagnosis of acute myocardial infarction (MI). He is cold and clammy and has severe chest pain with dyspnea. Which of the following nursing diagnosis has the Highest priority: *
a) altered body temperature b) imparied gas exchange c) fluid volume deficit d) acute pain
9. Ms. Nunex has an allergic reaction to a blood transfusion. Your FIRST nursing intervention is to: *
a) administer Benadryl IV b) stop the transfusion c) call the doctor d) collect a urine speciment to check for hematuria
10. When the nurse is assessing the patient who is to receive a blood transfusion, which of the following is essential in order to avoid a possible reaction: *
a) take initial vital signs b) determine the patients most recent CBC results c) ask if the patient has had previous transfusion reactions d) run the blood slowly over at least 4 hours
11. The nurse should watch for complications in the patient undergoing a femoral angiogram. Which of the following IS a complication: *
a) warmth and flushing occur as the dye is injected b) marked diuresis occurs after the test c) distal pulses are absent 30 min after dye is injected d) the site doesn\\\'t bleed after 15 min
12. When planning care for a patient receiving patient controlled analgesia (PCA) the nurse should anticipate the following disadvantage: *
a) slow onset of pain relief b) patient titrates his own comfort c) ineffective management of pain if patient is asleep or not alert d) development of chronic pain
13. Identify risk factors for coronary heart disease related to lifestyle habits that the nurse will include in the teaching plan for the patient just discharged to home AFTER hospitalization for coronary artery disease: *
a) cigarette smoking b) physical inactivity c) obesity d) all of the above
14. Mr Daniels diagnosis is congestive heart failure, a term commonly used when referring to both left and right sided heart failure. Which of the following are the Primary sympton(s) of RIGHT sided heart failure: *
a) dyspnea and cyanosis b) peripheral edema c) hepatomegaly d) B and C
15. Symptoms of LEFT sided heart failure include: *
a) orthopnea b) paroxysmal nocturnal dyspnea c) dependent edema d) A and B
16. If a patients total parenteral nutrition (TPN) solution is absorbed before the next volume of TPN is provided by the pharmacy, the nurse should: *
a) discontinue the system and flush the catheter with heparin and saline b) leave the system intact and notify the pharmacy immediately c) run D10W at the same rate as the ordered TPN until the TPN solution arrives; unless contraindicated for the patient d) run normal saline at the TKO rate
17. Mrs. Nelson is diagnosed as having primary or essential hypertension, which has no identifiable medical cause. The nurses assessment and intervention Requires the following: *
a) careful monitoring of blood pressure at frequent intervals b) determination of nosebleeds; anginal pain; dyspnea; alterations in vision; vertigo or headaches c) education of patient and significant other regarding treatment regimen d) All of the above
18. A 75 year old man was found on the floor by his daughter. He did not recognize her; was unable to move his left arm or leg; had difficulty speaking; and was incontinent of urine. He was admitted to the hospital with a diagnosis of cerebrovascular accident. To promote rehabilitation in the early stage of stroke, the nurse would do all of the following EXCEPT:
*
a) turn and position patient every 2 hours b) perform passive range of motion of affected extremities 4 or 5 times a day c) insert an indwelling urinare catheter d) secure patient\\\'s attention and speak slowly and simply and allow patient time to process
19. Which of the patients lab values would the nurse report to the physician PRIOR to surgery: *
a) potassium of 2.5 mEq/L b) Hemoglobin of 14 g/dl c) temperature of 99.6 degrees F (37.6 C) rectally or 98.6 degrees F (37 degrees C) orally d) white blood cell count (WBC) (Leukocyte Count) of 6000 cells per mm3
20. Which of the following potential post operative complications will the nurse be monitoring for a patient who had lower extremity vascular surgery for arterial occlusive disease: *
a) deep vein thrombosis and dysrhythmias b) bleeding and vascular occlusion c) septicemia and atelectasis d) pulmonary embolus and venous stasis
21. The nurse caring for a 93 year old female patient who suddenly develops incontinence and mental confusion. The MOST appropriate nursing action is: *
a) request an order to insert an indewelling catheter b) request an order for an urinalysis with culture and sensitivity to rule out a urinary tract infection c) request an order for propantheline (Pro-Banthine) to inhibit bladder contractions d) develop a nursing care plan to toilet the patient hourly to prevent further embarrassment
22. The patient is scheduled for an intravenous pyelogram (IVP). If the patient experiences ANY of the following reactions after injection of the contrast material for the IVP, which ONE would the nurse report immediately: *
a) felling of warmth b) flushing of the face c) salty taste in the mouth d) urticaria
23. Mrs. Trainor is to be discharged on Coumadin. Which of the following instructions would the nurse INCLUDE in discharge planning: *
a) smoking is contraindicated for patients receiving anticoagulants because fo the effect of nicotine on bleeding time b) many over the counter drugs; such as aspirin and ibuprofen; affect anticoagulation action; and should be taken only with the physicians consent c) any dental work needed should be done immediately after discharge d) if there is any brusing; stop the Coumadin immediately
24. The patient diagnosed with Type I, Insulin-dependent diabeters mellitus (IDDM) would: *
a) be restricted to a 1200 calorie American Diabetic Association diet b) have no damage to the islet cells of the pancreas c) need exogenous insulin d) need to receive daily doses of a hypoglycemic agent
25. How does morphine sulfate Relieve the symptoms of acute pulmonary edema: *
a) causes renal vasoconstriction b) causes coronary artery vasodilation c) decreases peripheral resistance so blood can be redistributed from pulmonary circulation to periphery d) increases the volume of circulation blood
26. Symptoms of hypoglycemia include all of the following EXCEPT: *
a) sweating b) nervousnes c) tremor d) flushed skin
27. The nurse should expect that insulin therapy may be temporarily substituted for oral hypoglycemic therapy IF the diabetic: *
a) develops an infection with fever b) suffers trauma c) undergoes major surgery d) develops any or all of the above
28. The nurse would NOT expect to find which symptom(s) of Diabetic Ketoacidosis (DKA): *
a) acetone breath ( a fruity odor) b) kussmaul respirations c) cold; clammy; pale skin d) nausea; vomiting and or abdominal pain
29. NPH Insulin administered to the patient at 7:30AM, reaches its peak action: *
a) between 10:00 AM and Noon b) between 1:30PM and 7:30PM c) between 10:00PM and Midnight d) 7:30AM the next day
30. The SINGLE most important means of preventing the spread of infection is: *
a) antibiotic therapy b) wearing gloves for all patient contact c) hand washing d) gowning and wearing mask
31. What is the MOST specific indicator of renal function: *
a) blood urea nitrogen level b) serum creatinine concentration c) urine specific gravity d) serum bicarbonate level
32. In teaching a patient safe, self-administration of Prednisone, a synthetic corticosteroid, you would include all of the following statements EXCEPT: *
a) Take the medication with food b) Protect yourself from infections c) You may need to increase your salt intake d) Never stop taking the medication abruptly
33. A fractured bone may produce the following signs and symptoms: *
a) pain and swelling b) loss of function c) shortening of limb d) all of the above
34. In preparing the patient to receive a short term central venous catheter (CVC), the nurse will place the patient in the following POSITION: *
a) supine b) reverse Trendelenburg position c) Trendelenburg position d) Fowlers Position
35. The GREATEST cause of central venous catheter (CVC) related complications is: *
a) pain b) air embolism c) bleeding d) septicemia
36. A draining pressure ulcer which involves the epidermis and dermis, would be classified and treated as FOLLOWS: *
a) Stage I: dry sterile dressing b) Stage II: transparent membrane (Op-site and Tegaderm) c) Stage III: hydrocolloid dressings d) Stage IV: betadine and hibiclens soaked sterile dressings
37. Radiation therapy is given for the following purpose(s): *
a) palliation b) cure c) A and B d) experimentation
38. You are orienting a new Nursing Assistant Certified (NAC) to your unit. You instruct the NAC that the Most immediate action to be taken when caring for the patient who develops nausea and vomiting: *
a) measure the emesis b) monitor vital signs c) turn the patient to the side to prevent aspiration d) find you so an antiemetic can be given
39. Your patient has had a thoracotomy. She returns to the unit with a closed chest drainage system. You should FIRST check the following: *
a) amount and color of drainage b) if tidaling is occurring c) positioning the system below the level of the patients chest d) all of the above
40. Which of the following assessments does NOT indicate possible wound infection: *
a) serous drainage from a penrose drain b) oral temperature of 99.0 degrees F c) erythema around incisional site d) tenderness in the incisional area
41. Nursing care of the patient with a Hemovac includes the following EXCEPT: *
a) noting color and amount of drainage b) emptying Hemovac if half-full or more c) increasing suction by attaching to continuous wall suction when drainage decreases d) maintaining suction by compressing evacuator after emptying
42. Which of these is often the EARLIEST indication of increasing intracranial pressure: *
a) increased restlessness followed closely by focal seizures b) decreasing blood pressure in association with rising pulse rate c) decrease in responsivensess followed by change in pupil reaction d) increased severity of headache in addition to diplopia
43. The physician orders 3000 mL of D5W over 24 hours. The administration set delivers 15gtt/mL. Caculate the approximate number of drops that should be administered per minute: *
a) 20 b) 31 c) 125 d) 187
44. The physician orders Heparin 7,500 units subcutaneously q 8 hours. You have available Heparin 10,000 units/mL. How many mL will you give: *
a) 0.75mL b) 0.50mL c) 0.10mL d) none of the above because Heparin is not given subcutaneously
45. You are the nurse in charge. The medication nurse reports that Mr. Swan-Ganz, who has been depressed and threatened to commit suicide last night, told her that he feels much better this morning. Your instructions to the staff are the following: *
a) encourage him to evaluate the reason for the improvement b) observe the patient closely as he may have settled on a method for suicide c) begin plans for discharge d) inform the physician that the patient is feeling better and request a decrease in Prozac (FLUOXETINE)
46. You are the nuse in charge. Which of the following patients should be assigned to the staff member who is Most Skilled at giving physical care: *
a) 75 year old Mrs Jones who is unable to move her lower extremities due to M.S. b) 45 year old Mr Brown who is recuperating from an acute M.I. c) 38 year old Ms Stevens being discharged home tomorrow after U.R.I. d) 27 year old Ms Carpenter suffering from anorexia nervosa
47. Mr Lord, who has a terminal illness, has been very abusive to the staff. This behavior has accelerated to the point that the staff is arguing over who should care for him. The most appropriate way to handle this would be the following: *
a) explain that someone must care for him and assign him to the staff on a rotating basis b) ask the social worker to have his family hire a private duty staff member to care for him c) request a float person to care for him d) explain to the staff that his behavior may be his way of working through his grief and discuss with them ways to cope with the abusive behavior
48. The physician orders oxygen per nasal cannula for the patient with COPD. Which of the following is an Appropriate order: *
a) Oxygen at 6L/min b) Oxygen at 4L/min c) Oxygen at 2L/min d) Oxygen at 8L/min
49. You are caring for a patient with an absolute neutrophil count of 400. Precautions include all of the following EXCEPT: *
a) no visitors with cough or signs and symptoms of infection b) Post sign that reads Thrombocytopenic Precautions c) monitor temperature closely d) teach patient to practice good personal hygiene
50. The most common pulmonary complications seen with AIDs are due to infection with: *
a) Cytomegalovirus b) Legionella c) Mycobacterium avium intracellular d) Pneumocystis carinii pneumonia
