1. To make a
definitive diagnosis of tuberculosis, the nurse understands
that the physician must order a:
A.
Chest x-ray
B.
Tuberculin skin test
C.
Pulmonary function test
D.
Sputum for acid- fast testing
2. The equipment
that will be used by the nurse during central venous catherter
site care for a client receiving total parenteral nutrition
is:
A.
Double sterile gloves
B.
Mask and sterile gloves
C.
Gown and sterile gloves
D.
Mask, gown, and sterile gloves
3. Before irrigating
a client’s nasogastric tube, the nurse must first
A.
Assess breath sounds
B.
Instill 15 ml. Of normal saline
C.
Auscultate for bowel sounds
D.
Check the tube for placement
4. A client has a
history of progressive carotid and cerebral atherosclerosis
and transient ischemic attacks (TIAs). The nurse understands
that TIAs are:
A.
Temporary episodes of neurologic dysfunction
B.
Transient attacks caused by multiple small emboli
C.
Periods of alternating exacerbations and remissions
D.
Ischemic attacks that result in progressive neurologic
deterioration
5. The nurse knows
that a positive diagnosis for HIV infection is made based on:
A.
A history of high risk
sexual behaviors
B.
Positive ELISA and Western Blot Tests
C.
Evidence of extreme weight loss and high fever
D.
Identification of an associated opportunistic infection
6. An ECG is
performed before a client is to have a cardiac
catheterization. Hypokalemia is suspected. To confirm the
presence of Hypokalemia, the nurse would expect the physician
to order:
A. Blood
cultures times 3
B. A
complete blood count
C. A
Serum Electrolyte level
D. An
x-ray film of the long bones
7. A patient
diagnosed as having non-insulin dependent diabetes mellitus (NIDDM).
The priority teaching goal would be that the client will be
able to:
A. Perform
foot care
B. Administer
insulin
C. Test
urine for sugar and acetone
D. Identify
hypoglycemia/ hyperglycemia
8. A patient returns
from cardiac catheterization with a pressure dressing over the
left groin. The patient is to be flat in the bed for 6 hours
with the leg straight. These measures are important to
prevent:
A. Orthostatic
hypotension
B. Headache
and disorientation
C. Bleeding
at the arterial puncture site
D. Infiltration
of radiopaque dye into tissue
9. When a patient
with chronic obstructive pulmonary disease (COPD) becomes
dyspenic and anxious, the nurse’s first action to decrease
dyspnea should be to:
A.
Increase the oxygen as
high as it will go
B. Check
vital signs, including blood pressure
C. Encourage
pursed lip breathing and slowing down of respiration
D. Tell
the client that he will be fine and there is nothing to worry
about
10. A patient
develops subcutaneous emphysema after a laryngectomy. This is
most readily detected by:
A. Palpating
crackles underneath the surface of the skin
B. Auscultation
of the lung fields
D.
Evaluating the blood
gases
E. Reviewing
the chest x-ray
11. The nurse knows
that a closed water-seal drainage system connected to a
client’s pleural chest tube is functioning properly when the
fluid in the water-seal chamber of the drainage system
A.
Contains many small air bubbles
B.
Bubbles vigorously on
inspiration
C.
Rises with inspiration
and falls with expiration
D.
Remains at a consistent level during the respiratory cycle
12. A unit of blood
is ordered. Which of the following is the most important
safeguard prior to administrating blood?
A.
Refrigerate until used
B.
Agitate the blood so it
will mix
C.
With another nurse,
carefully check the label against the patient wrist ID band.
D.
Infuse through a blood
warmer to prevent reaction.
13. Nursing measures
related to the inflow of dialysate fluid during peritoneal
dialysis include:
A.
Infusing the dialysate
solution over 2 hours
B.
Slightly warming the
solution before instilling
C.
Positioning the client
in the side lying position
D.
Withholding medication
until all solution is administered
14. The position
that would provide for the greatest respiratory capacity for a
client with dyspena would be the:
A.
Sims’ position
B.
Supine position
C.
Orthopenic position
D.
Semi- Fowler’s position
15. A male patient
with a history of congestive heart failure and atrial
fibrillation comes to the clinic for his regular 2 week visit.
The patient is 9 pounds heavier than his usual weight. The
nurse interprets that the most likely cause of this sudden
weight gain is:
A.
Fluid retention
B.
Urinary retention
C.
Renal insufficiency
D.
Abdominal distention
16. Halfway through
administration of a unit of blood, a patient complains of
lumbar pain. The nurse should :
A.
Obtain vital signs
B.
Stop the transfusion
C.
Asses the pain further
D.
Increase the flow of
normal saline
17. The nurse is
caring for a patient who is about to have a lumbar puncture.
Planned care following the procedure should include:
A.
Having the patient lie
in the supine position for 6 to 12 hours
B.
Encouraging the client
to ambulate every hour for 6 to 8 hours
C.
Maintaining the client
in the Trendelenburg’s position for 4 hours
D. Placing
patient in High Fowler’s position immediately after the
procedure
18. The nurse is
aware that a patient with a spinal cord injury is developing
autonomic dysreflexia when the patient has
A.
Flaccid paralysis and
numbness
B.
Absence of sweating and
pyrexia
C.
Escalating tachycardia
and shock
D.
Paroxysmal hypertension
and bradycardia
19. Upon assessment
of a patient the nurse recognizes that a pacemaker is
indicated when a client is experiencing
A.
Angina
B.
Chest pain
C.
Heart block
D.
Tachycardia
20. A patient with
cmphysema is short of breath and using accessory muscles of
respiration. The nurse recognizes that the patient’s
difficulty in breathing is caused by:
A.
Spasm of the bronchi
that traps the air
B.
An increase in the vital
capacity of the lungs
C.
A too rapid expulsion of
the air from the aveoli
D.
Difficulty in expelling
the air trapped in the alveoli
