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1. A nurse is caring for a client who had Clostridium welchii (Clostridium perfringens) cultured from a wound of the lower extremity. Which disease results when this organism enters a wound, causing crepitus?

• Tetanus
• Anthrax
• Botulism
• Gangrene

2. A client with a history of arthritis has an acute episode of right ventricular heart failure and is receiving furosemide (Lasix). The health care provider lowers the client’s usual dosage of aspirin. The client asks the nurse the reason for the lower dose. What is the nurse’s best response?

• ‘Aspirin accelerates metabolism of furosemide and decreases the diuretic effect.”
• “Aspirin in large doses after an acute stress episode increases the bleeding potential.”
• “Competition for renal excretion sites by the drugs causes increased serum levels of aspirin.”
• “Use of furosemide and aspirin concomitantly increases formation of uric acid crystals in the nephron.”

3. What should the nurse expect the health care provider to prescribe if a client exhibits clinical indicators of warfarin (Coumadin) overdose?

• Heparin
• Vitamin K
• Iron dextran
• Protamine sulfate

4. A nurse in a public health clinic is teaching clients how to prevent toxoplasmosis. What should the nurse instruct the clients to avoid?

• Contact with cat feces
• Working with heavy metals
• Ingestion of freshwater fish
• Excessive radiation exposure

5. In the postanesthesia care unit it is reported that the client received intrathecal morphine intraoperatively to control pain. Considering the administration of this medication, what should the nurse include as part of the client’s initial 24-hour postoperative care?

• Assessing the client for tachycardia
• Monitoring of respiratory rate hourly
• Administering naloxone every 3 to 4 hours
• Observing the client for signs of CNS excitement

6. A client is diagnosed with herpes genitalis. What should the nurse do to prevent cross-contamination?

• Institute droplet precautions.
• Arrange transfer to a private room.
• Wear a gown and gloves when giving direct care.
• Close the door and wear a mask when in the room.

7. A nurse is teaching a client about drug therapy against Plasmodium falciparum. What information should the nurse include in the teaching plan?

• The infection can be controlled.
• Immunity will prevent reinfestation.
• The infection generally can be eliminated.
• Immunity from the original infection is temporary.

8. What instructions should a nurse give a client for whom nitroglycerin tablets are prescribed?

• Limit the number of tablets to four per day.
• Discontinue the medication if a headache develops.
• Ensure that the medication is stored in a dark container.
• Increase the number of tablets if dizziness is experienced.

9. A nurse is planning to provide discharge teaching to the family of a client with AIDS. Which statement should the nurse include in the teaching plan?

• “Wash used dishes in hot, soapy water.”
• “Let dishes soak in hot water for 24 hours before washing.”
• “You should boil the client’s dishes for 30 minutes after use.”
• “Have the client eat from paper plates so they can be discarded.”

10. A client cannot understand how syphilis was contracted because there has been no sexual activity for several days. Which length of time associated with the incubation of syphilis should the nurse include in the teaching plan?

• 1 week
• 4 months
• 2 to 6 weeks
• 48 to 72 hours

11. Tissue plasminogen activator (t-PA) is to be administered to a client in the emergency department. Which is the priority nursing assessment?

• Apical pulse rate
• Electrolyte levels
• Signs of bleeding
• Tissue compatibility

12. A client with a partial occlusion of the left common carotid artery is to be discharged while still receiving warfarin (Coumadin). Which clinical adverse effect should the nurse identify as a reason for the client to seek medical consultation?

• Presence of blood in urine
• Increased swelling of the ankles
• Diminished ability to concentrate
• Occurrence of transient ischemic attacks

13. Metoprolol (Lopressor) is prescribed for a client. The nurse should question the prescription if the client has which diagnosis?

• Hypertension
• Angina pectoris
• Sinus bradycardia
• Myocardial infarction

14. Which drug requires the nurse to monitor the client for signs of hyperkalemia?

• Furosemide (Lasix)
• Metolazone (Zaroxolyn)
• Spironolactone (Aldactone)
• Hydrochlorothiazide (HydroDIURIL)

15. During an AIDS education class a client states, “Vaseline works great when I use condoms.” Which conclusion about the client’s knowledge of condom use can the nurse draw from this statement?

• An understanding of safer sex
• An ability to assume self-responsibility
• Ignorance related to correct condom use
• Ignorance concerning the transmission of HIV

16. A nurse is teaching a client about drug therapy for gonorrhea. Which fact about drug therapy should the nurse emphasize?

• Cures the infection
• Prevents complications
• Controls its transmission
• Reverses pathologic changes

17. A client is diagnosed with gastroenteritis. What does the nurse determine is the basic intention underlying the unique dietary management for this client?

• Provide optimal amounts of all important nutrients.
• Increase the amount of bulk and roughage in the diet.
• Eliminate chemical, mechanical, and thermal irritation.
• Promote psychologic support by offering a wide variety of foods.

18. A client with an invasive carcinoma of the bladder is receiving radiation to the lower abdomen in an attempt to shrink the tumor before surgery. What should the nurse do considering the side effects of radiation?

• Observe feces for the presence of blood.
• Monitor the blood pressure for hypertension.
• Administer enemas to remove sloughing tissue.
• Provide a high-bulk diet to prevent constipation.

19. A nurse is providing discharge instructions for a client with angina who has a prescription for sublingual nitroglycerin tablets. The nurse should teach the client that the nitroglycerin sublingual tablets have lost their potency when:

• sublingual tingling is experienced.
• the tablets are more than three months old.
• the pain is unrelieved, but facial flushing is increased.
• onset of relief is delayed, but the duration of relief is unchanged.

20. A client is receiving warfarin (Coumadin) for a pulmonary embolism. Which drug is contraindicated when taking warfarin?

• Ferrous sulfate
• Acetylsalicylic acid
• Atenolol (Tenormin)
• ChlorproMAZINE (Thorazine)

21. A client is concerned about contracting malaria while visiting relatives in Southeast Asia. What should the nurse teach the client to avoid to best prevent malaria?

• Mosquito bites
• Untreated water
• Undercooked food
• Overpopulated areas

22. A nurse is concerned about the public health implications of gonorrhea diagnosed in a 16-year-old adolescent. Which should be of most concern to the nurse?

• Finding the client’s contacts
• Interviewing the client’s parents
• Instructing the client about birth control measures
• Determining the reasons for the client’s promiscuity

23. A nurse is preparing a teaching plan for a client with syphilis. The nurse includes that syphilis is not considered contagious in the:

• tertiary stage.
• primary stage.
• secondary stage.
• incubation stage.

24. When assessing a client during peritoneal dialysis, a nurse observes that drainage of the dialysate from the peritoneal cavity has ceased before the required volume has returned. What should the nurse instruct the client to do?

• Drink a glass of water.
• Turn from side to side.
• Deep breathe and cough.
• Rotate the catheter periodically.

25. A nurse is assessing the therapeutic action of drugs classified as tumor necrosis factor inhibitors. What client response indicates to the nurse that a drug with this classification is effective?

• Continued remission in a client with ovarian cancer
• Increased insulin production in a client with diabetes mellitus
• Vasodilation of coronary arteries in a client with ischemic heart disease
• Reduction of inflammatory joint pain in a client with rheumatoid arthritis

26. A mother with the diagnosis of AIDS states that she has been caring for her baby even though she has not been feeling well. What important information should the nurse determine?

• If she has kissed the baby
• If the baby is breastfeeding
• When the baby last received antibiotics
• How long she has been caring for the baby

27. A client who abused intravenous drugs was diagnosed with the human immunodeficiency virus (HIV) several years ago. The nurse explains that the diagnostic criterion for acquired immunodeficiency syndrome (AIDS) has been met when the client:

• contracts HIV-specific antibodies.
• develops an acute retroviral syndrome.
• is capable of transmitting the virus to others.
• has a CD4+ T lymphocyte level of less than 200 cells/μL

28. A client is to have hemodialysis. What must the nurse do before this treatment?

• Obtain a urine specimen to evaluate kidney function
• Weigh the client to establish a baseline for later comparison
• Administer medications that are scheduled to be given within the next hour
• Explain that the peritoneum serves as a semipermeable membrane to remove wastes

29. A nurse is caring for a client with a diagnosis of acute salpingitis. Which condition most commonly causing inflammation of the fallopian tubes should the nurse include when planning a teaching program for this client?

• Syphilis
• Gonorrhea
• Hydatidiform mole
• Spontaneous abortion

30. A nurse is counseling a client who has gonorrhea. What additional fact about gonorrhea, besides the fact that it is highly infectious, should the nurse teach this client?

• It is easily cured.
• It occurs very rarely.
• It can produce sterility.
• It is limited to the external genitalia.

31. A nurse is taking the health history of a client who is to have surgery in 1 week. The nurse identifies that the client is taking ibuprofen (Advil) for discomfort associated with osteoarthritis and notifies the health care provider. Which drug does the nurse expect will most likely be prescribed instead of the Advil?

• Naproxen (Aleve)
• Ibuprofen (Motrin)
• Ketorolac (Toradol)
• Acetaminophen (Tylenol)

32. A nurse concludes that the simvastatin (Zocor) being administered to a client is effective. A decrease in what clinical finding supports this conclusion?

• INR
• Heart rate
• Triglycerides
• Blood pressure

33. During the postoperative period after surgery for a kidney transplant, the client’s creatinine level is 3.1 mg/dL. What should the nurse do first in response to this laboratory result?

• Notify the health care provider.
• Check the intravenous infusion.
• Obtain current blood test results.
• Assess for decreased urine output.

34. Warfarin (Coumadin) is prescribed for a client who has been receiving IV heparin for a partial occlusion of the left common carotid artery. The client expresses concern about why both drugs are needed at the same time. The nurse explains that this approach:

• allows clot dissolution while preventing new clot formation.
• permits the administration of smaller doses of each medication.
• immediately provides maximum protection against clot formation.
• provides an anticoagulant intravenously until the oral drug reaches therapeutic levels.

35. Which clients health problem motivates the nurse to question a prescription for a beta blocker?

• Heart failure
• Hypertension
• Sinus tachycardia
• Coronary artery disease

36. A nurse is caring for a client who is HIV positive. For which complication associated with this diagnosis is it most impor-tant for the nurse to teach prevention strategies?

• Infection
• Depression
• Social isolation
• Kaposi sarcoma

37. A nurse is providing discharge instructions about digoxin (Lanoxin). Which response should a nurse include as a reason for a client to withhold the digoxin?

• Chest pain
• Blurred vision
• Persistent hiccups
• Increased urinary output

38. What effect of povidone-iodine (Betadine) does a nurse consider when using it on the clients skin before obtaining a specimen for a blood culture?

• Makes the skin more supple
• Avoids drying the skin as does alcohol
• Eliminates surface bacteria that may contaminate the culture
• Provides a cooling agent to diminish the feeling from the puncture wound

39. For what client response must the nurse monitor to determine the effectiveness of amiodarone (Cordarone)?

• Results of fasting lipid profile
• Presence of cardiac dysrhythmias
• Degree of blood pressure control
• Incidence of ischemic chest pain

40. Blackwater fever occurs in some clients with malaria. For which response should the nurse assess this client?

• Dark red urine
• Low grade fever
• Clay-colored diarrhea
• Coffee-ground emesis

41. A client in the emergency department states, “I was bitten by a raccoon while I was fixing a water pipe in the crawl space of my basement.” Which is the mosteffective first-aid treatment for the nurse to use for this client?

• Administering an antivenin
• Maintaining a pressure dressing
• Cleansing the wound with soap and water
• Applying a tourniquet proximal to the wound

42. Which drug does a nurse anticipate may be prescribed to produce diuresis and inhibit formation of aqueous humor for a client with glaucoma?

• Chlorothiazide (Diuril)
• AcetaZOLAMIDE (Diamox)
• Bendroflumethiazide (Naturetin)
• Demecarium bromide (Humorsol)

43. A client is admitted to the hospital for general paresis as a complication of syphilis. Which therapy should the nurse anticipate will most likely be prescribed for this client?

• Penicillin therapy
• Major tranquilizers
• Behavior modification
• Electroconvulsive therapy

44. Which action should the nurse take when caring for a client with malaria?

• Institute seizure precautions.
• Prepare for blood transfusions.
• Maintain isolation precautions.
• Provide nutrition between paroxysms.

45. One week after being hospitalized for an acute myocardial infarction, a client reports a loss of appetite and feeling nauseated. Which of the clients prescribed medications should be withheld and the health care provider notified?

• Digoxin (Lanoxin)
• Furosemide (Lasix)
• Propranolol (Inderal)
• Spironolactone (Aldactone)

46. What should the nurse include in a teaching plan to help reduce the side effects associated with diltiazem (Cardizem)?

• Lie down after meals.
• Change positions slowly.
• Avoid dairy products in diet.
• Take the drug with an antacid.

47. A female client is upset with her diagnosis of gonorrhea and asks the nurse, “What can I do to prevent getting another infection in the future?” The nurse evaluates that the teaching is understood when the client states, “My best protection is to:

• douche after every intercourse.”
• avoid engaging in sexual behavior.”
• insist that my partner use a condom.”
• use a spermicidal cream with intercourse.”

48. A client reports fatigue and dyspnea and appears pale. The nurse questions the client about medications currently being taken. In light of the symptoms, which medication causes the nurse to be most concerned?

• Famotidine (Pepcid)
• Methyldopa (Aldomet)
• Ferrous sulfate (Feosol)
• Levothyroxine (Synthroid)

49. The laboratory INR results of a client receiving warfarin (Coumadin) have been variable. The nurse interviews the client to determine factors contributing to the problem. Which is most important for the nurse to identify?

• Use of analgesics
• Serum glucose level
• Serum potassium levels
• Adherence to the prescribed drug regimen

50. A client who is obtund has a blood pressure of80/35 mm Hg after a blood transfusion. In an effort to support renal perfusion, the nurse administers DOPamine (Intropin) at 2 mcg/kg/min as prescribed. What is the most relevant outcome indicating effectiveness of the medication for this client?

• A decrease in blood pressure
• An increase in urinary output
• A decrease in core temperature
• An increase in level of consciousness