Practice Tests: Practice Exam #10 - 40 questions

 

1. An older adult client is to receive and antibiotic, gentamicin. What diagnostic finding indicates the client may have difficult excreting the medication?
A) High gastric pH
B) High serum creatinine
C) Low serum albumin
D) Low serum blood urea nitrogen

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2. A client is admitted to the hospital with findings of liver failure with ascites. The health care provider orders spironolactone (Aldactone). What is the pharmacological effect of this medication?
A) Promotes sodium and chloride excretion
B) Increases aldosterone levels
C) Depletes potassium reserves
D) Combines safely with antihypertensives

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3. A client with tuberculosis is started on Rifampin. Which one of the following statements by the nurse would be appropriate to include in teaching? "You may notice:
A) an orange-red color to your urine."
B) your appetite may increase for the first week.”
C) it is common to experience occasional sleep disturbances."
D) if you take the medication with food, you may have nausea."

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4. The nurse has just received report on a group of clients and plans to delegate care of several of the clients to a practical nurse (PN). The first thing the RN should do before the delegation of care is
A) Provide a time-frame for the completion of the client care
B) Assure the PN that the RN will be available for assistance
C) Ask about prior experience with similar clients
D) Review the specific procedures unique to the assignment

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5. Which of the following assessments by the nurse would indicate that the client is having a possible adverse response to the isoniazid (INH)?
A) Severe headache
B) Appearance of jaundice
C) Tachycardia
D) Decreased hearing

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6. The nurse is caring for a client who is 4 days post-op for a transverse colostomy. The client is ready for discharge and asks the nurse to empty his colostomy pouch. What is the best response by the nurse?
A) "You should be emptying the pouch yourself."
B) "Let me demonstrate to you how to empty the pouch."
C) "What have you learned about emptying your pouch?"
D) "Show me what you have learned about emptying your pouch."

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7. A post-operative client is admitted to the post-anesthesia recovery room (PACU). The anesthetist reports that malignant hyperthermia occurred during surgery. The nurse recognizes that this complication is related to what factor?
A) Allergy to general anesthesia
B) Pre-existing bacterial infection
C) A genetic predisposition
D) Selected surgical procedures

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8. Which of the following laboratory results would suggest to the emergency room nurse that a client admitted after a severe motor vehicle crash is in acidosis?
A) Hemoglobin 15 gm/dl
B) Chloride 100 mEq/L
C) Sodium 130 mEq/L
D) Carbon dioxide 20 mEq/L

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9. The nurse is teaching a school-aged child and family about the use of inhalers prescribed for asthma. What is the best way to evaluate effectiveness of the treatments?
A) Rely on child’s self-report
B) Use a peak-flow meter
C) Note skin color changes
D) Monitor pulse rate

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10. The nurse is providing care to a newly a hospitalized adolescent. What is the major threat experienced by the hospitalized adolescent?
A) Pain management
B) Restricted physical activity
C) Altered body image
D) Separation from family

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11. A client on telemetry begins having premature ventricular beats (PVBs) at 12 per minute. In reviewing the most recent laboratory results, which would require immediate action by the nurse?
A) Calcium 9 mg/dl
B) Magnesium 2.5 mg/dl
C) Potassium 2.5 mEq/L
D) PTT 70 seconds

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12. A client has just been diagnosed with breast cancer. The nurse enters the room and the client tells the nurse that she is stupid. What is the most therapeutic response by the nurse?
A) Explore what is going on with the client
B) Accept the client’s statement without comment
C) Tell the client that the comment is inappropriate
D) Leave the client's room

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13. A 12 year-old child is admitted with a broken arm and is told surgery is required. The nurse finds him crying and unwilling to talk. What is the most appropriate response by the nurse?
A) Give him privacy
B) Tell him he will get through the surgery with no problem
C) Try to distract him
D) Make arrangements for his friends to visit

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14. A nurse is assigned to care for a comatose diabetic on IV insulin therapy. Which task would be most appropriate to delegate to an unlicensed assistive personnel (UAP)?
A) Check the client's level of consciousness
B) Obtain the regular blood glucose readings
C) Determine if special skin care is needed
D) Answer questions from the client's spouse about the plan of care

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15. The clinic nurse is discussing health promotion with a group of parents. A mother is concerned about Reye's Syndrome, and asks about prevention. Which of these demonstrates appropriate teaching?
A) "Immunize your child against this disease."
B) "Seek medical attention for serious injuries."
C) "Report exposure to this illness."
D) "Avoid use of aspirin for viral infections."

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16. The nurse is caring for a client with a new order for bupropion (Wellbutrin) for treatment of depression. The order reads “Wellbutrin 175 mg. BID x 4 days.” What is the appropriate action?
A) Give the medication as ordered
B) Question this medication dose
C) Observe the client for mood swings
D) Monitor neuro signs frequently

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17. A3 year-old child has tympanostomy tubes in place. The child's parent asks the nurse if he can swim in the family pool. The best response from the nurse is
A) "Your child should not swim at all while the tubes are in place."
B) "Your child may swim in your own pool but not in a lake or ocean."
C) "Your child may swim if he wears ear plugs."
D) "Your child may swim anywhere."

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18. A nurse has administered several blood transfusions over 3 days to a 12 year-old client with Thalassemia. What lab value should the nurse monitor closely during this therapy?
A) Hemoglobin
B) Red Blood Cell Indices
C) Platelet count
D) Neutrophil percent

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19. The nurse is explaining the effects of cocaine abuse to a pregnant client. Which of the following must the nurse understand as a basis for teaching?
A) Cocaine use can cause fetal growth retardation
B) The drug has been linked to neural tube defects
C) Newborn withdrawal generally occurs immediately after birth
D) Breast feeding promotes positive parenting behaviors

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20. The feeling of trust can best be established by the nurse during the process of the development of a nurse-client relationship by which of these characteristics?
A) Reliability and kindness
B) Demeanor and sincerity
C) Honesty and consistency
D) Sympathy and appreciativeness

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21. A client is receiving and IV antibiotic infusion and is scheduled to have blood drawn at 1:00 pm for a "peak" antibiotic level measurement. The nurse notes that the IV infusion is running behind schedule and will not be competed by 1:00. The nurse should:
A) Notify the client’s health care provider
B) Stop the infusion at 1:00 pm
C) Reschedule the laboratory test
D) Increase the infusion rate

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22. A 52 year-old post menopausal woman asks the nurse how frequently she should have a mammogram. What is the nurse’s best response?
A) "Your doctor will advise you about your risks."
B) "Unless you had previous problems, every 2 years is best."
C) "Once a woman reaches 50, she should have a mammogram yearly."
D) "Yearly mammograms are advised for all women over 35."

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23. In discharge teaching, the nurse should emphasize that which of these is a common side effect of clozapine (Clozaril) therapy?
A) Dry mouth
B) Rhinitis
C) Dry skin
D) Extreme salivation

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24. A client was admitted to the psychiatric unit for severe depression. After several days, the client continues to withdraw from the other clients. Which of these statements by the nurse would be the most appropriate to promote interaction with other clients?
A) "Your team here thinks it's good for you to spend time with others.
B) "It is important for you to participate in group activities."
C) "Come with me so you can paint a picture to help you feel better."
D) "Come play Chinese Checkers with Gloria and me."

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25. The mother of a 4 month-old infant asks the nurse about the dangers of sunburn while they are on vacation at the beach. Which of the following is the best advice about sun protection for this child?
A) "Use a sunscreen with a minimum sun protective factor of 15."
B) "Applications of sunscreen should be repeated every few hours."
C) "An infant should be protected by the maximum strength sunscreen."
D) "Sunscreens are not recommended in children younger than 6 months."

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26. A client has had a positive reaction to purified protein derivative (PPD). The client asks the nurse what this means. The nurse should indicate that the client has
A) active tuberculosis
B) been exposed to mycobacterium tuberculosis
C) never had tuberculosis
D) never been infected with mycobacterium tuberculosis

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27. The nurse administers cimetidine (Tagamet) to a 79 year-old male with a gastric ulcer. Which parameter may be affected by this drug, and should be closely monitored by the nurse?
A) Blood pressure
B) Liver function
C) Mental status
D) Hemoglobin

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28. A 9 year-old is taken to the emergency room with right lower quadrant pain and vomiting. When preparing the child for an emergency appendectomy, what must the nurse expect to be the child's greatest fear?
A) Change in body image
B) An unfamiliar environment
C) Perceived loss of control
D) Guilt over being hospitalized

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29. The nurse is planning care for a client who is taking cyclosporin (Neoral). What would be an appropriate nursing diagnosis for this client?
A) Alteration in body image
B) High risk for infection
C) Altered growth and development
D) Impaired physical mobility

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30. A client with paranoid thoughts refuses to eat because of the belief that the food is poisoned. The appropriate statement at this time for the nurse to say is
A) "Here, I will pour a little of the juice in a medicine cup to drink it to show you that it is OK."
B) "The food has been prepared in our kitchen and is not poisoned."
C) "Let's see if your partner could bring food from home."
D) "If you don't eat, I will have to suggest for you to be tube fed."

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31. A client has many delusions. As the nurse helps the client prepare for breakfast the client comments "Don’t waste good food on me. I’m dying from this disease I have." The appropriate response would be
A) "You need some nutritious food to help you regain your weight."
B) "None of the laboratory reports show that you have any physical disease."
C) "Try to eat a little bit, breakfast is the most important meal of the day."
D) "I know you believe that you have an incurable disease."

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32. A client tells the RN she has decided to stop taking sertraline (Zoloft) because she doesn’t like the nightmares, sex dreams, and obsessions she’s experiencing since starting on the medication. What is an appropriate response by the nurse?
A) "It is unsafe to abruptly stop taking any prescribed medication."
B) "Side effects and benefits should be discussed with your health care provider."
C) "This medication should be continued despite unpleasant symptoms."
D) "Many medications have potential side effects."

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33. The nurse is beginning nutritional counseling/teaching with a pregnant woman. What is the initial step in this interaction?
A) Teach her how to meet the needs of self and her family
B) Explain the changes in diet necessary for pregnant women
C) Question her understanding and use of the food pyramid
D) Conduct a diet history to determine her normal eating routines

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34. A client diagnosed with cirrhosis is started on lactulose (Cephulac). The main purpose of the drug for this client is to
A) add dietary fiber
B) reduce ammonia levels
C) stimulate peristalsis
D) control portal hypertension

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35. The nurse is teaching a client about the toxicity of digoxin. Which one of the following statements made by the client to the nurse indicates more teaching is needed?
A) "I may experience a loss of appetite."
B) "I can expect occasional double vision."
C) "Nausea and vomiting may last a few days."
D) "I must report a bounding pulse of 62 immediately."

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36. A client is to begin taking Fosamax. The nurse must emphasize which of these instructions to the client when taking this medication? "Take Fosamax
A) on an empty stomach."
B) after meals."
C) with calcium."
D) with milk 2 hours after meals."

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37. The nurse is caring for a 10 year-old child who has just been diagnosed with diabetes insipidus. The parents ask about the treatment prescribed, vasopressin. A What is priority in teaching the child and family about this drug?
A) The child should carry a nasal spray for emergency use
B) The family must observe the child for dehydration
C) Parents should administer the daily intramuscular injections
D) The client needs to take daily injections in the short-term

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38. The nurse is caring for a client with asthma who has developed gastroesophageal reflux disease (GERD). Which of the following medications prescribed for the client may aggravate GERD?
A) Anticholinergics
B) Corticosteroids
C) Histamine blocker
D) Antibiotics

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39. A client is receiving a nitroglycerin infusion for unstable angina. What assessment would be a priority when monitoring the effects of this medication?
A) Blood pressure
B) Cardiac enzymes
C) ECG analysis
D) Respiratory rate

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40. The nurse assesses the use of coping mechanisms by an adolescent 1 week after the client had a motor vehicle accident resulting in multiple serious injuries. Which of these characteristics are most likely to be displayed?
A) Ambivalence, dependence, demanding
B) Denial, projection, regression
C) Intellectualization, rationalization, repression
D) Identification, assimilation, withdrawal

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Practice Tests: Practice Exam #10 - 40 questions