1. Mr. X has colon cancer requires a permanent colostomy because of the tumor location. After the surgery, the patient must learn how to irrigate the colostomy. When irrigating, how far into the stoma should the patient insert the lubricated catheter?
a. 0.25” to 0.5”
b. 1” to 1.5”
c. 2” to 4”
d. 5” to 7”
2. A patient is to receive several oral medications. Nurse Olivia is aware that which nursing instruction or action is appropriate in this situation?
a. Tell the patient to take all the medications at once
b. Advise the patient to take each medication with 8 oz. of water
c. Leave the medications at the bedside for the patient to take when desired
d. State the name and action or use of each medication before administering it
3. When checking a patient’s medication profile, nurse Susan notes that the patient is receiving a drug that is contradicted in patient with glaucoma. She knows that this patient has a history of glaucoma and has been receiving the medication for the past 3 days. What should the nurse do first?
a. Continue to give the medication because the patient has been receiving it for 3 days
b. Report the information to the doctor to ensure patient safety
c. File an incident report because several other staff members gave the medication
d. Find out if there are extenuating reasons for giving the drug to this patient
4. What is the most important post operative instruction of nurse Fred must give a patient who has just returned form the operating room after receiving a subarachnoid block?
a. Avoid drinking liquids until the gag reflex returns
b. Avoid eating milk products for 24 hours
c. Notify a nurse if you experience blood in your urine
d. Remain supine for the time specified by the doctor
5. A primigravida patient delivers a full-term girl. When teaching the patient and her husband how to change their neonate’s diaper, nurse Aden should instruct them to:
a. Fold a cloth diaper so that a double thickness covers the front
b. Clean and dry the neonate’s perineal area from front to back
c. Place a disposable diaper over a cloth diaper to provide extra protection
d. Position the neonate so that urine will fall to the back of the diaper
6. When administering low doses of dopamine, nurse Charlie knows that dopamine activates which receptors?
7. A patient in the first trimester of pregnancy joins a childbirth education class. During this trimester, the class is most likely to cover which physiological aspect of pregnancy?
a. Signs and symptoms of labor
b. Quickening and fetal movements
c. Warning signs of complications
d. False labor and true labor
8. Nurse Juliet plans to administer dexamethasone cream to a patient who has dermatitis over the anterior chest. How should the nurse apply this topical agent?
a. With a circular motion, to enhance absorption
b. With an upward motion, to increase blood supply to the affected area
c. In long, even, outward, and downward strokes in the direction of hair growth
d. In long, even, outward, and downward strokes in the direction opposite hair growth
9. Nurse Faith is in psychiatric inpatient unit is caring for a patient with obsessive-compulsive disorder. As part of the patient’s treatment, the psychiatrist orders lorazepam therapy, the nurse should remind the patient to:
a. Avoid caffeine
b. Avoid aged cheeses
c. Stay out of the sun
d. Maintain an adequate salt intake
10. To prevent gastroesophageal reflux in a patient with hiatal hernia, nurse Bryan should provide which discharge instruction?
a. Lie down after meal to promote digestion
b. Avoid coffee and alcohol beverages
c. Take antacids with meals
d. Limit fluid intake with meals
11. A client who’s 32 weeks pregnant is hospitalized with preterm labor. After preterm labor is arrested, she’s discharged with a prescription for oral ritodrine (Yutopar). Which instruction should nurse Claire provide during discharge teaching?
a. Return to the clinic for a checkup in 6 weeks
b. Abstain from sexual intercourse unless you use a condom
c. You can return to your job as a hairdresser in 2 weeks
d. Take the medication as needed whenever contractions occur
12. Which nursing theorist addressed self-care deficits in her nursing theory?
a. Dorothy Johnson
b. Virginia Henderson
c. Dorothea Orem
d. Martha Rogers
13. During a follow-up visit to the physician, a client with hyperparathyroidism asks nurse Leslie to explain the physiology of the parathyroid glands. The nurse states that these glands produce parathyroid hormone (PTH). PTH maintains the balance between calcium and:
14. A client accidentally splashes chemicals into the eye. Nurse Arman knows that eye irrigation with plain tap water should begin immediately and continue for 15 to 20 minutes. What is the primary purpose of this first-aid treatment?
a. To hasten formation of scar tissue
b. To prevent vision loss
c. To eliminate the need for medical care
d. To serve as a stopgap measure until help arrives
15. Which of the following factors would have the most influence on the outcome of a crisis situation?
b. Previous coping skills
d. Perception of the problem
16. Which of the following is not a good indicator of an impending I.V. infiltration in an infant?
a. Erythema and pain
c. A lack of blood return
d. Blanching or streaking along the vein
17. A 35-year-old female client is requesting information about mammograms and breast cancer. She isn’t considered at high risk for breast cancer. What should nurse Lana tell this client?
a. She should have had a baseline mammogram before age 30
b. She should eat a low-fat diet to further decrease her risk of breast cancer
c. She should perform breast self-examination during the first 5 days of each menstrual cycle
d. When she begins having yearly mammograms, breast self-examinations will no longer be necessary
18. A client who’s scheduled for open heart surgery in 2 days has been having circulation problems in the feet and legs, so the physician orders antiembolism stockings. Now, nurse Alma is teaching the client about this treatment. What is the purpose of antiembolism stockings?
a. To decrease arterial blood circulation to the legs and feet
b. To decrease venous blood circulation from the legs and feet
c. To reduce or prevent edema in the legs and feet
d. To maintain warmth in the legs
19. Nurse Yoly is teaching a class about breast self-examinations. A client asks if she should have an annual mammogram. According to the American Cancer Society, how should the nurse respond?
a. All women over age 30 should have an annual mammogram
b. All women over age 40 should have an annual mammogram
c. Any woman over age 20 whose mother had breast cancer should have an annual mammogram
d. Any woman who feels she is at risk for breast cancer should have an annual mammogram
20. An 8-year-old child enters a health care facility. During assessment, the nurse discovers that the child is experiencing the anxiety of separation from his parents. Nurse Beth makes the nursing diagnosis of Fear related to separation from familiar environment and family. Which nursing intervention is most likely to help the child cope with fear and separation?
a. Ask the parents not to visit the child until he is adjusted to the new environment
b. Ask the physician to explain to the child why he needs to stay in the health care facility
c. Explain to the child that he must act like an “adult” while he’s in the facility
d. Have the parents stay with the child and participate in his care
21. Nurse Vangie teaches a client with newly diagnosed hypothyroidism about the need for thyroid hormone replacement therapy to restore normal thyroid function. Which thyroid preparation is the agent of choice for thyroid hormone replacement therapy?
a. methimazole (Tapazole)
b. thyroid USP desiccated (Thyroid USP Enseals)
c. liothyronine (Cytomel)
d. levothyroxine (Synthroid)
22. When giving an I.M. injection, nurse Gail should insert the needle into the muscle at an angle of:
a. 15 degrees
b. 30 degrees
c. 45 degrees
d. 90 degrees
23. A client has a diagnosis of type 2 diabetes mellitus. The physician prescribes tolazamide (Tolinase), 100 mg P.O. daily. How does the onset of action of tolazamide compare with that of the other sulfonylureas?
a. All sulfonylureas, including tolazamide, have a slow onset of action
b. All sulfonylureas, including tolazamide, have an immediate onset of action
c. Tolazamide has a slower onset of action than the other sulfonylureas
d. Tolazamide has a faster onset of action than the other sulfonylureas
24. After a vaginal delivery, a postpartum client complains of perineal discomfort when sitting. To promote comfort, nurse Agnes should provide which instruction?
a. Contract your buttocks before sitting or rising
b. Support your body weight on the arms of a chair
c. Place a pillow behind your back
d. Sit on an inflatable ring
25. A client is scheduled for surgery at 8 a.m. While completing the preoperative checklist, nurse Linda sees that the surgical consent form hasn’t been signed. It’s time to administer the preoperative analgesic. Which nursing action takes the highest priority in this situation?
a. Giving the preoperative analgesic at the scheduled time
b. Asking the client to sign the consent form
c. Notifying the surgeon that the consent form hasn’t been signed
d. Canceling the surgery