a. Avoid bathing the patient until the condition is remedied, and notify the physician

b. Ask the physician to refer the patient to a dermatologist, and suggest that the patient wear home-laundered sleepwear

c. Consult the dietitian about increasing the patient’s fat intake, and take necessary measures to prevent infection

d. Encourage the patient to increase his fluid intake, use nonirritating soap when bathing the patient, and apply lotion to the involved areas

2. When bathing a patient’s extremities, the nurse should use long, firm strokes from the distal to the proximal areas. This technique:

a. Provides an opportunity for skin assessment

b. Avoids undue strain on the nurse

c. Increases venous blood return

d. Causes vasoconstriction and increases circulation

3. Vivid dreaming occurs in which stage of sleep?

a. Stage I non-REM

b. Rapid eye movement (REM) stage

c. Stage II non-REM

d. Delta stage

4. The natural sedative in meat and milk products (especially warm milk) that can help induce sleep is:

a. Flurazepam

b. Temazepam

c. Tryptophan

d. Methotrimeprazine

5. Nursing interventions that can help the patient to relax and sleep restfully include all of the following except:

a. Have the patient take a 30- to 60-minute nap in the afternoon

b. Turn on the television in the patient’s room

c. Provide quiet music and interesting reading material

d. Massage the patient’s back with long strokes

6. Restraints can be used for all of the following purposes except to:

a. Prevent a confused patient from removing tubes, such as feeding tubes, I.V. lines, and urinary catheters

b. Prevent a patient from falling out of bed or a chair

c. Discourage a patient from attempting to ambulate alone when he requires assistance for his safety

d. Prevent a patient from becoming confused or disoriented

7. Which of the following is the nurse’s legal responsibility when applying restraints?

a. Document the patient’s behavior

b. Document the type of restraint used

c. Obtain a written order from the physician except in an emergency, when the patient must be protected from injury to himself or others

d. All of the above

8. Kubler-Ross’s five successive stages of death and dying are:

a. Anger, bargaining, denial, depression, acceptance

b. Denial, anger, depression, bargaining, acceptance

c. Denial, anger, bargaining, depression acceptance

d. Bargaining, denial, anger, depression, acceptance

9. A terminally ill patient usually experiences all of the following feelings during the anger stage except:

a. Rage

b. Envy

c. Numbness

d. Resentment

10. Nurses and other health care provides often have difficulty helping a terminally ill patient through the necessary stages leading to acceptance of death. Which of the following strategies is most helpful to the nurse in achieving this goal?

a. Taking psychology courses related to gerontology

b. Reading books and other literature on the subject of thanatology

c. Reflecting on the significance of death

d. Reviewing varying cultural beliefs and practices related to death

11. Which of the following symptoms is the best indicator of imminent death?

a. A weak, slow pulse

b. Increased muscle tone

c. Fixed, dilated pupils

d. Slow, shallow respirations

12. A nurse caring for a patient with an infectious disease who requires isolation should refers to guidelines published by the:

a. National League for Nursing (NLN)

b. Centers for Disease Control (CDC)

c. American Medical Association (AMA)

d. American Nurses Association (ANA)

13. To institute appropriate isolation precautions, the nurse must first know the:

a. Organism’s mode of transmission

b. Organism’s Gram-staining characteristics

c. Organism’s susceptibility to antibiotics

d. Patient’s susceptibility to the organism

14. Which is the correct procedure for collecting a sputum specimen for culture and sensitivity testing?

a. Have the patient place the specimen in a container and enclose the container in a plastic bag

b. Have the patient expectorate the sputum while the nurse holds the container

c. Have the patient expectorate the sputum into a sterile container

d. Offer the patient an antiseptic mouthwash just before he expectorate the sputum

15. An autoclave is used to sterilize hospital supplies because:

a. More articles can be sterilized at a time

b. Steam causes less damage to the materials

c. A lower temperature can be obtained

d. Pressurized steam penetrates the supplies better

16. The best way to decrease the risk of transferring pathogens to a patient when removing contaminated gloves is to:

a. Wash the gloves before removing them

b. Gently pull on the fingers of the gloves when removing them

c. Gently pull just below the cuff and invert the gloves when removing them

d. Remove the gloves and then turn them inside out

17. After having an I.V. line in place for 72 hours, a patient complains of tenderness, burning, and swelling. Assessment of the I.V. site reveals that it is warm and erythematons. This usually indicates:

a. Infection

b. Infiltration

c. Phlebitis

d. Bleeding

18. To ensure homogenization when diluting powdered medication in a vial, the nurse should:

a. Shake the vial vigorously

b. Roll the vial gently between the palms

c. Invert the vial and let it stand for 1 minute

d. Do nothing after adding the solution to the vial

19. The nurse is teaching a patient to prepare a syringe with 40 units of U-100 NPH insulin for self-injection. The patient’s first priority concerning self-injection in this situation is to:

a. Assess the injection site

b. Select the appropriate injection site

c. Check the syringe to verify that the nurse has removed the prescribed insulin dose

d. Clean the injection site in a circular manner with and alcohol sponge

20. The physician’s order reads “Administer 1 g cefazolin sodium (Ancef) in 150 ml of normal saline solution in 60 minutes.” What is the flow rate if the drop factor is 10 gtt = 1 ml?

a. 25 gtt/minute

b. 37 gtt/minute

c. 50 gtt/minute

d. 60 gtt/minute

21. A patient must receive 50 units of Humulin regular insulin. The label reads 100 units = 1 ml. How many milliliters should the nurse administer?

a. 0.5 ml

b. 0.75 ml

c. 1 ml

d. 2 ml

22. How should the nurse prepare an injection for a patient who takes both regular and NPH insulin?

a. Draw up the NPH insulin, then the regular insulin, in the same syringe

b. Draw up the regular insulin, then the NPH insulin, in the same syringe

c. Use two separate syringe

d. Check with the physician

23. A patient has just received 30 mg of codeine by mouth for pain. Five minutes later he vomits. What should the nurse do first?

a. Call the physician

b. Remedicate the patient

c. Observe the emesis

d. Explain to the patient that she can do nothing to help him

24. A patient is characterized with a #16 indwelling urinary (Foley) catheter to determine if:

a. Trauma has occurred

b. His 24-hour output is adequate

c. He has a urinary tract infection

d. Residual urine remains in the bladder after voiding

25. A staff nurse who is promoted to assistant nurse manager may feel uncomfortable initially when supervising her former peers. She can best decrease this discomfort by:

a. Writing down all assignments

b. Making changes after evaluating the situation and having discussions with the staff.

c. Telling the staff nurses that she is making changes to benefit their performance

d. Evaluating the clinical performance of each staff nurse in a private conference

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a. Synovitis

b. Arthritis

c. Bursitis

d. Tendinitis

2. Which term refers to the expectoration of blood from the respiratory tract?

a. A hemorrhage

b. Hematopoiesis

c. Hemoptysis

d. Hemopexis

3. Which term describes lack of coordination in performing planned, purposeful movements, resulting from a neurologic deficit?

a. Apraxia

b. Ataxia

c. Fasciculation

d. Myokymia

4. An elevation in the partial pressure of carbon dioxide in arterial blood (PaCO2) indicates that the patient has:

a. Hypernatremia

b. Hypocalcemia

c. Hypoxemia

d. Hypercapnia

5. The latest laboratory values indicate that the patient has thrombocytopenia. The combining form penia means:

a. Rupture

b. Deficiency

c. Formation

d. Stupor

6. A patient is admitted to the hospital with a urine specific gravity of 1.030, a temperature of 102°F (38.9° C), and flushed, dry skin. Based on these data, the nurse writes which of the following nursing diagnoses?

a. Potential for impaired skin integrity

b. Fluid volume deficit related to fever

c. Potential for fluid volume deficit caused by fever

d. Altered cardiopulmonary tissue perfusion related to fluid excess

7. The guidelines for writing an appropriate nursing diagnosis include all of the following except:

a. State the diagnosis in terms of a problem, not a need

b. Use nursing terminology to describe the patient’s response

c. Use statements that assist in planning independent nursing interventions

d. Use medical terminology to describe the probable cause of the patient’s response

8. Based on a physician’s order for oxygen by nasal catheter at 3 liters/ minute, an appropriate nursing order would be:

a. Cover the tip of the catheter with a water-soluble lubricant before insertion.

b. Measure the length of the catheter from the tip of the patient’s nose to the tip of the earlobe before insertion

c. Add sterile distilled water to the humidification container, as needed

d. All of the above

9. A nurse observes a dazed and apparently confused co-worker taking two diazepam (Valium) tablets by mouth as the co-worker is about to pour medications. What should the nurse do?

a. Call the head nurse immediately before the co-worker pours and administers the medications

b. Pour the medications for the co-worker while she goes for a cup of coffee

c. Report the co-worker to hospital security because she may be addicted to drugs

d. Watch the co-worker closely and report the incident to the head nurse at the end of the day.

10. A nurse manager notices that one of the staff nurses is always 15 to 20 minutes late. When the nurse manager discusses the problem with her, the nurse says that she has been late because her son’s nursery school does not open until 7 am. The nurse manager should respond by telling her to:

a. Ask one of the night nurses to cover for her

b. See if a neighbor can take the child to school

c. Find out if other schools open earlier

d. Find some way to solve the problem and be on time

11. A nurse has just moved to a new state, where she has accepted employment in a hospital-based hemodialysis unit. She needs information about her specific duties in caring for hemodialysis patients. She will find this information in:

a. Policy statements set by the National Kidney Foundation

b. The state’s nurse practice act

c. Medicare and Medicaid regulations

d. The hospital’s procedure manual

12. Which of the following is an example of nursing malpractice?

a. The nurse administers penicillin to a patient with a documented history of allergy to the drug. The patient experiences an allergic reaction and has cerebral damage resulting from anoxia.

b. The nurse applies a hot water bottle or a heating pad to the abdomen of a patient with abdominal cramping

c. The nurse assists a patient out of bed with the bed locked in position; the patient slips and fractures his right humerus

d. The nurse administers the wrong medication to a patient and the patient vomits. This information is documented and reported to the physician and the nursing supervisor

13. Therapeutic communication is a significant aspect of patient care. Which of the following statements most clearly defines this concept?

a. Therapeutic communication conveys feelings of warmth, acceptance, and empathy from the nurse to the patient in a nonjudgmental atmosphere

b. Therapeutic communication is a reciprocal interaction based on trust and aimed at identifying patient needs and developing mutual goals

c. Therapeutic communication is the assessment component of the nursing process, in which the nurse gathers health history information from the patient’s perspective

d. Therapeutic communication is an interactional process in which the nurse purposefully reviews and assesses the conversation and its potential outcomes

14. Many factors can become barriers to communication. In which of the following situations would communication least likely be hindered?

a. Mr. S., a 30-year-old Vietnamese immigrant, is admitted to the hospital with a fractured tibia; he speaks limited English

b. Ms. M., age 58 and unmarried, is admitted to the hospital for breast surgery

c. Mrs. R, age 26, is admitted to the hospital for a scheduled cesarean section; this is her first admission

d. Mr. G., age 78, arrives at the hospital by ambulance after suffering a stroke at home

15. The assessment component of the nursing process requires effective communication to elicit a complete, relevant history from the patient and to identify patient problems. What role does communication play in the other areas of the nursing process?

a. In the planning phase, effective therapeutic communication helps to establish nursing care priorities and patient-oriented goals

b. During the implementation phase, communication skills allow the nurse to assess the patient’s response to planned interventions

c. During the evaluation phase, effective communication allows the nurse to find out from the patient if he is responding to treatment or if changes in treatment are necessary

d. All of the above

16. All of the following would be considered objective assessment data for a patient admitted with diabetes mellitus except:

a. + 2 urine glucose level; negative urine acetone level

b. Chemstrip reading of 240 mg/dl

c. Patient complaints of polydipsia

d. Serum glucose level of 263 mg/dl

17. Which of the following statements about bowel sounds is accurate?

a. Peristalsis causes bowel sounds

b. Rapid, high-pitched, hyperactive bowel sounds indicate increased peristalsis

c. Decreased bowel sounds can be a symptom of paralytic ileus

d. All of the above

18. Independent nursing intervention commonly used for immobilized patients include all of the following except:

a. Active or passive ROM exercises, body repositioning, and activities of daily living (ADLs) as tolerated

b. Deep-breathing and coughing exercises with change of position every 2 hours

c. Diaphragmatic and abdominal breathing exercises and increased hydration

d. Weight bearing on a tilt table, total parenteral nutrition, and vitamin therapy

19. Independent nursing interventions commonly used for patients with pressure ulcers include:

a. Changing the patient’s position regularly to minimize pressure

b. Applying a drying agent such as an antacid to decrease moisture at the ulcer site

c. Debriding the ulcer to remove necrotic tissue, which can impede healing

d. Placing the patient in a whirlpool bath containing povidone-iodine solution as tolerated

20. A female patient has gained 24 lb after being admitted to the hospital. “I’m such a horse; I just can’t stand myself like this,” she tells the nurse. After assessing the patient, the nurse writes the following nursing diagnosis: Body image disturbance. To arrive at this diagnosis, the nurse should include which of the following assessment findings?

a. The patient’s perception of her body before the hospitalization and weight gain

b. The significance the patient places on these changes

c. The patient’s feelings about her body

d. All of the above

21. Stressors cause the release of the mineralocorticoid aldosterone, which regulates sodium absorption and potassium excretion in the renal tubules, resulting in:

a. The need for supplemental potassium

b. The need for a low-sodium (500-mg) diet

c. The conservation of water and maintenance of blood volume

d. Increased diuresis

22. In planning the care of a patient who is exposed to multiple stressors such as separation from loved ones, anxiety about impending surgery, and concern about potential complications or death, the nurse must:

a. Use both a structured and an unstructured format when interviewing the patient

b. Know the stressors affecting the patient

c. Develop the expected outcomes for each nursing diagnosis written for this patient

d. All of the above

23. An accurate method of calculating the daily urine output of an incontinent patient wearing pads or diapers is to:

a. Estimate the urine output

b. Count the number of urine saturated pads

c. Weigh a dry pad and each urine saturated pad and use a conversion calibration to calculate the urine output

d. Weigh all the urine-saturated pads together and use a conversion calibration to calculate the urine output

24. A fashion model is admitted via the emergency room with facial and chest burns. Her hospital stay includes 10 days in the intensive care unit and 5 days on the regular hospital unit. The patient has not been eating or sleeping and refuses to perform her activities of daily living (ADLs). She refuses to work with speech and physical therapists. Which of the following nursing diagnoses might appears on the patient’s current care plan?

a. Potential for noncompliance: Self-harm related to disturbed body image

b. Self-care deficit related to knowledge deficit and disturbed body image

c. Disturbance in self-concept: Personal identifying related to self-esteem

d. Disturbance in self-concept related to altered thought process

25. White the nurse is providing a patient’s personal hygiene, she observes that his skin is excessively dry. During this procedure the patient tells her that he is very thirsty. An appropriate nursing diagnosis would be:

a. Potential for impaired skin integrity related to altered gland function

b. Potential for impaired skin integrity related to dehydration

c. Impaired skin integrity relate to dehydration

d. Impaired skin integrity related to altered circulation

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