1.       Answer: (A) Identify the source of the conflict and understand the points of friction
This involves a problem solving approach, which addresses the root cause of the problem.

2.       Answer: (B) Is not beneficial; hence it should be prevented at all times
Conflicts are beneficial because it surfaces out issues in the open and can be solved right away. Likewise, members of the team become more conscientious with their work when they are aware that other members of the team are watching them.

3.       Answer: (C) Avoidance
This strategy shuns discussing the issue head-on and prefers to postpone it to a later time. In effect the problem remains unsolved and both parties are in a lose-lose situation.

4.       Answer: (D) Let the staff ventilate her feelings and ask how she can be of help.
Reaching out and helping the staff is the most effective strategy in dealing with burn out. Knowing that someone is ready to help makes the staff feel important; hence her self-worth is enhanced.

5.       Answer: (D) Focusing activity on the correction of identified behavior.
Performance appraisal deal with both positive and negative performance; is not meant to be a fault-finding activity

6.       Answer: (C) Patients are the best source of information regarding personnel appraisal.
The patient can be a source of information about the performance of the staff but it is never the best source. Directly observing the staff is the best source of information for personnel appraisal.

7.       Answer: (C) The evaluation is focused on objective data systematically.
Collecting objective data systematically can not be achieved in an informal appraisal. It is focused on what actually happens in the natural work setting.

8.       Answer: (D) The session is private between the two members.
The session is private between the manager and the staff and remains to be so when the two parties do not divulge the information to others.

9.       Answer: (B) Consultative
A consultative manager is almost like a participative manager. The participative manager has complete trust and confidence in the subordinate, always uses the opinions and ideas of subordinates and communicates in all directions.

10.    Answer: (D) Unity of direction
Unity of direction is a management principle, not an element of an organizational structure.

11.    Answer: (A) Staffing
Staffing is a management function involving putting the best people to accomplish tasks and activities to attain the goals of the organization.

12.    Answer: (B) Record of related learning experience (RLE)
Record of RLE is not required for employment purposes but it is required for the nurse’s licensure examination.

13.    Answer: (B) Induction
This step in the recruitment process gives time for the staff to submit all the documentary requirements for employment.

14.    Answer: (B) Decentralized
Decentralized structures allow the staff to make decisions on matters pertaining to their practice and communicate in downward, upward, lateral and diagonal flow.

15.    Answer: (C) Rightmost box
The leftmost box is occupied by the highest authority while the lowest level worker occupies the rightmost box.

16.    Answer: (D) Promotes better interpersonal relationship
Decentralized structures allow the staff to solve decisions by themselves, involve them in decision making; hence they are always given opportunities to interact with one another.

17.    Answer: (B) Provides care to a group of patients together with a group of nurses
This function is done in team nursing where the nurse is a member of a team that provides care for a group of patients.

18.    Answer: (B) Modular nursing
Modular nursing is a variant of team nursing. The difference lies in the fact that the members in modular nursing are paraprofessional workers.

19.    Answer: (B) Identify the values of the department
Identify the values of the department will set the guiding principles within which the department will operate its activities 

20.    Answer: (B) Rotation of duty will be done every four weeks for all patient care personnel.
Structure standards include management system, facilities, equipment, materials needed to deliver care to patients. Rotation of duty is a management system.

21.    Answer: (A) Process
Process standards include care plans, nursing procedure to be done to address the needs of the patients.

22.    Answer: (D) Identify possible courses of action
This is a step in a quality control process and not a basic step in the control process.

23.    Answer: (B) Characteristics used to measure the level of nursing care
Criteria are specific characteristics used to measure the standard of care.

24.    Answer: (A) Instructing the members of the standards committee to prepare policies
Instructing the members involves a directing function.

25.    Answer: (C) Patients’ reports 95% satisfaction rate prior to discharge from the hospital.
This refers to an outcome standard, which is a result of the care that is rendered to the patient.

26.    Answer: (A) The things that were planned are done
Controlling is defined as seeing to it that what is planned is done.

27.    Answer: (A) Span of control
Span of control refers to the number of workers who report directly to a manager.

28.    Answer: (B) Initiate a group interaction
Initiate a group interaction will be an opportunity to discuss the problem in the open.

29.    Answer: (C) Age of patients
An extraneous variable is not the primary concern of the researcher but has an effect on the results of the study. Adult patients may be young, middle or late adult.

30.    Answer: (B) Sr. Callista Roy
Sr. Callista Roy developed the Adaptation Model which involves the physiologic mode, self-concept mode, role function mode and dependence mode

31.    Answer: (C) Most accurate and valid method of data gathering
The most serious disadvantage of this method is accuracy and validity of information gathered

32.    Answer: (B) “Turnaround Time in Emergency Rooms”
The article is for pediatric patients and may not be relevant for adult patients.

33.    Answer: (C) Salary of nurses
Salary of staff nurses is not an indicator of patient satisfaction, hence need not be included as a variable in the study.

34.    Answer: (A) degree of agreement and disagreement
Likert scale is a 5-point summated scale used to determine the degree of agreement or disagreement of the respondents to a statement in a study.

35.    Answer: (B) Reliability
Reliability is repeatability of the instrument; it can elicit the same responses even with varied administration of the instrument

36.    Answer: (A) Sensitivity
Sensitivity is an attribute of the instrument that allow the respondents to distinguish differences of the options where to choose from

37.    Answer: (A) Validity
Validity is ensuring that the instrument contains appropriate questions about the research topic

38.    Answer: (A) Random
Random sampling gives equal chance for all the elements in the population to be picked as part of the sample.

39.    Answer: (B) Ethnography
Ethnography is focused on patterns of behavior of selected people within a culture

40.    Answer: (B) Madeleine Leininger
Madeleine Leininger developed the theory on transcultural theory based on her observations on the behavior of selected people within a culture

1. Identify the source of the conflict and understand the points of friction

2. Disregard what she feels and continue to work independently

3. Seek help from the Director of Nursing

4. Quit her job and look for another employment.

2. As a young manager, she knows that conflict occurs in any organization. Which of the following statements regarding conflict is NOT true?

1. Can be destructive if the level is too high

2. Is not beneficial; hence it should be prevented at all times

3. May result in poor performance

4. May create leaders

3. Katherine tells one of the staff, “I don’t have time to discuss the matter with you now. See me in my office later” when the latter asks if they can talk about an issue. Which of the following conflict resolution strategies did she use?

1. Smoothing

2. Compromise

3. Avoidance

4. Restriction

4. Kathleen knows that one of her staff is experiencing burnout. Which of the following is the best thing for her to do?

1. Advise her staff to go on vacation.

2. Ignore her observations; it will be resolved even without intervention

3. Remind her to show loyalty to the institution.

4. Let the staff ventilate her feelings and ask how she can be of help.

5. She knows that performance appraisal consists of all the following activities EXCEPT:

1. Setting specific standards and activities for individual performance.

2. Using agency standards as a guide.

3. Determine areas of strength and weaknesses

4. Focusing activity on the correction of identified behavior.

6. Which of the following statements is NOT true about performance appraisal?

1. Informing the staff about the specific impressions of their work help improve their performance.

2. A verbal appraisal is an acceptable substitute for a written report

3. Patients are the best source of information regarding personnel appraisal.

4. The outcome of performance appraisal rests primarily with the staff.

7. There are times when Katherine evaluates her staff as she makes her daily rounds. Which of the following is NOT a benefit of conducting an informal appraisal?

1. The staff member is observed in natural setting.

2. Incidental confrontation and collaboration is allowed.

3. The evaluation is focused on objective data systematically.

4. The evaluation may provide valid information for compilation of a formal report.

8. She conducts a 6-month performance review session with a staff member. Which of the following actions is appropriate?

1. She asks another nurse to attest the session as a witness.

2. She informs the staff that she may ask another nurse to read the appraisal before the session is over.

3. She tells the staff that the session is manager-centered.

4. The session is private between the two members.

9. Alexandra is tasked to organize the new wing of the hospital. She was given the authority to do as she deems fit. She is aware that the director of nursing has substantial trust and confidence in her capabilities, communicates through downward and upward channels and usually uses the ideas and opinions of her staff. Which of the following is her style of management?

1. Benevolent –authoritative

2. Consultative

3. Exploitive-authoritative

4. Participative

10. She decides to illustrate the organizational structure. Which of the following elements is NOT included?

1. Level of authority

2. Lines of communication

3. Span of control

4. Unity of direction

11. She plans of assigning competent people to fill the roles designed in the hierarchy. Which process refers to this?

1. Staffing

2. Scheduling

3. Recruitment

4. Induction

12. She checks the documentary requirements for the applicants for staff nurse position. Which one is NOT necessary?

1. Certificate of previous employment

2. Record of related learning experience (RLE)

3. Membership to accredited professional organization

4. Professional identification card

13. Which phase of the employment process includes getting on the payroll and completing documentary requirements?

1. Orientation

2. Induction

3. Selection

4. Recruitment

14. She tries to design an organizational structure that allows communication to flow in all directions and involve workers in decision making. Which form of organizational structure is this?

1. Centralized

2. Decentralized

3. Matrix

4. Informal

15. In a horizontal chart, the lowest level worker is located at the

1. Left most box

2. Middle

3. Right most box

4. Bottom

16. She decides to have a decentralized staffing system. Which of the following is an advantage of this system of staffing?

1. greater control of activities

2. Conserves time

3. Compatible with computerization

4. Promotes better interpersonal relationship

17. Aubrey thinks about primary nursing as a system to deliver care. Which of the following activities is NOT done by a primary nurse?

1. Collaborates with the physician

2. Provides care to a group of patients together with a group of nurses

3. Provides care for 5-6 patients during their hospital stay.

4. Performs comprehensive initial assessment

18. Which pattern of nursing care involves the care given by a group of paraprofessional workers led by a professional nurse who take care of patients with the same disease conditions and are located geographically near each other?

1. Case method

2. Modular nursing

3. Nursing case management

4. Team nursing

19. St. Raphael Medical Center just opened its new Performance Improvement Department. Ms. Valencia is appointed as the Quality Control Officer. She commits herself to her new role and plans her strategies to realize the goals and objectives of the department. Which of the following is a primary task that they should perform to have an effective control system?

1. Make an interpretation about strengths and weaknesses

2. Identify the values of the department

3. Identify structure, process, outcome standards & criteria

4. Measure actual performances

20. Ms. Valencia develops the standards to be followed. Among the following standards, which is considered as a structure standard?

1. The patients verbalized satisfaction of the nursing care received

2. Rotation of duty will be done every four weeks for all patient care personnel.

3. All patients shall have their weights taken recorded

4. Patients shall answer the evaluation form before discharge

21. When she presents the nursing procedures to be followed, she refers to what type of standards?

1. Process

2. Outcome

3. Structure

4. Criteria

22. The following are basic steps in the controlling process of the department. Which of the following is NOT included?

1. Measure actual performance

2. Set nursing standards and criteria

3. Compare results of performance to standards and objectives

4. Identify possible courses of action

23. Which of the following statements refers to criteria?

1. Agreed on level of nursing care

2. Characteristics used to measure the level of nursing care

3. Step-by-step guidelines

4. Statement which guide the group in decision making and problem solving

24. She wants to ensure that every task is carried out as planned. Which of the following tasks is NOT included in the controlling process?

1. Instructing the members of the standards committee to prepare policies

2. Reviewing the existing policies of the hospital

3. Evaluating the credentials of all nursing staff

4. Checking if activities conform to schedule

25. Ms. Valencia prepares the process standards. Which of the following is NOT a process standard?

1. Initial assessment shall be done to all patients within twenty four hours upon admission.

2. Informed consent shall be secured prior to any invasive procedure

3. Patients’ reports 95% satisfaction rate prior to discharge from the hospital.

4. Patient education about their illness and treatment shall be provided for all patients and their families.

26. Which of the following is evidence that the controlling process is effective?

1. The things that were planned are done

2. Physicians do not complain.

3. Employees are contended

4. There is an increase in customer satisfaction rate.

27. Ms. Valencia is responsible to the number of personnel reporting to her. This principle refers to:

1. Span of control

2. Unity of command

3. Carrot and stick principle

4. Esprit d’ corps

28. She notes that there is an increasing unrest of the staff due to fatigue brought about by shortage of staff. Which action is a priority?

1. Evaluate the overall result of the unrest

2. Initiate a group interaction

3. Develop a plan and implement it

4. Identify external and internal forces.

29. Kevin is a member of the Nursing Research Council of the hospital. His first assignment is to determine the level of patient satisfaction on the care they received from the hospital. He plans to include all adult patients admitted from April to May, with average length of stay of 3-4 days, first admission, and with no complications. Which of the following is an extraneous variable of the study?

1. Date of admission

2. Length of stay

3. Age of patients

4. Absence of complications

30. He thinks of an appropriate theoretical framework. Whose theory addresses the four modes of adaptation?

1. Martha Rogers

2. Sr. Callista Roy

3. Florence Nightingale

4. Jean Watson

31. He opts to use a self-report method. Which of the following is NOT TRUE about this method?

1. Most direct means of gathering information

2. Versatile in terms of content coverage

3. Most accurate and valid method of data gathering

4. Yields information that would be difficult to gather by another method

32. Which of the following articles would Kevin least consider for his review of literature?

1. “Story-Telling and Anxiety Reduction Among Pediatric Patients”

2. “Turnaround Time in Emergency Rooms”

3. “Outcome Standards in Tertiary Health Care Institutions”

4. “Environmental Manipulation and Client Outcomes”

33. Which of the following variables will he likely EXCLUDE in his study?

1. Competence of nurses

2. Caring attitude of nurses

3. Salary of nurses

4. Responsiveness of staff

34. He plans to use a Likert Scale to determine

1. degree of agreement and disagreement

2. compliance to expected standards

3. level of satisfaction

4. degree of acceptance

35. He checks if his instruments meet the criteria for evaluation. Which of the following criteria refers to the consistency or the ability to yield the same response upon its repeated administration?

1. Validity

2. Reliability

3. Sensitivity

4. Objectivity

36. Which criteria refer to the ability of the instrument to detect fine differences among the subjects being studied?

1. Sensitivity

2. Reliability

3. Validity

4. Objectivity

37. Which of the following terms refer to the degree to which an instrument measures what it is supposed to be measure?

1. Validity

2. Reliability

3. Meaningfulness

4. Sensitivity

38. He plans for his sampling method. Which sampling method gives equal chance to all units in the population to get picked?

1. Random

2. Accidental

3. Quota

4. Judgment

39. Raphael is interested to learn more about transcultural nursing because he is assigned at the family suites where most patients come from different cultures and countries. Which of the following designs is appropriate for this study?

1. Grounded theory

2. Ethnography

3. Case study

4. Phenomenology

40. The nursing theorist who developed transcultural nursing theory is

1. Dorothea Orem

2. Madeleine Leininger

3. Betty Newman

4. Sr. Callista Roy

Answers for LEADERSHIP, MANAGEMENT, BIOETHICS AND RESEARCH

1. Answer: (C) Country Club Management
Country club management style puts concern for the staff as number one priority at the expense of the delivery of services. He/she runs the department just like a country club where every one is happy including the manager.

2. Answer: (C) Servant leader
Servant leaders are open-minded, listen deeply, try to fully understand others and not being judgmental

3. Answer: (A) Possesses inspirational quality that makes followers gets attracted of him and regards him with reverence
Charismatic leaders make the followers feel at ease in their presence. They feel that they are in good hands whenever the leader is around.

4. Answer: (C) Assessment of personal traits is a reliable tool for predicting a manager’s potential.
It is not conclusive that certain qualities of a person would make him become a good manager. It can only predict a manager’s potential of becoming a good one.

5. Answer: (A) Recognizes staff for going beyond expectations by giving them citations
Path Goal theory according to House and associates rewards good performance so that others would do the same

6. Answer: (C) Great Man
Leaders become leaders because of their birth right. This is also called Genetic theory or the Aristotelian theory

7. Answer: (C) Laissez faire
Laissez faire leadership is preferred when the followers know what to do and are experts in the field. This leadership style is relationship-oriented rather than task-centered.

8. Answer: (D) Leadership is shared at the point of care.
Shared governance allows the staff nurses to have the authority, responsibility and accountability for their own practice.

9. Answer: (D) Inspires others with vision
Inspires others with a vision is characteristic of a transformational leader. He is focused more on the day-to-day operations of the department/unit.

10. Answer: (A) Have condescending trust and confidence in their subordinates
Benevolent-authoritative managers pretentiously show their trust and confidence to their followers

11. Answer: (A) Call for a staff meeting and take this up in the agenda.
This will allow for the participation of every staff in the unit. If they contribute to the solutions of the problem, they will own the solutions; hence the chance for compliance would be greater.

12. Answer: (C) Low morale of staff in her unit
Low morale of staff is an internal factor that affects only the unit. All the rest of the options emanate from the top executive or from outside the institution.

13. Answer: (B) Majority rule
Majority rule involves dividing the house and the highest vote wins.1/2 + 1 is a majority.

14. Answer: (B) system used to deliver care
A system used to deliver care. In the 70’s it was termed as methods of patient assignment; in the early 80’s it was called modalities of patient care then patterns of nursing care in the 90’s until recently authors called it nursing care systems.

15. Answer: (A) Concentrates on tasks and activities
Functional nursing is focused on tasks and activities and not on the holistic care of the patients

16. Answer: (A) Psychological and sociological needs are emphasized.
When the functional method is used, the psychological and sociological needs of the patients are neglected; the patients are regarded as ‘tasks to be done ‘

17. Answer: (A) Assessing nursing needs and problems
This option follows the framework of the nursing process at the same time applies the management process of planning, organizing, directing and controlling

18. Answer: (B) Preparing a nursing care plan in collaboration with the patient
The best source of information about the priority needs of the patient is the patient himself. Hence using a nursing care plan based on his expressed priority needs would ensure meeting his needs effectively.

19. Answer: (D) Patients who need the most care
In setting priorities for a group of patients, those who need the most care should be number-one priority to ensure that their critical needs are met adequately. The needs of other patients who need less care ca be attended to later or even delegated to assistive personnel according to rules on delegation.

20. Answer: (C) Integrate the solutions to his day-to-day activities
Integrate the solutions to his day-to-day activities is expected to happen during the third stage of change when the change agent incorporate the selected solutions to his system and begins to create a change.

21. Answer: (C) Focuses on routine tasks
Strategic planning involves options A, B and D except C which is attributed to operational planning

22. Answer: (A) The Good Shepherd Medical Center is a trendsetter in tertiary health care in the Philippines in the next five years
A vision refers to what the institution wants to become within a particular period of time.

23. Answer: (B) Goal
B

24. Answer: (C) Broken line
This is a staff relationship hence it is depicted by a broken line in the organizational structure

25. Answer: (C) Unity of command
The principle of unity of command means that employees should receive orders coming from only one manager and not from two managers. This averts the possibility of sowing confusion among the members of the organization

26. Answer: (B) Hierarchy
Hierarchy refers to the pattern of reporting or the formal line of authority in an organizational structure.

27. Answer: (B) Unity of direction
Unity of direction means having one goal or one objective for the team to pursue; hence all members of the organization should put their efforts together towards the attainment of their common goal or objective.

28. Answer: (A) “Let’s work together in harmony; we need to be supportive of one another”
The principle of ‘esprit d’ corps’ refers to promoting harmony in the workplace, which is essential in maintaining a climate conducive to work.

29. Answer: (A) Increase the patient satisfaction rate
Goal is a desired result towards which efforts are directed. Options AB, C and D are all objectives which are aimed at specific end.

30. Answer: (D) Organizational culture
An organizational culture refers to the way the members of the organization think together and do things around them together. It’s their way of life in that organization

31. Stephanie is a new Staff Educator of a private tertiary hospital. She conducts orientation among new staff nurses in her department. Joseph, one of the new staff nurses, wants to understand the channel of communication, span of control and lines of communication. Which of the following will provide this information?

32. Answer: (A) Organizational structure
Organizational structure provides information on the channel of authority, i.e., who reports to whom and with what authority; the number of people who directly reports to the various levels of hierarchy and the lines of communication whether line or staff.

33. Answer: (B) Informal
This is usually not published and oftentimes concealed.

34. Answer: (D) Tall organization
Tall organizations are highly centralized organizations where decision making is centered on one authority level.

35. Answer: (A) 1 & 2
Centralized organizations are needs only a few managers hence they are less expensive and easier to manage

36. Answer: (C) having legitimate right to act
Authority is a legitimate or official right to give command. This is an officially sanctioned responsibility

37. Answer: (B) Provide a pair of hands to other units as needed
Providing a pair of hands for other units is not a purpose in doing an effective staffing process. This is a function of a staffing coordinator at a centralized model.

38. Answer: (D) Staff preferences
Staff preferences should be the least priority in formulating objectives of nursing care. Individual preferences should be subordinate to the interest of the patients.

39. Answer: (A) Uses visioning as the essence of leadership.
Transformational leadership relies heavily on visioning as the core of leadership.

40. Answer: (C) Team management
Team management has a high concern for services and high concern for staff.

a.       Organization Man

b.      Impoverished Management

c.       Country Club Management

d.      Team Management

      2.     Her former manager demonstrated passion for serving her staff rather than being served. She takes time to listen, prefers to be a teacher first before being a leader, which is characteristic of

a.       Transformational leader

b.      Transactional leader

c.       Servant leader

d.      Charismatic leader

      3.     On the other hand, Ms. Castro notices that the Chief Nurse Executive has charismatic leadership style. Which of the following behaviors best describes this style?

a.       Possesses inspirational quality that makes followers gets attracted of him and regards him with reverence

b.      Acts as he does because he expects that his behavior will yield positive results

c.       Uses visioning as the core of his leadership

d.      Matches his leadership style to the situation at hand.

      4.     Which of the following conclusions of Ms. Castro about leadership characteristics is TRUE?

a.       There is a high correlation between the communication skills of a leader and the ability to get the job done.

b.      A manager is effective when he has the ability to plan well.

c.       Assessment of personal traits is a reliable tool for predicting a manager’s potential.

d.      There is good evidence that certain personal qualities favor success in managerial role.

      5.     She reads about Path Goal theory. Which of the following behaviors is manifested by the leader who uses this theory?

a.       Recognizes staff for going beyond expectations by giving them citations

b.      Challenges the staff to take individual accountability for their own practice

c.       Admonishes staff for being laggards.

d.      Reminds staff about the sanctions for non performance.

      6.     One leadership theory states that “leaders are born and not made,” which refers to which of the following theories?

a.       Trait

b.      Charismatic

c.       Great Man

d.      Situational

      7.     She came across a theory which states that the leadership style is effective dependent on the situation. Which of the following styles best fits a situation when the followers are self-directed, experts and are matured individuals?

a.       Democratic

b.      Authoritarian

c.       Laissez faire

d.      Bureaucratic

      8.     She surfs the internet for more information about leadership styles. She reads about shared leadership as a practice in some magnet hospitals. Which of the following describes this style of leadership?

a.       Leadership behavior is generally determined by the relationship between the leader’s personality and the specific situation

b.      Leaders believe that people are basically good and need not be closely controlled

c.       Leaders rely heavily on visioning and inspire members to achieve results

d.      Leadership is shared at the point of care.

      9.     Ms. Castro learns that some leaders are transactional leaders. Which of the following does NOT characterize a transactional leader?

a.       Focuses on management tasks

b.      Is a caretaker

c.       Uses trade-offs to meet goals

d.      Inspires others with vision

  10.     She finds out that some managers have benevolent-authoritative style of management. Which of the following behaviors will she exhibit most likely?

a.       Have condescending trust and confidence in their subordinates

b.      Gives economic or ego awards

c.       Communicates downward to the staff

d.      Allows decision making among subordinates

  11.     Harry is a Unit Manager I the Medical Unit. He is not satisfied with the way things are going in his unit. Patient satisfaction rate is 60% for two consecutive months and staff morale is at its lowest. He decides to plan and initiate changes that will push for a turnaround in the condition of the unit. Which of the following actions is a priority for Harry?

a.       Call for a staff meeting and take this up in the agenda.

b.      Seek help from her manager.

c.       Develop a strategic action on how to deal with these concerns.

d.      Ignore the issues since these will be resolved naturally.

  12.     She knows that there are external forces that influence changes in his unit. Which of the following is NOT an external force?

a.       Memo from the CEO to cut down on electrical consumption

b.      Demands of the labor sector to increase wages

c.       Low morale of staff in her unit

d.      Exacting regulatory and accreditation standards

  13.     After discussing the possible effects of the low patient satisfaction rate, the staff started to list down possible strategies to solve the problems head-on. Should they decide to vote on the best change strategy, which of the following strategies is referred to this?

a.       Collaboration

b.      Majority rule

c.       Dominance

d.      Compromise

  14.     One staff suggests that they review the pattern of nursing care that they are using, which is described as a:

a.       job description

b.      system used to deliver care

c.       manual of procedure

d.      rules to be followed

  15.     Which of the following is TRUE about functional nursing?

a.       Concentrates on tasks and activities

b.      Emphasizes use of group collaboration

c.       One-to-one nurse-patient ratio

d.      Provides continuous, coordinated and comprehensive nursing services

  16.     Functional nursing has some advantages, which one is an EXCEPTION?

a.       Psychological and sociological needs are emphasized.

b.      Great control of work activities.

c.       Most economical way of delivering nursing services.

d.      Workers feel secure in dependent role

  17.     He raised the issue on giving priority to patient needs. Which of the following offers the best way for setting priority?

a.       Assessing nursing needs and problems

b.      Giving instructions on how nursing care needs are to be met

c.       Controlling and evaluating the delivery of nursing care

d.      Assigning safe nurse: patient ratio

  18.     Which of the following is the best guarantee that the patient’s priority needs are met?

a.       Checking with the relative of the patient

b.      Preparing a nursing care plan in collaboration with the patient

c.       Consulting with the physician

d.      Coordinating with other members of the team

  19.     When Harry uses team nursing as a care delivery system, he and his team need to assess the priority of care for a group of patients, which of the following should be a priority?

a.       Each patient as listed on the worksheet

b.      Patients who needs least care

c.       Medications and treatments required for all patients

d.      Patients who need the most care

  20.     She is hopeful that her unit will make a big turnaround in the succeeding months. Which of the following actions of Harry demonstrates that he has reached the third stage of change?

a.       Wonders why things are not what it used to be

b.      Finds solutions to the problems

c.       Integrate the solutions to his day-to-day activities

d.      Selects the best change strategy

  21.     Julius is a newly-appointed nurse manager of The Good Shepherd Medical Center, a tertiary hospital located within the heart of the metropolis. He thinks of scheduling planning workshop with his staff in order to ensure an effective and efficient management of the department. Should he decide to conduct a strategic planning workshop, which of the following is NOT a characteristic of this activity?

a.       Long-term goal-setting

b.      Extends to 3-5 years in the future

c.       Focuses on routine tasks

d.      Determines directions of the organization

  22.     Which of the following statements refer to the vision of the hospital?

a.       The Good Shepherd Medical Center is a trendsetter in tertiary health care in the Philippines in the next five years Goal

b.      The officers and staff of The Good Shepherd Medical Center believe in the unique nature of the human person

c.       All the nurses shall undergo continuing competency training program.

d.      The Good Shepherd Medical Center aims to provide a patient-centered care in a total healing environment.

  23.     The statement, “The Good Shepherd Medical Center aims to provide patient-centered care in a total healing environment” refers to which of the following?

a.       Vision

b.      Goal

c.       Philosophy

d.      Mission

  24.     Julius plans to revisit the organizational chart of the department. He plans to create a new position of a Patient Educator who has a coordinating relationship with the head nurse in the unit. Which of the following will likely depict this organizational relationship?

a.       Box

b.      Solid line

c.       Broken line

d.      Dotted line

  25.     He likewise stresses the need for all the employees to follow orders and instructions from him and not from anyone else. Which of the following principles does he refer to?

a.       Scalar chain

b.      Discipline

c.       Unity of command

d.      Order

  26.     Julius orients his staff on the patterns of reporting relationship throughout the organization. Which of the following principles refer to this?

a.       Span of control

b.      Hierarchy

c.       Esprit d’ corps

d.      Unity of direction

  27.     He emphasizes to the team that they need to put their efforts together towards the attainment of the goals of the program. Which of the following principles refers to this?

a.       Span of control

b.      Unity of direction

c.       Unity of command

d.      Command responsibility

  28.     Julius stresses the importance of promoting ‘esprit d corps’ among the members of the unit. Which of the following remarks of the staff indicates that they understand what he pointed out?

a.       “Let’s work together in harmony; we need to be supportive of one another”

b.      “In order that we achieve the same results; we must all follow the directives of Julius and not from other managers.”

c.       “We will ensure that all the resources we need are available when needed.”

d.      “We need to put our efforts together in order to raise the bar of excellence in the care we provide to all our patients.”

  29.     He discusses the goal of the department. Which of the following statements is a goal?

a.       Increase the patient satisfaction rate

b.      Eliminate the incidence of delayed administration of medications

c.       Establish rapport with patients.

d.      Reduce response time to two minutes.

  30.     He wants to influence the customary way of thinking and behaving that is shared by the members of the department. Which of the following terms refer to this?

a.       Organizational chart

b.      Cultural network

c.       Organizational structure

d.      Organizational culture

  31.     He asserts the importance of promoting a positive organizational culture in their unit. Which of the following behaviors indicate that this is attained by the group?

a.       Proactive and caring with one another

b.      Competitive and perfectionist

c.       Powerful and oppositional

d.      Obedient and uncomplaining

  32.     Stephanie is a new Staff Educator of a private tertiary hospital. She conducts orientation among new staff nurses in her department. Joseph, one of the new staff nurses, wants to understand the channel of communication, span of control and lines of communication. Which of the following will provide this information?

a.       Organizational structure

b.      Policy

c.       Job description

d.      Manual of procedures

  33.     Stephanie is often seen interacting with the medical intern during coffee breaks and after duty hours. What type of organizational structure is this?

a.       Formal

b.      Informal

c.       Staff

d.      Line

  34.     She takes pride in saying that the hospital has a decentralized structure. Which of the following is NOT compatible with this type of model?

a.       Flat organization

b.      Participatory approach

c.       Shared governance

d.      Tall organization

  35.     Centralized organizations have some advantages. Which of the following statements are TRUE?

1. Highly cost-effective
2. Makes management easier
3. Reflects the interest of the worker
4. Allows quick decisions or actions.

a.       1 & 2

b.      2 & 4

c.       2, 3& 4

d.      1, 2, & 4

  36.     Stephanie delegates effectively if she has authority to act, which is BEST defined as:

a.       having responsibility to direct others

b.      being accountable to the organization

c.       having legitimate right to act

d.      telling others what to do

  37.     Regardless of the size of a work group, enough staff must be available at all times to accomplish certain purposes. Which of these purposes is NOT included?

a.       Meet the needs of patients

b.      Provide a pair of hands to other units as needed

c.       Cover all time periods adequately.

d.      Allow for growth and development of nursing staff.

  38.     Which of the following guidelines should be least considered in formulating objectives for nursing care?

a.       Written nursing care plan

b.      Holistic approach

c.       Prescribed standards

d.      Staff preferences

  39.     Stephanie considers shifting to transformational leadership. Which of the following statements best describes this type of leadership?

a.       Uses visioning as the essence of leadership.

b.      Serves the followers rather than being served.

c.       Maintains full trust and confidence in the subordinates

d.      Possesses innate charisma that makes others feel good in his presence.

  40.     As a manager, she focuses her energy on both the quality of services rendered to the patients as well as the welfare of the staff of her unit. Which of the following management styles does she adopt?

a.       Country club management

b.      Organization man management

c.       Team management

d.      Authority-obedience management

Answers for LEADERSHIP, MANAGEMENT, BIOETHICS AND RESEARCH

1.      Answer A is correct. Rapid continuous rewarming of a frostbite primarily lessens cellular damage. It does not prevent formation of blisters. It does promote movement, but this is not the primary reason for rapid rewarming. It might increase pain for a short period of time as the feeling comes back into the extremity; therefore, answers B, C, and D are incorrect.

2.      Answer D is correct. Hemodialysis works by using a dialyzing membrane to filter waste that has accumulated in the blood. It does not pass water through a dialyzing membrane nor does it eliminate plasma proteins or lower the pH, so answers A, B, and C are incorrect.

3.      Answer B is correct. The client who is immune-suppressed and is exposed to measles should be treated with medications to boost his immunity to the virus. An antibiotic or antiviral will not protect the client and it is too late to place the client in isolation, so answers A, C, and D are incorrect.

4.      Answer D is correct. The client with MRSA should be placed in isolation. Gloves, a gown, and a mask should be used when caring for the client and hand washing is very important. The door should remain closed, but a negative-pressure room is not necessary, so answers A and B are incorrect. MRSA is spread by contact with blood or body fluid or by touching the skin of the client. It is cultured from the nasal passages of the client, so the client should be instructed to cover his nose and mouth when he sneezes or coughs. It is not necessary for the client to wear the mask at all times; the nurse should wear the mask, so answer C is incorrect.

5.      Answer B is correct. Pain related to phantom limb syndrome is due to peripheral nervous system interruption. Answer A is incorrect because phantom limb pain can last several months or indefinitely. Answer C is incorrect because it is not psychological. It is also not due to infections, as stated in answer D.

6.      Answer A is correct. During a Whipple procedure the head of the pancreas, which is a part of the stomach, the jejunum, and a portion of the stomach are removed and reanastomosed. Answer B is incorrect because the proximal third of the small intestine is not removed. The entire stomach is not removed, as in answer C, and in answer D, the esophagus is not removed.

7.      Answer C is correct. Pepper is not processed and contains bacteria. Answers A, B, and D are incorrect because fruits should be cooked or washed and peeled, and salt and ketchup are allowed.

8.      Answer A is correct. Coumadin is an anticoagulant. One of the tests for bleeding time is a Protime. This test should be done monthly. Eating more fruits and vegetables is not necessary, and dark-green vegetables contain vitamin K, which increases clotting, so answer B is incorrect. Drinking more liquids and avoiding crowds is not necessary, so answers C and D are incorrect.

9.      Answer A is correct. The client who is having a central venous catheter removed should be told to hold his breath and bear down. This prevents air from entering the line. Answers B, C, and D will not facilitate removal.

10.  Answer B is correct. Clients with a history of streptococcal infections could have antibodies that render the streptokinase ineffective. There is no reason to assess the client for allergies to pineapples or bananas, there is no correlation to the use of phenytoin and streptokinase, and a history of alcohol abuse is also not a factor in the order for streptokinase; therefore, answers A, C, and D are incorrect.

11.  Answer B is correct. The client who is immune-suppressed and has bone marrow suppression should be taught not to floss his teeth because platelets are decreased. Using oils and cream-based soaps is allowed, as is eating salt and using an electric razor; therefore, answers A, C, and D are incorrect.

12.  Answer A is correct. The best method and safest way to change the ties of a tracheotomy is to apply the new ones before removing the old ones. Having a helper is good, but the helper might not prevent the client from coughing out the tracheotomy. Answer C is not the best way to prevent the client from coughing out the tracheotomy. Asking the doctor to suture the tracheotomy in place is not appropriate.

13.  Answer D is correct. The output of 300mL is indicative of hemorrhage and should be reported immediately. Answer A does nothing to help the client. Milking the tube is done only with an order and will not help in this situation, and slowing the intravenous infusion is not correct; thus, answers B and C are incorrect.

14.  Answer A is correct. The infant with tetrology of falot has five heart defects. He will be treated with digoxin to slow and strengthen the heart. Epinephrine, aminophyline, and atropine will speed the heart rate and are not used in this client; therefore, answers B, C, and D are incorrect.

15.  The correct answer is marked by an X in the diagram. The Tail of Spence is located in the upper outer quadrant of the breast.

16.  Answer A is correct. The toddler with a ventricular septal defect will tire easily. He will not grow normally but will not need more calories. He will be susceptible to bacterial infection, but he will be no more susceptible to viral infections than other children. Therefore, answers B, C, and D are incorrect.

17.  Answer B is correct. A nonstress test determines periodic movement of the fetus. It does not determine lung maturity, show contractions, or measure neurological well-being, making answers A, C, and D incorrect.

18.  Answer C is correct. The monitor indicates variable decelerations caused by cord compression. If Pitocin is infusing, the nurse should turn off the Pitocin. Instructing the client to push is incorrect because pushing could increase the decelerations and because the client is 8cm dilated, making answer A incorrect. Performing a vaginal exam should be done after turning off the Pitocin, and placing the client in a semi-Fowler’s position is not appropriate for this situation; therefore, answers B and D are incorrect.

19.  Answer C is correct. The graph indicates ventricular tachycardia. The answers in A, B, and D are not noted on the ECG strip.

20.  Answer B is correct. Lovenox injections should be given in the abdomen, not in the deltoid muscle. The client should not aspirate after the injection or clear the air from the syringe before injection. Therefore, answers A, C, and D are incorrect.

21.  Answer B is correct. Valium is not given in the same syringe with other medications, so answer A is incorrect. These medications can be given to the same client, so answer D is incorrect. In answer C, it is not necessary to wait to inject the second medication. Valium is an antianxiety medication, and Phenergan is used as an antiemetic.

22.  Answer B is correct. Voiding every 3 hours prevents stagnant urine from collecting in the bladder, where bacteria can grow. Douching is not recommended and obtaining a urinalysis monthly is not necessary, making answers A and C incorrect. The client should practice wiping from front to back after voiding and bowel movements, so answer D is incorrect.

23.  Answer C is correct. Of these clients, the one who should be assigned to the care of the nursing assistant is the client with dementia. Only an RN or the physician can place the client in seclusion, so answer A is incorrect. The nurse should empty the Foley catheter of the preeclamptic client because the client is unstable, making answer B incorrect. A nurse or physical therapist should ambulate the client with a fractured hip, so answer D is incorrect.

24.  Answer A is correct. The client who has recently had a thyroidectomy is at risk for tracheal edema. A padded tongue blade is used for seizures and not for the client with tracheal edema, so answer B is incorrect. If the client experiences tracheal edema, the endotracheal tube or airway will not correct the problem, so answers C and D are incorrect.

25.  Answer D is correct. Histoplasmosis is a fungus carried by birds. It is not transmitted to humans by cats, dogs, or turtles. Therefore, answers A, B, and C are incorrect.

1.      Answer D is correct. Methotrexate is a folic acid antagonist. Leucovorin is the drug given for toxicity to this drug. It is not used to treat iron-deficiency anemia, create a synergistic effects, or increase the number of circulating neutrophils. Therefore, answers A, B, and C are incorrect.

2.      Answer B is correct. The client who is allergic to dogs, eggs, rabbits, and chicken feathers is most likely allergic to the rubella vaccine. The client who is allergic to neomycin is also at risk. There is no danger to the client if he has an order for a TB skin test, ELISA test, or chest x-ray; thus, answers A, C, and D are incorrect.

3.      Answer B is correct. Zantac (rantidine) is a histamine blocker that should be given with meals for optimal effect, not before meals. However, Tagamet (cimetidine) is a histamine blocker that can be given in one dose at bedtime. Neither of these drugs should be given before or after meals, so answers A and D are incorrect.

4.      Answer C is correct. The proximal end of the double-barrel colostomy is the end toward the small intestines. This end is on the client’s right side. The distal end, as in answers A, B, and D, is on the client’s left side.

5.      Answer A is correct. If the nurse checks the fundus and finds it to be displaced to the right or left, this is an indication of a full bladder. This finding is not associated with hypotension or clots, as stated in answer B. Oxytoxic drugs (Pitocin) are drugs used to contract the uterus, so answer C is incorrect. It has nothing to do with displacement of the uterus. Answer D is incorrect because displacement is associated with a full bladder, not vaginal bleeding.

6.      Answer C is correct. Clients with an internal defibrillator or a pacemaker should not have an MRI because it can cause dysrhythmias in the client with a pacemaker. If the client has a need for oxygen, is claustrophobic, or is deaf, he can have an MRI, but provisions such as extension tubes for the oxygen, sedatives, or a signal system should be made to accommodate these problems. Therefore, answers A, B, and D are incorrect.

7.      Answer C is correct. A 6-month-old is too old for the colorful mobile. He is too young to play with the electronic game or the 30-piece jigsaw puzzle. The best toy for this age is the cars in a plastic container, so answers A, B, and D are incorrect.

8.      Answer C is correct. The client with polio has muscle weakness. Periods of rest throughout the day will conserve the client’s energy. A hot bath can cause burns; however, a warm bath would be helpful, so answer A is incorrect. Strenuous exercises are not advisable, making answer B incorrect. Visual disturbances are directly associated with polio and cannot be corrected with glasses; therefore, answer D is incorrect.

9.      Answer B is correct. The client with a protoepisiotomy will need stool softeners such as docusate sodium. Suppositories are given only with an order from the doctor, Methergine is a drug used to contract the uterus, and Parlodel is an anti-Parkinsonian drug; therefore, answers A, C, and D are incorrect.

10.  Answer C is correct. Total Parenteral Nutrition is a high-glucose solution. This therapy often causes the glucose levels to be elevated. Because this is a common complication, insulin might be ordered. Answers A, B, and D are incorrect. TPN is used to treat negative nitrogen balance; it will not lead to negative nitrogen balance. Total Parenteral Nutrition can be managed with oral hypoglycemic drugs, but it is difficult to do so. Total Parenteral Nutrition will not lead to further pancreatic disease.

11.  Answer B is correct. The client who is 10 weeks pregnant should be assessed to determine how she feels about the pregnancy. It is too early to discuss preterm labor, too late to discuss whether she was using a method of birth control, and after the client delivers, a discussion of future children should be instituted. Thus, answers A, C, and D are incorrect.

12.  Answer A is correct. The best IV fluid for correction of dehydration is normal saline because it is most like normal serum. Dextrose pulls fluid from the cell, lactated Ringer’s contains more electrolytes than the client’s serum, and dextrose with normal saline will also alter the intracellular fluid. Therefore, answers B, C, and D are incorrect.

13.  Answer A is correct. A thyroid scan uses a dye, so the client should be assessed for allergies to iodine. The client will not have a bolus of fluid, will not be asleep, and will not have a urinary catheter inserted, so answers B, C, and D are incorrect.

14.  Answer B is correct. RhoGam is used to prevent formation of Rh antibodies. It does not provide immunity to Rh isoenzymes, eliminate circulating Rh antibodies, or convert the Rh factor from negative to positive; thus, answers A, C, and D are incorrect.

15.  Answer B is correct. A client with a fractured foot often has a short leg cast applied to stabilize the fracture. A spica cast is used to stabilize a fractured pelvis or vertebral fracture. Kirschner wires are used to stabilize small bones such as toes and the client will most likely have a cast or immobilizer, so answers A, C, and D are incorrect.

16.  Answer A is correct. Iridium seeds can be expelled during urination, so the client should be taught to strain his urine and report to the doctor if any of the seeds are expelled. Increasing fluids, reporting urinary frequency, and avoiding prolonged sitting are not necessary; therefore, answers B, C, and D are incorrect.

17.  Answer C is correct. Immunosuppressants are used to prevent antibody formation. Antivirals, antibiotics, and analgesics are not used to prevent antibody production, so answers A, B, and D are incorrect.

18.  Answer A is correct. Before cataract removal, the client will have Mydriatic drops instilled to dilate the pupil. This will facilitate removal of the lens. Miotics constrict the pupil and are not used in cataract clients. A laser is not used to smooth and reshape the lens; the diseased lens is removed. Silicone oil is not injected in this client; thus, answers B, C, and D are incorrect.

19.  Answer C is correct. Placing simple signs that indicate the location of rooms where the client sleeps, eats, and bathes will help the client be more independent. Providing mirrors and pictures is not recommended with the client who has Alzheimer’s disease because mirrors and pictures tend to cause agitation, and alternating healthcare workers confuses the client; therefore, answers A, B, and D are incorrect.

20.  Answer C is correct. A Jackson-Pratt drain is a serum-collection device commonly used in abdominal surgery. A Jackson-Pratt drain will not prevent the need for dressing changes, reduce edema of the incision, or keep the common bile duct open, so answers A, B, and D are incorrect. A t-tube is used to keep the common bile duct open.

21.  Answer C is correct. The infant who is 32 weeks gestation will not be able to control his head, so head lag will be present. Mongolian spots are common in African American infants, not Caucasian infants; the client at 32 weeks will have scrotal rugae or redness but will not have vernix caseosa, the cheesy appearing covering found on most full-term infants. Therefore, answers A, B, and D are incorrect.

22.  Answer A is correct. Hematuria in a client with a pelvic fracture can indicate trauma to the bladder or impending bleeding disorders. It is not unusual for the client to complain of muscles spasms with multiple fractures, so answer B is incorrect. Dizziness can be associated with blood loss and is nonspecific, making answer C incorrect. Nausea, as stated in answer D, is also common in the client with multiple traumas.

23.  Answer C is correct. The client’s statement "They are trying to kill me" indicates paranoid delusions. There is no data to indicate that the client is hearing voices or is intoxicated, so answers A and D are incorrect. Delusions of grandeur are fixed beliefs that the client is superior or perhaps a famous person, making answer B incorrect.

24.  Answer B is correct. Because the nurse is unaware of when the bottle was opened or whether the saline is sterile, it is safest to obtain a new bottle. Answers A, C, and D are not safe practices.

25.  Answer C is correct. Infants with an Apgar of 9 at 5 minutes most likely have acryocyanosis, a normal physiologic adaptation to birth. It is not related to the infant being cold, experiencing bradycardia, or being lethargic; thus, answers A, B, and D are incorrect.

1.      Answer B is correct. Barbiturates create a sedative effect. When the client stops taking barbiturates, he will experience tachycardia, diarrhea, and tachpnea. Answer A is incorrect even though depression and suicidal ideation go along with barbiturate use; it is not the priority. Muscle cramps and abdominal pain are vague symptoms that could be associated with other problems. Tachycardia is associated with stopping barbiturates, but euphoria is not.

2.      Answer A is correct. If the fetal heart tones are heard in the right upper abdomen, the infant is in a breech presentation. If the infant is positioned in the right occipital anterior presentation, the FHTs will be located in the right lower quadrant, so answer B is incorrect. If the fetus is in the sacral position, the FHTs will be located in the center of the abdomen, so answer C is incorrect. If the FHTs are heard in the left lower abdomen, the infant is most likely in the left occipital transverse position, making answer D incorrect.

3.      Answer D is correct. Asthma is the presence of bronchiolar spasms. This spasm can be brought on by allergies or anxiety. Answer A is incorrect because the primary physiological alteration is not inflammation. Answer B is incorrect because there is the production of abnormally viscous mucus, not a primary alteration. Answer C is incorrect because infection is not primary to asthma.

4.      Answer A is correct. The client with mania is seldom sitting long enough to eat and burns many calories for energy. Answer B is incorrect because the client should be treated the same as other clients. Small meals are not a correct option for this client. Allowing her into the kitchen gives her privileges that other clients do not have and should not be allowed, so answer D is incorrect.

5.      Answer B is correct. Bryant’s traction is used for fractured femurs and dislocated hips. The hips should be elevated 15° off the bed. Answer A is incorrect because the hips should not be resting on the bed. Answer C is incorrect because the hips should not be above the level of the body. Answer D is incorrect because the hips and legs should not be flat on the bed.

6.      Answer B is correct. Herpes zoster is shingles. Clients with shingles should be placed in contact precautions. Wearing gloves during care will prevent transmission of the virus. Covering the lesions with a sterile gauze is not necessary, antibiotics are not prescribed for herpes zoster, and oxygen is not necessary for shingles; therefore, answers A, C, and D are incorrect.

7.      Answer B is correct. A trough level should be drawn 30 minutes before the third or fourth dose. The times in answers A, C, and D are incorrect times to draw blood levels.

8.      Answer B is correct. The client using a diaphragm should keep the diaphragm in a cool location. Answers A, C, and D are incorrect. She should refrain from leaving the diaphragm in longer than 8 hours, not 4 hours. She should have the diaphragm resized when she gains or loses 10 pounds or has abdominal surgery.

9.      Answer C is correct. Mothers who plan to breastfeed should drink plenty of liquids, and four glasses is not enough in a 24-hour period. Wearing a support bra is a good practice for the mother who is breastfeeding as well as the mother who plans to bottle-feed, so answer A is incorrect. Expressing milk from the breast will stimulate milk production, making answer B incorrect. Allowing the water to run over the breast will also facilitate "letdown," when the milk begins to be produced; thus, answer D is incorrect.

10.  Answer A is correct. The facial nerve is cranial nerve VII. If damage occurs, the client will experience facial pain. The auditory nerve is responsible for hearing loss and tinnitus, eye movement is controlled by the Trochear or C IV, and the olfactory nerve controls smell; therefore, answers B, C, and D are incorrect.

11.  Answer B is correct. Clients taking Pyridium should be taught that the medication will turn the urine orange or red. It is not associated with diarrhea, mental confusion, or changes in taste; therefore, answers A, C, and D are incorrect. Pyridium can also cause a yellowish color to skin and sclera if taken in large doses.

12.  Answer B is correct. Accutane is contraindicated for use by pregnant clients because it causes teratogenic effects. Calcium levels, apical pulse, and creatinine levels are not necessary; therefore, answers A, C, and D are incorrect.

13.  Answer D is correct. Clients taking Acyclovir should be encouraged to drink plenty of fluids because renal impairment can occur. Limiting activity is not necessary, nor is eating a high-carbohydrate diet. Use of an incentive spirometer is not specific to clients taking Acyclovir; therefore, answers A, B, and C are incorrect.

14.  Answer A is correct. Clients who are pregnant should not have an MRI because radioactive isotopes are used. However, clients with a titanium hip replacement can have an MRI, so answer B is incorrect. No antibiotics are used with this test and the client should remain still only when instructed, so answers C and D are not specific to this test.

15.  Answer D is correct. Clients taking Amphotericin B should be monitored for liver, renal, and bone marrow function because this drug is toxic to the kidneys and liver, and causes bone marrow suppression. Jaundice is a sign of liver toxicity and is not specific to the use of Amphotericin B. Changes in vision are not related, and nausea is a side effect, not a sign of toxicity; nor is urinary frequency. Thus, answers A, B, and C are incorrect.

16.  Answer C is correct. The client with chest pain should be seen first because this could indicate a myocardial infarction. The client in answer A has a blood glucose within normal limits. The client in answer B is maintained on blood pressure medication. The client in answer D is in no distress.

17.  Answer B is correct. Pancreatic enzymes should be given with meals for optimal effects. These enzymes assist the body in digesting needed nutrients. Answers A, C, and D are incorrect methods of administering pancreatic enzymes.

18.  Answer C is correct. The lens allows light to pass through the pupil and focus light on the retina. The lens does not stimulate the retina, assist with eye movement, or magnify small objects, so answers A, B, and D are incorrect.

19.  Answer C is correct. Miotic eyedrops constrict the pupil and allow aqueous humor to drain out of the Canal of Schlemm. They do not anesthetize the cornea, dilate the pupil, or paralyze the muscles of the eye, making answers A, B, and D incorrect.

20.  Answer A is correct. When using eyedrops, allow 5 minutes between the two medications; therefore, answer B is incorrect. These medications can be used by the same client but it is not necessary to use a cyclopegic with these medications, making answers C and D incorrect.

21.  Answer B is correct. Clients with color blindness will most likely have problems distinguishing violets, blues, and green. The colors in answers A, C, and D are less commonly affected.

22.  Answer D is correct. The client with a pacemaker should be taught to count and record his pulse rate. Answers A, B, and C are incorrect. Ankle edema is a sign of right-sided congestive heart failure. Although this is not normal, it is often present in clients with heart disease. If the edema is present in the hands and face, it should be reported. Checking the blood pressure daily is not necessary for these clients. The client with a pacemaker can use a microwave oven, but he should stand about 5 feet from the oven while it is operating.

23.  Answer A is correct. Clients who are being retrained for bladder control should be taught to withhold fluids after about 7 p.m., or 1 The times in answers B, C, and D are too early in the day.

24.  Answer D is correct. Cranberry juice is more alkaline and, when metabolized by the body, is excreted with acidic urine. Bacteria does not grow freely in acidic urine. Increasing intake of meats is not associated with urinary tract infections, so answer A is incorrect. The client does not have to avoid citrus fruits and pericare should be done, but hydrogen peroxide is drying, so answers B and C are incorrect.

25.  Answer C is correct. NPH insulin peaks in 8–12 hours, so a snack should be offered at that time. NPH insulin onsets in 90–120 minutes, so answer A is incorrect. Answer B is untrue because NPH insulin is time released and does not usually cause sudden hypoglycemia. Answer D is incorrect, but the client should eat a bedtime snack.

View the NCLEX-RN Practice Test Part 7

1.      Answer B is correct. Chest tubes work to reinflate the lung and drain serous fluid. The tube does not equalize expansion of the lungs. Pain is associated with collapse of the lung, and insertion of chest tubes is painful, so answers A and C are incorrect. Answer D is true, but this is not the primary rationale for performing chest tube insertion.

2.      Answer D is correct. Success with breastfeeding depends on many factors, but the most dependable reason for success is desire and willingness to continue the breastfeeding until the infant and mother have time to adapt. The educational level, the infant’s birth weight, and the size of the mother’s breast have nothing to do with success, so answers A, B, and C are incorrect.

3.      Answer C is correct. Green-tinged amniotic fluid is indicative of meconium staining. This finding indicates fetal distress. The presence of scant bloody discharge is normal, as are frequent urination and moderate uterine contractions, making answers A, B, and D incorrect.

4.      Answer C is correct. Duration is measured from the beginning of one contraction to the end of the same contraction. Answer A refers to frequency. Answer B is incorrect because we do not measure from the end of one contraction to the beginning of the next contraction. Duration is not measured from the peak of the contraction to the end, as stated in D.

5.      Answer B is correct. The client receiving Pitocin should be monitored for decelerations. There is no association with Pitocin use and hypoglycemia, maternal hyperreflexia, or fetal movement; therefore, answers A, C, and D are incorrect.

6.      Answer D is correct. Fetal development depends on adequate nutrition and insulin regulation. Insulin needs increase during the second and third trimesters, insulin requirements do not moderate as the pregnancy progresses, and elevated human chorionic gonadotrophin elevates insulin needs, not decreases them; therefore, answers A, B, and C are incorrect.

7.      Answer A is correct. A calm environment is needed to prevent seizure activity. Any stimulation can precipitate seizures. Obtaining a diet history should be done later, and administering an analgesic is not indicated because there is no data in the stem to indicate pain. Therefore, answers B and C are incorrect. Assessing the fetal heart tones is important, but this is not the highest priority in this situation as stated in answer D.

8.      Answer A is correct. The client who is age 42 is at risk for fetal anomalies such as Down syndrome and other chromosomal aberrations. Answers B, C, and D are incorrect because the client is not at higher risk for respiratory distress syndrome or pathological jaundice, and Turner’s syndrome is a genetic disorder.

9.      Answer C is correct. The client with a missed abortion will have induction of labor. Prostin E. is a form of prostaglandin used to soften the cervix. Magnesium sulfate is used for preterm labor and preeclampsia, calcium gluconate is the antidote for magnesium sulfate, and Pardel is a dopamine receptor stimulant used to treat Parkinson’s disease; therefore, answers A, B, and D are incorrect. Pardel was used at one time to dry breast milk.

10.  Answer A is correct. The client’s blood pressure and urinary output are within normal limits. The only alteration from normal is the decreased deep tendon reflexes. The nurse should continue to monitor the blood pressure and check the magnesium level. The therapeutic level is 4.8–9.6mg/dL. Answers B, C, and D are incorrect. There is no need to stop the infusion at this time or slow the rate. Calcium gluconate is the antidote for magnesium sulfate, but there is no data to indicate toxicity.

11.  Answer C is correct. Autosomal recessive disorders can be passed from the parents to the infant. If both parents pass the trait, the child will get two abnormal genes and the disease results. Parents can also pass the trait to the infant. Answer A is incorrect because, to have an affected newborn, the parents must be carriers. Answer B is incorrect because both parents must be carriers. Answer D is incorrect because the parents might have affected children.

12.  Answer D is correct. Alpha fetoprotein is a screening test done to detect neural tube defects such as spina bifida. The test is not mandatory, as stated in answer A. It does not indicate cardiovascular defects, and the mother’s age has no bearing on the need for the test, so answers B and C are incorrect.

13.  Answer B is correct. During pregnancy, the thyroid gland triples in size. This makes it more difficult to regulate thyroid medication. Answer A is incorrect because there could be a need for thyroid medication during pregnancy. Answer C is incorrect because the thyroid function does not slow. Fetal growth is not arrested if thyroid medication is continued, so answer D is incorrect.

14.  Answer C is correct. Cyanosis of the feet and hands is acrocyanosis. This is a normal finding 1 minute after birth. An apical pulse should be 120–160, and the baby should have muscle tone, making answers A and B incorrect. Jaundice immediately after birth is pathological jaundice and is abnormal, so answer D is incorrect.

15.  Answer A is correct. Clients with sickle cell crises are treated with heat, hydration, oxygen, and pain relief. Fluids are increased, not decreased. Blood transfusions are usually not required, and the client can be delivered vaginally; thus, answers B, C, and D are incorrect.

16.  Answer A is correct. Before ultrasonography, the client should be taught to drink plenty of fluids and not void. The client may ambulate, an enema is not needed, and there is no need to withhold food for 8 hours. Therefore, answers B, C, and D are incorrect.

17.  Answer D is correct. By 1 year of age, the infant is expected to triple his birth weight. Answers A, B, and C are incorrect because they are too low.

18.  Answer B is correct. A nonstress test is done to evaluate periodic movement of the fetus. It is not done to evaluate lung maturity as in answer A. An oxytocin challenge test shows the effect of contractions on fetal heart rate and a nonstress test does not measure neurological well-being of the fetus, so answers C and D are incorrect.

19.  Answer B is correct. Hypospadia is a condition in which there is an opening on the dorsal side of the penis. Answer A is incorrect because hypospadia does not concern the urethral opening. Answer C is incorrect because the size of the penis is not affected. Answer D is incorrect because the opening is on the dorsal side, not the ventral side.

20.  Answer A is correct. Transition is the time during labor when the client loses concentration due to intense contractions. Potential for injury related to precipitate delivery has nothing to do with the dilation of the cervix, so answer B is incorrect. There is no data to indicate that the client has had anesthesia or fluid volume deficit, making answers C and D incorrect.

21.  Answer C is correct. Varicella is chicken pox. This herpes virus is treated with antiviral medications. The client is not treated with antibiotics or anticoagulants as stated in answers A and D. The client might have a fever before the rash appears, but when the rash appears, the temperature is usually gone, so answer B is incorrect.

22.  Answer B is correct. Clients with chest pain can be treated with nitroglycerin, a beta blocker such as propanolol, or Varapamil. There is no indication for an antibiotic such as Ampicillin, so answers A, C, and D are incorrect.

23.  Answer B is correct. Anti-inflammatory drugs should be taken with meals to avoid stomach upset. Answers A, C, and D are incorrect. Clients with rheumatoid arthritis should exercise, but not to the point of pain. Alternating hot and cold is not necessary, especially because warm, moist soaks are more useful in decreasing pain. Weight-bearing activities such as walking are useful but is not the best answer for the stem.

24.  Answer D is correct. Morphine is contraindicated in clients with gallbladder disease and pancreatitis because morphine causes spasms of the Sphenter of Oddi. Meperidine, Mylanta, and Cimetadine are ordered for pancreatitis, making answers A, B, and C incorrect.

25.  Answer B is correct. Hallucinogenic drugs can cause hallucinations. Continuous observation is ordered to prevent the client from harming himself during withdrawal. Answers A, C, and D are incorrect because hallucinogenic drugs don’t create both stimulant and depressant effects or produce severe respiratory depression. However, they do produce psychological dependence rather than physical dependence.

1.      Answer B is correct. When the membranes rupture, there is often a transient drop in the fetal heart tones. The heart tones should return to baseline quickly. Any alteration in fetal heart tones, such as bradycardia or tachycardia, should be reported. After the fetal heart tones are assessed, the nurse should evaluate the cervical dilation, vital signs, and level of discomfort, making answers A, C, and D incorrect.

2.      Answer A is correct. The active phase of labor occurs when the client is dilated 4–7cm. The latent or early phase of labor is from 1cm to 3cm in dilation, so answers B and D are incorrect. The transition phase of labor is 8–10cm in dilation, making answer C incorrect.

3.      Answer B is correct. The infant of an addicted mother will undergo withdrawal. Snugly wrapping the infant in a blanket will help prevent the muscle irritability that these babies often experience. Teaching the mother to provide tactile stimulation or provide for early infant stimulation are incorrect because he is irritable and needs quiet and little stimulation at this time, so answers A and D are incorrect. Placing the infant in an infant seat in answer C is incorrect because this will also cause movement that can increase muscle irritability.

4.      Answer C is correct. Following epidural anesthesia, the client should be checked for hypotension and signs of shock every 5 minutes for 15 minutes. The client can be checked for cervical dilation later after she is stable. The client should not be positioned supine because the anesthesia can move above the respiratory center and the client can stop breathing. Fetal heart tones should be assessed after the blood pressure is checked. Therefore, answers A, B, and D are incorrect.

5.      Answer B is correct. The best way to prevent post-operative wound infection is hand washing. Use of prescribed antibiotics will treat infection, not prevent infections, making answer A incorrect. Wearing a mask and asking the client to cover her mouth are good practices but will not prevent wound infections; therefore, answers C and D are incorrect.

6.      Answer B is correct. The client with a hip fracture will most likely have disalignment. Answers A, C, and D are incorrect because all fractures cause pain, and coolness of the extremities and absence of pulses are indicative of compartment syndrome or peripheral vascular disease.

7.      Answer B is correct. After menopause, women lack hormones necessary to absorb and utilize calcium. Doing weight-bearing exercises and taking calcium supplements can help to prevent osteoporosis but are not causes, so answers A and C are incorrect. Body types that frequently experience osteoporosis are thin Caucasian females, but they are not most likely related to osteoporosis, so answer D is incorrect.

8.      Answer B is correct. The infant’s hips should be off the bed approximately 15° in Bryant’s traction. Answer A is incorrect because this does not indicate that the traction is working correctly, nor does C. Answer D is incorrect because Bryant’s traction is a skin traction, not a skeletal traction.

9.      Answer A is correct. Balanced skeletal traction uses pins and screws. A Steinman pin goes through large bones and is used to stabilize large bones such as the femur. Answer B is incorrect because only the affected leg is in traction. Kirschner wires are used to stabilize small bones such as fingers and toes, as in answer C. Answer D is incorrect because this type of traction is not used for fractured hips.

10.  Answer A is correct. Bleeding is a common complication of orthopedic surgery. The blood-collection device should be checked frequently to ensure that the client is not hemorrhaging. The client’s pain should be assessed, but this is not life-threatening. When the client is in less danger, the nutritional status should be assessed and an immobilizer is not used; thus, answers B, C, and D are incorrect.

11.  Answer A is correct. The client’s family member should be taught to flush the tube after each feeding and clamp the tube. The placement should be checked before feedings, and indigestion can occur with the PEG tube, just as it can occur with any client, so answers B and C are incorrect. Medications can be ordered for indigestion, but it is not a reason for alarm. A percutaneous endoscopy gastrostomy tube is used for clients who have experienced difficulty swallowing. The tube is inserted directly into the stomach and does not require swallowing; therefore, answer D is incorrect.

12.  Answer C is correct. The client with a total knee replacement should be assessed for anemia. A hematocrit of 26% is extremely low and might require a blood transfusion. Bleeding of 2cm on the dressing is not extreme. Circle and date and time the bleeding and monitor for changes in the client’s status. A low-grade temperature is not unusual after surgery. Ensure that the client is well hydrated, and recheck the temperature in 1 hour. If the temperature is above 101°F, report this finding to the doctor. Tylenol will probably be ordered. Voiding after surgery is also not uncommon and no need for concern; therefore answers A, B, and D are incorrect.

13.  Answer B is correct. Plumbism is lead poisoning. One factor associated with the consumption of lead is eating from pottery made in Central America or Mexico that is unfired. The child lives in a house built after 1976 (this is when lead was taken out of paint), and the parents make stained glass as a hobby. Stained glass is put together with lead, which can drop on the work area, where the child can consume the lead beads. Answer A is incorrect because simply traveling out of the country does not increase the risk. In answer C, the house was built after the lead was removed with the paint. Answer D is unrelated to the stem.

14.  Answer A is correct. The equipment that can help with activities of daily living is the high-seat commode. The hip should be kept higher than the knee. The recliner is good because it prevents 90° flexion but not daily activities. A TENS (Transcutaneous Electrical Nerve Stimulation) unit helps with pain management and an abduction pillow is used to prevent adduction of the hip and possibly dislocation of the prosthesis; therefore, answers B, C, and D are incorrect.

15.  Answer B is correct. Narcan is the antidote for narcotic overdose. If hypoxia occurs, the client should have oxygen administered by mask, not cannula. There is no data to support the administration of blood products or cardioresuscitation, so answers A, C, and D are incorrect.

16.  Answer B is correct. The 6-year-old should have a roommate as close to the same age as possible, so the 12-year-old is the best match. The 10-year-old with sarcoma has cancer and will be treated with chemotherapy that makes him immune suppressed, the 6-year-old with osteomylitis is infected, and the client in answer A is too old and is female; therefore, answers A, C, and D are incorrect.

17.  Answer B is correct. Cox II inhibitors have been associated with heart attacks and strokes. Any changes in cardiac status or signs of a stroke should be reported immediately, along with any changes in bowel or bladder habits because bleeding has been linked to use of Cox II inhibitors. The client does not have to take the medication with milk, remain upright, or allow 6 weeks for optimal effect, so answers A, C, and D are incorrect.

18.  Answer D is correct. A plaster-of-Paris cast takes 24 hours to dry, and the client should not bear weight for 24 hours. The cast should be handled with the palms, not the fingertips, so answer A is incorrect. Petaling a cast is covering the end of the cast with cast batting or a sock, to prevent skin irritation and flaking of the skin under the cast, making answer B incorrect. The client should be told not to dry the cast with a hair dryer because this causes hot spots and could burn the client. This also causes unequal drying; thus, answer C is incorrect.

19.  Answer A is correct. There is no reason that the client’s friends should not be allowed to autograph the cast; it will not harm the cast in any way, so answers B, C, and D are incorrect.

20.  Answer A is correct. The nurse is performing the pin care correctly when she uses sterile gloves and Q-tips. A licensed practical nurse can perform pin care, there is no need to clean the weights, and the nurse can help with opening the packages but it isn’t required; therefore, answers B, C, and D are incorrect.

21.  Answer A is correct. A body cast or spica cast extends from the upper abdomen to the knees or below. Bowel sounds should be checked to ensure that the client is not experiencing a paralytic illeus. Checking the blood pressure is a treatment for any client, offering pain medication is not called for, and checking for swelling isn’t specific to the stem, so answers B, C, and D are incorrect.

22.  Answer C is correct. Halo traction will be ordered for the client with a cervical fracture. Russell’s traction is used for bones of the lower extremities, as is Buck’s traction. Cruchfield tongs are used while in the hospital and the client is immobile; therefore, answers A, B, and D are incorrect.

23.  Answer B is correct. The controller for the continuous passive-motion device should be placed away from the client. Many clients complain of pain while having treatments with the CPM, so they might turn off the machine. The CPM flexes and extends the leg. The client is in the bed during CPM therapy, so answer A is incorrect. Answer C is incorrect because clients will experience pain with the treatment. Use of the CPM does not alleviate the need for physical therapy, as suggested in answer D.

24.  Answer A is correct. The client’s palms should rest lightly on the handles. The elbows should be flexed no more than 30° but should not be extended. Answer B is incorrect because 0° is not a relaxed angle for the elbows and will not facilitate correct walker use. The client should walk to the middle of the walker, not to the front of the walker, making answer C incorrect. The client should be taught not to carry the walker because this would not provide stability; thus, answer D is incorrect.

25.  Answer C is correct. The client with a prolapsed cord should be treated by elevating the hips and covering the cord with a moist, sterile saline gauze. The nurse should use her fingers to push up on the presenting part until a cesarean section can be performed. Answers A, B, and D are incorrect. The nurse should not attempt to replace the cord, turn the client on the side, or cover with a dry gauze.

• NCLEX-RN Practice Exam Part 1 – Answers and Rationales for NCLEX-RN Practice Exam Part 1
• NCLEX-RN Practice Exam Part 2 – Answers and Rationales for NCLEX-RN Practice Exam Part 2
• NCLEX-RN Practice Exam Part 3 – Answers and Rationales for NCLEX-RN Practice Exam Part 3
• NCLEX-RN Practice Exam Part 4 – Answers and Rationales for NCLEX-RN Practice Exam Part 4
• NCLEX-RN Practice Exam Part 5 – Answers and Rationales for NCLEX-RN Practice Exam Part 5
• NCLEX-RN Practice Exam Part 6 – Answers and Rationales for NCLEX-RN Practice Exam Part 6
• NCLEX-RN Practice Exam Part 7 – Answers and Rationales for NCLEX-RN Practice Exam Part 7
• NCLEX-RN Practice Exam Part 8 – Answers and Rationales for NCLEX-RN Practice Exam Part 8
• NCLEX-RN Practice Exam Part 9 – Answers and Rationales for NCLEX-RN Practice Exam Part 9

If you want to have more NCLEX practice exam questions like this, we strongly suggest to get a copy of NCLEX-RN Exam Cram and NCLEX-RN Exam Practice Questions Exam Cramfrom informit.com.

1.      The primary reason for rapid continuous rewarming of the area affected by frostbite is to:

a.       Lessen the amount of cellular damage

b.      Prevent the formation of blisters

c.       Promote movement

d.      Prevent pain and discomfort

2.      A client recently started on hemodialysis wants to know how the dialysis will take the place of his kidneys. The nurse’s response is based on the knowledge that hemodialysis works by:

a.       Passing water through a dialyzing membrane

b.      Eliminating plasma proteins from the blood

c.       Lowering the pH by removing nonvolatile acids

d.      Filtering waste through a dialyzing membrane

3.      During a home visit, a client with AIDS tells the nurse that he has been exposed to measles. Which action by the nurse is most appropriate?

a.       Administer an antibiotic

b.      Contact the physician for an order for immune globulin

c.       Administer an antiviral

d.      Tell the client that he should remain in isolation for 2 weeks

4.      A client hospitalized with MRSA (methicillin-resistant staph aureus) is placed on contact precautions. Which statement is true regarding precautions for infections spread by contact?

a.       The client should be placed in a room with negative pressure.

b.      Infection requires close contact; therefore, the door may remain open.

c.       Transmission is highly likely, so the client should wear a mask at all times.

d.      Infection requires skin-to-skin contact and is prevented by hand washing, gloves, and a gown.

5.      A client who is admitted with an above-the-knee amputation tells the nurse that his foot hurts and itches. Which response by the nurse indicates understanding of phantom limb pain?

a.       "The pain will go away in a few days."

b.      "The pain is due to peripheral nervous system interruptions. I will get you some pain medication."

c.       "The pain is psychological because your foot is no longer there."

d.      "The pain and itching are due to the infection you had before the surgery."

6.      A client with cancer of the pancreas has undergone a Whipple procedure. The nurse is aware that during the Whipple procedure, the doctor will remove the:

a.       Head of the pancreas

b.      Proximal third section of the small intestines

c.       Stomach and duodenum

d.      Esophagus and jejunum

7.      The physician has ordered a minimal-bacteria diet for a client with neutropenia. The client should be taught to avoid eating:

a.       Fruits

b.      Salt

c.       Pepper

d.      Ketchup

8.      A client is discharged home with a prescription for Coumadin (sodium warfarin). The client should be instructed to:

a.       Have a Protime done monthly

b.      Eat more fruits and vegetables

c.       Drink more liquids

d.      Avoid crowds

9.      The nurse is assisting the physician with removal of a central venous catheter. To facilitate removal, the nurse should instruct the client to:

a.       Perform the Valsalva maneuver as the catheter is advanced

b.      Turn his head to the left side and hyperextend the neck

c.       Take slow, deep breaths as the catheter is removed

d.      Turn his head to the right while maintaining a sniffing position

10.  A client has an order for streptokinase. Before administering the medication, the nurse should assess the client for:

a.       Allergies to pineapples and bananas

b.      A history of streptococcal infections

c.       Prior therapy with phenytoin

d.      A history of alcohol abuse

11.  The nurse is providing discharge teaching for the client with leukemia. The client should be told to avoid:

a.       Using oil- or cream-based soaps

b.      Flossing between the teeth

c.       The intake of salt

d.      Using an electric razor

12.  The nurse is changing the ties of the client with a tracheotomy. The safest method of changing the tracheotomy ties is to:

a.       Apply the new tie before removing the old one.

b.      Have a helper present.

c.       Hold the tracheotomy with the nondominant hand while removing the old tie.

d.      Ask the doctor to suture the tracheostomy in place.

13.  The nurse is monitoring a client following a lung resection. The hourly output from the chest tube was 300mL. The nurse should give priority to:

a.       Turning the client to the left side

b.      Milking the tube to ensure patency

c.       Slowing the intravenous infusion

d.      Notifying the physician

14.  The infant is admitted to the unit with tetrology of falot. The nurse would anticipate an order for which medication?

a.       Digoxin

b.      Epinephrine

c.       Aminophyline

d.      Atropine

15.  The nurse is educating the lady’s club in self-breast exam. The nurse is aware that most malignant breast masses occur in the Tail of Spence. On the diagram, place an X on the Tail of Spence.

16.  The toddler is admitted with a cardiac anomaly. The nurse is aware that the infant with a ventricular septal defect will:

a.       Tire easily

b.      Grow normally

c.       Need more calories

d.      Be more susceptible to viral infections

17.  The nurse is monitoring a client with a history of stillborn infants. The nurse is aware that a nonstress test can be ordered for this client to:

a.       Determine lung maturity

b.      Measure the fetal activity

c.       Show the effect of contractions on fetal heart rate

d.      Measure the well-being of the fetus

18.  The nurse is evaluating the client who was admitted 8 hours ago for induction of labor. The following graph is noted on the monitor. Which action should be taken first by the nurse?

a.       Instruct the client to push

b.      Perform a vaginal exam

c.       Turn off the Pitocin infusion

d.      Place the client in a semi-Fowler’s position

19.  The nurse notes the following on the ECG monitor. The nurse would evaluate the cardiac arrhythmia as:

a.       Atrial flutter

b.      A sinus rhythm

c.       Ventricular tachycardia

d.      Atrial fibrillation

20.  A client with clotting disorder has an order to continue Lovenox (enoxaparin) injections after discharge. The nurse should teach the client that Lovenox injections should:

a.       Be injected into the deltoid muscle

b.      Be injected into the abdomen

c.       Aspirate after the injection

d.      Clear the air from the syringe before injections

21.  The nurse has a preop order to administer Valium (diazepam) 10mg and Phenergan (promethazine) 25mg. The correct method of administering these medications is to:

a.       Administer the medications together in one syringe

b.      Administer the medication separately

c.       Administer the Valium, wait 5 minutes, and then inject the Phenergan

d.      Question the order because they cannot be given at the same time

22.  A client with frequent urinary tract infections asks the nurse how she can prevent the reoccurrence. The nurse should teach the client to:

a.       Douche after intercourse

b.      Void every 3 hours

c.       Obtain a urinalysis monthly

d.      Wipe from back to front after voiding

23.  Which task should be assigned to the nursing assistant?

a.       Placing the client in seclusion

b.      Emptying the Foley catheter of the preeclamptic client

c.       Feeding the client with dementia

d.      Ambulating the client with a fractured hip

24.  The client has recently returned from having a thyroidectomy. The nurse should keep which of the following at the bedside?

a.       A tracheotomy set

b.      A padded tongue blade

c.       An endotracheal tube

d.      An airway

25.  The physician has ordered a histoplasmosis test for the elderly client. The nurse is aware that histoplasmosis is transmitted to humans by:

a.       Cats

b.      Dogs

c.       Turtles

d.      Birds

GET ANSWERS AND RATIONALE

If you want to have more NCLEX practice exam questions like this, we strongly suggest to get a copy of NCLEX-RN Exam Cram and NCLEX-RN Exam Practice Questions Exam Cramfrom informit.com.

1.      A client with pneumacystis carini pneumonia is receiving trimetrexate. The rationale for administering leucovorin calcium to a client receiving Methotrexate is to:

a.       Treat anemia.

b.      Create a synergistic effect.

c.       Increase the number of white blood cells.

d.      Reverse drug toxicity.

2.      A client tells the nurse that she is allergic to eggs, dogs, rabbits, and chicken feathers. Which order should the nurse question?

a.       TB skin test

b.      Rubella vaccine

c.       ELISA test

d.      Chest x-ray

3.      The physician has prescribed rantidine (Zantac) for a client with erosive gastritis. The nurse should administer the medication:

a.       30 minutes before meals

b.      With each meal

c.       In a single dose at bedtime

d.      60 minutes after meals

4.      A temporary colostomy is performed on the client with colon cancer. The nurse is aware that the proximal end of a double barrel colostomy:

a.       Is the opening on the client’s left side

b.      Is the opening on the distal end on the client’s left side

c.       Is the opening on the client’s right side

d.      Is the opening on the distal right side

5.      While assessing the postpartal client, the nurse notes that the fundus is displaced to the right. Based on this finding, the nurse should:

a.       Ask the client to void

b.      Assess the blood pressure for hypotension

c.       Administer oxytocin

d.      Check for vaginal bleeding

6.      The physician has ordered an MRI for a client with an orthopedic ailment. An MRI should not be done if the client has:

a.       The need for oxygen therapy

b.      A history of claustrophobia

c.       A permanent pacemaker

d.      Sensory deafness

7.      A 6-month-old client is placed on strict bed rest following a hernia repair. Which toy is best suited to the client?

a.       Colorful crib mobile

b.      Hand-held electronic games

c.       Cars in a plastic container

d.      30-piece jigsaw puzzle

8.      The nurse is preparing to discharge a client with a long history of polio. The nurse should tell the client that:

a.       Taking a hot bath will decrease stiffness and spasticity.

b.      A schedule of strenuous exercise will improve muscle strength.

c.       Rest periods should be scheduled throughout the day.

d.      Visual disturbances can be corrected with prescription glasses.

9.      A client on the postpartum unit has a proctoepisiotomy. The nurse should anticipate administering which medication?

a.       Dulcolax suppository

b.      Docusate sodium (Colace)

c.       Methyergonovine maleate (Methergine)

d.      Bromocriptine sulfate (Parlodel)

10.  A client with pancreatic cancer has an infusion of TPN (Total Parenteral Nutrition). The doctor has ordered for sliding-scale insulin. The most likely explanation for this order is:

a.       Total Parenteral Nutrition leads to negative nitrogen balance and elevated glucose levels.

b.      Total Parenteral Nutrition cannot be managed with oral hypoglycemics.

c.       Total Parenteral Nutrition is a high-glucose solution that often elevates the blood glucose levels.

d.      Total Parenteral Nutrition leads to further pancreatic disease.

11.  An adolescent primigravida who is 10 weeks pregnant attends the antepartal clinic for a first check-up. To develop a teaching plan, the nurse should initially assess:

a.       The client’s knowledge of the signs of preterm labor

b.      The client’s feelings about the pregnancy

c.       Whether the client was using a method of birth control

d.      The client’s thought about future children

12.  An obstetric client is admitted with dehydration. Which IV fluid would be most appropriate for the client?

a.       .45 normal saline

b.      Dextrose 1% in water

c.       Lactated Ringer’s

d.      Dextrose 5% in .45 normal saline

13.  The physician has ordered a thyroid scan to confirm the diagnosis. Before the procedure, the nurse should:

a.       Assess the client for allergies

b.      Bolus the client with IV fluid

c.       Tell the client he will be asleep

d.      Insert a urinary catheter

14.  The physician has ordered an injection of RhoGam for a client with blood type A negative. The nurse understands that RhoGam is given to:

a.       Provide immunity against Rh isoenzymes

b.      Prevent the formation of Rh antibodies

c.       Eliminate circulating Rh antibodies

d.      Convert the Rh factor from negative to positive

15.  The nurse is caring for a client admitted to the emergency room after a fall. X-rays reveal that the client has several fractured bones in the foot. Which treatment should the nurse anticipate for the fractured foot?

a.       Application of a short inclusive spica cast

b.      Stabilization with a plaster-of-Paris cast

c.       Surgery with Kirschner wire implantation

d.      A gauze dressing only

16.  A client with bladder cancer is being treated with iridium seed implants. The nurse’s discharge teaching should include telling the client to:

a.       Strain his urine

b.      Increase his fluid intake

c.       Report urinary frequency

d.      Avoid prolonged sitting

17.  Following a heart transplant, a client is started on medication to prevent organ rejection. Which category of medication prevents the formation of antibodies against the new organ?

a.       Antivirals

b.      Antibiotics

c.       Immunosuppressants

d.      Analgesics

18.  The nurse is preparing a client for cataract surgery. The nurse is aware that the procedure will use:

a.       Mydriatics to facilitate removal

b.      Miotic medications such as Timoptic

c.       A laser to smooth and reshape the lens

d.      Silicone oil injections into the eyeball

19.  A client with Alzheimer’s disease is awaiting placement in a skilled nursing facility. Which long-term plans would be most therapeutic for the client?

a.       Placing mirrors in several locations in the home

b.      Placing a picture of herself in her bedroom

c.       Placing simple signs to indicate the location of the bedroom, bathroom, and so on

d.      Alternating healthcare workers to prevent boredom

20.  A client with an abdominal cholecystectomy returns from surgery with a Jackson-Pratt drain. The chief purpose of the Jackson-Pratt drain is to:

a.       Prevent the need for dressing changes

b.      Reduce edema at the incision

c.       Provide for wound drainage

d.      Keep the common bile duct open

21.  The nurse is performing an initial assessment of a newborn Caucasian male delivered at 32 weeks gestation. The nurse can expect to find the presence of:

a.       Mongolian spots

b.      Scrotal rugae

c.       Head lag

d.      Vernix caseosa

22.  The nurse is caring for a client admitted with multiple trauma. Fractures include the pelvis, femur, and ulna. Which finding should be reported to the physician immediately?

a.       Hematuria

b.      Muscle spasms

c.       Dizziness

d.      Nausea

23.  A client is brought to the emergency room by the police. He is combative and yells, "I have to get out of here. They are trying to kill me." Which assessment is most likely correct in relation to this statement?

a.       The client is experiencing an auditory hallucination.

b.      The client is having a delusion of grandeur.

c.       The client is experiencing paranoid delusions.

d.      The client is intoxicated.

24.  The nurse is preparing to suction the client with a tracheotomy. The nurse notes a previously used bottle of normal saline on the client’s bedside table. There is no label to indicate the date or time of initial use. The nurse should:

a.       Lip the bottle and use a pack of sterile 4×4 for the dressing

b.      Obtain a new bottle and label it with the date and time of first use

c.       Ask the ward secretary when the solution was requested

d.      Label the existing bottle with the current date and time

25.  An infant’s Apgar score is 9 at 5 minutes. The nurse is aware that the most likely cause for the deduction of one point is:

a.       The baby is cold.

b.      The baby is experiencing bradycardia.

c.       The baby’s hands and feet are blue.

d.      The baby is lethargic.

GET ANSWERS AND RATIONALE