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