Recalls 5 - NP3 Flashcards
1
Q
Situation: A newly graduated nurse is preparing to apply for licensure in the Philippines. They are studying Republic Act 9173 to understand the qualifications, responsibilities, and ethical standards required for professional practice in the country.
- What additional qualifications must a nurse possess to occupy the position of chief nurse or director of nursing service as per RA 9173?
A. A master’s degree major in nursing and at least five (5) years of experience in a supervisory or managerial position in nursing
B. A master’s degree in any field and at least three (3) years of experience in nursing service administration
C. A bachelor’s degree in nursing and at least ten (10) years of experience in a managerial position
D. A bachelor’s degree in nursing and at least five (5) years of experience in general nursing
A
A. A master’s degree major in nursing and at least five (5) years of experience in a supervisory or managerial position in nursing
2
Q
- According to RA 9173, what is the term of office for each member of the Board of Nursing?
A. 2 years
B. 3 years
C. 4 years
D. 5 years
A
B. 3 years
3
Q
- According to RA 9173, how many members are there in the Board of Nursing?
A. 3 members
B. 5 members
C. 7 members
D. 9 members
A
C. 7 members
4
Q
- Under RA 9173, which of the following is NOT a ground for the revocation or suspension of a nurse’s certificate of registration/professional license?
A. Unprofessional and unethical conduct
B. Gross incompetence or serious ignorance
C. Refusal to participate in continuing education
D. Malpractice or negligence in the practice of nursing
A
C. Refusal to participate in continuing education
5
Q
- When does RA 9173, the Philippine Nursing Act of 2002, take effect?
A. Thirty (30) days after signing by the President
B. Fifteen (15) days after approval by Congress
C. Fifteen (15) days after publication in the Official Gazette or in any two (2) newspapers of general circulation in the Philippines
D. Immediately after being signed by the President
A
C. Fifteen (15) days after publication in the Official Gazette or in any two (2) newspapers of general circulation in the Philippine
6
Q
Situation: You are Nurse Sung Deok-sun, providing education to Choi Taek, a 16-year-old with Type 1 Diabetes Mellitus. Your focus includes understanding the etiology of diabetes, assessing self-care skills, managing complications, and appropriate emergency interventions.
- Choi Taek, newly admitted, asks about the cause of his Type 1 diabetes. What process should you describe to him?
A. The tissues in your body are resistant to the action of insulin, making the glucose levels in your blood increase.
B. Damage to your pancreas causes an increase in the amount of glucose that it releases, and there is not enough insulin to control it.
C. The amount of glucose that your body makes overwhelms your pancreas and decreases your production of insulin.
D. Destruction of special cells in the pancreas causes a decrease in insulin production. Glucose levels rise because insulin normally breaks it down.
A
D. Destruction of special cells in the pancreas causes a decrease in insulin production. Glucose levels rise because insulin normally breaks it down.
7
Q
- Choi Taek has reported a positive urine ketone test. What is the most appropriate nurse’s response based on this finding?
A. The patient should withhold his next scheduled dose of insulin.
B. The patient should promptly eat some protein and carbohydrates.
C. The patient’s insulin levels are inadequate.
D. The patient would benefit from a dose of metformin (Glucophage).
A
C. The patient’s insulin levels are inadequate.
8
Q
- Which criterion supports the diagnosis of diabetes and warrants checking blood glucose levels?
A. Fasting plasma glucose greater than or equal to 126 mg/dL
B. Random plasma glucose greater than 150 mg/dL
C. Fasting plasma glucose greater than 116 mg/dL on 2 separate occasions
D. Random plasma glucose greater than 126 mg/dL
A
A. Fasting plasma glucose greater than or equal to 126 mg/dL
9
Q
- Choi Taek reports abdominal pain, appears weak, and is displaying Kussmaul respirations at 30 breaths/minute. What prescriptions should you implement in his care? (Select all that apply.)
- Dextrose 50% by intravenous (IV) push
- Regular insulin by IV infusion
- Obtain a STAT capillary blood glucose measurement
- Start an IV line and begin an infusion of 0.9% sodium chloride
- Draw blood for the prescribed serum potassium level
A. 1, 3, 4
B. 1, 2, 3, 4
C. 2, 3, 4, 5
D. All of the above
A
C. 2, 3, 4, 5
10
Q
- The nurse is reviewing medication orders for Choi Taek. Which prescription should the nurse clarify with the healthcare provider (HCP)?
A. 12 units of subcutaneous detemir insulin daily at 2000
B. 8 units of regular insulin by IV infusion for serum glucose greater than 300 mg/dL
C. 16 units of subcutaneous lispro insulin daily at 1000 before breakfast
D. 18 units of NPH insulin PO daily at 0700 for blood glucose greater than 80 mg/dL
A
D. 18 units of NPH insulin PO daily at 0700 for blood glucose greater than 80 mg/dL
11
Q
Situation: You are Nurse Sung Deok-sun, providing education to Kim Jung Hwan, a 55-year-old recently diagnosed with Type 2 Diabetes Mellitus. Your focus includes understanding the etiology of diabetes, assessing self-care skills, managing complications, and appropriate emergency interventions.
- Kim Jung Hwan, newly diagnosed with Type 2 diabetes, asks about the primary treatment approach. What should you emphasize?
A. “A pancreas transplant will cure my diabetes.”
B. “I will take my oral antidiabetic agents only when my blood sugar is high.”
C. “I will follow the weight loss plan provided by the dietitian.”
D. “I will call the diabetes educator whenever I have questions about my insulin.”
A
C. “I will follow the weight loss plan provided by the dietitian.”
12
Q
- Kim Jung Hwan, who has been managing his Type 2 diabetes with oral medications and lifestyle changes, presents to the emergency department with a blood glucose level of 623 mg/dL and confusion following a recent gastrointestinal virus. What is the priority nursing action?
A. Administer antihypertensive medications.
B. Administer sodium bicarbonate intravenously.
C. Reverse acidosis by administering insulin.
D. Perform fluid and electrolyte replacement.
A
D. Perform fluid and electrolyte replacement.
13
Q
- Kim Jung Hwan is at risk for Hyperglycemic Hyperosmolar Syndrome (HHS). In which population is HHS most commonly observed?
A. Obese patients with no known history of diabetes.
B. Patients with Type 1 diabetes and poor dietary control.
C. Adolescents with Type 2 diabetes and sporadic use of antihyperglycemics.
D. Middle-aged or older individuals with Type 2 diabetes or no known history of diabetes.
A
D. Middle-aged or older individuals with Type 2 diabetes or no known history of diabetes.
14
Q
- Kim Jung Hwan asks how long he can store a vial of insulin at room temperature before it goes bad. What is the best response?
A. “If you use the vial within 1 month, it can be kept at room temperature.”
B. “If you use the vial within 21 days, it may be kept at room temperature.”
C. “If you use the vial within 2 weeks, it may be kept at room temperature.”
D. “If you use the vial within 1 week, it may be kept at room temperature.”
A
A. “If you use the vial within 1 month, it can be kept at room temperature.”
15
Q
- Kim Jung Hwan, who has been diagnosed with Type 2 diabetes-related peripheral neuropathy, is receiving health education. Which of the following recommendations should the registered nurse (RN) provide? Select all that apply.
- “Every day, check your feet, especially in the spaces between your toes, and report any changes in skin right away.”
- “Avoid wearing socks to reduce the amount of perspiration and irritation on your skin.”
- “Before stepping into the tub, use a thermometer to check the water’s temperature.”
- “Prevent nail breakage by keeping toenails clipped close to the skin.”
- “Wear well-fitting, closed-toe shoes at all times, even when indoors.”
A. 1, 3, 5
B. 2, 4, 5
C. 1, 3
D. All of the above
A
C. 1, 3
16
Q
Situation: Nurse Seo Woo-jin is managing the care of Cha Eun-jae, a 34-year-old female patient who was admitted with severe headache and altered mental status. After thorough diagnostic testing, Cha Eun-jae has been diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Nurse Seo Woo-jin needs to monitor her condition closely, manage her symptoms, and educate her about the treatment plan.
- Cha Eun-jae is diagnosed with SIADH. Which of the following clinical manifestations should Nurse Seo Woo-jin expect to find during the assessment? Select all that apply.
- Elevated serum osmolality
- Elevated urine specific gravity
- Decreased serum osmolality
- Decreased urine output
- Decreased serum sodium
A. 2, 3, 5
B. 1, 4, 5
C. 2, 3, 4, 5
D. All of the above
A
C. 2, 3, 4, 5
16
Q
- Cha Eun-jae’s serum sodium level is critically low at 120 mEq/L. Nurse Seo Woo-jin understands that which of the following treatments is appropriate for severe hyponatremia in SIADH?
A. Rapid infusion of hypotonic saline
B. Slow infusion of isotonic saline
C. Rapid infusion of hypertonic saline
D. Administration of diuretics
A
C. Rapid infusion of hypertonic saline
17
Q
- Cha Eun-jae is prescribed demeclocycline for her SIADH. Nurse Seo Woo-jin knows that the purpose of this medication is to:
A. Increase ADH secretion
B. Decrease renal response to ADH
C. Replace deficient ADH
D. Promote water retention
A
B. Decrease renal response to ADH
17
Q
- During the follow-up visit, Nurse Seo Woo-jin reviews Cha Eun-jae’s sodium levels. Which range of serum sodium is considered critical and requires immediate intervention?
A. 130-135 mEq/L
B. 125-130 mEq/L
C. 115-120 mEq/L
D. 140-145 mEq/L
A
C. 115-120 mEq/L
18
Q
- What is a priority nursing diagnosis for Cha Eun-jae who has been diagnosed with SIADH?
A. Risk for peripheral neurovascular dysfunction
B. Excess fluid volume
C. Hypothermia
D. Ineffective airway clearance
A
B. Excess fluid volume
19
Q
Situation: Nurse Anneliese is assigned to Erika, a 35-year-old teacher diagnosed with diabetes insipidus (DI) after a car accident caused head trauma. Erika has been experiencing excessive thirst and urination. Nurse Anneliese needs to manage Erika’s symptoms and provide education on her condition and treatment plan.
- Erika complains of severe thirst. What is the underlying cause of this symptom in diabetes insipidus?
A. Elevated blood glucose levels
B. Increased renal reabsorption of water
C. Deficient antidiuretic hormone (ADH) production
D. High serum calcium levels
A
C. Deficient antidiuretic hormone (ADH) production
20
Q
- Nurse Anneliese notices that Erika’s serum sodium levels are elevated. What does this indicate in the context of diabetes insipidus?
A. Effective management of fluid balance
B. Dehydration due to excessive urine output
C. Overhydration from excessive fluid intake
D. Normal renal function
A
B. Dehydration due to excessive urine output
21
Q
- During a follow-up visit, Erika mentions frequent headaches. What potential complication should Nurse Anneliese consider?
A. Hyperglycemia
B. Hyponatremia
C. Hypercalcemia
D. Hypokalemia
A
B. Hyponatremia
22
Q
- Erika’s urine output is being monitored. Which of the following would indicate effective management of her DI?
A. Urine output decreases to 1.5 liters per day
B. Urine specific gravity increases to 1.030
C. Serum sodium levels decrease to 125 mEq/L
D. Erika reports severe headaches
A
A. Urine output decreases to 1.5 liters per day
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25. Nurse Anneliese is educating Erika about the signs of water intoxication. Which symptom should she highlight?
A. Increased thirst
B. Dry mucous membranes
C. Sudden weight loss
D. Reduced urine output
D. Reduced urine output
24
Situation: Nurse Yoon Seo Jung is assessing a male patient, Kang Dong Joo, who has recently been diagnosed with Addison’s disease. The focus is on understanding clinical manifestations, appropriate interventions, and management strategies.
26. Kang Dong Joo, newly diagnosed with Addison’s disease, exhibits several symptoms. Which of the following clinical signs should Nurse Yoon Seo Jung expect? Select all that apply.
1. Increased body or facial hair
2. Purple or red striae on the abdomen
3. Skin color that is tanned in appearance
4. Orthostatic hypotension
5. Anorexia and weight loss
A. 3, 4, 5
B. 1, 3, 5
C. 3, 4
D. 1, 4
A. 3, 4, 5
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27. Kang Dong Joo is experiencing signs of an Addisonian crisis. Which of the following should Nurse Yoon Seo Jung prioritize in the management of this crisis?
A. Administer high-dose hydrocortisone intravenously as prescribed.
B. Encourage increased oral fluid intake without medical supervision.
C. Increase the dose of oral glucocorticoids immediately.
D. Monitor blood glucose levels and provide immediate glucose supplementation
A. Administer high-dose hydrocortisone intravenously as prescribed.
26
28. Kang Dong Joo’s Addison’s disease requires ongoing management. Which dietary recommendation is most appropriate for him?
A. High protein and carbohydrate diet.
B. Low-sodium and high-potassium diet.
C. Low-protein and high-fat diet.
D. High-fiber and low-carbohydrate diet.
A. High protein and carbohydrate diet.
27
29. Kang Dong Joo’s laboratory results show hyperkalemia and hyponatremia. What is the significance of these findings in the context of Addison’s disease?
A. They indicate an acute exacerbation of heart failure.
B. They are consistent with the electrolyte imbalances seen in Addison’s disease.
C. They suggest a complication from diabetes mellitus.
D. They are a sign of renal failure.
B. They are consistent with the electrolyte imbalances seen in Addison’s disease.
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30. Which lifestyle adjustment should Nurse Yoon Seo Jung emphasize for Kang Dong Joo to help manage his Addison’s disease effectively?
A. “Increase your physical exercise to boost overall health.”
B. “Avoid situations that may lead to physical or emotional stress.”
C. “Engage in regular high-intensity workouts to improve endurance.”
D. “Limit your fluid intake to prevent fluid overload.”
B. “Avoid situations that may lead to physical or emotional stress.”
29
Situation: Nurse Lee Mi-hyun is working at a busy regional hospital in the Philippines. She is assigned to manage the care of Kim Doo-shik, a local businessman who has recently been diagnosed with Cushing's syndrome. Kim Doo-shik has been struggling with the symptoms of his condition while trying to maintain his demanding job. Nurse Lee Mi-hyun needs to coordinate his care, address his concerns about the disease, and help him manage his treatment plan effectively while considering his lifestyle and the local healthcare resources available.
31. Kim Doo-shik, newly diagnosed with Cushing’s syndrome, is presenting with specific physical signs. Which of the following manifestations should Nurse Lee Mi-hyun expect? Select all that apply.
1. Moon facies
2. Thin, fragile skin
3. Hyperpigmentation of the skin
4. Truncal obesity
5. Hirsutism
A. 1, 4
B. 1, 2, 4
C. 1, 2, 4, 5
D. All of the above
C. 1, 2, 4, 5
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32. Kim Doo-shik has been prescribed mitotane for his Cushing’s syndrome. What should Nurse Lee Mi-hyun instruct him about this medication?
A. Mitotane is used to stimulate adrenal hormone production.
B. Mitotane can cause hyperglycemia and should be monitored closely.
C. Mitotane is used to suppress ACTH production from the pituitary gland.
D. Mitotane is a form of chemotherapy used to reduce cortisol levels by targeting adrenal glands.
D. Mitotane is a form of chemotherapy used to reduce cortisol levels by targeting adrenal glands.
31
33. Nurse Lee Mi-hyun is reviewing Kim Doo-shik’s medication regimen. Which of the following instructions should she give him regarding corticosteroid therapy?
A. Take the medication at bedtime to mimic the natural cortisol rhythm.
B. Take the medication in the morning to align with the body's natural cortisol secretion.
C. Take the medication with meals to reduce gastrointestinal irritation.
D. Take the medication at noon to manage symptoms effectively.
B. Take the medication in the morning to align with the body's natural cortisol secretion.
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34. During Kim Doo-shik’s follow-up visit, Nurse Lee Mi-hyun reviews his lab results. His serum sodium is elevated, and his potassium is low. What should Nurse Lee Mi-hyun infer about these findings?
A. These electrolyte imbalances are typical of primary adrenal insufficiency.
B. The electrolyte changes are consistent with Cushing’s syndrome, indicating mineralocorticoid excess.
C. These findings suggest acute adrenal crisis.
D. The lab results are indicative of a side effect of antidiabetic medication.
B. The electrolyte changes are consistent with Cushing’s syndrome, indicating mineralocorticoid excess.
33
35. Nurse Lee Mi-hyun is preparing Kim Doo-shik for a dexamethasone suppression test. What should she explain to him about this test?
A. The test involves intravenous administration of dexamethasone and subsequent imaging of the adrenal glands.
B. The test involves oral administration of dexamethasone at 11 PM, with a plasma cortisol level checked at 8 AM.
C. The test involves oral administration of dexamethasone, followed by hourly plasma cortisol levels for 3 hours.
D. The test involves intravenous administration of dexamethasone, followed by plasma cortisol measurement 3 hours later.
B. The test involves oral administration of dexamethasone at 11 PM, with a plasma cortisol level checked at 8 AM.
34
Situation: Nurse Jeong Gu-won is caring for Do Do-Hee, a 45-year-old female who has been admitted to the hospital with a diagnosis of Graves' disease. Do Do-Hee has been experiencing severe symptoms of hyperthyroidism, including agitation, tremors, and high fever. Upon examination, her symptoms suggest the possibility of thyroid storm. Nurse Jeong Gu-won needs to assess her condition, implement immediate interventions, and provide patient education about managing her hyperthyroidism effectively.
36. Which clinical manifestation is characteristic of Graves' disease and would Nurse Jeong Gu-won expect to observe in Do Do-Hee?
1. Exophthalmos
2. Irregular heart rhythm
3. Obesity
4. Insomnia and anxiety
5. Hand tremors
6. Increased perspiration
A. 1, 2, 4, 6
B. 1, 3, 4, 5, 6
C. 1, 3, 4, 5
D. 1, 2, 4, 5, 6
D. 1, 2, 4, 5, 6
35
37. When planning Do Do-Hee's diet to manage hyperthyroidism, what should Nurse Jeong Gu-won include in her meal plan?
A. Small, frequent meals, high in protein and calories
B. Large, bland meals
C. Clear liquid diet
D. High-fiber and low-fat diet
A. Small, frequent meals, high in protein and calories
36
38. Which laboratory finding is most indicative of hyperthyroidism in Do Do-Hee?
A. Elevated TSH levels
B. Low T3 and T4 levels
C. Elevated T3 and T4 levels
D. Normal T3 and T4 levels
C. Elevated T3 and T4 levels
37
39. Which symptom should Nurse Jeong Gu-won be most vigilant for in managing Do Do-Hee’s thyroid storm?
A. Elevated appetite and weight gain
B. Severe agitation and delirium
C. Decreased urinary frequency
D. Increased dryness of the skin
B. Severe agitation and delirium
38
40. What is the primary goal of treatment for thyroid storm?
A. Decrease thyroid hormone levels
B. Decrease thyroid gland size
C. Increase thyroid hormone production
D. Normalize thyroid function tests
A. Decrease thyroid hormone levels
39
Situation: Nurse Pia is preparing to administer a unit of packed red blood cells (PRBCs) to Rancho, who has a diagnosis of severe anemia. Nurse Pia ensures that all necessary preparations are in place before starting the transfusion.
41. What is Nurse Pia's first action before starting the blood transfusion?
A. Prime the IV tubing with normal saline.
B. Check Rancho's identification band and confirm the blood type with another nurse.
C. Administer pre-medications as prescribed.
D. Assess Rancho's baseline vital signs.
B. Check Rancho's identification band and confirm the blood type with another nurse.
40
42. After starting the transfusion, Nurse Pia observes that Rancho begins to show signs of a transfusion reaction, including chills, back pain, and fever. What is the most appropriate initial action for Nurse Pia?
A. Stop the transfusion immediately and disconnect the blood bag.
B. Administer acetaminophen and continue monitoring Rancho.
C. Apply a warm compress to Rancho’s back and continue the transfusion slowly.
D. Notify the blood bank to report the reaction.
A. Stop the transfusion immediately and disconnect the blood bag.
40
43. Nurse Pia is preparing to administer a unit of fresh-frozen plasma (FFP) to Rancho. Which of the following is the correct procedure for administering FFP?
A. Infuse the FFP over 1 to 2 hours.
B. Use a blood warmer to heat the FFP before infusion.
C. Administer the FFP with normal saline through a blood transfusion pump.
D. Infuse the FFP immediately upon thawing and complete the infusion within 30 minutes.
D. Infuse the FFP immediately upon thawing and complete the infusion within 30 minutes.
41
44. Rancho’s blood transfusion is nearly complete, and Nurse Pia notes that it has been infusing for over 4 hours. What is the best course of action for Nurse Pia?
A. Continue the transfusion until the bag is empty.
B. Reduce the infusion rate and continue the transfusion.
C. Stop the transfusion and dispose of the remaining blood.
D. Return the remaining blood to the blood bank.
C. Stop the transfusion and dispose of the remaining blood.
42
45. To ensure the safe and effective administration of the blood product, Nurse Pia needs to use the correct gauge for the IV catheter. What is the appropriate range of gauge sizes for the IV catheter used in blood transfusion?
A. 16-gauge to 18-gauge
B. 18-gauge to 20-gauge
C. 20-gauge to 22-gauge
D. 22-gauge to 24-gauge
B. 18-gauge to 20-gauge
43
Situation: Nurse Claudine is managing Rico’s care in the hospital for congestive heart failure (CHF). Rico’s symptoms are being monitored and adjusted as needed. Nurse Claudine needs to ensure that all aspects of his care, including medication management, lifestyle changes, and disease monitoring, are optimized.
46. Nurse Claudine is reviewing Rico's treatment plan for congestive heart failure. Which medication class is considered a cornerstone of CHF management due to its ability to reduce afterload and improve cardiac output?
A. Angiotensin-converting enzyme (ACE) inhibitors
B. Diuretics
C. Beta-blockers
D. Calcium channel blockers
A. Angiotensin-converting enzyme (ACE) inhibitors
44
47. Rico presents with orthopnea and dyspnea. Upon lung auscultation, Nurse Claudine hears fine crackles that do not clear with coughing. What is the most likely cause of these lung sounds?
A. Bronchitis
B. Atelectasis
C. Pulmonary edema
D. Lung cancer
C. Pulmonary edema
45
48. Nurse Claudine is explaining the procedure of a stress test to Rico. Which of the following best describes how a stress test is performed?
A. The patient is given medication to increase heart rate while lying down.
B. The patient exercises on a treadmill or stationary bike while their heart rate, blood pressure, and ECG are monitored.
C. The patient undergoes an echocardiogram while at rest.
D. The patient receives an injection of a radioactive substance, and images of the heart are taken.
B. The patient exercises on a treadmill or stationary bike while their heart rate, blood pressure, and ECG are monitored.
46
49. Nurse Claudine is educating Rico on how to manage his CHF at home. Which statement by Rico indicates he has understood the importance of monitoring his condition? Select all that apply.
1. "I will take my medications as prescribed and not skip doses."
2. "I’ll check my weight every day at the same time and report any significant changes."
3. "I’ll avoid all physical activity to prevent fatigue."
4. "I will limit my fluid intake and avoid high-sodium foods."
5. "I’ll see my healthcare provider only when I feel very sick."
A. 1, 2, 4
B. 1, 2, 5
C. 2, 3, 4
D. 3, 4, 5
A. 1, 2, 4
47
50. Rico reports experiencing fatigue and shortness of breath during moderate exertion, such as walking up a flight of stairs. He has no symptoms at rest. Based on the New York Heart Association (NYHA) Classification, how would you classify Rico's heart failure?
A. NYHA Class I
B. NYHA Class II
C. NYHA Class III
D. NYHA Class IV
B. NYHA Class II
48
51. Nurse Sandiego, a senior nurse, is teaching his students about caring for a client immediately following transsphenoidal hypophysectomy. It would be essential for him to obtain a prescription for which medication?
A. Ondansetron
B. Methimazole
C. Omeprazole
D. Methylphenidate
A. Ondansetron
49
52. The senior nurse conducts a lecture for nursing students. It would be appropriate for him to state which of the following procedures requires a sterile technique? Select all that apply.
A. Changing the dressing for a central line
B. Inserting an indwelling urinary catheter
C. Removing a peripheral vascular access device
D. Suctioning an endotracheal tube with in-line suction
E. Inserting a nasogastric tube (NGT)
B. Inserting an indwelling urinary catheter
50
54. He then comes back to the hospital and cares for assigned clients. He should initially intervene when the client reports:
A. nausea during an infusion of amphotericin
B. palpitations after receiving rapid-acting insulin.
C. drowsiness after receiving fentanyl.
D. itching in the perineal area while receiving intravenous dexamethasone.
B. palpitations after receiving rapid-acting insulin.
50
53. He is now teaching the class on acid-base imbalances. It would be correct for the class to identify which of the following would cause respiratory acidosis? Select all that apply.
A. Aspirin overdose
B. Pneumothorax
C. Opioid overdose
D. Anxiety
E. Renal disease
C. Opioid overdose
51
55. He is now then teaching a group of students a potential cause of metabolic alkalosis. It would indicate a correct understanding if a student stated which condition could cause this acid-base imbalance?
A. Hyperventilation
B. Urinary retention
C. Opioid toxicity
D. Excessive vomiting
D. Excessive vomiting
52
56. Which of the following interventions is helpful in reducing the effects of GERD?
A. Lie down after eating.
B. Wear a girdle.
C. Elevate the head of the bed on 4-6 inch blocks.
D. Increase fluid intake just before bedtime.
C. Elevate the head of the bed on 4-6 inch blocks.
53
57. The ER nurse is made aware that a 7-year-old client with an avulsion fracture to the left tibia is 20 minutes out. She knows to expect which of the following?
A. A fracture that pulls a part of the bone from the tendon or ligament.
B. A fracture with which the whole cross-section of the bone is fractured.
C. A fracture that results from an underlying disease or disorder, not physical trauma or stressors.
D. A fracture that affects only one side of the bone.
A. A fracture that pulls a part of the bone from the tendon or ligament.
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60. San Lorenzo ward nurse is providing discharge instructions to a client with hepatitis A. Which of the following instructions should she include?
A. You will need to take daily showers or baths with chlorhexidine.
B. It is important to clean common surfaces with warm soapy water.
C. You will need to have repeat stool testing to determine if you are still infectious.
D. Check with your primary healthcare provider prior to taking any medications.
D. Check with your primary healthcare provider prior to taking any medications.
55
58. You have developed a care plan for a client with a self-care deficit related to bathing and hygiene. You should initially plan to:
A. ask the family to assist the client with baths.
B. provide the client with supervised bed baths.
C. assess the client for their self-care strengths and weaknesses.
D. provide assistive devices to the client while they bathe.
C. assess the client for their self-care strengths and weaknesses.
56
59. A nurse is caring for an 80-year-old woman with a long-standing history of asthma. The nurse is preparing to give a dose of theophylline to the patient. He knows that the most critical sign to assess before giving this dose is:
A. Temperature
B. Blood Pressure
C. Urinary Output
D. Pulse
D. Pulse
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61. Nurse Beca is reviewing arterial blood gas (ABG) results for a client. The ABG report shows the following values: pH 7.59 [7.35-7.45], PaCO2 30 mmHg [35-45 mm Hg], HCO-3 24 mEq/L [22-28 mEq/L], PaO2 85 mmHg [80-100 mm Hg]. Nurse Beca interprets this ABG result as
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
D. Respiratory alkalosis
57
62. Nurse Suzu has attended a staff education program about indwelling urinary catheter-associated infections (CAUTI). Which nursing intervention is most effective in preventing a CAUTI in hospitalized clients?
A. Implementing strict sterile technique during catheter insertion and maintenance.
B. Using antibacterial indwelling urinary catheters for all clients requiring urinary catheterization.
C. Limiting the duration of indwelling urinary catheter use and promptly removing them when no longer needed.
D. Administering prophylactic antibiotics to all clients with indwelling urinary catheters in place.
C. Limiting the duration of indwelling urinary catheter use and promptly removing them when no longer needed.
58
63. Marie, the newly hired nurse, is preparing to administer medications to assigned clients. Which prescription should the nurse clarify with the doctor?
A. Warfarin to a client with an international normalized ratio (INR) of 1.8 seconds
B. Digoxin to a client with a serum potassium level of 3.1 mEq/L
C. Enoxaparin to a client with a platelet count of 155,000 mm3
D. Lisinopril to a client with a serum creatinine level of 0.6 mg/dL
B. Digoxin to a client with a serum potassium level of 3.1 mEq/L
58
64. The assigned nurse is performing a continuing education seminar. It would be correct for her to identify which factor increases the older adult's risk for illness?
A. Increased lymph tissue
B. Increased autoimmune responses
C. Increased circulation of lymphocytes
D. Increased T and B cell production
B. Increased autoimmune responses
59
65. The nurse supervises a student nurse auscultating lung sounds on a group of clients. Which statement by the student nurse would require follow-up?
A. "Wheezes arise from the small airways and usually do not clear with coughing."
B. "A pleural friction rub causes loud, rough, scratching sounds usually during inspiration."
C. "Thick, tenacious secretions that clear with coughing cause crackles."
D. "Fluid or secretions in large airways typically cause coarse crackles."
C. "Thick, tenacious secretions that clear with coughing cause crackles."
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66. Mario, the med-surg head nurse, is caring for a client with severe liver cirrhosis who is prescribed albumin infusion. He understands that the primary purpose of albumin administration in this client population is to do which of the following?
A. Increase platelet counts
B. Correct electrolyte imbalances
C. Enhance oncotic pressure
D. Stimulate erythropoiesis
C. Enhance oncotic pressure
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67. He cares for a client who reports dumping syndrome following gastric bypass surgery. To alleviate the symptoms of dumping syndrome, he should recommend that the client
Select all that apply.
A. take a dose of their prescribed proton pump inhibitor immediately before meals.
B. stay upright for 30 minutes following eating.
C. eat high-fiber foods to decrease late dumping syndrome.
D. increase their intake of simple carbohydrates to prevent spikes in blood sugar.
E. eat five to six small meals a day to avoid overloading the stomach.
C. eat high-fiber foods to decrease late dumping syndrome.
E. eat five to six small meals a day to avoid overloading the stomach.
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68. Mario is now caring for a client requiring intubation via endotracheal tube (ETT). He anticipates that the doctor will prescribe which medication immediately prior to intubation?
A. propofol
B. baclofen
C. phenytoin
D. haloperidol
A. propofol
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69. He is assessing a client receiving mechanical ventilation. Which clinical data is most important to review before weaning the client off the ventilator?
A. Chest x-ray
B. Sputum culture
C. Lung sounds
D. Arterial blood gas (ABG)
D. Arterial blood gas (ABG)
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70. He observes the newly hired registered nurse prepare to administer neutral protamine hagedorn (NPH) insulin to a client. Which action by the newly hired nurse requires follow-up? The newly hired nurse:
A. asks the client which site the insulin was last injected.
B. checks the client's blood glucose levels prior to administering the insulin injection.
C. shakes the insulin vial before withdrawing insulin.
D. reminds the client to report symptoms of clammy skin and disorientation.
C. shakes the insulin vial before withdrawing insulin.
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71. He evaluates a student's ability to appropriately apply personal protective equipment (PPE). It would indicate effective teaching if the student dons PPE in which order? Place the steps in the appropriate order.
1. Gown
2. Gloves
3. Goggles
4. Mask
A. 1234
B. 4321
C. 1432
D. 3421
C. 1432
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72. His student is developing a care plan for a client with Bell's palsy. Which problem should the student prioritize in the care plan?
A. Risk for infection
B. Risk for disturbed sensory perception
C. Risk for disturbed body image
D. Risk for ineffective tissue perfusion
B. Risk for disturbed sensory perception
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73. He read his client’s chart and saw a prescribed 3 g/hr of intravenous magnesium sulfate via continuous infusion. The label reads 20 g of magnesium sulfate in 1000 mL of normal saline. How many mL/hr should he set the pump to deliver the prescribed dose?
A. 152
B. 148
C. 150
D. 154
C. 150
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74. He has become aware of the following client situations. He should first follow up with which client? A client:
A. that had a myocardial infarction two days ago and the troponin is elevated.
B. with infective endocarditis that wants to leave against medical advice.
C. that has arterial insufficiency and is reporting leg pain after walking in the hall.
D. recovering from cardiac catheterization that has developed atrial fibrillation.
D. recovering from cardiac catheterization that has developed atrial fibrillation.
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75. Which nursing intervention would be his priority for a patient receiving 3% saline maintenance fluids?
A. Monitor serum HCO3-
B. Monitor urine sodium
C. Assess blood pressure
D. Collect 24-hour urine output
C. Assess blood pressure
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76. He is helping the nursing aid pass meal trays. When providing a meal tray for a client diagnosed with pheochromocytoma, which dietary item should he remove?
A. Macaroni and cheddar cheese
B. Watermelon slices
C. Caffeine free cola
D. Baked chicken
A. Macaroni and cheddar cheese
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77. The PALMER queen is reviewing leadership and management concepts with a student nurse. Which of the following statements by the student nurse would require follow-up?
A. “The Laissez-faire leadership style is a passive leadership approach.”
B. “A registered nurse may delegate accountability to a nursing aide”
C. “The rights of delegation include task, circumstance, person, direction, supervision.”
D. “The nurse practice act defines roles and responsibilities of nursing professionals.”
B. “A registered nurse may delegate accountability to a nursing aide”
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78. Nurse Gloria reviews a client's medical record taking prescribed isoniazid for pulmonary tuberculosis. Which laboratory data is most important to monitor?
A. PT and PTT
B. CBC
C. BUN
D. Liver enzymes
D. Liver enzymes
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79. She is teaching a group of students about fluids and electrolytes. It would be correct for the nurse to state that the role of calcium is to Select all that apply.
A. promote blood clotting.
B. increase bone density.
C. promote healthy dentition.
D. regulate fluid balance.
E. maintain neuromuscular health.
A. promote blood clotting.
B. increase bone density.
C. promote healthy dentition.
E. maintain neuromuscular health
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80. She cares for a client with a hyphema. She should plan to take which action?
A. Shield the affected eye.
B. Place the client supine.
C. Apply a cold compress to the eye.
D. Request a prescription for aspirin.
A. Shield the affected eye.
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81. Her patient is seeking guidance on secondary prevention strategies to prevent cancer. Which strategies would be most appropriate for her to include in the client's educational plan?
Select all that apply.
A. Eliminate alcohol intake
B. Pap smears
C. Rehabilitation programs
D. Colonoscopies
E. Regular cancer screenings
B. Pap smears
D. Colonoscopies
E. Regular cancer screenings
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82. She is caring for a client brought in after being found walking around a neighborhood without shoes, confused and disoriented. She should initially:
A. obtain vital signs.
B. perform a mental status exam.
C. attempt to locate the client's family.
D. request an order for a psychiatry consultation.
A. obtain vital signs.
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83. Which of the following should she include when teaching a 65-year-old male client with COPD about exercise? Select all that apply.
A. Instruct the client to avoid sudden position changes that may cause dizziness.
B. Recommend that the client restrict fluid until after exercising is finished.
C. Instruct the client to push a little further beyond his fatigue with each session.
D. Instruct the client to avoid exercising in very cold or very hot temperatures.
E. Encourage the client to exercise if he feels ill or weak.
F. Recommend consuming a high-carb, low protein diet.
A. Instruct the client to avoid sudden position changes that may cause dizziness.
D. Instruct the client to avoid exercising in very cold or very hot temperatures.
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84. She attends to a client with shortness of breath, bilateral lung crackles, weak pulses, and frothy pink sputum. Which of the following orders should she question for this client?
A. Supplemental oxygen via nasal cannula or mask
B. Losartan
C. Fowler’s position
D. Diltiazem
D. Diltiazem
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85. She is now caring for a client who has pulmonary tuberculosis (TB). Which infection control measure should she implement?
A. Restrict visitors who are pregnant
B. Remove any portable fans in the room
C. Wear a dosimeter badge during client care
D. Place the client further away from the nursing station
B. Remove any portable fans in the room
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86. She is caring for a client with atrial fibrillation. Which of the following client findings requires immediate follow-up by her?
A. Irregular QRS complexes on telemetry reading
B. Irregular peripheral pulse
C. Reports of intermittent palpitations
D. Blurred vision
D. Blurred vision
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87. She is caring for a client with a kidney injury with a serum potassium level of 6.1 mEq/L (mmol/L). Which of the following actions is her priority?
A. Obtain a prescription for a diuretic to increase urine output
B. Check the client's sodium level
C. Place the client on a cardiac monitor
D. Encourage oral fluid intake
C. Place the client on a cardiac monitor
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88. Nurse Lindo is preparing a client for angiography using contrast media. Which of the following side effects should Lindo educate the client is not an expected side effect?
A. Sudden nausea
B. A headache lasting several days
C. A feeling of facial flushing
D. Sudden urge to urinate
B. A headache lasting several days
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90. He is caring for a child with rickets. Which dietary intervention should he anticipate in the client's plan of care?
A. Increasing dietary intake of vitamin D-rich foods.
B. Limiting dietary intake of calcium-rich foods.
C. Encouraging consumption of caffeine-containing beverages.
D. Promoting a high-protein diet.
A. Increasing dietary intake of vitamin D-rich foods.
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89. He is teaching at an interdisciplinary conference focused on age-related changes. Which of the following are expected in the older adult? Select all that apply.
A. Fatty tissue is redistributed
B. Skin becomes less elastic
C. Cardiac output increases
D. Muscle mass increases
E. Hormone production increases
F. Visual and hearing acuity diminishes
A. Fatty tissue is redistributed
B. Skin becomes less elastic
F. Visual and hearing acuity diminishes
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91. He is preparing to administer prescribed intravenous phenytoin to a client with epilepsy. Prior to starting the infusion, he should:
A. establish continuous cardiac monitoring.
B. obtain the serum peak level prior to infusion.
C. initiate continuous electroencephalography (EEG) monitoring.
D. insert an indwelling urinary catheter.
A. establish continuous cardiac monitoring.
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92. Anna, the newly hired nurse, cares for a client with venous thromboembolism (VTE) prescribed a heparin infusion and warfarin. Which statement, if made by Anna, requires follow-up?
A. "The infusion should be discontinued once the INR is 4.0."
B. "Protamine sulfate should be available if the aPTT gets too high."
C. "Hypotension and tachycardia may suggest an internal hemorrhage."
D. "Both medications increase the client's risk of bleeding."
A. "The infusion should be discontinued once the INR is 4.0."
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93. Anna is caring for a client with thick, tenacious mucus due to cystic fibrosis who is prescribed acetylcysteine. What is the primary therapeutic effect of acetylcysteine in this situation?
A. Reduction of airway inflammation by inhibiting leukotriene synthesis.
B. Promotion of bronchodilation by blocking muscarinic receptors.
C. Enhancement of mucociliary clearance by reducing mucus viscosity.
D. Prevention of oxidative damage to lung tissue by scavenging free radicals.
C. Enhancement of mucociliary clearance by reducing mucus viscosity.
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94. She is caring for a client scheduled for a bronchoscopy. The client asks what to expect during the recovery period. Which response her is most appropriate?
A. "You may experience some sore throat and coughing for a few days after the procedure."
B. "You'll need to avoid eating or drinking anything for at least 24 hours following the procedure."
C. "You'll be discharged immediately after the procedure and can resume your normal activities."
D. "Expect to have difficulty breathing for several days after the procedure."
A. "You may experience some sore throat and coughing for a few days after the procedure."
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95. She is caring for a female client who is receiving prescribed isotretinoin. Which laboratory data is essential prior to the initiation of this therapy?
A. Pregnancy test
B. C-Reactive Protein
C. BUN and Creatinine
D. Prothrombin time (PT)
A. Pregnancy test
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97. She is reviewing newly prescribed medications for assigned clients. Which of the following prescribed medications should she question?
A. Levothyroxine for a client with a myxedema coma
B. Hydrochlorothiazide for a client with hyperparathyroidism
C. Hydrocortisone for a client with adrenal insufficiency
D. Regular insulin for a client with diabetic ketoacidosis
B. Hydrochlorothiazide for a client with hyperparathyroidism
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96. She receives a client who has just returned from a circular skin punch biopsy to confirm a skin cancer diagnosis. She should prioritize observing the site for:
A. Dehiscence
B. Infection
C. Bleeding
D. Swelling
A. Dehiscence
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98. She is caring for a client who sustained a cervical spinal cord injury. Which priority vital sign should she obtain?
A. Respiratory rate
B. Blood Pressure
C. Pulse
D. Temperature
A. Respiratory rate
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99. She is providing discharge instructions to a client prescribed phenazopyridine. Which of the following instructions should she include?
A. Discontinue this medication if urinary discoloration occurs
B. Take this medication on an empty stomach
C. This medication may increase the amount of urine you produce
D. Urine may have a reddish or orange coloration after taking this medication
D. Urine may have a reddish or orange coloration after taking this medication
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100. She cares for a client who is at risk of developing pressure ulcers. Which of the following would she recognize as accurate statements regarding pressure ulcers? Select all that apply.
A. In a stage II pressure ulcer, part of the dermis and epidermis are lost.
B. In a stage I pressure ulcer, there is a loss of integrity of the epidermis only.
C. In a stage III pressure ulcer, there is a deep tissue injury that can expose fat.
D. In a stage IV pressure ulcer, the base of the wound is covered by eschar.
E. Stage III involves extensive tissue damage and can lead to bone and muscle involvement.
C. In a stage III pressure ulcer, there is a deep tissue injury that can expose fat.
