Recalls 6 - NP3

Question 1

Situation: You’ll be working in the Medical Step-down Unit, where you expect to deal with numerous patients who have acid-base imbalances. To be thoroughly prepared as a professional nurse, you plan to review key information on how to manage various types of acid-base imbalances.

1. As a nurse you were taught how to evaluate arterial blood gas (ABG) values. Which of the following steps would you do FIRST?

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A. Evaluate HCO3
B. Evaluate pH
C. Determine acid base status

D. Evaluate PaCO2

Question 2

2. Which of the following conditions may cause metabolic acidosis due to a decrease in bicarbonate (HC03) level?
3. Loss of gastric fluids from vomiting or nasogastric suction
4. Loss of body fluids from drains below the umbilicus
5. Gastrointestinal fistulas
6. Aspirin ingestion

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A. 3 and 4
B. 1 and 2

C. 1 and 4
D. 2 and 3

Question 3

4. The nurse reviews the arterial blood gas results of a client and notes the following: pH 7.45, Paco2 of 30 mm Hg, and HCO3 of 20 mEq/L (20 mmol/L).

The nurse analyzes these results as indicating which condition?

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A. Metabolic acidosis, compensated
B. Respiratory alkalosis, compensated

C. Metabolic alkalosis, uncompensated
D. Respiratory acidosis, uncompensated

Answer 3

B. Respiratory alkalosis, compensated

Question 3

3. Jian, 30 years old, was brought to the Emergency Department (ED) with nausea confusion, dehydration and oliguria. Her mother informs you that Jian has been depressed after losing her job as a bank executive. An empty bottle of aspirin was found in her bathroom sink. Her laboratory values revealed the if.: pH = 7.35, PaCO2=16 mmHg, PaO2=130 mmHg, and HCO3=15mEq/L. What is the CORRECT acid-base interpretation of her ABG?

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A. Partially compensated respiratory acidosis
B. Uncompensated metabolic acidosis
C. Partially compensated metabolic: acidosis
D. Compensated metabolic acidosis.

Answer 3

D. Compensated metabolic acidosis.

Question 4

5. Anne, a client with a 3-day history of nausea and vomiting and suspected gastroenteritis presents to the emergency department. Anne is hypoventilating and has a respiratory rate of 10 breaths per minute. The electrocardiogram (ECG) monitor displays tachycardia, with a heart rate of 120 beats per minute. Arterial blood gases are drawn, and the nurse reviews the results, expecting to note which finding?

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A. A decreased pH and an increased Paco2

B. An increased pH and a decreased Paco2
C. A decreased pH and a decreased HCO3
D. An increased pH and an increased HCO3

Question 5

6. Nurse AVA is caring for a client having respiratory distress related to an anxiety attack. Recent arterial blood gas (ABG) values are pH = 7.53, Pao2 =72 mm Hg, Paco2 = 32 mm Hg, and HCO3 = 28 mEq/L (28 mmol/L). Which conclusion about the client would the nurse make?

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A. The client has acidotic blood.
B. The client is probably overreacting.
C. The client is fluid volume overloaded.
D. The client is probably hyperventilating.

Answer 5

D. The client is probably hyperventilating.

Question 6

Situation: Nurse Ces, an infectious control nurse, is caring for a client with Pulmonary Tuberculosis.

7. Which client has special risk factors that warrant testing for tuberculosis?

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A. 45-year-old Caucasian man who has been homeless for 2 years

B. 15-year-old Caucasian woman with asthma
C. 72-year-old woman who is a recent immigrant from Russia
D. 50-year-old Iowa farmer

Answer 6

A. 45-year-old Caucasian man who has been homeless for 2 years

Question 7

8. Nurse Ces knows that the priority action for a client admitted with a productive cough, weight loss, and a suspected diagnosis of tuberculosis is:

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A. Instruction on preventing disease transmission

B. Planning for frequent rest period
C. Recording accurate Intake and output
D. Reviewing current dietary patterns

Answer 7

A. Instruction on preventing disease transmission

Question 8

9. Nurse Ces concludes that an intradermal TB test result is positive in any person if the following is present:

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A. An induration of 15 mm or more

B. An induration of 10 cm or more
C. An induration of 5-9 mm
D. A hivelike vesicle

Answer 8

A. An induration of 15 mm or more

Question 9

10. A client with tuberculosis has a prescription for Myambutol (Ethambutol HCI). Nurse Ces should tell the client to notify the doctor immediately if he notices:

A. Gastric distress
B. Changes in hearing
C. Red discoloration of body fluids
D. Changes in color vision

Answer 9

D. Changes in color vision

Question 10

11. The Mantoux test is used to determine whether a person has been exposed to tuberculosis. If the test is positive, Nurse Ces will find a:

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A. Fluid filled vesicle

B. Sharply demarcated erythema
C. Central area of induration
D. Circular blanched area

Question 11

Situation: You are the nurse on duty caring for multiple patients with cardiac conditions.

12. A patient with a history of type 2 diabetes is admitted to the hospital with chest pain and is scheduled for a cardiac catheterization. Which medication should you withheld for 24 hours before the procedure and for 48 hours afterward?

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A. Glipizide
B. Metformin
C. Repaglinide
D. Regular insulin

Question 12

13. One of your clients is having a sinus bradycardia, with a heart rate of 45 beats per minute and blood pressure of 82/60 mm Hg, reports dizziness. Which intervention would you anticipate will be prescribed?

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A. Administer digoxin.

B. Defibrillate the client.
C. Continue to monitor the client.
D. Prepare for transcutaneous pacing.

Question 13

14. You are watching the cardiac monitor and notices that a client’s rhythm suddenly changes. There are no P waves, the QRS complexes are wide, and the ventricular rate is regular but more than 140 beats per minute. The nurse determines that the client is experiencing which dysrhythmia?

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A. Sinus tachycardia
B. Ventricular Fibrillation
C. Ventricular tachycardia
D. Premature ventricular contractions

Question 14

15. You are assisting to defibrillate a client in ventricular fibrillation. Which intervention is your priority after placing the pads on the client’s chest and before discharging the device?

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A. Ensure that the client has been intubated.
B. Set the defibrillator to “synchronize” mode.
C. Administer an amiodarone bolus.
D. Confirm the cardiac rhythm.

Answer 14

D. Confirm the cardiac rhythm.

Question 15

16. You noticed that your client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. Which finding would you anticipate when auscultating the client’s breath sounds?

A. Stridor
B. Crackles
C. Scattered rhonchi
D. Diminished breath sound

Answer 15

B. Crackles

Question 16

17. You are assessing the neurovascular status of a client who returned to the surgical nursing unit 4 hours ago after undergoing aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and edema. The pedal pulse is palpable. How would you interpret the client’s neurovascular status?

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A. The neurovascular status is expected because of increased blood flow through the leg.
B. The neurovascular status is moderately impaired, and the surgeon needs to be called.

C. The neurovascular status is slightly deteriorating and needs to be monitored for another hour.
D. The neurovascular status shows adequate arterial flow, but venous complications are arising.

Question 17

18. A client has frequent bursts of ventricular tachycardia on the cardiac monitor. Which factor is your highest priority with regard to this dysrhythmia?

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A. It can develop into ventricular fibrillation at any time.
B. It is almost impossible to convert to a normal rhythm.
C. It is uncomfortable for the client, giving a sense of impending doom.
D. It produces a high cardiac output with cerebral and myocardial ischemia

Question 18

19. Your client with ventricular fibrillation is about to be defibrillated. Which energy level (in joules, J) would you set on the monophasic defibrillator machine for the first delivery?

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A. 50 J
B. 120 J

C. 200 J
D. 360 J

Question 19

21. A client is wearing a continuous cardiac monitor, which begins to sound its alarm. You notice that there are no electrocardiographic complexes on the screen. Which is the priority nursing action?

A. Call a code.
B. Check the client’s status.
C. Call the primary health care provider.
D. Document the lack of complexes.

Answer 19

B. Check the client’s status.

Question 20

20. You are caring for a client who had a resection of an abdominal aortic aneurysm yesterday. The client has an intravenous (IV) infusion at a rate of 150 mL/hr, unchanged for the last 10 hours. The client’s urine output for the last 3 hours has been 90, 50, and 28 mL (28 mL is most recent). The client’s blood urea nitrogen level is 35 mg/dL (12.6 mmol/L), and the serum creatinine level is 1.8 mg/dL (159 mcmol/L), measured this morning. Which nursing action is your priority?

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A. Check the serum albumin level.
B. Check the urine specific gravity.
C. Continue to monitor urine output.
D. Call the primary health care provider.

Answer 20

D. Call the primary health care provider.

Question 21

22. You are evaluating a client’s response to cardioversion. Which assessment would be the priority?

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A. Blood pressure
B. Airway patency
C. Oxygen flow rate
D. Level of consciousness

Question 22

Situation: You are on shift, responsible for managing the care of several patients with various respiratory conditions.

23. A 12-year-old child with asthma is being treated for a severe asthma attack in the emergency room. What symptom should you specifically watch for, as it would signal a worsening of the child’s condition?

A. Warm, dry skin
B. Decreased wheezing
C. Pulse rate of 90 beats per minute
D. Respirations of 18 breaths per minute

Answer 22

B. Decreased wheezing

Question 23

24. An 8-year-old child undergoing home treatment for right lower lobe pneumonia calls the clinic with their parent, who reports that the child is experiencing discomfort on the right side and that ibuprofen is not providing relief. What guidance should you offer to the parent?

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A. Increase the dose of ibuprofen.
B. Increase the frequency of ibuprofen.
C. Encourage the child to lie on the left side.

D. Encourage the child to lie on the right side.

Question 24

25. A new parent is worried about sudden infant death syndrome (SIDS) and asks the nurse for guidance on the safest sleep position for their newborn. What position should you recommend for placing the infant?

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A. Side or prone
B. Back or prone
C. Stomach with the face turned
D. Back rather than on the stomach

Answer 24

D. Back rather than on the stomach

Question 25

26. You are discussing the immunization schedule with the parent of a child with cystic fibrosis. What information should you, as the nurse, provide to the parent regarding the child’s vaccinations?

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A. “The immunization schedule will need to be altered.”
B. “The child should not receive any hepatitis vaccines.”
C. “The child will receive all of the immunizations except for the polio series.”
D. “The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination.”

Answer 25

D. “The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination.”

Question 26

27. You are an emergency department nurse evaluating a child diagnosed with epiglottitis. What signs should you watch for to determine if the child may be experiencing an airway obstruction?

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A. The child exhibits nasal flaring and bradycardia.
B. The child is leaning forward, with the chin thrust out.

C. The child has a low-grade fever and complains of a sore throat.
D. The child is leaning backward, supporting self with the hands and arms.

Answer 26

B. The child is leaning forward, with the chin thrust out.

Question 27

28. A child with croup is being treated with a cool mist vaporizer in their hospital room. The child is visibly distressed, crying persistently, and attempting to leave the area. What should you do to address the child’s discomfort and ensure their safety?

A. Tell the parent that the child must stay in the tent.
B. Place a toy in the tent to make the child feel more comfortable.
C. Call the pediatrician and obtain a prescription for a mild sedative.
D. Let the parent hold the child and direct the cool mist over the child’s face.

Answer 27

D. Let the parent hold the child and direct the cool mist over the child’s face.

Question 28

29. You reviews the tuberculin skin test (TST) results for a 3-year-old child and notes an induration area measuring 10 mm. How should you interpret these results?

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A. Positive
B. Negative

C. Inconclusive
D. Definitive and requiring a repeat test

Question 29

30. The parent of a hospitalized 2-year-old child with viral laryngotracheobronchitis (croup) asks you why antibiotics were not prescribed by the doctor. How should you respond?

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A. “The child may be allergic to antibiotics.”
B. “The child is too young to receive antibiotics.”
C. “Antibiotics are not indicated unless a bacterial infection is present.”

D. “The child still has the maternal antibodies from birth and does not need antibiotics.”

Answer 29

C. “Antibiotics are not indicated unless a bacterial infection is present.”

Question 30

31. You are an emergency department nurse evaluating a patient who has experienced a blunt trauma to the chest. Which sign would suggest that the patient may have a pneumothorax?

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A. A low respiratory rate
B. Diminished breath sounds
C. The presence of a barrel chest
D. A sucking sound at the site of injury

Question 31

Situation: The nurse is preparing for an upcoming shift and decides to review her knowledge on various medications. She focuses on understanding the indications, side effects, and proper administration techniques for commonly used drugs in her unit.

32. A patient is prescribed guaifenesin. How would the nurse know the patient understands the correct way to take this medication if the patient describes which specific action?

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A. Take an extra dose if fever develops
B. Take the medication with meals only
C. Increase water intake when taking the medication

D. Decrease the amount of daily fluid intake

Answer 31

C. Increase water intake when taking the medication

Question 32

32. The nurse is getting ready to administer intravenous naloxone to a patient with an opioid overdose. What supportive medical equipment should the nurse ensure is available at the patient’s bedside?

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A. Nasogastric tube
B. Paracentesis tray
C. Resuscitation equipment

D. Central line insertion tray

Answer 32

C. Resuscitation equipment

Question 33

33. Zafirlukast is prescribed for a client with bronchial asthma. Which laboratory test does the nurse expect to be prescribed before the administration of this medication?

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A. Platelet count
B. Neutrophil count

C. Liver function tests
D. Complete blood count

Question 34

35. The nurse has provided a patient on ethambutol with information about the medication. How can the nurse confirm that the patient understands the instructions if the patient says they will promptly report which specific symptom?

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A. Impaired sense of hearing

B. Gastrointestinal side effects
C. Orange-red discoloration of body secretions
D. Difficulty in discriminating the color red from green

Question 35

34. A patient is about to start a 6-month course of isoniazid therapy. What should the nurse plan to teach the patient to do during their treatment?

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A. Use alcohol in small amounts only.
B. Report yellow eyes or skin immediately.

C. Increase intake of Swiss or aged cheeses.
D. Avoid vitamin supplements during therapy.

Answer 35

B. Report yellow eyes or skin immediately.

Question 36

36. A patient with atrial fibrillation is receiving a continuous heparin infusion at 1000 units/hr. Which lab result would signal to the nurse that the patient is receiving an effective therapeutic dose?

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A. Prothrombin time of 12.5 seconds
B. Activated partial thromboplastin time of 28 seconds
C. Activated partial thromboplastin time of 60 seconds

D. Activated partial thromboplastin time longer than 120 seconds

Answer 36

C. Activated partial thromboplastin time of 60 seconds

Question 37

37. The nurse provides discharge instructions to a patient with atrial fibrillation who is taking warfarin sodium. Which statement by the patient shows they require further education?

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A. “I will avoid alcohol consumption.”
B. “I will take coated aspirin for my headaches.”

C. “I will take my pills every day at the same time.”
D. “I have already called my family to pick up a MedicAlert bracelet.”

Answer 37

B. “I will take coated aspirin for my headaches.”

Question 38

38. The home health care nurse is visiting a patient with hypertension and high LDL cholesterol, whose serum cholesterol level is 420 mg/dL (11 mmol/L). The patient is prescribed warfarin, and the nurse provides education about the medication. Which statement by the patient indicates that further teaching is needed?

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A. “Constipation and bloating might be a problem.”
B. “I’ll continue to watch my diet and reduce my fats.”
C. “Walking a mile each day will help the whole process.”
D. “I’ll continue my nicotinic acid from the health food store.”

Answer 38

D. “I’ll continue my nicotinic acid from the health food store.”

Question 39

39. For a patient receiving intravenous heparin therapy for atrial fibrillation, which medication should the nurse ensure is readily available on the nursing unit?

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A. Vitamin K
B. Protamine sulfate

C. Potassium chloride
D. Aminocaproic acid

Answer 39

B. Protamine sulfate

Question 40

40. A patient on daily digoxin has a serum potassium level of 3 mEq/L (3 mmol/L) and reports anorexia. The cardiologist orders a serum digoxin level test. Which digoxin level would the nurse identify as being outside the therapeutic range?

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A. 0.5 ng/mL (0.63 nmol/L)
B. 0.8 ng/mL (1.02 nmol/L)
C. 0.9 ng/mL (1.14 nmol/L)
D. 2.2 ng/mL (2.8 nmol/L)

Answer 40

D. 2.2 ng/mL (2.8 nmol/L)

Question 41

41. Nurse Evelyn is assessing a patient newly diagnosed with COPD. The patient reports a chronic cough with sputum production. What assessment finding would she expect in this patient?

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A. Clear, thin sputum
B. Pink, frothy sputum

C. Yellow-green, thick sputum
D. Rust-colored sputum

Question 42

42. A patient with COPD is prescribed an inhaled corticosteroid. Nurse Evelyn instructs the patient on how to use the inhaler properly. Which statement by the patient indicates the need for further teaching?

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A. “I should rinse my mouth with water after using the inhaler.”
B. “I will use the inhaler before using my bronchodilator.”

C. “I will press down on the inhaler while I breathe in deeply.”
D. “I should wait at least 1 minute between puffs if instructed to take more than one.”

Answer 42

B. “I will use the inhaler before using my bronchodilator.”

Question 43

43. A patient with COPD is receiving supplemental oxygen therapy. Which observation would indicate that the patient might be experiencing oxygen toxicity?

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A. Cyanosis of the lips and fingertips
B. A decreased respiratory rate
C. Complaints of dry cough and substernal discomfort
D. Decreased oxygen saturation levels

Question 44

44. A patient with COPD is experiencing increased shortness of breath and has a history of frequent exacerbations. Nurse Evelyn is reviewing the patient’s medications. Which class of medication would she expect to be prescribed to help manage this patient’s symptoms?

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A. Antihistamines
B. Antibiotics
C. Bronchodilators

D. Antivirals

Answer 44

C. Bronchodilators

Question 45

45. A patient with COPD is participating in pulmonary rehabilitation. Nurse Evelyn is educating the patient about lifestyle changes to improve their condition. Which lifestyle modification would she most likely recommend?

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A. Increase daily intake of caffeine
B. Engage in regular physical activity

C. Avoid all dietary fats
D. Limit fluid intake to prevent congestion

Answer 45

B. Engage in regular physical activity

Question 46

Situation: Annaliza, a senior nurse, is reviewing her knowledge regarding delegation and task management.

46. Annaliza, a nurse in a busy Philippine hospital is delegating tasks to a team of nurses and nursing assistants. Which task should she delegate to a nursing assistant?

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A. Administering intravenous medications
B. Performing a comprehensive physical assessment
C. Assisting a patient with daily activities and basic care
D. Developing a care plan for a complex patient

Answer 46

C. Assisting a patient with daily activities and basic care

Question 47

47. The head nurse is reviewing the delegation process with a new nurse in a hospital in the Philippines. Which of the following principles should the nurse use to ensure effective delegation?

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A. Delegate tasks that require the nurse’s unique skills to unlicensed personnel
B. Ensure that the delegatee has the necessary competence and training for the task

C. Delegate all tasks to ensure that the workload is evenly distributed
D. Only delegate tasks that are easy and can be done quickly

Answer 47

B. Ensure that the delegatee has the necessary competence and training for the task

Question 48

48. Nurse Annaliza is dealing with a situation where a nursing assistant is frequently late for their shift. What is the most appropriate action for the nurse manager to take?

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A. Ignore the lateness if it does not affect patient care
B. Discuss the issue with the nursing assistant privately and address the pattern of lateness

C. Reprimand the nursing assistant publicly to set an example
D. Reassign the nursing assistant to a different shift without discussing the issue

Answer 48

B. Discuss the issue with the nursing assistant privately and address the pattern of lateness

Question 49

49. Nurse Annaliza is preparing to delegate a complex wound dressing change. Which aspect of delegation is critical for ensuring that the task is performed safely?

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A. Verifying that the task is within the scope of practice for the delegatee

B. Delegating the task without providing instructions
C. Only providing verbal instructions without written guidelines
D. Assuming that the delegatee knows how to perform the task without supervision

Answer 49

A. Verifying that the task is within the scope of practice for the delegatee

Question 50

50. A nurse manager in the Philippines needs to prioritize tasks for a busy unit. Which of the following tasks should the nurse manager prioritize?

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A. Completing paperwork for routine audits
B. Addressing a sudden change in a patient’s condition
C. Organizing a staff social event

D. Conducting a review of patient satisfaction surveys

Question 51

SITUATION: Sarah is a 55-year-old woman diagnosed with advanced gastric cancer. Over the past few weeks, she has experienced a significant decrease in appetite, persistent fatigue, dehydration, and weight loss of approximately 15 lbs. Due to her inability to consume food, Sarah has been admitted to the hospital for further evaluation and management.

51. What intervention should you identify as best to meet Sarah’s nutritional needs?

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A. Administration of parenteral feeds via a peripheral IV
B. TPN administered via a peripherally inserted central catheter

C. Insertion of an NG tube for administration of feeds
D. Maintaining NPO status and IV hydration until treatment completion

Answer 51

B. TPN administered via a peripherally inserted central catheter

Question 52

52. The method of nutrition administration is being initiated. Based on your nursing expertise, why is it necessary to begin the administration slowly?

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A. Patients receiving TPN are at risk for hypercalcemia if calories are started too rapidly.

B. Malnourished patients receiving parenteral nutrition are at risk for hypophosphatemia if calories are started too aggressively.
C. Malnourished patients who receive fluids too rapidly are at risk for hypernatremia.
D. Patients receiving TPN need a slow initiation of treatment in order to allow digestive enzymes to accumulate

Question 53

53. Which of the following nursing assessments most directly addresses a major complication of this kind of nutrition administration?

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A. Checking the patients capillary blood glucose levels regularly

B. Having the patient frequently rate his or her hunger on a 10-point scale
C. Measuring the patients heart rhythm at least every 6 hours
D. Monitoring the patients level of consciousness each shift

Answer 53

A. Checking the patients capillary blood glucose levels regularly

Question 54

54. In preparing a care plan for Sarah, what nursing diagnosis should the you prioritize?

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A. Risk for Activity Intolerance
B. Risk for Infection

C. Risk for Functional Urinary Incontinence
D. Risk for Sleep Deprivation

Answer 54

B. Risk for Infection

Question 55

55. Sarah suddenly complained of slight chest pain, dyspnea and appears cyanotic. You suspect that she is experiencing what possible IMMEDIATE complication?

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A. Sepsis due to IV line
B. Air embolism
C. Hyperglycemia
D. Fluid overload

Answer 55

B. Air embolism

Question 56

SITUATION: You are a nurse assigned to care for Mr. Thompson, a 72-year-old patient admitted to the medical-surgical ward with a diagnosis of COPD. Mr. Thompson has been experiencing increased shortness of breath, chronic cough, and fatigue, which have significantly impacted his daily activities.

57. As you perform your assessment, you auscultated diminished breath sounds which signify changes in the airway. In this case, what will you expect Mr. Thompson to have?

A. Kyphosis and clubbing of the fingers
B. Dyspnea and hypoxemia
C. Sepsis and pneumothorax
D. Bradypnea and pursed lip breathing

Answer 56

B. Dyspnea and hypoxemia

Question 57

56. What PRIORITY nursing action should you do with the presenting clinical manifestations of the patient?

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A. Report to the physician status Sarah at once.
B. Take Blood pressure and respiratory rate.
C. Stop temporarily the Total Parenteral Nutrition
D. Administer Oxygen inhalation.

Answer 57

C. Stop temporarily the Total Parenteral Nutrition

Question 58

58. You are providing palliative care to Mr. Thompson. What is your primary goal of doing this kind of nursing care?

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A. To improve the patients and family’s quality of life
B. To support aggressive and innovative treatments for cure
C. To provide physical support for the patient

D. To help the patient develop a separate plan with each discipline of the health care team

Question 59

59. You noticed that Mr. Thompson been receiving high-flow oxygen therapy since the last shift. What symptoms should you anticipate if Mr. Thompson is experiencing oxygen toxicity?

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A. Bradycardia and frontal headache
B. Dyspnea and substernal pain

C. Peripheral cyanosis and restlessness
D. Hypotension and tachycardia

Answer 59

B. Dyspnea and substernal pain

Question 60

60. You know that patients like Mr. Thompson requires a reliable and precise oxygen delivery. Which mask will you expect the physician to order?

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A. Non-rebreather air mask
B. Tracheostomy collar
C. Venturi mask

D. Face tent

Answer 60

C. Venturi mask

Question 61

61. Mr. Thompson asked what he could have done to minimize the risk of contracting this disease. What would be your best answer?

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A. The most important risk factor for COPD is exposure to occupational toxins.
B. The most important risk factor for COPD is inadequate exercise.
C. The most important risk factor for COPD is exposure to dust and pollen.
D. The most important risk factor for COPD is cigarette smoking.

Answer 61

D. The most important risk factor for COPD is cigarette smoking.

Question 62

63. You are developing the teaching portion of your care plan. What would be the most important component for you to emphasize?

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A. Smoking up to one-half of a pack of cigarettes weekly is allowable.
B. Chronic inhalation of indoor toxins can cause lung damage.
C. Minor respiratory infections are considered to be self-limited and are not treated.
D. Activities of daily living (ADLs) should be clustered in the early morning hours.

Question 62

62. You must ensure that you give appropriate nursing care to Mr. Thomson because you know that it can lead to which of the following complication?

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A. Lung cancer
B. Cystic fibrosis
C. Respiratory failure

D. Hemothorax

Answer 62

C. Respiratory failure

Question 63

64. Mr. Thompson is about to be discharged. When conducting a discharge teaching to client about breathing exercises, what should you include?

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A. Lie supine to facilitate air entry
B. Avoid pursed lip breathing
C. Use diaphragmatic breathing

D. Use chest breathing

Answer 63

C. Use diaphragmatic breathing

Question 64

65. Which of the following energy-conserving strategies should COPD patients avoid?

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A. Exhaling while pushing or exerting effort during daily activities
B. Assuming a tripod position with elbows supported on the table when shaving or combing hair
C. Inhaling when resting, sitting, or lying down
D. Standing in front of a mirror while shaving or combing hair

Answer 64

D. Standing in front of a mirror while shaving or combing hair

Question 65

SITUATION: Jerome, a 40-year-old male, has been diagnosed with Type 2 Diabetes Mellitus. He has a history of hypertension and obesity, and his family history includes diabetes. Jerome works a sedentary desk job and leads a relatively inactive lifestyle. His diet consists of high-calorie, high-fat foods, and he rarely engages in physical exercise.

66. Jerome has been regulating his blood glucose levels with dietary adjustments and metformin. If his daily metformin dose will be increased, what assessment should be your highest priority?

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A. Monitoring the patients neutrophil levels
B. Assessing the patient for signs of impaired liver function
C. Monitoring the patients level of consciousness and behavior

D. Reviewing the patients creatinine and BUN levels

Question 66

67. Knowing the current medication he is taking, which statement would warrant you the need for further teaching?

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A. “It is okay if I skip meals once in a while.”
B. “I need to let my doctor know if I get unusually tired.”
C. “I need to constantly watch for signs of low blood sugar.”
D. “I will be sure to not drink alcohol excessively while on this medication.”

Question 67

68. You already endorsed Jerome to the next shift nurse, who happens to be newly hired. Instead of metformin, the nurse administered 20 units of insulin. Jerome developed hypoglycemia and eventually died. If this occurs, the newly hired registered nurse is liable for:

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A. negligence
B. battery
C. malpractice

D. assault

Answer 67

C. malpractice

Question 68

69. He developed cardiovascular autonomic neuropathy (CAN). Which instruction would you provide for the nursing assistant assisting the patient with morning care?

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A. Provide a complete bed bath for this patient.
B. Sit the patient up slowly on the side of the bed before standing.

C. Only let the patient wash his or her face and brush his or her teeth.
D. Be sure to provide rest periods between activities.

Answer 68

B. Sit the patient up slowly on the side of the bed before standing.

Question 69

70. When preparing to review a teaching plan for Jerome, which value would be essential to check in order to assess his adherence to the prescribed diabetic regimen?

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A. Fasting glucose level
B. Oral glucose tolerance test results
C. Glycosylated hemoglobin (HgbA1c) level

D. Fingerstick glucose findings for 24 hours

Answer 69

C. Glycosylated hemoglobin (HgbA1c) level

Question 70

71. Jerome appears to have an altered level of consciousness and prominent signs of dehydration. His blood glucose level is found to be 623 mg/dL. His wife reports that he recently had amoebiasis and has been confused for the past 3 hours. The diagnosis of hyperglycemic hyperosmolar syndrome (HHS) has been made. What should be the priority nursing action?

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A. Administration of antihypertensive medications
B. Administering sodium bicarbonate intravenously
C. Reversing acidosis by administering insulin
D. Fluid and electrolyte replacement

Answer 70

D. Fluid and electrolyte replacement

Question 71

SITUATION: Ernalyn is a dedicated nurse employed at the National Kidney Center of the Kumpuruhus. With a compassionate heart and a keen eye for detail, she diligently monitors multiple patients with problems in genitourinary tract.

72. A client with end stage renal disease has been managed by peritoneal dialysis. Which finding should be reported to the doctor immediately?

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A. The amount of dialysate return is less than that instilled.
B. The client complains of abdominal pain and nausea.
C. The dialysate return is colorless in appearance.
D. The client has lost two pounds in the last week.

Question 72

73. One of the patient is admitted with a tentative diagnosis of bladder cancer. Which finding most likely contributed to the development of bladder cancer?

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A. Two PPD cigarette use for 25 years
B. Frequent urinary tract infections
C. Employment in the textile industry

D. A history of renal calculi

Question 73

74. Ernalyn is providing dietary instructions to an admitted client with oxalate renal calculi. Before discharge, the nurse conducted a health teaching session with the client about the permissible foods. Subsequently, the nurse asked the client to recall what was discussed. Which statement made by the patient would require further education?

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A. “I rely on coffee in the morning to kickstart my day and maintain productivity. The aroma of freshly brewed coffee permeates the kitchen, signaling the start of a new day.”
B. “I absolutely love my pizza extra cheesy, especially when it’s loaded with a blend of mozzarella, cheddar, and Parmesan cheese.”

C. “Mama, thank you very much! You know that I love chicken nuggets!”
D. “I used to struggle with watery stool, which is why I’ve made it a habit to eat a banana regularly after meals.”

Question 74

75. For which patient should Ernalyn be most concerned about the risk for developing kidney disease?

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A. A 25-year-old patient who developed a urinary tract infection during pregnancy
B. A 55-year-old patient with a history of kidney stones
C. A 63-year-old patient with type 2 diabetes
D. A 79-year-old patient with stress urinary incontinence

Answer 74

C. A 63-year-old patient with type 2 diabetes

Question 75

76. The aforementioned patient at risk for kidney disease is ordered to have a urinalysis. When would Ernalyn instruct the patient to collect this sample ideally?

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A. With first morning void
B. Before any meal
C. At bedtime
D. Immediately

Answer 75

A. With first morning void

Question 76

77. Ernalyn is admitting a 66-year-old male patient suspected of having a urinary tract infection. Which part of the patient’s medical history supports this diagnosis?

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A. Patient’s wife had a UTI 1 month ago
B. Followed for prostate disease for 2 years
C. Intermittent catheterization 6 months ago

D. Kidney stone removal 1 year ago

Question 77

78. Ernalyn is assigned to supervise a new graduate nurse who is orienting to the unit. The new nurse is conducting health teaching for a patient with a UTI on how to properly take the prescribed Ciprofloxacin. Which of the following statements by the nurse would not require Ernalyn to intervene?

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A. “We should check with the health care provider because the patient should take this drug until signs and symptoms of UTI is evident only.”
B. “A full course of ciprofloxacin is not the appropriate treatment for a patient with UTI.”
C. “It is better to take this medication after having your lunch.”
D. “Longer courses of ciprofloxacin therapy are required for hospitalized patients to prevent nosocomial infections.”

Answer 77

C. “It is better to take this medication after having your lunch.”

Question 78

79. The patient felt the impact of having a UTI. He asked nurse Ernalyn how he could have prevented it. Which of the following statements should not be included in the health teaching?

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A. “You should always drink 2 to 3 L of fluid every day.”
B. “Empty your bladder regularly even if you do not feel the urge to urinate.”
C. “Drinking cranberry juice daily will decrease the number of bacteria in your bladder.”
D. “It’s okay to soak in the tub with bubble bath because it will keep you clean.”

Answer 78

D. “It’s okay to soak in the tub with bubble bath because it will keep you clean.”

Question 79

80. A patient diagnosed with acute kidney failure had a urine output of 1560 mL for the past 8 hours. Lilo, a nursing assistant who is caring for this patient under the supervision of nurse Ernalyn asks how a patient with kidney failure can have such a large urine output. What is the nurse best response?

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A. “The patient’s kidney failure was caused by hypovolemia, and we have given him IV fluids to correct the problem.”
B. “Acute kidney failure patients go through a diuretic phase when their kidneys begin to recover and may put out as much as 10 L of urine per day.”
C. “With that much urine output, there must have been a mistake in the patient’s diagnosis.”
D. “An increase in urine output like this is an indicator that the patient is entering the recovery phase of acute kidney failure.”

Answer 79

B. “Acute kidney failure patients go through a diuretic phase when their kidneys begin to recover and may put out as much as 10 L of urine per day.”

Question 79

SITUATION: Mrs. Marites, a 72-year-old female, is admitted to the medical-surgical ward with worsening shortness of breath, fatigue, and swelling in her lower extremities. Over the past week, she has been unable to perform her daily activities without feeling extremely tired and breathless. Her medical history includes chronic heart failure. On assessment, her vital signs are as follows: blood pressure 150/90 mmHg, heart rate 110 beats per minute, respiratory rate 24 breaths per minute, and oxygen saturation 88% on room air.

81. Which of the following is the applicable nursing problem of Mrs. Marites?

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A. Activity intolerance
B. Ineffective family health management
C. Impaired verbal communication
D. Deficient knowledge

Answer 79

A. Activity intolerance

Question 80

82. What kind of nursing diagnosis does Mrs. Marites have?

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A. Risk Nursing Diagnosis
B. Health Promotion Diagnosis
C. Actual Nursing Diagnosis
D. Syndrome Diagnosis

Answer 80

C. Actual Nursing Diagnosis

Question 81

83. In making the nursing diagnosis, what could be the possible etiology of Mrs. Marites’ problem?

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A. Chronic Heart Failure
B. Decreased cardiac output
C. BP: 150/90 mmHg, HR: 110bpm, RR: 24bpm
D. Shortness of breath

Answer 81

B. Decreased cardiac output

Question 82

84. Which of the following patient outcomes show that the goal is met and the intervention made is effective?

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A. Patient demonstrates decreased anxiety
B. Patient makes sound decisions regarding care and treatment
C. Patient and family members adhere to healthy regimen
D. Patient demonstrates tolerance for desired activity

Answer 82

D. Patient demonstrates tolerance for desired activity

Question 83

SITUATION: Marou Pawk, a fourth-year nursing student on the verge of graduation, is exploring the various roles nurses can undertake. She is keen to understand the diverse responsibilities and opportunities available to her once she becomes a registered nurse.

85. A nurse can be responsible for creating staff schedules, delegating patient care tasks, and evaluating performance metrics. Additionally, she addresses staff concerns and ensures that shifts are covered appropriately. This role exemplifies:

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A. Researcher
B. Teacher
C. Manager
D. Leader

Answer 83

C. Manager

Question 83

86. During a patient’s discharge from the hospital, a nurse provides comprehensive instructions on how to manage their newly prescribed medications, including potential side effects and dietary restrictions. She also schedules follow-up appointments and explains the importance of each step in the care process. This role is an example of:

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A. Teacher
B. Caregiver
C. Leader
D. Communicator

Answer 83

A. Teacher

Question 83

87. A nurse provides physical assistance to a patient who is unable to move independently, helping with activities such as feeding and personal hygiene, while consistently respecting and upholding the patient’s dignity and personal preferences. This role is best described as:

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A. Caregiver
B. Teacher
C. Researcher
D. Communicator

Answer 83

A. Caregiver

Question 84

88. A nurse motivates a group of healthcare professionals to participate in a new wellness initiative aimed at reducing staff burnout. She leads by example, shares her experiences, and encourages others to adopt stress management techniques. This role exemplifies:

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A. Leader
B. Manager
C. Caregiver
D. Researcher

Answer 84

A. Leader

Question 85

89. A nurse provides emotional support to a patient undergoing cancer treatment, helping them navigate their feelings and develop coping strategies. She uses therapeutic communication to foster a trusting relationship and support the patient’s psychological well-being. This role exemplifies:

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A. Counselor
B. Manager
C. Leader
D. Change Agent

Answer 85

A. Counselor

Question 86

91. In a community health clinic, Nurse Juliet is working with diabetic clients to encourage healthier lifestyle choices. She organizes educational sessions on nutrition and exercise, providing personalized advice and support to help clients manage their condition effectively. Through her efforts, she fostered positive behavior changes in her clients. What role is the nurse demonstrating?

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A. Client advocate
B. Leader
C. Manager

D. Change agent

Question 86

90. When a patient decides against a recommended surgical procedure due to personal reasons, the nurse ensures that the patient’s decision is respected, provides alternative options, and stand for the patient’s right to make their own healthcare choices. This role is best described as:

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A. Client Advocate
B. Caregiver
C. Researcher
D. Teacher

Answer 86

A. Client Advocate

Question 87

92. After observing a patient’s unusual symptoms, she recalls similar cases from her experience and quickly predicts that the patient is likely experiencing a specific condition, which the medical team then confirms. This is an example of:

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A. Research Process
B. Intuition

C. Trial and Error
D. Critical Thinking

Answer 87

B. Intuition

Question 88

93. She encounters a new type of medical device and systematically reviews its operation manual, compares it with previous devices, and conducts a series of tests to understand its functionality. This approach is known as:

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A. Trial and Error
B. Intuition
C. Research Process
D. Critical Thinking

Question 89

94. Sandara Ting has a patient whose blood pressure readings are erratic. She initially tries adjusting the patient’s position to see if the blood pressure will change. However, the blood pressure remains elevated. He then recalibrated the blood pressure cuff and assessing for other factors to improve the patient’s blood pressure. This method demonstrates:

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A. Intuition
B. Research Process
C. Trial and Error
D. Critical Thinking

Answer 89

C. Trial and Error

Question 89

95. She reviews recent studies and evidence-based guidelines to develop a new care protocol for managing patients with chronic pain, aiming to improve patient outcomes. This systematic approach is an example of:

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A. Critical Thinking
B. Research Process
C. Intuition
D. Trial and Error

Answer 89

B. Research Process

Question 90

SITUATION: Nurse Chang Hai is actively engaged in nursing research at a renowned university hospital. As a researcher, she meticulously collects and analyzes data, collaborates with other healthcare professionals, and contributes to the development of evidence-based practices.

96. She performs a research study on the effectiveness of the use of warm saline solution as compared with the use of cool oatmeal bath to promote wound debridement among patients immediately chosen with crusty and scaly skin condition. The most appropriate research design is?

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A. Quasi-experimental research
B. Qualitative research
C. Experimental research

D. Descriptive research

Question 91

97. A study is entitled “Hypoglycemia: Its effect with the development and extent of developmental delay in the cohort of children with Type I DM”. A study uses insulin and a new drug therapy among patients immediately available in her ward. This is an example of:

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A. Experimental
B. Quasi experimental
C. Quantitative design

D. Ethnography

Question 92

98. Which of the following hypothesis is a statistical hypothesis?

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A. Compliance to dietary regimen is not associated with the level of educational attainment of patients
B. The amount of caloric restrictions hastens the reduction in body mass among obese patients
C. Weight loss is related with dietary restrictions
D. Dietary preferences affect rapid weight loss

Answer 92

A. Compliance to dietary regimen is not associated with the level of educational attainment of patients

Question 93

99. A research was initiated to determine the causes of anorexia and weight loss among patients with cancer. It is believed that the use of radiation and chemotherapy promote loss of lean body mass. The researcher decided to test the use of high protein intake to avoid decline in body weight among cancer patients and compares body mass with similar patients he handpicked from her ward who uses regular diet. The research design applicable is?

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A. descriptive
B. quasi experimental
C. phenomenological
D. Experimental

Question 94

100. An experimental approach in which neither the subjects nor the researcher is aware of who is in the experimental and control group?

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A. halo effects
B. double blind
C. experimenter’s effects
D. external validity

Answer 94

B. double blind