Pediatric Drill 7

Question 1. At a well baby clinic the nurse is assigned to assess an 8 month-old child. Which of these developmental achievements would the nurse anticipate that the child would be able to perform?

1. Say 2 words
2. Pull up to stand
3. Sit without support
4. Drink from a cup

Question 2. A polydrug user has been in recovery for 8 months. The client has began skipping breakfast and not eating regular dinners. The client has also started frequenting bars to "see old buddies." The nurse understands that the client’s behavior is a warning sign to indicate that the client may be

1. headed for relapse
2. feeling hopeless
3. approaching recovery
4. in need of increased socialization

Question 3. At the day treatment center a client diagnosed with Schizophrenia - Paranoid Type sits alone alertly watching the activities of clients and staff. The client is hostile when approached and asserts that the doctor gives her medication to control her mind. The client's behavior most likely indicates

1. Feelings of increasing anxiety related to paranoia
2. Social isolation related to altered thought processes
3. Sensory perceptual alteration related to withdrawal from environment
4. Impaired verbal communication related to impaired judgment

Question 4. When teaching adolescents about sexually transmitted diseases, what should the nurse emphasize that is the most common infection?

1. Gonorrhea
2. Chlamydia
3. Herpes
4. HIV

Question 5. A client is admitted with the diagnosis of meningitis. Which finding would the nurse expect in assessing this client?

1. Hyperextension of the neck with passive shoulder flexion
2. Flexion of the hip and knees with passive flexion of the neck
3. Flexion of the legs with rebound tenderness
4. Hyperflexion of the neck with rebound flexion of the legs



Question 6. A client is admitted with a diagnosis of hepatitis B. In reviewing the initial laboratory results, the nurse would expect to find elevation in which of the following values?

1. Blood urea nitrogen
2. Acid phosphatase
3. Bilirubin
4. Sedimentation rate

Question 7. A Hispanic client in the postpartum period refuses the hospital food because it is "cold." The best initial action by the nurse is to
1. Have the unlicensed assistive personnel (UAP) reheat the food if the client wishes
2. Ask the client what foods are acceptable or bad
3. Encourage her to eat for healing and strength
4. Schedule the dietitian to meet with the client as soon as possible

Question 8. What is the most important aspect to include when developing a home care plan for a client with severe arthritis?

1. Maintaining and preserving function
2. Anticipating side effects of therapy
3. Supporting coping with limitations
4. Ensuring compliance with medications

Question 9. A client is experiencing hallucinations that are markedly increased at night. The client is very frightened by the hallucinations. The client’s partner asked to stay a few hours beyond the visiting time, in the client’s private room. What would be the best response by the nurse demonstrating emotional support for the client?

1. "No, it would be best if you brought the client some reading material that she could read at night."
2. "No, your presence may cause the client to become more anxious."
3. "Yes, staying with the client and orienting her to her surroundings may decrease her anxiety."
4. "Yes, would you like to spend the night when the client’s behavior indicates that she is frightened?"

Question 10. During an examination of a 2 year-old child with a tentative diagnosis of Wilm's tumor, the nurse would be most concerned about which statement by the mother?

1. My child has lost 3 pounds in the last month.
2. Urinary output seemed to be less over the past 2 days.
3. All the pants have become tight around the waist.
4. The child prefers some salty foods more than others.

Question 11. The nurse is caring for a child receiving chest physiotherapy (CPT). Which of the following actions by the nurse would be appropriate?

1. Schedule the therapy thirty minutes after meals
2. Teach the child not to cough during the treatment
3. Confine the percussion to the rib cage area
4. Place the child in a prone position for the therapy

Question 12. The nurse is assessing a child for clinical manifestations of iron deficiency anemia. Which factor would the nurse recognize as cause for the findings?

1. Decreased cardiac output
2. Tissue hypoxia
3. Cerebral edema
4. Reduced oxygen saturation

Question 13. First-time parents bring their 5 day-old infant to the pediatrician's office because they are extremely concerned about its breathing pattern. The nurse assesses the baby and finds that the breath sounds are clear with equal chest expansion. The respiratory rate is 38-42 breaths per minute with occasional periods of apnea lasting 10 seconds in length. What is the correct analysis of these findings?


1. The pediatrician must examine the baby
2. Emergency equipment should be available
3. This breathing pattern is normal
4. A future referral may be indicated

Question 14. A victim of domestic violence states to the nurse, "If only I could change and be how my companion wants me to be, I know things would be different." Which would be the best response by the nurse?

1. "The violence is temporarily caused by unusual circumstances; don’t stop hoping for a change."
2. "Perhaps, if you understood the need to abuse, you could stop the violence."
3. "No one deserves to be beaten. Are you doing anything to provoke your spouse into beating you?"
4. "Batterers lose self-control because of their own internal reasons, not because of what their partner did or did not do."

Question 15. Post-procedure nursing interventions for electroconvulsive therapy include

1. Applying hard restraints if seizure occurs
2. Expecting client to sleep for 4 to 6 hours
3. Remaining with client until oriented
4. Expecting long-term memory loss

Question 16. Which type of accidental poisoning would the nurse expect to occur in children under age 6?

1. Oral ingestion
2. Topical contact
3. Inhalation
4. Eye splashes

Question 17. A mother asks the nurse if she should be concerned about the tendency of her child to stutter. What assessment data will be most useful in counseling the parent?

1. Age of the child
2. Sibling position in family
3. Stressful family events
4. Parental discipline strategies

Question 18. A client was admitted to the psychiatric unit with major depression after a suicide attempt. In addition to feeling sad and hopeless, the nurse would assess for

1. Anxiety, unconscious anger, and hostility
2. Guilt, indecisiveness, poor self-concept
3. Psychomotor retardation or agitation
4. Meticulous attention to grooming and hygiene

Question 19. A nurse is to present information about Chinese folk medicine to a group of student nurses. Based on this cultural belief, the nurse would explain that illness is attributed to the..

1. Yang, the positive force that represents light, warmth, and fullness
2. Yin, the negative force that represents darkness, cold, and emptiness
3. Use of improper hot foods, herbs and plants
4. A failure to keep life in balance with nature and others

Question 20. A pre-term newborn is to be fed breast milk through nasogastric tube. Why is breast milk preferred over formula for premature infants?

1. Contains less lactose
2. Is higher in calories/ounce
3. Provides antibodies
4. Has less fatty acid

Question 21. A nurse is caring for a client with multiple myeloma. Which of the following should be included in the plan of care?

1. Monitor for hyperkalemia
2. Place in protective isolation
3. Precautions with position changes
4. Administer diuretics as ordered

Question 22. The nurse assesses a client who has been re-admitted to the psychiatric in-patient unit for schizophrenia. His symptoms have been managed for several months with fluphenazine (Prolixin). Which should be a focus of the first assessment?

1. Stressors in the home
2. Medication compliance
3. Exposure to hot temperatures
4. Alcohol use

Question 23. A nurse is conducting a community wide seminar on childhood safety issues. Which of these children is at the highest risk for poisoning?

1. 9 month-old who stays with a sitter 5 days a week
2. 20 month-old who has just learned to climb stairs
3. 10 year-old who occasionally stays at home unattended
4. 15 year-old who likes to repair bicycles

Question 24. A 30 month-old child is admitted to the hospital unit. Which of the following toys would be appropriate for the nurse to select from the toy room for this child?

1. Cartoon stickers
2. Large wooden puzzle
3. Blunt scissors and paper
4. Beach ball

Question 25. Which nursing action is a priority as the plan of care is developed for a 7 year-old child hospitalized for acute glomerulonephritis?

1. Assess for generalized edema
2. Monitor for increased urinary output
3. Encourage rest during hyperactive periods
4. Note patterns of increased blood pressure

Question 26. The nurse is talking to parents about nutrition in school aged children. Which of the following is the most common nutritional disorder in this age group?

1. Bulimia
2. Anorexia
3. Obesity
4. Malnutrition

Question 27. The mother of a 15 month-old child asks the nurse to explain her child's lab results and how they show her child has iron deficiency anemia. The nurse's best response is

1. "Although the results are here, your doctor will explain them later."
2. "Your child has less red blood cells that carry oxygen."
3. "The blood cells that carry nutrients to the cells are too large."
4. "There are not enough blood cells in your child's circulation."

Question 28. The nurse is preparing a 5 year-old for a scheduled tonsillectomy and adenoidectomy. The parents are anxious and concerned about the child's reaction to impending surgery. Which nursing intervention would be best to prepare the child?

1. Introduce the child to all staff the day before surgery
2. Explain the surgery 1 week prior to the procedure
3. Arrange a tour of the operating and recovery rooms
4. Encourage the child to bring a favorite toy to the hospital

Question 29. A 38 year-old female client is admitted to the hospital with an acute exacerbation of asthma. This is her third admission for asthma in 7 months. She describes how she doesn't really like having to use her medications all the time. Which explanation by the nurse best describes the long-term consequence of uncontrolled airway inflammation?

1. Degeneration of the alveoli
2. Chronic bronchoconstriction of the large airways
3. Lung remodeling and permanent changes in lung function
4. Frequent pneumonia

Question 30. In a child with suspected coarctation of the aorta, the nurse would expect to find

1. Strong pedal pulses
2. Diminishing cartoid pulses
3. Normal femoral pulses
4. Bounding pulses in the arms

Question 31. A 2 year-old child has just been diagnosed with cystic fibrosis. The child's father asks the nurse "What is our major concern now, and what will we have to deal with in the future?" Which of the following is the best response?

1. "There is a probability of life-long complications."
2. "Cystic fibrosis results in nutritional concerns that can be dealt with."
3. "Thin, tenacious secretions from the lungs are a constant struggle in cystic fibrosis."
4. "You will work with a team of experts and also have access to a support group that the family can attend."

Question 32. The nurse should recognize that physical dependence is accompanied by what findings when alcohol consumption is first reduced or ended?

1. Seizures
2. Withdrawal
3. Craving
4. Marked Tolerance

Question 33. A client is admitted with a pressure ulcer in the sacral area. The partial thickness wound is 4cm by 7cm, the wound base is red and moist with no exudate and the surrounding skin is intact. Which of the following coverings is most appropriate for this wound?
1. Transparent dressing
2. Dry sterile dressing with antibiotic ointment
3. Wet to dry dressing
4. Occlusive moist dressing

Question 34. The nurse is caring for residents in a long term care setting for the elderly. Which of the following activities will be most effective in meeting the growth and development needs for persons in this age group?

1. Aerobic exercise classes
2. Transportation for shopping trips
3. Reminiscence groups
4. Regularly scheduled social activities

Question 35. The client who is receiving enteral nutrition through a gastrostomy tube has had 4 diarrhea stools in the past 24 hours. The nurse should

1. Review the medications the client is receiving
2. Increase the formula infusion rate
3. Increase the amount of water used to flush the tube
4. Attach a rectal bag to protect the skin

Question 36. The nurse assesses delayed gross motor development in a 3 year-old child. The inability of the child to do which action confirms this finding?

1. Stand on 1 foot
2. Catch a ball
3. Skip on alternate feet
4. Ride a bicycle

Question 37. The nurse is talking with a client. The client abruptly says to the nurse, "The moon is full. Astronauts walk on the moon. Walking is a good health habit." The client’s behavior most likely indicates

1. Neologisms
2. Dissociation
3. Flight of ideas
4. Word salad

Question 38. A client was admitted to the psychiatric unit with a diagnosis of bipolar disorder. He constantly bothers other clients, tries to help the housekeeping staff, demonstrates pressured speech and demands constant attention from the staff. Which activity would be best for the client?

1. Reading
2. Checkers
3. Cards
4. Ping-pong

Question 40. During the evaluation phase for a client, the nurse should focus on

1. All finding of physical and psychosocial stressors of the client and in the family
2. The client's status, progress toward goal achievement, and ongoing re-evaluation
3. Setting short and long-term goals to insure continuity of care from hospital to home
4. Select interventions that are measurable and achievable within selected timeframes

Question 41. The nurse is caring for a client with an unstable spinal cord injury at the T7 level. Which intervention should take priority in planning care?

1. Increase fluid intake to prevent dehydration
2. Place client on a pressure reducing support surface
3. Use skin care products designed for use with incontinence
4. Increase caloric intake to aid healing

Question 42. The nurse admits a client newly diagnosed with hypertension. What is the best method for assessing the blood pressure?

1. Standing and sitting
2. In both arms
3. After exercising
4. Supine position

Question 43. (In planning care for a child diagnosed with minimal change nephrotic syndrome, the nurse should understand the relationship between edema formation and

1. Increased retention of albumin in the vascular system
2. Decreased colloidal osmotic pressure in the capillaries
3. Fluid shift from interstitial spaces into the vascular space
4. Reduced tubular reabsorption of sodium and water

Question 44. The nurse is making a home visit to a client with chronic obstructive pulmonary disease (COPD). The client tells the nurse that he used to be able to walk from the house to the mailbox without difficulty. Now, he has to pause to catch his breath halfway through the trip. Which diagnosis would be most appropriate for this client based on this assessment?

1.. Activity intolerance caused by fatigue related to chronic tissue hypoxia
2. Impaired mobility related to chronic obstructive pulmonary disease
3. Self care deficit caused by fatigue related to dyspnea
4. Ineffective airway clearance related to increased bronchial secretions

Question 45. The nurse is caring for a client who has developed cardiac tamponade. Which finding would the nurse anticipate?

1. Widening pulse pressure
2. Pleural friction rub
3. Distended neck veins
4. Bradycardia

Question 46. A mother wants to switch her 9 month-old infant from an iron-fortified formula to whole milk because of the expense. Upon further assessment, the nurse finds that the baby eats table foods well, but drinks less milk than before. What is the best advice by the nurse?

1. Change the baby to whole milk
2. Add chocolate syrup to the bottle
3. Continue with the present formula
4. Offer fruit juice frequently

Question 47. A 65-year-old Hispanic-Latino client with prostate cancer rates his pain as a 6 on a 0-to-10 scale. The client refuses all pain medication other than Motrin, which does not relieve his pain. The next action for the nurse to take is to

1. Ask the client about the refusal of certain pain medications
2. Talk with the client's family about the situation
3. Report the situation to the health care provider
4. Document the situation in the notes

Question 48. Privacy and confidentiality of all client information is legally protected. In which of these situations would the nurse make an exception to this practice?

1. When a family member offers information about their loved one
2. When the client threatens self-harm and harm to others
3. When the health care provider decides the family has a right to know the client's diagnosis
4. When a visitor insists that the visitor has been given permission by the client

Question 49. At the geriatric day care program a client is crying and repeating "I want to go home. Call my daddy to come for me." The nurse should

1. Invite the client to join the exercise group
2. Tell the client you will call someone to come for her
3. Give the client simple information about what she will be doing
4. Firmly direct the client to her assigned group activity

Question 50. Which of the following nursing assessments in an infant is most valuable in identifying serious visual defects?

1. Red reflex test
2. Visual acuity
3. Pupil response to light
4. Cover test


ANSWERS

Pediatric Drill 7 answers

Question 1. At a well baby clinic the nurse is assigned to assess an 8 month-old child. Which of these developmental achievements would the nurse anticipate that the child would be able to perform?

1. Say 2 words
2. Pull up to stand
3. Sit without support
4. Drink from a cup

Looking for answers(s):3
Explanation: The correct answer is Sit without support The age at which the normal child develops the ability to sit steadily without support is 8 months.

Question 2. A polydrug user has been in recovery for 8 months. The client has began skipping breakfast and not eating regular dinners. The client has also started frequenting bars to "see old buddies." The nurse understands that the client’s behavior is a warning sign to indicate that the client may be

1. headed for relapse
2. feeling hopeless
3. approaching recovery
4. in need of increased socialization

Looking for answers(s):1
Explanation: The correct answer is headed for relapse It takes 9 to 15 months to adjust to a lifestyle free of chemical use, thus it is important for clients to acknowledge that relapse is a possibility and to identify early signs of relapse.

Question 3. At the day treatment center a client diagnosed with Schizophrenia - Paranoid Type sits alone alertly watching the activities of clients and staff. The client is hostile when approached and asserts that the doctor gives her medication to control her mind. The client's behavior most likely indicates

1. Feelings of increasing anxiety related to paranoia
2. Social isolation related to altered thought processes
3. Sensory perceptual alteration related to withdrawal from environment
4. Impaired verbal communication related to impaired judgment

Looking for answers(s):2
Explanation: The correct answer is Social isolation related to altered thought processes Hostility and absence of involvement are data supporting a diagnosis of social isolation. Her psychiatric diagnosis and her idea about the purpose of medication suggests altered thinking

Question 4. When teaching adolescents about sexually transmitted diseases, what should the nurse emphasize that is the most common infection?

1. Gonorrhea
2. Chlamydia
3. Herpes
4. HIV

Looking for answers(s):2
Explanation: The correct answer is Chlamydia Chlamydia has the highest incidence of any sexually transmitted disease in this country. Prevention is similar to safe sex practices taught to prevent any STD: use of a condom and spermicide for protection during intercourse.

Question 5. A client is admitted with the diagnosis of meningitis. Which finding would the nurse expect in assessing this client?

1. Hyperextension of the neck with passive shoulder flexion
2. Flexion of the hip and knees with passive flexion of the neck
3. Flexion of the legs with rebound tenderness
4. Hyperflexion of the neck with rebound flexion of the legs

Looking for answers(s):2
Explanation: The correct answer is Flexion of the hip and knees with passive flexion of the neck. A positive Brudzinski’s sign—flexion of hip and knees with passive flexion of the neck; a positive Kernig’s sign—inability to extend the knee to more than 135 degrees, without pain behind the knee, while the hip is flexed usually establishes the diagnosis of meningitis.

Question 6. A client is admitted with a diagnosis of hepatitis B. In reviewing the initial laboratory results, the nurse would expect to find elevation in which of the following values?

1. Blood urea nitrogen
2. Acid phosphatase
3. Bilirubin
4. Sedimentation rate

Looking for answers(s):3
Explanation: The correct answer is Bilirubin In the laboratory data provided, the only elevated level expected is bilirubin. Additional liver function tests will confirm the diagnosis.

Question 7. A Hispanic client in the postpartum period refuses the hospital food because it is "cold." The best initial action by the nurse is to
1. Have the unlicensed assistive personnel (UAP) reheat the food if the client wishes
2. Ask the client what foods are acceptable or bad
3. Encourage her to eat for healing and strength
4. Schedule the dietitian to meet with the client as soon as possible

Looking for answers(s):2
Explanation: The correct answer is B: Ask the client what foods are acceptable Many Hispanic women subscribe to the balance of hot and cold foods in the post partum period. What defines "cold" can best be explained by the client or family.

Question 8. What is the most important aspect to include when developing a home care plan for a client with severe arthritis?

1. Maintaining and preserving function
2. Anticipating side effects of therapy
3. Supporting coping with limitations
4. Ensuring compliance with medications

Looking for answers(s):1
Explanation: The correct answer is Maintaining and preserving function To maintain quality of life, the plan for care must emphasize preserving function. Proper body positioning and posture and active and passive range of motion exercises important interventions for maintaining function of affected joints.

Question 9. A client is experiencing hallucinations that are markedly increased at night. The client is very frightened by the hallucinations. The client’s partner asked to stay a few hours beyond the visiting time, in the client’s private room. What would be the best response by the nurse demonstrating emotional support for the client?

1. "No, it would be best if you brought the client some reading material that she could read at night."
2. "No, your presence may cause the client to become more anxious."
3. "Yes, staying with the client and orienting her to her surroundings may decrease her anxiety."
4. "Yes, would you like to spend the night when the client’s behavior indicates that she is frightened?"

Looking for answers(s):3
Explanation: The correct answer is "Yes, staying with the client and orienting her to her surroundings may decrease her anxiety."Encouraging the family or a close friend to stay with the client in a quiet surrounding can help increase orientation and minimize confusion and anxiety.

Question 10. During an examination of a 2 year-old child with a tentative diagnosis of Wilm's tumor, the nurse would be most concerned about which statement by the mother?

1. My child has lost 3 pounds in the last month.
2. Urinary output seemed to be less over the past 2 days.
3. All the pants have become tight around the waist.
4. The child prefers some salty foods more than others.

Looking for answers(s):3
Explanation: The correct answer is Clothing has become tight around the waist Parents often recognize the increasing abdominal girth first. This is an early sign of Wilm''s tumor, a malignant tumor of the kidney.

Question 11. The nurse is caring for a child receiving chest physiotherapy (CPT). Which of the following actions by the nurse would be appropriate?

1. Schedule the therapy thirty minutes after meals
2. Teach the child not to cough during the treatment
3. Confine the percussion to the rib cage area
4. Place the child in a prone position for the therapy

Looking for answers(s):3
Explanation: The correct answer is Confine the percussion to the rib cage area Percussion (clapping) should be only done in the area of the rib cage.

Question 12. The nurse is assessing a child for clinical manifestations of iron deficiency anemia. Which factor would the nurse recognize as cause for the findings?

1. Decreased cardiac output
2. Tissue hypoxia
3. Cerebral edema
4. Reduced oxygen saturation

Looking for answers(s):2
Explanation: The correct answer is Tissue hypoxia When the hemoglobin falls sufficiently to produce clinical manifestations, the findings are directly attributable to tissue hypoxia, a decrease in the oxygen carrying capacity of the blood.

Question 13. First-time parents bring their 5 day-old infant to the pediatrician's office because they are extremely concerned about its breathing pattern. The nurse assesses the baby and finds that the breath sounds are clear with equal chest expansion. The respiratory rate is 38-42 breaths per minute with occasional periods of apnea lasting 10 seconds in length. What is the correct analysis of these findings?


1. The pediatrician must examine the baby
2. Emergency equipment should be available
3. This breathing pattern is normal
4. A future referral may be indicated

Looking for answers(s):3
Explanation: The correct answer is This breathing pattern is normal Respiratory rate in a newborn is 30-60 breaths/minute and periods of apnea often occur, lasting up to 15 seconds. The nurse should reassure the parents that this is normal to allay their anxiety.

Question 14. A victim of domestic violence states to the nurse, "If only I could change and be how my companion wants me to be, I know things would be different." Which would be the best response by the nurse?

1. "The violence is temporarily caused by unusual circumstances; don’t stop hoping for a change."
2. "Perhaps, if you understood the need to abuse, you could stop the violence."
3. "No one deserves to be beaten. Are you doing anything to provoke your spouse into beating you?"
4. "Batterers lose self-control because of their own internal reasons, not because of what their partner did or did not do."

Looking for answers(s):4
Explanation: The correct answer is "Batterers lose self-control because of their own internal reasons, not because of what their partner did or did not do." Only the perpetrator has the ability to stop the violence. A change in the victim’s behavior will not cause the abuser to become nonviolent.

Question 15. Post-procedure nursing interventions for electroconvulsive therapy include

1. Applying hard restraints if seizure occurs
2. Expecting client to sleep for 4 to 6 hours
3. Remaining with client until oriented
4. Expecting long-term memory loss

Looking for answers(s):3
Explanation: The correct answer is Remaining with client until oriented Client awakens post-procedure 20-30 minutes after treatment and appears groggy and confused. The nurse remains with the client until the client is oriented and able to engage in self care.

Question 16. Which type of accidental poisoning would the nurse expect to occur in children under age 6?

1. Oral ingestion
2. Topical contact
3. Inhalation
4. Eye splashes
Looking for answers(s):1
Explanation: The correct answer is Oral ingestion The greatest risk for young children is from oral ingestion. While children under age 6 may come in contact with other poisons or inhale toxic fumes, these are not common.

Question 17. A mother asks the nurse if she should be concerned about the tendency of her child to stutter. What assessment data will be most useful in counseling the parent?

1. Age of the child
2. Sibling position in family
3. Stressful family events
4. Parental discipline strategies

Looking for answers(s):1
Explanation: The correct answer is Age of the child During the preschool period children are using their rapidly growing vocabulary faster than they can produce their words. This failure to master sensorimotor integrations results in stuttering. This dysfluency in speech pattern is a normal characteristic of language development. Therefore, knowing the child''s age is most important in determining if any true dysfunction might be occurring.

Question 18. A client was admitted to the psychiatric unit with major depression after a suicide attempt. In addition to feeling sad and hopeless, the nurse would assess for

1. Anxiety, unconscious anger, and hostility
2. Guilt, indecisiveness, poor self-concept
3. Psychomotor retardation or agitation
4. Meticulous attention to grooming and hygiene

Looking for answers(s):3
Explanation: The correct answer is Psychomotor retardation or agitation Somatic or physiologic symptoms of depression include: fatigue, psychomotor retardation or psychomotor agitation, chronic generalized or local pain, sleep disturbances, disturbances in appetite, gastrointestinal complaints and impaired libido.

Question 19. A nurse is to present information about Chinese folk medicine to a group of student nurses. Based on this cultural belief, the nurse would explain that illness is attributed to the..

1. Yang, the positive force that represents light, warmth, and fullness
2. Yin, the negative force that represents darkness, cold, and emptiness
3. Use of improper hot foods, herbs and plants
4. A failure to keep life in balance with nature and others

Looking for answers(s):2
Explanation: The correct answer is B: Yin, the negative force that represents darkness, cold, and emptiness. Chinese folk medicine proposes that health is regulated by the opposing forces of yin and yang. Yin is the negative female force characterized by darkness, cold and emptiness. Excessive yin predisposes one to nervousness.
Question 20. A pre-term newborn is to be fed breast milk through nasogastric tube. Why is breast milk preferred over formula for premature infants?

1. Contains less lactose
2. Is higher in calories/ounce
3. Provides antibodies
4. Has less fatty acid

Looking for answers(s):3
Explanation: The correct answer is Provides antibodies Breast milk is ideal for the preterm baby who needs additional protection against infection through maternal antibodies. It is also much easier to digest, therefore less residual is left in the infant''s stomach.

Question 21. A nurse is caring for a client with multiple myeloma. Which of the following should be included in the plan of care?

1. Monitor for hyperkalemia
2. Place in protective isolation
3. Precautions with position changes
4. Administer diuretics as ordered

Looking for answers(s):3
Explanation: The correct answer is Precautions with position changes Because multiple myeloma is a condition in which neoplastic plasma cells infiltrate the bone marrow resulting in osteoporosis, client’s are at high risk for pathological fractures.

Question 22. The nurse assesses a client who has been re-admitted to the psychiatric in-patient unit for schizophrenia. His symptoms have been managed for several months with fluphenazine (Prolixin). Which should be a focus of the first assessment?

1. Stressors in the home
2. Medication compliance
3. Exposure to hot temperatures
4. Alcohol use

Looking for answers(s):2
Explanation: The correct answer is Medication compliance Prolixin is an antipsychotic / neuroleptic medication useful in managing the symptoms of Schizophrenia. Compliance with daily doses is a critical assessment.

Question 23. A nurse is conducting a community wide seminar on childhood safety issues. Which of these children is at the highest risk for poisoning?

1. 9 month-old who stays with a sitter 5 days a week
2. 20 month-old who has just learned to climb stairs
3. 10 year-old who occasionally stays at home unattended
4. 15 year-old who likes to repair bicycles

Looking for answers(s):2
Explanation: The correct answer is Twenty month-old who has just learned to climb stairs. Toddlers are at most risk for poisoning because they are increasingly mobile, need to explore and engage in autonomous behavior.

Question 24. A 30 month-old child is admitted to the hospital unit. Which of the following toys would be appropriate for the nurse to select from the toy room for this child?

1. Cartoon stickers
2. Large wooden puzzle
3. Blunt scissors and paper
4. Beach ball

Looking for answers(s):2
Explanation: The correct answer is Large wooden puzzle Appropriate toys for this child''s age include items such as push-pull toys, blocks, pounding board, toy telephone, puppets, wooden puzzles, finger paint, and thick crayons.

Question 25. Which nursing action is a priority as the plan of care is developed for a 7 year-old child hospitalized for acute glomerulonephritis?

1. Assess for generalized edema
2. Monitor for increased urinary output
3. Encourage rest during hyperactive periods
4. Note patterns of increased blood pressure

Looking for answers(s):4
Explanation: The correct answer is Note patterns of increased blood pressure Hypertension is a key assessment in the course of the disease.

Question 26. The nurse is talking to parents about nutrition in school aged children. Which of the following is the most common nutritional disorder in this age group?

1. Bulimia
2. Anorexia
3. Obesity
4. Malnutrition

Looking for answers(s):3
Explanation: The correct answer is Obesity Many factors contribute to the high rate of obesity in school aged children. These include heredity, sedentary lifestyle, social and cultural factors and poor knowledge of balanced nutrition.
Question 27. The mother of a 15 month-old child asks the nurse to explain her child's lab results and how they show her child has iron deficiency anemia. The nurse's best response is

1. "Although the results are here, your doctor will explain them later."
2. "Your child has less red blood cells that carry oxygen."
3. "The blood cells that carry nutrients to the cells are too large."
4. "There are not enough blood cells in your child's circulation."

Looking for answers(s):2
Explanation: The correct answer is "Your child has less red blood cells that carry oxygen." The results of a complete blood count in clients with iron deficiency anemia will show decreased red blood cell levels, low hemoglobin levels and microcytic, hypochromic red blood cells. A simple but clear explanation is appropriate.

Question 28. The nurse is preparing a 5 year-old for a scheduled tonsillectomy and adenoidectomy. The parents are anxious and concerned about the child's reaction to impending surgery. Which nursing intervention would be best to prepare the child?

1. Introduce the child to all staff the day before surgery
2. Explain the surgery 1 week prior to the procedure
3. Arrange a tour of the operating and recovery rooms
4. Encourage the child to bring a favorite toy to the hospital

Looking for answers(s):2
Explanation: The correct answer is Explain the surgery 1 week prior to the procedure A 5 year-old can understand the surgery, and should be prepared well before the procedure. Most of these procedures are "same day" surgeries and do not require an overnight stay.

Question 29. A 38 year-old female client is admitted to the hospital with an acute exacerbation of asthma. This is her third admission for asthma in 7 months. She describes how she doesn't really like having to use her medications all the time. Which explanation by the nurse best describes the long-term consequence of uncontrolled airway inflammation?

1. Degeneration of the alveoli
2. Chronic bronchoconstriction of the large airways
3. Lung remodeling and permanent changes in lung function
4. Frequent pneumonia

Looking for answers(s):3
Explanation: The correct answer is Lung remodeling and permanent changes in lung function While an asthma attack is an acute event from which lung function essentially returns to normal, chronic under-treated asthma can lead to lung remodeling and permanent changes in lung function. Increased bronchial vascular permeability leads to chronic airway edema which leads to mucosal thickening and swelling of the airway. Increased mucous secretion and viscosity may plug airways, leading to airway obstruction. Changes in the extracellular matrix in the airway wall may also lead to airway obstruction. These long-term consequences should help you to reinforce the need for daily management of the disease whether or not the patient "feels better".

Question 30. In a child with suspected coarctation of the aorta, the nurse would expect to find

1. Strong pedal pulses
2. Diminishing cartoid pulses
3. Normal femoral pulses
4. Bounding pulses in the arms

Looking for answers(s):4
Explanation: The correct answer is Bounding pulses in the arms Coarctation of the aorta, a narrowing or constriction of the descending aorta, causes increased flow to the upper extremities (increased pressure and pulses)

Question 31. A 2 year-old child has just been diagnosed with cystic fibrosis. The child's father asks the nurse "What is our major concern now, and what will we have to deal with in the future?" Which of the following is the best response?

1. "There is a probability of life-long complications."
2. "Cystic fibrosis results in nutritional concerns that can be dealt with."
3. "Thin, tenacious secretions from the lungs are a constant struggle in cystic fibrosis."
4. "You will work with a team of experts and also have access to a support group that the family can attend."

Looking for answers(s):3
Explanation: The correct answer is "Thin, tenacious secretions from the lungs are a constant struggle in cystic fibrosis." All of the options will be concerns with cystic fibrosis, however the respiratory threats are the major concern in these clients. Other information of interest is that cystic fibrosis is an autosomal recessive disease. There is a 25% chance that each of these parent''s pregnancies will result in a child with systic fibrosis.

Question 32. The nurse should recognize that physical dependence is accompanied by what findings when alcohol consumption is first reduced or ended?

1. Seizures
2. Withdrawal
3. Craving
4. Marked Tolerance

Looking for answers(s):2
Explanation: The correct answer is Withdrawal The early signs of alcohol withdrawal develop within a few hours after cessation or reduction of alchohol intake.

Question 33. A client is admitted with a pressure ulcer in the sacral area. The partial thickness wound is 4cm by 7cm, the wound base is red and moist with no exudate and the surrounding skin is intact. Which of the following coverings is most appropriate for this wound?
1. Transparent dressing
2. Dry sterile dressing with antibiotic ointment
3. Wet to dry dressing
4. Occlusive moist dressing

Looking for answers(s):4
Explanation: The correct answer is Occlusive moist dressing This wound has granulation tissue present and must be protected. The use of a moisture retentive dressing is the best choice because moisture supports wound healing.

Question 34. The nurse is caring for residents in a long term care setting for the elderly. Which of the following activities will be most effective in meeting the growth and development needs for persons in this age group?

1. Aerobic exercise classes
2. Transportation for shopping trips
3. Reminiscence groups
4. Regularly scheduled social activities

Looking for answers(s):3
Explanation: The correct answer is Reminiscence groups According to Erikson''s theory, older adults need to find and accept the meaningfulness of their lives, or they may become depressed, angry, and fear death. Reminiscing contributes to successful adaptation by maintaining self-esteem, reaffirming identity, and working through loss.

Question 35. The client who is receiving enteral nutrition through a gastrostomy tube has had 4 diarrhea stools in the past 24 hours. The nurse should

1. Review the medications the client is receiving
2. Increase the formula infusion rate
3. Increase the amount of water used to flush the tube
4. Attach a rectal bag to protect the skin

Looking for answers(s):1
Explanation: The correct answer is Review the medications the client is receiving Antibiotics and medications containing sorbitol may induce diarrhea.

Question 36. The nurse assesses delayed gross motor development in a 3 year-old child. The inability of the child to do which action confirms this finding?

1. Stand on 1 foot
2. Catch a ball
3. Skip on alternate feet
4. Ride a bicycle

Looking for answers(s):1
Explanation: The correct answer is Stand on 1 foot At this age, gross motor development allows a child to balance on 1 foot.

Question 37. The nurse is talking with a client. The client abruptly says to the nurse, "The moon is full. Astronauts walk on the moon. Walking is a good health habit." The client’s behavior most likely indicates

1. Neologisms
2. Dissociation
3. Flight of ideas
4. Word salad

Looking for answers(s):3
Explanation: The correct answer is Flight of ideas Flight of ideas - defines nearly continuous flow of speech, jumping from 1 topic to another.

Question 38. A client was admitted to the psychiatric unit with a diagnosis of bipolar disorder. He constantly bothers other clients, tries to help the housekeeping staff, demonstrates pressured speech and demands constant attention from the staff. Which activity would be best for the client?

1. Reading
2. Checkers
3. Cards
4. Ping-pong

Looking for answers(s):4
Explanation: The correct answer is Ping-pong This provides an outlet for physical energy and requires limited attention.

Question 40. During the evaluation phase for a client, the nurse should focus on

1. All finding of physical and psychosocial stressors of the client and in the family
2. The client's status, progress toward goal achievement, and ongoing re-evaluation
3. Setting short and long-term goals to insure continuity of care from hospital to home
4. Select interventions that are measurable and achievable within selected timeframes
Looking for answers(s):2
Explanation: The correct answer is The client''s status, progress toward goal achievement, and ongoing re-evaluation. Evaluation process of the nursing process focuses on the client''s status, progress toward goal achievement and ongoing re-evaluation of the plan of care.

Question 41. The nurse is caring for a client with an unstable spinal cord injury at the T7 level. Which intervention should take priority in planning care?

1. Increase fluid intake to prevent dehydration
2. Place client on a pressure reducing support surface
3. Use skin care products designed for use with incontinence
4. Increase caloric intake to aid healing

Looking for answers(s):2
Explanation: The correct answer is Place client on a pressure reducing support surface This client is at greatest risk for skin breakdown because of immobility and decreased sensation. The first action should be to choose and then place the client on the best support surface to relieve pressure, shear and friction forces.

Question 42. The nurse admits a client newly diagnosed with hypertension. What is the best method for assessing the blood pressure?

1. Standing and sitting
2. In both arms
3. After exercising
4. Supine position

Looking for answers(s):2
Explanation: The correct answer is In both arms Blood pressure should be taken in both arms due to the fact that one subclavian artery may be stenosed, causing a false high in that arm.

Question 43. (In planning care for a child diagnosed with minimal change nephrotic syndrome, the nurse should understand the relationship between edema formation and

1. Increased retention of albumin in the vascular system
2. Decreased colloidal osmotic pressure in the capillaries
3. Fluid shift from interstitial spaces into the vascular space
4. Reduced tubular reabsorption of sodium and water

Looking for answers(s):2
Explanation: The correct answer is Decreased colloidal osmotic pressure in the capillaries. The increased glomerular permeability to protein causes a decrease in serum albumin which results in decreased colloidal osmotic pressure.

Question 44. The nurse is making a home visit to a client with chronic obstructive pulmonary disease (COPD). The client tells the nurse that he used to be able to walk from the house to the mailbox without difficulty. Now, he has to pause to catch his breath halfway through the trip. Which diagnosis would be most appropriate for this client based on this assessment?

1.. Activity intolerance caused by fatigue related to chronic tissue hypoxia
2. Impaired mobility related to chronic obstructive pulmonary disease
3. Self care deficit caused by fatigue related to dyspnea
4. Ineffective airway clearance related to increased bronchial secretions

Looking for answers(s):1
Explanation: The correct answer is Activity intolerance caused by fatigue related to chronic tissue hypoxia. Activity intolerance describes a condition in which the client''s physiological capacity for activities is compromised.

Question 45. The nurse is caring for a client who has developed cardiac tamponade. Which finding would the nurse anticipate?

1. Widening pulse pressure
2. Pleural friction rub
3. Distended neck veins
4. Bradycardia

Looking for answers(s):3
Explanation: The correct answer is Distended neck veins In cardiac tamponade, intrapericardial pressures rise to a point at which venous blood cannot flow into the heart. As a result, venous pressure rises and the neck veins become distended.

Question 46. A mother wants to switch her 9 month-old infant from an iron-fortified formula to whole milk because of the expense. Upon further assessment, the nurse finds that the baby eats table foods well, but drinks less milk than before. What is the best advice by the nurse?

1. Change the baby to whole milk
2. Add chocolate syrup to the bottle
3. Continue with the present formula
4. Offer fruit juice frequently

Looking for answers(s):3
Explanation: The correct answer is Continue with the present formula The recommended age for switching from formula to whole milk is 12 months. Switching to cow''s milk before the age of 1 can predispose an infant to allergies and lactose intolerance.

Question 47. A 65-year-old Hispanic-Latino client with prostate cancer rates his pain as a 6 on a 0-to-10 scale. The client refuses all pain medication other than Motrin, which does not relieve his pain. The next action for the nurse to take is to

1. Ask the client about the refusal of certain pain medications
2. Talk with the client's family about the situation
3. Report the situation to the health care provider
4. Document the situation in the notes

Looking for answers(s):1
Explanation: The correct answer is Ask the client about the refusal of certain pain medications. Beliefs regarding pain are one of the oldest culturally related research areas in health care. Astute observations and careful assessments must be completed to determine the level of pain a person can tolerate. Health care practitioners must investigate the meaning of pain to each person within a cultural explanatory framework.

Question 48. Privacy and confidentiality of all client information is legally protected. In which of these situations would the nurse make an exception to this practice?

1. When a family member offers information about their loved one
2. When the client threatens self-harm and harm to others
3. When the health care provider decides the family has a right to know the client's diagnosis
4. When a visitor insists that the visitor has been given permission by the client

Looking for answers(s):2
Explanation: The correct answer is When the client threatens self-harm and harm to others. Privacy and confidentiality of all client information is protected with the exception of the client who threatens self harm or endangering the public.

Question 49. At the geriatric day care program a client is crying and repeating "I want to go home. Call my daddy to come for me." The nurse should

1. Invite the client to join the exercise group
2. Tell the client you will call someone to come for her
3. Give the client simple information about what she will be doing
4. Firmly direct the client to her assigned group activity

Looking for answers(s):3
Explanation: The correct answer is Give the client simple information about what she will be doing. The distressed disoriented client should be gently oriented to reduce fear and increase the sense of safety and security. Environmental changes provoke stress and fear.


Question 50. Which of the following nursing assessments in an infant is most valuable in identifying serious visual defects?

1. Red reflex test
2. Visual acuity
3. Pupil response to light
4. Cover test

Looking for answers(s):1
Explanation: The correct answer is Red reflex test A brilliant, uniform red reflex is an important sign because it virtually rules out almost all serious defects of the cornea, aqueous chamber, lens, and vitreous chamber.

Assessing Vital Signs

Vital Signs or Cardinal Signs are:

Body temperature

Pulse

Respiration

Blood pressure

Pain

I. Body Temperature

The balance between the heat produced by the body and the heat loss

from the body.

Types of Body Temperature

Core temperature –temperature of the deep tissues of the body.

Surface body temperature

Alteration in body Temperature

Pyrexia – Body temperature above normal range( hyperthermia)

Hyperpyrexia – Very high fever, 41ºC(105.8 F) and above

Hypothermia – Subnormal temperature.

Normal Adult Temperature Ranges

Oral 36.5 –37.5 ºC

Axillary 35.8 – 37.0 ºC

Rectal 37.0 – 38.1 ºC

Tympanic 36.8 – 37.9ºC

Methods of Temperature-Taking

1. Ora l – most accessible and convenient method.

a. Put on gloves, and position the tip of the thermometer under the

patients tongue on either of the frenulun as far back as possible. It

promotes contact to the superficial blood vessels and ensure a more

accurate reading.

b. Wash thermometer before use.

c. Take oral temp 2-3 minutes.

d. Allow 15 min to elapse between client’s food intake of hot or cold

food, smoking.

e. Instruct the patient to close his lips but not to bite down with his teeth

to avoid breaking the thermometer in his mouth.

Contraindications

Young children an infants

Patients who are unconscious or disoriented

Who must breath through the mouth

Seizure prone

Patient with N/V

Patients with oral lesions/surgeries

2. Rectal- most accurate measurement of temperature

a. Position- lateral position with his top legs flexed and drape him to provide

privacy.

b. Squeeze the lubricant onto a facial tissue to avoid contaminating the

lubricant supply.

c. Insert thermometer by 0.5 – 1.5 inches

d. Hold in place in 2minutes

e. Do not force to insert the thermometer

Contraindications

Patient with diarrhea

Recent rectal or prostatic surgery or injury because it may injure inflamed tissue

Recent myocardial infarction

Patient post head injury

3. Axillary – safest and non-invasive

a. Pat the axilla dry

b. Ask the patient to reach across his chest and grasp his opposite shoulder.

This promote skin contact with the thermometer

c. Hold it in place for 9 minutes because the thermometer isn’t close in a

body cavity

Note:

Use the same thermometer for repeat temperature taking to ensure more

consistent result

Store chemical-dot thermometer in a cool area because exposure to heat

activates the dye dots.

4. Tympanic thermometer

a. Make sure the lens under the probe is clean and shiny

b. Stabilized the patient’s head; gently pull the ear straight back (for

children up to age 1) or up and back (for children 1 and older to adults)

c. Insert the thermometer until the entire ear canal is sealed

d. Place the activation button, and hold it in place for 1 second

5. Chemical-dot thermometer

a. Leave the chemical-dot thermometer in place for 45 seconds

b. Read the temperature as the last dye dot that has change color, or fired.

Nursing Interventions in Clients with Fever

a. Monitor V.S

b. Assess skin color and temperature

c. Monitor WBC, Hct and other pertinent lab records

d. Provide adequate foods and fluids.

e. Promote rest

f. Monitor I & O

g. Provide TSB

h. Provide dry clothing and linens

i. Give antipyretic as ordered by MD

II. Pulse – It’s the wave of blood created by contractions of the left ventricles of

the

heart.

Normal Pulse rate

1 year 80-140 beats/min

2 years 80- 130 beats/min

6 years 75- 120 beats/min

10 years 60-90 beats/min

Adult 60-100 beats/min

Tachycardia – pulse rate of above 100 beats/min

Bradycardia- pulse rate below 60 beats/min

Irregular – uneven time interval between beats.

What you need:

a. Watch with second hand

b. Stethoscope (for apical pulse)

c. Doppler ultrasound blood flow detector if necessary

Radial Pulse

a. Wash your hand and tell your client that you are going to take his pulse

b. Place the client in sitting or supine position with his arm on his side or across

his

chest

c. Gently press your index, middle, and ring fingers on the radial artery, inside

the patient’s wrist.

d. Excessive pressure may obstruct blood flow distal to the pulse site

e. Counting for a full minute provides a more accurate picture of irregularities

Doppler device

a. Apply small amount of transmission gel to the ultrasound probe

b. Position the probe on the skin directly over a selected artery

c. Set the volume to the lowest setting

d. To obtain best signals, put gel between the skin and the probe and tilt the

probe 45 degrees from the artery.

e. After you have measure the pulse rate, clean the probe with soft cloth

soaked in antiseptic. Do not immerse the probe

III. Respiration - is the exchange of oxygen and carbon dioxide between the

atmosphere

and the body

Assessing Respiration

Rate – Normal 14-20/ min in adult

The best time to assess respiration is immediately after taking client’s pulse

Count respiration for 60 second

As you count the respiration, assess and record breath sound as stridor,

wheezing, or stertor.

Respiratory rates of less than 10 or more than 40 are usually considered

abnormal and should be reported immediately to the physician.

IV. Blood Pressure

Adult – 90- 132 systolic

60- 85 diastolic

Elderly 140-160 systolic

70-90 diastolic

a. Ensure that the client is rested

b. Use appropriate size of BP cuff.

c. If too tight and narrow- false high BP

d. If too lose and wide-false low BP

e. Position the patient on sitting or supine position

f. Position the arm at the level of the heart, if the artery is below the heart

level, you may get a false high reading

g. Use the bell of the stethoscope since the blood pressure is a low frequency

sound.

h. If the client is crying or anxious, delay measuring his blood pressure to

avoid false-high BP

Electronic Vital Sign Monitor

a. An electronic vital signs monitor allows you to continually tract a patient’s

vital

sign without having to reapply a blood pressure cuff each time.

b. Example: Dinamap VS monitor 8100

c. Lightweight, battery operated and can be attached to an IV pole

d. Before using the device, check the client7s pulse and BP manually using the

same arm you’ll using for the monitor cuff.

e. Compare the result with the initial reading from the monitor. If the results

differ call the supply department or the manufacturer’s representative.

Basic Drills

1.According to Maslow, which of the following categories of needs represents the most basic?

a. Physiologic needs
b.Self-actualization
c. Safety and security needs
d. Belongingness

2.Which of the following statements reflects the World Health Organization’s definition of health?

a. A state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity.
b. A condition of homeostatis and adaptation.
c. An individual’s location along a wellness--illness continuum.
d. A fluid, ever-changing balance reflected through physical, mental, and social behavior.

3.Which of the following statements defines culture?

a. The learned patterns of behavior, beliefs, and values that can be attributed to a particular group of people.
b. A group of people distinguished by genetically transmitted material.
c. The status of belonging to a particular region by origin, birth, or naturalization.
d. The classification of a group based upon certain distinctive characteristics.

4.The reason that case management has gained such prominence in health care can be traced to

a. decreased cost of care associated with inpatient stay.
with rapid and frequent inter-unit transfers from specialty to standard care units.

b. increased length of hospital stay.
c. discharge from specialty care units to home.
d. limited availability for inter-unit hospital transfers.

5.A preferred provider organization is described as a

a. business arrangement between hospitals and physicians.
b. prepaid group health practice system.
c. limited insurance program.
d. health care savings account program.

6.Which of the following categories identifies the focus of community/public health nursing practice?

a. Promoting and maintaining the health of populations and preventing and minimizing the progress of disease
b. Rehabilitation and restorative services
c. Adaptation of hospital care to the home environment
d. Hospice care delivery

7.A major goal for home care nurses is

a. restoring maximum health function.
b. promoting the health of populations.
c. minimizing the progress of disease.
d. maintaining the health of populations.

8.In the United States, nurses performing invasive procedures need to be up-to-date with their immunizations, particularly

a. hepatitis B.
b. hepatitis E..
c. hepatitis A.
d. hepatitis C.

9.At what time during a patient’s hospital stay does discharge planning begin?

a. Admission
b. Twenty-four hours prior to discharge
c. The shift prior to discharge
d. By the third hospital day

10.The leading health problems of elementary school children include

a. cancer.-
b. alcohol and drug abuse.
c. mental and emotional problems
d.homicide.

11.Which skill needed by the nurse to think critically involves identification of patient problems indicated by data?

a. Analysis
b. Interpretation
c. Inferencing
d. Explanation

12.The ethics theory that focuses on ends or consequences of actions is the

a. utilitarian theory.
b. formalist theory.
c. deontological theory.
d. adaptation theory.

13.Which of the following ethical principles refers to the duty to do good?

a. Beneficence
b. Fidelity
c. Veracity
d. Nonmaleficence

14.During which step of the nursing process does the nurse analyze data related to the patient's health status?

a. Assessment
b. Implementation
c. Diagnosis
d. Evaluation

15.The basic difference between nursing diagnoses and collaborative problems is that

a. nurses manage collaborative problems using physician-prescribed interventions.
b. collaborative problems can be managed by independent nursing interventions.
c. nursing diagnoses incorporate physician-prescribed interventions.
d. nursing diagnoses incorporate physiologic complications that nurses monitor to detect change in status.

16.Health education of the patient by the nurseis an independent function of nursing practice.

a. Health education is an independent function of nursing practice and is included in all state nurse practice acts.
b. requires a physician's order.
c. must be approved by the physician.
d. must focus on wellness issues.

17.Nonadherence to therapeutic regimens is a significant problem for which of the following age groups?

a. Adults 65 and over
b. Teenagers
c. Children
d. Middle-aged adults

18.Experiential readiness to learn refers to the patient'spast history with education and life experience.

a. Experiential readiness refers to past experiences that influence a person's ability to learn.
b. emotional status.
c. acceptance of an existing illness.
d. ability to focus attention.

19.Asking the patient questions to determine if the person understands the health teaching provided would be included during which step of the nursing process?

a. Evaluation
b. Assessment
c. Planning and goals
d. Implementation

20.Which of the following items is considered the single most important factor in assisting the health professional in arriving at a diagnosis or determining the person's needs?

a. History of present illness
b. Physical examination
c. Diagnostic test results
d. Biographical data

21.Of the following areas for assessing the patient profile, which should be addressed after the others?

a. Body image
b. Education
c. Occupation
d. Environment

22.Which of the following methods of physical examination refers to the translation of physical force into sound?

a. Percussion
b. Palpation
c. Auscultation
d. Manipulation

23.In which range of body mass index (BMI) are patients considered to have increased risk for problems associated with poor nutritional status?

a. Below 24
b. 25-29
c. 30 to 34
d. Over 40

24.To calculate the ideal body weight for a woman, the nurse allows

a. 100 pounds for 5 feet of height.
b. 106 pounds for 5 feet of height.
c. 6 pounds for each additional inch over 5 feet.
d. 80 pounds for 5 feet of height.

25. A steady state within the body is termed
a. homeostasis.
b. constancy.
c. adaptation.
d. stress.

26.Which of the following terms, according to Lazarus, refers to the process through which an event is evaluated with respect to what is at stake and what might and can be done?

a. Cognitive appraisal
b. Coping
c. Hardiness
d. Adaptation

27.An increase in the number of new cells in an organ or tissue that is reversible when the stimulus for production of new cells is removed is termed

a. hyperplasia.
b. hypertrophy.
c. atrophy.
d. neoplasia.

28. Which of the following types of cells have a latent ability to regenerate?

a. Stable
b. Labile
c. Permanent
d. Epithelial

29.The relaxation techniques of progressive muscle relaxation, relaxation with guided imagery, and the Benson Relaxation Response share which of the following elements?

a. A mental device (something on which to focus the attention)
b. Nutritional foundation
c. Analgesic preparation
d. Physician's order

30.Which of the following terms has been defined by the American Psychiatric Association as a group of behavioral or psychological symptoms or a pattern that manifests itself in significant distress, impaired functioning, or accentuated risk of enduring severe suffering or possible death?

a. Mental disorder
b. Emotional disorder
c. Anxiety
d. Schizophrenia

31.Establishing financial security has been identified as a developmental task of which of the following groups?

a. Middle adult
b. Older adult
c. Young adult
d. Teenager

32.When up to a 6-month period elapses between the experience of trauma and the onset of symptoms of posttraumatic stress disorder (PTSD), the episode is termed

a. delayed.
b. acute.
c. chronic.
d. primary.


33.Which of the following statements accurately describes a risk factor for depression?

a. History of physical or sexual abuse
b. Male gender
c. Age over 50 years
d. Negative family history of depression

34.Of the following stages of grieving as described by Kubler-Ross, which is the initial?

a. Denial
b. Anger
c. Bargaining
d. Depression

35.Which of the following terms refers to Leininger's description of the learned and transmitted knowledge about values, beliefs, rules of behavior, and lifestyle practices that guide a designated group in their thinking and actions in patterned ways?

a. Culture
b. Minority
c. Race
d. Subculture

36.The inability of a person to recognize his or her own values, beliefs, and practices and those of others because of strong ethnocentric tendencies is termed.

a. cultural blindness.
b. acculturation.
c. cultural imposition.
d. cultural taboo.

37. Which of the following groups of individuals may stare at the floor during conversations as a sign of respect?

a. Native Americans
b. Indo-Chinese
c. Arabs
d. Asians



38.For which of the following religious groups is all meat prohibited?

a. Hinduism
b. Seventh-Day Adventism
c. Judaism
d. Islam

39.The paradigm that explains the cause of illness as an imbalance in the forces of nature is the

a. holistic perspective.
b. magico-religious view.
c. biomedical view.
d. scientific view.

40.The aim of genomic medicine is

a. improving predictions about individuals’ susceptibility to diseases
b. reproduction
c. cure of disease
d. cloning

41.Nondisjunction of a chromosome results in which of the following diagnoses?

a. Down Syndrome
b. Huntingon Disease
c. Duchenne Muscular Dystrophy
d. Marphan Syndrome

42.Which type of Mendelian inherited condition results in both genders being affected equally in a vertical pattern?

a. Automosomal dominant inheritance
b. Automosomal recessive inheritance
c. X-linked inheritance.
d. Multifactorial genetic inheritance

43.A specific BRCA1 cancer-predisposing gene mutation seems to occur more frequently among women of which descent?

a. Ashkanazi Jewish
b. Mediterranean
c. African American
d. Chinese and Japanese

44.Which of the following statements describes accurate information related to chronic illness?

a. Most people with chronic conditions do not consider themselves sick or ill.
b. Most people with chronic conditions take on a sick role identity.
c. Chronic conditions do not result from injury.
d. Most chronic conditions are easily controlled.

45.In which phase of the trajectory model of chronic illness are the symptoms under control and managed?

a. Stable
b. Acute
c. Comeback
d. Downward

46.Which phase of the trajectory model of chronic illness is characterized by reactivation of the illness?

a. Unstable
b. Stable
c. Acute
dComeback
47.Which phase of the trajectory model of chronic illness is characterized by the gradual or rapid decline in the trajectory despite efforts to halt the disorder?

a. Dying
b. Unstable
c. Acute
d. Downward

48.In order to help prevent the development of an external rotation deformity of the hip in a patient who must remain in bed for any period of time, the most appropriate nursing action would be to use

a. a trochanter roll extending from the crest of the ilium to the midthigh.
b. pillows under the lower legs.
c. a hip-abductor pillow.
d. a footboard.



49.To prevent footdrop, the patient is positioned in:

a. Order to keep the feet at right angles to the leg
b. A semi-sitting position in bed
c. A sitting position with legs hanging off the side of the bed
d. A side-lying position

50.Through which of the following activities does the patient learn to consciously contract excretory sphincters and control voiding cues?

a. Biofeedback
b. Kegel exercises
c. Habit training
d. Bladder training

51.During which stage of pressure ulcer development does the ulcer extend into the subcutaneous tissue?

a. Stage III
b. Stage IV
c. Stage II
d. Stage I

52.During which stage of pressure ulcer development does the ulcer extend into the underlying structures, including the muscle and possibly the bone?

a. Stage IV
b. Stage III
c. Stage II
d. Stage I

53.Which type of incontinence is associated with weakened perineal muscles that permit leakage of urine when intra-abdominal pressure is increased?

a. Stress incontinence
b. Urge incontinence
c. Reflex (neurogenic) incontinence
d. Functional incontinence

54.Ageism refers to

a. Bias against older people based solely on chronological age
b. fear of old age.
c. loss of memory.
d. benign senescent forgetfulness.

55.When assessing the older adult, the nurse anticipates increase in which of the follow components of respiratory status?

a. Residual lung volume
b. Vital capacity
c. Gas exchange and diffusing capacity
d. Cough efficiency

56.According to the classification of hypertension diagnosed in the older adult, hypertension that can be attributed to an underlying cause is termed

a. secondary.
b. primary.
c. essential.
d. isolated systolic.

57.Which of the following terms refers to the decrease in lens flexibility that occurs with age, resulting in the near point of focus getting farther away?

a. Presbyopia
b. Presbycusis
c. Cataract
d. Glaucoma

58.Which of the following states is characterized by a decline in intellectual functioning?

a. Dementia
b.Depression
c. Delirium
d. Delusion

59.When a person who has been taking opioids becomes less sensitive to their analgesic properties, that person is said to have developed a (an)

a. tolerance.
b. addiction.
c. dependence.
d. balanced analgesia.



60.Prostaglandins are chemical substances thought to

a. increase sensitivity of pain receptors.
b. reduce the perception of pain.
c. inhibit the transmission of pain.
d. inhibit the transmission of noxious stimuli.

61.Which of the following principles or guidelines accurately informs the nurse regarding placebos?

a. Placebos should never be used to test the person's truthfulness about pain.
b. A placebo effect is an indication that the person does not have pain.
c. A placebo should be used as the first line of treatment for the patient.
d. A positive response to a placebo indicates that the person's pain is not real.

62.Regarding tolerance and addiction, the nurse understands that

a. although patients may need increasing levels of opioids, they are not addicted.
b. tolerance to opioids is uncommon.
c. addiction to opioids commonly develops.
d. the nurse must be primarily concerned about development of addiction by the patient in pain.

63.The preferred route of administration of medication in the most acute care situations is which of the following routes?

a. Intravenous
b. Epidural
c. Subcutaneous
d. Intramuscular

64.Mu opioids have which of the following effects on respiratory rate:

a. Stimulation, then depression
b. No change
c. Stimulation, only
d. Depression, only

65.Which of the following electrolytes is a major cation in body fluid?

a. Potassium
b. Chloride
c. Bicarbonate
d. Phosphate

66.Which of the following electrolytes is a major anion in body fluid?

a. Chloride
b. Potassium.
c.Sodium
c. Calcium

67.Oncotic pressure refers to

a. the osmotic pressure exerted by proteins.
b. the number of dissolved particles contained in a unit of fluid.
c. the excretion of substances such as glucose through increased urine output.
d.the amount of pressure needed to stop flow of water by osmosis.

68.Which of the following solutions is hypotonic?

a. 0.45% NaCl.
b. Lactated Ringer's solution.
c. 0.9% NaCl.
d. 5% NaCl.

69.The normal serum value for potassium is

a. 3.5-5.5 mEq/L.
b. 135-145 mEq/L.
c. 96-106 mEq/L.
d. 8.5-10.5 mg/dL.

70.In which type of shock does the patient experiences a mismatch of blood flow to
the cells?

a. Distributive
b. Cardiogenic
c. Hypovolemic
d. Septic

71.Which stage of shock is best described as that stage when the mechanisms that regulate blood pressure fail to sustain a systolic pressure above 90 mm Hg?

a. Progressive
b. Refractory
c. Compensatory
d. Irreversible

72.When the nurse observes that the patient's systolic blood pressure is less than 80--90 mm Hg, respirations are rapid and shallow, heart rate is over 150 beats per minute, and urine output is less than 30 cc per hour, the nurse recognizes that the patient is demonstrating which stage of shock?

a. Compensatory
b. Progressive
c. Refractory
d. Irreversible

73.Which of the following vasoactive drugs used in treating shock results in reduced preload and afterload, reducing oxygen demand of the heart?

a. Nitroprusside (Nipride)
b. Dopamine (Intropin)
c. Epinephrine (adrenaline)
d. Methoxamine (Vasoxyl)

74.The nurse anticipates that the immunosuppressed patient is at greatest risk for which type of shock?

a. Septic
b. Neurogenic
c. Cardiogenic
d. Anaphylactic

75.Which of the following colloids is expensive but rapidly expands plasma volume?

a. Albumin
b. Dextran
c. Lactated Ringers
d. Hypertonic Saline

76.Which of the following terms refers to cells that lack normal cellular characteristics and differ in shape and organization with respect to their cells of origin?

a. Anaplasia
b. Neoplasia
c. Dysplasia
d. Hyperplasia

77.Palliation refers to

a. relief of symptoms associated with cancer.
b. hair loss.
c. the spread of cancer cells from the primary tumor to distant sites.
d. the lowest point of white blood cell depression after therapy that has toxic effects on the bone marrow.

78.During which step of cellular carcinogenesis do cellular changes exhibit increased malignant behavior?

a. Progression
b. Promotion
c. Initiation
d. Prolongation

79.The drug, Interleukin-2, is an example of which type of biologic response modifier?

a. Cytokine
b. Monoclonal antibodies
c. Retinoids
d. Antimetabolites

80.Of the following terms, which is used to refer to the period of time during which mourning a loss takes place?

a. Bereavement
b. Grief
c. Mourning
c. Hospice

81.Which of the following "awareness contexts" is characterized by the patient, the family, and the health care professionals being aware that the patient is dying but all pretend otherwise?

a. Mutual pretense awareness
b. Closed awareness
c. Suspected awareness
d. Open awareness

82.For individuals known to be dying by virtue of age and/or diagnoses, which of the following signs indicate approaching death:

a. Increased restlessness
b.Increased wakefulness
c. Increased eating
d. Increased urinary output

83.Which of the following terms best describes a living will?

a. Medical directive
b. Proxy directive
c. Health care power of attorney
d. Durable power of attorney for health


84.A malignant tumor

a. gains access to the blood and lymphatic channels.
b. demonstrates cells that are well-differentiated.
c. is usually slow growing.
d. grows by expansion.

85.Which of the following classes of antineoplastic agents is cell--cycle-specific?

a. Antimetabolites (5-FU)
b. Antitumor antibiotics (bleomycin)
c. Alkylating agents (cisplatin)
b. Nitrosureas (carmustine)

86.Regarding the surgical patient, which of the following terms refers to the period of time that constitutes the surgical experience?

a. Perioperative phase
b. Preoperative phase
c. Intraoperative phase
d. Postoperative phase

87.When the indication for surgery is without delay, the nurse recognizes that the surgery will be classified as

a. emergency.
b. urgent.
c. required.
d. elective.

88.When a person with a history of chronic alcoholism is admitted to the hospital for surgery, the nurse anticipates that the patient may show signs of alcohol withdrawal delirium during which time period?

a. Up to 72 hours after alcohol withdrawal
b. Immediately upon admission
c. Upon awakening in the post-anesthesia care unit
d. Up to 24 hours after alcohol withdrawal

89.Which of the following categories of medications may result in seizure activity if withdrawn suddenly?

a.Tranquilizers
b. Adrenal corticosteroids
c. Antidepressants
d. Diuretics

90.When the patient is encouraged to concentrate on a pleasant experience or restful scene, the cognitive coping strategy being employed by the nurse is

a. imagery.
b. optimistic self-recitation.
c. distraction.
d. progressive muscular relaxation.

91.According to the American Society of Anesthesiology Physical Status Classification System, a patient with severe systemic disease that is not incapacitating is noted to have physical status classification

a. P3
b. P4
c. P1
d. P2

92.Which stage of anesthesia is termed surgical anesthesia?

a. III
b. I
c. II
d. IV

93.Fentanyl (Sublimaze) is categorized as which type of intravenous anesthetic agent?

a. Neuroleptanalgesic
b. Tranquilizer
c. Opioid
d. Dissociative agent

94Which of the following manifestations is often the earliest sign of malignant hyperthermia?

a. Tachycardia (heart rate above 150 beats per minute)
b. Hypotension
c. Elevated temperature
d. Oliguria

95.Which of the following terms is used to refer to protrusion of abdominal organs through the surgical incision?

a. Evisceration
b. Hernia
c. Dehiscence
d. Erythema

96.When the method of wound healing is one in which wound edges are not surgically approximated and integumentary continuity is restored by granulations, the wound healing is termed

a. second intention healing.
b. primary intention healing.
c. first intention healing.
d. third intention healing.

97.The nurse recognizes which of the following signs as typical of the patient in shock?

a. Rapid, weak, thready pulse
b. Flushed face
c. Warm, dry skin
d. Increased urine output

98.When the nurse observes that the postoperative patient demonstrates a constant low level of oxygen saturation, although the patient's breathing appears normal, the nurse identifies that the patient may be suffering which type of hypoxemia?

a. Subacute
b. Hypoxic
c. Episodic
d. Anemic

99.When the surgeon performs an appendectomy, the nurse recognizes that the surgical category will be identified as

a. clean contaminated.
b. clean.
c. contaminated.
d. dirty.

100.Which of the following terms is used to describe inability to breathe easily except in an upright position?

a. Orthopnea
b. Dyspnea
c. Hemoptysis
d. Hypoxemia

101.In relation to the structure of the larynx, the cricoid cartilage is

a. the only complete cartilaginous ring in the larynx.
b. used in vocal cord movement with the thyroid cartilage.
c. the largest of the cartilage structures.
d. the valve flap of cartilage that covers the opening to the larynx during swallowing.

102.Which respiratory volume is the maximum volume of air that can be inhaled after maximal expiration?

a. Inspiratory reserve volume
b. Tidal volume
c. Expiratory reserve volume
d. Residual volume

103.The individual who demonstrates displacement of the sternum is described as having a

a. pigeon chest.
b. barrel chest.
c. funnel chest.
d. kyphoscoliosis.

104.When the nurse auscultates chest sounds that are harsh and cracking, sounding like two pieces of leather being rubbed together, she records her finding as

a. pleural friction rub.
b. crackles.
c. sonorous wheezes.
d. sibilant wheezes.

105.Which of the following terms is used to describe hemorrhage from the nose?

a. Epistaxis
b. Xerostomia
c.Rhinorrhea
d. Dysphagia

106.The herpes simplex virus (HSV-1), which produces a cold sore (fever blister), has an incubation period of

a. 2-12 days.
b. 0-3 months.
c. 20-30 days.
d. 3-6 months.

107.Another term for clergyman's sore throat is

a. chronic granular pharyngitis.
b. aphonia.
c. atrophic pharyngitis.
d. hypertrophic pharyngitis.

108.Which type of sleep apnea is characterized by lack of airflow due to pharyngeal occlusion?

a. Obstructive
b. Simple
c. Mixed
d. Central

109.When the patient who has undergone laryngectomy suffers wound breakdown, the nurse monitors him very carefully because he is identified as being at high risk for

a. carotid artery hemorrhage.
b. pulmonary embolism.
c. dehydration.
d. pneumonia.

110.Which of the following terms refers to lung tissue that has become more solid in nature due to a collapse of alveoli or infectious process?

a. Consolidation
b. Atelectasis
c. Bronchiectasis
d. Empyema

111.Which of the following community-acquired pneumonias demonstrates the highest occurrence during summer and fall?

a. Legionnaires' disease
b. Streptococcal (pneumococcal) pneumonia
c. Mycoplasma pneumonia
d. Viral pneumonia

112.When interpreting the results of a Mantoux test, the nurse explains to the patient that a reaction occurs when the intradermal injection site shows

a. redness and induration.
b. drainage.
c. tissue sloughing.
d. bruising.

113.Which of the following actions is most appropriate for the nurse to take when the patient demonstrates subcutaneous emphysema along the suture line or chest dressing 2 hours after chest surgery?

a. Record the observation..
b. Apply a compression dressing to the area.
c. Measure the patient's pulse oximetry.
d. Report the finding to the physician immediately.

114.Which of the following types of lung cancer is characterized as fast growing and tending to arise peripherally?

a. Large cell carcinoma
b. Bronchioalveolar carcinoma
c. Adenocarcinoma
d. Squamous cell carcinoma

115.Which of the following methods is the best method for determining nasogastric tube placement in the stomach?

a. X-ray
b. Observation of gastric aspirate
c. Testing of pH of gastric aspirate
d. Placement of external end of tube under water

116.Which of the following types of lung cancer is the most prevalent carcinoma of the lung for both men and women?

a. Adenocarcinoma
b. Large cell carcinoma
c. Squamous cell carcinoma
d. Small cell carcinoma

117.Emphysema is described as:

a. A disease of the airways characterized by destruction of the walls of overdistended alveoli.
b. A disease that results in a common clinical outcome of reversible airflow obstruction.
c. The presence of cough and sputum production for at least a combined total of two or three months in each of two consecutive years.
d. Chronic dilatation of a bronchus or bronchi

118.Which of the following is the most important risk factor for development of Chronic Obstructive Pulmonary Disease?

a. Cigarette smoking
b. Occupational exposure
c. Air pollution
d. Genetic abnormalities

119.Which type of chest configuration is typical of the patient with COPD?

a. Barrel chest
b. Pigeon chest
c. Flail chest
d. Funnel chest


120.In which stage of COPD is the forced expiratory volume (FEV1) < 30%?

a. III
b. II
c. I
d. O

121.Of the following oxygen administration devices, which has the advantage of providing high oxygen concentration?

a. Non-rebreather mask
b. Venturi mask
c. Catheter
d. Face tent

122.Which of the following ranges identifies the amount of pressure within the endotracheal tube cuff that is believed to prevent both injury and aspiration?

a. 20-25 mm Hg water pressure.
b. 10-15 mm Hg water pressure.
c. 30-35 mm Hg water pressure.
d. 0-5 mm Hg water pressure

123.When performing endotracheal suctioning, the nurse applies suctioning while withdrawing and gently rotating the catheter 360 degrees for which of the following time periods?

a. 10-15 seconds
b. 30-35 seconds
Applying suction for 30-35 seconds is hazardous and may result in the patient's developing hypoxia, which can lead to dysrhythmias and, ultimately, cardiac arrest.
c. 20-25 seconds
d. 0-5 seconds

124.In general, chest drainage tubes are not used for the patient undergoing

a. Pneumonectomy
b. Lobectomy
c. Wedge resection
d. Segmentectomy

125.Which term is used to describe the ability of the heart to initiate an electrical impulse?

a. Automaticity
b. Contractility
c. Conductivity
d. Excitability

126.The nurse auscultates the apex beat at which of the following anatomical locations?

a. Fifth intercostal space, midclavicular line
b. Mid-sternum
c. 2” to the left of the lower end of the sternum
d. 1” to the left of the xiphoid process

127.Which of the following terms describes the amount of blood ejected per heartbeat?

a. Stroke volume
b. Cardiac output
c. Ejection fraction
d. Afterload

128.When measuring the blood pressure in each of the patient's arms, the nurse recognizes that in the normal adult, the pressures

a. differ no more than 5 mm Hg between arm pressures.
b. must be equal in both arms.
c. may vary 10 mm Hg or more between arms.
d. may vary, with the higher pressure found in the left arm.

129.Central venous pressure is measured in which of the following heart chambers?

a. Right atrium
b. Left atrium
c. Left ventricle
d. Right ventricle

130.Which of the following ECG characteristics is usually seen when a patient's serum potassium level is low?

a. U wave
b. T wave
c. P wave
d. QT interval

131.Which of the following ECG waveforms characterizes conduction of an electrical impulse through the left ventricle?

a. QRS complex
b. P wave
c. PR interval
d. QT interval

132.When the nurse observes that the patient's heart rate increases during inspiration and decreases during expiration, the nurse reports that the patient is demonstrating

a. sinus dysrhythmia.
b. normal sinus rhythm.
c. sinus bradycardia.
d. sinus tachycardia.

133.Which of the following terms is used to describe a tachycardia characterized by abrupt onset, abrupt cessation, and a QRS of normal duration?

a. Paroxysmal atrial tachycardia
b. Sinus tachycardia
c. Atrial flutter
d. Atrial fibrillation

134.When the nurse observes an ECG tracing on a cardiac monitor with a pattern in lead II and observes a bizarre, abnormal shape to the QRS complex, the nurse has likely observed which of the following ventricular dysrhythmias?

a. Premature ventricular contraction
b. Ventricular bigeminy
c. Ventricular tachycardia
d. Ventricular fibrillation

135.Premature ventricular contractions are considered precursors of ventricular tachycardia when they

a. occur at a rate of more than six per minute.
b. occur during the QRS complex.
c. have the same shape.
d. are paired with a normal beat.

136.When no atrial impulse is conducted through the AV node into the ventricles, the patient is said to be experiencing which type of AV block?

a. Third degree
b. First degree
c. Second degree, type I
d. Second degree, type II

137.Which of the following terms refers to chest pain brought on by physical or emotional stress and relieved by rest or medication?

a. angina pectoris
b. atherosclerosis
c. atheroma
d. ischemia


138.Of the following risk factors, which is considered modifiable?

a. Diabetes mellitus
b. Gender
c. Race
d. Increasing age

139.When the patient with known angina pectoris complains that he is experiencing chest pain more frequently even at rest, the period of pain is longer, and it takes less stress for the pain to occur, the nurse recognizes that the patient is describing

a. unstable angina.
b. intractable angina.
c. variant angina.
d. refractory angina.

140.Heparin therapy is usually considered therapeutic when the patient's activated partial thromboplasin time (aPTT) is how many times normal?

a. 1.5 to 2
b. .5 to 1
c. 2.5 to 3
d .25 to .75

141.When the post-cardiac surgery patient demonstrates restlessness, nausea, weakness, and peaked T waves, the nurse reviews the patient's serum electrolytes anticipating which abnormality?

a. Hyperkalemia
b. Hypercalcemia
c. Hypomagnesemia
d. Hyponatremia


142.In order to be effective, Percutaneous Transluminal Coronary Angioplasty (PTCA) must be performed within what time frame, beginning with arrival at the emergency department after diagnosis of myocardial infarction?

a. 60 minutes
b. 30 minutes
c. 9 days
d. 6-12 months

143.Which of the following statements reflect a goal of rehabilitation for the patient with an MI:

a. To improve the quality of life
b. To limit the effects and progression of atherosclerosis
c. To return the patient to work and a pre illness lifestyle
d. To prevent another cardiac event

144.Which of the following methods to induce hemostasis after sheath removal post Percutaneous Transluminal Coronary Angioplasty is the least effective?

a. Application of a sandbag to the area
b. Application of a vascular closure device, such as AngiosealTM, VasosealTM, c. Direct manual pressure
d. Application of a pneumatic compression device (e.g., Fem-StopTM)

145.A long-term effect of which of the following procedures post acute MI induces angioneogenesis?

a. Transmyocardial laser revascularization
b. Bracytherapy
c. Atherectomy
d. Stent placement


146.Which of the following medications are used to reverse the effects of heparin?

a. Protamine sulfate
b. Streptokinase
c. Clopidigrel (Plavix)
d.Aspirin
147.Which of the following terms refers to leg pain that is brought on walking and caused by arterial insufficiency?

a. Intermittent claudication
b. Dyspnea
c. Orthopnea
d. Thromboangitis obliterans

148.When the post-cardiac surgical patient demonstrates vasodilation, hypotension, hyporeflexia, slow gastrointestinal motility (hypoactive bowel sounds), lethargy, and respiratory depression, the nurse suspects which of the following electrolyte imbalances?

a. Hypermagnesemia
b. Hypokalemia
c. Hyperkalemia
d. Hypomagnesemia

149.When the nurse notes that the post cardiac surgery patient demonstrates low urine output (< 25 ml/hr) with high specific gravity (> 1.025), the nurse suspects:

a. Inadequate fluid volume
b. Normal glomerular filtration
c. Overhydration
d. Anuria


150.When the valve used in valve replacement surgery is made from the patient's own heart valve, which of the following terms is used?

a. Autograft
b. Allograft
c. Homograft
d. Xenograft

151.Which of the following procedures most specifically describes splitting or separating fused cardiac valve leaflets?

a. Commisurotomy
b. Annuloplasty
c. Chordoplasty
d. Valvuloplasty

152.Which of the following mitral valve conditions generally produces no symptoms?

a. Prolapse
b.Stenosis
c. Regurgitation
d. Infection

153.In which type of cardiomyopathy does the heart muscle actually increase in size and mass weight, especially along the septum?

a. Hypertrophic
b. Dilated
c. Restrictive
d. Arrhythmogenic right ventricular cardiomyopathy



154.Which of the following patient behaviors, if observed by the nurse, would indicate that the cardiac patient's level of anxiety has decreased?

a. Answers questions regarding status with no problem.
b. Discusses prognosis freely.
c. Verbalizes fears and concerns.
d. Participates in support groups.

155.The patient with which of the follow characteristics is considered high risk for the development of infective endocarditis?

a. The patient who has complex cyanotic congenital malformations is at high risk for the development of infective endocarditis.
b. Mitral valve prolapse with valvular regurgitation
c. Hypertrophic cardiomyopathy
d. Acquired valvular dysfunction

156.Which of the following terms indicates the amount of blood pumped out of the ventricle with each contraction of the heart?

a. Stroke volume
b. Afterload
c. Cardiac output
d. Preload

157.When the balloon on the distal tip of a pulmonary artery catheter is inflated and a pressure is measured, the measurement obtained is referred to as the

a. pulmonary artery wedge pressure.
b. central venous pressure.
c. pulmonary artery pressure.
d. cardiac output.

158.Which of the following medications is categorized as a loop diuretic?

a. Furosemide (Lasix)
b. Chlorothiazide (Diuril)
c. Chlorthalidone (Hygroton)
d. Spironolactone (Aldactone)

159.When the nurse observes that the patient always has difficulty breathing when lying flat, the nurse records that the patient is demonstrating

a. Orthopnea
b. Dyspnea on exertion.
c. Hyperpnea.
d. Paroxysmal nocturnal dyspnea.

160.The patient with cardiac failure is taught to report which of the following symptoms to the physician or clinic immediately?

a. Persistent cough
b. Increased appetite
c. Weight loss
d. Ability to sleep through the night

161.A classic sign of cardiogenic shock is

a. Tissue hypoperfusion
b. High blood pressure
c. Hyperactive bowel sounds
d. Increased urinary output

162.Vasoactive drugs which cause the arteries and veins to dilate, thereby shunting much of the intravascular volume to the periphery and causing a reduction in preload and afterload include agents such as

a. Sodium nitroprusside (Nipride)
b. Norepinephrine (Levophed)
c. Dopamine (Inotropin)
d. Furosemide (Lasix)

163.Which of the following terms refers to a muscular, cramp-like pain in the extremities consistently reproduced with the same degree of exercise and relieved by rest?

a. Intermittent claudication
b. Aneurysm
c. Bruit
d. Ischemia

164.Which of the following observations regarding ulcer formation on the patient's lower extremity indicate to the nurse that the ulcer is a result of venous insufficiency?

a. The border of the ulcer is irregular.
b. The ulcer is very painful to the patient, even though superficial.
c. The ulcer base is pale to black.
d. The ulcer is deep, involving the joint space.

165.A diagnostic test that involves injection of a contrast media into the venous system through a dorsal vein in the foot is termed

a. contrast phlebography.
b. air plethysmography
c. lymphangiography.
d. lymphoscintigraphy.

166.The nurse teaches the patient with peripheral vascular disease to refrain from smoking because nicotine causes

a. vasospasm.
b. slowed heart rate.
c. depression of the cough reflex.
d. diuresis.

167.Which of the following types of aneurysms results in bleeding into the layers of the arterial wall?

a. Dissecting
b. Saccular
c. False
d. Anastomotic

168.Which of the following terms refers to enlarged, red, and tender lymph nodes?

a. Lymphadenitis
b. Lymphangitis
c. Lymphedema
d. Elephantiasis

169.Which of the following terms is given to hypertension in which the blood pressure, which is controlled with therapy, becomes uncontrolled (abnormally high) with the discontinuation of therapy?

a. Rebound
b. Essential
c. Primary
d. Secondary

170.Officially, hypertension is diagnosed when the patient demonstrates a systolic blood pressure greater than ______ mm Hg and a diastolic blood pressure greater than _____ mm Hg over a sustained period.

a. 140, 90
b. 130, 80
c. 110, 60
d. 120, 70

171.The nurse teaches the patient which of the following guidelines regarding lifestyle modifications for hypertension?

a. Maintain adequate dietary intake of potassium
b. Reduce smoking to no more than four cigarettes per day
c. Limit aerobic physical activity to 15 minutes, three times per week
d. Stop alcohol intake

172.Of the following diuretic medications, which conserves potassium?

a. Spironolactone (Aldactone)
b. Furosemide (Lasix)
c. Chlorothiazide (Diuril)
d. Chlorthalidone (Hygroton)

173.Which of the following adrenergic inhibitors acts directly on the blood vessels, producing vasodilation?

a. Prazosin hydrochloride (Minipress)
b. Reserpine (Serpasil)
c. Propranolol (Inderal)
d. Clonidine hydrochloride (Catapres)

174.Which of the following terms refers to an abnormal decrease in white blood cells, red blood cells, and platelets?

a. Pancytopenia
b. Anemia
c. Leukopenia
d. Thrombocytopenia

175.Which of the following terms refers to a form of white blood cell involved in immune response?

a. Lymphocyte
b. Granulocyte
c. Spherocyte
d. Thrombocyte

176.The term that is used to refer to a primitive cell, capable of self-replication and differentiation, is

a. stem cell.
b. band cell.
c. spherocyte.
d. reticulocyte.

177.Of the following hemolytic anemias, which is categorized as inherited?

a. Sickle cell anemia
b. Autoimmune hemolytic anemia
c. Cold agglutinin disease
d. Hypersplenism

178.The antidote to heparin is
a. protamine sulfate.
b. vitamin K.
c. Narcan.
d. Ipecac.

179.Which of the following terms describes a gastric secretion that combines with vitamin B-12 so that it can be absorbed?

a. Intrinsic factor
b. Amylase
c. Pepsin
d. Trypsin
180. When bowel sounds are heard about every 15 seconds, the nurse would record that the bowel sounds are

a. normal.
b. hypoactive.
c. sluggish.
d. absent.

181.When gastric analysis testing reveals excess secretion of gastric acid, which of the following diagnoses is supported?

a. Duodenal ulcer
b. Chronic atrophic gastritis
c. Gastric cancer
d. Pernicious anemia

182.Which of the following terms is used to describe stone formation in a salivary gland, usually the submandibular gland?

a. Sialolithiasis
b. Parotitis
c. Sialadenitis
d. Stomatitis

183.Irritation of the lips associated with scaling, crust formation, and fissures is termed

a. leukoplakia.
b. lichen planus.
c. actinic cheilitis.
d. chancre.

184.Regarding oral cancer, the nurse provides health teaching to inform the patient that

a. many oral cancers produce no symptoms in the early stages.
b. most oral cancers are painful at the outset.
c. Blood testing is used to diagnose oral cancer.
d.a typical lesion is soft and crater-like.

185.The most common symptom of esophageal disease is

a. dysphagia.
b. nausea.
c. vomiting.
d. odynophagia.

186.Halitosis and a sour taste in the mouth are signs and symptoms associated most directly with

a. esophageal diverticula.
b. achalasia.
c. gastroesophageal reflux.
d. hiatal hernia.

187.Which of the following terms refers to the symptom of gastroesophageal reflux disease (GERD) which is characterized by a burning sensation in the esophagus?

a. Pyrosis
b. Dyspepsia
c. Dysphagia
d. Odynophagia



188.The nurse teaches the patient with gastroesophageal reflux disease (GERD) which of the following measures to manage his disease?

a. Avoid eating or drinking 2 hours before bedtime.
b. Minimize intake of caffeine, beer, milk, and foods containing peppermint and spearmint.
c. Elevate the foot of the bed on 6- to 8-inch blocks
d. Eat a low carbohydrate diet

189.Which of the following statements accurately describes cancer of the esophagus?

a. Chronic irritation of the esophagus is a known risk factor.
b. It is three times more common in women in the U.S. than men.
c. It is seen more frequently in Caucasians than in African Americans.

d. It usually occurs in the fourth decade of life.

190. Which of the following venous access devices can be used for no more than 30 days in patients requiring parenteral nutrition?

a. Non-tunneled catheter
b. Peripherally-inserted central catheter (PICC)
c. Tunneled catheters
d. Implanted ports

191.To ensure patency of central venous line ports, dilute heparin flushes are used in which of the following situations?

a. Daily when not in use
b. With continuous infusions
c. Before blood drawing
d. When the line is discontinued

192.For which of the following medications must the nurse contact the pharmacist in consultation when the patient receives all oral medications by feeding tube?

a. Enteric-coated tablets
b. Simple compressed tablets
c. Buccal or sublingual tablets
d. Soft gelatin capsules filled with liquid

193.Medium -length nasoenteric tubes are used for:

a. Feeding
b. Decompression
c. Aspiration
d. Emptying

194.Mercury is typically used in the placement of which of the following tubes?

a. Miller-Abbott
b. Gastric sump
c. Dobbhoff
d.EnterafloW

195.The most significant nursing problem related to continuous tube feedings is

a. potential for aspiration
b. interruption of GI integrity
c. disturbance in the sequence of intestinal and hepatic metabolism
d. interruption in fat metabolism and lipoprotein synthesis

196.When the nurse prepares to give a bolus tube feeding to the patient and determines that the residual gastric content is 150 cc, her best action is to

a. reassess the residual gastric content in 1 hour.
b. notify the physician.
c. give the tube feeding.
d. withhold the tube feeding indefinitely.

197. If tube feeding is continuous, the placement of the feeding tube should be checked

a. every shift.
b. every hour.
c. every 24 hours.
d. when a tube feeding is continuous, it is unnecessary to check placement.

198.Decrease in absorption of which of the following vitamins in the geriatric patient results in pernicious anemia?

a. B12
b. C
c. D
d. B6

199.Which of the following terms refers to tarry, black stools?

a. Melena
b. Hemarthrosis
c.Hematemesis
d. Pyrosis

200. Which of the following statements accurately reflects a rule of thumb upon which the nurse may rely in assessing the patient's fluid balance?

a. Minimal intake of 1.5 liters per day
b. Minimal urine output of 50 milliliters per hour
c. Minimal urine output of 10 milliliters per hour
d. Minimal intake of 2 liters per day

201.The nurse recognizes that the patient with a duodenal ulcer will likely experience

a. pain 2-3 hours after a meal.
b. vomiting.
c. hemorrhage.
d. weight loss.

202. Of the following categories of medications, which is used in combination with bismuth salts to eradicate Helicobacter pylori?

a. Antibiotics
b. Antacids
c. Proton pump inhibitors
d. Histamine-2 receptor antagonists

203. Which of the following medications represents the category proton (gastric acid) pump inhibitors?

a. Omeprazole (Prilosec)
b. Sucralfate (Carafate)
c. Famotidine (Pepcid)
d. Metronidazole (Flagyl)

204. Which of the following medications used for the treatment of obesity prevents the absorption of triglycerides?

a. Orlistat (Xenical)
b. bupropion hydrochloride (Wellbutrin)
c. Sibutramine hydrochoride (Meridia)
d. Fluoxetine hydrochloride (Prozac)



205. Of the following bariatric surgical procedures, which is the best procedure for long-term weight loss?

a. Roux-en-Y
b. Vertical banded gastroplasty
c.Gastric ring application
d. Jejuno-ileal bypass

206. Which of the following statements regarding gastric cancer is accurate?

a. The incidence of cancer of the stomach continues to decrease in the United States.
b. Most gastric cancer deaths occur in people younger than 40 years.
c. Females have a higher incidence of gastric cancers than males.
d. A diet high in smoked foods and low in fruits and vegetables may decrease the risk of gastric cancer.

207. Which of the following categories of laxatives draw water into the intestines by osmosis?

a. Saline agents (milk of magnesia)
b. Bulk-forming agents (Metamucil)
c. Stimulants (Dulcolax)
d. Fecal softeners (Colace)

208.Crohn's disease is a condition of malabsorption caused by

a. inflammation of all layers of intestinal mucosa.
b. infectious disease.
c. disaccharidase deficiency.
d. gastric resection.


209.The nurse teaches the patient whose surgery will result in a sigmoid colostomy that the feces expelled through the colostomy will be

a. solid.
b. semi-mushy.
c. mushy.
d. fluid.

210. When irrigating a colostomy, the nurse lubricates the catheter and gently inserts it into the stoma no more than _______ inches

a. 3”
b. 2”
c. 4”
d. 5”

211.A longitudinal tear or ulceration in the lining of the anal canal is termed a (an)

a. anal fissure.
b. anorectal abscess.
c. anal fistula.
d. hemorrhoid.

212. Which type of diarrhea is caused by increased production and secretion of water and electrolyes by the intestinal mucosa into the intestinal lumen?

a. Secretory diarrhea
b. Osmotic diarrhea
c. Mixed diarrhea
d. Diarrheal disease

213.Which of the following terms is used to refer to intestinal rumbling?

a. Borborygmus
b. Tenesmus
c. Azotorrhea
d. Diverticulitis

214.The presence of mucus and pus in the stools suggests

a. Inflammatory colitis
b. Small bowel disease
c. Disorders of the colon
d. Intestinal malabsorption

215. Celiac sprue is an example of which category of malabsorption?

a. Mucosal disorders causing generalized malabsorption
b. Infectious diseases causing generalized malabsorption
c. Luminal problems causing malabsorption
d. Postoperative malabsorption

216.Typical signs and symptoms of appendicitis include:

a. Nausea
b. Left lower quadrant pain
c. Pain when pressure is applied to the right lower quadrant of the abdomen.
d. High fever

217.Regional enteritis is characterized by:

a. Transmural thickening
b. Diffuse involvement
c. Severe diarrhea
d. Exacerbations and remissions


218. What is the most common cause of small bowel obstruction?

a. Adhesions
b. Hernias
c. Neoplasms
d. Volvulus

219. Which of the follow statements provides accurate information regarding cancer of the colon and rectum?

a. Cancer of the colon and rectum is the second most common type of internal cancer in the United States.
b. Rectal cancer affects more than twice as many people as colon cancer.
c.The incidence of colon and rectal cancer decreases with age.
d. There is no hereditary component to colon cancer.

220. Which of the following characteristics are risk factors for colorectal cancer?

a. Familial polyposis
b. Age younger than 40
c. Low fat, low protein, high fiber diet
d. History of skin cancer

221.Which type of jaundice in adults is the result of increased destruction of red blood cells?

a. Hemolytic
b. Hepatocellular
c. Obstructive
d. Non-obstructive

222.The nurse places the patient after liver biopsy in which of the following
positions?

a. On the right side
b. On the left side
c. Trendelenburg
d. High Fowler's

223. Which of the following terms is used to describe a chronic liver disease in which scar tissue surrounds the portal areas?

a. Alcoholic cirrhosis
b. Postnecrotic cirrhosis
c. Biliary cirrhosis
d. Compensated cirrhosis

224.Which of the following terms describes the passage of a hollow instrument into a cavity for the withdrawal of fluid?

a. Paracentesis
b. Astrerixis
c. Ascites
d. Dialysis

225.Which of the following terms most precisely refers to the incision of the common bile duct for removal of stones?

a. Choledocholithotomy
b. Cholecystostomy
c. Choledochotomy
d. Choledochoduodenostomy

226.Which of the following clinical characteristics is associated with Type 1 diabetes (previously referred to as insulin-dependent diabetes mellitus [IDDM])?

a. Presence of islet cell antibodies
b. Obesity
c. Rare ketosis
d. Requirement for oral hypoglycemic agents

227.Which of the following clinical characteristics is associated with Type 2 diabetes (previously referred to as non-insulin-dependent diabetes mellitus [NIDDM])?

a. Can control blood glucose through diet and exercise
b. Usually thin at diagnosis
c. Ketosis-prone
d. Demonstrate islet cell antibodies

228. Of the following types of insulin, which is the most rapid acting?

a. Humalog
b. Regular
c. NPH
d. Ultralente

229. Of the following categories of oral antidiabetic agents, which exert their primary action by directly stimulating the pancreas to secrete insulin?

a. Sulfonylureas
b. Thiazolidinediones
c. Biguanides

d. Alpha glucosidase inhibitors

230.The nurse teaches the patient about diabetes including which of the following statements?

a. Elevated blood glucose levels contribute to complications of diabetes, such as
b. Sugar is found only in dessert foods.
c. The only diet change needed in the treatment of diabetes is to stop eating sugar.
d. Once insulin injections are started in the treatment of Type 2 diabetes, they can never be discontinued.

231.The nurse teaches the patient about glargine (Lantus), a "peakless" basal insulin including which of the following statements?

a. Do not mix the drug with other insulins
b. Administer the total daily dosage in two doses.
c. Draw up the drug first, then add regular insulin.
d. The drug is rapidly absorbed and has a fast onset of action.

232.Which of the following disorders is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex?

a. Cushing's syndrome
b. Addison's disease
c. Graves' disease
d. Hashimoto's disease

233. Of the following disorders, which results from excessive secretion of somatotropin?

a. Acromegaly
b. Cretinism
c. Dwarfism

d. Adrenogenital syndrome

234.Which of the following hormones is secreted by the posterior pituitary?

a. Vasopressin
b. Calcitonin
c. Corticosteroids
d. Somatostatin

235.Trousseau's sign is positive when

a. carpopedal spasm is induced by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff.
b. a sharp tapping over the facial nerve just in front of the parotid gland and anterior to the ear causes spasm or twitching of the mouth, nose, and eye.
c. after making a clenched fist, the palm remains blanched when pressure is placed over the radial artery.
d. The patient complains of pain in the calf when his foot is dorsiflexed.

236.The digestion of carbohydrates is aided by

a. amylase.
b. lipase.
c. trypsin.
d. secretin.

237.The term used to describe total urine output of less than 400 mL in 24 hours is

a. oliguria.
b. anuria.
c. nocturia.
d. dysuria.


238.When fluid intake is normal, the specific gravity of urine should be

a. 1.010-1.025.
b. 1.000.
c. less than 1.010.
d. greater than 1.025.

239. Of the following terms, which refers to casts in the urine?

a. Cylindruria
b. Crystalluria
c. Pyuria
d. Bacteriuria

240. When the nurse observes the patient's urine to be orange, she further assesses the patient for

a. intake of medication such as phenytoin (Dilantin).
b. bleeding.
c. intake of multiple vitamin preparations.
d. infection.

241.To assess circulating oxygen levels the 2001 Kidney Disease Outcomes Quality Initiative: Management of Anemia Guidelines recommends the use of which of the following diagnostic tests?

a. Hemoglobin
b. Hematocrit
c. Serum iron levels
d. Arterial blood gases




242.Which of the following types of incontinence refers to involuntary loss of urine through an intact urethra as a result of a sudden increase in intra-abdominal pressure?

a. Stress
b. Overflow
c. Urge
d. Reflex

243.To facilitate entry of a catheter into the male urethra, the penis should be positioned at which of the following degree angles (in relation to the body)?

a. 90 degrees
b. 45 degrees
c. 180 degrees
d. 270 degrees

244.In assessing the appropriateness of removing a suprapubic catheter, the nurse recognizes that the patient's residual urine must be less than which of the following amounts on two separate occasions (morning and evening)?

a. 100 cc
b. 30 cc
c. 50 cc
d. 400 cc

245.When providing care to the patient with bilateral nephrostomy tubes, the nurse never does which of the following?

a. Clamps each nephrostomy tube when the patient is moved
b. Reports a dislodged nephrostomy tube immediately
c. Measures urine output from each tube separately
d. Irrigates each nephrostomy tube with 30 cc of normal saline q8h as ordered


246. Which type of medication may be used in the treatment of a patient with incontinence to inhibit contraction of the bladder?

a. Anticholinergic agent
b. Estrogen hormone
c. Tricyclic antidepressants
d. Over-the-counter decongestant

247.Which of the following is a reversible cause of urinary incontinence in the older adult?

a. Constipation.
b. Increased fluid intake
c. Age
d. Decreased progesterone level in the menopausal woman.

248.Bladder retraining following removal of an indwelling catheter begins with
instructing the patient to follow a 2-3 hour timed voiding schedule.
Immediately after the removal of the indwelling catheter, the patient is placed on a timed voiding schedule, usually two to three hours. At the given time interval, the patient is instructed to void.

a. encouraging the patient to void immediately.
b. advising the patient to avoid urinating for at least 6 hours.
c. performing straight catherization after 4 hours.

249. Which of the following terms is used to refer to inflammation of the renal pelvis?

a.Pyelonephritis
b. Cystitis
c. Urethritis
d. Interstitial nephritis


250.If an indwelling catheter is necessary, nursing interventions that should be implemented to prevent infection include

a. performing meticulous perineal care daily with soap and water.
b. using clean technique during insertion.
c. using sterile technique to disconnect the catheter from tubing to obtain urine specimens.
d. placing the catheter bag on the patient's abdomen when moving the patient.

251.The nurse who provides teaching to the female patient regarding prevention of recurrent urinary tract infections includes which of the following statements?

a. Void immediately after sexual intercourse.
b. Take tub baths instead of showers.
c. Increase intake of coffee, tea, and colas.
d. Void every 5 hours during the day.

252.A history of infection specifically caused by group A beta-hemolytic streptococci is associated with which of the following disorders?

a. Acute glomerulonephritis
b. Acute renal failure
c. Chronic renal failure
d. Nephrotic syndrome

253.Rejection of a transplanted kidney within 24 hours after transplant is termed

a. hyperacute rejection.
b. acute rejection.
c. chronic rejection.
d. simple rejection.


254.When caring for a patient with an uncomplicated, mild urinary tract infection (UTI), the nurse knows that recent studies have shown which of the following drugs to be a good choice for short-course (e.g. 3-day) therapy?

a. Levofloxacin (Levaquin)
b. Trimethoprim sulfamethoxazole (TMP-SMZ, Bactrim, Septra)
c. Nitrofurantoin (Macrodantin, Furadantin)
d. Ciprofloxacin (Cipro)

255.Which of the following terms refers to difficult or painful sexual intercourse?

a. Dyspareunia
b. Amenorrhea
c. Dysmenorrhea
d. Endometriosis

256.The opening into the vagina on the perineum is termed the

a. introitus.
b. adnexa.
c. cervix.
d. hymen.

257. Which of the following hormones is primarily responsible for stimulating the production of progesterone?

a. Luteinizing hormone
b. Follicle-stimulating hormone
c.Estrogen.
d. Androgen




258. When the results of a Pap smear are reported as class 5, the nurse recognizes that the common interpretation is

a. malignant.
b. normal.
c. probably normal.
d. suspicious.

259. For women aged 19-39 years, recommended health screening diagnostic testing includes which of the following?

a. Pap smear
b. Mammography
c. Cholesterol and lipid profile
d. Bone mineral density testing

260. Which of the following statements reflects nursing care of the woman with mild to moderate ovarian hyperstimulation syndrome (OHSS)?

a. Advise the patient to decrease her activity, monitor her urine output and to return for frequent office visits.
b. Advise the patient to measure her weight and abdominal circumference daily.
c. Advise the patient to monitor her heart rate and to report if her pulse falls below 60 beats per minute.
d. Prepare the patient for immediate hospitalization.

261. Which of the following terms is used to describe a procedure in which cervical tissue is removed as result of detection of abnormal cells?

a. Conization
b. Colporrhaphy
c. Cryotherapy
d. Perineorrhaphy


262. Of the following terms, which is used to refer to a type of gestational trophoblastic neoplasm?

a. Hydatidiform mole
b. Dermoid cyst
c. Doderlein's bacilli
d. Bartholin's cyst

263. When the female client reports a frothy yellow-brown vaginal discharge, the nurse suspects the client has a vaginal infection caused by

a. trichomonas vaginalis.
b. candida albicans.
c. gardnerella vaginalis.
d. chlamydia.

264. The nurse providing education regarding sexually transmitted diseases includes which of the following statements regarding herpes virus 2 (herpes genitalis)?

a. In pregnant women with active herpes virus, babies delivered vaginally may become infected with the virus.
b. Transmission of the virus requires sexual contact.
c. Transmission occurs only when the carrier has symptoms.
d. The virus is very difficult to kill.

265.An opening between the bladder and the vagina is called a

a. vesicovaginal fistula.
b. cystocele.
c. rectocele.
d. rectovaginal fistula.


266. Which of the following statements defines laparoscopic myomectomy—an alternative to hysterectomy for the treatment of excessive bleeding due to fibroids?

a.Removal of fibroids through a laparoscope inserted through a small abdominal incision.
b. Cauterization and shrinking of fibroids using a laser or electrical needles.
c. Coagulation of the fibroids using electrical current.
d. Resection of the fibroids using a laser through a hyserscope passed through the cervix.

267. Stage 3 of breast development, according to Tanner, occurs when

a. the areola (a darker tissue ring around the nipple) develops.
b. breast budding begins.
c. the areola and nipple form a secondary mound on top of breast tissue.
d. the breast develops into a single contour
In stage 5, the female demonstrates continued development of a larger breast with a single contour.

268. When the female patient demonstrates thickening, scaling, and erosion of the nipple and areola, the nurse recognizes that the patient is exhibiting signs of

a. Paget's disease.
b. acute mastitis.
c. fibroadenoma.
d. peau d'orange (edema).

269.The nurse teaches the female patient who is premenopausal to perform breast self-examination (BSE)

a. on day 5 to day 7, counting the first day of menses as day 1.
b. with the onset of menstruation
c. on day 2 to day 4, counting the first day of menses as day 1.

d. any time during the month.

270. Which type of biopsy is used for nonpalpable lesions found on mammography?

a. Stereotactic.
b. Excisional
c. Incisional.
d. Tru-Cut core

271.The nurse recognizes which of the following statements as accurately reflecting a risk factor for breast cancer?

a. Mother affected by cancer before 60 years of age
b. Onset of menses before 14 years of age
c. Multiparity
d. No alcohol consumption.

272. Which of the following terms is used to describe removal of the breast tissue and an axillary lymph node dissection leaving muscular structure intact as surgical treatment of breast cancer?

a. Modified radical mastectomy
b. Segmental mastectomy
c. Total mastectomy
d. Radical mastectomy

273. Ductal lavage is used for

a. women at higher risk for benign proliferative breast disease.
b. women at low risk for breast cancer.
c. screening women over age 65.
d. women with breast implants.


274. The 2000 NIH Consensus Development Conference Statement states that what percentage of women with invasive breast cancer should consider the option of systemic chemotherapy, not just women whose tumors are greater than 1cm in size?

a. 100% (all)
b. 75%
c. 50%
d. 25%

275. Which of the following terms refers to surgical removal of one of the testes?

a. Orchiectomy
b. Circumcision
c. Vasectomy
d. Hydrocelectomy

276. The term or disease associated with buildup of fibrous plaques in the sheath of the corpus cavernosum causing curvature of the penis when it is erect is known as

a. Peyronie's disease.
b. Bowen's disease.
c. phimosis.
d. priapism.

277. Which of the following terms is used to describe the opening of the urethra on the dorsum of the penis?

a. Epispadias
b. Hypospadias
c. Urethral stricture
d. Urethritis



278. The nurse teaches the patient who has been prescribed Viagra which of the following guidelines?

a. Do not take more than one tablet per day of your prescribed dose.
b. Viagra should be taken immediately before intercourse.
c. Viagra will result in erection formation.
d. Viagra will restore sex drive.

279. The obstructive and irritative symptom complex caused by benign prostatic hypertrophy is termed

a. prostatism.
b. prostatitis.
c. prostaglandin.
c. prostatectomy.

280. Proteins formed when cells are exposed to viral or foreign agents that are capable of activating other components of the immune system are referred to as

a. interferons.
b. antibodies.
c. antigens.
d. complements.

281.Cytotoxic T cells

a. lyse cells infected with virus.
b. are important in producing circulating antibodies.
c. attack foreign invaders (antigens) directly.
d. decrease B cell activity to a level at which the immune system is compatible with life.



282. During which stage of the immune response does the circulating lymphocyte containing the antigenic message return to the nearest lymph node?

a. Proliferation
b. Recognition
c. Response
d. Effector

283.Which of the following responses identifies a role of T lymphocytes?

a.Transplant rejection
b. Anaphylaxis
c. Allergic hay fever and asthma
d. Bacterial phagocytosis and lysis

284. Of the following classifications of medications, which is known to inhibit prostaglandin synthesis or release?

a. Nonsteroidal anti-inflammatory drugs (NSAIDs) in large doses
b. Antibiotics (in large doses)
c. Adrenal corticosteroids
d. Antineoplastic agents

285. Which of the following statements reflect current stem cell research?

a. The stem cell is known as a precursor cell that continually replenishes the body's entire supply of both red and white cells.
b. Stem cell transplantation can restore immune system functioning.
c. Stem cell transplantion has been performed in the laboratory only.
d. Clinical trials are underway in patients with acquired immune deficiencies only.



286. The nurse's base knowledge of primary immunodeficiencies includes which of the following statements? Primary immunodeficiencies

a. develop early in life after protection from maternal antibodies decreases.
b. occur most commonly in the aged population.
c. develop as a result of treatment with antineoplastic agents.
d. disappear with age.

287. Agammaglobulinemia is also known as

a. Bruton's disease.
b. Nezelof syndrome.
c. Wiskott-Aldrich syndrome.
d. Common variable immunodeficiency (CVID)

288. When the nurse administers intravenous gamma-globulin infusion, she recognizes that which of the following complaints, if reported by the patient, may indicate an adverse effect of the infusion?

a. Tightness in the chest
b. Nasal stuffiness
c. Increased thirst
d. Burning urination

289. Ataxia is the term that refers to

a. uncoordinated muscle movement.
b. vascular lesions caused by dilated blood vessels.
c. inability to understand the spoken word.
d. difficulty swallowing.



290. Which of the following microorganisms is known to cause retinitis in people with HIV/AIDS?

a. Cytomegalovirus
b. Cryptococcus neoformans
c.Mycobacterium avium.
d. Pneumocystic carinii

291. Of the following blood tests, which confirms the presence of antibodies to HIV?

a. Enzyme-linked immunoabsorbant assay (ELISA)
b. Erythrocyte sedimentation rate (ESR)
c. p24 antigen
d. Reverse transcriptase

292. When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean.

a. his body has not produced antibodies to the AIDS virus.
b. he has not been infected with HIV.
c. he is immune to the AIDS virus.
d. antibodies to the AIDS virus are in his blood.

293. Which of the following substances may be used to lubricate a condom?

a. K-Y jelly
b. Skin lotion
c. Baby oil
d. Petroleum jelly

294. More than 500 CD4+ T lymphocytes/mm3 indicates which stage of HIV infection?

a. CDC category A - HIV asymptomatic
b. Primary infection (acute HIV infection or acute HIV syndrome)
c. CDC category B - HIV symptomatic
d. CDC category C - AIDS

295. The term used to define the balance between the amount of HIV in the body and the immune response is

a. viral set point
b. window period
c. primary infection stage
d. viral clearance rate

296. Which of the following statements reflect the treatment of HIV infection?

a. Treatment of HIV infection for an individual patient is based on the clinical condition of the patient, CD4 T cell count level, and HIV RNA (viral load).
b. Treatment should be offered to all patients once they reach CDC category B - HIV symptomatic.
c. Treatment should be offered to only selected patients once they reach CDC category B - HIV symptomatic.
d. Treatment should be offered to individuals with plasma HIV RNA levels less than 55,000 copies/mL (RT-PCR assay.)

297. Which of the following body substances causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle?

a. Histamine
b. Bradykinin
c. Serotonin
Serotonin is a chemical mediator that acts as a potent vasoconstrictor and d. Prostaglandin


298. Which type of hypersensitivity reaction involves immune complexes formed when antigens bind to antibodies?

a. Type III
b. Type I
c. Type II
d. Type IV

299. When the patient's eosinophil count is 50-90% of blood leukocytes, the nurse interprets the result as

a. indicative of idiopathic hypereosinophilic syndrome.
b. indicating an allergic disorder.
c. suggesting an allergic reaction.
d. normal.

300. Which of the following interventions is the single most important aspect for the patient at risk for anaphylaxis?

a. Prevention
b. Use of antihistamines
c. Desensitization
d. Wearing of medical alert bracelet

301. When the nurse observes diffuse swelling involving the deeper skin layers in the patient who has experienced an allergic reaction, the nurse records the finding as

a. angioneurotic edema.
b. urticaria.
c. contact dermatitis.
d. pitting edema.


302. Atopic allergic disorders are characterized by

a. a hereditary predisposition.
b. an IgA-mediated reaction.
c. production of a systemic reaction.
d. a response to physiologic allergens.

303. The nurse teaches the patient with allergies about anaphylaxis including which of the following statements?

a. The most common cause of anaphylaxis is penicillin.
b. Anaphylactoid (anaphylaxis-like) reactions are commonly fatal.
c. The most common food item causing anaphylaxis is chocolate.
d. Systemic reactions include urticaria and angioedema

304. Which of the following statements describes the clinical manifestations of a delayed hypersensitivity (type IV) allergic reaction to latex?

a. Signs and symptoms are localized to the area of exposure, usually the back of the hands.
b. Signs and symptoms can be eliminated by changing glove brands or using powder-free gloves.
c. Signs and symptoms may worsen when hand lotion is applied before donning latex gloves.
d. Signs and symptoms occur within minutes after exposure to latex.

305. Which of the following terms refers to fixation or immobility of a joint?
a. Ankylosis
b. Hemarthrosis
c. Diarthrodial
d. Arthroplasty



306. Accumulation of crystalline depositions in articular surfaces, bones, soft tissue, and cartilage is referred to as

a. tophi.
b. subchondral bone.
c. pannus.
d. joint effusion.

307. Passive range-of-motion exercises are indicated during which stage of rheumatic disease?

a. Acute
b. Subacute
c. Inactive
d. Remission

308. Which of the following connective tissue disorders is characterized by insoluble collagen being formed and accumulating excessively in the tissues?

a. Scleroderma
b. Rheumatoid arthritis
c. Systemic lupus erythematosus
d. Polymyalgia rheumatic

309. Osteoarthritis is known as a disease that

a. is the most common and frequently disabling of joint disorders.
b. affects young males.
c. requires early treatment because most of the damage appears to occur early in the course of the disease.
d. affects the cartilaginous joints of the spine and surrounding tissues.


310. Which of the following newer pharmacological therapies used for the treatment of osteoarthritis is thought to improve cartilage function and retard degradation as well as have some anti-inflammatory effects?

a. Viscosupplementation
b. Glucosamine
c. Chondroitin
Chondroitin and glucosamine are thought to improve tissue function and retard d. Capsaicin

311. Which of the following statements reflect nursing interventions in the care of the patient with osteoarthritis?

a. Encourage weight loss and an increase in aerobic activity.
b. Provide an analgesic after exercise.
c. Assess for the gastrointestinal complications associated with COX-2 inhibitors.
d. Avoid the use of topical analgesics.

312. Fibromyalgia is a common condition that

a. involves chronic fatigue, generalized muscle aching and stiffness.
b. is caused by a virus.
c. is treated by diet, exercise, and physical therapy.
d. usually lasts for less than two weeks,

313. Which of the following terms refers to a condition characterized by destruction of the melanocytes in circumscribed areas of the skin?

a. Vitiligo
b. Hirsutism
c. Lichenification
d. Telangiectases


314. Of the following types of cells, which are believed to play a significant role in cutaneous immune system reactions?

a. Langerhans' cells
b. Merkel's cells
c. Melanocytes
d. Phagocytes

315. When the nurse assesses the patient and observes blue-red and dark brown plaques and nodules, she recognizes that these manifestations are associated with

a.Kaposi's sarcoma.
b. platelet disorders.
c. allergic reactions.
d. syphilis.

316.The nurse reading the physician's report of an elderly patient’s physical examination knows a notation that the patient demonstrates xanthelasma refers to

a. yellowish waxy deposits on upper eyelids.
b. liver spots.
c. dark discoloration of the skin.
d. bright red moles.

317.The nurse notes that the patient demonstrates generalized pallor and recognizes that this finding may be indicative of

a. anemia.
b. albinism.
c. vitiligo.
d. local arterial insufficiency.


318. Which of the following terms refers most precisely to a localized skin infection of a single hair follicle?

a. Furuncle
b. Carbuncle
c. Chelitis.
d. Comedone.

319. The nurse recommends which of the following types of therapeutic baths for its antipruritic action?

a. Colloidal (Aveeno, oatmeal)
b. Sodium bicarbonate (baking soda)
c. Water
d. Saline

320. Which of the following materials consists of a powder in water?

a. Suspension
b. Hygroscopic agent
c. Paste
d. Linament

321. Which of the following skin conditions is caused by staphylococci, streptococci, or multiple bacteria?

a. Impetigo
b. Scabies
c. Pediculosis capitis
d. Poison ivy



322. The nurse teaches the patient who demonstrates herpes zoster (shingles) that

a. the infection results from reactivation of the chickenpox virus.
b. once a patient has had shingles, they will not have it a second time.
c. a person who has had chickenpox can contract it again upon exposure to a person with shingles.
d. There are no known medications that affect the course of shingles.

323. Development of malignant melanoma is associated with which of the following risk factors?

a. Individuals with a history of severe sunburn
b. African-American heritage
c. People who tan easily
d. Elderly individuals residing in the Northeast

324. When caring for a patient receiving autolytic debridement therapy, the nurse

a. advises the patient about the foul odor that will occur during therapy.
b. ensures that the dressing is kept dry at all times.
c. ensures that the wound is kept open to the air for at least six hours per day.
d. Uses an enzymatic debriding agent such as Pancrease.

325. Which of the following reflect the pathophysiology of cutaneous signs of HIV disease?

a. Immune function deterioration
b. High CD4 count
c. Genetic predisposition
d. Decrease in normal skin flora




326. Most skin conditions related to HIV disease may be helped primarily by

a. highly active antiretroviral therapy (HAART).
b. symptomatic therapies.
c. low potency topical corticosteroid therapy.
d. improvement of the patient's nutritional status.

327. Which of the following terms refers to a graft derived from one part of a patient's body and used on another part of that same patient's body?

a. Autograft
b. Allograft
c. Homograft
d. Heterograft

328. When the emergency nurse learns that the patient suffered injury from a flash flame, the nurse anticipates which depth of burn?

a. Deep partial thickness
b. Superficial partial thickness
c. Full thickness
d. Superficial

329. Regarding emergency procedures at the burn scene, the nurse teaches which of the following guidelines?

a. Never wrap burn victims in ice.
b. Apply ice directly to a burn area.
c. Never apply water to a chemical burn.
d. Maintain cold dressings on a burn site at all times.




330. The first dressing change for an autografted area is performed

a. as soon as foul odor or purulent drainage is noted, or 3-5 days after surgery.
b. within 12 hours after surgery.
c. within 24 hours after surgery.
d. as soon as sanguineous drainage is noted.

331. Which of the following observations in the patient who has undergone allograft for treatment of burn site must be reported to the physician immediately?

a. Crackles in the lungs
b. Pain at the allograft donor site
c. Sanguineous drainage at the allograft donor site
d. Decreased pain at the allograft recipient site

332. Which of the following factors are associated with increased fluid requirements in the management of patients with burn injury?

a. Inhalation injuries
b. Chemical burn injuries
c. Low-voltage electrical injuries
d. Hypoglycemia

333. antimicrobial barrierActicoat dressings used in the treatment of burn wounds can be left in place for
a. five days.
b. seven to ten days.
c. three days.
d. two days.





334.A new biosynthetic dressing used , is used to treatin the treatment of burns, TransCyte

a. burns of indeterminate depth
b. partial-thickness burns.
c. superficial burns.
d. donor sites.

335. Which of the following statements reflect current research regarding the utilization of non-pharmacological measures in the management of burn pain?

a. Music therapy may provide reality orientation, distraction, and sensory stimulation.
b. Music therapy diverts the patient's attention toward painful stimulus.
c. Humor therapy has not proven effective in the management of burn pain.
d. Pet therapy has proven effective in the management of burn pain.

336. The most important intervention in the nutritional support of a patient with a burn injury is to provide adequate nutrition and calories to:

a. decrease catabolism.
b. increase metabolic rate.
c. increase glucose demands.
d. increase skeletal muscle breakdown.

337. Which of the following terms refers to the absence of the natural lens?

a. Aphakia
b. Scotoma
c. Keratoconus
d. Hyphema



338.Edema of the conjunctiva is termed

a. chemosis.
b. papilledema.
c. proptosis.
d. strabismus.

339. When the patient tells the nurse that his vision is 20/200, and asks what that means, the nurse informs the patient that a person with 20/200 vision

a. sees an object from 20 feet away that a person with normal vision sees from 200 feet away.
b. sees an object from 200 feet away that a person with normal vision sees from 20 feet away.
c. sees an object from 20 feet away that a person with normal vision sees from 20 feet away.
d. sees an object from 200 feet away that a person with normal vision sees from 200 feet away.

340. Which type of glaucoma presents an ocular emergency?

a. Acute angle-closure glaucoma
b. Normal tension glaucoma
c. Ocular hypertension
d. Chronic open-angle glaucoma

341. Which of the following categories of medications increases aqueous fluid outflow in the patient with glaucoma?

a. Cholinergics
b. Beta-blockers
c. Alpha-adrenergic agonists
d. Carbonic anhydrase inhibitors


342. Which of the following statements describe refractive surgery?

a. Refractive surgery is an elective, cosmetic surgery performed to reshape the cornea.
b. Refractive surgery will alter the normal aging of the eye.
c. Refractive surgery may be performed on all patients, even if they have underlying health conditions.
d. Refractive surgery may be performed on patients with an abnormal corneal structure as long as they have a stable refractive error.

343. The nurse knows that a postoperative vision-threatening complication of LASIK refractive surgery, diffuse lamellar keratitis (DLK) occurs

a. in the first week after surgery.
b. 1 month after surgery.
c. 2-3 months after surgery.
d. 6 months after surgery.

344. The nurse advises the patient undergoing photodynamic therapy (PDT) for macular degeneration to avoid exposure to direct sunlight or bright lights for

a. the first five days after the procedure.
b. the first 24 hours after the procedure.
c. two weeks after the procedure.
d. the first month after the procedure.

345. Retinoblastoma is the most common eye tumor of childhood; it is hereditary in

a. 30-40% of cases.
b. 10-20% of cases.
c. 25-50% of cases.
d. 50-75% of cases.


346. Which of the following terms refers to altered sensation of orientation in space?

a. Dizziness
b. Vertigo
c. Tinnitus
d. Nystagmus

347. Of the following terms, which describes a condition characterized by abnormal spongy bone formation around the stapes?

a. Otosclerosis
b. Middle ear effusion
c. Chronic otitis media
d. Otitis externa

348. Ossiculoplasty is defined as

a. surgical reconstruction of the middle ear bones.
b. surgical repair of the eardrum.
c. incision into the tympanic membrane.
d. incision into the eardrum.

349. Which of the following terms refers to surgical repair of the tympanic membrane?

a. Tympanoplasty
b. Tympanotomy
c. Myringotomy
d. Ossiculoplasty

350. Of the following tests, which uses a tuning fork between two positions to assess hearing?

a. Rinne's
b. Whisper
c. Watch tick
d. Weber's

351. Which of the following conditions of the inner ear is associated with normal hearing?

a.Vestibular neuronitis
b. Meniere's disease
c. Labyrinthitis
d. Endolymphatic hydrops

352. Of the following terms, which refers to the progressive hearing loss associated with aging?

a. Presbycusis
b. Exostoses
c. Otalgia
d. Sensorineural hearing loss

353. Which of the following statements describes benign paroxysmal positional vertigo (BPPV)?

a. The vertigo is usually accompanied by nausea and vomiting; however hearing impairment does not generally occur.
b.The onset of BPPV is gradual.
c. BPPV is caused by tympanic membrane infection.
d. BPPV is stimulated by the use of certain medication such as acetaminophen.

354. Nursing management of the patient with acute symptoms of benign paroxysmal positional vertigo includes which of the following?

a. Bed rest

b. The Epley repositioning procedure
c. Meclizine for 2-4 weeks
d. The Dix-Hallpike procedure.

355. Which of the following terms refers to the inability to recognize objects through a particular sensory system?

a. Agnosia
b. Dementia
c. Ataxia
d. Aphasia

356. Which of the following terms refers to weakness of both legs and the lower part of the trunk?

a. Paraparesis
b. Hemiplegia
c. Quadriparesis
d. Paraplegia

357. Of the following neurotransmitters, which demonstrates inhibitory action, helps control mood and sleep, and inhibits pain pathways?

a. Serotonin
b. Enkephalin
c. Norepinephrine
d. Acetylcholine

358. The lobe of the brain that contains the auditory receptive areas is the ____________ lobe.

a. temporal
b. frontal

c. parietal
d. occipital

359. The lobe of the brain that is the largest and controls abstract thought is the ____________ lobe.

a. frontal
b. temporal
c. parietal
d. occipital

360. Which of the following terms is used to describe the fibrous connective tissue that covers the brain and spinal cord?

a. Meninges
b. Dura mater
c. Arachnoid mater
d. Pia mater

361. The cranial nerve that is responsible for salivation, tearing, taste, and sensation in the ear is the _____________________ nerve.

a. vestibulocochlear
b. oculomotor
c. trigeminal
d. facial

362. The cranial nerve that is responsible for muscles that move the eye and lid is the _____________________ nerve.

a. oculomotor
b. trigeminal
c. vestibulocochlear

d. facial

363.The cranial nerve that is responsible for facial sensation and corneal reflex is the _____________________ nerve.

a. trigeminal
b. oculomotor
c. vestibulocochlear
d. facial

364. Upper motor neuron lesions cause

a. no muscle atrophy.
b. decreased muscle tone.
c. flaccid paralysis.
d. absent or decreased reflexes.

365. Lower motor neuron lesions cause

a. flaccid muscle paralysis.
b. increased muscle tone.
c. no muscle atrophy.
d. hyperactive and abnormal reflexes.

366. The percentage of patients over the age of 70 admitted to the hospital with delirium is about

a. 25%.
b. 10%.
c. 40%.
d. 50%.



367. Structural and motor changes related to aging that may be assessed in geriatric patients during an examination of neurologic function include which of the following?

a. Decreased or absent deep tendon reflexes
b. Increased pupillary responses
c. Increased autonomic nervous system responses.
d. Enhanced reaction and movement times

368. What safety actions does the nurse need to take for a patient on oxygen therapy who is undergoing magnetic resonance imaging (MRI)?

a. Ensure that no patient care equipment containing metal enters the room where the MRI is located.
b. Securely fasten the patient's portable oxygen tank to the bottom of the MRI table after the patient has been positioned on the top of the MRI table.
c. Check the patient's oxygen saturation level using a pulse oximeter after the patient has been placed on the MRI table.
d. No special safety actions need to be taken.

369. Which of the following terms refer to a method of recording, in graphic form, the electrical activity of the muscle?

a. Electromyogram
b. Electroencephalogram
c. Electrocardiography
d. Electrogastrography

370. Which of the following are sympathetic effects of the nervous system?

a. Dilated pupils
b. Decreased blood pressure
c. Increased peristalsis
d. Decreased respiratory rate

371. Lesions in the temporal lobe may result in which of the following types of agnosia?

a. Auditory
b. Visual
c. Tactile
d. Relationship

372. When the nurse observes that the patient has extension and external rotation of the arms and wrists and extension, plantar flexion, and internal rotation of the feet, she records the patient's posturing as

a. decerebrate.
b. normal.
c. flaccid.
d. decorticate.

373. Monro-Kellie hypothesis refers to

a. the dynamic equilibrium of cranial contents.
b. unresponsiveness to the environment.
c. the brain's attempt to restore blood flow by increasing arterial pressure to overcome the increased intracranial pressure.
d. a condition in which the patient is wakeful but devoid of conscious content, without cognitive or affective mental function.

374. A patient who demonstrates an obtunded level of consciousness

a. sleeps almost constantly but can be aroused and can follow simple commands.
b. has difficulty following commands, and may be agitated or irritable.
c. sleeps often and shows slowed speech and thought processes.
d. does not respond to environmental stimuli.


375. An osmotic diuretic, such as Mannitol, is given to the patient with increased intracranial pressure (IICP) in order to

a. dehydrate the brain and reduce cerebral edema.
b. control fever.
c. control shivering.
d. reduce cellular metabolic demands.

376. Which of the following positions are employed to help reduce intracranial pressure (ICP)?

a. Avoiding flexion of the neck with use of a cervical collar
b. Keeping the head flat with use of no pillow
c. Rotating the neck to the far right with neck support
d. Extreme hip flexion supported by pillows

377. Which of the following insults or abnormalities most commonly causes ischemic stroke?

a. Cocaine use
b. Arteriovenous malformation
c. Trauma
d. Intracerebral aneurysm rupture


378. When the patient is diagnosed as having global aphasia, the nurse recognizes that the patient will

a. be unable to form words that are understandable or comprehend the spoken word.
b. be unable to comprehend the spoken word.
c. be unable to form words that are understandable.
d. be unable to speak at all.


379. Which of the following terms related to aphasia refers to the inability to perform previously learned purposeful motor acts on a voluntary basis?

a. Apraxia
b. Agnosia
c. Agraphia
d. Perseveration

380. Which of the following terms related to aphasia refers to the failure to recognize familiar objects perceived by the senses?

a. Agnosia
b. Agraphia
c. Apraxia
d. Perseveration

381. Which of the following terms related to aphasia refers to difficulty reading?

a. Alexia
b. Agnosia
c. Agraphia
d. Perseveration

382. Which of the following terms related to aphasia refers to difficulty in selecting appropriate words, particularly nouns?

a. Anomia
b. Acalculia
c. Dysarthria
d. Paraphasia




383. A patient has had neurologic deficits lasting for more than 24 hours, and now the symptoms are resolving. The nurse concludes that the patient has had which type of stroke?

a. Reversible ischemic neurologic deficit
b. Transient ischemic attack (TIA)
c. Stroke in evolution
d. Completed stroke

384. Which of the following is a modifiable risk factor for transient ischemic attacks and ischemic strokes?

a. History of smoking.
b. Thyroid disease
c. Social drinking
d. Advanced age

385. A patient who has had a previous stroke and is taking warfarin tells the nurse that he started taking garlic to help reduce his blood pressure. The nurse knows that garlic when taken together with warfarin

a. can greatly increase the international normalization ratio (INR) and therefore increase the risk of bleeding.
b. have no drug-drug interactions and therefore may be taken together.
c. can cause platelet aggregation and therefore increase the risk of blood clotting.
d. may increase cerebral blood flow causing migraine headaches.

386. Later signs of increased intracranial pressure (ICP) later include which of the following?

a. Projectile vomiting
b. Increased pulse rate
c. Decreased blood pressure

d. Narrowed pulse pressure

387.Bleeding between the dura mater and arachnoid membrane is termed

a. subdural hematoma.
b. intracerebral hemorrhage.
c. epidural hematoma.
d. extradural hematoma.

388. Which of the following statements reflect nursing management of the patient with expressive aphasia?

a. Encourage the patient to repeat sounds of the alphabet.
b. Speak clearly and in simple sentences; use gestures or pictures when able.
c. Speak slowly and clearly to assist the patient in forming the sounds.
d. Frequently reorient the patient to time, place, and situation.

389. Health promotion efforts to decrease the risk for ischemic stroke involve encouraging a healthy lifestyle including

a. a low fat, low cholesterol diet, and increasing exercise.
b. eating fish no more than once a month.
c. a high protein diet and increasing weight-bearing exercise.
d. a low cholesterol, low protein diet, and decreasing aerobic exercise.

390. Before the patient diagnosed with a concussion is released from the Emergency Department, the nurse teaches the family or friends who will be tending to the patient to contact the physician or return to the ED if the patient

a. vomits.
b. complains of headache.
c. complains of generalized weakness.
d. sleeps for short periods of time.


391. When the nurse reviews the physician's progress notes for the patient who has sustained a head injury and sees that the physician observed Battle's sign when the patient was in the Emergency Department, the nurse knows that the physician observed

a. an area of bruising over the mastoid bone.
b. a bloodstain surrounded by a yellowish stain on the head dressing.
c. escape of cerebrospinal fluid (CSF) from the patient's ear.
d. escape of cerebrospinal fluid (CSF) from the patient's nose.

392. Which of the following findings in the patient who has sustained a head injury indicate increasing intracranial pressure (ICP)?

a. Widened pulse pressure
b. Increased pulse
c. Decreased respirations
d. Decreased body temperature

393. Which of the following nursing interventions is appropriate when caring for the awake and oriented head injury patient?

a. Supply oxygen therapy to keep blood gas values within normal range.
b. Do not elevate the head of the bed.
c. Encourage the patient to cough every 2 hours.
d. Use restraints if the patient becomes agitated.

394. Of the following stimuli, which is known to trigger an episode of autonomic hyperreflexia in the patient who has suffered a spinal cord injury?

a. Applying a blanket over the patient
b. Diarrhea
c. Placing the patient in a sitting position

d. Voiding

395. Risk factors that increase the likelihood of post-traumatic seizures following a head injury include which of the following?

a. Age over 65 years
b. Loss of consciousness for less than 1 day
c. Glasgow Coma Scale (GCS) score less than 10
d. Epidural hematoma

396. A post-traumatic seizure classified as early occurs

a. within 1-7 days of injury.
b. within 4 hours of injury.
c. within 24 hours of injury.
d. more than 7 days following surgery.

397. The nurse assesses the dressing of a patient with a basal skull fracture and sees the halo sign - a blood stain surrounded by a yellowish stain. The nurse knows that this sign

a. is highly suggestive of a cerebrospinal fluid (CSF) leak.
b. may indicate a subdural hematoma..
c. is highly suggestive of a cerebral contusion.
d. normally occurs within 24 hours following a basal skull fracture.

398. A Glasgow Coma Scale (GCS) score of 7 or less is generally interpreted as

a. coma.
b. a need for emergency attention.
c. least responsive.
d. most responsive.


399. Which of the following terms refers to muscular hypertonicity with increased resistance to stretch?

a. Spasticity
b. Akathesia
c. Ataxia
d. Myclonus

400. Of the following terms, which refers to blindness in the right or left halves of the visual fields of both eyes?

a.Homonymous hemianopsia
b. Scotoma
c. Diplopia
d. Nystagmus

401.Which of the following terms is used to describe rapid, jerky, involuntary, purposeless movements of the extremities?

a.Chorea
b. Bradykinesia
c. Dyskinesia
d. Spondylosis

402. Which of the phases of a migraine headache usually lasts less than an hour?

a. Aura
b.Prodrome
c.Headache
d. Recovery



403.The most common type of brain neoplasm is the

a. glioma.
b. angioma.

c. meningioma.

d. neuroma.

404. Which of the following diseases is a chronic, degenerative, progressive disease of the central nervous system characterized by the occurrence of small patches of demyelination in the brain and spinal cord?

a. Multiple sclerosis
b. Parkinson's disease
c. Huntington's disease
d. Creutzfeldt-Jakob's disease

405. Which of the following diseases is associated with decreased levels of dopamine due to destruction of pigmented neuronal cells in the substantia nigra in the basal ganglia of the brain?

a. Parkinson's disease
b. Multiple sclerosis
c. Huntington's disease
d. Creutzfeldt-Jakob's disease

406. Which of the following diseases is a chronic, progressive, hereditary disease of the nervous system that results in progressive involuntary dance-like movement and dementia?

a. Huntington's disease
b. Multiple sclerosis

c. Parkinson's disease
d. Creutzfeldt-Jakob's disease

407. Which of the following diseases is a rare, transmissible, progressive fatal disease of the central nervous system characterized by spongiform degeneration of the gray matter of the brain?

a. Creutzfeldt-Jakob's disease
b. Multiple sclerosis
c. Parkinson's disease
d. Huntington's disease

408. Bell's palsy is a disorder of which cranial nerve?

a. Facial (VII)
b. Trigeminal (V)
c. Vestibulocochlear (VIII)
d. Vagus (X)

409. The most common cause of acute encephalitis in the United States is

a. Herpes Simplex Virus (HSV).
b. Cryptococcus neoformans.
c. Western equine bacteria.
d. Candida albicans.

410. Which of the following reflects basic nursing measures in the care of the patient with viral encephalitis?

a. Providing comfort measures
b. Administering narcotic analgesics
c. Administering amphotericin B.
d. Monitoring cardiac output

411. Nursing management of the patient with new variant Creutzfeldt-Jakob Disease (nvCJD) includes

a. providing supportive care.
b. initiating isolation procedures.
c. preparing for organ donation.
d. administering amphotericin B.

412. Three medications referred to as the 'ABC drugs' are currently the main pharmacological therapy for multiple sclerosis. Which of the following statements reflects information to be included in patient teaching?

a. Flu-like symptoms can be controlled with nonsteroidal anti-inflammatory drugs (NSAIDs) and usually resolve after a few months of therapy.
b. Take interferon beta-la (Avonex) with food or milk.
c. Take interferon beta-1b (Betaseron) at night before bedtime for best effects.
d. Take glatiramer acetate (Copaxone) on an empty stomach.

413. Korsakoff's syndrome is characterized by

a. psychosis, disorientation, delirium, insomnia, and hallucinations.
b. severe dementia and myocLonus.
c. tremor, rigidity, and bradykinesia.
d. choreiform movement and dementia.

414. The primary North American vector transmitting arthropod-borne virus encephalitis is the

a. mosquito
b. tick.
c. horse.
d. flea.


415. The initial symptoms of new variant Creutzfeldt-Jakob Disease (nvCJD) are

a. anxiety, depression, and behavioral changes.
b. memory and cognitive impairment.
c. diplopia and bradykinesia.
d. akathisia and dysphagia.

416. A patient with fungal encephalitis receiving amphotericin B complaints of fever, chills, and body aches. The nurse knows that these symptoms

a. may be controlled by the administration of diphenhydramine (Benedryl) and acetaminophen (Tylenol) approximately 30 minutes prior to administration of the amphotericin.
b. indicate renal toxicity and a worsening of the patient's condition.
c. are primarily associated with infection with Coccidioides immitis and Aspergillus.
d. indicate the need for immediate blood and cerebral spinal fluid (CSF) cultures.

417.The patient with Herpes Simplex Virus (HSV) encephalitis is receiving acyclovir (Zovirax). The nurse monitors blood chemistry test results and urinary output for

a. renal complications related to acyclovir therapy.
b. signs and symptoms of cardiac insufficiency.
c. signs of relapse.
d. signs of improvement in the patient's condition.

418. Medical management of arthropod-borne virus (arboviral) encephalitis is aimed at

a. controlling seizures and increased intracranical pressure.
b. preventing renal insufficiency.
c. maintaining hemodynamic stability and adequate cardiac output.
d. preventing muscular atrophy.


419. The patient receiving mitoxantrone (Novantrone) for treatment of secondary progressive multiple sclerosis (MS) is closely monitored for

a. leukopenia and cardiac toxicity.
b. mood changes and fluid and electrolyte alterations.
c. renal insufficiency.
d. hypoxia.

420. What percentage of patients who survived the polio epidemic of the 1950s are now estimated to have developed post-polio syndrome?

a. 60-80%
b. 50%
c. 25-30%
d. 10%

421. Which of the following statements describe the pathophysiology of post-polio syndrome?

a. The exact cause is unknown, but aging or muscle overuse is suspected.
b. The exact cause is unknown, but latent poliovirus is suspected.
c. Post-polio syndrome is caused by an autoimmune response.
d. Post-polio syndrome is caused by long-term intake of a low-protein, high-fat diet in

422. Which of the following statements reflect nursing interventions of a patient with post-polio syndrome?

a. Providing care aimed at slowing the loss of strength and maintaining the physical, psychological and social well being of the patient.
b. Administering antiretroviral agents.
c. Planning activities for evening hours rather then morning hours.
d. Avoiding the use of heat applications in the treatment of muscle and joint pain.


423. Which of the following terms is used to describe edema of the optic nerve?

a. Papilledema
b. Scotoma
c. Lymphedema
d. Angioneurotic edema

424. Degenerative neurologic disorders include which of the following?

a. Huntington's disease
b. Paget's disease
c. Osteomyelitis
d. Glioma

425. Bone density testing in patients with post-polio syndrome has demonstrated

a. low bone mass and osteoporosis.
b. osteoarthritis.
c. calcification of long bones.
d. no significant findings.

426. Which of the following terms refers to mature compact bone structures that form concentric rings of bone matrix?

a. Lamellae
b. Endosteum
c.Trabecula
d. Cancellous bone




427.An osteon is defined as a

a. microscopic functional bone unit.
b. bone-forming cell.
c. bone resorption cell.
d. mature bone cell.

428. Which of the following terms refers to the shaft of the long bone?

a. Diaphysis
b. Epiphysis
c. Lordosis
d. Scoliosis

429. Paresthesia is the term used to refer to

a. abnormal sensations..
b. absence of muscle movement suggesting nerve damage.
c. involuntary twitch of muscle fibers.
d. absence of muscle tone.

430. Which of the following terms refers to a grating or crackling sound or sensation?

a. Crepitus
b. Callus
c. Clonus
d. Fasciculation

431. Which of the following terms refers to muscle tension being unchanged with muscle shortening and joint motion?

a. Isotonic contraction
b. Isometric contraction

c. Contracture
d. Fasciculation

432. During which stage or phase of bone healing after fracture does callus formation occur?

a. Reparative
b. Remodeling
c. Inflammation
d. Revascularization

433. During which stage or phase of bone healing after fracture is devitalized tissue removed and new bone reorganized into its former structural arrangement?

a. Remodeling
b. Inflammation
c. Revascularization
d. Reparative

434. Which nerve is assessed when the nurse asks the patient to spread all fingers?

a. Ulnar
b. Peroneal
c. Radial
d. Median

435. Which nerve is assessed when the nurse asks the patient to dorsiflex the ankle and extend the toes?

a. Peroneal
b. Radial
c. Median
d. Ulnar



436. Which of the following statements reflect the progress of bone healing?

a. Serial x-rays are used to monitor the progress of bone healing.
b. All fracture healing takes place at the same rate no matter the type of bone fractured.
c. The age of the patient influences the rate of fracture healing.
d. Adequate immobilization is essential until there is ultrasound evidence of bone formation with ossification.

437. Diminished range of motion, loss of flexibility, stiffness, and loss of height are history and physical findings associated with age-related changes of the

a. joints.
b. bones.
c. muscles.
d. ligaments.

438. Fracture healing occurs in four areas, including the

a. external soft tissue.
b. cartilage.
c. bursae.
d. fascia.

439. Which of the following is an indicator of neurovascular compromise?

a. Capillary refill more than 3 seconds
b. Warm skin temperature
c. Diminished pain
d. Pain on active stretch.


440. Which of the following terms refers to moving away from midline?

a. Abduction
b. Adduction
c. Inversion
d. Eversion

441.Surgical fusion of a joint is termed

a. arthrodesis.
b. open reduction with internal fixation (ORIF).
c. heterotrophic ossification.
d. arthroplasty.

442. Which of the following devices is designed specifically to support and immobilize a body part in a desired position?

a. Splint
b. Brace
c. Continuous passive motion (CPM) device
d. Trapeze

443. When caring for the patient in traction, the nurse is guided by which of the following principles?

a. Skeletal traction is never interrupted.
b. Weights should rest on the bed.
c. Knots in the ropes should touch the pulley.
d. Weights are removed routinely.

444. Meniscectomy refers to the

a. replacement of one of the articular surfaces of a joint.

b. incision and diversion of the muscle fascia.
c. excision of damaged joint fibrocartilage.
d. removal of a body part.

445. In order to avoid hip dislocation after replacement surgery, the nurse teaches the patient which of the following guidelines?

a. Never cross the affected leg when seated.
b. Keep the knees together at all times.
c. Avoid placing a pillow between the legs when sleeping.
d. Bend forward only when seated in a chair.

446. Injury to the ______ nerve as a result of pressure is a cause of footdrop.

a. Peroneal
b. Sciatic
c. Femoral
d. Achilles

447. The nurse teaching the patient with a cast about home care includes which of the following instructions?

a. Dry a wet fiberglass cast thoroughly using a hair dryer on a cool setting to avoid skin problems.
b. Cover the cast with plastic or rubber.
c. Keep the cast below heart level.
d. Fix a broken cast by applying tape.

448. A continuous passive motion (CPM) device applied after knee surgery

a. promotes healing by increasing circulation and movement of the knee joint.
b. provides active range of motion.
c. promotes healing by immobilizing the knee joint.

d. prevents infection and controls edema and bleeding.

449. Which of the following terms refers to disease of a nerve root?

a. Radiculopathy
b. Involucrum
c. Sequestrum
d. Contracture


450. Of the following common problems of the upper extremities, which results from entrapment of the median nerve at the wrist?

a. Carpal tunnel syndrome
b. Ganglion
c. Dupuytren's contracture
d. Impingement syndrome

451. When the nurse notes that the patient's left great toe deviates laterally, she recognizes that the patient has a

a. hallux valgus.
b. hammertoe.
c. pes cavus.
d. flatfoot.

452. Localized rapid bone turnover, most commonly affecting the skull, femur, tibia, pelvic bones, and vertebrae, characterizes which of the following bone disorders?

a. Osteitis deformans
b. Osteomalacia
c. Osteoporosis
d. Osteomyelitis


453. Most cases of osteomyelitis are caused by which of the following microorganisms?

a. Staphylococcus
b. Proteus species
c. Pseudomonas species
d. Escherichia coli

454. Which of the following statements reflects information to be included when teaching the patient about plantar fasciitis?

a. Management of plantar fasciitis includes stretching exercises.
b. Plantar fasciitis presents as an acute onset of pain localized to the ball of the foot that occurs when pressure is placed upon it and diminishes when pressure is released.
c. The pain of plantar fasciitis diminishes with warm water soaks.
d. Complications of plantar fasciitis include neuromuscular damage and decreased ankle range of motion.

455.Lifestyle risk factors for osteoporosis include

a. lack of exposure to sunshine.
b. lack of aerobic exercise.
c. a low protein, high fat diet.
d. an estrogen deficiency or menopause.

456. The nurse teaches the patient with a high risk for osteoporosis about risk-lowering strategies including which of the following statements?

a. Walk or perform weight-bearing exercises out of doors..
b. Increase fiber in the diet.
c. Reduce stress.
d. Decrease the intake of vitamin A and D.

457.Instructions for the patient with low back pain include which of the following?

a. When lifting, avoid overreaching.
b. When lifting, place the load away from the body.
c. When lifting, use a narrow base of support.
d. When lifting, bend the knees and loosen the abdominal muscles.

458. Dupuytren's contracture causes flexion of the

a. fourth and fifth fingers.
b. thumb.
c. index and middle fingers.
d. ring finger.

459. A metabolic bone disease characterized by inadequate mineralization of bone is

a. osteomalacia
b. osteoporosis
c. osteomyelitis
d. osteoarthritis

460. Which of the following terms refers to an injury to ligaments and other soft tissues of a joint?

a. Sprain
b. Dislocation
c. Subluxation
d. Strain

461. Which of the following terms refers to failure of fragments of a fractured bone to heal together?

a. Nonunion

b. Dislocation
c. Subluxation
d. Malunion

462. The Emergency Department nurse teaches patients with sports injuries to remember the acronym RICE, which stands for which of the following combinations of treatment?

a. Rest, ice, compression, elevation
b. Rest, ice, circulation, and examination
c.Rotation, immersion, compression and elevation
d. Rotation, ice, compression, and examination

463.The nurse anticipates that the physician will perform joint aspiration and wrapping with compression elastic dressing for which of the following musculoskeletal problems?

a. Joint effusion
b. Strain
c. Sprain
d. Avascular necrosis

464. When x-ray demonstrates a fracture in which bone has splintered into several pieces, that fracture is described as

a. comminuted.
b. compound.
c. depressed.
d. impacted.

465. When x-ray demonstrates a fracture in which the fragments of bone are driven inward, the fracture is described as

a. depressed.

b. compound.
c. comminuted.
d. impacted.

466. A fracture is termed pathologic when the fracture

a. occurs through an area of diseased bone.
b. results in a pulling away of a fragment of bone by a ligament or tendon and its attachment.
c. presents as one side of the bone being broken and the other side being bent.
d. involves damage to the skin or mucous membranes.

467. The most common complication after knee arthroscopy is

a. joint effusion.
b. infection.
c. knee giving way.
d. knee locking.

468. When the patient who has experienced trauma to an extremity complains of severe burning pain, vasomotor changes, and muscles spasms in the injured extremity, the nurse recognizes that the patient is likely demonstrating signs of

a. reflex sympathetic dystrophy syndrome.
b. avascular necrosis of bone.
c. a reaction to an internal fixation device.
d. heterotrophic ossification.

469. Which of the following terms refers to a fracture in which one side of a bone is broken and the other side is bent?

a. Greenstick

b. Spiral
c. Avulsion
d. Oblique

470. The nurse assesses subtle personality changes, restlessness, irritability, and confusion in a patient who has sustained a fracture. The nurse suspects

a. fat embolism syndrome.
b. compartment syndrome.
c. hypovolemic shock.
d. reflex sympathetic dystrophy syndrome.

471. A Colles' fracture is a fracture of the

a. distal radius.
b. elbow.
c. humeral shaft.
d. clavicle.

472. With fractures of the femoral neck, the leg is

a. shortened, adducted, and externally rotated.
b. shortened, abducted, and internally rotated.
c. adducted and internally rotated.
d. abducted and externally rotated.

473.Which of the following terms most precisely refers to an infection acquired in the hospital that was not present or incubating at the time of hospital admission?

a. Nosocomial infection
b. Primary bloodstream infection
c. Secondary bloodstream infection
d. Emerging infectious diseases



474.The usual incubation period (infection to first symptom) for AIDS is

a. 10 years.
b. 3--6 months.
c. 1 year.
d. 5 years.

475. The usual incubation period (infection to first symptom) for hepatitis B is

a. 45-160 days.
b. 15-50 days.
c. 6-9 months.
d. The incubation periods for hepatitis D, E, and G are unclear.


476. Which of the following terms refers to a state of microorganisms being present within a host without causing host interference or interaction?

a. Colonization
b. Susceptible
c. Immune
d. Infection

477. The nurse teaches the parent of the child with chickenpox that the child is no longer contagious to others when

a. the vesicles and pustules have crusted.
b. the first rash appears.
c. the fever disappears.
d. the rash is changing into vesicles, and pustules appear.


478. Which of the following statements reflects the nursing management of the patient with West Nile Virus infection?

a. There is no treatment for West Nile Virus infection.
b. The incubation period is three to five days.
c. Patients with West Nile virus present with gastrointestinal complaints, such as nausea, vomiting, diarrhea, and abdominal pain.
d. Transmission of West Nile virus occurs from human-to-human.

479. Prophylaxis antibiotic for anthrax is given to people with symptoms who have been in a defined "hot zone" for a period of

a. 60 days.
b. 30 days.
c. 14 days.
d. 10 days.

480. If a case of smallpox is suspected, the nurse should

a. call the CDC Emergency Preparedness Office.
b. immediately vaccinate the patient and anyone in contact with the patient.
c. establish isolation with positive pressure.
d. Assess the patient for signs of a rash similar to chickenpox in appearance and progression.

481. The six elements necessary for infection are a causative organism, a reservoir of available organisms, a portal or mode of exit from the reservoir, a mode of transmission from reservoir to host, a susceptible host, and a

a. mode of entry to host.
b. mode of exit from the host.
c. virulent host.
d. latent time period.

482. Which of the following statements reflect what is known about the Ebola and Marburg viruses?

a. The diagnosis should be considered in a patient who has a febrile, hemorrhagic illness after traveling to Asia or Africa.
b. Treatment during the acute phase includes administration of acyclovir, and ventilator and dialysis support.
c. The viruses can be spread only by airborne exposure.
d. Symptoms include severe lower abdominal pain, nausea, vomiting, and dehydration.

483.Bubonic plague occurs

a. after the organism enters through the skin.
b. occurs after the organism is inhaled..
c. occurs when the organism causes a bloodstream infection.
d. after the organism is transferred by human to human contact.

484.The term given to the category of triage that refers to life-threatening or potentially life-threatening injury or illness requiring immediate treatment is

a. emergent.
b. urgent.
c. immediate..
d. non-acute.

485.When the patient has been field triaged and categorized as blue, the nurse recognizes that the patient requires

a. fast-track or psychological support.
b. emergent care.
c. immediate care.
d. urgent care.


486. Which of the following guidelines is appropriate to helping family members cope with sudden death?

a. Show acceptance of the body by touching it, giving the family permission to touch.
b. Inform the family that the patient has passed on.
c. Obtain orders for sedation for family members.
d. Provide details of the factors attendant to the sudden death.

487. Which of the following solutions should the nurse anticipate for fluid replacement in the male patient?

a. Lactated Ringer's solution.
b. Type O negative blood
c. Dextrose 5% in water
d. Hypertonic saline

488.Induction of vomiting is indicated for the accidental poisoning patient who has ingested

a. aspirin.
b. rust remover.
c. gasoline.
d. toilet bowl cleaner.

489. Which of the following phases of psychological reaction to rape is characterized by fear and flashbacks?

a. Heightening anxiety phase
b. Acute disorganization phase
c. Denial phase
d. Reorganization phase



490. When preparing for an emergency bioterroism drill, the nurse instructs the drill volunteers that each biological agents requires specific patient management and medications to combat the virus, bacteria, or toxin. Which of the following statements reflect the patient management of variola virus (small pox)?

a. Small pox spreads rapidly and requires immediate isolation.
b. Acyclovir is effective against smallpox.
c. Small pox is spread by inhalation of spores.
d. Vaccination is effective only if administered within 12 to 24 hours of exposure.

491. Which of the following statements reflect the nursing management of pulmonary anthrax (B. anthracis)?

a. Prophylaxis with fluoroquinone is suggested after exposure.
b. Airborne person-to-person transmission occurs.
c. Diagnosis is by pulmonary function testing and chest x-ray.
d. Pulmonary effects include respiratory failure, shock, and death within five to seven

492. Which of the following terms refers to injuries that occur when a person is caught between objects, run over by a moving vehicle, or compressed by machinery?

a. Crush injuries
b. Blunt trauma
c. Penetrating abdominal injuries
d. Intra-abdominal injuries

493.A person suffering from carbon monoxide poisoning

a. appears intoxicated.
b. presents with severe hypertension.
c. appears hyperactive.
d. will always present with a cherry red skin coloring.


494. Treatment of an acetaminophen overdose includes the administration of

a. N-acetylcysteine (Mucomyst).
b. flumazenil (Romazicon).
c. naloxone (Narcan).
d. diazepam (Valium).

495. Which of the following statements reflect the nursing management of the patient with a white phosphorus chemical burn?

a. Do not apply water to the burn.
b. Immediately drench the skin with running water from a shower, hose or faucet.
c. Alternate applications of water and ice to the burn.
d. Wash off the chemical using warm water, then flush the skin with cool water.

496. During a disaster, the nurse sees a victim with a green triage tag. The nurse knows that the person has

a. injuries that are minor and treatment can be delayed hours to days.
b. injuries that are life-threatening but survivable with minimal intervention.
c. injuries that are significant and require medical care, but can wait hours without d. indicates injuries that are extensive and chances of survival are unlikely even with definitive care.

497. If a person has been exposed to radiation, presenting symptoms, such as nausea, vomiting, loss of appetite, diarrhea, or fatigue can be expected to occur within _______ hours after exposure?

a. 48 to 72
b. 6 to 12
c. 12 to 24
d. 24 to 48


498.Which of the following refers to a management tool for organizing personnel, facilities, equipment, and communication for any emergency situation?

a. The Incident Command System
b. Office of Emergency Management
c. National Disaster Medical System
d. The Hospital Emergency Preparedness Plan

499.Which of the following terms refers to a process by which an individual receives education about recognition of stress reactions and management strategies for handling stress?

a. Defusing
b. Debriefing
c. Follow-up
d. Critical incident stress management

500.The first step in decontamination is

a.removal of the patient's clothing and jewelry and then rinsing the patient with water.
b. a thorough soap and water wash and rinse of the patient.
c. to immediately apply personal protective equipment.
d. to immediately apply a chemical decontamination foam to the area of contamination.


ANSWERS