2011年10月17日星期一

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Answer and Rationale- NCLEX Practice Questions 3


1. Answer: A
The parathyroid glands regulate the calcium level in the blood. In hyperparathyroidism, the serum calcium level will be elevated. Parathyroid hormone levels may be high or normal but not low. The body will lower the level of vitamin D in an attempt to lower calcium. Urine calcium may be elevated, with calcium spilling over from elevated serum levels. This may cause renal stones.
2. Answer: D
A patient with Addison's disease requires normal dietary sodium to prevent excess fluid loss. Adequate caloric intake is recommended with a diet high in protein and complex carbohydrates, including grains.
3. Answer: C
A post-operative diabetic patient who is unable to eat is likely to be suffering from hypoglycemia. Confusion and shakiness are common symptoms. An anesthesia reaction would not occur on the second post-operative day. Hyperglycemia and ketoacidosis do not cause confusion and shakiness.
4. Answer: A
Bowel perforation is the most serious complication of fiberoptic colonoscopy. Important signs include progressive abdominal pain, fever, chills, and tachycardia, which indicate advancing peritonitis. Viral gastroenteritis and colon cancer do not cause these symptoms. Diverticulitis may cause pain, fever, and chills, but is far less serious than perforation and peritonitis.
5. Answer: A, B, and C
Prothrombin time, partial thromboplastin time, and platelet count are all included in coagulation studies. The hemoglobin level, though important information prior to an invasive procedure like liver biopsy, does not assess coagulation.
6. Answer: B
Hepatitis A is the only type that is transmitted by the fecal-oral route through contaminated food. Hepatitis B, C, and D are transmitted through infected bodily fluids.
7. Answer: A
Hepatitis C is a viral infection transmitted through bodily fluids, such as blood, causing inflammation of the liver. Patients with hepatitis C may not donate blood for transfusion due to the high risk of infection in the recipient. Cholecystitis (gall bladder disease), diverticulosis, and history of Crohn's disease do not preclude blood donation.
8. Answer: A
Naproxen sodium is a nonsteroidal anti-inflammatory drug that can cause inflammation of the upper GI tract. For this reason, it is contraindicated in a patient with gastritis. Calcium carbonate is used as an antacid for the relief of indigestion and is not contraindicated. Clarithromycin is an antibacterial often used for the treatment of Helicobacter pylori in gastritis. Furosemide is a loop diuretic and is contraindicated in a patient with gastritis.
9. Answer: D
Cholecystitis, inflammation of the gallbladder, is most commonly caused by the presence of gallstones, which may block bile (necessary for fat absorption) from entering the intestines. Patients should decrease dietary fat by limiting foods like fatty meats, fried foods, and creamy desserts to avoid irritation of the gallbladder.
10. Answer: D
Patients with pulmonary edema experience air hunger, anxiety, and agitation. Respiration is fast and shallow and heart rate increases. Stridor is noisy breathing caused by laryngeal swelling or spasm and is not associated with pulmonary edema.
11. Answer: C
An automatic internal cardioverter-defibrillator delivers an electric shock to the heart to terminate episodes of ventricular tachycardia and ventricular fibrillation. This is necessary in a patient with significant ventricular symptoms, such as tachycardia resulting in syncope. A patient with myocardial infarction that resolved with no permanent cardiac damage would not be a candidate. A patient recovering well from coronary bypass would not need the device. Atrial tachycardia is less serious and is treated conservatively with medication and cardioversion as a last resort.
12. Answer: B
The implanted pacemaker will interfere with the magnetic fields of the MRI scanner and may be deactivated by them. Shellfish/iodine allergy is not a contraindication because the contrast used in MRI scanning is not iodine-based. Open MRI scanners and anti-anxiety medications are available for patients with claustrophobia. Psychiatric medication is not a contraindication to MRI scanning.
13. Answer: B
Typical symptoms of pulmonary embolism include chest pain, shortness of breath, and severe anxiety. The physician should be notified immediately. A patient with pulmonary embolism will not be sleepy or have a cough with crackles on exam. A patient with fever, chills and loss of appetite may be developing pneumonia.
14. Answer: C
A rapidly enlarging abdominal aortic aneurysm is at significant risk of rupture and should be resected as soon as possible. No other appropriate treatment options currently exist.
15. Answer: D
A platelet count of 25,000/microliter is severely thrombocytopenic and should prompt the initiation of bleeding precautions, including monitoring urine and stool for evidence of bleeding. Monitoring for fever and requiring protective clothing are indicated to prevent infection if white blood cells are decreased. Transfusion of red cells is indicated for severe anemia.
16. Answer: B
Increased pressure caused by bleeding or swelling within the skull can damage delicate brain tissue and may become life threatening. Repeated vomiting can be an early sign of pressure as the vomit center within the medulla is stimulated. The anterior fontanel is closed in a 4-year-old child. Evidence of sleepiness at 10 PM is normal for a four year old. The average 4-year-old child cannot read yet, so this too is normal.
17. Answer: A
Koplik's spots are small blue-white spots visible on the oral mucosa and are characteristic of measles infection. The body rash typically begins on the face and travels downward. High fever is often present. "Tear drop on a rose petal" refers to the lesions found in varicella (chicken pox).
18. Answer: C
Petechiae on the soft palate are characteristic of rubella infection. Choices A, B, and D are characteristic of scarlet fever, a result of group A Streptococcus infection.
19. Answer: B
This child weighs 30 kg, and the pediatric dose of diphenhydramine is 5 mg/kg/day (5 X 30 = 150/day). Therefore, the correct dose is 150 mg/day. Divided into 3 doses per day, the child should receive 50 mg 3 times a day rather than 25 mg 3 times a day. Dosage should not be titrated based on symptoms without consulting a physician.
20. Answer: D
Normally, the testes descend by one year of age. In young infants, it is common for the testes to retract into the inguinal canal when the environment is cold or the cremasteric reflex is stimulated. Exam should be done in a warm room with warm hands. It is most likely that both testes are present and will descend by a year. If not, a full assessment will determine the appropriate treatment.

NCLEX Practice Questions 3


1. A patient is admitted to the hospital with a diagnosis of primary hyperparathyroidism. A nurse checking the patient's lab results would expect which of the following changes in laboratory findings?

A. Elevated serum calcium.
B. Low serum parathyroid hormone (PTH).
C. Elevated serum vitamin D.
D. Low urine calcium. 


2. A patient with Addison's disease asks a nurse for nutrition and diet advice. Which of the following diet modifications is NOT recommended?

A. A diet high in grains.
B. A diet with adequate caloric intake.
C. A high protein diet.
D. A restricted sodium diet. 


3. A patient with a history of diabetes mellitus is in the second post-operative day following cholecystectomy. She has complained of nausea and isn't able to eat solid foods. The nurse enters the room to find the patient confused and shaky. Which of the following is the most likely explanation for the patient's symptoms?

A. Anesthesia reaction.
B. Hyperglycemia.
C. Hypoglycemia.
D. Diabetic ketoacidosis. 


4. A nurse assigned to the emergency department evaluates a patient who underwent fiberoptic colonoscopy 18 hours previously. The patient reports increasing abdominal pain, fever, and chills. Which of the following conditions poses the most immediate concern?

A. Bowel perforation.
B. Viral gastroenteritis.
C. Colon cancer.
D. Diverticulitis. 


5. A patient is admitted to the same day surgery unit for liver biopsy. Which of the following laboratory tests assesses coagulation?

A. Partial thromboplastin time.
B. Prothrombin time.
C. Platelet count.
D. Hemoglobin 


6. A nurse is assessing a clinic patient with a diagnosis of hepatitis A. Which of the following is the most likely route of transmission?

A. Sexual contact with an infected partner.
B. Contaminated food.
C. Blood transfusion.
D. Illegal drug use. 


7. A leukemia patient has a relative who wants to donate blood for transfusion. Which of the following donor medical conditions would prevent this?

A. A history of hepatitis C five years previously.
B. Cholecystitis requiring cholecystectomy one year previously.
C. Asymptomatic diverticulosis.
D. Crohn's disease in remission. 


8. A physician has diagnosed acute gastritis in a clinic patient. Which of the following medications would be contraindicated for this patient?

A. Naproxen sodium (Naprosyn).
B. Calcium carbonate.
C. Clarithromycin (Biaxin).
D. Furosemide (Lasix). 


9. The nurse is conducting nutrition counseling for a patient with cholecystitis. Which of the following information is important to communicate?

A. The patient must maintain a low calorie diet.
B. The patient must maintain a high protein/low carbohydrate diet.
C. The patient should limit sweets and sugary drinks.
D. The patient should limit fatty foods. 


10. A patient admitted to the hospital with myocardial infarction develops severe pulmonary edema. Which of the following symptoms should the nurse expect the patient to exhibit?

A. Slow, deep respirations.
B. Stridor.
C. Bradycardia.
D. Air hunger. 


11. A nurse caring for several patients on the cardiac unit is told that one is scheduled for implantation of an automatic internal cardioverter-defibrillator. Which of the following patients is most likely to have this procedure?

A. A patient admitted for myocardial infarction without cardiac muscle damage.
B. A post-operative coronary bypass patient, recovering on schedule.
C. A patient with a history of ventricular tachycardia and syncopal episodes.
D. A patient with a history of atrial tachycardia and fatigue. 


12. A patient is scheduled for a magnetic resonance imaging (MRI) scan for suspected lung cancer. Which of the following is a contraindication to the study for this patient?

A. The patient is allergic to shellfish.
B. The patient has a pacemaker.
C. The patient suffers from claustrophobia.
D. The patient takes anti-psychotic medication. 


13. A nurse calls a physician with the concern that a patient has developed a pulmonary embolism. Which of the following symptoms has the nurse most likely observed?

A. The patient is somnolent with decreased response to the family.
B. The patient suddenly complains of chest pain and shortness of breath.
C. The patient has developed a wet cough and the nurse hears crackles on auscultation of the lungs.
D. The patient has a fever, chills, and loss of appetite. 


14. A patient comes to the emergency department with abdominal pain. Work-up reveals the presence of a rapidly enlarging abdominal aortic aneurysm. Which of the following actions should the nurse expect?

A. The patient will be admitted to the medicine unit for observation and medication.
B. The patient will be admitted to the day surgery unit for sclerotherapy.
C. The patient will be admitted to the surgical unit and resection will be scheduled.
D. The patient will be discharged home to follow-up with his cardiologist in 24 hours. 


15. A patient with leukemia is receiving chemotherapy that is known to depress bone marrow. A CBC (complete blood count) reveals a platelet count of 25,000/microliter. Which of the following actions related specifically to the platelet count should be included on the nursing care plan?

A. Monitor for fever every 4 hours.
B. Require visitors to wear respiratory masks and protective clothing.
C. Consider transfusion of packed red blood cells.
D. Check for signs of bleeding, including examination of urine and stool for blood. 


16. A nurse in the emergency department is observing a 4-year-old child for signs of increased intracranial pressure after a fall from a bicycle, resulting in head trauma. Which of the following signs or symptoms would be cause for concern?

A. Bulging anterior fontanel.
B. Repeated vomiting.
C. Signs of sleepiness at 10 PM.
D. Inability to read short words from a distance of 18 inches. 


17. A nonimmunized child appears at the clinic with a visible rash. Which of the following observations indicates the child may have rubeola (measles)?

A. Small blue-white spots are visible on the oral mucosa.
B. The rash begins on the trunk and spreads outward.
C. There is low-grade fever.
D. The lesions have a "tear drop on a rose petal" appearance. 


18. A child is seen in the emergency department for scarlet fever. Which of the following descriptions of scarlet fever is NOT correct?

A. Scarlet fever is caused by infection with group A Streptococcus bacteria.
B. "Strawberry tongue" is a characteristic sign.
C. Petechiae occur on the soft palate.
D. The pharynx is red and swollen. 


19. A child weighing 30 kg arrives at the clinic with diffuse itching as the result of an allergic reaction to an insect bite. Diphenhydramine (Benadryl) 25 mg 3 times a day is prescribed. The correct pediatric dose is 5 mg/kg/day. Which of the following best describes the prescribed drug dose?

A. It is the correct dose.
B. The dose is too low.
C. The dose is too high.
D. The dose should be increased or decreased, depending on the symptoms. 


20. The mother of a 2-month-old infant brings the child to the clinic for a well baby check. She is concerned because she feels only one testis in the scrotal sac. Which of the following statements about the undescended testis is the most accurate?

A. Normally, the testes are descended by birth.
B. The infant will likely require surgical intervention.
C. The infant probably has with only one testis.
D. Normally, the testes descend by one year of age.

Answer and Rationale - NCLEX Practice Questions 2

Answer Key
1. D
2. A
3. D
4. B
5. C
6. B
7. B
8. C
9. D
10. D
11. D
12. C
13. B
14. C
15. A
16. A
17. D
18. D
19. B
20. B
21. A
22. D
23. B
24. A
25. D

NCLEX Practice Questions 2


1. A patient tells you that her urine is starting to look discolored. If you believe this change is due to medication, which of the following patient's medication does not cause urine discoloration?
A. Sulfasalazine
B. Levodopa
C. Phenolphthalein
D. Aspirin
2. You are responsible for reviewing the nursing unit's refrigerator. If you found the following drug in the refrigerator it should be removed from the refrigerator's contents?
A. Corgard
B. Humulin (injection)
C. Urokinase
D. Epogen (injection)
3. A 34 year old female has recently been diagnosed with an autoimmune disease. She has also recently discovered that she is pregnant. Which of the following is the only immunoglobulin that will provide protection to the fetus in the womb?
A. IgA
B. IgD
C. IgE
D. IgG
4. A second year nursing student has just suffered a needlestick while working with a patient that is positive for AIDS. Which of the following is the most important action that nursing student should take?
A. Immediately see a social worker
B. Start prophylactic AZT treatment
C. Start prophylactic Pentamide treatment
D. Seek counseling
5. A thirty five year old male has been an insulin-dependent diabetic for five years and now is unable to urinate. Which of the following would you most likely suspect?
A. Atherosclerosis
B. Diabetic nephropathy
C. Autonomic neuropathy
D. Somatic neuropathy
6. You are taking the history of a 14 year old girl who has a (BMI) of 18. The girl reports inability to eat, induced vomiting and severe constipation. Which of the following would you most likely suspect?
A. Multiple sclerosis
B. Anorexia nervosa
C. Bulimia
D. Systemic sclerosis
7. A 24 year old female is admitted to the ER for confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Which of the following would you most likely suspect?
A. Diverticulosis
B. Hypercalcaemia
C. Hypocalcaemia
D. Irritable bowel syndrome
8. Rho gam is most often used to treat____ mothers that have a ____ infant.
A. RH positive, RH positive
B. RH positive, RH negative
C. RH negative, RH positive
D. RH negative, RH negative
9. A new mother has some questions about (PKU). Which of the following statements made by a nurse is not correct regarding PKU?
A. A Guthrie test can check the necessary lab values.
B. The urine has a high concentration of phenylpyruvic acid
C. Mental deficits are often present with PKU.
D. The effects of PKU are reversible.
10. A patient has taken an overdose of aspirin. Which of the following should a nurse most closely monitor for during acute management of this patient?
A. Onset of pulmonary edema
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Parkinson's disease type symptoms
11. A fifty-year-old blind and deaf patient has been admitted to your floor. As the charge nurse your primary responsibility for this patient is?
A. Let others know about the patient's deficits
B. Communicate with your supervisor your concerns about the patient's deficits.
C. Continuously update the patient on the social environment.
D. Provide a secure environment for the patient.
12. A patient is getting discharged from a SNF facility. The patient has a history of severe COPD and PVD. The patient is primarily concerned about their ability to breath easily. Which of the following would be the best instruction for this patient?
A. Deep breathing techniques to increase O2 levels.
B. Cough regularly and deeply to clear airway passages.
C. Cough following bronchodilator utilization
D. Decrease CO2 levels by increase oxygen take output during meals.
13. A nurse is caring for an infant that has recently been diagnosed with a congenital heart defect. Which of the following clinical signs would most likely be present?
A. Slow pulse rate
B. Weight gain
C. Decreased systolic pressure
D. Irregular WBC lab values
14. A mother has recently been informed that her child has Down's syndrome. You will be assigned to care for the child at shift change. Which of the following characteristics is not associated with Down's syndrome?
A. Simian crease
B. Brachycephaly
C. Oily skin
D. Hypotonicity
15. A patient has recently experienced a (MI) within the last 4 hours. Which of the following medications would most like be administered?
A. Streptokinase
B. Atropine
C. Acetaminophen
D. Coumadin
16. A patient asks a nurse, “My doctor recommended I increase my intake of folic acid. What type of foods contain folic acids?”
A. Green vegetables and liver
B. Yellow vegetables and red meat
C. Carrots
D. Milk
17. A nurse is putting together a presentation on meningitis. Which of the following microorganisms has noted been linked to meningitis in humans?
A. S. pneumonia
B. H. influenza
C. N. meningitis
D. Cl. difficile
18. A nurse is administering blood to a patient who has a low hemoglobin count. The patient asks how long to RBC's last in my body? The correct response is.
A. The life span of RBC is 45 days.
B. The life span of RBC is 60 days.
C. The life span of RBC is 90 days.
D. The life span of RBC is 120 days.
19. A 65 year old man has been admitted to the hospital for spinal stenosis surgery. When does the discharge training and planning begin for this patient?
A. Following surgery
B. Upon admit
C. Within 48 hours of discharge
D. Preoperative discussion
20. A child is 5 years old and has been recently admitted into the hospital. According to Erickson which of the following stages is the child in?
A. Trust vs. mistrust
B. Initiative vs. guilt
C. Autonomy vs. shame
D. Intimacy vs. isolation
21. A toddler is 16 months old and has been recently admitted into the hospital. According to Erickson which of the following stages is the toddler in?
A. Trust vs. mistrust
B. Initiative vs. guilt
C. Autonomy vs. shame
D. Intimacy vs. isolation
22. A young adult is 20 years old and has been recently admitted into the hospital. According to Erickson which of the following stages is the adult in?
A. Trust vs. mistrust
B. Initiative vs. guilt
C. Autonomy vs. shame
D. Intimacy vs. isolation
23. A nurse is making rounds taking vital signs. Which of the following vital signs is abnormal?
A. 11 year old male – 90 b.p.m, 22 resp/min., 100/70 mm Hg
B. 13 year old female – 105 b.p.m., 22 resp/min., 105/60 mm Hg
C. 5 year old male- 102 b.p.m, 24 resp/min., 90/65 mm Hg
D. 6 year old female- 100 b.p.m., 26 resp/min., 90/70mm Hg
24. When you are taking a patient's history, she tells you she has been depressed and is dealing with an anxiety disorder. Which of the following medications would the patient most likely be taking?
A. Elavil
B. Calcitonin
C. Pergolide
D. Verapamil
25. Which of the following conditions would a nurse not administer erythromycin?
A. Campylobacterial infection
B. Legionnaire's disease
C. Pneumonia
D. Multiple Sclerosis 

2011年10月16日星期日

NCLEX Practice Questions 1 Answer and Rational

1. (A) and (B) are both contraindicated with pregnancy.

2. (F) All of the others have can cause photosensitivity reactions.

3. (D) All of the others can cause urine discoloration.

4. (A) Corgard could be removed from the refigerator.

5. (D) IgG is the only immunoglobulin that can cross the placental barrier.

6. (B) AZT treatment is the most critical innervention.

7. (C) Autonomic neuropathy can cause inability to urinate.

8. (B) All of the clinical signs and systems point to a condition of anorexia nervosa.

9. (B) Hypercalcaemia can cause polyuria, severe abdominal pain, and confusion.

10. (C) Rho gam prevents the production of anti-RH antibodies in the mother that has a Rh positive fetus.

11. (D) The effects of PKU stay with the infant throughout their life.

12. (D) Aspirin overdose can lead to metabolic acidosis and cause pulmonary edema development.

13. (D) This patient’s safety is your primary concern.

14. (C) The bronchodilator will allow a more productive cough.

15. (B) Weight gain is associated with CHF and congenital heart deficits.

16. (C) The skin would be dry and not oily.

17. (A) Streptokinase is a clot busting drug and the best choice in this situation.

18. (A) Green vegetables and liver are a great source of folic acid.

19. (D) Cl. difficile has not been linked to meningitis.

20. (D) RBC’s last for 120 days in the body.

21. (B) Discharge education begins upon admit.

22. (B) Initiative vs. guilt- 3-6 years old

23. (A) Trust vs. Mistrust- 12-18 months old

24. (D) Intimacy vs. isolation- 18-35 years old

25. (B) HR and Respirations are slightly increased. BP is down.

26. (A) Elavil is a tricyclic antidepressant.

27. (D) Erythromycin is used to treat conditions A-C.

28. (D) Answer choices A-C were symptoms of acute hyperkalemia.

29. (C) Weight loss would be expected.

30. (A) Loss of appetite would be expected.

31. (D) Choice A is linked to Plague, Choice B is linked to peptic ulcers, Choice C is linked to Cholera.

32. (A) Choice B is linked to Rheumatic fever, Choice C is linked to Anthrax, Choice D is linked to Endocarditis.

33. (D) A CT scan would be performed for further investigation of the hemiparesis.

34. (C) Weight gain and poor temperature tolerance indicate something may be wrong with the thyroid function.

35. (C) Blood cultures would be performed to investigate the fever and rash symptoms.

36. (A) With a history of diabetes, the first response should be to check blood sugar levels.

37. (C) Age is not the greatest factor in potty training. The overall mental and physical abilities of the child is the most important factor.

38. (C) The poison control center will have an exact plan of action for this child.

39. (C) Vastus lateralis is the most appropriate location.

40. (D) In this case you are able to determine the name of the child by the father’s statement. You should not withhold the medication from the child following identification. 

NCLEX Practice Questions 1

1. A nurse is reviewing a patient’s medication during shift change. Which of the following medication would be contraindicated if the patient were pregnant? Note: More than one answer may be correct.

A: Coumadin
B: Finasteride
C: Celebrex
D: Catapress
E: Habitrol
F: Clofazimine


2. A nurse is reviewing a patient’s PMH. The history indicates photosensitive reactions to medications. Which of the following drugs has not been associated with photosensitive reactions? Note: More than one answer may be correct.

A: Cipro
B: Sulfonamide
C: Noroxin
D: Bactrim
E: Accutane
F: Nitrodur


3. A patient tells you that her urine is starting to look discolored. If you believe this change is due to medication, which of the following patient’s medication does not cause urine discoloration?

A: Sulfasalazine
B: Levodopa
C: Phenolphthalein
D: Aspirin


4. You are responsible for reviewing the nursing unit’s refrigerator. If you found the following drug in the refrigerator it should be removed from the refrigerator’s contents?

A: Corgard
B: Humulin (injection)
C: Urokinase
D: Epogen (injection)


5. A 34 year old female has recently been diagnosed with an autoimmune disease. She has also recently discovered that she is pregnant. Which of the following is the only immunoglobulin that will provide protection to the fetus in the womb?

A: IgA
B: IgD
C: IgE
D: IgG


6. A second year nursing student has just suffered a needlestick while working with a patient that is positive for AIDS. Which of the following is the most important action that nursing student should take?

A: Immediately see a social worker
B: Start prophylactic AZT treatment
C: Start prophylactic Pentamide treatment
D: Seek counseling


7. A thirty five year old male has been an insulin-dependent diabetic for five years and now is unable to urinate. Which of the following would you most likely suspect?

A: Atherosclerosis
B: Diabetic nephropathy
C: Autonomic neuropathy
D: Somatic neuropathy


8. You are taking the history of a 14 year old girl who has a (BMI) of 18. The girl reports inability to eat, induced vomiting and severe constipation. Which of the following would you most likely suspect?

A: Multiple sclerosis
B: Anorexia nervosa
C: Bulimia
D: Systemic sclerosis


9. A 24 year old female is admitted to the ER for confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Which of the following would you most likely suspect?

A: Diverticulosis
B: Hypercalcaemia
C: Hypocalcaemia
D: Irritable bowel syndrome


10. Rho gam is most often used to treat____ mothers that have a ____ infant.

A: RH positive, RH positive
B: RH positive, RH negative
C: RH negative, RH positive
D: RH negative, RH negative

11. A new mother has some questions about (PKU). Which of the following statements made by a nurse is not correct regarding PKU?

A: A Guthrie test can check the necessary lab values.
B: The urine has a high concentration of phenylpyruvic acid
C: Mental deficits are often present with PKU.
D: The effects of PKU are reversible.


12. A patient has taken an overdose of aspirin. Which of the following should a nurse most closely monitor for during acute management of this patient?

A: Onset of pulmonary edema
B: Metabolic alkalosis
C: Respiratory alkalosis
D: Parkinson’s disease type symptoms


13. A fifty-year-old blind and deaf patient has been admitted to your floor. As the charge nurse your primary responsibility for this patient is?

A: Let others know about the patient’s deficits.
B: Communicate with your supervisor your patient safety concerns.
C: Continuously update the patient on the social environment.
D: Provide a secure environment for the patient.


14. A patient is getting discharged from a SNF facility. The patient has a history of severe COPD and PVD. The patient is primarily concerned about their ability to breath easily. Which of the following would be the best instruction for this patient?

A: Deep breathing techniques to increase O2 levels.
B: Cough regularly and deeply to clear airway passages.
C: Cough following bronchodilator utilization
D: Decrease CO2 levels by increase oxygen take output during meals.


15. A nurse is caring for an infant that has recently been diagnosed with a congenital heart defect. Which of the following clinical signs would most likely be present?

A: Slow pulse rate
B: Weight gain
C: Decreased systolic pressure
D: Irregular WBC lab values


16. A mother has recently been informed that her child has Down’s syndrome. You will be assigned to care for the child at shift change. Which of the following characteristics is not associated with Down’s syndrome?

A: Simian crease
B: Brachycephaly
C: Oily skin
D: Hypotonicity


17. A patient has recently experienced a (MI) within the last 4 hours. Which of the following medications would most like be administered?

A: Streptokinase
B: Atropine
C: Acetaminophen
D: Coumadin


18. A patient asks a nurse, “My doctor recommended I increase my intake of folic acid. What type of foods contain the highest concentration of folic acids?”

A: Green vegetables and liver
B: Yellow vegetables and red meat
C: Carrots
D: Milk


19. A nurse is putting together a presentation on meningitis. Which of the following microorganisms has noted been linked to meningitis in humans?

A: S. pneumonia
B: H. influenza
C: N. meningitis
D: Cl. difficile


20. A nurse is administering blood to a patient who has a low hemoglobin count. The patient asks how long to RBC’s last in my body? The correct response is.

A: The life span of RBC is 45 days.
B: The life span of RBC is 60 days.
C: The life span of RBC is 90 days.
D: The life span of RBC is 120 days.

21. A 65 year old man has been admitted to the hospital for spinal stenosis surgery. When does the discharge training and planning begin for this patient?

A: Following surgery
B: Upon admit
C: Within 48 hours of discharge
D: Preoperative discussion


22. A child is 5 years old and has been recently admitted into the hospital. According to Erickson which of the following stages is the child in?

A: Trust vs. mistrust
B: Initiative vs. guilt
C: Autonomy vs. shame
D: Intimacy vs. isolation


23. A toddler is 16 months old and has been recently admitted into the hospital. According to Erickson which of the following stages is the toddler in?

A: Trust vs. mistrust
B: Initiative vs. guilt
C: Autonomy vs. shame
D: Intimacy vs. isolation


24. A young adult is 20 years old and has been recently admitted into the hospital. According to Erickson which of the following stages is the adult in?

A: Trust vs. mistrust
B: Initiative vs. guilt
C: Autonomy vs. shame
D: Intimacy vs. isolation


25. A nurse is making rounds taking vital signs. Which of the following vital signs is abnormal?

A: 11 year old male – 90 b.p.m, 22 resp/min. , 100/70 mm Hg
B: 13 year old female – 105 b.p.m., 22 resp/min., 105/60 mm Hg
C: 5 year old male- 102 b.p.m, 24 resp/min., 90/65 mm Hg
D: 6 year old female- 100 b.p.m., 26 resp/min., 90/70mm Hg


26. When you are taking a patient’s history, she tells you she has been depressed and is dealing with an anxiety disorder. Which of the following medications would the patient most likely be taking?

A: Elavil
B: Calcitonin
C: Pergolide
D: Verapamil


27. Which of the following conditions would a nurse not administer erythromycin?

A: Campylobacterial infection
B: Legionnaire’s disease
C: Pneumonia
D: Multiple Sclerosis


28. A patient’s chart indicates a history of hyperkalemia. Which of the following would you not expect to see with this patient if this condition were acute?

A: Decreased HR
B: Paresthesias
C: Muscle weakness of the extremities
D: Migranes


29. A patient’s chart indicates a history of ketoacidosis. Which of the following would you not expect to see with this patient if this condition were acute?

A: Vomiting
B: Extreme Thirst
C: Weight gain
D: Acetone breath smell


30. A patient’s chart indicates a history of meningitis. Which of the following would you not expect to see with this patient if this condition were acute?

A: Increased appetite
B: Vomiting
C: Fever
D: Poor tolerance of light
31. A nurse if reviewing a patient’s chart and notices that the patient suffers from conjunctivitis. Which of the following microorganisms is related to this condition?

A: Yersinia pestis
B: Helicobacter pyroli
C: Vibrio cholera
D: Hemophilus aegyptius


32. A nurse if reviewing a patient’s chart and notices that the patient suffers from Lyme disease. Which of the following microorganisms is related to this condition?

A: Borrelia burgdorferi
B: Streptococcus pyrogens
C: Bacilus anthracis
D: Enterococcus faecalis


33. A fragile 87 year-old female has recently been admitted to the hospital with increased confusion and falls over last 2 weeks. She is also noted to have a mild left hemiparesis. Which of the following tests is most likely to be performed?

A: FBC (full blood count)
B: ECG (electrocardiogram)
C: Thyroid function tests
D: CT scan


34. A 84 year-old male has been loosing mobility and gaining weight over the last 2 months. The patient also has the heater running in his house 24 hours a day, even on warm days. Which of the following tests is most likely to be performed?

A: FBC (full blood count)
B: ECG (electrocardiogram)
C: Thyroid function tests
D: CT scan


35. A 20 year-old female attending college is found unconscious in her dorm room. She has a fever and a noticeable rash. She has just been admitted to the hospital. Which of the following tests is most likely to be performed first?

A: Blood sugar check
B: CT scan
C: Blood cultures
D: Arterial blood gases


36. A 28 year old male has been found wandering around in a confused pattern. The male is sweaty and pale. Which of the following tests is most likely to be performed first?

A: Blood sugar check
B: CT scan
C: Blood cultures
D: Arterial blood gases


37. A mother is inquiring about her child’s ability to potty train. Which of the following factors is the most important aspect of toilet training?

A: The age of the child
B: The child ability to understand instruction.
C: The overall mental and physical abilities of the child.
D: Frequent attempts with positive reinforcement.


38. A parent calls the pediatric clinic and is frantic about the bottle of cleaning fluid her child drank 20 minutes. Which of the following is the most important instruction the nurse can give the parent?

A: This too shall pass.
B: Take the child immediately to the ER
C: Contact the Poison Control Center quickly
D: Give the child syrup of ipecac


39. A nurse is administering a shot of Vitamin K to a 30 day-old infant. Which of the following target areas is the most appropriate?

A: Gluteus maximus
B: Gluteus minimus
C: Vastus lateralis
D: Vastus medialis


40. A nurse has just started her rounds delivering medication. A new patient on her rounds is a 4 year-old boy who is non-verbal. This child does not have on any identification. What should the nurse do?

A: Contact the provider
B: Ask the child to write their name on paper.
C: Ask a co-worker about the identification of the child.
D: Ask the father who is in the room the child’s name.

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