1. You are assessing an 80-year-old patient presenting with an unintended weight loss of 10 pounds in the last 8 weeks. During assessment, patient has ill-fitting dentures and limited intake of high-fiber foods. Based on the information provided the patient is at risk for? a. Constipation b. Deficient fluid volume c. Malabsorption of nutrients d. Excessive intake of convenience foods.
2. You are about to teach a nutrition education class to a group of older adults at a senior center. When planning the class, you should be aware that individuals at this lifespan stage presents with of the following? a. A decreased need for calcium b. An increased need for glucose c. An increased need for sodium d. A decreased need for calories.
3. A nurse is caring for a patient who is palliative following metastasis. The nurse is aware of the need to uphold the ethical principle of beneficence. How can the nurse best exemplify this principle in the care of this patient? a. The nurse tactfully regulates the number and timing of visitors as the patient´s wishes. b. The nurse stays with the patient during his or her death.. c. The nurse ensures that all members of the care team are aware of the patient´s DNR order. d. The nurse liaises with members of the care team to ensure continuity of care.
4. A patient with a diagnosis of peptic ulcer disease has just been prescribed omeprazole (Prilosec). How should the nurse best describe this medication´s therapeutic action? a. This medication will reduce the amount of acid secreted in your stomach. b. This medication will make the lining of your stomach more resistant to damage. c. This medication will specifically address the pain that accompanies peptic ulcer disease. d. This medication will help your stomach lining to repair itself.
5. You are admitting an elderly woman who is accompanied by her husband. The husband wants to know where the information you are obtaining is going to be kept. You inform the husband that all the information is kept in the patient´s electronic health records. But despite the orientation, the husband states, “I am not comfortable with that. It is too easy for someone to break/hack into the computer records these days.” Based on your knowledge, what is your best response? a. The Institute of Medicine has called for the implementation of the computerized health record, so all hospitals are doing it. b. We´ve been doing this for several years with good success, so our records are very safe. c. This hospital is as concerned as you are about keeping our patient´s records private. So, we take special precautions to make sure no one can break into our patient´s medical records. d. Your wife´s record´s will be safe, because only people who work in the hospital have the credentials to access them.
6. You are the nurse caring for a 51-year-old man who has just been told in a family meeting that he has stage IV colon cancer. You expect that the patient now has an increase in blood pressure, heart rate and respiratory rate. You spend time talking with this patient and his vital signs become closer to normal range. To what would you attribute this phenomenon? a. Cortisol level are decreasing. b. Endocrine activity has increased. c. The patient is adapting to noxious stressors. d. The sympathetic response has been activated.
7. A nurse provides care in an inner-city hospital that serves a culturally diverse population. When attempting to foster positive and therapeutic nurse-patient interactions, the nurse should recognize that these interactions are primarily dependent on what variable? a. The knowledge of patient tendencies during illness b. The ability of the nurse to work with a multicultural health care team. c. The ability to understand and be understood. d. Cultural diversity among the unit staff.
8. A nurse is planning the care of a 48-year-old woman who has just received a diagnosis of breast cancer. The patient has been explicit about her desire to integrate a variety of complementary therapies into her treatment regimen. What is the nurse´s primary responsibility around the use of complementary therapies? a. To become skilled in administering as many complementary therapies as possible. b. To liaise between practitioners of complementary therapies and the medical team. c. To examine the evidence base underlying each of the patient´s chosen complementary therapies.
d. To assess the patient´s use of complementary therapies in order to promote safety.
9. A nurse is providing care for a female patient who is Hispanic. The care team is discussing the patient´s nutritional status and one of the nurse’s colleagues´ states, “I suppose we should try to get her some tacos or burritos since that´s what she´s probably used to. “How should the nurse best interpret the colleague´s statement? a. The colleague may have stereotypical views of Hispanics. b. The colleague is exemplifying the process of acculturation. c. The colleague is aware of the dietary characteristics of Hispanic culture. d. The colleague may harbor resentment against Hispanics.
10. A 72-years-old woman computed tomography (CT) reveals lung cancer with metastasis to the liver. The patient´s son has been adamant that any “bad news” be withheld from his in order to protect her from stress, stating that this is a priority in his culture. How should the nurse and the other members of the care team best respond to this request? a. Explain to the son the team´s ethical obligation to inform the patient. b. Refer the family to social work. c. Have a nurse or physician from the patient´s culture make contact with her and her son. d. Speak with the son to explore his rationale and attempt to reach a consensus.
11. At the clinic, you are caring for an elderly patient with a new diagnosis of osteoarthritis. The patient´s daughter is accompanying him, and you have explained why the incidence of chronic disease tends to increase with age. Based on your knowledge what is the best explanation? a. With age, biologic changes reduce the efficiency of body systems. b. With age, less support and care, older adults are prone to illness. c. With age, the older adult assumes a sick role. d. With age, illnesses are diagnosed more often.
12. A patient tells the nurse that her doctor just told her that her new diagnosis of rheumatoid arthritis is considered to be a “chronic condition” She asks the nurse what “chronic condition” means. What would be the nurse´s best response? a. “Chronic conditions are health problems that require management of several months or longer”. b. “Chronic conditions are diseases that come and go in a relatively predictable cycle” c. “Chronic conditions are medical conditions that culminate in disabilities that require hospitalization”
d. “Chronic conditions are those that require short-term management in extended-care facilities”.
13. A 37-year-old woman with multiple sclerosis is married and has three children. The nurse has worked extensively with the woman and her family to plan appropriate care. What is the nurse´s most important role with this patient? a. Ensure the patient adheres to all treatments. b. Provide the patient with advice on alternative treatment options. c. Provide a detailed plan of activities of daily living (ADLs) for the patient. d. Help the patient develop strategies to implement treatment regiments.
14. A nurse is assessing the size and density of a patient´s abdominal organs. If the results of palpation are unclear to the nurse, what assessment technique should be implemented? a. Percussion b. Auscultation c. Inspection d. Rectal examination.
15. The nurse in the ICU is admitting a 57-year.old man with a diagnosis of possible septic shock. The nurse´s assessment reveals that the patient has a normal blood pressure, increased heart rate, decreased bowel sounds, and cold, clammy skin. The nurse´s analysis of these data should lead to what preliminary conclusion? a. The patient is in the compensatory stage of shock. b. The patient is in the progressive stage of shock. c. The patient will stabilize and be released by tomorrow. d. The patient is in the irreversible stage of shock.
16. Traditionally, nurses have been involved with tertiary cancer prevention. However, an increasing emphasis is being placed on both primary and secondary prevention. What would be an example of primary prevention? a. Yearly Pap tests. b. Testicular self-examination. c. Teaching patients to wear sunscreen. d. Screening mammograms.
17. The nurse is caring for a 39-year-old woman with a family history of breast cancer. She requested a breast tumor marking test and the results have come back positive. As a result, the patient is requesting a bilateral mastectomy. This surgery is an example of what type of oncologic surgery.? a. Salvage surgery. b. Palliative surgery. c. Prophylactic surgery. d. Reconstructive surgery.
18. The nurse is caring for a patient that has just been given a 6-month prognosis following a diagnosis of extensive stage small-cell lung cancer. The patient states that he would like to die at home, but the team believes that the patient´s care needs are unable to be met in a home environment. What might you suggest as an alternative? a. Discuss a referral for rehabilitation hospital. b. Assign the patient to a home care list. c. Discuss a referral for acute care. d. Discuss a referral for hospice care.
19. A patient is admitted to the ED complaining of severe abdominal pain, stating that he has been vomiting “coffee-ground like” emesis. The patient is diagnosed with a perforated gastric ulcer and is informed that he needs surgery. When can the patient most likely anticipate that the surgery will be scheduled? a. Within 24 hours b. Within the next week. c. Without delay. d. As soon as a surgical suite is available. .
20. The nurse is preparing a patient for surgery. The patient states that she is very nervous and really does not understand what the surgical procedure is for or how it will be performed. What is the most appropriate action for the nurse to take? a. Have the patient sign the informed consent and place it in the chart. b. Call the physician to review the procedure with the patient. c. Explain the procedure clearly to the patient and her family. d. Provide the patient with a pamphlet explaining the procedure.
21. The nurse admitting a patient who is insulin dependent to the same-day surgical suite for carpal tunnel surgery. How should this patient´s diagnosis of type I diabetes affects the care that the nurse plans? a. The nurse should administer a bolus of dextrose IV solution preoperatively. b. The nurse should keep the patient NPO for at least 8 hours preoperatively. c. The nurse should initiate a subcutaneous infusion of long-acting insulin. d. The nurse should assess the patient´s blood glucose levels vigilantly.
22. The nurse is creating the care plan for a 70-year-old obese patient who has been admitted to the postsurgical unit following a colon resection. This patient´s age and increased body mass index mean that she is at increased risk for what complication in the postoperative period? a. Hyperglycemia b. Azotemia c. Falls d. Infection.
23. You are providing preoperative teaching to a patient scheduled for hip replacement surgery in 1 month. During the preoperative teaching, the patient gives you a list of medications she takes, the dosage, and frequency. Which of the following interventions provides the patient with the most accurate information? a. Instruct the patient to stop taking St. John´s wort at least 2 weeks prior to surgery due to its interaction with anesthetic agents. b. Instruct the patient to continue taking ephedrine prior to surgery due to its beneficial effect on blood pressure. c. Instruct the patient to discontinue Synthroid due to its effect on blood coagulation and the potential for heart dysrhythmias. d. Instruct the patient to continue any herbal supplements unless otherwise instructed and inform the patient that these supplements have minimal effect on the surgical procedure.
24. An OR nurse will be participating in the intraoperative phase of a patient´s kidney transplant. What action will the nurse prioritize in this aspect of nursing care? a. Monitoring the patient´s physiologic status. b. Providing emotional support to family. c. Maintaining the patient´s cognitive status.
d. Maintaining a clean environment.
25. The nurse is caring for a trauma victim in the ED who will require emergency surgery due to injuries. Before the patient leaves the ED for the OR, the patient goes into cardiac arrest. The nurse assists in the successful resuscitation and proceeds to release the patient to the OR staff. When can the ED nurse perform the preoperative assessment? a. When he or she has the opportunity to review the patient´s electronic health record. b. When the patient arrives in the OR. c. When assisting with the resuscitation. d. Preoperative assessment is not necessary in this case.
26- A 90 year –old female patient is scheduled to undergo a partial mastectomy for the treatment of breast cancer. What nursing diagnosis should the nurse prioritize when planning this patient’s postoperative care? a. Risk for Delayed Growth and development related to prolonged hospitalization. b. Risk for Decisional Conflict related to discharge planning. c. Risk for Impaired Memory related to old age. d. Risk for infection related to reduced immune function.
27- You are assessing a male client diagnosed with gonorrhea. Which symptom most likely prompted the client to seek medical attention? a. Rash of the palm of the hands and soles of the feet. b. Cauliflower – like warts on the penis. c. Painful red papules on the shaft of the penis. d. Foul – smelling discharge from the penis.
28- A client reports experiencing vulvar pruritus. Which assessment factor may indicate that the client has an infection caused by Candida albicans? a. Cottage – cheese like discharge. b. Yellow – Green discharge. c. Gray- white discharge d. Discharge with fishy odor.
29- Which of the following statement about herpes zoster is not true? a. Patients with a past medical history (PMHx) of chickenpox at risk of post herpetic neuralgia. b. A sexually transmitted disease. c. A condition that causes symptoms such as burning, tingling pain and lesions generally on one side of the body. d. Caused by the varicella zoster virus.
30- A patient has sustained a long bone fracture. The nurse is preparing a care plan for this patient. Which intervention should Mr. Soto RN include in the care plan to enhance fracture healing? a. Limit weight bearing and exercising b. Monitor color, temperature, and pulses of the affected extremity. c. Avoid immobilization of the fracture fragments d. Administration of high doses of corticosteroids.
31- An older adult patient has come to the clinic for a regular check-up. The nurse’s initial inspection reveals an increased thoracic curvature of the patient’s spine. The nurse should document the presence of which of the following a. Scoliosis b. Epiphyses c. Lordosis d. Kyphosis.
32- A patient asks the nursing assistant for a bedpan. When the patient finished, the nursing assistant notifies the nurse that the patient has bright red streaking of blood in the stool. What is the most likely a result of? a. Diet high in red meat b. Upper GI bleed c. Hemorrhoids d. Use of iron supplements.
33- A patient who had surgery for gallbladder disease has just returned to the postsurgical unit from postanesthetic recovery. The nurse caring for this patient knows to immediately report what assessment finding to the physician? a. Decreased breath sounds. b. Drainage of bile – colored fluid onto the abdominal dressing. c. Rigidity of the abdomen. d. Acute pain with movement.
34- You are caring for 42 y/o male. The health care provided has ordered aminophylline 110 mg IV every 12 hours. On stock you have available. a. 4.4 mL b. 0.4 mL c. 4.0 mL d. 4.44 mL.
35- A woman has been diagnosed with breast cancer and is being treated aggressively with a chemotherapeutic regimen. As a result of this regimen, she has an inability to fight infection due to the fact that her bone marrow is unable to produce a sufficient amount of what? a. Lymphocytes b. Cytoblasts c. Antibodies d. Capillaries.
36- Since the emergence of HIV/AIDS, there have been significant changes in epidemiologic trends. Members of what group have the greatest risk of contracting HIV. a. Gay, bisexual, and other men who have sex with men. b. Recreational drug users c. Blood transfusion recipients d. Health care providers.
37- A clinic nurse is caring for a patient admitted with AIDS. The nurse has assessed that the patient is experiencing a progressive decline in cognitive, behavioral, and motor functions. The nurse recognizes that these symptoms are most likely related to the onset of what complication? a. HIV encephalopathy. b. B- cell lymphoma c. Kaposi’s sarcoma. d. Wasting syndrome.
38- A nurse is assessing a 28-year-old man with HIV who has been admitted with pneumonia. In assessing the patient, which of the following observations takes immediate priority? a. Oral temperature of 100 F. b. Tachypnea and restlessness. c. Frequent loose stools d. Weigh loss of 1 pound since yesterday.
39- A patient has come into the free clinic asking to be tested for HIV infection. The patient asks the nurse how the test works. The nurse responds that if the testing shows the antibodies to the AIDS virus are present in the blood, this indicates what? a. The patient is immune to HIV. b. The patient’s immune system is intact. c. The patient has AIDS – related complications. d. The patient has been infected with HIV.
40- Working in the clinics, you call your next patient. A 35 y/o female with a chief complaint (cc) of back pain. During the musculoskeletal examination you asked the patient to turn to the left as shows in the picture:
You observe and report an increase in the lumbar curvature of the spine. The nurse should recognize the presence of what health problem? a. Osteoporosis b. Kyphosis c. Lordosis d. Scoliosis.
42. The human body is designed to protect its vital parts. A fracture of what type of bone may interfere with the protection of vital organs.? a. Long bones. b. Short bones. c. Flat bones d. Irregular bones.
43. A nurse is caring for an older adult who has been diagnosed with geriatric failure to thrive. This patient´s prolonged immobility creates a risk for what complication? a. Muscle clonus b. Muscle atrophy c. Rheumatoid arthritis d. Muscle fasciculations.
44. The nurse´s comprehensive assessment of an older adult involves the assessment of the patient´s gait. How should the nurse best perform this assessment.? a. Instruct the patient to walk heel-to-toe for 15 to 20 steps. b. Instruct the patient to walk in a straight line while not looking at the floor. c. Instruct the patient to walk away from the nurse for a short distance and then toward the nurse. d. Instruct the patient to balance on one foot for as long as possible and then walk in a circle around the room.
45. The nurse is assessing a patient for dietary factors that may influence her risk for osteoporosis. The nurse should question the patient about her intake of what nutrient.? a. Potassium b. Simple carbohydrates. c. Vitamin D d. Protein e. Soluble fiber.
46. A nurse is caring for a patient who has had a plaster arm cast applied. Immediately post-application, the nurse should provide what teaching to the patient.? a. The cast will feel cool to touch for the first 30 minutes. b. The cast should be wrapped snuggly with a towel until the patient gets home. c. The cast should be supported on a board while drying. d. The cast will only have full strength when dry.
47. A patient broke his arm in a sports accident and required the application of a cast. Shortly following application, the patient complained of an inability to straighten his fingers and was subsequently diagnosed with Volkmann contracture. What pathophysiologic process caused this complication.? a. Obstructed arterial blood flow to the forearm and hand. b. Simultaneous pressure on the ulnar and radial nerves. c. Irritation of Merkel cells in the patient´s skin surfaces. d. Uncontrolled muscle spasms in the patient´s forearm.
48. A patient with a fractured femur is in balanced suspension traction. The patient needs to repositioned toward the head of the bed. During repositioning, what should the nurse do.? a. Place slight additional tension on the traction cords. b. Release the weights and replace them immediately after positioning. c. Reposition the bed instead of repositioning the patient. d. Maintain consistent traction tension while repositioning.
49. A patient with diabetes is attending a class on the prevention of associated diseases. What action should the patient perform to reduce the risk of osteomyelitis.? a. Increase calcium and vitamin intake. b. Perform meticulous foot care. c. Exercise 3 to 4 times weekly for at least 30 minutes. d. Take corticosteroids as ordered.
50. A nurse is caring for a patient who is scheduled for a colonoscopy and whose bowel preparation will include polyethylene glycol electrolyte lavage prior to the procedure. The presence of what health problem would contraindicate the use of this form of form of bowel preparation. a. Inflammatory bowel disease. b. Intestinal polyps. c. Diverticulitis. d. Colon cancer.
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