Practice Test 10

1. A patient arrives at the emergency department complaining of midsternal chest pain.

Which of the following nursing action should take priority?
A. A complete history with emphasis on preceding events.
B. An electrocardiogram.
C. Careful assessment of vital signs.
D. Chest exam with auscultation.
2. A patient has been hospitalized with pneumonia and is about to be discharged. A nurse
provides discharge instructions to a patient and his family. Which misunderstanding by the
family indicates the need for more detailed information?
A. The patient may resume normal home activities as tolerated but should avoid physical
exertion and get adequate rest.
B. The patient should resume a normal diet with emphasis on nutritious, healthy foods.
C. The patient may discontinue the prescribed course of oral antibiotics once the symptoms have
completely resolved.
D. The patient should continue use of the incentive spirometer to keep airways open and free of
secretions.
3. A nurse is caring for an elderly Vietnamese patient in the terminal stages of lung cancer.
Many family members are in the room around the clock performing unusual rituals and
bringing ethnic foods. Which of the following actions should the nurse take?
A. Restrict visiting hours and ask the family to limit visitors to two at a time.
B. Notify visitors with a sign on the door that the patient is limited to clear fluids only with no
solid food allowed.
C. If possible, keep the other bed in the room unassigned to provide privacy and comfort to the
family.
D. Contact the physician to report the unusual rituals and activities.
4. The charge nurse on the cardiac unit is planning assignments for the day. Which of the
following is the most appropriate assignment for the float nurse that has been reassigned
from labor and delivery?
A. A one-week postoperative coronary bypass patient, who is being evaluated for placement of a
pacemaker prior to discharge.
B. A suspected myocardial infarction patient on telemetry, just admitted from the Emergency
Department and scheduled for an angiogram.
C. A patient with unstable angina being closely monitored for pain and medication titration.
D. A postoperative valve replacement patient who was recently admitted to the unit because all
surgical beds were filled.

5. A newly diagnosed 8-year-old child with type I diabetes mellitus and his mother are
receiving diabetes education prior to discharge. The physician has prescribed Glucagon for
emergency use. The mother asks the purpose of this medication. Which of the following
statements by the nurse is correct?
A. Glucagon enhances the effect of insulin in case the blood sugar remains high one hour after
injection.
B. Glucagon treats hypoglycemia resulting from insulin overdose.
C. Glucagon treats lipoatrophy from insulin injections.
D. Glucagon prolongs the effect of insulin, allowing fewer injections.
6. An infant with congestive heart failure is receiving diuretic therapy at home. Which of
the following symptoms would indicate that the dosage may need to be increased?
A. Sudden weight gain.
B. Decreased blood pressure.
C. Slow, shallow breathing.
D. Bradycardia.
7. A patient taking Dilantin (phenytoin) for a seizure disorder is experiencing
breakthrough seizures. A blood sample is taken to determine the serum drug level. Which
of the following would indicate a sub-therapeutic level?
A. 15 mcg/mL.
B. 4 mcg/mL.
C. 10 mcg/dL.
D. 5 mcg/dL.
8. A patient arrives at the emergency department complaining of back pain. He reports
taking at least 3 acetaminophen tablets every three hours for the past week without relief.
Which of the following symptoms suggests acetaminophen toxicity?
A. Tinnitus.
B. Diarrhea.
C. Hypertension.
D. Hepatic damage.
9. A nurse is caring for a cancer patient receiving subcutaneous morphine sulfate for pain.
Which of the following nursing actions is most important in the care of this patient?
A. Monitor urine output.
B. Monitor respiratory rate.
C. Monitor heart rate.
D. Monitor temperature.
10. A patient arrives at the emergency department with severe lower leg pain after a fall in
a touch football game. Following routine triage, which of the following is the appropriate
next step in assessment and treatment?
A. Apply heat to the painful area.
B. Apply an elastic bandage to the leg.
C. X-ray the leg.
D. Give pain medication.

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 antipsychotic 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 patient is undergoing the induction stage of treatment for leukemia. The nurse
teaches family members about infectious precautions. Which of the following statements by
family members indicates that the family needs more education?
A. We will bring in books and magazines for entertainment.
B. We will bring in personal care items for comfort.
C. We will bring in fresh flowers to brighten the room.
D. We will bring in family pictures and get well cards.

17. A nurse is caring for a patient with acute lymphoblastic leukemia (ALL). Which of the
following is the most likely age range of the patient?
A. 3-10 years.
B. 25-35 years.
C. 45-55 years.
D. over 60 years.
18. A patient is admitted to the oncology unit for diagnosis of suspected Hodgkins disease.
Which of the following symptoms is typical of Hodgkins disease?
A. Painful cervical lymph nodes.
B. Night sweats and fatigue.
C. Nausea and vomiting.
D. Weight gain.
19. The Hodgkins disease patient described in the question above undergoes a lymph node
biopsy for definitive diagnosis. If the diagnosis of Hodgkins disease were correct, which of
the following cells would the pathologist expect to find?
A. Reed-Sternberg cells.
B. Lymphoblastic cells.
C. Gauchers cells.
D. Rieders cells
20. A patient is about to undergo bone marrow aspiration and biopsy and expresses fear
and anxiety about the procedure. Which of the following is the most effective nursing
response?
A. Warn the patient to stay very still because the smallest movement will increase her pain.
B. Encourage the family to stay in the room for the procedure.
C. Stay with the patient and focus on slow, deep breathing for relaxation.
D. Delay the procedure to allow the patient to deal with her feelings.