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1. A home care nurse is assessing a geriatric client.

What is the most common cause of

medication errors in noninstitutionalized geriatric clients?

a. Knowledge deficit
b. Poor vision
c. Dementia
d. Confusion

2. Which drug delivery system relieves the nurse of the responsibility for transcribing the
medication order?

a. Floor stock
b. Unit-dose
c. Individual prescription
d. Automated

3. Before administering the evening dose of a prescribed medication, the nurse on the
evening shift finds an unlabeled, filled syringe in the client's medication drawer. What
should the nurse do?

a. Discard the syringe to avoid a medication error.

b. Obtain a label for the syringe from the pharmacy
c. Use the syringe because it looks like it contains the same medication the nurse was
prepared to give.
d. Call the day nurse to verify the contents of the syringe

4. The nurse is assisting with a subclavian vein central line insertion when the client's
oxygen saturation rapidly drops. He complains of shortness of breath and becomes
tachypneic. The nurse suspects a pneumothorax has developed. Further assessment
findings supporting the presence of a pneumothorax include:

a. diminished or absent breath sounds on the affected side

b. paradoxical chest wall movement with respirations (flail chest)
c. tracheal deviation to the unaffected side.(Tension Pneumothorax)
d. muffled or distant heart sounds.( Cardiac Tamponade)

5. When monitoring a client's central venous pressure (CVP), the nurse knows that a
normal CVP measurement is:

a. 2 cm water.
b. 1 mm Hg.
c. 10 mm Hg.
d. 5 cm water.
6. During an admission assessment, the nurse asks a client why he's being admitted to the
facility. The client responds, "The physician found a lump in my prostate gland. I guess I have
cancer." Which response by the nurse would be most therapeutic?

a. "There is no way to know whether you have cancer until a biopsy is done."
b. "It isn't unusual for a man your age to have an enlarged prostate. Try not to worry."
c. "It's important to keep a positive attitude. There is a good chance it isn't cancer."
d. "You think you have cancer?"

7. Which action would be contraindicated for a client who develops a temperature of 102° F
(38.9° C).

a. Monitoring temperature every 4 hours

b. Increasing fluid intake
c. Covering the client with a light blanket
d. Providing a low-calorie diet

8. A client hospitalized with pneumonia has thick, tenacious secretions. To help liquefy these
secretions, the nurse should:

a. turn the client every 2 hours.

b. elevate the head of the bed 30 degrees.
c. encourage increased fluid intake.
d. maintain a cool room temperature.

9. The nurse is giving nutritional counseling to the mother of a child with celiac disease. Which
statement by the mother would indicate understanding?

a. "My son can't eat wheat, rye, oats, or barley."

b. "My son needs a diet rich in gluten."
c. "My son must avoid potatoes, rice, flour, and cornstarch."
d. "My son can safely eat frozen and packaged foods."

10. After intentionally taking an overdose of hydrocodone (Vicodin), a client is admitted to the
emergency department. Activated charcoal is prescribed. Before administering the drug, the
nurse should ensure that the client:

a. is able to follow commands.

b. has a nasogastric (NG) tube in place.
c. has an advance directive on file.
d. has audible bowel sounds.

11. Which of the following types of solutions, when administered I.V., would cause a
shift of fluid from body tissues to the bloodstream?

a. Hypotonic
b. Isotonic
c. Sodium chloride
d. Hypertonic

12. When developing a plan of care for an older adult, the nurse should consider which
challenges faced by clients in this age-group?

a. Selecting vocation, becoming financially independent, and managing a home

b. Developing leisure activities, preparing for retirement, and resolving empty-nest crisis
c. Managing a home, developing leisure activities, and preparing for retirement
d. Adjusting to retirement, deaths of family members, and decreased physical strength

13. The nurse is delivering the client's 10 a.m. medications. The client is away from his
room for a diagnostic study. Which action is most appropriate for the nurse to take?

a. Leave the medications on the client's bedside table.

b. Ask the client's roommate to keep the medications for the client until he returns.
c. Lock the medications in the medicine preparation area until the client returns.
d. Have the client skip that dose of medication.

14. A client who received general anesthesia returns from surgery. Postoperatively,
which nursing diagnosis takes highest priority for this client?

a. Pain related to surgery

b. Deficient fluid volume related to blood and fluid loss from surgery
c. Impaired physical mobility related to surgery
d. Risk for aspiration related to anesthesia

15. When assessing a client with cellulitis of the right leg, which of the following would
the nurse expect to find?

a. Painful skin that is swollen and pale in color

b. Cold, red skin
c. Small, localized blackened area of skin
d. Red, swollen skin with inflammation spreading to surrounding tissues

16. Which member of the health care team is responsible for obtaining informed
consent from a client?

a. The primary nurse

b. The physician
c. The nurse working with the physician
d. The physician's assistant

17. The nurse prepares to perform light palpation. How is light palpation performed?
a. By indenting the skin ½" to ¾" (1.3 to 1.9 cm)
b. By indenting the skin 1" to 2" (2.5 to 5 cm)
c. By indenting the skin 1", using both hands
d. By indenting the skin 1" and then releasing the pressure quickly

18. The nurse is caring for a client on a regimen of four medications to treat
tuberculosis. The nurse discovers that the client isn't taking all of his medications. What
is appropriate for the nurse to say to the client?

a. "Don't you realize that resistance can develop if you don't take your medications
b. "You need to take your medication as you were instructed. Do you need
c. "Why aren't you taking your medications? Don't you want to get better?"
d. "Taking many medications can be difficult. Tell me about the difficulties you're

19. The nurse is caring for a client with a history of falls. The first priority when caring for
a client at risk for falls is:

a. placing the call light for easy access.

b. keeping the bed in the lowest possible position.
c. instructing the client not to get out of bed without assistance.
d. keeping the bedpan available so that the client doesn't have to get out of bed.

20. A client who speaks little English has emergency gallbladder surgery. During
discharge preparation, which nursing action would best help this client understand
wound care instructions?

a. Asking frequently whether the client understands the instructions

b. Asking an interpreter to relay the instructions to the client
c. Writing out the instructions and having a family member read them to the client
d. Demonstrating the procedure and having the client return the demonstration

21. The physician orders dextrose 5% in water, 1,000 ml to be infused over 8 hours.
The I.V. tubing delivers 15 drops/ml. The nurse should run the I.V. infusion at a rate of:

a. 15 drops/minute.
b. 21 drops/minute.
c. 32 drops/minute.
d. 125 drops/minute.

22. Which type of evaluation occurs continuously throughout the teaching and learning
a. Formative
b. Retrospective
c. Summative
d. Informative

23. The nurse is developing a drug therapy regimen that won't interfere with the client's
lifestyle. When doing this, the nurse must consider the drug's:

a. adverse effects.
b. route of excretion.
c. peak concentration time.
d. steady-state duration of action.

24. When a nurse enters the room, the client complains that she's spitting up blood
when she coughs. The nurse takes a quick health history that includes:

a. the history of the present problem, medications, review of systems, and recent major
b. the history of the present problem, allergies, medications, and recent major
c. the history of the present problem, medications, family history, psychosocial history,
and review of systems.
d. the history of the present problem, allergies, medications, review of systems, and
recent major operations.

25. As a result of a serious motorcycle accident, a client suffers paraplegia. When the
nurse tries to administer medication, the client refuses it, saying, "I don't have to take
those pills if I don't want to. What good will they do?" Which action by the nurse would
be most appropriate?

a. Insisting that the client take the medication

b. Reporting the client's comments to the physician
c. Explaining the consequences of not taking the medication
d. Exploring how the client's feelings affect the decision to refuse medication

26. A client who has been admitted for surgery seems preoccupied and anxious the
night before the operation. Which comment by the nurse would promote therapeutic

a. "Are you worried about your surgery tomorrow?"

b. "Would you like me to call a chaplain to talk with you about any concerns you may
have about surgery?"
c. "You seem worried about something. Would it help to talk about it?"
d. "It isn't unusual to worry about surgery. If you'd like, I'll ask the physician for
something to help you sleep."

27. The nurse is reviewing a client's arterial blood gas (ABG) report. Which ABG value
reflects the acid concentration in the blood?

a. pH
b. PaO2
c. PaCO2
d. HCO3

28. Which pulse should the nurse palpate during rapid assessment of an unconscious

a. Radial
b. Brachial
c. Femoral
d. Carotid

29. The physician orders heparin, 7,500 units, to be administered subcutaneously every
6 hours. The vial reads 10,000 units per milliliter. The nurse should anticipate giving
how much heparin for each dose?

a. ¼ ml
b. ½ ml
c. ¾ ml
d. 1¼ ml

30. Which of the following is the most common source of airway obstruction in an
unconscious victim?

a. A foreign object
b. Saliva or mucus
c. The tongue
d. Edema

31. When preparing a client for a diagnostic study of the colon, the nurse teaches the
client how to self-administer a prepackaged enema. Which statement by the client
indicates effective teaching?

a. "I will administer the enema while sitting on the toilet."

b. "I will administer the enema while lying on my left side with my right knee flexed."
c. "I will administer the enema while lying on my right side with my left knee flexed."
d. "I will administer the enema while lying on my back with both knees flexed."
32. A client hasn't voided since before surgery, which took place 8 hours ago. When
assessing the client, the nurse will:

a. be unable to palpate the bladder.

b. feel that the bladder is smooth.
c. palpate the bladder above the symphysis pubis.
d. palpate the bladder at the umbilicus.

33. After assessing a client, the nurse formulates relevant nursing diagnoses. Which of
the following is a complete nursing diagnosis statement?

a. Ineffective airway clearance related to mucus plugs and nonproductive cough

b. Hyperventilation related to anxiety
c. Tachycardia
d. Shortness of breath related to anxiety

34. The nurse is teaching the parents of a child with cystic fibrosis about proper
nutrition. Which of the following instructions should the nurse include?

a. Encourage a high-calorie, high-protein diet.

b. Restrict fluids to 1,500 ml per day.
c. Limit salt intake to 2 g per day.
d. Encourage foods high in vitamin B.

35. To avoid recording an erroneously low systolic blood pressure because of failure to
recognize an auscultatory gap, the nurse should:

a. have the client lie down while taking his blood pressure.
b. inflate the cuff to at least 200 mm Hg.
c. take blood pressure readings in both arms.
d. inflate the cuff at least another 30 mm Hg after the radial pulse becomes unpalpable.

36. The physician writes the following order for a client: "Digoxin .125 mg P.O. once
daily." To prevent a dosage error, how should the nurse transcribe this order onto the
medication administration record?

a. "Digoxin .125 mg P.O. once daily" (exactly as written by the physician)

b. "Digoxin 0.125 mg P.O. once daily"
c. "Digoxin 0.1250 mg P.O. once daily"
d. "Digoxin .1250 mg P.O. once daily"

37. A client, age 68, admitted for treatment of a colon tumor, asks the nurse, "Do I have
cancer?" Which response by the nurse would be best?

a. "Most people your age develop some type of colon problem."

b. "Your physician can discuss this in more detail."
c. "You sound concerned about what is happening."
d. "You'll have to have some tests before cancer can be ruled out."

38. The nurse is caring for a client who is taking an anticoagulant. The nurse should
teach the client to:

a. report incidents of diarrhea.

b. avoid foods high in vitamin K.
c. use a straight razor when shaving.
d. take aspirin for pain relief.

39. The nurse administers racemic epinephrine to an 8-year-old boy. Ten minutes after
administration, the nurse should be alert for:

a. bradycardia
b. respiratory distress.
c. signs of improved oxygenation.
d. diminished cyanosis.

40. A client twists the right ankle while playing basketball and seeks care for ankle pain
and swelling. After the nurse applies ice to the ankle for 30 minutes, which statement by
the client suggests that ice application has been effective?

a. "I need something stronger for pain relief."

b. "My ankle looks less swollen now."
c. "My ankle appears redder now."
d. "My ankle feels very warm."

41. The physician prescribes meperidine (Demerol), 75 mg I.M. every 4 hours as

needed, to control a client's postoperative pain. The package isert reads: "Meperidine,
100 mg/ml." How many milliliters of meperidine should the client receive?

a. 0.25
b. 0.5
c. 0.6
d. 0.75

42. Which of the following planes divides the body longitudinally into anterior and
posterior regions?

a. Frontal plane
b. Sagittal plane
c. Midsagittal plane
d. Transverse plane

43. The nurse is preparing to help a client with weakness in his right leg get out of bed
to a chair. Where should the nurse place the chair?

a. Parallel to the bed on the right side

b. Perpendicular to the bed on the right side
c. Parallel to the bed on the left side
d. Parallel to the bed on either side

44. A client who recently immigrated to the United States from Korea is hospitalized with
second- and third-degree burns. He speaks little English and has been lying quietly in
bed. Ten hours after his admission, the nurse conducts a serial assessment and asks
him whether he's in pain. He smiles and shakes his head vigorously back and forth.
Which nursing action would be most appropriate at this time?

a. Documenting that the client is resting quietly and denies pain

b. Calling a family member to obtain information about the client
c. Giving the client the prescribed
d. Checking vital signs and assessing for nonverbal indications of pain

45. A client scheduled for cardiac catheterization tells the nurse she is nervous because
she has heard of people dying during this procedure. Which response by the nurse
would be best?

a. "I don't blame you for being nervous. We all worry

b. "Don't worry. You're in excellent hands."
c. "Why do you feel this way? Do you know someone who had a problem?"
d. "You sound really upset. Would you like to talk about it?"

47. The label of a drug package reads "meperidine hydrochloride (Demerol), 50 mg/ml."
How many milliliters would the nurse give a client for a 30-mg dose?

a. 1.6 ml
b. 1 ml
c. 0.6 ml
d. 0.5 ml

48. Which intervention should the nurse try first for a client who exhibits signs of sleep

a. Administer sleeping medication before bedtime.

b. Ask the client each morning to describe the quality of sleep during the previous night.
c. Teach the client relaxation techniques, such as guided imagery, meditation, and
progressive muscle relaxation.
d. Provide the client with normal sleep aids, such as pillows, back rubs, and snacks.
49. A client has a nasogastric (NG) tube. How should the nurse administer oral
medication to this client?

a. Crush the tablets and wash the powder down the NG tube, using a syringe filled with
saline solution.
b. Heat the tablets until they liquefy, and then pour the liquid down the NG tube.
c. Crush the tablets and prepare a liquid form, and then insert
d. Cut the tablets in half and wash them down the NG tube, using a syringe filled with

50. The nurse is assessing a postoperative client. Which of the following should the
nurse document as subjective data?

a. Vital signs
b. Laboratory test results
c. Client's description of pain
d. Electrocardiographic (ECG) waveforms

Which of the following factors can cause hepatitis A?

A. Contact with infected blood
B. Blood transfusions with infected blood
C. Eating contaminated shellfish
D. Sexual contact with an infected person

After a person experiences a closure of the epiphyses, which of the following is true?
A. The bone grows in length but not thickness.
B. The bone increases in thickness and is remodeled.
C. Both bone length and thickness continues.
D. No further increase in bone length occur
Which intervention is appropriate for the nurse caring for a client in severe pain receiving a continuous
I.V. infusion of morphine?
A. Assisting with a naloxone challenge test before therapy begins
B. Discontinuing the drug immediately if signs of dependence appear
C. Changing the administration route to P.O. if the client can tolerate fluids
D. Obtaining baseline vital signs before administering the first dose

Every morning a client with type 1 diabetes receives 15 units of Humulin 70/30. What does this type of
insulin contain?
A. 70 units of neutral protamine Hagedorn (NPH) insulin and 30 units of regular insulin
B. 70 units of regular insulin and 30 units of NPH insulin (Your Answer)
C. 70% NPH insulin and 30% regular insulin
D. 70% regular insulin and 30% NPH insulin

The electrocardiogram (ECG) tracing shown below, excluding the seventh beat, has a normal QRS
complex, one premature atrial contraction (PAC), and what other attributes?
A. P wave is identifiable, PR interval is 0.16 second, and sinus rhythm is at 95 beats/minute
B. P wave and PR interval are unidentifiable and sinus arrhythmia is at 95 beats/minute
C. P wave is identifiable, PR interval is 0.16 second, and sinus rhythm is at 95 beats/minute
D. P wave is identifiable, PR interval is 0.16 second, and sinus arrhythmia is at 95 beats/minute

The nurse is teaching the client how to use a cane. Which of the following statements is most
A. The client should hold the cane on the involved side.
B. The client should hold the cane close to his body.
C. The stride length and the timing of each step should be equal.
D. The nurse should stand behind the client to prevent falls.

For a client with hyperglycemia, which assessment finding best supports a nursing diagnosis of
Deficient fluid volume?
A. Cool, clammy skin
B. Distended neck veins
C. Increased urine osmolarity
D. Decreased serum sodium level

A client with osteoarthritis tells the nurse she is concerned that the disease will prevent her from
doing her chores. Which suggestion should the nurse offer?
A. "Do all your chores in the morning, when pain and stiffness are least pronounced."
B. "Do all your chores after performing morning exercises to loosen up."
C. "Pace yourself and rest frequently, especially after activities."
D. "Do all your chores in the evening, when pain and stiffness are least pronounced

After abdominal surgery, which factor would predispose a client to deep vein thrombosis?
A. The client is 5′9" tall and weighs 128 lb.
B. The client has been pregnant four times.
C. The client usually walks 3 miles a day.
D. The client will be immobile during and shortly after surgery.

10) The nurse is caring for a client who's hypoglycemic. This client will have a blood glucose level:
A. below 70 mg/dl.
B. between 70 and 120 mg/dl.
C. between 120 and 180 mg/dl.
D. over 180 mg/dl.