NURSING PRACTICE I Fundamentals of Professional Nursing Practice

1) A client who has fractured leg has been instructed to ambulate without weight bearing on the affected leg. The nurse evaluates that the client is ambulating correctly if she uses which of the following crutch walking gaits? a) Two point gait b) Four point gait c) Three point gait d) Swing to gait 2) A client is prescribed atropine, 0.4 mg IM. The atropine vial is labeled 0.5 mg/ml. How many ml should the nurse plan to administer? a) 0.6 ml b) 0.7 ml c) 0.8 ml d) 0.9ml 3) What height would be appropriate for elevation of the enema bag for a cleansing enema? a) Slightly above the hips b) 12- 18 inches above the hips c) 18- 24 inches above the hip d) Less than 12 inches above the hips 4) What is the best position for the patient during an enema? a) Lithotomy b) Right lateral sims c) Dorsal recumbent d) Left lateral sims 5) When a client wants to read his chart, the nurse should a) Call the doctor to obtain permission b) Give the client the chart and answer questions for him c) Tell the client that he can read the chart when the doctor makes rounds d) Ask the client what he wants to know and answer those questions without giving him the chart 6) Older adults with known cardiovascular disease must balance which of the following measures for optimum health? a) Diet, exercise, and medication b) Stress, hypertension, and pain c) Mental health, diet, and stress d) Social events, diet and smoking 7) A client with angina shows the nurse her nitroglycerin that she is carrying in a plastic bag in her pocket. The nurse instructs the client that nitroglycerin should be kept in a) Refrigerator b) Cool, moist place c) Dark container to shield from the light d) Plastic bag where it is readily available 8) Non steroidal anti inflammatory drugs are frequently used in treatment of musculoskeletal conditions. It is important for the nurse to remind the client a) To take NSAIDs at least 3xday b) To exercise the joints at least 1 hour after taking the medication c) To take antacids 1 hour after taking NSAIDs d) Take NSAIDs with food

9) A client whose condition remains stable after a myocardial infarction gradually increases his activity. Which of the following conditions should the nurse assess to determine whether the activity is appropriate for the client a) Edema b) Cyanosis c) Dyspnea d) Weight loss 10) The client with an NGT begins to complain abdominal distention. Which of the following should the nurse implement first? a) Call the physician b) Irrigate the NGT c) Check the function of the suction equipment d) Reposition the NGT 11) The nurse is preparing a teaching plan for 46 yr old client recently diagnosed with DM type 2. What is the first step in this process? a) Establish goals b) Choose video materials and brochures c) Assess the clients learning needs d) Set priorities of learning needs 12) An expected physiologic response to a low potassium level is a) Cardiac dysrhythmias b) Hyperglycemia c) Hypertension d) Increased energy 13) A client in a cardiac rehabilitation program states that he would like to make sure he is eating right foods to ensure adequate endurance on the treadmill. Which of the following nutrients is most helpful for promoting endurance during sustained activity? a) CHON b) CHO c) Fat d) Water 14) A clients chest tube is connected to a chest tube drainage system with a water seal. The nurse notes that the fluid in the water seal column is fluctuating with each breath that the client takes. The fluctuation means that a) No obstruction in chest tube b) Client is developing subcutaneous emphysema c) Chet tube is working properly d) There is a leak in the chest tube drainage system 15) A client is trying to lose weight at a moderate pace. If the client eliminates 1000 calories per day from his normal intake, how many pounds would he lose in 1 week? a) 1 pound b) 2 pounds c) 3 pounds d) 4 pounds 16) The nurse walks into the room of a client who has a DNR order and finds the client without pulse, respirations, or blood pressure. What is the most appropriate action? a) Stay in the room and notify the nursing team for assistance b) Push the emergency alarm to call a code c) Dial the hospital phone number for a code d) Pull the curtain and leave the room 17) The nurse recognizes that a client with pain disorder is improving when the client states which of the following a) I need to have a good cry about all the pain Ive been in and then not dwell on it

b) I need to find another physician who can accurately diagnose my condition c) The pain medicine that you gave me helps me to relax d) Im angry with all of the doctors Ive see who dont know what theyre doing 18) Two days, post operatively; Sam complained of abdominal pain and shortness of breath. The nurse observed abdominal distention. The most likely cause of Sams present condition is: a) Flatulence b) Constipation c) Slowed esophageal emptying d) Increased peristalsis 19) After 5 minutes of giving enema, Sam complained of abdominal cramping. The most appropriate action to take is: a) Clamp the tubing temporarily b) Encourage the client to change position c) Remove rectal tube d) Take no action as this is expected 20) All of the following nursing interventions are correct when using the z track method of drug injection except? a) Prepare the injection site with alcohol b) Use needle that is at least 1 inch long c) Aspirate for blood before injection to promote absorption d) Rub the site vigorously after the injection to promote absorption 21) The best way to instill the eyedrops is to: a) Instruct the patient to look upward, and drop the medication into the center of the lower lid b) Instruct the patient to look ahead, and drop the medication into the center of the lower lid c) Drop the medication into the lower canthus regardless of position d) Drop the medication into the center of the canthus regardless of the position 22) If transfusion reaction occurs, the nurse should: a) Call the MD and wait the order based on the specific type of reaction b) Stop the transfusion immediately and keep the vein open c) Slow the transfusion rate and observe for an increase in severity of the reaction d) Slow the transfusion and request a venipuncture for retyping to start the second transfusion 23) Which of the following nursing interventions is appropriate for preventing pressure ulcers? a) Clean the skin daily using mild soap and hot water b) Perform a systematic skin assessment at least once a day c) Massage bony prominences gently every shift d) Encourage the client to sit in a chair as much as possible 24) Which of the following nursing diagnosis would the nurse identify as a priority after surgical repair of cleft lip? a) Pain b) Risk for infection c) Impaired physical mobility d) Impaired parenting 25) The nurse collects the urine specimen for culture analysis. Which of the following is the correct care of the specimen? a) Promptly send the specimen to the laboratory b) Send the specimen with the next pick up c) Send the specimen the next time a nursing assistant is available d) Store the specimen in the refrigerator until it can be sent to the laboratory 26) The antidote for Coumadin is

a) Protamine sulfate b) Thrombin c) Heparin d) Vitamin K 27) The nurse is preparing a client for thoracentesis. How should the nurse postion the client for the procedure? a) Supine with arms over head b) Sims postion c) Prone position without pillow d) Sitting forward with arms supported on bedside table 28) After a cholecystectomy, a client asks he has to have an NGT. The nurse states the purpose of NGT is to a) Administer high caloric liquid feedings b) Facilitate collective of gastric secretions c) Prevent postoperative distention d) Simplify administration of medications 29) Which of the following neurologic changes indicates that the client is in progressive stage of shock? a) Restlessness b) Confusion c) Incoherent speech d) Unconsciousness 30) The nurse has an order to administer ampicillin 250 mg IM. After reconstituting the ampicillin with sterile water for injection, the solution available is 500 mg/ml. How many ml should the nurse administers? a) 0.3 ml b) 0.4 ml c) 0.5 ml d) 0 .6 ml 31) The nurse is caring for the elderly, debilitated client who has been bedridden for an extended period. Which of the following is the predominant clinical finding indicating that the client has developed pneumonia? a) Fever and chills b) Productive cough c) Confusion d) Pleuritic chest pain 32) The nurse who is stuck by a used needle but has not completed the hepatitis B immunization should receive a) Both active and passive immunization b) Active immunization c) Passive immunization d) Immunization only after a blood titer has been drawn 33) How does a 24- hour urine collection differ from a simple urinalysis? a) The first voided specimen is discarded b) The last voided specimen is discarded c) Urine specimen does nit need to be refrigerate d) The specimen must be labeled 34) Which of the following is a priority nursing diagnosis for a client with myasthenia gravis who is seen in emergency department for epistaxis? a) Ineffective breathing pattern b) Risk for aspiration c) Risk for injury d) Self care deficit

35) Which of the following measures should be implemented promptly after a clients NGT has been removed? a) Provide the client with oral hygiene b) Offer the client liquids to drink c) Encourage the client to cough and deep breath d) Auscultate the clients bowel sounds 36) The nurse is performing a respiratory assessment on a client who ahs a pleural effusion. Which of the following assessment data would the nurse anticipate finding to support this diagnosis? a) Decreased chest movement on the affected side b) Normal bronchial breath sound c) Hyperresonance on percussion d) Fever 37) A client undergoes a series of diagnostic test to rule out inflammatory bowel disease. The nurse should schedule the test in the following order a) Barium swallow, colonoscopy, barium enema b) Barium swallow, barium enema, colonoscopy c) Colonoscopy, barium enema, barium swallow d) Colonoscopy, barium swallow, barium enema 38) Pablo inserts an indwelling catheter into a female client. Which action is appropriate for this procedure? Pablo: a) Advances the catheter 4 more inches after urine returns b) Cleanses the client with antiseptic from anus to clitoris c) Utilizes medical asepsis through the entire procedure d) Cleanses directly over the clients meatus prior to insertion 39) Which of the following is the correct technique when administering a SQ injection a) Use a 1 inch needle for injection b) Insert the needle at 45 degree angle to the skin c) Spread the skin tightly at the sight of injection d) Draw 0.2 ml of air into the syringe before administration 40) Legal responsibility for obtaining consent for surgery is the responsibility of the a) Physician b) RN c) Admission clerk d) Anesthesiologist 41) Which statement describes the correct sequence for assessment of the abdomen? a) Palpation, inspection, percussion, and auscultation b) Palpation, percussion, auscultation, inspection c) Inspection, palpation, auscultation and percussion d) Inspection, auscultation, percussion, and palpation 42) The nurse teaches the client with IDA that food sources with high iron content include a) Cheese b) Squash c) Eggs d) Beef 43) A client is taking large doses of aspirin daily to treat her rheumatoid arthritis. Which of the following side effects should the nurse instruct her to report? a) Abdominal cramps b) Tinnitus c) Rash d) Hypotension 44) The infusion rate of TPN is tapered before being discontinued. This is done to prevent which of the following complication?

a) Essential fatty acid deficiency b) Dehydration c) Rebound hypoglycemia d) malnutrition 45) A client has consented to have a central venous catheter placed. The best position in which to place the client in trendelenburg position. The reason is that trendelenburg position a) Allows the physician to visualize subclavian vein b) Reduce the possibility of air embolism c) Reduce the possibility of embolism d) Makes the procedure more comfortable for the client 46) Which type of insulin can be administered by a continuous drip a) Humulin N b) NPH insulin c) Regular insulin d) Lente insulin 47) Which blood gas parameters primarily reflect respiratory function? a) PCO2 b) CO2 content of the blood c) HCO3 d) Base excess 48) The nurse is performing routine care of tracheostomy care. Which of the following steps would be appropriate for the nurse to include in the performance of the procedure? a) Remove the inner cannula every 2 hours for cleaning b) Secure the tracheostomy ties with a square knot c) Use cut gauze under the neck plate to protect the skin d) Suction the inner cannula on completion of the procedure 49) The physician prescribes phenytoin for the client with seizure disorders. Phenytoin can only be mixed with which of the following solutions? a) Ringers lactate b) D5W c) D5LR d) Normal saline 50) A client is having a pneumonectomy done today; the nurse is planning his postoperative care. Nursing intervention for a postoperative left pneumonectomy would include: a) Monitor the chest tube b) Position the client on the right side c) Position the client in semi fowlers position under the shoulder and back d) Monitor the right lung for an increase in rales 51) What is the nurses most appropriate response when finding a sealed container of IV 50% dextrose in a catch all bin on the unit? a) Leave it where found and notify risk management b) Send it to pharmacy c) File an incident report d) Discard it in sharps container 52) Which assessment finding is considered within the limits on a client who underwent cystoscopy hours ago? a) Abdominal pain b) Pink tinged urine c) Bladder distention d) 35 cc urine output

53) Jo prepares to insert on indwelling catheter into a female client. Which action is appropriate for this procedure? a) Test the retention balloon with sterile water before insertion b) Cleanse with antiseptic from base of the penis to the meatus c) Use a catheter that is slightly larger than the opening of the meatus d) Lubricate on inch of the catheter tip with water soluble lubricant 54) Jose is scheduled for a liver biopsy. In preparing him for the test, the nurse should a) Explain to him that he will be kept NPO for 24 hours before the exam b) Practice him so that he will be able to hold his breath for 1 minute c) Explain that he will be receiving a laxative to prevent a distended bowel from applying pressure on the liver d) Explain that his vital signs will be checked frequently after the test 55) After the liver biopsy, the best position is a) High fowlers b) Prone c) Supine d) Right lateral 56) A complication for which the nurse should be alert following a liver biopsy is a) Hepatic coma b) Jaundice c) Ascites d) Shock 57) Which nursing implication is appropriate for a client undergoing a paracentesis? a) Have the client void before the procedure b) Keep the client NPO c) Observe the client for hypertension following the procedure d) Place the client on the right side following the procedure 58) When infusing TPN, the nurse should assess the client for which of the following complications? a) Essential amino acid deficiency b) Essential fatty acid deficiency c) Hyperglycemia d) Infection 59) When assessing for blood transfusion reaction in a client with dark skin, the nurse should assess for which of the following? a) Hypertension b) Diaphoresis c) Polyuria d) Warm skin 60) When cleaning the skin around an incision and drain site, which of the following procedures should the nurse follow? a) Clean the incision and drain site separately b) Clean from the incision to the drain site c) Clean from the drain site to incision site d) Clean the incision site and drain site simultaneously 61) A client has been diagnosed with right sided heart failure. Which of the following clinical manifestations would the nurse expect to find in the client? a) Intermittent claudication b) Dyspnea c) Dependent edema d) Crackles 62) A client is admitted with acute pancreatitis. Which of the following laboratory value is indicative of pancreatits? a) Decreased urinary amylase

b) Hypercalcemia c) Hypoglycemia d) Increased serum amylase and lipase 63) Later that day, Ambrose develops respiratory alkalosis. The nurse should expect the laboratory values should expect the laboratory values to reflect a) Elevated pH and PCO2 b) Decreased pH and PCO2 c) Elevated pH, decreased PCO2 d) Decreased pH, elevated PCO2 64) Ambrose appears to be very anxious with respirations that are shallow and very rapid (40/minute). He complains of feeling dizzy and lightheaded and having of tingling sensation of the fingertips and around the lips. The nurse should recognize that Ambrose complains are probably related to a) Eupnea b) Hyperventilation c) Respiratory alkalosis d) CO2 intoxication 65) Nursing interventions for Ambrose should focus on reassurance and: a) Administering O2 b) Using an incentive spirometer c) Having the client breathe into a paper bag d) Administering an IV containing bicarbonate ions 66) The physician orders IV 2 liters to be administered q 12h, the drop factor of tubing is 10 gtts/ml. The nurse should set the flow to provide a) 38gtts/min b) 28 gtts/ml c) 28gtts/min d) 38gtts/ml 67) After surgery a client is to receive an antibiotic by IV piggy back in 50 ml of D5W. The piggy back is to infuse in 20 minutes. The drop factor of IV set is 10 gtt/ml. The nurse should set the piggy back to at a) 18 gtts/ml b) 28gtts/ml c) 25gtts/ml d) 45gtts/ml 68) Another client who just has surgery is to receive the following IV fluids over 24 hours. 1000 ml D5W, 0.5 liter normal saline, 1500ml D5NS. In addition, an antibiotic piggy back in 50 ml D5W is ordered every 8 hours. Nurse Pacita calculates that the clients IV fluid intake for hours will be a) 3150 ml b) 3200 ml c) 3650 ml d) 3750 ml 69) While coughing, a post-op abdominal surgery patient complains of a sudden sharp abdominal pain. The nurse observes that the patients wound edges have separated and the viscera are exposed. The nurse should? a) Notify the physician immediately b) Apply a sterile strip to the wound edges c) Encourage the client to cough harder d) Apply a sterile wet saline compress 70) A hemovac is use to do all the following except: a) Promote wound healing b) Remove the drainage form the surgical wound c) Lessen the post operative discomfort

d) Prevent wound infection 71) When evaluating a client response to fluid replacement therapy, the observation that indicates adequate tissue perfusion to vital organs is a) Urinary output of 30 ml per hour b) Control venous pressure reading is 2 cm h2o c) Pulse rate of 120 and 110 in a 15 minute period d) BP reading 50/30 and 70/40 mmHg within 30 minutes 72) Myra wants to perform a full range of motion on a clients extremities. When putting an ankle through range of motion Isa must perform a) Flexion, extension, left and right rotation b) Abduction, flexion, adduction, and extension c) Pronation, supination, rotation, and extension d) Dorsiflexion, plantar flexion, eversion, and inversion 73) An x-ray film of a clients arm reveals a comminuted fracture of the left radial bone. The nurse understand that with comminuted fracture a) There is a break in the skin and the bone is protruding b) Splintering has occurred on one side and bending on the other c) The bone has broken into several fragments but the skin is intact d) The bone is broken into two parts and the skin may or not breakdown Elvira, a 56 yr old woman is admitted to the hospital with severe burns on her legs, head, and lower abdomen and some minor burns on the other surfaces 74) The nurse would recognizes that there is a need for the immediate venous access because the client a) Needs antibiotic therapy ASAP b) Needs pain medication delivered through the venous route c) Needs fluid losses replaced immediately d) Needs hyper alimentation 75) On viewing Elviras laboratory results, the nurse notes a serum potassium level of 3.2 mmol/L. the nurse would encourage the client to drink a) Cranberry juice b) Grape juice c) Ginger juice d) Orange juice A research was conducted on the effects of the nurse expressive role in the reduction of anxiety in patient who undergo nasogastric tube insertion 76) Before discharge from the hospital after a myocardial infarction, a client is taught to exercise by gradually increasing the distance walked. Which of the vital signs should the nurse teach the client to monitor to determine whether to increase or decrease the exercise level? a) Pulse rate b) BP c) Body temperature d) RR 77) The research is experimental which means that they utilized a) An interview scheduled b) A survey c) A questionnaire d) Control and experimental groups 78) The independent variable is a) Patients b) Expressive role c) Reduction of anxiety d) Nasogastric insertion 79) The dependent variable is

a) Nasogastric insertion b) Patient c) Expressive role d) Reduction of anxiety 80) This study was done to check the procedure of research a) Protest study b) Proposal c) Pilot study d) Test retest 81) Which of the following is not characteristic of experimental research? a) Value plays a significant part in research b) Research ideas are capable of being tested c) Results of test made on the group are compared d) Research subjects are randomly selected and placed into groups for the purpose of manipulation The use of lagundi and herbal ointment to help decreases asthma and other respiratory ailment have been strongly recommended based on traditional practice. 82) Camille wants to do a study on this topic: effect of lagundi and herbal ointment on asthma and other respiratory ailment. This type of research that best suits this topic is a) Basic research b) Applied research c) Phenomenon research d) Historical research 83) A type of research design wherein there is the absence of intervention on the independent variable can be categorized as a) Non experimental design b) Quasi experimental design c) Semi experimental design d) True experimental design 84) The above mentioned topic on the use of traditional medicines serves this function on research which a) To clarify an unclear method of care b) Resolve a clinical problem c) Include new modalities of care d) Enhance patient care 85) Camille did the review of related literature for the purpose of a) Identifying problems that can be simulated b) Gathering of data about what is already known or unknown about the problem c) Answering the research questions d) Determine statistical treatment of data research 86) This statistical tool for the treatment of data compares the response of two respondent groups in the study on the phenomenon under investigation. It is used when responses are interval data a) T test b) ANOVA c) Weighted mean d) Percentage 87) This statistical tool for the treatment of data is used to determine the proportion of a part to a whole such as a given number of respondents in relation to the entire population a) Weighted mean b) Percentage c) T test

d) Multiple regression 88) This statistical tool for the treatment of data is used to determine the order of decreasing or increasing magnitude of variables a) Weighted mean b) Percentage c) Multiple regression analysis d) Ranking 89) It refers to overall average of responses or perceptions of the study respondents a) Percentage b) Weighted mean c) ANOVA d) Ranking 90) Presentation of findings or the findings of the study can be presented in various ways as follows except a) Textual form b) Tabular form c) Figures d) Diary 91) Types of ordinal scale wherein it is used to assess the attitude of respondents, using continuum of cumulative statement a) Likert scale b) Graphic rating scale c) Guttmann scale d) Semantic differential scale 92) Who among the following ca witness a will? a) 2 senior nurses b) Doctor, nurse, 17 yr old patient c) 18 yr old male patient with cancer, nurse, doctor who just came out from prison for crime involving sexual harassment d) None of the above 93) Which of the following will shall be disallowed in a probate proceeding? a) Will was entirely written, dated, and signed by the testator b) Will was duly acknowledged before a notary public c) Will was rewritten by the testator but undated d) Will was attested and subscribed by no witnesses e) NOTA 94) All are void or inexistent contacts. Which one is not a) Those expressly prohibited or declarative void by law b) Those which contemplate a possible service c) Those whose object is outside the commerce of men d) NOTA 95) All of the following are characteristics of giving consent except a) Vitiated b) Given by a competent person c) Given voluntarily d) Lawful 96) Nurse Linda would be correct if she states that a general term applied to a person whose property is transmitted through succession, whether or not he left a will is a) Jurisprudence b) Ponencia c) Will d) Testator e) Decedent

97) It is the purpose of the organization, the reason for its being that is why organization exist a) Mission b) Vision c) Philosophy d) Objectives 98) The assessment of strengths, weaknesses, and identifying opportunities and threat of an organization for future improvement a) SWOT analysis b) MBWA technique c) SWAT team d) NOTA 99) The vertical solid between individuals in the organization chart that best describes the concept of person/one boss indicates a) Chain of command b) Span of control c) Unity of command d) Scalar chain 100) A newly hired nurse was accepted in the organization because of his advance skill and knowledge which refer to what type of power a) Referent b) Legitimate c) Information d) Expert