1. A client has just returned from surgery.

20 minutes later the client is seen trying to get out of bed, trailing the IV line and the wound drain. The nurses best nursing action is to: a. Put a restraint jacket on the client on put a note in the clients chart for the physician. b. Call the nursing supervisor to have a sitter assigned to the patient immediately c. Reorient the client, make sure the call light is within reach and move the client close to the nurse station as possible. d. Put a restraint jacket on the client and place client in a wheelchair next to the nurse station 2. Which client has special risk factor that warrant testing for tuberculosis a. 45 year old Caucasian man who has been homeless for 2 years b. 15 year old Caucasian woman with asthma c. 72 year old woman who is a recent immigrant from Russia d. 50 year old lowa farmer 3. A 10 year old child has juvenile rheumatoid arthritis. Which action taken by the child has understood the nurses teaching regarding measures that would reduce the risk for activity intolerance. a. Delaying eating breakfast until the morning medications have been taken b. Increasing fluid intake c. Taking a warm bath before going to school d. Continuing to participate in ADLs despite fatigue and persistent pain 4. When auscultating for the heart sounds that the heart sound (S1) is best heard: a. Using the bell of the stethoscope b. With the client lying on the right side c. At the second intercoastal space, right sterna border d. At the fifth intercoastal space, ;eft sterna border 5. For an adolescent boy, the main life stage task is to: a. Developing a sense of trust in others and to his environment b. Finalizing his goals and plans for the future c. Strinving to attain independence and identity d. Resolving inner conflicts and turmoil 6. A child lying on a stretcher upon admission suddenly complains of nausea and beings to vomit. The nurse should immediately. a. Turn the childs head to the side b. Suction the childs oropharynx c. Raise the head of the stretcher d. Insert an NG tube 7. The nurse can quickly access volume depletion in a clients ulcerative colitis by: a. Measuring the SP gravity of the clients urine output b. Taking the clients BP supine then sitting and noting any changes c. Comparing the clients current weight with the weight upon admission d. Administering the oral water test

OB 1. Which of the following BBT change indentifies the characteristic of ovulation a. Falls slightly the increases by 0.5 Celsius b. Rises slightly, then falls by 0.5 Celsius c. Is affected by a surge of FSH d. Is due to an estrogen surge 2. When calculating the 1 minute Apgar, the nurse adds the ff. assessment findings: HR over 100, RR - slow and irregular; muscle tone poor response to slap on soles on feet; weak cry; coly body pink; extremeties; blue. In view of theses assessment findings, which Apgar score would the nurse record: a. 5 b. 6 c. 7 d. 8 3. A newborn infant that weighs 7lbs at birth now weighs 6lbs 8oz. Implementing health teaching, the nurse tells the mother the percentage of birth weight usually lost by normal and healthy babies. Which represents the maximum amount of weight loss for this newborn? a. 6oz (170 g) b. 8oz (227 g) c. 11oz (317 g) d. 16oz (454 g) 4. The woman who is pregnant who is likely given the trial of labor for vaginal birth after caesarian section is the one who had a: a. CS through a classical incision because of severe fetal distress b. Low transverse CS for breech presentation. This pregnancy is vertex presentation c. CS for fetopelvic disproportion d. Low temperature CS for active vaginal/ perineal infection; culture at 39 weeks, this pregnancy was positive for herpes 5. A pregnant womans last LMP began on April. Calcute the exact estimation of her EDD. 6. A pregnant woman is told to increase her intake of foods rich in iron. Which food would the nurse suggest as the best source of iron a. Lean red meat b. Nuts Shellfish c. Shellfish d. Dairy products 7. At which complication of pregnancy does a Rh negative woman is at risk? a. Spontaneous abortion b. Preeclampsia c. Maternal anemia d. Erythroblastosis fetalis 8. The nurse manager on a maternity unit is informed that a woman who is 36 weeks pregnant with preeclampsia is to be admitted. Which bed is the best choice?

a. Bed on double room 50 ft away from the nurse station who has a rheumatic heart disease b. Bed in a double room next to the nurse station with roommate who is a drug addict c. Bed in a four-bed unit with all other women who post partum d. Bed in a four-bed unit with other women who have pyelonephritis, diabetes and PROM 9. The nurse analyzes the following data: A woman in labor who has 6cm dilation, + 1 station(vertex position) with modeling of the babys head at + 2 station for 3 hours. The babys FHR has increased from a baseline of 140 to 170. The physician orders Pitocin augmentation of labor. The nurses correct action would be to: a. Add Pitocin to the IV and label it correctly b. Start Pitocin drip using an IV pump c. Accurately chart the Pitocin infusion d. Refuse to carry out order for Pitocin augmentation 10. Of the ff. findings in a full term newborn, which is not an expected outcome of maternal hormone influence and therefore should be reported. a. Withs milk b. Slight Vaginal Bleeding c. Undescended testicles d. Linea Nigra 11. The nurse is to assign an NA in a postpartum unit to care for clients. The aide has a cold that day but no other problems. Which client the nurse would not want to assign the NA? a. Woman in renal failure b. Woman who has hypertension c. Woman who had a prolonged labor d. Woman who has AIDS 12. The Hct decreases an average of 7 10% during pregnancy. This is referred to as physiological anemia of pregnancy. a. The total erythrocyte count increases by about 30%, the plasma volume increases by about 50% b. The total erythrocyte count increases by about 50%, The plasma volume increases by about 30% c. The total erythrocyte count decreases by 30%, the plasma volume increases by about 50% d. The erythrocyte count remains the same. The plasma count decreases by 50% 13. A term neonate is to be released from hospital at 2 days of age. The nurse performs a physical examination before discharge. 13. Nurse Valerie examines the neonates hands and palms. Which of the following findings requires further assessment? a. Many crease across the palm. b. Absence of creases on the palm. c. A single crease on the palm. d. Two large creases across the palm.

14. The mother asks when the soft spots close? The nurse explains that the neonates anterior fontanel will normally close by age a. 2 to 3 months. b. 6 to 8 months. c. 12 to 18 months. d. 20 to 24 months. 15. When performing the physical assessment, the nurse explains to the mother that in a term neonate, sole creases are a. Absent near the heels. b. Evident under the heels only, c. Spread over the entire foot. d. Evident only towards the transverse arch. 16. When assessing the neonates eyes, the nurse notes the following: absence of tears, corneas of unequal size, constriction of the pupils in response to bright light, and the presence of red circles on the pupils on ophthalmic examination. Which of these findings needs further assessment? a. The absence of tears. b. Corneas of unequal size. c. Constriction of the pupils. d. The presence of red circles on the pupils. 17. After teaching the mother about the neonates positive Babinski reflex, the nurse determines that the mother understands the instructions when she says that a positive Babinski reflex indicates. a. Immature muscle coordination. b. Immature central nervous system. c. Possible lower spinal cord defect. d. Possible injury to nerves that innervate the feet. 18. Nurse Kris is responsible for assessing a male neonate approximately 24 hours old. The neonate was delivered vaginally. The nurse should plan to assess the neonates physical condition. a. Midway between feedings. b. Immediately after a feeding. c. After the neonate has been NPO for three hours. d. Immediately before a feeding. 19. The nurse notes a swelling on the neonates scalp that crosses the suture line. The nurse documents this condition as a. Cephallic hematoma. b. Caput succedaneum. c. Hemorrhage edema. d. Perinatal caput. 20. The nurse measures the circumference of the neonates heads and chest, and then explains to the mother that when the two measurements are compared, the head is normally about a. The same size as the chest. b. 2 centimeter larger than the chest. c. 2 centimeter smaller than the chest. d. 4 centimeter larger than chest.

21. After explaining the neonates cranial molding, the nurse determines that the mother needs further instructions from which statement? a) The molding is caused by an overriding of the cranial bones. b) The degree of molding is related to the amount of pressure on the head. c) The molding will disappear in a few days. d) The fontanels maybe damaged if the molding does not resolved quickly. 22. When instructing the mother about the neonates need for sensory and visual stimulation, the nurse should plan to explain that the most highly develop sense in the neonate is a. Task b. Smell c. Touch d. Hearing Nurse Joan works in a childrens clinic and helps with the care for well and ill children of various ages. 23. A mother brings her 4 month old infant to the clinic. The mother asks the nurse when she should wean the infant from breastfeeding and begin using a cup. Nurse Joan should explain that the infant will show readiness to be weaned by a. Taking solid foods well. b. Sleeping through the night. c. Shortening the nursing time. d. Eating on a regular schedule. 24. Mother Arlene says the infants physician recommends certain foods but the infant refuses to eat them after breastfeeding. The nurse should suggest that the mother alter the feeding plan by a. Offering desert followed by vegetable and meat. b. Offering breast milk as long as the infant refuses to eat solid food. c. Mixing minced food with cows milk and feeding it to the infant through a large hole nipple. d. Giving the infant a few minutes of breast and then offering solid food. 25. Which of the following abilities would a nurse expect a 4 month old infant to perform? a. Sitting up without support. b. Responding to pleasure with smiles. c. Grasping a rattle when it is offered. d. Turning from either side to the back. 26. The nurse plans to administer the Denver Developmental Screening Test(DDST) to a five month old infant. The nurse should explain to the mother that the test measures the infants a. Intelligence quotient. b. Emotional development. c. Social and physical activities. d. Pre-disposition to genetic and allergic illnesses. 27. When discussing a seven month old infants mother regarding the motor skill development, the nurse should explain that by age seven months, an infant most likely will be able to a. Walk with support. b. Eat with a spoon. c. Stand while holding unto a furniture d. Sit alone using the hands for support.

28. A mother brings her one month old infant to the clinic for check-up. Which of the following developmental achievements would the nurse assess for? a. Smiling and laughing out loud. b. Rolling from back to side. c. Holding a rattle briefly. d. Turning the head from side to side. 29. A two month old infant is brought to the clinic for the first immunization against DPT. The nurse should administer the vaccine via what route? a. Oral. b. Intramascular c. Subcutaneous d. Intradermal 30. The nurse teaches the clients mother about the normal reaction that the infant might experience 12 to 24 hours after the DPT immunization, which of the following reactions would the nurse discuss? a. Lethargy. b. Mild fever. c. Diarrhea d. Nasal Congestion 31. An infant is observed to be competent in the following developmental skills: stares at an object, place her hands to the mouth and takes it off, coos and gargles when talk to and sustains part of her own weight when held to in a standing position. The nurse correctly assessed infants age as a. Two months. b. Four months c. Six months d. Eight months. 32. The mother says, the soft spot near the front of her babys head is still big, when will it close? Nurse Lilibeths correct response would be at a. 2 to 4 months. b. 5 to 8 months. c.. 9 to 12 months. d. 13 to 18 months. prop 33. A mother states that she thinks her 9-month old is developing slowly. When evaluating the infants development, the nurse would not expect a normal 9-month old to be able to a. Creep and crawl. b. Begin to use imitative verbal expressions. c. Put an arm through a sleeve while being dressed. d. Hold a bottle with good hand mouth coordination. 34. The mother of the 9-month old says, it is difficult to add new foods to his diet, he spits everything out, she says. The nurse should teach the mother to a. Mix new foods with formula b. Mix new foods with more familiar foods. c. Offer new foods one at a time. d. Offer new foods after formula has been offered. 35. Which of the following tasks is typical for an 18-month old baby? a. Copying a circle b. Pulling toys c. Playing toy with other children d. Building a tower of eight blocks

36. Mother Riza brings her normally developed 3-year old to the clinic for a check-up. The nurse would expect that the child would be at least skilled in a. Riding a bicycle b. Tying shoelaces c. Stringing large beads d. Using blunt scissors 37. The mother tells the nurse that she is having problem toilet-training her 2-year old child. The nurse would tell the mother that the number one reason that toilet training in toddlers fails because the a. Rewards are too limited b. Training equipment is inappropriate c. Parents ignore accidents that occur during training d. The child is not develop mentally ready to be trained 38.. A child is not developmentally ready to be trained. A 2-1/2 year old child is brought to the clinic by his father who explains that the child is afraid of the dark and says no when asked to do something. The nurse would explain that the negativism demonstrated by toddler is frequently an expression of a. Quest for autonomy b. Hyperactivity c. Separation anxiety d. Sibling rivalry 39. The nurse would explain to the father which concept of Piagets cognitive development as the basis for the childs fear of darkness? a. Reversibility b. Animism c. Conservation of matter d. Object permanence 40. Mother asks the nurse for advice about discipline. The nurse would suggest that the mother would first use a. Structured interaction b. Spanking c. Reasoning d. Scolding 41. When a nurse assesses for pain in toddlers, which of the following techniques would be least effective? a. Ask them about the pain b. Observe them for restlessness c. Watch their face for grimness d. Listen for pain cues in their cries. 42. The mother reports that her child creates a quite scene every night at bedtime and asks what she can do to make bedtime a little more pleasant. The nurse should suggest that the mother to a. Allow the child to stay up later one or two nights a week. b. Establish a set bedtime and follow a routine c. Let the child play toy just before bedtime d. Give the child a cookie if bedtime is pleasant.

43. The mother asks about dental care for her child. She says that she helps brush the childs teeth daily. Which of the following responses by the nurse would be most appropriate? a. Since you help brush her teeth, theres no need to see a dentist now b. You should have begun dental appointments last year but it is not too late c. Your child does not need to see the dentist until she starts school d. A dental check-up is a good idea, even if no noticeable problems are present 44.. The mother says that she will be glad to let her child brush her teeth without help, but at what age should this begin? Nurse Roselyn should respond at a. 3 years b. 5 years c. 6 years d. 7 years 45. The mother tells the nurse that her other child, a 4-year old boy, has developed some strange eating habits, including not finishing her meals and eating the same foods for several days in a row. She would like to develop a plan to connect this situation. In developing such a plan, the nurse and mother should consider a. Deciding on a good reward for finishing a meal b. Allowing him to make some decisions about the foods he eats c. Requiring him to eat the foods served at meal times. d. Not allowing him to play with friends until he eats all the food she served. 46. Nurse Bryan knows that one of the most effective strategies to teach a Four year old about safety is to a. Show him potential dangers to avoid b. Tell him he is bad when they do something dangerous c. Provide good examples of safety behavior d. Show him pictures of children who have involve with accidents 47.. A 9 year old girl is brought to the pediatricians office for an annual physical checkup. She has no history of significant health problems. When the nurse asks the girl about her best friend, the nurse is assessing a. Language development b. Motor development c. Neurological development d. Social development 48. The child probably tells the nurse that brushing and flossing her teeth is her responsibility. When responding to this information, the nurse should realize that the child a. Is too young to be given this responsibility b. Is most likely quite capable of this responsibility c. Should have assumed this responsibility much sooner d. Is probably just exaggerating the responsibility 49. The mother tells the nurse that the child is continually telling jokes and riddles to the point of driving the other family members crazy. The nurse should explain that this behavior is a sign of a. Inadequately parental attention b. Mastery of language ambiguities c. Inappropriate peer influence d. Excessive television watching

50. The mother relates that the child is beginning to identify behaviors that pleases others as good behavior. The childs behavior is characteristics of which Kohlbergs level of moral development? a. Pre-conventional morality b. Conventional morality c. Post conventional morality d. Autonomous morality 51. The mother asks the nurse about the childs apparent need for between-meals snacks, especially after school. The nurse and mother develop a nutritional plan for the child, keeping in mind that the child.. a. Does not need to eat between meals b. Should eat snacks his mother prepares c. Should help prepare own snacks d. Will instinctively select nutritional snacks 52. The mother is concerned about the childs compulsion for collecting things. The nurse explains that this behavior is related to the cognitive ability to perform. a. Concrete operations b. Formal operations c. Coordination of d. Tertiary circular reactions 53. The nurse explained to the mother that according to Ericksons framework of psychosocial development, play as a vehicle of development can help the school age child develop a sense of a. Initiative b. Industry c. Identity d. Intimacy 54. The school nurse is planning a series of safety and accident prevention classes for a group of third grades. What preventive measures should the nurse stress during the first class, knowing the leading cause of incidental injury and death in this age? a. Flame-retardant clothing b. Life preserves c. Protective eyewear d. Auto seat belts 55.. The mother of a 10-year old boy expresses concern that he is overweight. When developing a plan of care with the mother, Nurse Katrina should encourage her to a. Limit childs between-,meal snacks b. Prohibit the child from playing outside if he eat snacks c. Include the child in meal planning and preparation d. Limit the childs calories intake to 1,200kCal/day 56.. When assessing an 18-month old, the nurse notes a characteristics protruding abdomen. Which of the following would explain the rationale for this findings? a. Increased food intake owing to age b. Underdeveloped abdominal muscles c. Bowlegged posture d. Linear growth curve 57. If parents keep a toddler dependent in areas where he is capable of using skills, the toddler will develop a sense of which of the following? a. Mistrust b. Shame

c. Guilt d. Inferiority 58. Which of the following fears would the nurse typically associate with toddlerhood? a. Mutilation b. The dark c. Ghosts d. Going to sleep 59. A mother of a 2 year old has just left the hospital to check on her other children. Which of the following would best help the 2 year old who is now crying inconsolably? a. Taking a nap b. Peer play group c. Large cuddly dog d. Favorite blanket 60. Which of the following is an appropriate toy for an 18 month old? a. Multiple-piece puzzle b. Miniature Cars c. Finger paints d. Comic Book 61. When teaching parents about typical toddler eating patterns, which of the following should be included? a. Food jags b. Preference to eat alone c. Consistent table manners d. Increase in appetite 62. Which of the following toys should the nurse recommend for a 5-month old? a. A big red balloon b. A teddy bear with button eyes c. A push-pull wooden truck d. A colorful busy box 63 When teaching parents about typical toddler eating patterns, which of the following should be included? a. Food jags b. Preference to eat alone c. Consistent table manners d. Increase in appetite 64. Which of the following toys should the nurse recommend for a 5-month old? a. A big red balloon b. A teddy bear with button eyes c. A push-pull wooden truck d. A colorful busy box

Medical and Surgical 1. After the lungs, the kidneys work to maintain body pH. The best explanation of how the kidneys accomplish regulation of pH is that they a. Secrete hydrogen ions and sodium. b. Secrete ammonia. c. Exchange hydrogen and sodium in the kidney tubules. d. Decrease sodium ions, hold on to hydrogen ions, and then secrete sodium bicarbonate. 2. The nurse explains to a client who has just received the diagnosis of Noninsulin-Dependent Diabetes Mellitus (NIDDM) that sulfonylureas, one group of oral hypoglycemic agents, act by: a. Stimulating the pancreas to produce or release insulin b. Making the insulin that is produced more available for use c. Lowering the blood sugar by facilitating the uptake and utilization of glucose d. Altering both fat and protein metabolism 3. Myasthenic crisis and cholinergic crisis are the major complications of myasthenia gravis. Which of the following is essential nursing knowledge when caring for a client in crisis? a. Weakness and paralysis of the muscles for swallowing and breathing occur in either crisis b. Cholinergic drugs should be administered to prevent further complications associated with the crisis c. The clinical condition of the client usually improves after several days of treatment d. Loss of body function creates high levels of anxiety and fear 4. A 54-year-old client was put in Quinidine (a drug that decreases myocardial excitability) to prevent atrial fibrillation. He also has kidney disease. The nurse is aware that this drug, when given to a client with kidney disease, may: a. Cause cardiac arrest b. Cause hypotension c. Produce mild bradycardia d. Be very toxic even in small doses 5. A client is about to be discharged on the drug bishydroxycoumarin (Dicumarol). Of the principles below, which one is the most important to teach the client before discharge? a. He should be sure to take the medication before meals b. He should shave with an electric razor c. If he misses a dose, he should double the dose at the next scheduled time d. It is the responsibility of the physician to do the teaching for this medication 6. A cyanotic client with an unknown diagnosis is admitted to the emergency room. In relation to oxygen, the first nursing action would be to:

a. Wait until the client's lab work is done b. Not administer oxygen unless ordered by the physician c. Administer oxygen at 2 liters flow per minute d. Administer oxygen at 10 liters flow per minute and check the client's nail beds 7. A client with a diagnosis of gout will be taking colchicine and allopurinol bid to prevent recurrence. The most common early sign of colchicine toxicity that the nurse will assess for is: a. Blurred vision b. Anorexia c. Diarrhea d. Fever

8. A client has chronic dermatitis involving the neck, face and antecubital creases. She has a strong family history of varied allergy disorders. This type of dermatitis is probably best described as: a. Contact dermatitis b. Atopic dermatitis c. Eczema d. Dermatitis medicamentosa 9. The nurse would expect to find an improvement in which of the blood values as a result of dialysis treatment? a. High serum creatinine levels b. Low hemoglobin c. Hypocalcemia d. Hypokalemia 10. A 24-year-old client is admitted to the hospital following an automobile accident. She was brought in unconscious with the following vital signs: BP 130/76, P 100, R 16, T 98F. The nurse observes bleeding from the client's nose. Which of the following interventions will assist in determining the presence of cerebrospinal fluid? a. Obtain a culture of the specimen using sterile swabs and send to the laboratory b. Allow the drainage to drip on a sterile gauze and observe for a halo or ring around the blood c. Suction the nose gently with a bulb syringe and send specimen to the laboratory d. Insert sterile packing into the nares and remove in 24 hours 11. A 24-year-old male is admitted with a possible head injury. His arterial blood gases show that his pH is less than 7.3, his PaCO2 is elevated above 60 mmHg, and his PaO2 is less than 45 mmHg. Evaluating this ABG panel, the nurse would conclude that: a. That it is reversible b. Amnesia will occur c. Loss of consciousness may be transient d. Laceration of the brain may occur 12. A client with tuberculosis is given the drug pyrazinamide (Pyrazinamide). Which one of the following diagnostic tests would be inaccurate if the client is receiving the drug? a. Liver function test b. Gall bladder studies c. Thyroid function studies d. Blood glucose 13. Which one of the following conditions could lead to an inaccurate pulse oximetry reading if the sensor is attached to the client's ear?

a. Artificial nails b. Vasodilation c. Hypothermia d. Movement of the head 14. While on a camping trip, a friend sustains a snake bite from a poisonous snake. The most effective initial intervention would be to: a. Place a restrictive band above the snake bite b. Elevate the bite area above the level of the heart c. Position the client in a supine position d. Immobilize the limb

15. There is a physician's order to irrigate a client's bladder. Which one of the following nursing measures will ensure patency? a. Use a solution of sterile water for the irrigation b. Apply a small amount of pressure to push the mucus out of the catheter tip if the tube is not patent c. Carefully insert about 100 mL of aqueous Zephiran into the bladder, allow it to remain for 10 hour, and then siphon it out d. Irrigate with 20mL's of normal saline to establish patency 16. A female client has orders for an oral cholecystogram. Prior to the test, the nursing intervention would be to: a. Provide a high fat diet for dinner, then NPO b. Explain that diarrhea may result from the dye tablets c. Administer the dye tablets following a regular diet for dinner d. Administer enemas until clear 17. The physician has just completed a liver biopsy. Immediately following the procedure, the nurse will position the client: a. On his right side to promote hemostasis b. In Fowler's position to facilitate ventilation c. Supine to maintain blood pressure d. In Sims' position to prevent aspiration 18. When a client has peptic ulcer disease, the nurse would expect a priority intervention to be: a. Assisting in inserting a Miller-Abbott tube b. Assisting in inserting an arterial pressure line c. Inserting a nasogastric tube d. Inserting an IV 19. In preparation for discharge of a client with arterial insufficiency and Raynaud's disease, client teaching instructions should include: a. Walking several times each day as a part of an exercise routine b. Keeping the heat up so that the environment is warm c. Wearing TED hose during the day d. Using hydrotherapy for increasing oxygenation 20. When a client asks the nurse why the physician says he "thinks" he has tuberculosis, the nurse explains to him that diagnosis of tuberculosis can take several weeks to confirm. Which of the following statements supports this answer? a. A positive reaction to a tuberculosis skin test indicates that the client has active tuberculosis, even if one negative sputum is obtained

b. A positive sputum culture takes at least 3 weeks, due to the slow reproduction of the bacillus c. Because small lesions are hard to detect on chest x-rays, x-rays usually need to be repeated during several consecutive weeks d. A client with a positive smear will have to have a positive culture to confirm the diagnosis 21. The nurse is counseling a client with the diagnosis of glaucoma. She explains that if left untreated, this condition leads to a. Blindness b. Myopia c. Retrolental fibroplasia d. Uveitis

22. A nursing assessment for initial signs of hypoglycemia will include a. Pallor, blurred vision, weakness, behavioral changes b. Frequent urination, flushed face, pleural friction rub c. Abdominal pain, diminished deep tendon reflexes, double vision d. Weakness, lassitude, irregular pulse, dilated pupils 23. The physician has ordered a 24-hour urine specimen. After explaining the procedure to the client, the nurse collects the first specimen. This specimen is then a. Discarded, then the collection begins b. Saved as part of the 24-hour collection c. Tested, then discarded d. Placed in a separate container and later added to the collection 24. Following an accident, a client is admitted with a head injury and concurrent cervical spine injury. The physician will use Crutchfield tongs. The purpose of these tongs is to: a. Hypoextend the vertebral column b. Hyperextend the vertebral column c. Decompress the spinal nerves d. Allow the client to sit up and move without twisting his spine 25. The most appropriate nursing intervention for a client requiring a finger probe pulse oximeter is to: a. Apply the sensor probe over a finger and cover lightly with gauze to prevent skin breakdown b. Set alarms on the oximeter to at least 100 percent c. Identify if the client has had a recent diagnostic test using intravenous dye d. Remove the sensor between oxygen saturation readings 26. A client being treated for esophageal varices has a Sengstaken-Blakemore tube inserted to control the bleeding. The most important assessment is for the nurse to: a. Check that a hemostat is at the bedside b. Monitor IV fluids for the shift c. Regularly assess respiratory status d. Check that the balloon is deflated on a regular basis 27. A 55-year-old client with sever epigastric pain due to acute pancreatitis has been admitted to the hospital. The client's activity at this time should be: a. Ambulation as desired b. Bedrest in supine position c. Up ad lib and right side-lying position in bed d. Bedrest in Fowler's position

28. Of the following blood gas values, the one the nurse would expect to see in the client with acute renal failure is a. pH 7.49, HCO3 24, PCO2 46 b. pH 7.49, HCO3 14, PCO2 30 c. pH 7.26, HCO3 24, PCO2 46 d. pH 7.26, HCO3 14, PCO2 30 29. A client in acute renal failure receives an IV infusion of 10% dextrose in water with 20 units of regular insulin. The nurse understands that the rationale for this therapy is to: a. Correct the hyperglycemia that occurs with acute renal failure b. Facilitate the intracellular movement of potassium c. Provide calories to prevent tissue catabolism and azotemia d. Force potassium into the cells to prevent arrhythmias

30. A client has had a cystectomy and ureteroileostomy (ileal conduit). The nurse observes this client for complications in the postoperative period. Which of the following symptoms indicates an unexpected outcome and requires priority care? a. Edema of the stoma b. Mucus in the drainage appliance c. Redness of the stoma d. Feces in the drainage appliance 31. A nursing care plan for a client with a suprapubic cystostomy would include: a. Placing a urinal bag around the tube insertion to collect the urine b. Clamping the tube and allowing the client to void through the urinary meatus before removing the tube c. Catheter irrigations every 4 hours to prevent formation of urinary stones d. Limiting fluid intake to 1500 mL per day 32. For a client who has ataxia, which of the following tests would be performed to assess the ability to ambulate? a. Kernig's b. Romberg's c. Riley-Day's d. Hoffmann's 33. A client admitted to a surgical unit for possible bleeding in the cerebrum has vital signs taken every hour to monitor to neurological status. Which of the following neurological checks will give the nurse the best information about the extent of bleeding? a. Pupillary checks b. Spinal tap c. Deep tendon reflexes d. Evaluation of extrapyramidal motor system 34. Assessing for immediate postoperative complications, the nurse knows that a complication likely to occur following unresolved atelectasis is a. Hemorrhage b. Infection c. Pneumonia d. Pulmonary embolism

35. A young client is in the hospital with his left leg in Buck's traction. The team leader asks the nurse to place a footplate on the affected side at the bottom of the bed. The purpose of this action is to a. Anchor the traction b. Prevent footdrop c. Keep the client from sliding down in bed d. Prevent pressure areas on the foot 36. A nurse is reviewing a patients 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 37. A nurse is reviewing a patients 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 Nitrodur 38. 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 patients medication does not cause urine discoloration? A: Sulfasalazine B: Levodopa C: Phenolphthalein D: Aspirin 39. You are responsible for reviewing the nursing units refrigerator. If you found the following drug in the refrigerator it should be removed from the refrigerators contents? A: Corgard B: Humulin (injection) C: Urokinase D: Epogen (injection) 40. 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 41. 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 42. 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 42. 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

43. 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 44. 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 45. 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. 46. 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: Parkinsons disease type symptoms 47. 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 patients 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.

48. 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.

49. 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 50. A mother has recently been informed that her child has Downs syndrome. You will be assigned to care for the child at shift change. Which of the following characteristics is not associated with Downs syndrome? A: Simian crease B: Brachycephaly C: Oily skin D: Hypotonicity 51. 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 52. 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 53. 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

54. A nurse is administering blood to a patient who has a low hemoglobin count. The patient asks how long to RBCs 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.

55. 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 56. When you are taking a patients 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 57. Which of the following conditions would a nurse not administer erythromycin? A: Campylobacterial infection B: Legionnaires disease C: Pneumonia D: Multiple Sclerosis 58. A patients 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 59. A patients 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 60. A patients 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 61. A nurse if reviewing a patients 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 62. A nurse if reviewing a patients 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

63. 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 64. 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 65. 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 66. 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 67. 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 68. 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 69. A nurse has just started her rounds delivering medication. A new patient on her rounds is a 4 yearold 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 childs name.

70. A 68-year-old woman is diagnosed with thrombocytopenia due to acute lymphocytic leukemia. She is admitted to the hospital for treatment. The nurse should assign the patient A. to a private room so she will not infect other patients and health care workers. B. to a private room so she will not be infected by other patients and health care workers. C. to a semiprivate room so she will have stimulation during her hospitalization. D. to a semiprivate room so she will have the opportunity to express her feelings about her illness. 71. The nurse teaches a group of mothers of toddlers how to prevent accidental poisoning. Which of the following suggestions should the nurse give regarding medications? A. Lock all medications in a cabinet. B. Child proof all the caps to medication bottles. C. Store medications on the highest shelf in a cupboard. D. Place medications in different containers. 72. While inserting a nasogastric tube, the nurse should use which of the following protective measures? A. Gloves, gown, goggles, and surgical cap. B. Sterile gloves, mask, plastic bags, and gown. C. Gloves, gown, mask, and goggles. D. Double gloves, goggles, mask, and surgical cap. 73. A 6-year-old boy is returned to his room following a tonsillectomy. He remains sleepy from the anesthesia but is easily awakened. The nurse should place the child in which of the following positions? A. Sims. B. Side-lying. C. Supine. D. Prone. 74. A nursing team consists of an RN, an LPN/LVN, and a nursing assistant. The nurse should assign which of the following patients to the LPN/LVN? A. A 72-year-old patient with diabetes who requires a dressing change for a stasis ulcer. B. A 42-year-old patient with cancer of the bone complaining of pain. C. A 55-year-old patient with terminal cancer being transferred to hospice home care. D. A 23-year-old patient with a fracture of the right leg who asks to use the urinal.

Psychiatric 1. 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 2. 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 3. 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 4. . A mother is inquiring about her childs 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.

Fundamentals 1. 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