1. Using alcohol and insulin together may result in: a. Hypoglycemia b. Hyperglycemia c. Photosensitivity d.

Dawn phenomenon

 2. A client receives a prescription for 62.5 mcg of digoxin elixir PO. If the elixir label read 0.05mg/ml, the nurse will give: a. 12.5 ml b. 1.2 ml c. 1.25 ml d. 0.125 ml

 3. Which diuretic be used for a client with diabetes insipidus? a. Furosemide b. Hydroclorothiazide c. Mannitol d. Spironolactone

 4. A client requires 250 ml of saline solution IV over 2 hours. What is the infusion rate? a. 250 ml/hour b. 500 ml/hour c. 125 ml/hour d. 100 ml/hour

 5. If a physician orders 5000 units of heparin to be given subcutaneously and the vial of hearin contains 20000 units/ml, a nurse should give: a. 0.25 ml b. 0.5 ml c. 1 ml d. 4 ml

 6. Anticholinergic are used to treat spasticity of the GI and urinary tracts and: a. Chronic asthma b. Senile dementia c. BPH d. Angle closure glaucoma

 7. If a drug order is for 2000 ml of PLR solution given IV over 24-hour period and the drip factor is 15, what is the correct equation for calculating the drip rate: a. Drip rate = (24 hours x 15) 2000 ml b. Drip rate = (1440 minutes x 2000 ml) 15 c. Drip rate = (24 hours x 2000 ml) 15 d. Drip rate = (2000 ml x 15) 1440 minutes

 8. If physician orders 40 mEq of oral potassium chloride solution and the drug comes in 10 % solution of 20 mEq/15ml, a nurse should give: a. 40 ml b. 30 ml c. 20 ml d. 10 ml

 9. When used as a preanesthetic to a cholecystectomy, atropine: a. Reduces hyperreflexia during surgery b. Minimizes the risk of postoperative ileus c. Prevents respiratory depression during surgery d. Reduces excess salivation and gastric secretions

 10. Anticholinegics are contraindicated in a client with: a. Asthma b. Epilepsy c. Glaucoma d. Hypothyroidism

 11. When performing a neurologic assessment on a client, the nurse finds that the clients pupil are fixed and dilated. What does this assessment indicates? a. The client is permanently paralyzed b. The client is going to be blind as a result of an injury c. The client probably has meningitis d. The client has received a significant brain injury

 12. A client is being admitted to the labor unit. Because shes well advanced in labor, the nurse must prioritize the admission questions. Which information is most important to obtain when birth is imminent? a. Duration of previous labor b. Frequency of contractions c. Presence of bloody show d. Expected due date

 13. During the first 24 hours after a client is diagnosed with addisonian crisis, the nurse should perform which intervention frequently? a. Weigh the client b. Test urine for ketones c. Assess vital signs d. Administer oral hydrocortisone

 14. Murmurs that indicate heart disease are commonly accompanied by other symptoms such as: a. Dyspnea on exertion b. Subcutaneous emphysema c. Thoracic petechiae d. Periorbital edema

 15. A toddler is admitted with a seizure disorder. According to the parents, the child stops breathing and turns blue after having a seizure. The physician prescribes phenytoin. Before discharge, the nurse teaches the parents how to handle seizures. Which instruction should the nurse include? a. Give the child the medication as soon as seizure begins b. Place a tongue depressor blade in the childs mouth during a seizure c. Remove nearby objects that could cause injury during a seizure d. Keep the medication in the childs room so it wont be forgotten

 16. When assembling the equipment to start the blood transfusion, which of the following solutions is used to start the IV? a. Sterile water b. Normal saline c. Ten percent dextrose and water d. Lactated Ringers

 17. The nurse must remain at the bedside for 15 minutes after the blood started to assess for any transfusion reaction. Which one of the following is not a sign or symptom of such a reaction? a. chills, fever, dyspnea b. Decreased blood pressure, increased pulse rate c. Bleeding under the skin d. Hives, itching

 18. Which one of the following nursing actions must be taken immediately if a transfusion reaction occurs? a. Notify the physician. b. Check the vital signs and take a urine sample. c. Stop the blood transfusion and infuse normal saline. d. Slow down the rate of blood flow and continue the assessment.

Situation: Carl Bates, a 75 year-old man, underwent abdominal surgery for a bowel obstruction. In the immediate post-op period, he developed signs and symptoms of hypovolemic shock.

19. At what systolic blood pressure level is perfusion to the vital organs compromised in a usually normotensive client? a. 100 mm Hg - Normal b. 90 mm Hg - indicates low blood pressure

c. 80 mm Hg - indicates low blood pressure d. 70 mm Hg - indicates low blood pressure

 20. Blood levels of antigeotensin and rennin are increased during shock. What triggers this response? Adrenal response to antideuretic hormone (ADH) Renal response to ischemia. Cardiac response to catecholamines Central nervous system response to diminished blood pressure.

 21. Why dopamine is frequently used to treat shock? a. It is a powerful vasodilator b. It has no untoward side effects c. Cardiac function is not affected d. Good kidney perfusion is maintained.

 22. What is the best parameter for adequate fluid replacement in a client who is in shock? a. Systolic blood pressure above 100 mm Hg should be made to replace blood loss-MS. 11th ed. 364 b. Systolic blood pressure above 90 mm Hg - no replacement at all-MS. 11th ed. 364 c. Urine output of 30 ml/hour - should be > 30 ml/hr-MS. 11th ed. 364 d. Urine output of 20 ml/hour - should be > 30 ml/hr-MS. 11th ed. 364

 23. A fluid challenge is begun on Mr. Bates. Which assessments will give the best indication of client response to this treatment? a. Swan-Ganz readings, hourly urine outputs b. Blood pressure, apical rate checks c. Lung sounds, arterial blood gases d. Electrolytes, BUN, creatinine results

 24. Why are adrenergic agents particularly useful in treating hypotension and controlling superficial bleeding? a. They cause dilatation of peripheral vessels b. They cause constriction of peripheral vessels. c. They decrease the cardiac output. d. They block the effects of acetylcholine

 25. Adrenergic drugs, such as epinephrine (Adrenalin), are given in emergency situations for what primary reasons? a. To increase cardiac output by increasing the rate and strength of myocardial contraction b. To increase tone and motility of the gastrointestinal tract not the effects of adrenergic drug (sympathomimetic drugs), Nursing pharmacology c. To prevent spasm and constriction of peripheral vessels constriction but not spasm of vessel d. To prevent cardiac dysrythmias.

 26. The most serious side effect of the adrenergic drugs is which of the following? a. b. c. d. Dilated pupils Headache Cardiac dysrthmias Nervousness

 27. A 40-year-old client with fractures of both arms has bilateral casts from his shoulders to his hands. Which of the following is the best method of obtaining and monitoring his pulse? a. Take his temporal pulse b. Place the client on a cardiac monitor c. Omit taking the pulse if his other vital signs are normal d. Inform the physician that the pulse cannot be monitored

 28. For a 40-year-old male, which of the following sets of vital signs would be considered normal? a. BP 130/72, pulse 73, respirations 16 b. BP 90/60, pulse 70, respirations 32 c. BP 100/50, pulse 44, respirations 10 d. BP 180/100, pulse 72, respirations 20

 29. As you begin to take a client's oral temperature, she tells you that she has just had some ice chips. The appropriate nursing action is to: a. give her a sip of warm water, wait five minutes, then take her temperature b. take a rectal temperature c. proceed to take the oral temperature d. wait 30 minutes before taking an oral temperature

 30. The interchange of oxygen and carbon dioxide between the alveoli of the lungs and the pulmonary blood is called: a. external respiration b. internal respiration c. inspiration d. ventilation

 31. Some medications are in the form of a powdered drug compressed into a small, hard disk. These medications can sometimes be broken on a scored line; others are entericcoated. This type of drug preparation is a: a. Pill b. Tablet c. Capsule d. Lozenge

 32. The amount of time required for the body's elimination process to reduce the concentration of a drug to one-half what it was at initial administration is called the: a. onset of action b. peak plasma level c. drug half-life d. plateau

 33. The name given to a drug by the drug manufacturer is referred to as its: a. generic name b. chemical name c. brand name d. official name

 34. A secondary, or unintended, effect of a drug on the body is called a: a. cumulative effect b. side effect c. toxic effect d. drug interaction

 35. The administration of a medication under the tongue is called: a. Buccal b. Oral c. Sublingual d. Lacrimal

 36. A client is clenching his abdomen while the nurse is inserting a rectal suppository. Which of the following should the nurse do? a. Ask the client to hold his breath while inserting the suppository b. Call the pharmacy to change the route of the medication c. Ask the client to breathe through his mouth d. Ask the client to insert the suppository himself

 37. The nurse has just administered an otic medication to a client. In which position should the client remain after the medication is administered? a. side-lying position for 5 minutes b. Fowler's position for 10 minutes c. supine position for 5 minutes d. dorsal recumbent position for 10 minutes

 38. A client is prescribed an ophthalmic medication. Which of the following should the nurse do? a. Instruct the client to look down while administering the medication b. Instruct the client to look toward their nose while administering the medication c. See if the client can administer their own medication d. Instruct the client to look up while administering the medication

 39. A febrile 73-year-old client is scheduled to receive a medication through a transdermal patch. Which of the following should the nurse do? a. Place the patch on a part of the client's arm covered with body hair b. Place the patch on the client's abdomen c. Report the client's temperature and call the physician for a possible dose change of the medication d. Place the patch on the palm of the client's nondominant hand

 40. A client's intravenous medication arrives from the pharmacy in a large syringe. What should the nurse do prior to providing the medication to this client? a. Check to see if the client has a syringe pump at the bedside b. Inject the medication into the client's running intravenous fluid c. Inject the medication into a smaller bag of intravenous fluid d. Inject the medication into the mini-infuser

 41. Which of the following is a reason why nurses need to have knowledge about diagnostic tests? a. to phone the doctor with abnormal values b. to assist the laboratory personnel c. to teach the client how to prepare for the test d. to delegate assignments to unlicensed personnel

 42. A client's hemoglobin level has been reported as being low. Which of the following is associated with a low hemoglobin level? a. severe burns b. hemorrhage c. hyperthyroidism d. iron-deficiency anemia

 43. During an assessment, the nurse learns that a 48-year-old client has a family history of renal disease. Which of the following diagnostic tests might be indicated for this client? a. red blood cell count b. serum sodium c. blood urea nitrogen level d. serum osmolality

 44. A client is ordered to have peak and trough theophylline levels drawn. At which times should the nurse tell the laboratory to draw these blood samples? a. one hour after the dose and 3 hours after the dose b. one hour after the dose and 2 hours after the dose c. two hours after the dose and 1 hour before the next dose d. right before the next dose and two hours after the dose

 45. A client with diabetes needs to have a blood test drawn to determine how well the diabetes has been controlled over the last three months. Which blood test will provide this information? a. troponin T b. prothrombin time c. hemoglobin A1c d. fasting blood glucose

 46. A nurse is teaching a preschool child about safety. Which age-specific hazards should the nurse emphasize? a. traffic injuries b. sports injuries c. substance abuse d. firearms

 47. Adolescent poisonings are most likely to be caused by which factor? a. inadequate supervision b. improper storage of toxic household substances c. recreational drugs d. an overdose of a prescribed medication

 48. When teaching parents to prevent poisoning, the nurse should advise them: a. to reuse empty milk cartons to store lawn and garden chemicals b. to administer syrup of ipecac whenever it is suspected that a child has ingested a poisonous substance c. to say that medicine is candy so that children will take it more readily d. not to take medications with great enjoyment in front of children

 49. Which factor reduces the risk of electrical hazards? a. two-pronged electrical plugs b. three-pronged electrical plugs c. non-insulated wiring in the home d. using frayed cords cautiously

 50. A client has an infection of the innermost lining of the heart. Which layer of the heart is affected? a. Endocardium b. Epicardium c. Myocardium d. Pericardium

 51. The atria and ventricles are separated by which of the following valves? a. pulmonic and aortic b. tricuspid and bicuspid c. pulmonic and tricuspid d. aortic and bicuspid

 52. The coronary arteries fill with blood during: a. systole or ventricular relaxation b. systole or ventricular constriction c. diastole or ventricular relaxation d. diastole or ventricular constriction

 53. A client is experiencing an irregular heart rate and might need a pacemaker. Which of the following structures is considered the natural pacemaker of the heart? a. atrioventricular node b. ventricularpulmonic node c. pulmonicventricular node d. sinoatrial node

 54. A client was admitted to the coronary care unit with a low cardiac output. How is the cardiac output calculated? a. heart rate divided by the stroke volume b. stroke volume divided by the heart rate c. heart rate times the stroke volume d. pulse rate times the heart rate

 55. A client is prescribed a medication to increase the contractility of his heart. Which of the following should the nurse include when teaching the client about this medication? a. It will reduce the work your heart has to do b. It will make it easier for you to breath c. It will improve your heart's ability to pump blood d. It will decrease your blood pressure

 56. Hemoglobin has four areas in which oxygen can become attached. When all four of these areas are filled with oxygen, the hemoglobin molecule is said to be: a. Filled b. Saturated c. Completed d. Maximized

 57. The mother of a school-age client is concerned that her son's heart rate changes with every breath. The nurse explains this condition as being: a. sinus arrhythmia b. ventricular fibrillation c. atrial tachycardia d. coronary artery disease

 58. A 5-year-old client has been diagnosed with strep throat. The physician asks the mother to schedule an appointment for the child to be seen by a pediatric cardiologist. The mother is concerned and asks the nurse why. Which of the following would be the best response for the nurse to make? a. "Strep throat causes heart failure in children." b. "The doctor didn't tell you everything about your child's health." c. "The doctor is confused and told you something that he should have told to the parents of another child." d. "Strep throat can cause rheumatic fever, an inflammatory condition of the heart."

 59. A client has been diagnosed with heart disease and wants to make some changes. Which of the following can the client change to improve his cardiac functioning? (Select all that apply) a. heredity b. elevated blood lipid levels c. Age d. High blood pressure e. Gender f. Cigarette smoking g. Obesity

 60. A client with hypertension has been diagnosed with congestive heart failure and says that he isn't aware that his heart has failed! An appropriate response by the nurse would be: a. "Your heart has been working hard because you've had high blood pressure." b. "Didn't your doctor tell you about that?" c. "It's something that happens to all people."

 61. A client is admitted with a possible myocardial infarction. The nurse notes that the client is easily fatigued with simple actions and rests in the middle of activities. An appropriate nursing diagnosis for these observations would be: a. altered tissue perfusion b. decreased cardiac output c. activity intolerance d. deficient knowledge

 62. A client with vascular and cardiac dysfunction is admitted to the hospital. Because of extreme fatigue, the nurse is assisting the client assume a comfortable position. Which of the following positions should be avoided with this client? a. side lying b. supine c. Fowler's d. elevate legs above the level of the heart

 63. A client with severe cardiac dysfunction is being started on a medication to reduce oxygen consumption. Which of the following medication classifications does this? a. ACE inhibitors b. beta blockers c. positive inotropic d. vasodilators

 64. A client is receiving a diuretic to improve cardiac functioning. Which of the following should the nurse do to ensure this medication is not harming the client? a. Evaluate the serum sodium level b. Provide frequent skin care c. Contact the physician for an order to have a serum potassium level drawn d. Review the signs and symptoms of fluid overload with the client

 65. A 33-year-old woman with primary pulmonary hypertension is being evaluated for a heart-lung transplant. The nurse asks her what treatments she is currently receiving for her disease. She is likely to respond by mentioning which treatments? a. b. c. d. Diuretics Aminoglycerides Antihistamines Sulfonamides

 66. A client is diagnosed with gout. Which foods should the nurse instruct the client to avoid? a. Green leafy vegetables b. Liver c. Chocolate d. Eggs

 67. A trauma victim in the intensive care unit has a tension pneumothorax. Which of the following signs and symptoms are associated with a tension pneumothorax? a. Flattened neck veins b. Tracheal deviation to the affected side c. Tracheal deviation to the opposite side d. Bradypnea

 68. The nurse is caring for a client diagnosed with acute renal failure. The nurse notes on the intake and output record that the total urine output for the previous 24 hours was 95 mL. What is urinary output less than 100 mL in 24 hours known as? a. Oliguria b. Anuria c. Polyuria d. Polydipsia

 69. Mrs Cruz, 38 years old, expressed her desire to undergo bilateral tubal ligation (BTL). She is G4 P4,her youngest child is 6 months old. The following are important instructions to be given the procedure. Which is the most important? a. The couple must be certain that they understand and desire the procedure b. Do not take anything by mouth after midnight until the procedure c. Take a shower or bath before the procedure d. Bring a responsible person as a companion

 70. Mrs Cruz, 38 years old, expressed he desire to undergo bilateral tubal ligation (BTL). She is G4 P4, her youngest child is 6 months old. Which of the following statement is not true about BTL? a. Very effective and safe b. Allow immediate sterility C. Irreversible D. Does not interrupt sexual activities

 71. Clarissa assigned at the Family Planning Program on the health center. She gives consultation service every Wednesday afternoon. If patients forget to take her contraceptive pill for one day, what will advise to her most likely? a. Take two pills at the same time the following day b. Take one pill as soon as she remembers it c. Stop taking the pills d. Switch to an injectable form

 72. The most prominent contraceptive action of IUD is: a. Causes inflammation of the genital tract b. Thickened cervical mucus c. Prohibits implantation of fertilized ovum in the endometrium d. Hastened the transport of the ovum through the fallopian tube

 73. Mrs. Advincula is expecting her third child, the other children are both born at term age 2 and 5, she had one abortion . Mrs. Advinculasgravida /para status is; A. gravida 2, para 2 (2102) B. gravida 3,para 2 (2012) C. gravida 4, para 2 (2012) D. gravida 3, para 2 (2002)

 74. Mrs. Perry, 35 years old segundi, 37 38 weeks of gestation was rushed to the ER due to sudden gush of painless vaginal bleeding. Admitting impression is placenta previa. In taking care of patient with placenta previa, the nursemidwife should do the following, except: a. Internal examination b. Inform relatives to prepare blood for possible transfusion c. Notify pediatrician for possible admission of preterm baby d. Prepare a double set up delivery when labor is imminent

 75. Mrs. Rosanna Roces is on her fifth month of pregnancy . Which of the following fetal development has been achieved during the fifth moth of gestation? a. ossification of bone is completed b. can feel her babys movement C. vernixcaseosa is developed D. heartbeat is audible by Doppler

 76. Mrs. Rosanna Roces is on her fifth month of pregnancy . Using Mc Donalds Rule, how do the nurse calculate the length of pregnancy in weeks? a. squaring the number of the months of pregnancy b. multiply fundic height in cms by 8/7 c. multiplyfundic height in cms by 2/7 d. approximately the same as the fundic height

 77. When Mrs. Roces enters the eight month of pregnancy, how often will her pre-natal check-up? a. Once a week b. As often as desires C. once a month D. twice a month

 78. Mrs. Rosanna Roces is on her fifth month of pregnancy . What level of the abdomen can the fundic height be palpated at 5 months gestation? a. Midpoint between symphysis pubis and umbilicus b. Midpoint between umbilicus and xiphoid C. Symphysis pubis D. Umbilicus

 79. The Public Health Nurse is advised to change her schedule of consultation. How often should be her check up on her ninth month of pregnancy? a. Every other week b. Twice a week C. Every week D. As needed d.prenatal visit is important to assure healthy pregnancy

 80. She asks how will recognize a true labor. What are the characteristics of the uterine contractions in a true labor? a. Regular with increasing frequency and duration b. Regular and remain constant in frequency c. Occasional and irregular in duration d. Regular with diminishing frequency and duration