1. Which individual is at greatest risk for developing hypertension?
A) 45 year-old African American attorney
B) 60 year-old Asian American shop owner
C) 40 year-old Caucasian nurse
D) 55 year-old Hispanic teacher
2. A child who ingested 15 maximum strength acetaminophen tablets 45 minutes ago is seen in the emergency department. Which of these orders should the nurse do first?
A) Gastric lavage PRN
B) Acetylcysteine (mucomyst) for age per pharmacy
C) Start an IV Dextrose 5% with 0.33% normal saline to keep vein open
D) Activated charcoal per pharmacy
3. Which complication of cardiac catheterization should the nurse monitor for in the initial 24 hours after the procedure?
A) angina at rest
B) thrombus formation
D) falling blood pressure
4. A client is admitted to the emergency room with renal calculi and is complaining of moderate to severe flank pain and nausea. The client’s temperature is 100.8 degrees Fahrenheit. The priority nursing goal for this client is
A) Maintain fluid and electrolyte balance
B) Control nausea
C) Manage pain
D) Prevent urinary tract infection
5. What would the nurse expect to see while assessing the growth of children during their school age years?
A) Decreasing amounts of body fat and muscle mass
B) Little change in body appearance from year to year
C) Progressive height increase of 4 inches each year
D) Yearly weight gain of about 5.5 pounds per year
6. At a community health fair the blood pressure of a 62 year-old client is 160/96. The client states “My blood pressure is usually much lower.” The nurse should tell the client to
A) go get a blood pressure check within the next 48 to 72 hours
B) check blood pressure again in 2 months
C) see the health care provider immediately
D) visit the health care provider within 1 week for a BP check
7. The hospital has sounded the call for a disaster drill on the evening shift. Which of these clients would the nurse put first on the list to be discharged in order to make a room available for a new admission?
A) A middle aged client with a history of being ventilator dependent for over 7 years and admitted with bacterial pneumonia five days ago
B) A young adult with diabetes mellitus Type 2 for over 10 years and admitted with antibiotic induced diarrhea 24 hours ago
C) An elderly client with a history of hypertension, hypercholesterolemia and lupus, and was admitted with Stevens-Johnson syndrome that morning
D) An adolescent with a positive HIV test and admitted for acute cellulitus of the lower leg 48 hours ago
8. A client has been newly diagnosed with hypothyroidism and will take levothyroxine (Synthroid) 50 mcg/day by mouth. As part of the teaching plan, the nurse emphasizes that this medication:
A) Should be taken in the morning
B) May decrease the client’s energy level
C) Must be stored in a dark container
D) Will decrease the client’s heart rate
9. A 3 year-old child comes to the pediatric clinic after the sudden onset of findings that include irritability, thick muffled voice, croaking on inspiration, hot to touch, sit leaning forward, tongue protruding, drooling and suprasternal retractions. What should the nurse do first?
A) Prepare the child for x-ray of upper airways
B) Examine the child’s throat
C) Collect a sputum specimen
D) Notify the healthcare provider of the child’s status
10. In children suspected to have a diagnosis of diabetes, which one of the following complaints would be most likely to prompt parents to take their school age child for evaluation?
C) Bed wetting
D) Weight loss
11. A client comes to the clinic for treatment of recurrent pelvic inflammatory disease. The nurse recognizes that this condition most frequently follows which type of infection?
12. An RN who usually works in a spinal rehabilitation unit is floated to the emergency department. Which of these clients should the charge nurse assign to this RN?
A) A middle-aged client who says “I took too many diet pills” and “my heart feels like it is racing out of my chest.”
B) A young adult who says “I hear songs from heaven. I need money for beer. I quit drinking 2 days ago for my family. Why are my arms and legs jerking?”
C) An adolescent who has been on pain medications for terminal cancer with an initial assessment finding of pinpoint pupils and a relaxed respiratory rate of 10
D) An elderly client who reports having taken a “large crack hit” 10 minutes prior to walking into the emergency room
13. When teaching a client with coronary artery disease about nutrition, the nurse should emphasize
A) Eating 3 balanced meals a day
B) Adding complex carbohydrates
C) Avoiding very heavy meals
D) Limiting sodium to 7 gms per day
14. Which of these findings indicate that a pump to deliver a basal rate of 10 ml per hour plus PRN for pain break through for morphine drip is not working?
A) The client complains of discomfort at the IV insertion site
B) The client states “I just can’t get relief from my pain.”
C) The level of drug is 100 ml at 8 AM and is 80 ml at noon
D) The level of the drug is 100 ml at 8 AM and is 50 ml at noon
15. The nurse is speaking at a community meeting about personal responsibility for health promotion. A participant asks about chiropractic treatment for illnesses. What should be the focus of the nurse’s response?
A) Electrical energy fields
B) Spinal column manipulation
C) Mind-body balance
D) Exercise of joints
16. The nurse is performing a neurological assessment on a client post right CVA. Which finding, if observed by the nurse, would warrant immediate attention?
A) Decrease in level of consciousness
B) Loss of bladder control
C) Altered sensation to stimuli
D) Emotional lability
17. A child who has recently been diagnosed with cystic fibrosis is in a pediatric clinic where a nurse is performing an assessment. Which later finding of this disease would the nurse not expect to see at this time?
A) Positive sweat test
B) Bulky greasy stools
C) Moist, productive cough
D) Meconium ileus
18. The home health nurse visits a male client to provide wound care and finds the client lethargic and confused. His wife states he fell down the stairs 2 hours ago. The nurse should
A) Place a call to the client’s health care provider for instructions
B) Send him to the emergency room for evaluation
C) Reassure the client’s wife that the symptoms are transient
D) Instruct the client’s wife to call the doctor if his symptoms become worse
19. Which of the following should the nurse implement to prepare a client for a KUB (Kidney, Ureter, Bladder) radiograph test?
A) Client must be NPO before the examination
B) Enema to be administered prior to the examination
C) Medicate client with Lasix 20 mg IV 30 minutes prior to the examination
D) No special orders are necessary for this examination
20. The nurse is giving discharge teaching to a client 7 days post myocardial infarction. He asks the nurse why he must wait 6 weeks before having sexual intercourse. What is the best response by the nurse to this question?
A) “You need to regain your strength before attempting such exertion.”
B) “When you can climb 2 flights of stairs without problems, it is generally safe.”
C) “Have a glass of wine to relax you, then you can try to have sex.”
D) “If you can maintain an active walking program, you will have less risk.”