NURS 4431 EXAM 1 PREP QUESTIONS WITH
ANSWERS 100% VERIFIED
A nurse is admitting a client who has acute pancreatitis. Which of the following provider
prescriptions should the nurse anticipate?
A. Initiate a low-residue diet.
B. Pantoprazole 80 mg IV bolus twice daily
C. Ambulate twice daily.
D. Pancrelipase 500 units/kg PO three times daily with meals - ANSWER B. Pantoprazole
80 mg IV bolus twice daily
Rationale: The nurse should anticipate a provider's prescription for a proton pump
inhibitor to decrease gastric acid production, which ultimately decrease pancreatic
secretions.
A nurse is caring for a client who has a new diagnosis of urolithiasis. Which of the
following should the nurse identify as an associated risk factor?
A. Hypocalcemia
B. BMI less than 25
C. Family history
D. Diuretic use - ANSWER C. Family history
Rationale: Family history is strongly correlated with the formation of urolithiasis. A nurse
should assess a client who has kidney stones for familial tendencies toward stone
formation.
A nurse is preparing to administer vaccines to a 1-year-old child. Which of the following
vaccines should the nurse give? (Select all that apply.)
A. Measles, mumps rubella (MMR)
B. Diphtheria, tetanus and acellular pertussis (DTaP)
,C. Varicella (VAR)
D. Rotavirus (RV)
E. Human papillomavirus (HPV4) - ANSWER A. Measles, mumps rubella (MMR)
C. Varicella (VAR)
Rationale: Measles, mumps rubella (MMR) is correct. A 1-year-old child should receive
the first of two doses of the MMR vaccine.Diphtheria, tetanus and acellular pertussis
(DTaP) is incorrect. By 1 year of age, the child should have already received three doses
of DTaP: at 2 months, 4 months, and 6 months. The child should receive a fourth dose at
15 months of age.Varicella (VAR) is correct. A 1-year-old child should receive the first of
two doses of the VAR vaccine.Rotavirus (RV) is incorrect. A 1-year-old child should have
received the RV vaccine in a two or three dose series starting at 2 months of age.Human
papillomavirus (HPV4) is incorrect. A child should receive a three dose series of the
HPV4 vaccine at 11 or 12 years of age.
A nurse is speaking with the mother of a 6-year-old child. Which of the following
statements by the mother should concern the nurse?
A. "The teacher says my child has to squint to see the board."
B. "My child has recently lost both front top teeth."
C. "My child often cheats when we play board games."
D. "Sometimes my child acts bossy with his friends." - ANSWER A. "The teacher says my
child has to squint to see the board."
Rationale: Squinting to see the board can indicate a vision problem. It is essential to
assess children for hearing and vision problems. If not caught early, they lead to
frustration and decreased ability to learn.
A nurse is assessing a toddler at a well-child visit. At what point in the physical
examination should the nurse examine the child's tympanic membrane?
A. At the end
B. At the beginning
C. Before examining the head and neck
,D. Before auscultating the chest and abdomen - ANSWER A. At the end
Rationale: When examining a toddler, the nurse should follow a modified head-to-toe
approach, starting at the head but deferring anything that the toddler is likely to view as
invasive and traumatic to the very end. The toddler is likely to resist not only having the
ears examined, but also anything that follows.
A nurse is completing an admission assessment on an adolescent client who is a
vegetarian. He eats milk products but does not like beans. Which of the following items
should the nurse suggest the client order for lunch to provide the nutrients most likely to
be lacking in his diet?
A. Peanut butter and jelly sandwich
B. Baked potato topped with sour cream
C. Bagel with cream cheese
D. Fruit salad - ANSWER A. Peanut butter and jelly sandwich
Rationale: A vegetarian diet may be low in protein, especially if the client does not
substitute protein-rich beans for meat protein. Peanut butter is an excellent source of
protein. A peanut butter and jelly sandwich, especially if prepared on protein-enriched
bread, can provide almost 20 grams of protein.
A nurse is preparing to perform an abdominal assessment on a child. Identify the
sequence the nurse should follow. (Move the steps into the box on the right, placing
them in the selected order of performance. Use all the steps.)
A. Inspection
B. Superficial palpation
C. Deep palpation
D. Auscultation - ANSWER A. Inspection
D. Auscultation
, B. Superficial palpation
C. Deep palpation
Rationale: When performing an abdominal assessment on a child, the nurse should first
inspect the abdomen without touching and observe for anything that could indicate a
medical concern. Because palpation prior to auscultation can alter the bowel sounds,
the nurse should auscultate the abdomen for bowel sounds next. Then, the nurse should
palpate the abdomen superficially so the child won't tense her abdominal muscles.
Finally, the nurse should perform a deep palpation of the abdomen, making sure to
palpate any painful areas last.
A nurse is caring for a 4-year-old child who has croup and wet the bed overnight. When
the parents visit the next day, the nurse explains the situation and one of the parents
says, "She never wets the bed at home. I am so embarrassed." Which of the following
responses should the nurse make?
A. "It is expected for children who are hospitalized to regress. The toileting skills will
return when your child is feeling better."
B. "I know this can really be embarrassing. I have kids myself, so I understand, and it
doesn't bother me."
C. "Your child did not seem upset, so I wouldn't worry about it if I were you."
D. "Why does it bother you that your child has wet the bed?" - ANSWER A. "It is
expected for children who are hospitalized to regress. The toileting skills will return
when your child is feeling better."
Rationale: A recently learned skill, such as toilet training, is often temporarily lost due to
the stress of hospitalization. The nurse should reassure the parents that regression is
an expected behavior in children who are hospitalized and that her child will regain
bladder control when she is feeling better.
A nurse is caring for a client during the first trimester of pregnancy. After reviewing the
client's blood work, the nurse notices she does not have immunity to rubella. Which of
the following times should the nurse understand is recommended for rubella
immunization?
ANSWERS 100% VERIFIED
A nurse is admitting a client who has acute pancreatitis. Which of the following provider
prescriptions should the nurse anticipate?
A. Initiate a low-residue diet.
B. Pantoprazole 80 mg IV bolus twice daily
C. Ambulate twice daily.
D. Pancrelipase 500 units/kg PO three times daily with meals - ANSWER B. Pantoprazole
80 mg IV bolus twice daily
Rationale: The nurse should anticipate a provider's prescription for a proton pump
inhibitor to decrease gastric acid production, which ultimately decrease pancreatic
secretions.
A nurse is caring for a client who has a new diagnosis of urolithiasis. Which of the
following should the nurse identify as an associated risk factor?
A. Hypocalcemia
B. BMI less than 25
C. Family history
D. Diuretic use - ANSWER C. Family history
Rationale: Family history is strongly correlated with the formation of urolithiasis. A nurse
should assess a client who has kidney stones for familial tendencies toward stone
formation.
A nurse is preparing to administer vaccines to a 1-year-old child. Which of the following
vaccines should the nurse give? (Select all that apply.)
A. Measles, mumps rubella (MMR)
B. Diphtheria, tetanus and acellular pertussis (DTaP)
,C. Varicella (VAR)
D. Rotavirus (RV)
E. Human papillomavirus (HPV4) - ANSWER A. Measles, mumps rubella (MMR)
C. Varicella (VAR)
Rationale: Measles, mumps rubella (MMR) is correct. A 1-year-old child should receive
the first of two doses of the MMR vaccine.Diphtheria, tetanus and acellular pertussis
(DTaP) is incorrect. By 1 year of age, the child should have already received three doses
of DTaP: at 2 months, 4 months, and 6 months. The child should receive a fourth dose at
15 months of age.Varicella (VAR) is correct. A 1-year-old child should receive the first of
two doses of the VAR vaccine.Rotavirus (RV) is incorrect. A 1-year-old child should have
received the RV vaccine in a two or three dose series starting at 2 months of age.Human
papillomavirus (HPV4) is incorrect. A child should receive a three dose series of the
HPV4 vaccine at 11 or 12 years of age.
A nurse is speaking with the mother of a 6-year-old child. Which of the following
statements by the mother should concern the nurse?
A. "The teacher says my child has to squint to see the board."
B. "My child has recently lost both front top teeth."
C. "My child often cheats when we play board games."
D. "Sometimes my child acts bossy with his friends." - ANSWER A. "The teacher says my
child has to squint to see the board."
Rationale: Squinting to see the board can indicate a vision problem. It is essential to
assess children for hearing and vision problems. If not caught early, they lead to
frustration and decreased ability to learn.
A nurse is assessing a toddler at a well-child visit. At what point in the physical
examination should the nurse examine the child's tympanic membrane?
A. At the end
B. At the beginning
C. Before examining the head and neck
,D. Before auscultating the chest and abdomen - ANSWER A. At the end
Rationale: When examining a toddler, the nurse should follow a modified head-to-toe
approach, starting at the head but deferring anything that the toddler is likely to view as
invasive and traumatic to the very end. The toddler is likely to resist not only having the
ears examined, but also anything that follows.
A nurse is completing an admission assessment on an adolescent client who is a
vegetarian. He eats milk products but does not like beans. Which of the following items
should the nurse suggest the client order for lunch to provide the nutrients most likely to
be lacking in his diet?
A. Peanut butter and jelly sandwich
B. Baked potato topped with sour cream
C. Bagel with cream cheese
D. Fruit salad - ANSWER A. Peanut butter and jelly sandwich
Rationale: A vegetarian diet may be low in protein, especially if the client does not
substitute protein-rich beans for meat protein. Peanut butter is an excellent source of
protein. A peanut butter and jelly sandwich, especially if prepared on protein-enriched
bread, can provide almost 20 grams of protein.
A nurse is preparing to perform an abdominal assessment on a child. Identify the
sequence the nurse should follow. (Move the steps into the box on the right, placing
them in the selected order of performance. Use all the steps.)
A. Inspection
B. Superficial palpation
C. Deep palpation
D. Auscultation - ANSWER A. Inspection
D. Auscultation
, B. Superficial palpation
C. Deep palpation
Rationale: When performing an abdominal assessment on a child, the nurse should first
inspect the abdomen without touching and observe for anything that could indicate a
medical concern. Because palpation prior to auscultation can alter the bowel sounds,
the nurse should auscultate the abdomen for bowel sounds next. Then, the nurse should
palpate the abdomen superficially so the child won't tense her abdominal muscles.
Finally, the nurse should perform a deep palpation of the abdomen, making sure to
palpate any painful areas last.
A nurse is caring for a 4-year-old child who has croup and wet the bed overnight. When
the parents visit the next day, the nurse explains the situation and one of the parents
says, "She never wets the bed at home. I am so embarrassed." Which of the following
responses should the nurse make?
A. "It is expected for children who are hospitalized to regress. The toileting skills will
return when your child is feeling better."
B. "I know this can really be embarrassing. I have kids myself, so I understand, and it
doesn't bother me."
C. "Your child did not seem upset, so I wouldn't worry about it if I were you."
D. "Why does it bother you that your child has wet the bed?" - ANSWER A. "It is
expected for children who are hospitalized to regress. The toileting skills will return
when your child is feeling better."
Rationale: A recently learned skill, such as toilet training, is often temporarily lost due to
the stress of hospitalization. The nurse should reassure the parents that regression is
an expected behavior in children who are hospitalized and that her child will regain
bladder control when she is feeling better.
A nurse is caring for a client during the first trimester of pregnancy. After reviewing the
client's blood work, the nurse notices she does not have immunity to rubella. Which of
the following times should the nurse understand is recommended for rubella
immunization?
