NCLEX Leadership Questions (300 Questions and Answers)

NCLEX Leadership Questions and Answers   NCLEX Leadership Questions: 300 1. An agitated, confused female client arrives in the emergency department. Her history includes type 1 diabetes mellitus, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting: A. 2 to 5 g of a simple carbohydrate. B. 10 to 15 g of a simple carbohydrate. C. 18 to 20 g of a simple carbohydrate. D. 25 to 30 g of a simple carbohydrate. 2. A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, the nurse formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client, which “related-to” phrase should the nurse add? A. Related to bone demineralization resulting in pathologic fractures B. Related to exhaustion secondary to an accelerated metabolic rate C. Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces D. Related to tetany secondary to a decreased serum calcium level 3. Nurse Joey is assigned to care for a postoperative male client who has diabetes mellitus. During the assessment interview, the client reports that he’s impotent and says he’s concerned about its effect on his marriage. In planning this client’s care, the most appropriate intervention would be to: A. Encourage the client to ask questions about personal sexuality. B. Provide time for privacy. C. Provide support for the spouse or significant other. D. Suggest referral to a sex counselor or other appropriate professional. 4. during a class on exercise for diabetic clients, a female client asks the nurse educator how often to exercise. The nurse educator advises the clients to exercise how often to meet the goals of planned exercise? A. At least once a week B. At least three times a week C. At least five times a week D. Every day 5. Nurse Oliver should expect a client with hypothyroidism to report which health concerns? A. Increased appetite and weight loss B. Puffiness of the face and hands C. Nervousness and tremors D. Thyroid gland swelling 6. A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should nurse Hans recognize as an adverse drug effect? A. Dysuria B. Leg cramps C. Tachycardia D. Blurred vision 7. A 67-year-old male client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based on these assessment findings, Nurse Richard would suspect which of the following disorders? A. Diabetes mellitus B. Diabetes insipidus C. Hypoparathyroidism D. Hyperparathyroidism 8. When caring for a male client with diabetes insipidus, Nurse Juliet expects to administer: A. vasopressin (Pitressin Synthetic). B. furosemide (Lasix). C. regular insulin. D. 10% dextrose. 9. The nurse is aware that the following is the most common cause of hyperaldosteronism? A. Excessive sodium intake B. A pituitary adenoma C. Deficient potassium intake D. An adrenal adenoma 10. A male client with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, nurse Sharmaine would be most accurate in stating: A. “The test needs to be repeated following a 12-hour fast.” B. “It looks like you aren’t following the prescribed diabetic diet.” C. “It tells us about your sugar control for the last 3 months.” D. “Your insulin regimen needs to be altered significantly.” 11. Following a unilateral adrenalectomy, Nurse Betty would assess for hyperkalemia shown by which of the following? A. Muscle weakness B. Tremors C. Diaphoresis D. Constipation 12. Nurse Louie is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus? A. antidiuretic hormone (ADH). B. thyroid-stimulating hormone (TSH). C. follicle-stimulating hormone (FSH). D. luteinizing hormone (LH). 13. Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, Nurse Tina assesses the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs? A. Diabetic ketoacidosis B. Thyroid crisis C. Hypoglycemia D. Tetany 14. For a male client with hyperglycemia, which assessment finding best supports a nursing diagnosis of Deficient fluid volume? A. Cool, clammy skin B. Distended neck veins C. Increased urine osmolarity D. Decreased serum sodium level 15. When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, Nurse April is most likely to detect: A. a blood pressure of 130/70 mm Hg. B. a blood glucose level of 130 mg/dl. C. bradycardia. D. a blood pressure of 176/88 mm Hg. 16. A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate? A. Infusing I.V. fluids rapidly as ordered B. Encouraging increased oral intake C. Restricting fluids D. Administering glucose-containing I.V. fluids as ordered 17. A female client has a serum calcium level of 7.2 mg/dl. During the physical examination, Nurse Noah expects to assess: A. Trousseau’s sign. B. Homans’ sign. C. Hegar’s sign. D. Goodell’s sign. 18. Which outcome indicates that treatment of a male client with diabetes insipidus has been effective? A. Fluid intake is less than 2,500 ml/day. B. Urine output measures more than 200 ml/hour. C. Blood pressure is 90/50 mm Hg. D. The heart rate is 126 beats/minute. 19. Jemma, who weighs 210 lb (95 kg) and has been diagnosed with hyperglycemia tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that she has large hands and a hoarse voice. Which of the following would the nurse suspect as a possible cause of the client’s hyperglycemia? A. Acromegaly B. Type 1 diabetes mellitus C. Hypothyroidism D. Deficient growth hormone 20. Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend: A. Increasing saturated fat intake and fasting in the afternoon. B. Increasing intake of vitamins B and D and taking iron supplements. C. Eating a candy bar if lightheadedness occurs. D. Consuming a low-carbohydrate, high protein diet and avoiding fasting. 21. An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, Nurse Libby prepares to take emergency action to prevent the potential complication of: A. Thyroid storm. B. Cretinism. C. myxedema coma. D. Hashimoto’s thyroiditis. 22. A male client with type 1 diabetes mellitus asks the nurse about taking an oral antidiabetic agent. Nurse Jack explains that these medications are only effective if the client: A. prefers to take insulin orally. B. has type 2 diabetes. C. has type 1 diabetes. D. is pregnant and has type 2 diabetes. 23. When caring for a female client with a history of hypoglycemia, nurse Ruby should avoid administering a drug that may potentiate hypoglycemia. Which drug fits this description? A. sulfisoxazole (Gantrisin) B. mexiletine (Mexitil) C. prednisone (Orasone) D. lithium carbonate (Lithobid) 24. After taking glipizide (Glucotrol) for 9 months, a male client experiences secondary failure. Which of the following would the nurse expect the physician to do? A. Initiate insulin therapy. B. Switch the client to a different oral antidiabetic agent. C. Prescribe an additional oral antidiabetic agent. D. Restrict carbohydrate intake to less than 30% of the total caloric intake. 25. During preoperative teaching for a female client who will undergo subtotal thyroidectomy, the nurse should include which statement? A. “The head of your bed must remain flat for 24 hours after surgery.” B. “You should avoid deep breathing and coughing after surgery.” C. “You won’t be able to swallow for the first day or two.” D. “You must avoid hyper extending your neck after surgery.” 26. Nurse Ronn is assessing a client with possible Cushing’s syndrome. In a client with Cushing’s syndrome, the nurse would expect to find: A. Hypotension. B. Thick, coarse skin. C. Deposits of adipose tissue in the trunk and dorsocervical area. D. Weight gain in arms and legs. 27. A male client with primary diabetes insipidus is ready for discharge on desmopressin (DDAVP). Which instruction should nurse Lina provide? A. “Administer desmopressin while the suspension is cold.” B. “Your condition isn’t chronic, so you won’t need to wear a medical identification bracelet.” C. “You may not be able to use desmopressin nasally if you have nasal discharge or blockage.” D. “You won’t need to monitor your fluid intake and output after you start taking desmopressin.” 28. Nurse Wayne is aware that a positive Chvostek’s sign indicate? A. Hypocalcaemia B. Hyponatremia C. Hypokalemia D. Hypermagnesemia 29. In a 29-year-old female client who is being successfully treated for Cushing’s syndrome, nurse Lyzette would expect a decline in: A. Serum glucose level. B. Hair loss. C. Bone mineralization. D. Menstrual flow. 30. A male client has recently undergone surgical removal of a pituitary tumor. Dr. Wong prescribes corticotropin (Acthar), 20 units I.M. q.i.d. as a replacement therapy. What is the mechanism of action of corticotropin? A. It decreases cyclic adenosine monophosphate (cAMP) production and affects the metabolic rate of target organs. B. It interacts with plasma membrane receptors to inhibit enzymatic actions. C. It interacts with plasma membrane receptors to produce enzymatic actions that affect protein, fat, and carbohydrate metabolism. D. It regulates the threshold for water reabsorption in the kidneys. 31. Capillary glucose monitoring is being performed every 4 hours for a female client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 p.m., the client has a capillary glucose level of 250 mg/dl for which he receives 8 U of regular insulin. Nurse Vince should expect the doses: A. Onset to be at 2 p.m. and its peak to be at 3 p.m. B. Onset to be at 2:15 p.m. and its peak to be at 3 p.m. C. Onset to be at 2:30 p.m. and its peak to be at 4 p.m. D. Onset to be at 4 p.m. and its peak to be at 6 p.m. 32. A female client with Cushing’s syndrome is admitted to the medical-surgical unit. During the admission assessment, nurse Tyzz notes that the client is agitated and irritable, has poor memory, reports loss of appetite, and appears disheveled. These findings are consistent with which problem? A. Depression B. Neuropathy C. Hypoglycemia D. Hyperthyroidism 33. Nurse Ruth is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication? A. Tetany B. Hemorrhage C. Thyroid storm D. Laryngeal nerve damage 34. After undergoing a subtotal thyroidectomy, a female client develops hypothyroidism. Dr. Smith prescribes levothyroxine (Levothroid), 25 mcg P.O. daily. For which condition is levothyroxine the preferred agent? A. Primary hypothyroidism B. Graves’ disease C. Thyrotoxicosis D. Euthyroidism 35. Which of these signs suggests that a male client with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion is experiencing complications? A. Tetanic contractions B. Neck vein distention C. Weight loss D. Polyuria 36. A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse hypertensive crisis caused by pheochromocytoma, nurse Lyka expects to administer: A. phentolamine (Regitine). B. methyldopa (Aldomet). C. mannitol (Osmitrol). D. felodipine (Plendil). 37. A male client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client’s hypertension is caused by excessive hormone secretion from which of the following glands? A. Adrenal cortex B. Pancreas C. Adrenal medulla D. Parathyroid 38. Nurse Troy is aware that the most appropriate for a client with Addison’s disease? A. Risk for infection B. Excessive fluid volume C. Urinary retention D. Hypothermia 39. Acarbose (Precose), an alpha-glucosidase inhibitor, is prescribed for a female client with type 2 diabetes mellitus. During discharge planning, nurse Pauleen would be aware of the client’s need for additional teaching when the client states: A. “If I have hypoglycemia, I should eat some sugar, not dextrose.” B. “The drug makes my pancreas release more insulin.” C. “I should never take insulin while I’m taking this drug.” D. “It’s best if I take the drug with the first bite of a meal.” 40. A female client whose physical findings suggest a hyper pituitary condition undergoes an extensive diagnostic workup. Test results reveal a pituitary tumor, which necessitates a transsphenoidal hypophysectomy. The evening before the surgery, Nurse Jacob reviews preoperative and postoperative instructions given to the client earlier. Which postoperative instruction should the nurse emphasize? A. “You must lie flat for 24 hours after surgery.” B. “You must avoid coughing, sneezing, and blowing your nose.” C. “You must restrict your fluid intake.” D. “You must report ringing in your ears immediately.” 41. Dr. Kennedy prescribes glipizide (Glucotrol), an oral antidiabetic agent, for a male client with type 2 diabetes mellitus who has been having trouble controlling the blood glucose level through diet and exercise. Which medication instruction should the nurse provide? A. “Be sure to take glipizide 30 minutes before meals.” B. “Glipizide may cause a low serum sodium level, so make sure you have your sodium level checked monthly.” C. “You won’t need to check your blood glucose level after you start taking glipizide.” D. “Take glipizide after a meal to prevent heartburn.” 42. For a diabetic male client with a foot ulcer, the physician orders bed rest, a wet-to-dry dressing change every shift, and blood glucose monitoring before meals and bedtime. Why are wet-to-dry dressings used for this client? A. They contain exudates and provide a moist wound environment. B. They protect the wound from mechanical trauma and promote healing. C. They debride the wound and promote healing by secondary intention. D. They prevent the entrance of microorganisms and minimize wound discomfort. 43. When instructing the female client diagnosed with hyperparathyroidism about diet, Nurse Gina should stress the importance of which of the following? A. Restricting fluids B. Restricting sodium C. Forcing fluids D. Restricting potassium 44. Which nursing diagnosis takes highest priority for a female client with hyperthyroidism? A. Risk for imbalanced nutrition: More than body requirements related to thyroid hormone excess B. Risk for impaired skin integrity related to edema, skin fragility, and poor wound healing C. Body image disturbance related to weight gain and edema D. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess 45. A male client with a tentative diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNS) has a history of type 2 diabetes that is being controlled with an oral diabetic agent, tolazamide (Tolinase). Which of the following is the most important laboratory test for confirming this disorder? A. Serum potassium level B. Serum sodium level C. Arterial blood gas (ABG) values D. Serum osmolarity 46. A male client has just been diagnosed with type 1 diabetes mellitus. When teaching the client and family how diet and exercise affect insulin requirements, Nurse Joy should include which guideline? A. “You’ll need more insulin when you exercise or increase your food intake.” B. “You’ll need less insulin when you exercise or reduce your food intake.” C. “You’ll need less insulin when you increase your food intake.” D. “You’ll need more insulin when you exercise or decrease your food intake.” 47. Nurse Noemi administers glucagon to her diabetic client, then monitors the client for adverse drug reactions and interactions. Which type of drug interacts adversely with glucagon? A. Oral anticoagulants B. Anabolic steroids C. Beta-adrenergic blockers D. Thiazide diuretics 48. Which instruction about insulin administration should Nurse Kate give to a client? A. “Always follow the same order when drawing the different insulins into the syringe.” B. “Shake the vials before withdrawing the insulin.” C. “Store unopened vials of insulin in the freezer at temperatures well below freezing.” D. “Discard the intermediate-acting insulin if it appears cloudy.” 49. Nurse Perry is caring for a female client with type 1 diabetes mellitus who exhibits confusion, light-headedness, and aberrant behavior. The client is still conscious. The nurse should first administer: A. I.M. or subcutaneous glucagon. B. I.V. bolus of dextrose 50%. C. 15 to 20 g of a fast-acting carbohydrate such as orange juice. D. 10 U of fast-acting insulin. 50. For the first 72 hours after thyroidectomy surgery, nurse Jamie would assess the female client for Chvostek’s sign and Trousseau’s sign because they indicate which of the following? A. Hypocalcaemia B. Hypercalcemia C. Hypokalemia D. Hyperkalemia 51) Knowing that gluconeogenesis helps to maintain blood levels, a nurse should: 1. Document weight changes because of fatty acid mobilization 2. Evaluate the patient’s sensitivity to low room temperatures because of decreased adipose tissue insulation 3. Protect the patient from sources of infection because of decreased cellular protein deposits 4. Do all of the above 52. Clinical manifestations associated with a diagnosis of type 1 DM include all of the following except: 1. Hypoglycemia 2. Hyponatremia 3. Ketonuria 4. Polyphagia 53. The lowest fasting plasma glucose level suggestive of a diagnosis of DM is: 1. 90mg/dl 2. 115mg/dl 3. 126mg/dl 4. 180mg/dl 54. Rotation sites for insulin injection should be separated from one another by 2.5 cm (1 inch) and should be used only every: 1. Third day 2. Week 3. 2-3 weeks 4. 2-4 weeks 55. A clinical feature that distinguishes a hypoglycemic reaction from a ketoacidosis reaction is: 1. Blurred vision 2. Diaphoresis 3. Nausea 4. Weakness 56. Clinical nursing assessment for a patient with microangiopathy who has manifested impaired peripheral arterial circulation includes all of the following except: 1. Integumentary inspection for the presence of brown spots on the lower extremities 2. Observation for paleness of the lower extremities 3. Observation for blanching of the feet after the legs are elevated for 60 seconds 4. Palpation for increased pulse volume in the arteries of the lower extremities 57. The nurse expects that a type 1 diabetic may receive ____ of his or her morning dose of insulin preoperatively: 1. 10-20% 2. 25-40% 3. 50-60% 4. 85-90% 58. Albert, a 35-year-old insulin dependent diabetic, is admitted to the hospital with a diagnosis of pneumonia. He has been febrile since admission. His daily insulin requirement is 24 units of NPH. Every morning Albert is given NPH insulin at 0730. Meals are served at 0830, 1230, and 1830. The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of: 1. 1130 and 1330 2. 1330 and 1930 3. 1530 and 2130 4. 1730 and 2330 59. A bedtime snack is provided for Albert. This is based on the knowledge that intermediate-acting insulins are effective for an approximate duration of: 1. 6-8 hours 2. 10-14 hours 3. 16-20 hours 4. 24-28 hours 60. Albert refuses his bedtime snack. This should alert the nurse to assess for: 1. Elevated serum bicarbonate and a decreased blood pH. 2. Signs of hypoglycemia earlier than expected. 3. Symptoms of hyperglycemia during the peak time of NPH insulin. 4. Sugar in the urine 61. A client is taking NPH insulin daily every morning. The nurse instructs the client that the most likely time for a hypoglycemic reaction to occur is: 1. 2-4 hours after administration 2. 6-14 hours after administration 3. 16-18 hours after administration 4. 18-24 hours after administration 62. An external insulin pump is prescribed for a client with DM. The client asks the nurse about the functioning of the pump. The nurse bases the response on the information that the pump: 1. Gives small continuous dose of regular insulin subcutaneously, and the client can self-administer a bolus with an additional dosage from the pump before each meal. 2. Is timed to release programmed doses of regular or NPH insulin into the bloodstream at specific intervals. 3. Is surgically attached to the pancreas and infuses regular insulin into the pancreas, which in turn releases the insulin into the bloodstream. 4. Continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels. 63. A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the ER. Which finding would a nurse expect to note as confirming this diagnosis? 1. Elevated blood glucose level and a low plasma bicarbonate 2. Decreased urine output 3. Increased respirations and an increase in pH 4. Comatose state 64. A client with DM demonstrates acute anxiety when first admitted for the treatment of hyperglycemia. The most appropriate intervention to decrease the client’s anxiety would be to: 1. Administer a sedative 2. Make sure the client knows all the correct medical terms to understand what is happening. 3. Ignore the signs and symptoms of anxiety so that they will soon disappear 4. Convey empathy, trust, and respect toward the client. 65. A nurse is preparing a plan of care for a client with DM who has hyperglycemia. The priority nursing diagnosis would be: 1. High risk for deficient fluid volume 2. Deficient knowledge: disease process and treatment 3. Imbalanced nutrition: less than body requirements 4. Disabled family coping: compromised. 66. A nurse is caring for a client admitted to the ER with DKA. In the acute phase the priority nursing action is to prepare to: 1. Administer regular insulin intravenously 2. Administer 5% dextrose intravenously 3. Correct the acidosis 4. Apply an electrocardiogram monitor. 67. A nurse performs a physical assessment on a client with type 2 DM. Findings include a fasting blood glucose of 120mg/dl, temperature of 101, pulse of 88, respirations of 22, and a bp of 140/84. Which finding would be of most concern of the nurse? 1. Pulse 2. BP 3. Respiration 4. Temperature 68. A client with type 1 DM calls the nurse to report recurrent episodes of hypoglycemia with exercise. Which statement by the client indicated an inadequate understanding of the peak action of NPH insulin and exercise? 1. “The best time for me to exercise is every afternoon.” 2. “The best time for me to exercise is right after I eat.” 3. “The best time for me to exercise is after breakfast.” 4. “The best time for me to exercise is after my morning snack.” 69. A client with diabetes mellitus visits a health care clinic. The client’s diabetes previously had been well controlled with glyburide (Diabeta), 5 mg PO daily, but recently the fasting blood glucose has been running 180-200mg/dl. Which medication, if added to the clients regimen, may have contributed to the hyperglycemia? 1. Prednisone (Deltasone) 2. Atenolol (Tenormin) 3. Phenelzine (Nardil) 4. Allopurinol (Zyloprim) 70. Glucose is an important molecule in a cell because this molecule is primarily used for: 1. Extraction of energy 2. Synthesis of protein 3. Building of genetic material 4. Formation of cell membranes. 71. When a client is first admitted with hyperglycemic hyperosmolar nonketotic syndrome (HHNS), the nurse’s priority is to provide: 1. Oxygen 2. Carbohydrates 3. Fluid replacement 4. Dietary instruction 72. The nurse is admitting a client with hypoglycemia. Identify the signs and symptoms the nurse should expect. Select all that apply. 1. Thirst 2. Palpitations 3. Diaphoresis 4. Slurred speech 5. Hyperventilation 73. When a client is in diabetic ketoacidosis, the insulin that would be administered is: 1. Human NPH insulin 2. Human regular insulin 3. Insulin lispro injection 4. Insulin glargine injection 74. The nurse recognizes that additional teaching is necessary when the client who is learning alternative site testing (AST) for glucose monitoring says: 1. “I need to rub my forearm vigorously until warm before testing at this site.” 2. “The fingertip is preferred for glucose monitoring if hyperglycemia is suspected.” 3. “I have to make sure that my current glucose monitor can be used at an alternate site.” 4. “Alternate site testing is unsafe if I am experiencing a rapid change in glucose levels.” 75. Which adaptations should the nurse caring for a client with diabetic ketoacidosis expect the client to exhibit? Select all that apply: 1. Sweating 2. Low PCO2 3. Retinopathy 4. Acetone breath 5. Elevated serum bicarbonate 76. All of the following statements about Hashimoto's disease are true accept: a. Many patients are entirely asymptomatic b. Not all patients become hypothyroid c. Most cases of obesity are attributable to Hashimoto's disease d. Hypothyroidism may be subclinical 77. The most common benign tumor of the pituitary gland is a: a. Glioma b Prolactinoma c. Carcinoid tumor d. Islet cell tumor . 78.12. Symptoms of polycystic ovarian syndrome (PCOS) may include all of the following except: a. Pelvic pain b. Acne, oily skin, and dandruff c. Infertility d. Weight Loss 79. Women with PCOS are at increased risk for all of the following except: a. Pregnancy b. Diabetes c. Cardiovascular disease d. Metabolic syndrome 80. All of the following organs may be affected by multiple endocrine neoplasia type 1 except: a. Parathyroid glands b. Kidneys c. Pancreas and Duodenum d. Pituitary gland 81. What is the treatment for hyperparathyroidism? a. Synthetic thyroid hormone b. Desiccated thyroid hormone c. Surgical removal of the glands d. Calcium and phosphate 82. The most common causes of death in people with cystic fibrosis is: a. Dehydration b. Opportunistic infection c. Lung cancer d. Respiratory failure 83. Untreated hyperthyroidism during pregnancy may result in all of the following except: a. Premature birth and miscarriage b. Low birth weight c. Autism d. Preeclampsia 84. Short stature and undeveloped ovaries suggest which of the following disorders: a. Polycystic ovarian syndrome b. Prolactinoma c. Grave's disease d. Turner syndrome 85. Endocrine disorders may be triggered by all of the following except: a. Stress b. Infection c. Chemicals in the food chain and environment d. Cell phone use 86. An analysis of data from the Women's Health Initiative questioned the use of which therapy to prevent heart disease? a. Synthetic thyroid hormone b. Oral contraceptives c. Weight-loss drugs d. Postmenopausal hormone replacement therapy 87. The parathyroid glands play a major role in regulating which substances? A. Calcium and Phosphorus B. Chloride and potassium C. Potassium and calcium D. Sodium and potassium a. Calcium and Phosphorus 88. The primary function of insulin is to: A. Lower blood glucose levels B. Produce melanin C. regulate the body’s metabolic rate D. stimulate release of digestive enzymes 89. A client is admitted to the hospital with a medical DX of hyperthyroidism. When taking a history which information would be most significant? A. edema, intolerance to cold, lethargy b. peri-orbital edema, lethargy mask like face c. weight loss, intolerance to cold, muscle wasting d. weight loss, intolerance to heat, exophthalmos 90. Which nursing action is most appropriate for a client in ketoacidosis? a. admin of carbs b. admin of IV fluids c. applying cold compress d. giving glucagon IV 91. The nurse smells a sweet fruity odor on the breath of a client admitted with DM. This odor may be associated with? a. alcohol intoxication b. insulin shock c. ketoacidosis 92. A client asks what the purpose of the Hb A1c test is. The nurses best explanation would be that the test measures the average: a. blood sugar lvl's over a 6-10 week period b. hemoglobin lvl's over a 6 - 10 week period c. protein lvl over a 3 month period d. vanillylmandelic acid lvl's 93. Which of the following would be a nursing priority for a client just DX with Addison's disease? a. avoiding unnecessary activity b. encouraging client to wear a med alert tag c. ensuring the client is adequately hydrated d. explaining that the client will need lifelong hormone therapy 94. A nurse is caring for a client in the late stage of Ketoacidosis. The nurse notices that the clients’ breath has a characteristic fruity odor. Which of the following substances is responsible for the fruity smell in the breath? a. iodine b. acetone ol d. glucose 95. A nurse is caring for a client with Addison's disease. Which of the following nursing considerations should be employed when caring for this client? a. avoid sodium in the clients diet b. monitor and protect skin integrity c. document the specific gravity of urine d. monitor increases in blood pressure 96. A nurse is assigned to care for and monitor any complications in a 40 yr client with chronic diabetes. Which of the following is a macrovascular complication of diabetes? a. neuropathy b. retinopathy c. nephropathy d. Arteriosclerosis 97. A nurse is instructing a 50yr diabetic client about the steps to be followed for self admin of insulin. Which of the following instructions should be included in the client teaching? a. instruct client to avoid injections to the abdomen b. encourage client to always inject insulin in the same site c. inform client about the type of syringe to use d. encourage client to do active exercise after injection 98. A nurse is preparing a diet plan for a 50yr with simple goiter. Which of the following should be included in the client’s diet to decrease the enlargement of the thyroid gland? a. iodine b. sodium c. potassium d. calcium 99. A nurse is caring for a 60yr client affected with hypoparathyroidism. When checking the lab report, the nurse finds the clients’ calcium level was very low. Which of the following vitamins regulates the calcium level in the body? a. A b. D c. E d. K 100. A client presents to the emergency room with a history of Graves' disease. The client reports having symptoms for a few days, but has not previously sought or received any additional treatment. The client also reports having had a cold a few days back. Which of the following interventions would be appropriate to implement for this client, based on the history and current symptoms? Select all that apply. A. Administer aspirin B. Replace intravenous fluids C. Induce shivering D. Relieve respiratory distress E. Administer a cooling blanket 101. Select the member of the healthcare team that is paired with one of the main functions of this team member. A. Occupational therapist: Gait exercises B. Physical therapist: The provision of assistive devices to facilitate the activities of daily living C. Speech and language therapist: The treatment of swallowing disorders D. Case manager: Ordering medications and treatments 102. The recommended daily caloric intake for sedentary older men, active adult women and children is: A. 2400 calories B. 1600 calories C. 2800 calories D. 2000 calories 103. Ill health, malnutrition, and wasting as a result of chronic disease are all associated with: A. Surgical asepsis B. Catabolism C. Cachexia D. Venous stasis 104. Select all the possible opportunistic infections that adversely affect HIV/AIDS infected patients. A. Visual losses B. Kaposi’s sarcoma C. Wilms’ sarcoma D. Tuberculosis E. Peripheral neuropathy F. Toxoplasma gondii 105. What can help reduce a patient’s anxiety and postsurgical pain? A. Preoperative teaching B. Preoperative checklist C. Psychological counseling D. Preoperative medication 106. Which disease decreases the metabolic rate? A. Cancer B. Hypothyroidism C. Chronic obstructive pulmonary disease D. Cardiac failure 107. When caring for an infant during cardiac arrests, which pulse must be palpated to determine cardiac function? A. Carotid B. Brachial C. Pedal D. Radial 108. The patient should be sitting when deep breathing and coughing because this position: A. Is physically more comfortable for the patient B. Helps the patient to support their incision with a pillow C. Loosens respiratory secretions D. Allows the patient to observe their area and relax 109. Which procedures necessitate the use of surgical asepsis techniques? Select all that apply. A. Intramuscular medication administration B. Central line intravenous medication administration C. Donning gloves in the operating room D. Neonatal bathing E. Foley catheter insertion F. Emptying a urinary drainage bag 110. What is the ultimate purpose and goal of performance improvement activities? A. To increase efficiency B. To contain costs C. To improve processes D. To improve policies 111. The primary difference between practical nursing licensure and a nursing certification in an area of practice is that nursing licensure is: A. Insures competency and a nursing certification validates years of experience. B. Mandated by the American Nurses Association and a nursing certification are not. C. Is legally mandated by the states and a nursing certification is not. D. Renewed every two years and a nursing certification is renewed every five years. 112. What intervention is the best to relieve constipation during pregnancy? A. Increasing the consumption of fruits and vegetables B. Taking a mild over-the-counter laxative C. Lying flat on back when sleeping D. Reduction of iron intake by half or more 113. You are the RN working on 2 easts with adult medical surgical patients. Your unit has been instructed to perform a horizontal evacuation of your patients because there is a fire on 1 east. Where will you evacuate your patients to? A. 3 west B. 3 east C. 2 west D. 1 west 114. Which electrolyte is essential for enzyme and neurochemical activities? A. Chloride B. Magnesium C. Potassium D. Phosphate 115. Number the choices below to reflect the correct sequence for using a fire extinguisher: A. Aim at the base of the fire (2) B. Squeeze the handle (3) C. Sweep back and forth (4) D. Pull the pin (1) 116. As you are working you suspect that another licensed practical nurse is verbally and physically abusing a patient. What is the first thing that you will do? A. Nothing because you are not certain that it is occurring B. Nothing because you only suspect the abuse C. Call the police or the security department D. Report your suspicions to the charge nurse 117. Which of the following is the World Health Organization’s (WHO) definition of health? A. The absence of all illness and disease B. The absence of any comorbidity C. A holistic state of wellbeing D. A use of health promotion activities 118. Which nursing theorist believes that most patients are capable of performing self-care? A. Dorothea Orem B. Madeleine Leininger C. Martha Rogers D. Sister Callista Roy 119. What element is minimally assessed during a basic prenatal physical examination? A. Palpation and auscultation of the abdomen B. Examination of the anus and rectum C. Urinalysis for glucose, protein and ketones D. Visual assessment of cervix and vagina 120. A positive over-the-counter pregnancy test is considered a: A. Possible sign of pregnancy. B. Presumptive sign of pregnancy. C. Probable sign of pregnancy. D. Positive sign of pregnancy. 121. Select all of the signs and symptoms of hyperthyroidism. A. Thickened bodily hair B. Heat intolerance C. Constipation D. Insomnia E. Increased appetite F. Palpitations G. Cold skin 122. During which phase of the nursing process does data get collected and validated with the patient and/or family members by the nurse? A. The implementation phase B. The assessment phase C. The evaluation phase D. The planning phase 123. Which of the following is the best worded expected outcome? A. “The nurse will provide for adequate hydration” B. “The nurse will insure that the patient is safe” C. “The patient will cough and deep breathe every two hours” D. “The patient will value health” 124. What is a major difference between a problems oriented medical record and a source oriented medical record? A. The problem oriented medical system has a centralized part of the chart for interdisciplinary progress notes and the source oriented medical record has separate areas for each profession’s progress notes. B. The problem oriented medical system consists of narrative progress notes and the source oriented medical record uses SOAP. C. The source oriented medical system uses charting by exception and the source oriented medical record system does not. D. The source oriented medical system has a centralized part of the chart for interdisciplinary progress notes and the problem oriented medical record has separate areas for each profession’s progress notes. 125. Which of the following are necessary elements of malpractice? Select all that apply. A. A breach of duty B. An intentional act C. A nonintentional act D. Forseeability E. Patient harm F. Causation 126. Select the following fire emergency interventions in correct sequential order. A. Pull the fire alarm. (2) B. Contain the fire. (3) C. Rescue patients in danger.(1) D. Extinguish the fire. (4) 127. After your patient has been told that they have Cushing’s syndrome, the patient asks you what Cushing’s syndrome is. How would you respond to this patient’s question? A. “Cushing’s syndrome is a type of irritable bowel syndrome.” B. “Cushing’s syndrome is a disorder of the adrenal gland.” C. “Cushing’s syndrome often occurs among patients who are getting radiation therapy.” D. “Cushing’s syndrome often occurs among patients who are chemotherapy.” 128. You are preparing a sterile field for a operating room surgical procedure. When should you stop the preparation of this sterile field? A. When you have placed a sterile item only 1 inch and not 2 inches from the edge of the sterile field B. When you have completely finished the field. You cannot stop the set up until it is all done. C. When you have accidentally poured a sterile liquid into a container that was on the sterile field D. When you turn your upper body only away from the field because the surgeon calls your name 129. Avulsed teeth should be placed in: A. Normal saline. B. Cold water. C. Milk. D. Warm water. 130. You are working in a pediatric unit of the hospital and caring for a six year old boy who is hospitalized with cystic fibrosis and respiratory compromise. Which developmental task is the challenge for this boy at his age? A. To cough, deep breathe and improve respiratory status B. To establish industry and self confidence C. To develop autonomy and self-control D. To develop initiative and a sense of purpose 131. The embryonic period during pregnancy takes place from: A. Weeks 1 to 12. B Weeks 1 to 10. C.Weeks 3 to 5. D.Weeks 6 to 10. 132. Place these human needs in order from the greatest priority to the least priority using # 1 as the greatest priority and # 5 as the least of all in terms of priority. A. Self-esteem and esteem by others 4 B. Self-actualization 5 C. Psychological needs 2 D. Love and belonging 3 E. Physiological needs 1 133. During which week does the fetal heart begin pumping its own blood? A. 3rd week B. 5th week C. 9th week D. 6th week 134. Which of the following is a vector of infection? A. A contaminated ball B. A contaminated thermometer C. An infected person D. An infectious fly 135. Which oral disorder appears as yellow or white spots on the oral mucosa that are not possible to scrape off without bleeding? A. Herpes simplex B. Candidiasis C. Alphthous ulcers D. Leukoplakia 136. Which type of cancer has the poorest prognosis? A. Squamous cell carcinoma B. Breast cancer C. Pancreatic cancer D. Gastric cancer 137. States throughout our nation vary somewhat in terms of things that nursing assistants can and cannot legally do. Which statements about these states to state differences are accurate? Select all that apply. A. Nursing assistants can change catheter tubing’s but not catheters B. Nursing assistants can change sterile dressings C. Nursing assistants have an expanding role in many states. D. Nursing assistants cannot assess the physical status of the patients. E. Nursing assistants can apply topical medication lotions to intact skin. F. The trend is moving toward nurses only staffing patterns. 138. A cesarean mode of delivery, often utilized for various reasons, is the most common mode for females with which pelvic type? A. Android B. Anthropoid C. Gynecoid D. Platypelloid 139. How many bones make up a newborn’s skull? A. 8 B. 4 C. 6 D. 5 140. Your patient has just returned from the diagnostic imaging department and the doctor has told the patient that they have a Mallory-Weiss tear. The patient asks you what a Mallory-Weiss tear is. How should you respond to this patient? A. “A Mallory-Weiss tear is a kind of diverticulitis.” B. “A Mallory-Weiss tear is an esophageal tear” C. “A Mallory-Weiss tear is a lacrimal gland disorder.” D. “A Mallory-Weiss tear is a tear that results from a peptic ulcer.” 141. You have been asked to speak at a new nursing assistants' orientation class about infection control and hand washing techniques. What would you include in this teaching? A. Demonstrate the correct one minute hand washing procedure using soap and running water. B. Demonstrate the correct 2 minute hand washing procedure using soap and running water. C. Using hot water so that the natural fats on the skins are emulsified with the soap. D. Using cold water so that the natural fats on the skins are emulsified with the soap. 142. How many minims are contained in 1 milliliter? Between 10-11 12 20 Between 15 or 16 143. Peri wound maceration occurs when: A. The skin around the wound softens and is damaged. B. Selecting a dressing individualized to the type of wound. C. Negative-pressure to “air out” the wound is used. D. The skin around the wound dries out and hardens. 144. Which patient is at greatest risk for cholelithiasis and choledocholithiasis? A. A 70-year-old male patient who has liver disease B. A 70-year-old female patient who has liver disease C. A 50-year-old male patient who is Asian D. A 50-year-old female patient who is Asian 145. Select the method of special precautions that is accurately paired with the personal protective equipment that is minimally required in order to prevent the spread of infection. A. Contact precautions: Gowns, gloves and mask B. Droplet precautions: Face mask C. Airborne transmission precautions: Negative pressure room D. Contact precautions: Gloves 146. Which statement about Meniere’s disease is accurate and true? A. Meniere’s disease most commonly occurs among members of the elderly population. B. Meniere’s disease is insidious and it always affects both ears. C. Meniere’s disease occurs with an impairment of the second cranial nerve. D. Antiemetic drugs are used for the treatment of patients affected with Meniere’s disease. 147. Which of these patients is affected with a healthcare acquired infection? A. A 18-year-old male patient who developed a intravenous line infection two days after insertion B. A 72-year-old male patient who is at risk for infection secondary to AIDS/HIV C. A 67-year-old female patient who was admitted with a urinary tract infection D. A 5-year-old pediatric patient who develops the measles rash 3 days after admission 148. The stages of infection in correct sequential order are: A. The prodromal, incubation, illness and convalescence stages B. The incubation, prodromal, illness and convalescence stages C. The prodromal, primary, secondary and tertiary stages D. The inflammation, infection and immunity stages 149. What is the single most important thing that nurses do in order to prevent the spread of infection? A. Applying standard precautions B. Using personal protective equipment C. Adhering to the principles of asepsis D. Hand washing 150. Rh negative maternal blood indicates: A. An incompatibility in the blood between the mother and fetus. B. That antibodies in the mother’s blood are attacking her baby’s blood. C. The mother will require a blood transfusion at the time of delivery. D. The mother does not have a specific marker on her red blood cells. 151. Which cardiac arrhythmia can be either acquired or congenital and can spontaneously disappear on its own or lead to ventricular fibrillation? A. Wenckebach B. Premature arterial contractions C. Torsade de pointes D. Premature ventricular contractions 152. Which quality assurance or performance improvement technique is used to identify underlying process flaws? A. Small group process B. Root cause analysis C. People at fault process D. Cause and effect 153. Which legal document will most likely contain the patient’s decision to not get cardiopulmonary resuscitation? A. Healthcare surrogacy B. Healthcare proxy C. Advance directives D. Durable power of attorney 154. Select the stage of a pressure ulcer that is accurately pair with its characteristics. A. Stage I: Only slight blanching when pressure is applied to the skin. B. Stage II: The epidermis and part of the dermis is damaged or lost. C. Stage III: The wound has slough and eschar. D. Stage IV: The loss of skin usually exposes some fat. 155. You have been assigned to care for a neonate who has been diagnosed with the Tetralogy of Fallot. The mother asks you what the Tetralogy of Fallot is. How should you respond to this mother? A. “The Tetralogy of Fallot is a congenital gastrointestinal disorder” B. “The Tetralogy of Fallot is a congenital cardiac disorder” C. “The Tetralogy of Fallot will affect the baby’s reflexes” D. “The Tetralogy of Fallot will affect the baby’s ability to breastfeed” 156. The protrusion of an internal organ through a wound or surgical incision is referred to as: A. Serosanguineous. B. Dehiscence. C. Evisceration. D. Exuded. 157. Which pain assessment scale is used exclusively for infants and neonates from 32 weeks of gestation to six months of age? A. The PEPPS pain scale B. The FLACC pain scale C. The Faces pain scale D. The CRIES pain scale 158. Which of the following is a hazard of immobility? A. Loss of bone calcium B. Increased vital capacity C. Venous vasoconstriction D. A positive nitrogen balances 159. How many daily feedings are considered normal for a newborn? A. 8 to 10 B. 10 to 12 C. 6 to 8 D. 12 to 14 160. The hormone produces mother’s milk is: A. Progesterone B. Estrogen. C. Prolactin. D. Colostrum. 161. Which of the following is a life-threatening acute complication of diabetes mellitus? A. Neuropathy B. Hypoglycemia C. Retinopathy D. Impaired microcirculation 162. Sutures and staples are typically removed following surgery within: A. 7 to 10 days if healing is considered adequate. B. 10 to 14 days if healing is considered adequate. C. 7 to 10 days if no further dressings are needed. D. 10 to 14 days if no further dressings are needed. 163. Which of these breath sounds is considered normal and not adventitious? A. Vesicular breath sounds B. Fine rales C. Rhonchi D. Wheezes 164. Which type of burn leads to the greatest degree of pain? A. A first-degree burn B. A second-degree burn C. A third-degree burn D. A fourth-degree burn 165. Babies should double their birth weight by the: A. 5th to 6th month. B. 3rd to 4th month. C. 4th to 5th month. D. 5th to 7th month. 166. Which of the following is best for a client who has difficulty swallowing and chokes frequently? A. A liquid diet. B. Tilting the head back when swallowing. C. Tucking the chin in when swallowing. D. Following each bite with a drink of water. 167. How long can women lactate for? A. Indefinitely B. 12 to 18 months C. 18 to 24 months D. 30 to 36 months 168. Which anatomic malformations are associated with the Tetralogy of Fallot? A. A sub-aortic septal defect, an overriding aorta, left ventricular hypertrophy, and right ventricular outflow B. A sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and left ventricular outflow C. A sub-aortic septal defect, an overriding aorta, pulmonary atresia, and right ventricular outflow D. A sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and right ventricular outflow 169. Your 32-year-old female patient has erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac problems and skin nodules. What disorder would you most likely suspect based on these signs and symptoms? A. Leukemia B. Histoplasmosis C. Pneumocystis jirovec D. Rheumatoid arthritis 170. Select the cranial nerve that is accurately paired with its name. A. The first cranial nerve: The trochlear nerve B. The twelfth cranial nerve: The hypoglossal nerve C. The tenth cranial nerve: The olfactory nerve D. The thirteenth cranial nerve: The auditory nerve 171. Round off these numbers to the nearest tenth: A. 5.5778 = _5.6________ B. 1.027 = ___1______ C. 62.999 = ____63_____ D. 55.123 = _55.1________ 96.676 = _96.7________ 172. The doctor has ordered 500 mg of a medication po once a day. The tablets on hand are labeled as 1 tablet = 250 mg. How many tablets will you administer to your patient? A. 1 Tablet B. 2 Tablets C. 3 Tablets D. 4 Tablets 173. Which patient is exercising their right to autonomy in the context of patient rights? A. An 86-year-old female who remains independent in terms of the activities of daily living. B. An unemancipated 16-year-old who chooses to not have an intravenous line. C. A 32-year-old who does not need the help of the nurse to bathe and groom themselves. D. A 99-year-old who wants CPR despite the fact that the nurse and doctor do not think that it would be successful. 174. The mnemonic “PERLA” is useful for the assessment of the eyes. What does PERLA stand for? A. Pupils equally reactive to light and accommodation B. Patient eyes are equally recessed and responsive to light and acuity C. Patient eyes are equally responsive to light and acuity D. Pupils equally reactive to light and acuity 175. You are performing a neurological assessment of your adolescent patient. The patient has the Moro reflex. How should you interpret this neurological assessment finding? A. It is normal among adolescents. B. It indicates that the patient has an intact peripheral nervous system. C. It indicates that the patient has an intact central nervous system. D. It is not a normal finding. 176. Which patient is most at risk for Osgood-Schlatter disease? A. An elderly female who is hospitalized with a hip fracture and on bed rest B. A middle-aged male patient who has been exposed to asbestos in the shipping industry C. An adolescent who is physically active and the captain of their soccer team D. An infant of low birth weight and a gestational age of 28 weeks 177. Your client is adversely affected with fever, night sweats, occult hematuria, tenderness of the spleen and Osler’s nodes. What disorder would you most likely suspect? A. Tuberculosis B. AIDS/HIV C. Pericarditis D. Endocarditis 178. Your pediatric weighs 15.8 kg. How many pounds does this child weigh? A. 36 pounds B. 33.6 pounds C. 35 pounds D. 34.8 pounds 179. An episiotomy is: A. A surgical incision of the perineum to prevent tearing during delivery. B. Releasing the red plug from the cervix just before crowning occurs. C. An incision in the abdomen with which the baby can be delivered through. D. The severance of the umbilical cord between mother and child. 180. How many calories per kilogram does an average full-term infant require when the infants is around 1-2 months old? A. 140 calories per kilogram per day B. 120 calories per kilogram per day C. 100 calories per kilogram per day D. 160 calories per kilogram per day 181. What are the six levels of consciousness from the most to the least responsive level of consciousness? Number all six using 1 as the most conscious and 6 as the least conscious. A. Obtunded B. Confused C. Lethargic D. Comatose E. Stuporous F. Alert 182. Select the stage of shock that is accurately paired with its characteristic. A. The initial stage of shock: Hyperventilation occurs and the blood pH rises. B. The compensatory stage of shock: Hypoxia occurs and lactic acid rises. C. The progressive stage of shock: Histamine is released; fluid and proteins leak into surrounding tissues and the blood thickens. D. The refractory stage of shock: Potassium ions leak out; sodium ions build up and metabolic acidosis increases. 183. The doctor has ordered 1,000 cc of intravenous fluid every 8 hours. You will be using intravenous tubing that delivers 20 cc/drop. At what rate will you adjust the intravenous fluid flow? _____ gtts per minute. A. 38 gtts/min B. 42 gtts/min C. 50 gtts/min D. 40 gtts/min 184. During which stage of anesthesia is a patient most likely to experience involuntary motor activity? A. Stage I B. Stage II C. Stage III D. Stage VI 185. Select all of the risk factors that are associated with deep vein thrombosis. A. The use of oral contraceptives B. Type B and O blood C. Rh negative blood D. Obesity E. Nulliparity F. Leukemia 186. Most water leaves the body by way of the: A. Lungs. B. Intestines. C. Skin. D. Kidneys. 187. Which statement about glaucoma is true and accurate? A. Acute angle-closure glaucoma is an ocular emergency. B. Acute angle-closure glaucoma leads to the loss of peripheral vision and tunnel vision. C. Primary open-angle glaucoma leads to eye pain, nausea and vomiting, blurry vision and halos. D. Bubbles are implanted to protect the retina from the glaucoma. 188. A cavity containing pus surrounded by inflamed tissue is: A. Cellulitis. B. An abscess. C. Extravasation. D. An adhesion. 189. The doctor has ordered 20 cc an hour of normal saline intravenously for your pediatric patient. You will be using pediatric intravenous tubing that delivers 60 cc per drop. How many drops per minute will you administer using this pediatric intravenous set? Fill in the blank. ____ drops per minute. A. 30 drops per minute B. 25 drops per minute C. 20 drops per minute D. 22 drops per minute 190. What does the mnemonic device ABCDE stand for? A. Allergy, bleeding, chemicals, dietary, environment B. Allergy, bleeding, cardio, diabetes, endocrine C. Allergy, bleeding, cardio, digestive, endocrine D. Allergy, bleeding, cortisone, diabetes, emboli 191. Which of the following assessment tools is used to determine the patients’ level of consciousness? A. The Snellen Scale B. The Norton Scale C. The Morse Scale D. The Glasgow Scale 192. Wilms’ tumor is a form of: A. Renal cancer. B. Liver cancer. C. Basal cell carcinoma. D. Brain cancer. 193. You will be reinforcing teaching and instructing the patient. Which basic principle of teaching should you follow? A. Sequence the instruction from the least complex to the most complex. B. Assume that the patient knows little or nothing about the topic. C. Tell the patient to call their significant other so you can instruct them. D. Use medically oriented terms so the patient will be able to speak with the doctor. 194. As you are administering penicillin intravenously, you determine that the patient becomes hypotensive and with a bounding, rapid pulse rate. What is the first thing that you would do? A. Decrease the rate of the intravenous medication flow. B. Increase the rate of the intravenous medication flow. C. Call the doctor. D. Stop the intravenous flow. 195. Your patient has a blood potassium level of 9.2 mEq/L. What intervention should you anticipate for this patient? A. Intravenous potassium supplementation B. Intravenous calcium supplementation C. Kidney dialysis D. Parenteral nutrition 196. Which of the following foods enhances the absorption of an iron supplement? A. Orange juice B. Green beans C. Fortified Milk D. Baked potato 197. Select a myth or falsehood relating to pain, pain management and addiction. A. Addiction can be accurately predicted. B. Withdrawal, drug tolerance and physical dependence do not indicate addiction. C. Pain medications can be used with patients who have a substance abuse history. D. Addiction is signaled when the client employs deception and stockpiling. 198. What is the expected date of delivery for the woman who has had their last menstrual period on April 20th? A. January 20th B. January 27th C. January 29th D. January 31st 199. Clumsiness, difficulty running, climbing, and riding a bicycle are some of the earliest signs and symptoms of: A. Duchenne’s muscular dystrophy B. Osteomyelitis C. Talipes or clubfoot D. Septic joint, supportive arthritis 200. Which statement about adjuvant medications is true and accurate? A. Licensed practical nurses cannot administer adjuvant medications. B. Adjuvant medications are schedule 2 narcotics. C. Adjuvant medications are schedule 1 narcotics. D. Adjuvant medications can be purchased over the counter. 201. Which nonpharmacological technique entails the use of electronic monitoring equipment while the patient controls basic bodily mechanisms? A. Meditation B. Visualization C. Biofeedback D. Chiropractic 202. Which of the following is considered normal for the neonate? A. Chest Circumference: 10 to 13 inches B. Length: 16 to 22 inches C. Weight: 1,500 to 4,000 g D. Head Circumference: 12.6 to 14.5 inches 203. Your patient has been diagnosed with giant cell arthritis. What medication will this patient most likely be given? A. High doses of aspirin B. High doses of prednisone C. Methotrexate D. Albuterol 204. The wound irrigation process cleanses the wound and: A. Reduces the potential of pain in the wound region or area. B. Stops the spread of infection by way of magnifying the “clean” area. C. Pushes extravasated blood from a hematoma into nearby healthy tissue. D. Allows for the introduction of medications in solution form. 205. You are caring for a four-year-old female patient who was severely burned in a house fire. How would you determine the extent of this child’s burns? A. By using the Lund and Browder chart B. By using the Rule of Nines C. By using the Rule of Tens D. By using the Parkland Formula 206. Your client has a doctor’s order that reads “advance diet as tolerated”. This client has returned from the recovery room after an appendectomy and he states, “I am hungry”. What would you offer this client to consume? A. Cheese and crackers B. Apple sauce C. Chicken broth D. A peanut butter sandwiches 207. Idiopathic thrombocytopenia purpura is: A. Highly similar to disseminated intravascular coagulation (DIC). B. Caused by the over production of platelets. C. A bleeding disorder that is characterized with too few platelets. D. Treated with immune system boosting medications. 208. Select the type of skeletal fracture that is correctly paired with its description. A. A complete fracture: The fractured bone penetrates through the skin to the skin surface. B. A pathological fracture: A fracture that results from some physical trauma. C. A greenstick fracture: This bends but does not fracture the bone. D. An avulsion fracture: A fracture that pulls a part of the bone from the tendon or ligament 209. Select the criteria that is accurately paired with its indication of birth weight or gestational age. A. Low birth weight: The neonate’s weight is less than 1,500 g at the time of delivery. B. Appropriate for gestational age: The neonate’s weight ranges from the 10th to the 90th percentile. C. Large for gestational age: The neonate’s weight is above the 99th percentile. D. Small for gestational age: The neonate’s weight is below the 20th percentile. 210. Diabetes insipidus is the result of: A. A diet high in sugar and carbohydrates. B. A complicated pregnancy. C. A disorder of the pancreas. D. A disorder of the pituitary gland. 211. Which position will you place your patient in when they are demonstrating the signs and symptoms of hypovolemic shock? A. The Trendelenburg positions B. The supine position C. The left lateral position D. The right lateral position 212. the fine, down-like hairs on the newborn’s ears, shoulders, lower back, and/or forehead are known as: A. Vernix. B. Lanugo. C. Milia. D. Vibrissae. 213. What is the softening and thinning of the cervix during labor known as? A. Dilation B. Symphysis C. Effacement D. Hyperplasia 214. Which of the following joints normally has 360-degree circumflexion? A. The knee B. The shoulder C. The elbow D. The finger tips 215. Which healthcare associated infection is the greatest risk for patients? A. Pneumonia B. Catheter related infections C. Intravenous line infections D. C. difficile 216. Select the nursing theorist who is accurately paired with the theory or model of nursing that they are credited with. A. The Twelve Nursing Problems: Faye Glenn Abdullah B. The Nature of Nursing: Imogene King C. The Goal Attainment Theory: Virginia Henderson D. The Interpersonal Relations Model: Hildegard Peplau 217. Which technique or method is used to determine whether or not the patient has an irregular pulse? A. Apical pulse B. Inspection C. Auscultation D. Percussion 218. Select the tactile sensation that is accurately paired with its description or procedure for testing. A. Fine motor coordination: The use of the fingers B. Stereognosis: Equal hearing in both ears C. Two-point discrimination: The nurse gently pricks the patient’s skin D. Gross motor function: The use of the lower limbs 219. Which is considered an internal disaster? A. A patient fall B. The massive spread of pneumonia C. A computer hacking episode D. Unexpected staff absences due to illness 220. Who is credited with the stages of cognitive development? A. Erikson B. Piaget C. Freud D. Lister 221. You are working on a pediatric unit. Which toy or other diversional item or activity is most appropriate for your 18-month-old patient? A. A story books B. A beach balls C. An interactive play session with other children less than 2 years of age D. Pickup sticks 222. You are caring for a patient who has no cognitive functioning but only basic human functions such opening the eyes and the sleep – wake cycle. What level of consciousness does this patient have? A. Obtunded B. A persistent vegetative state C. Locked in syndrome D. Brain death 223.A client with diabetes experiences Somogyi's effect. To prevent this complication, the nurse should instruct the client to: A. Take his insulin each day at 1400 hours B. Engage in physical activity daily C. Increase the amount of regular insulin D. Eat a protein and carbohydrate snack at bedtime 224. A client with type 1 DM has a finger stick glucose level of 258mg/dl at bedtime. An order for sliding scale insulin exists. The nurse should: 1. Call the physician 2. Encourage the intake of fluids 3. Administer the insulin as ordered 4. Give the client ½ c. of orange juice 225. The physician orders 36 units of NPH and 12 units of regular insulin. The nurse plans to administer these drugs in 1 syringe. Identify the steps in this procedure by listing them in priority order. ANS: 1324 1. Inject air equal t