NURS 4431 EXAM 1 PREP | 105 QUESTIONS AND
ANSWERS | 2025/2026 UPDATE | WITH ACTUAL
SOLUTIONS
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.
ANSWERS | 2025/2026 UPDATE | WITH ACTUAL
SOLUTIONS
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.
