1. A patient hospitalized with severe depression and suicidal ideation refuses to talk with the nurse. The nurse recognizes that the suicidal patient has difficulty:
A. Expressing feelings of low self-worth
B. Discussing remorse and guilt for actions
C. Displaying dependence on others
D. Expressing anger toward others
2. A patient receiving hydrochlorothiazide is instructed to increase her dietary intake of potassium. The best snack for the patient requiring increased potassium is:
A. Pear
B. Apple
C. Orange
D. Banana
3. The nurse is caring for a patient following removal of the thyroid. Immediately post-op, the nurse should:
A. Maintain the patient in a semi-Fowler’s position with the head and neck supported by pillows
B. Encourage the patient to turn her head side to side, to promote drainage of oral secretions
C. Maintain the patient in a supine position with sandbags placed on either side of the head and neck
D. Encourage the patient to cough and breathe deeply every 2 hours, with the neck in a flexed position
4. A patient hospitalized with chronic dyspepsia is diagnosed with gastric cancer. Which of the following is associated with an increased incidence of gastric cancer
A. Dairy products
B. Carbonated beverages
C. Refined sugars
D. Luncheon meats
5. A patient is sent to the psychiatric unit for forensic evaluation after he is accused of arson. His tentative diagnosis is antisocial personality disorder. In reviewing the patient’s record, the nurse could expect to find:
A history of consistent employment
B. A below-average intelligence
C. A history of cruelty to animals
D. An expression of remorse for his actions
6. The licensed vocational nurse may not assume the primary care for a patient:
A. In the fourth stage of labor
B. Two days post-appendectomy
C. With a venous access device
D. With bipolar disorder
7. The physician has ordered dressings with Sulfamylon cream for a patient with full-thickness burns of the hands and arms. Before dressing changes, the nurse should give priority to:
A. Administering pain medication
B. Checking the adequacy of urinary output
C. Requesting a daily complete blood count
D. Obtaining a blood glucose by finger stick
8. The nurse is teaching a group of parents about gross motor development of the toddler. Which behavior is an example of the normal gross motor skill of a toddler?
A. She can pull a toy behind her.
B. She can copy a horizontal line.
C. She can build a tower of eight blocks.
D. She can broad-jump.
9. A patient hospitalized with a fractured mandible is to be discharged. Which piece of equipment should be kept on the patient with a fractured mandible?
A. Wire cutters
B. Oral airway
C. Pliers
D. Tracheostomy set
10. The nurse is to administer digoxin elixir to a 6-month-old with a congenital heart defect. The nurse auscultates an apical pulse rate of 100. The nurse should:
A. Record the heart rate and call the physician
B. Record the heart rate and administer the medication
C. Administer the medication and recheck the heart rate in 15 minutes
D. Hold the medication and recheck the heart rate in 30 minutes
11. A mother of a 3-year-old hospitalized with lead poisoning asks the nurse to explain the treatment for her daughter. The nurse’s explanation is based on the knowledge that lead poisoning is treated with:
A. Gastric lavage
B. Chelating agents
C. Antiemetics
D. Activated charcoal
12. An 18-month-old is scheduled for a cleft palate repair. The usual type of restraints for the child with a cleft palate repair are:
A. Elbow restraints
B. Full arm restraints
C. Wrist restraints
D. Mummy restraints
13. A patient with glaucoma has been prescribed Timoptic (timolol) eyedrops. Timoptic should be used with caution in the patient with a history of:
A. Diabetes
B. Gastric ulcers
C. Emphysema
D. Pancreatitis
14. An elderly patient who experiences nighttime confusion wanders from his room into the room of another patient. The nurse can best help decrease the patient’s confusion by:
A. Assigning a nursing assistant to sit with him until he falls asleep
B. Allowing the patient to room with another elderly patient
C. Administering a bedtime sedative
D. Leaving a nightlight on during the evening and night shifts
15. Which of the following is a common complaint of the patient with end-stage renal failure?
A. Weight loss
B. Itching
C. Ringing in the ears
D. Bruising
16. Which of the following medication orders needs further clarification?
A. Darvocet 65 mg PO q 4–6 hrs. PRN
B. Nembutal 100 mg PO at bedtime
C. Coumadin 10mg PO
D. Estrace 2 mg PO q day
17. The best diet for the patient with Meniere’s syndrome is one that is:
A. High in fiber
B. Low in sodium
C. High in iodine
D. Low in fiber
18. Which of the following findings is associated with right-sided heart failure?
A. Shortness of breath
B. Nocturnal polyuria
C. Daytime oliguria
D. Crackles in the lungs
19. An 8-year-old admitted with an upper-respiratory infection has an order for O2 saturation via pulse oximeter. To ensure an accurate reading, the nurse should:
A. Place the probe on the child’s abdomen
B. Calibrate the oximeter at the beginning of each shift
C. Apply the probe and wait 15 minutes before obtaining a reading
D. Place the probe on the child’s finger
20. An infant with Tetralogy of Fallot is discharged with a prescription for lanoxin elixir. The nurse should instruct the mother to:
A. Administer the medication using a nipple
B. Administer the medication using the calibrated dropper in the bottle
C. Administer the medication using a plastic baby spoon
D. Administer the medication in a baby bottle with 1oz. of water
21. The patient scheduled for electroconvulsive therapy tells the nurse, “I’m so afraid. What will happen to me during the treatment?” Which of the following statements is most therapeutic for the nurse to make?
A. “You will be given medicine to relax you during the treatment.”
B. “The treatment will produce a controlled grand mal seizure.”
C. “The treatment might produce nausea and headache.”
D. “You can expect to be sleepy and confused for a time after the treatment.”
22. Which of the following skin lesions is associated with Lyme’s disease?
A. Bull’s eye rash
B. Papular crusts
C. Bullae
D. Plaques
23. Which of the following snacks would be suitable for the child with gluten-induced enteropathy?
A. Soft oatmeal cookie
B. Buttered popcorn
C. Peanut butter and jelly sandwich
D. Cheese pizza
24. A patient with schizophrenia is receiving chlorpromazine (Thorazine) 400mg twice a day. An adverse side effect of the medication is:
A. Photosensitivity
B. Elevated temperature
C. Weight gain
D. Elevated blood pressure
25. Which information should be given to the patient taking phenytoin (Dilantin)?
A. Taking the medication with meals will increase its effectiveness.
B. The medication can cause sleep disturbances.
C. More frequent dental appointments will be needed for special gum care.
D. The medication decreases the effects of oral contraceptives.
26. A patient with a history of emboli is receiving Lovenox (enoxaparin). Which drug is given to counteract the effects of enoxaparin
A. Calcium gluconate
B. Aquamephyton
C. Methergine
D. Protamine sulfate
27. The nurse is formulating a plan of care for a patient with a cognitive disorder. Which activity is most appropriate for the patient with confusion and short attention span?
A. Taking part in a reality-orientation group
B. Participating in unit community goal setting
C. Going on a field trip with a group of patients
D. Meeting with an assertiveness training group
28. The mother of a child with hemophilia asks the nurse which over-the-counter medication is suitable for her child’s joint discomfort. The nurse should tell the mother to purchase:
A. Advil (ibuprofen)
B. Tylenol (acetaminophen)
C. Aspirin (acetylsalicylic acid)
D. Naproxen (naprosyn)
29. Which home remedy is suitable to relieve the itching associated with varicella?
A. Dusting the lesions with baby powder
B. Applying gauze saturated in hydrogen peroxide
C. Using cool compresses of normal saline
D. Applying a paste of baking soda and water
30. A newborn male has been diagnosed with hypospadias with chordee. The nurse understands that the infant will have altered patterns of urination because:
A. The urinary meatus is on the dorsum of the penis.
B. The ureters will reflux urine into the kidneys.
C. The urinary meatus is on the top of the penis.
D. The bladder lies outside the abdominal cavity
31. The recommended time for administering Zantac (ranitidine) is:
A. Before breakfast
B. Midafternoon
C. After dinner
D. At bedtime
32. Which statement best describes the difference between the pain of angina and the pain of myocardial infarction?
A. Pain associated with angina is relieved by rest.
B. Pain associated with myocardial infarction is always more severe.
C. Pain associated with angina is confined to the chest area.
D. Pain associated with myocardial infarction is referred to the left arm.
33. The nurse is developing a bowel-retraining plan for a patient with multiple sclerosis. Which measure is likely to be least helpful to the patient:
A. Limiting fluid intake to 1000 mL per day
B. Providing a high-roughage diet
C. Elevating the toilet seat for easy access
D. Establishing a regular schedule for toileting
34. The nurse is providing dietary teaching for a patient with Meniere’s disease. Which statement indicates that the patient understands the role of diet in triggering her symptoms?
A. “I can expect to see more problems with tinnitus if I eat a lot of dairy products.”
B. “I need to limit foods that taste salty or that contain a lot of sodium.”
C. “I can help control problems with vertigo if I avoid breads and cereals.”
D. “I need to eat fewer foods that are high in potassium, such as raisins and bananas.”
35. The nurse is assessing a multigravida, 36 weeks gestation for symptoms of pregnancy-induced hypertension and preeclampsia. The nurse should give priority to assessing the patient for:
A. Facial swelling
B. Pulse deficits
C. Ankle edema
D. Diminished reflexes
36. An adolescent with borderline personality is hospitalized with suicidal ideation and self-mutilation. Which goal is both therapeutic and realistic for this patient?
A. The patient will remain in her room when feeling overwhelmed by sadness.
B. The patient will request medication when feeling loss of emotional control.
C. The patient will leave group activities to pace when feeling anxious.
D. The patient will seek out a staff member to verbalize feelings of anger and sadness.
37. A patient with angina has an order for nitroglycerin ointment. Before applying the medication, the nurse should:
A. Apply the ointment to the previous application
B. Obtain both a radial and an apical pulse
C. Remove the previously applied ointment
D. Tell the patient he will experience pain relief in 15 minutes
38. The nurse is caring for a patient who is unconscious following a fall. Which comment by the nurse will help the patient become reoriented when he regains consciousness?
A. “I am your nurse and I will be taking care of you today.” B. “Can you tell me your name and where you are?” C. “I know you are confused right now, but everything will be alright.” D. “You were in an accident that hurt your head. You are in the hospital.”
39. Following a generalized seizure, the nurse can expect the patient to:
A. Be unable to move the extremities
B. Be drowsy and prone to sleep
C. Remember events before the seizure
D. Have a drop in blood pressur
40. A patient with oxalate renal calculi should be taught to avoid eating:
A. Strawberries
B. Oranges
C. Apples
D. Pears
41. A 6-year-old is diagnosed with Legg-Calve Perthes disease of the right femur. An important part of the child’s care includes instructing the parents:
A. To increase the amount of dietary protein
B. About exercises to strengthen affected muscles
C. About relaxation exercises to minimize pain in the joints
D. To prevent weight bearing on the affected leg
42. The nurse is assessing an infant with Hirschsprung’s disease. The nurse can expect the infant to:
A. Weigh less than expected for height and age
B. Have a scaphoid-shaped abdomen
C. Exhibit clubbing of the fingers and toes
D. Have hyperactive deep tendon reflexes
43. The physician has prescribed supplemental iron for a prenatal patient. The nurse should tell the patient to take the medication with:
A. Milk, to prevent stomach upset
B. Tomato juice, to increase absorption
C. Oatmeal, to prevent constipation
D. Water, to increase serum iron levels
44. The nurse is teaching a patient with a history of obesity and hypertensionregarding dietary requirements during pregnancy. Which statement indicates that the patient needs further teaching?
A. “I need to reduce my daily intake to 1,200 calories a day.”
B. “I need to drink at least a quart of milk a day.”
C. “I shouldn’t add salt when I am cooking.”
D. “I need to eat more protein and fiber each day.”
45. An elderly patient is admitted to the psychiatric unit from the nursing home. Transfer information indicates that the patient has become confused and disoriented, with behavioral problems. The patient will also likely show a loss of ability in:
A. Speech
B. Judgment
C. Endurance
D. Balance
46. The physician has ordered an external monitor for a laboring patient. If the fetus is in the left occipital posterior (LOP) position, the nurse knows that the ultrasound transducer will be located:
A. Near the symphysis pubis
B. Near the umbilicus
C. Over the fetal back
D. Over the fetal abdomen
47. A patient develops tremors while withdrawing from alcohol. Which medication is routinely administered to lessen physiological effects of alcohol withdrawal?
A. Dolophine (methadone)
B. Klonopin (clonazepam)
C. Narcan (Naloxone)
D. Antabuse (disulfiram)
48. A patient with Type II diabetes has an order for regular insulin 10 units SC each morning. The patient’s breakfast should be served within:
A. 15 minutes
B. 20 minutes
C. 30 minutes
D. 45 minutes
49. A 10-year-old has an order for Demerol (meperidine) 35 mg IM for pain. The medication is available as Demerol 50mg per ml. How much should the nurse administer?
A. 0.5mL
B. 0.6mL
C. 0.7mL
D. 0.8mL
50. Which antibiotic is contraindicated for the treatment of infections in infants and young children?
A. Tetracyn (tetracycline)
B. Amoxil (amoxicillin)
C. Cefotan (cefotetan)
D. E-Mycin (erythromycin)
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