1.

The client with a major burn injury

receives total parenteral nutrition (TPN).
The primary reason for this therapy is to
help:
a. Correct water and electrolyte imbalance.
b. Allow the gastrointestinal tract to rest.
c. Provide supplemental vitamins and minerals.
d. Ensure adequate caloric and protein intake.
2. The client asks the nurse what the word
eschar means. Which of the following
descriptions by the nurse best defines eschar?
a. Eschar is scar tissue in a developmental stage.
b. Eschar is crust formation without a blood
supply.
c. Eschar is burned tissue that has become
infected.
d. Eschar is visible living tissue with a rich blood
supply.
3. The nurse is administering fluids
intravenously as prescribed to a client who
sustained superficial partial-thickness burn
injuries of the back and legs. In evaluating the
adequacy of fluid resuscitation, the nurse
understands that which of the following would
provide the most reliable indicator for
determining the adequacy?
a. Vital signs
b. Urine output
c. Mental status
d. Peripheral pulses
4. The client asks the nurse what causes a
peptic ulcer to develop. The nurse responds
that recent research indicates that many
peptic ulcers are the result of which of the
following?
a. Work-related stress
b. Helicobacter pylori infection
c. Diets high in fat
d. A genetic defect in the gastric mucosa
5. The nurse instructs the client who has had
a hemorrhoidectomy not to use sitz baths
until at least 12 hours postoperatively to
avoid inducing which of the following
complications?
a. Haemorrhage
b. Rectal spasm
c. Urine retention
d. Constipation
6. When the clients common bile duct is
obstructed, the nurse should evaluate the
client for signs and symptoms of which of
the following complications?
a. Respiratory distress
b. Circulatory overload
c. Urinary tract infection
d. Prolonged bleeding time
7. A 40-year-old client is admitted to the hospital
with a diagnosis of abdominal pain. Following
numerous diagnostic tests, it is concluded that the
client has acute cholecystitis. The nurse should
contact the physician to question which of the
following orders?
a. I.V. fluid therapy of normal saline solution to be
infused at 100 mL/hr until further orders
b. Administer morphine sulphate 10 mg I.M. every 4
hours as needed for severe abdominal pain
c. Nothing by mouth (NPO) until further orders
d. Insert a nasogastric tube and connect to low
intermittent suction
8. A client undergoes a traditional cholecystectomy
and choledocholithotomy and returns from
surgery with a T-tube. To evaluate the effectiveness
of the T-tube, the nurse should understand that the
primary reason for the T-tube is to accomplish
which of the following?
a. Promote wound drainage
b. Provide a way to irrigate the biliary tract
c. Minimize the passage of bile into the duodenum
d. Prevent bile from entering the peritoneal cavity
9. The nurse evaluates the clients most recent
laboratory data. Which laboratory finding would
be consistent with a diagnosis of acute
pancreatitis?
a. Hyperglycemia
b. Leukopenia
c. Thrombocytopenia
d. Hyperkalemia
10. The nurse carefully monitors the client with
acute pancreatitis for which of the following
complications?
a. Heart failure
b. Duodenal ulcer
c. Cirrhosis
d. Pneumonia
11. Pancreatic enzyme replacements are ordered
for a client with chronic pancreatitis. What should
the nurse instruct the client to take them to obtain
the most therapeutic effect?
a. Three times daily between meals
b. With each meal and snack
c. In the morning and at bedtime
d. Every four hours at specified times
12. The nurse is providing medication instructions to a
client with breast cancer who is receiving
cyclophosphamide (Cytoxan, Neosar). The nurse tells the
client to:
a. Take the medication with food.
b. Increase fluid intake to 2000 to 3000 mL daily.
c. Decrease sodium intake while taking the medication.
d. Increase potassium intake while taking the
medication.
13. The client with nonHodgkin's lymphoma is receiving
daunorubicin (DaunoXome). Which of the following
would indicate to the nurse that the client is experiencing
a toxic effect related to the medication?
a. Fever
b. Diarrhea
c. Complaints of nausea and vomiting
d. Crackles on auscultation of the lungs
14. The client with squamous cell carcinoma of the larynx
is receiving bleomycin (Blenoxane) intravenously. The
nurse caring for the client anticipates that which
diagnostic study will be prescribed?
a. Echocardiography
b. Electrocardiography
c. Cervical radiography
d. Pulmonary function studies
15. The client with lung cancer is receiving a high
dose of methotrexate (Rheumatrex, Trexall).
Leucovorin (citrovorumfactor, folic acid) is also
prescribed. The nurse caring for the client
understands that the purpose of administering the
leucovorin is to:
a. Preserve normal cells.
b. Promote DNA synthesis.
c. Promote medication excretion.
d. Promote the synthesis of nucleic acids.
16. Which goal for the clients care should take
priority during the first days of hospitalization for
an exacerbation of ulcerative colitis?
a. Promoting self-care and independence
b. Managing diarrhea
c. Maintaining adequate nutrition
d. Promoting rest and comfort
17. The client with ovarian cancer is being treated
with vincristine (Oncovin, Vincasar PFS). The nurse
monitors the client, knowing that which of the
following indicates a side effect specific to this
medication?
a. Diarrhea
b. Hair loss
c. Chest pain
d. Numbness and tingling in the fingers and toes
18. Tamoxifen (Nolvadex) is prescribed for the
client with metastatic breast carcinoma. The nurse
administering the medication understands that
the primary action of this medication is to:
a. Increase DNA and RNA synthesis.
b. Promote the biosynthesis of nucleic acids.
c. Increase estrogen concentration and estrogen
response.
d. Compete with estradiol for binding to estrogen
in tissues containing high concentrations of
receptors.
19. A female client with carcinoma of the breast is
admitted to the hospital for treatment with
intravenously administered doxorubicin
(Adriamycin). The client tells the nurse that she
has been told by her friends that she is going to
lose all her hair. The appropriate nursing response
is which of the following?
a. Your friends are correct.
b. You will not lose your hair.
c. Hair loss may occur, but it will grow back just
as it is now.
d. Hair loss may occur, and it will grow back, but
it may have a different color or texture.
20. The clinic nurse prepares instructions for a
client who developed stomatitis following the
administration of a course of antineoplastic
medications. The nurse tells the client to:
a. Rinse the mouth with baking soda or saline.
b. Avoid foods and fluids for the next 24 hours.
c. Swab the mouth daily with lemon and glycerin
pads.
d. Brush the teeth and use waxed dental floss
three times a day.
21. A patient comes to the hospital complaining of
sudden onset of sharp, severe pain originating in the
lumbar region and radiating around the side and toward
the bladder. The patient also reports nausea and vomiting
and appears pale, diaphoretic, and anxious. The doctor
tentatively diagnoses renal calculi and orders flat plate
abdominal x-rays. Renal calculi can form anywhere in the
urinary tract. What is there most common formation
site?
a. Kidney
b. Ureter
c. Bladder
d. Urethra
22. Which of the following reasons explains why
meperidine (Demerol) is not recommended for
chronic cancer-related pain?
a. It has a high potential for abuse
b. It has agonist-antagonist property.
c. It must be given intramuscularly to be
effective.
d. It contains a metabolite that causes seizure.
23. The initial diagnosis of pancreatitis is
confirmed if the clients blood work shows a
significant elevation in which of the
following serumvalues?
a. Amylase
b. Glucose
c. Potassium
d. Trypsin
24. The nurse should teach the client with
chronic pancreatitis to monitor the
effectiveness of pancreatic enzyme
replacement therapy by doing which of the
following?
a. Monitoring fluid intake.
b. Observing regular glucose fingerstick tests.
c. Observing stools for steatorrhea.
d. Testing urine for ketones.
25. The client with chronic pancreatitis
should be monitored closely for the
development of which of the following
disorders?
a. Cholelithiasis
b. Hepatitis
c. Irritable bowel syndrome
d. Diabetes mellitus
26. The physician orders oral neomycin as
well as neomycin enema for a client with
cirrhosis. The nurse understands that the
purpose of this therapy is to:
a. Reduce abdominal pressure
b. Preventing straining during defecation
c. Block ammonia formation
d. Reduce bleeding within the intestine
27. If a gallstone becomes dislodged in the
common bile duct, the nurse should
anticipate that the clients stools would most
likely become what color?
a. Green
b. Gray
c. Black
d. Brown
28. A nurse is preparing to hang the first bag
of total parenteral nutrition (TPN) solution
via the central line of an assigned client. The
nurse obtains which most essential piece of
equipment before hanging the solution?
a. Urine test strips
b. Blood glucose meter
c. Electronic infusion pump
d. Noninvasive blood pressure monitor
29. A client is to take one daily dose of
ranitidine (Zantac) at home to treat her
peptic ulcer. The nurse knows that the client
understands proper drug administration of
ranitidine when she says that she will take
the drug at which of the following times?
a. Before meals
b. With meals
c. At bedtime
d. When pain occurs
30. When caring the client who is receiving
an aminoglycoside antibiotic, the nurse
monitors which of the following laboratory
values?
a. Serum sodium
b. Serum potassium
c. Serum creatinine
d. Serum calcium