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Write your answers before the number. Use Capital letters. No erasure and retracing.
Which of the following actions, if performed by the nurse, would be considered negligence?
a. Obtaining a Guthrie blood test on a 4 day old infant.
b. Massaging lotion on the abdomen of a 3 year old diagnosed Wilms tumor.
c. Instructing a 5 year old asthmatic to blow on a pinwheel.
d. Playing kickball with a 10 year old with juvenile arthritis.
After receiving report, which of the following patients should the nurse see first?
a. A 14 year old patient in sickle cell crisis with an infiltrated IV.
b. A 59 year old patient with leukemia who has received half of a packed red cell transfusion.
c. A 68 year old patient scheduled for a bronchoscopy.
d. A 74 year old patient complaining of a leaky colostomy bag.
The nurse is caring for a patient with an acute myocardial infarction. Which of the following
laboratory findings would most concern the nurse?
a. Erythrocyte sedimentation rate(ESR):10mm/h
b. Hematocrit(Hct):42%
c. Creatine Kinase(CK):150U/ml
d. Serum glucose: 100mg/dL
The nurse is caring for a patient with a diagnosis of COPD, Bronchitis-type, in the long term care
facility. The patient is wheezing, and his oxygen saturation is 85%. 4 hours ago, the O2 saturation
was 88%. It is most important for the nurse to take which of the following actions?
a. Administer beclomethasone (Vanceril), two puffs per metered dose inhale.
b. Listen to breath sounds
c. Increase oxygen to 4L per mask.
d. Administer albuterol (Proventil), two puffs per metered dose inhaler.
The nurse is caring for patients in the outpatient clinic. A client tells the nurse that he developed
weakness and numbness in the legs the precious day and now his body feels the same way. The
clients blood pressure is 120/80, PR 86,RR 20. The client denies any pain but appears anxious to
the nurse. It would be most important for the nurse to ask which of the following questions?
a. have you recently fallen or had some other type of physical injury?
b. have you recently had a viral infection such as a cold?
c. Have you recently taken any over-the-counter medication?
d. Have you recently experienced headaches?
the physician orders heparin for a 46 year old woman, in order to evaluate the effectiveness of the
patients heparin therapy, the nurse should monitor which of the following laboratory values?
a. Platelet count
b. Clotting time
c. Bleeding time
d. Prothrombin time

7. The nurse cares for a patient receiving full strength Unsure by tube feeding. The nurse knows that
the MOST common complication of a tube feeding is
a. Edema
b. Diarrhea
c. Hypokalemia

d. Vomiting
8. To enhance the percutaneous absorption of nitroglycerine ointment, it would be most appropriate
for the nurse to select a site that is
a. Muscular
b. Near the heart
c. Non hairy
d. Over a bony prominence.
9. The nurse assists the physicians with the removal; of a chest tube. Before the physician removes
the chest tube, the nurse instruct the patient to
a. A. exhale and bear down
b. Hold his breath for 5 secs
c. Inhale and exhale rapidly
d. Cough as hard as he can.
10. When do coronary arteries primarily receive blood flow?

a. During inspiration
b. During diastole
c. During expiration
d. During systole
11. Atherosclerosis impedes coronary blood flow by which of the following mechanisms?
a. Plaques obstruct the vein.
b. Plaques obstruct the artery
c. Blood clots from outside vessel wall
d. Hardened vessels dilate to allow the blood to flow through
12. Which of the following is the most common symptom of myocardial infarction?
a. Chest pain
b. Dyspnea
c. Edema
d. Palpitations
13. Which of the following systems is the most likely origin of pain the client describes as
knifelike chest pain that increases in intensity with inspiration?
a. Cardiac
b. Gastrointestinal
c. Musculoskeletal
d. Pulmonary
14. What supplemental medication is most frequently ordered in conjuction with furosemide
a. Chloride
b. Digoxin
c. Potassium
d. sodium
15. After an anterior wall myocardial infarction, which of the following problems is indicated
by auscultation of crackles in the lungs?
a. Left sided heart failure
b. Pulmonic valve malfunction
c. Right sided heart failure
d. Tricuspid valve malfunction

Solve: the nurse calculates the IV flow rate for the postoperative patient. The patient is to receive 3000ml
of ringers Lactate solution IV to run over 24 hrs. the IV infusiomn set has a drop factor of 10 drops per
milliliter. The nurse should regulate the patients IV to deliver (a.) how many cc/hr? (b.) how many drops
per min?

Answer Key
1. B. manipulation of mass may cause dissemination of cancer cells. Obtain the Guthrie blood test,
no later than 7 days after delivery. Blowing of pinwheel serves as exercise that will extend
expiratory time and increase expiratory pressure.
2. A. IV fluids are critical to reduce clotting and pain. On a leukemic patient there is no indication
that he is unstable. On 68 and 74 year old patients are stable.
3. C. enzyme specific to brain, myocardium and skeletal muscles; indicates tissue necrosis or injury;
normal: men 12-70U/mL, women 10-55U/ml. ESR is for inflammation/necrosis; normal: men 115mm/h, women 1-20mm/h. Hct indicates that increased with dehydration and decreases with
fluid volume excess. Normal: M:40-45%, W:37-45%. Serum glucose indicates insulin

4. D. bronchodilator, relaxes bronchial smooth muscles. Administer bronchodilator first to open

passageways. The situation does not require further assessment. Increased O2 levels in patients
blood may lead to respiratory depression.
5. B. GBS often preceded by a viral infection as well as immunization/vaccinations. (a) is a
symptoms consistent with GBS but not related to injury. (c) has no association with symptoms.
(d) GBS affects peripheral, not central nervous system.
6. B. also known as partial thromboplastin time. Platelet evaluates platelet production and it is not
altered. Bleeding time detects platelet and vascular p[problems and not also altered. Prothrombin
time used to monitor Coumadin therapy.
7. B. intolerance to solution, rate; give slowly; other symptoms of intolerance N+V, aspiration,
glycosuria, diaphoresis. Edema is not frequently seen. If present physician change the formula to
contain less sodium. Hypokalemia is not commonly seen and vomiting can happen with rapid
increase in rate.
8. C. skin site free of hair will increase absorption; avoid distal part of extremities due to less than
maximal absorption.
9. A. Valsalva maneuver; increased intrathoracic pressure; occlusive dressing applied. Holding
breath and coughing hard is unnecessary. Inhaling and exhaling rapidly is unsafe.
10. B. although the coronary arteries may receive a minute portion of blood during systole, most of
the blood flow to coronary arteries is supplied during diastole. Breathing pattern is irrelevant to
blood flow.
11. B. Arteries, not veins, supply the coronary arteries with oxygen and other nutrients.
Atherosclerosis is a direct result of plaque formation in the artery. Hardened vessels can't dilate
properly and, therefore, constrict blood flow.
12. A. The most common symptom of an MI is chest pain, resulting from deprivation of oxygen to
the heart. Dyspnea is the second most common symptom, related to an increase in the metabolic
needs of the body during an MI. Edema is a later sign of heart failure, often seen after an MI.
Palpitations may result from reduced cardiac output, producing arrhythmias.
13. D. Pulmonary pain is generally described by these symptoms. Musculoskeletal pain only increase
with movement. Cardiac and GI pains don't change with respiration.
14. C. Supplemental potassium is given with furosemide because of the potassium loss that occurs as
a result of this diuretic. Chloride and sodium arent loss during diuresis. Digoxin acts to increase
contractility but isnt given routinely with furosemide.
15. A. The left ventricle is responsible for the most of the cardiac output. An anterior wall MI may
result in a decrease in left ventricular function. When the left ventricle doesnt function properly,
resulting in left-sided heart failure, fluid accumulates in the interstitial and alveolar spaces in the
lungs and causes crackles. Pulmonic and tricuspid valve malfunction causes right-sided heart


amount of solution 3000 cc

no of hours
24 h


amount of solution X drop factor 3000 x 10

no . of hours X 60
24 x 60

= 1440 =20.83=21 gtts /min