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Practice Test 4

1. The primary reason for rapid continuous rewarming of the area affected by frostbite is
to:
A. Lessen the amount of cellular damage
B. Prevent the formation of blisters
C. Promote movement
D. Prevent pain and discomfort
2. A client recently started on hemodialysis wants to know how the dialysis will take the
place of his kidneys. The nurses response is based on the knowledge that hemodialysis
works by:
A. Passing water through a dialyzing membrane
B. Eliminating plasma proteins from the blood
C. Lowering the pH by removing nonvolatile acids
D. Filtering waste through a dialyzing membrane
3. During a home visit, a client with AIDS tells the nurse that he has been exposed to
measles. Which action by the nurse is most appropriate?
A. Administer an antibiotic
B. Contact the physician for an order for immune globulin
C. Administer an antiviral
D. Tell the client that he should remain in isolation for 2 weeks
4. A client hospitalized with MRSA (methicillin-resistant staph aureus) is placed on contact
precautions. Which statement is true regarding precautions for infections spread by
contact?
A. The client should be placed in a room with negative pressure.
B. Infection requires close contact; therefore, the door may remain open.
C. Transmission is highly likely, so the client should wear a mask at all times.
D. Infection requires skin-to-skin contact and is prevented by hand washing, gloves, and a gown.
5. A client who is admitted with an above-the-knee amputation tells the nurse that his foot
hurts and itches. Which response by the nurse indicates understanding of phantom limb
pain?
A. The pain will go away in a few days.
B. The pain is due to peripheral nervous system interruptions. I will get you some pain
medication.
C. The pain is psychological because your foot is no longer there.
D. The pain and itching are due to the infection you had before the surgery.
6. A client with cancer of the pancreas has undergone a Whipple procedure. The nurse is
aware that during the Whipple procedure, the doctor will remove the:
A. Head of the pancreas
B. Proximal third section of the small intestines
C. Stomach and duodenum
D. Esophagus and jejunum

7. The physician has ordered a minimal-bacteria diet for a client with neutropenia. The
client should be taught to AVOID eating:
A. Packed fruits
B. Salt
C. Fresh raw pepper
D. Ketchup
8. A client is discharged home with a prescription for Coumadin (sodium warfarin). The
client should be instructed to:
A. Have a Protime done monthly
B. Eat more fruits and vegetables
C. Drink more liquids
D. Avoid crowds
9. The nurse is assisting the physician with removal of a central venous catheter. To
facilitate removal, the nurse should instruct the client to:
A. Perform the Valsalva maneuver as the catheter is advanced
B. Turn his head to the left side and hyperextend the neck
C. Take slow, deep breaths as the catheter is removed
D. Turn his head to the right while maintaining a sniffing position
10. A client has an order for streptokinase. Before administering the medication, the nurse
should assess the client for:
A. Allergies to pineapples and bananas
B. A history of streptococcal infections
C. Prior therapy with phenytoin
D. A history of alcohol abuse
11. The nurse is providing discharge teaching for the client with leukemia. The client
should be told to avoid:
A. Using oil- or cream-based soaps
B. Flossing between the teeth
C. The intake of salt
D. Using an electric razor
12. The nurse is changing the ties of the client with a tracheotomy. The safest method of
changing the tracheotomy ties is to:
A. Apply the new tie before removing the old one.
B. Have a helper present.
C. Hold the tracheotomy with the non-dominant hand while removing the old tie.
D. Ask the doctor to suture the tracheostomy in place.
13. The nurse is monitoring a client following a lung resection. The hourly output from the
chest tube was 300mL. The nurse should give priority to:
A. Turning the client to the left side
B. Milking the tube to ensure patency
C. Slowing the intravenous infusion
D. Notifying the physician

14. The infant is admitted to the unit with tetrology of falot. The nurse would anticipate an
order for which medication?
A. Digoxin
B. Epinephrine
C. Aminophylline
D. Atropine
15. The nurse is educating the ladys club in self-breast exam.
The nurse is aware that most malignant breast masses occur in
the Tail of Spence. On the diagram below, select where the Tail
of Spence is.

16. The toddler is admitted with a cardiac anomaly. The nurse is aware that the infant with
a ventricular septal defect will:
A. Tire easily
B. Grow normally
C. Need more calories
D. Be more susceptible to viral infections
17. The nurse is monitoring a client with a history of stillborn infants. The nurse is aware
that a nonstress test can be ordered for this client to:
A. Determine lung maturity
B. Measure the fetal activity
C. Show the effect of contractions on fetal heart rate
D. Measure the wellbeing of the fetus

18. The nurse is evaluating the client who


was admitted 8 hours ago for induction of
labor. The following graph is noted on the
monitor. Which action should be taken first
by the nurse?
A. Instruct the client to push
B. Perform a vaginal exam
C. Turn off the Pitocin infusion
D. Place the client in a semi-Fowlers position

19. The nurse notes the following on the ECG monitor. The nurse would evaluate the
cardiac arrhythmia as:

A. Atrial flutter
B. A sinus rhythm
C. Ventricular tachycardia
D. Atrial fibrillation

20. A client with clotting disorder has an order to continue Lovenox (enoxaparin) injections
after discharge. The nurse should teach the client that Lovenox injections should:
A. Be injected into the deltoid muscle
B. Be injected into the abdomen
C. Aspirate after the injection
D. Clear the air from the syringe before injections

21. The nurse has a preop order to administer Valium (diazepam) 10mg and Phenergan
(promethazine) 25mg. The correct method of administering these medications is to:
A. Administer the medications together in one syringe
B. Administer the medication separately
C. Administer the Valium, wait 5 minutes, and then inject the Phenergan
D. Question the order because they cannot be given at the same time
22. A client with frequent urinary tract infections asks the nurse how she can prevent the
reoccurrence. The nurse should teach the client to:
A. Douche after intercourse
B. Void every 3 hours
C. Obtain a urinalysis monthly
D. Wipe from back to front after voiding
23. Which task should be assigned to the nursing assistant?
A. Placing the client in seclusion
B. Emptying the Foley catheter of the pre-eclamptic client
C. Feeding the client with dementia
D. Ambulating the client with a fractured hip
24. The client has recently returned from having a thyroidectomy. The nurse should keep
which of the following at the bedside?
A. A tracheotomy set
B. A padded tongue blade
C. An endotracheal tube
D. An airway
25. The physician has ordered a histoplasmosis test for the elderly client. The nurse is
aware that histoplasmosis is transmitted to humans by:
A. Cats
B. Dogs
C. Turtles
D. Birds
26. Whats the first intervention for a patient experiencing chest pain and an p02 of 89%?
A. Administer morphine.
B. Administer oxygen.
C. Administer sublingual nitroglycerin.
D. Obtain an electrocardiogram (ECC)
27. Which of the following signs and symptoms usually signifies rapid expansion and
impending rupture of an abdominal aortic aneurysm?
A. Abdominal pain.
B. Absent pedal pulses.
C. Chest pain.
D. Lower back pain.

28. In which of the following types of cardiomyopathy does cardiac output remain normal?
A. Dilated.
B. Hypertrophic.
C. Obliterative.
D. Restrictive.
29. Which of the following interventions should be your first priority when treating a
patient experiencing chest pain while walking?
A. Have the patient sit down.
B. Get the patient back to bed.
C. Obtain an ECG.
D. Administer sublingual nitroglycerin.
30. Which of the following positions would best aid breathing for a patient with acute
pulmonary edema?
A. Lying flat in bed.
B. Left side-lying position.
C. High Fowlers position.
D. Semi-Fowlers position.
31. A pregnant woman arrives at the emergency department (ED) with abruptio
placentae at 34 weeks gestation. Shes at risk for which of the following blood dyscrasias?
A. Thrombocytopenia.
B. Idiopathic thrombocytopenic purpura (ITP).
C. Disseminated intravascular coagulation (DIC).
D. Heparin-associated thrombosis and thrombocytopenia (HATT).
32. A 16-year-old patient involved in a motor vehicle accident arrives in the ED
unconscious and severely hypotensive. Hes suspected to have several fractures of his pelvis
and legs. Which of the following parenteral fluids is the best choice for his current
condition?
A. Fresh frozen plasma.
B. 0.9% sodium chloride solution.
C. Lactated Ringers solution.
D. Packed red blood cells.
33. Corticosteroids are potent suppressors of the bodys inflammatory response. Which of
the following conditions or actions do they suppress?
A. Cushing syndrome.
B. Pain receptors.
C. Immune response.
D. Neural transmission.
34. A patient infected with human immunodeficiency virus (HIV) begins zidovudine
therapy. Which of the following statements best describes this drugs action?
A. It destroys the outer wall of the virus and kills it.
B. It interferes with viral replication.
C. It stimulates the immune system.
D. It promotes excretion of viral antibodies.

35. A 20-year-old patient is being treated for pneumonia. He has a persistent cough and
complains of severe pain on coughing. What could you tell him to help him reduce his
discomfort?
A. Hold your cough as much as possible.
B. Place the head of your bed flat to help with coughing.
C. Restrict fluids to help decrease the amount of sputum.
D. Splint your chest wall with a pillow for comfort.
36. A 19-year-old patient comes to the ED with acute asthma. His respiratory rate is 44
breaths/minute, and he appears to be in acute respiratory distress. Which of the following
actions should you take first?
A. Take a full medical history.
B. Give a bronchodilator by nebulizer.
C. Apply a cardiac monitor to the patient.
D. Provide emotional support for the patient.
37. A firefighter who was involved in extinguishing a house fire is being treated for smoke
inhalation. He develops severe hypoxia 48 hours after the incident, requiring intubation
and mechanical ventilation. Which of the following conditions has he most likely
developed?
A. Acute respiratory distress syndrome (ARDS).
B. Atelectasis.
C. Bronchitis.
D. Pneumonia.
38. Which of the following measures best determines that a patient who had a
pneumothorax no longer needs a chest tube?
A. You see a lot of drainage from the chest tube.
B. Arterial blood gas (ABG) levels are normal.
C. The chest X-ray continues to show the lung is 35% deflated.
D. The water-seal chamber doesnt fluctuate when no suction is applied.
39. Which of the following nursing interventions should you use to prevent foot drop and
contractures in a patient recovering from a subdural hematoma?
A. High-top sneakers.
B. Low-dose heparin therapy.
C. Physical therapy consultation.
D. Sequential compressive device.
40. Which of the following signs of increased intracranial pressure (ICP) would appear first
after head trauma?
A. Bradycardia.
B. Large amounts of very dilute urine.
C. Restlessness and confusion.
D. Widened pulse pressure.

41. When giving intravenous (I.V.) phenytoin, which of the following methods should you
use?
A. Use an in-line filter.
B. Withhold other anticonvulsants.
C. Mix the drug with saline solution only.
D. Flush the I.V. catheter with dextrose solution.
42. After surgical repair of a hip, which of the following positions is best for the patients
legs and hips?
A. Abduction.
B. Adduction.
C. Prone.
D. Subluxated.
43. Which of the following factors should be the primary focus of nursing management in a
patient with acute pancreatitis?
A. Nutrition management.
B. Fluid and electrolyte balance.
C. Management of hypoglycemia.
D. Pain control.
44. After a liver biopsy, place the patient in which of the following positions?
A. Left side-lying, with the bed flat.
B. Right side-lying, with the bed flat.
C. Left side-lying, with the bed in semi-Fowlers position.
D. Right side-lying, with the bed in semi-Fowlers position.
45. Which of the following potentially serious complications could occur with therapy for
hypothyroidism?
A. Acute hemolytic reaction.
B. Angina or cardiac arrhythmia.
C. Retinopathy.
D. Thrombocytopenia.
46. Adequate fluid replacement and vasopressin replacement are objectives of therapy for
which of the following disease processes?
A. Diabetes mellitus.
B. Diabetes insipidus.
C. Diabetic ketoacidosis.
D. Syndrome of inappropriate antidiuretic hormone secretion (SIADH).
47. Patients with Type 1 diabetes mellitus may require which of the following changes to
their daily routine during periods of infection?
A. No changes.
B. Less insulin.
C. More insulin.
D. Oral diabetic agents.

48. On a follow-up visit after having a vaginal hysterectomy, a 32-year-old patient has a
decreased hematocrit level. Which of the following complications does this suggest?
A. Hematoma.
B. Hypovolemia.
C. Infection.
D. Pulmonary embolus (PE).
49. A patient has partial-thickness burns to both legs and portions of his trunk. Which of
the following I.V. fluids is given first?
A. Albumin.
B. D5W.
C. Lactated Ringers solution.
D. 0.9% sodium chloride solution with 2 mEq of potassium per 100 ml.
50. Which of the following techniques is correct for obtaining a wound culture specimen
from a surgical site?
A. Thoroughly irrigate the wound before collecting the specimen.
B. Use a sterile swab and wipe the crusty area around the outside of the wound.
C. Gently roll a sterile swab from the center of the wound outward to collect drainage.
D. Use a sterile swab to collect drainage from the dressing.