RENR PRACTICE TEST 10

1. A nurse is caring for a client who has a urinary tract infection. The client reports pain and a burning sensation
upon urination, and cloudy urine with an odor. Which of the following is the priority intervention by the nurse?
A. Offer a warm sitz bath.
B. Recommend drinking cranberry juice.
C. Encourage increased fluids.
D. Administer an antibiotic as prescribed.

2. A nurse is preparing educational material to present to a female client who has frequent urinary tract
infections (UTIs). Which of the following information should the nurse include?
i. Avoid sitting in a wet bathing suit.
ii. Wipe the perineal area back to front following elimination.
iii. Empty the bladder when there is an urge to void.
iv. Wear synthetic fabric underwear.
A. i and ii
B. ii and iii
C. i and iii
D. i and iv

3. The nurse is caring for a pregnant woman receiving an intravenous infusion with magnesium sulfate.
What is the most appropriate nursing intervention?
a. Count respirations and report a rate of less than 12 breaths/min.
b. Count respirations and report a rate of more than 20 breaths/min.
c. Check blood pressure and report a rate of less than 100/60 mm Hg.
d. Monitor urinary output and report a rate of less than 100 mL/hr.

4. A nurse on a medical unit is caring for several clients. Which of the following clients are NOT at risk for
developing pyelonephritis?
A. A client who is 32 weeks of gestation
B. A client who has kidney calculi
C. A client who has a urine pH of 4.2
D. A client who has a neurogenic bladder

5. Why are infants more vulnerable to fluid and electrolyte imbalances than adults?
a. They have a smaller surface area than adults in proportion to body weight.
b. Water needs and losses per kilogram are lower than those for adults.
c. A greater percentage of body water in infants is extracellular.
d. Infants have a lower metabolic turnover of water.

6. A nurse is completing the admission assessment of a client who has a kidney stone. Which of the following
is an expected finding?
A. Bradycardia
B. Diaphoresis
C. Nocturia
D. Bradypnea

7. A nurse is caring for a client who has a left renal calculus and an indwelling urinary catheter. Which of the
following assessment findings requires immediate intervention by the nurse?
A. Flank pain that radiates to the lower abdomen
B. Client report of nausea
C. Absent urine output for 2 hr
D. Client report of feeling sweaty

8. A nurse is reviewing discharge instructions with a client who had spontaneous passage of a calcium
phosphate kidney stone. Which of the following should NOT be included in the teaching?
A. Limit intake of food high in animal protein.
B. Reduce sodium intake.
C. Strain urine for 48 hr.
D. Report burning with urination to the provider.
9. The nurse is teaching parents of an infant about the causes of iron deficiency anemia. Which statement
best describes iron deficiency anemia in infants?
a. It is caused by depression of the hematopoietic system.
b. It is easily diagnosed because of an infants emaciated appearance.
c. Clinical manifestations are similar regardless of the cause of the anemia.
d. Clinical manifestations result from a decreased intake of milk and the premature addition of solid foods.

10. A nurse is completing discharge instructions with a client who has spontaneously passed a uric acid stone.
Which of the following foods should the nurse instruct the client to decrease in his diet?
i. organ meat
ii. poultry
iii. red wine
iv. peanuts
a. i and ii only
b. i, ii, and iii
c. iii and iv
d. i, ii, iii and iv

11. A nurse is preparing a client for her first Papanicolaou (Pap) test. Which of the following statements is
appropriate for the nurse to make?
A. “You should urinate immediately after the procedure is over.”
B. “You will not feel any discomfort.”
C. “You may experience some bleeding after the procedure.”
D. “You will need to hold your breath during the procedure.”

12. A nurse in a doctor’s office is reviewing a client’s laboratory results. The client’s rapid plasma reagin (RPR)
is positive. Which of the following tests confirm the diagnosis of syphilis?
A. Venereal Disease Research Laboratory (VDRL)
B. D-dimer
C. Treponema pallidum particle agglutination assay
D. Sickledex

13. A nurse in a clinic is reviewing the facility’s testing process and procedures for human immune deficiency
virus (HIV) with a new employee. Which of the following information should the nurse include in the review?
A. In the presence of HIV, the enzyme immunoassay (EIA) test is typically reactive within 72 hr after the client
is infected.
B. The Western blot assay is used to confirm the diagnosis of HIV.
C. The polymerase chain reaction (PRC) test is used to confirm the diagnosis of HIV.
D. In the presence of HIV the enzyme immunoassay (EIA) test is typically reactive within 48 hr after the client
is infected.

14. A nurse is providing instructions to a client before a mammogram. Which of the following should the nurse
instruct the client to avoid prior to the procedure?
A. Multivitamin
B. Deodorant
C. Sexual intercourse
D. Exercise

15. A nurse is providing instructions for a client who is scheduled for a cervical biopsy. Which of the following
should the nurse include in the instructions?
A. “The procedure is painless.”
B. “Heavy bleeding is common during the first 12 hours after the procedure.”
C. “Plan to rest for the first 72 hours after the procedure.”
D. “Avoid the use of tampons for 2 weeks after the procedure.”
16. A school nurse is providing an education session about menstruation with a group of adolescent female
students. Which of the following statements should the nurse include?
i. “The range for a typical menstrual cycle is between 21 and 42 days.”
ii. “The first day of the menstrual cycle begins with the last day of the menstrual period.”
iii. “Ovulation typically occurs around the 14th day of the menstrual cycle.”
iv. “It is not unusual for a menstrual period to last as long as 7 days.”
A. i , ii, iii
B. ii, iii, iv
C. i, iii, iv
D. i, ii, iv

17. A nurse in a doctor’s office is providing information to a client who has dysfunctional uterine bleeding
(DUB). Which of the following statements by the client indicate understanding of the information?
A. “My heavy bleeding may be due to a hormonal imbalance.”
B. “If I do not ovulate, my menstrual flow will be lighter.”
C. “Oral contraceptives are contraindicated for women who have heavy uterine bleeding like mine.”
D. “My condition is more common in women who are in their 30s.”

18. A nurse is reviewing the medical record of a client who has premenstrual syndrome (PMS). Which of the
following medications are NOT used to treat premenstrual syndrome?
A. Fluoxetine (Prozac)
B. Spironolactone (Aldactone)
C. Ethinyl estradiol/drospirenone (Yasmin)
D. Ferrous sulfate (Feosol)

19. A nurse is providing support to a client who has a recent diagnosis of endometriosis. The nurse should
reinforce with the client that which of the following conditions is a complication of endometriosis?
A. Insulin resistance
B. Infertility
C. Vaginitis
D. Pelvic inflammatory disease

20. A nurse is instructing a client how to perform Kegel exercises. Which of the following instructions should
the nurse NOT include?
A. Perform a set of exercises four times a daily.
B. Contract the circumvaginal and/or perirectal muscles.
C. Perform while sitting, lying, and standing.
D. Tighten abdominal muscles during contractions.

A 30 year old female was admitted to the medical ward with a history of cough, dyspnoea and wheezing. She is
a known asthmatic on Ventolin (salbutamol) inhaler, 2 puffs when needed. She is refusing to take the
medication because of the side effects. Questions 21 – 23.

21. Another common clinical manifestation of Asthma is:

a. Asphyxia
b. Bradycardia
c. Hypotension
d. Chest tightness

22. THE BEST response the nurse can give for the patient’s refusal to take the medication is
a. “What would you like us to do for you?”
b. “please sign the refusal of treatment form”
c. “right now you have no choice but to take it”
d. “ventolin dilates the bronchioles and will give you relief.”
23. Which of the following nursing diagnoses is of HIGHEST priority?
a. Activity intolerance related to asthma
b. Ineffective airway clearance related to thick secretion
c. Risk for dehydration related to decreased fluid intake
d. Ineffective breathing pattern related to narrowing of the airway

24. A nurse is reviewing the medical record of a client who has fibrocystic breast condition. Which of the
following is an expected finding?
a. Palpable rubberlike lump in the upper outer quadrant
b. BRCA1 gene mutation
c. An elevated CA-125
d. Peau d’orange dimpling of the breast

25. An older adult client is having an annual physical exam at a doctor’s office. Which of the following client
findings indicates additional follow-up is needed in regard to the prostate gland?
a. Prostate-specific antigen (PSA) is 7.1 ng/mL.
b. A digital rectal exam (DRE) reveals an enlarged prostate that is smooth and firm.
c. The client reports urinating once during the night.
d. Smegma is present below the glands of the penis.

26. A nurse is providing information to a client who is scheduled for a transrectal ultrasound (TRUS). Which of
the following information should the nurse include?
A. “This procedure will determine whether you have prostate cancer.”
B. “The doctor will insert a finger into your anus during the procedure.”
C. “Sound waves will be used to create a picture of your prostate.”
D. “An anesthetic will be used during the procedure.”

27. A nurse in a doctor’s office is obtaining a history from a client who is being evaluated for benign prostatic
hyperplasia (BPH). Which of the following findings is NOT indicative of this condition?
A. Backache
B. Frequent urinary tract infections
C. Hematuria
D. Urinary incontinence

28. A nurse is caring for a client who has a new diagnosis of benign prostatic hyperplasia (BPH). The nurse
should anticipate a prescription for which of the following medications?
A. Oxybutynin (Ditropan)
B. Diphenhydramine (Benadryl)
C. Ipratropium (Atrovent)
D. Tamsulosin (Flomax)

29. A nurse is instructing a client who is scheduled for a transurethral resection of the prostate (TURP) about his
postoperative care. Which of the following information should the nurse include in the teaching?
A. “You may have a continuous sensation of needing to void even though you have a catheter.”
B. “You will be on bed rest for the first 2 days after the procedure.”
C. “You will be instructed to limit your fluid intake after the procedure.”
D. “Your urine should be clear yellow the evening after the surgery.”

30. A nurse is providing teaching to a client who is scheduled for a bone scan. Which of the following
statements by the nurse is appropriate?
A. “The procedure will take about 1 hour.”
B. “You will be placed in a tube like structure during the procedure.”
C. “You will need to take precautions with your urine for 24 hours after the procedure.”
D. “A radioactive substance will be injected before the procedure.”
 A two year ole toddler has been diagnosed as having Tetralogy of Fallot. He has been admitted to the hospital
for management of his condition. Questions 31 – 34.

31. Which of the following structural changes DOES NOT occur in Tetralogy of Fallot?
a. Enlargement of the right atrium
b. Narrowing of the pulmonary artery
c. Defect in the septum between the atria
d. Defect in the septum between the ventricles

32. Which of the following modalities would be included in the management of this patient?
i. Chest x ray
ii. Morphine sulphate
iii. Electrocardiogram
iv. Cardiac catheterization
a. i, ii
b. i, iii
c. ii, iii
d. ii, iv

33. Which of the following instructions should be included when teaching the parents on home care
management to prevent complications in the client?
i. Ensure personal hygiene
ii. Maintain dental hygiene
iii. Avoid overexertion of child
iv. Ensure child receives a balanced diet
a. i, ii
b. i, iii
c. ii, iii
d. ii, iv

34. The child was placed on propranolol 10mgs. What are the desired actions of this drug?
i. Reduced heart rate
ii. Increased heart rate
iii. Decreased force of contraction
iv. Increased force of contraction
a. i, ii
b. i, iii
c. ii, iii
d. i, iv

35. An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed
precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are
most suggestive of:
A. Air emboli.
B. Allergic reaction.
C. Hemolytic reaction.
D. Circulatory overload.

36. A nurse is reviewing the health record of a client who is to undergo total joint arthroplasty. The nurse should
recognize which of the following findings as a contraindication to this procedure?
A. Age of 78
B. History of cancer
C. Previous joint replacement
D. Bronchitis 2 weeks ago
37. A nurse is admitting a client to the orthopedic unit following a total knee arthroplasty. Which of the
following actions by the nurse is NOT appropriate?
A. Maintain continuous passive motion device.
B. Palpate dorsopedal pulses.
C. Place pillow behind the knee.
D. Elevate heels off bed.

38. A nurse is planning discharge teaching for a client who had a total hip arthroplasty. Which of the following
should the nurse NOT include in the teaching?
A. Clean the incision daily with soap and water.
B. Turn the toes inward when sitting or lying.
C. Sit in a straight-backed armchair.
D. Use a raised toilet seat.

39. When assessing the fetus using Leopold maneuvers, the nurse feels a round, firm, movable fetal part in the
fundal portion of the uterus and a long, smooth surface in the mothers right side close to midline. What is the
likely position of the fetus?
a. ROA
b. LSP
c. RSA
d.LOA

40. The nurse recognizes that a woman is in true labor when she states:
a. I passed some thick, pink mucus when I urinated this morning.
b. My bag of waters just broke.
c. The contractions in my uterus are getting stronger and closer together.
d. My baby dropped, and I have to urinate more frequently now.

41. A nurse is presenting information to clients at a health fair on measures to reduce the risk of amputation. All
of the following are information the nurse should provide to the clients EXCEPT?
A. Encourage clients who smoke to consider smoking cessation programs.
B. Encourage clients who have diabetes mellitus to maintain blood glucose within the reference range.
C. Instruct clients to unplug electrical equipment when performing repairs.
D. Advise clients to drive heavy machinery after taking pain mediations.

42. A nurse is assessing an older adult client who has arteriosclerosis and is scheduled for a possible right lower
extremity amputation. Which of the following are NOT expected findings in the affected extremity?
A. Skin cool to touch from mid-calf to the toes
B. Lower leg appears dusky when client is sitting
C. Palpable pounding pedal pulse
D. Lack of hair on lower leg

43. A nurse is caring for a client following a below-the-elbow amputation. Which of the following is NOT an
appropriate action by the nurse?
A. Encourage dependent positioning of the residual limb.
B. Inspect for presence and amount of drainage.
C. Wrap the residual limb in a circular manner using gauze.
D. Assess for feelings of body image changes.

44. A client who had an above-the-knee amputation reports having sharp, stabbing type of phantom pain. Which
of the following is an appropriate action by the nurse?
A. Facilitate counseling services.
B. Encourage use of cold therapy.
C. Question whether the pain is real.
D. Administer an antiepileptic medication.
45. A nurse is preparing a plan of care to prevent a client from developing flexion contractions following a
below-the-knee amputation 24 hr ago. Which of the following should the nurse include in the plan of care?
A. Elevate the residual limb on a pillow.
B. Position the client prone several times each day.
C. Wrap the stump in a figure-eight pattern.
D. Encourage sitting in a chair during the day.

46. A nurse is admitting an older adult client who has suspected osteoporosis. Which of the following is NOT
an expected clinical finding?
A. History of consuming one glass of wine daily
B. Loss in height of 2 in (5.1 cm)
C. Body mass index (BMI) of 21
D. Kyphotic curve at upper thoracic spine

47. A nurse is performing health screenings of clients at a health fair. Which of the following clients is at the
LEAST risk for osteoporosis?
A. A 30-year-old client who jogs 3 miles daily
B. A 45-year-old client who takes phenytoin (Dilantin) for seizures
C. A 65-year-old client who has a sedentary lifestyle
D. A 70-year-old client who has smoked for 50 years

48. A nurse is planning discharge teaching on home safety for an older adult client who has osteoporosis. Which
of the following information should the nurse NOT include in the teaching?
A. Remove throw rugs in walkways.
B. Use prescribed assistive devices.
C. Remove clutter from the environment.
D. Walk with caution on wet surfaces.

49. A nurse is providing dietary teaching about calcium-rich foods to a client who has osteoporosis. Which of
the following foods should the nurse include in the instructions?
A. White bread
B. White beans
C. White meat or chicken
D. White rice

50. A nurse is providing care for a client who had a vertebroplasty of the thoracic spine. Which of the following
is an appropriate action by the nurse?
A. Apply heat to the client’s puncture site.
B. Place the client in a supine position.
C. Turn the client every 4 hr.
D. Ambulate the client within the first hour post-procedure.

51. Acute salicylate (ASA, aspirin) poisoning results in:

A. Chemical pneumonitis.
B. Hepatic damage.
C. Retractions and grunting.
D. Disorientation and loss of consciousness.

52. A tearful, anxious patient at the outpatient clinic reports, I should be dead. The initial task of the nurse
conducting the assessment interview is to:
A. Assess the lethality of a suicide plan.
B. Encourage expression of anger.
C. Establish a rapport with the patient.
D. Determine risk factors for suicide.
 A 52 year old engineer was admitted to Male Medical Ward from the Accident and Emergency Department. He
is extremely anxious and is complaining if nausea, weakness and a heavy squeezing pain in related to the
substernal area. On examination he is dyspnoeic and diaphoretic with a BP of 160/110 mm Hg, P 120 bpm, R 40
bpm. He is diagnosed with Angina Pectoris

53. Which of the following nursing diagnoses is most appropriate for the patient?
a. Decreased cardiac output related to decreased oxygen supply
b. Decreased cardiac output related to increased oxygen supply
c. Increased cardiac output related to decreased oxygen supply
d. Increased cardiac output related to increased oxygen supply

54. Which of the following investigation results would support this patient’s diagnosis of Angina Pectoris?
i. Increased leukocytes
ii. Increased haematocrit
iii. Increased haemoglobin
iv. Increased cardiac enzymes
a. i and ii
b. i and iv
c. ii and iii
d. ii and iv

55. The patient is prescribed nitroglycerine by transdermal patch. To which of the following sites should the
patch be applied?
a. Legs, back, chest
b. Thighs, legs, back
c. Chest, arms, shoulders
d. Chest abdomen, buttocks

56. This patient complains of shortness of breath. Which of the following interventions will be most
appropriate?
i. Nebulise with normal saline
ii. Place in a semi fowler’s position
iii. Administer oxygen 5 litres per minute
iv. Apply intermittent positive pressure ventilation with ambu bag
a. i and ii
b. i and iii
c. ii and iii
d. iii and iv
_______________________________________________________________________

57. A woman says, “I can’t take anymore! Last year my husband had an affair and now we don’t communicate.
Three months ago, I found a lump in my breast. Yesterday my daughter said she’s quitting college”. If this
person’s immediate family is unable to provide sufficient situational support, the nurse should:
a. suggest hospitalization for a short period.
b. ask what other relatives or friends are available for support.
c. tell the patient, You must be strong. Don’t let this crisis overwhelm you.
d. foster insight by relating the present situation to earlier situations involving loss.

58. A school-age child with chronic renal failure is admitted to the hospital with a serum potassium level of 5.2
mEq/L. Which prescribed medication should the nurse plan to administer?
a. Spironolactone (Aldactone)
b. Sodium polystyrene sulfonate (Kayexalate)
c. Lactulose (Cephulac)
d. Calcium carbonate (Calcitab)

59. Which nurse is performing the technique of light palpation appropriately?

a. Nurse A applies the bimanual technique to determine size and location of the patients heart.
b. Nurse B uses the fingertips to feel for temperature differences on the patients legs.
c. Nurse C places the ulnar surface of the hands on the patients thorax to detect vibrations.
d. Nurse D depresses the patients abdomen approximately 4 cm to assess pulsations.
60. During conversation, the nurse observes that the patient is talking continuously and excitedly, and is
switching rapidly from one topic to another with seemingly no relationship between topics. This behavior is
often associated with which disorder?
a. Depression
b. Obsessive-compulsive disorder
c. Schizophrenia
d. Bipolar disorder

61. A patient is admitted to the emergency department with a tracheal obstruction. What sound does the nurse
expect to hear as this patient breathes?
a. Dull sounds on percussion
b. Soft, muffled rhonchi heard over the trachea
c. Bubbling or rasping sounds heard over the trachea
d. High-pitched sounds on inspiration and exhalation

62. Which situation illustrates a screening assessment?

a. A patient visits an obstetric clinic for the first time and the nurse conducts a detailed history and physical
examination.
b. A hospital sponsors a health fair at a local mall and provides cholesterol and blood pressure checks to mall
patrons.
c. The nurse in an urgent care center checks the vital signs of a patient who is complaining of leg pain.
d. A patient newly diagnosed with diabetes mellitus comes to test his fasting blood glucose level.

63. A female client who has had bipolar disorder for several years decides to stop all of her medications because
she is tired of the side effects. She also cancels all appointments with her therapist, stating that it is just too
difficult to plan the visits in her hectic schedule. This client is considered:
a. Depressed
b. Noncompliant
c. Suffering from an anxiety disorder
d. Possessing obsessive-compulsive tendencies

64. During the interview process with a homeless client, which is an appropriate nursing action?
a. Wait until later in the interview to ask questions such as address or nearest relative.
b. Ask the client early in the interview what is his or her highest education level.
c. Ask the client where he or she planned to sleep that night.
d. Encourage the client to bathe as soon as possible.

65. Adult disorders such as chronic anxiety and depression often are associated with childhood:
a. Illnesses
b. Fears
c. Education
d. Abuse

66. For children older than 4 years, separation anxiety should last for no longer than:
a. A few days
b. A few weeks
c. A few months
d. 1 year

67. The parents of a 9-year-old girl with mental retardation voice concerns to the nurse regarding their childs
eating insects and leaves. The parents report that this behavior has been occurring for almost 4 months. From
what is this child most likely suffering?
a. Pica
b. Rumination disorder
c. Enuresis
d. Encopresis
68. A 16-year-old teenage boy who is bullied at school has recently started staying in his room and not
associating with his friends. His grades are dropping and he refuses to eat dinner with his family. What actions
should his parents be advised to take?
a. Accept this as a normal part of adolescent behavior and do not interfere.
b. Take the door off his room and scold him for his behavior.
c. Realize that his peer group will handle this as he needs to break away from family.
d. Set limits with him in a respectful manner and assist him to problem solve.

69. A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy
for the first time. Which is the most appropriate nursing action to prevent or minimize these reactions with
subsequent treatments?
a. Encourage drinking large amounts of favorite fluids.
b. Encourage child to take nothing by mouth (remain NPO) until nausea and vomiting subside.
c. Administer an antiemetic before chemotherapy begins.
d. Administer an antiemetic as soon as child has nausea.

70. By the ages of 14 to 17, teens are able to demonstrate problem solving skills using concepts, generalizations,
and being flexible in planning actions and goals. What is this an example of?
a. Concrete operations
b. Pre-operational thinking
c. Operational thinking
d. Abstract thinking

71. A female client is 3 days postoperative and has been receiving meperidine (Demerol) for pain control. The
family mentions to the nurse that the client has been taking phenelzine (Nardil) for years for her depression. The
client did not list this medication on admission. What signs and symptoms should the nurse look for in case of
reaction between these two medications?
a. Increased pulse and respirations
b. Hyperactivity and difficulty concentrating
c. Increased tearing and increased urinary output
d. Sedation, disorientation, and hallucinations

72. The nurse is aware that he or she may be administering the new antianxiety medication pregabalin (Lyrica)
to clients without an anxiety disorder for the purpose of treating:
a. Depression
b. Psychotic episodes
c. Neuropathic pain
d. Bipolar disorder

73. In preparing discharge planning for a client who has been prescribed lithium for the treatment of bipolar
disorder, the nurse must be sure that the client demonstrates an understanding of the need to monitor his or her
diet for intake of:
a. Potassium
b. Carbohydrates
c. Protein
d. Sodium

74. A female client calls the clinic for advice after forgetting to take her morning dose of twice-daily lithium 5
hours ago. Which instructions should the nurse give the client?
a. Take the dose immediately, and then take the second dose 3 hours late.
b. Take half of a dose now, and then take the second dose at the normal time.
c. Eliminate the dose missed, and take the second dose at the normal time.
d. Immediately take the missed dose, and take the second dose at the normal time.

75. Which of the following is NOT a characteristic of a therapeutic relationship?

a. Acceptance
b. Rapport
c. Problem solving
d. Genuineness
76. What would be the appropriate response to an adolescent who states, this has been the worst day of my life?
a. You should focus your mind on positive thoughts.
b. Everybody has a bad day now and then.
c. You’re young. What could be so terrible?
d. Tell me about the worst day of your life.

77. The nurse asks, “do your parents drink every day?” The adolescent suddenly shouts, “I’m not going to talk
about that! It’s none of your business, anyway! Leave me alone!” How does the nurse interpret the adolescent’s
behavior?
a. The adolescent is acting out and needs to be brought under control so the conference can continue.
b. The adolescent is trying to shift the focus of the conference away from himself, and the nurse needs to
refocus.
c. The adolescent is demonstrating that this problem requires the assistance of a psychiatrist.
d. The adolescent is responding to the discrediting of his parents, which causes anxiety.

78. A patient reports having difficulty swallowing. Based on this information, how does the nurse assess the
cranial nerve related to swallowing?
a. Ask the patient about feeling the blunt end of a paper clip along the jaw line.
b. Observe the rising of the soft palate when the patient says Ahh.
c. Observe the symmetry of the face when the patient talks.
d. Assess taste on the anterior part of the tongue.

79. A 15-year-old boy was previously active in a band and saved money to buy a special guitar. What would a
nurse assess as an early sign of depression in this boy?
a. He gives up the band to spend time with his girlfriend.
b. He spends all of his time at the library studying to qualify for the honor society.
c. He gives his guitar away and spends his time listening to music in his room.
d. He withdraws all of his money out of the bank to buy an expensive leather jacket.

80. A mother is concerned because her adolescent son is always in trouble for fighting at school and always
seems to be angry. She mentions that her husband drinks a bit. Which understanding will guide the nurse’s
response?
a. The boy is displaying antisocial behavior and should be evaluated for mental illness.
b. The boy is displaying one of the typical defense patterns of children of alcoholics and should receive
immediate treatment.
c. The mother is displaying her own anger with her husband’s drinking, and she needs immediate intervention.
d. The boy is only one member of the family affected by alcoholism, and all members should receive immediate
intervention.

81. What is the most appropriate classroom intervention for a child with attention deficit hyperactivity disorder
(ADHD) for the school nurse to suggest?
a. Seat the child in the back of the room to prevent distractions for other children.
b. Pair the child with a student buddy to offer reminders to pay attention.
c. Divide work assignments into shorter periods with breaks in between.
d. Separate the child from others to increase his focus on schoolwork.

82. Which statement best illustrates that the main causes of teen mortality are high-risk behaviors?
a. Teenagers generally leave home before they are mature enough.
b. Teenagers often engage in activities that put them at risk for life-threatening diseases.
c. Teenagers are prone to developing chronic diseases that lead to disability early in life.
d. Teenagers want to get pregnant at an early age to be able to enjoy life later on.

83. A 14-year-old girl with obsessive-compulsive disorder (OCD) tells the nurse other adolescents tease her
because she washes her hands many times during the school day. For what does this disorder put the adolescent
at greater risk?
a. Anorexia nervosa
b. Depression
c. ADHD
d. A learning disability
84. Which statement made by a parent of an adolescent with anorexia nervosa indicates an understanding of this
condition?
a. There really isn’t anything to worry about. Don’t they say you can never be too thin?
b. My daughter just doesn’t have much of an appetite.
c. She is just trying to punish me for divorcing her father.
d. She seems to see herself as fat, even though her weight is below normal.

85. What is an appropriate nursing intervention for a hospitalized child who is autistic?
a. Place the child in a location where she can watch all of the activity on the unit.
b. Use the child’s chronological age as a guide for communication.
c. Keep the child’s room free of toys or objects that she might want to take home with her.
d. Organize care to provide as few disruptions to the routine as possible.

86. A nurse is planning to speak with a parent support group about childhood autism. What will the nurse
include?
a. Significant signs of the disorder manifest by 1 year of age.
b. The earliest signs of autism are impulsivity and over activity.
c. Autism is usually diagnosed when the child goes to elementary school.
d. Medications can cure childhood autism.

87. An adolescent is brought to the emergency department after an automobile accident. When the nurse
approaches the adolescent, he becomes combative. The nurse notes his speech is slurred and his gait is ataxic.
What does the nurse suspect the adolescent has used?
a. Alcohol
b. Cocaine
c. Amphetamines
d. Marijuana

88. Which is caused by a virus that primarily infects a specific subset of T lymphocytes, the CD4+ T cells?
a. Wiskott-Aldrich syndrome
b. Idiopathic thrombocytopenic purpura
c. Acquired immunodeficiency syndrome (AIDS)
d. Severe combined immunodeficiency disease

89. Which clinical manifestation should the nurse expect when a child with sickle cell anemia experiences an
acute vaso occlusive crisis?
a. Circulatory collapse
b. Cardiomegaly, systolic murmurs
c. Hepatomegaly, intrahepatic cholestasis
d. Painful swelling of hands and feet; painful joints

90. Meperidine (Demerol) is not recommended for children in sickle cell crisis because it:
A. May induce seizures.
B. Is easily addictive.
C. Is not adequate for pain relief.
D. Is given by intramuscular injection.

91. A school-age child is admitted in vasoocclusive sickle cell crisis. The child’s care should include:
A. Correction of acidosis.
B. Adequate hydration and pain management.
C. Pain management and administration of heparin.
D. Adequate oxygenation and replacement of factor VIII.

92. Which is most descriptive of the pathophysiology of leukemia?

a. Increased blood viscosity occurs.
b. Thrombocytopenia (excessive destruction of platelets) occurs.
c. Unrestricted proliferation of immature white blood cells (WBCs) occurs.
d. First stage of coagulation process is abnormally stimulated.
93. A boy with leukemia screams whenever he needs to be turned or moved. Which is the most probable cause
of this pain?
a. Edema
b. Bone involvement
c. Petechial hemorrhages
d. Changes within the muscles

94. Myelosuppression, associated with chemotherapeutic agents or some malignancies such as leukemia, can
cause bleeding tendencies because of a(n):
A. Decrease in leukocytes.
B. Increase in lymphocytes.
C. Vitamin C deficiency.
D. Decrease in blood platelets.

95. A child with leukemia is receiving triple intrathecal chemotherapy consisting of methotrexate, cytarabine,
and hydrocortisone. The purpose of this is to prevent:
A. Infection.
B. Brain tumor.
C. Drug side effects.
D. Central nervous system (CNS) disease.

96. A young boy will receive a bone marrow transplant (BMT). This is possible because one of his older
siblings is a histocompatible donor. Which is this type of BMT called?
a. Syngeneic
b. Allogeneic
c. Monoclonal
d. Autologous

97. Which is the most effective pain-management approach for a child who is having a bone marrow aspiration?
a. Relaxation techniques
b. Administration of an opioid
c. EMLA cream applied over site
d. Conscious or unconscious sedation

98. Which immunization should not be given to a child receiving chemotherapy for cancer?
a. Tetanus vaccine
b. Inactivated poliovirus vaccine
c. Diphtheria, pertussis, tetanus (DPT)
d. Measles, rubella, mumps

99. Which is often administered to prevent or control hemorrhage in a child with cancer?
a. Nitrosoureas
b. Platelets
c. Whole blood
d. Corticosteroids

100. The nurse is administering an IV chemotherapeutic agent to a child with leukemia. The child suddenly
begins to wheeze and have severe urticaria. Which is the most appropriate nursing action?
a. Stop drug infusion immediately.
b. Recheck rate of drug infusion.
c. Observe child closely for next 10 minutes.
d. Explain to child that this is an expected side effect.