RPN Integrated Practice Test V:

1. What events or things are important to include in your report to the staff of the incoming shift?
a. The nursing interventions implemented
b. Changes that happened during your shift
c. Documents that have been done
d. Treatments that have been carried out

2. A 65-year old male patient was admitted to the unit. The family arrived to the unit shortly after the patient died. How will the
PN show respect to the family?
a. Tell them that it is alright to cry
b. Let the family wait and bring to them the patient’s belongings
c. Offer them a private room to sit
d. Introduce the family to the nursing supervisor/manager

3. Mr. BD who has stage 2 Alzheimer’s disease is admitted to the hospital. He is very confused and disoriented. A few hours
after admission, he jumps off from the bed, attempts to remove all intravenous lines and throws things near him. Because of
this behavior, the doctor orders restraints. The PN requested assistance to restrain both his hands and apply a restraint jacket.
His family was not happy with the intervention and the niece asked the PN why her uncle was restrained? What is the PN’s
best response?
a. It is the doctor’s order that we place him on restraints
b. It was for the patient’s safety that we placed him on restraints
c. It is the hospital policy that we place him restraints for behavior such as this

4. In the emergency room, a 65-year-old female with a wrist fracture suddenly cried when asked about how she got a fracture.
She shared that her daughter abuses her and how she hits her all the time. She also shared that her daughter also abuses her
children. Which among the following situations poses the greatest danger?
a. The daughter takes all her retirement money away from her
b. The daughter is abusive to her children
c. The daughter can potentially kill someone
d. She constantly uses abusive and profane language

5. Mr. K is concerned about his hyperactive 18 month old toddler Ryan. Mr. K asks the PN how he can manage his son
especially when eating. What is the best nursing response?
a. Discuss with Mr. K safety rules for Ryan
b. Put the child in the playpen when hyperactive
c. Discourage running while eating
d. Put the child in the car seat during camping trip or any trip.

6. How will the PN know that the participants of a breast-cancer prevention class are motivated in taking actions on preventing
such cancer?
a. The participants make verbal comments that the class was very beneficial
b. Some participants demonstrate the correct way of doing the breast-self examination
c. The participants are actively asking questions after the class
d. The participants are requesting for another similar class in the future

7. MC has undergone a mastectomy and is admitted to your unit. How will you know that she is ready to care for herself?
a. She asks pertinent queries about wound care
b. She helps the nurse in changing the dressing
c. She looks at her wound
d. She informs the nurse about her concerns at how to take care of the wound

8. How will the school nurse promote physical exercise to a group of students in the camp?
a. By physical fitness
b. By cultural backgrounds
c. By growth and development level
d. By physical growth
9. The daughter of a 92-year-old patient asked the community health nurse about the resources needed for her mother. While
she was asking the question, the patient interrupted and said “We need home care”. The PN was about to propose a nursing
home placement. What is the most appropriate response for the PN to take at this time?
a. Have the daughter tour a nursing home
b. Ask the mother and daughter discuss what resources they need
c. Tell the mother, “I would like to know your daughter’s opinion on what resources are needed”
d. Identify the resources needed.

10. A 73-year-old male patient who has some nutrition problems is going to be discharged. The patient’s brother who has limited
resources expressed his willingness to take care of his older brother. What should the PN do?
a. Refer the patient to appropriate community resources
b. Let the brother prepare nutritious food
c. Have a community nurse visit the patient

11. Ms. Sheila, 85 years old has an advanced stage of Alzheimer’s disease. Her family is providing care for her. For the past
week, her family members are uncertain to continue to care for her. The family also mentioned about community health nurse
who regularly visits the client. What would be your response to ensure the safety of the client?
a. Suggest for a nursing home placement
b. Refer to a social worker
c. Inform the family of available resources
d. Suggest for respite care.

12. A patient is for discharge and is waiting for his wife. He has come on a weekly basis to the hospital for follow-up. How will
the PN ensure that he will comply with his follow-up plans?
a. Ask him if a neighbor could bring him to the hospital
b. Ask him if his wife can drive to the hospital
c. Ask him, “will this follow-up cause any problem for you?”

13. The PN is organizing a crosswalk to minimize the occurrences of motor accidents. What would be the nurse’s initial step to
do?
a. Send letters to the pupils about the plan of organizing a crosswalk
b. Conduct a meeting with the school principal and the parents
c. Conduct a meeting with the Ministry of Transportation

14. The PN is visiting a group home for children with cerebral palsy. Which among the following is considered as the primary
source of data?
a. Doctor
b. Records
c. Parents of the children
d. Observations of children’s behavior and activities

15. The PN is developing health teaching plan on promotion of nutrition to a group of teenagers. Which one should be
considered?
a. Show video tape about proper nutrition
b. Introduce a game outlining the different food groups according to the Canada’s food guide
c. Develop a group discussion on the promotion of nutrition
d. Ask a dietician from the community to provide a lecture on the promotion on nutrition

16. A mother of a hyperactive child asks the home visiting nurse why she is recommending the Canadian Food Guide to be used
in her food planning. How would the visiting nurse respond?
a. Because of your son’s hyperactivity, you need to plan your meals according to the Canadian Food Guide.
b. It is for his growth and development that I am recommending the Canadian Food Guide
c. Your son needs to have the complete nutritional requirements at his age

17. A terminally ill patient with leukemia has decided to stay at home after receiving aggressive treatment in the hospital.
However, the family is concerned about taking care of the patient a she just had a bone marrow transplant six months ago.
What is your best nursing response in advocating the decision of the patient?
a. Refer the client to a respite care
b. Call the community health center
 c. Immediately inform the attending physician
d. Refer the case to the community’s self-care group.

18. Which among the following statements made by a client in a smoking cessation program best indicates that your health
teachings are effective?
a. I cut back my smoking from 25 to 20 cigarettes each day
b. I started to quit smoking last week
c. I only smoke once in the morning and in the evening
d. I smoke only when I’m stressed

19. A terminally ill patient wants to say goodbye to his dog. The policy in the unit does not allow any pet to visit the unit. You
ask your nursing supervisor to advocate for the patient but your charge nurse refused to allow the patient’s dog to come and
visit. How can the PN continue to advocate for the client?
a. Apologize to the patient and tell the patient that nurses cannot change the policy
b. Approach the nursing supervisor to explore the hospital policy and possibly obtain a special permit to bring the dog
c. Tell the family to bring the dog in the evening when no one could see them
d. Request that the nurse supervisor advocates for change on pet’s visitation.

20. What would you include to your discharge teaching to a new mother about safety of her infant?
a. Proper positioning while sleeping
b. Put away toxic substances and poisonous things
c. Enforce restricting rules while playing

21. PN Regine was assigned to conduct a smoking cessation program for teenagers, ages 12-16 in an aboriginal school. The best
tool to assess the group’s learning needs would be to;
a. Conduct a quiz about the advantages and disadvantages of smoking
b. Inquire from the school counselor regarding the learning abilities and needs of the students
c. Ask the non-smoking participants to talk about their side of not engaging in smoking
d. Allow an ex-smoker to talk about her story of quitting smoking

22. A normal baby was brought by her mother to the clinic for her regular check-up. How would the PN ask the mother to
determine if the mother is facilitating the baby’s developmental task of trust as defined by Erickson?
a. Do you hold the baby when she cries?
b. Do you give a pacifier to the baby when she cries
c. What positions does your baby assume when she sleeps?
d. What immunizations did your child already have?

23. Michelle had a periorbital edema, was feeling dizzy, and was in pain. She was accompanied to the emergency room by her
partner, Joan. Her partner told the PN that she “fell” the night before coming to hospital. What should the PN do initially?
a. Apply warm compress to Michelle’s eyes
b. Ask the partner to leave the interview room so the nurse can talk to the patient privately
c. Explore with Michelle and Joan the factual events of the incident
d. Give analgesic to Michelle

24. PN Nancy administers the wrong preoperative medication. She filed an incident report and informed her supervisor. In
addition to what she has done, who else should she notify?
a. The pharmacist
b. The patient
c. The doctor
d. Her colleague

25. A patient with diabetes mellitus has a small ulcer on her toe and requires foot care. Who is the best person to administer such
care?
a. The nurse assigned to the patient
b. The diabetic nurse clinician
c. The nurse with foot care training
d. The infection control nurse
26. The PN is conducting health teaching class to a group of teenagers on nutrition. During the discussion part, one student asked
the PN why she was teaching nutrition to the teens only. How will the PN respond?
a. It is not appropriate for teens to skip meals
b. Anorexia nervosa and bulimia are very common disorders among teens
c. I teach to the teens only in order to decrease the incidence of anorexia nervosa and bulimia
d. I teach this class in order to improve your knowledge on nutrition

27. You are the PN in a medical unit assigned to a patient who requires blood transfusion. What is your nursing responsibility
prior to starting blood transfusion?
a. Check the patient’s name against the MAR sheet
b. Check the ID band of the patient with MAR sheet
c. Check the blood product with two nurses
d. Run a normal saline first before administering the blood

28. The PN has developed a close relationship with a male patient who has been in the unit for a while now. When the PN enters
the patient’s room, one of his male friends who’s visiting, tells the patient, Hey! Your sweetheart is here. How will the PN
respond?
a. Ignore the remark and tell the patient that it is time for his therapy
b. Tell the visiting friend that his remarks were inappropriate
c. Ask the visiting friend what the patient was telling him about her.

29. Often times, what kind of patients are most likely diagnosed with substance abuse?
a. Patients with chronic pain taking Tylenol
b. Patients on nitroglycerine patch
c. Patients who has previous psychiatric admissions

30. A 28-year-old male patient, who was admitted to the hospital for sudden change of behavior, is presently angry. The PN puts
him in a private room. After a couple of minutes the PN left the room, the PN hears the patient shouting, yelling, and hitting
continuously on the wall. What should the PN do?
a. Go to the room immediately to find out what is happening and call the security
b. Call the security immediately for back up then wait for the security before entering the room
c. Call the security immediately for back up immediately and wait inside the patient’s room.

31. Mr. Harris is a policeman for 35 years, diagnosed with depression for 3 years and had undergone knee surgery five days ago.
How would you know that the patient is improving?
a. He tells the nurse that he takes his medications regularly
b. He realizes that his knee pain is causing him insomia
c. He tells the nurse that he called his friends to visit him
d. He informs his nurse that his pain is subsiding even with ambulation

32. A terminally ill patient wants to say goodbye to his dog. The policy in the unit does not allow any pet to visit to the unit. How
can the PN advocate for the client?
a. Apologize to the patient and tell the patient that nurse cannot change the policy
b. Suggest to the patient to go to the hospital administrator to obtain a permit to bring the dog
c. Ask the PN’s direct supervisor and advocate for the change of the policy
d. Tell the family to bring the dog in the evening when no one could see them.

33. Upon collecting information from an independent 85-year old female patient who wears a hearing aid, the PN notices that the
patient gives inappropriate answers to her questions. What should the PN do?
a. Increase the one of her voice to facilitate good communication
b. Talk slowly in a low-pitched voice while positioning in front of the patient
c. Stay at the side of the patient where the hearing aid is located and talk in a moderate tone
d. Ask permission from the patient to check and adjust the volume of the hearing aid.

34. A 70- year- old female who had pneumonia is ready for discharge. She has a hearing impairment for many years. How are
you going to give her discharge instructions?
a. Speak slowly in a low-pitched tone
b. Give her writing discharge instructions
 c. Speak to her in simple terms

35. The PN is having a great difficulty distancing herself from the care of her client when she leaves work. What would be the
best nursing strategy for her to adopt?
a. Recognize herself that she is just too compassionate and caring
b. Request that the client be assigned to another nurse
c. Share her concerns with the client
d. Share her concerns with the trusted colleague

36. The PN enters W’s room for the first time and says, “W., I’m E. I’ll help you get settled” W. responds, “I want another nurse.
I don’t like you. You’re mean.” Before responding to W. initial outburst, the PN should:
a. Make sure she is on a safe distance from the patient
b. Move closer to the patient to show that she is not afraid
c. Assess her own feelings and responses to the patient’s behavior
d. Recognize that it takes time for relationships to develop and not feel hurt.

37. Which of the following nursing assessments indicates that the client with depression is improving?
a. Reduced level of anxiety
b. Changes in neurovegetative signs
c. Compliance with medications
d. Requests to talk with the nurse

38. The patient’s mother is teaching her daughter to take a deep breath and scream during the first stage of labor. What is the best
nursing action to take in this situation?
a. Tell the mother that she is doing the right thing
b. Explain to the mother the proper techniques of deep breathing
c. Teach the daughter the proper techniques of deep breathing
d. Tell the mother that she is teaching the wrong deep breathing technique

39. The patient told you that he has decided together with his family to discontinue chemotherapy. How should you respond to
the patient?
a. Would you like to speak to somebody about your decisions?
b. Do you know the consequences of your decisions?
c. Has the physician discussed with you the benefits of chemotherapy?
d. Tell me your reasons for making that decision

40. Brian attended a smoking cessation program and asks the PN on how he can help his friend quit smoking. What is your
appropriate nursing response?
a. Let your friend choose his own time to try to quit and support his decision
b. Let him know that you believe he can do it every time the topic of quitting is brought up
c. Find out what community resources is available to help smokers quit.
d. Give him the Nicotine gum for a start

41. A 13- year- old patient with a diagnosis of gonorrhea requests you not to tell her parents about her disease. She asks you who
needs to know her diagnosis. How will you respond?
a. Because of your age, I need to call your parents
b. I’ll respect your request for confidentiality
c. The public health team needs to know about your diagnosis
d. “Sorry but I have nothing to do with this”

42. A 26- year- old Chinese female client who doesn’t speak English comes to the prenatal clinic for check-up and counseling.
The PN communicates with the client through an interpreter. On the third visit, the PN realizes that a nurse-client relationship
has not been established yet. How would the PN manage the situation?
a. Revalidate with the interpreter the client’ s first impressions and expectations
b. Provide informative materials in the patient’s own language
c. Transfer the care to the client’s own culture in the community
d. Use gestures and non-verbal communication techniques in communicating with her.
43. A 16- year- old female patient with a 55% burn was due for a dressing change. The patient’s mother asked the PN if she
could observe the dressing change. How should the PN respond?
a. Allow the mother to observe the dressing change
b. Use this opportunity to teach the mother about burn prevention
c. Tell the mother that she must leave the room before the dressing is

47. A community daycare centre has an outbreak of Pertussis or “whooping cough”. You are the PN assigned in the community,
what would be your most prompt response?
a. Report to the public health authorities
b. Provide test to all the children affected
c. Advise to close the operations of the day care centre
d. Conduct screening tests for immunizations

48. A mother and her 15 year old daughter came to the clinic. The mother tells the PN that her daughter has severe cough and
has been smoking since she was 10 years old. How would the PN initially establish rapport with the daughter? The PN
will say to the daughter:
a. “I want for us to talk about your coughing and smoking”
b. “I can offer you programs on smoking cessation if you like”
c. “Your mother is worried about your cough and smoking”
d. “ I heard your cough. Tell me about it”,

49. A 45- year -old female came to the clinic asking about Hormone Replacement Therapy (HRT) as she had not been having
menstrual periods for four months now. She is thinking that she may be pregnant. What is the PN’s best nursing response?
a. Give the patient necessary information about HRT
b. Refer the patient to her physician
c. Tell the patient that is possible that she is pregnant but that you need more information
d. Check the patient if she’s pregnant.

50. A two-day-post hysterectomy patient was admitted to the unit. One hour after receiving Meperidine (Demerol)
50mg po, the patient is still complaining of pain and asks for another tablet. How should the PN respond?
a. “It takes time for the medicine to take effect”.
b. “ I can’t give you another tablet since you had it an hour ago”
c. “I’ll ask the doctor to increase the dosage of the medicine.”
d. “This is usually a symptom after surgery”.

51. A post-operative female patient was given Meperidine (Demerol) 50 mg po. After one hour of giving the medication, the
patient’s son complained to the nurse saying that the patient is moaning and restless. How will you respond to the patient’s
son?
a. Tell the son that the effect of the medication has not been achieved yet.
b. Inform the doctor
c. Assess if the patient is still in pain; telling the son “I will assess her further”

52. What immunization does a teenager (11-16 years of age) typically receives?
a. MMR
b. Hepatitis
c. Varicella
d. Tetanus and Diphtheria

53. A 24-year-old man was not wearing a helmet was caught in a bicycle accident. Later on, he feels drowsy and seems to forget
the names of his friends. Attending to this situation, what should the PN do?
a. Check for neurological reflexes and Glasgow coma scale
b. Do a neurological assessment and call for an ambulance
c. Tell the man to wear a helmet next time
d. Advice the man to seek help from a psychiatrist.

54. A husband and a wife visit the well baby clinic. The PN notices that the husband is the only one answering the
nurse’s questions. The wife is staring on the floor, doesn’t smile and puts her chin down. You suspect the wife
with:
a. Anxiety
 b. Panic attack
c. Depression

55. Barbara, the PN received the following patient report from the outgoing night shift: Mrs. Smith had a chest pain
and was given nitroglycerine, at 7:15 a.m. Mrs. Jack complained of pain and is asking for analgesics. Mrs. Hansen is for
immediate transfer to physiotherapy. How will Barbara handle the situation in priority?
a. Assess Mrs. Smith, give analgesic to Mrs. Jack and facilitate the transfer of Mrs. Hansen
b. Administer the analgesic to Mrs. Jack, assess Mrs. Smith and facilitate the transfer of Mrs. Hansen
c. Transfer Mrs. Hansen, assess Mrs. Smith and medicate Mrs. Jack.

56. A 17-year - old girl reported to the hospital for amenorrhea. What assessment question is most appropriate for the
patient to ask.
a. Are you on any medications?
b. Are you taking family planning pills?
c. Are you pregnant?
d. Are you on a strict diet?

57. An 89-year-old female vomited blood and was brought to the hospital. She is scheduled for a gastric resection.
Who is going to explain the procedure?
a. Nurse
b. Family physician
c. Anesthesiologist
d. Surgeon

58. An unconscious patient in your unit is about to receive an antibiotic therapy. However in obtaining from his
history, you found out that three years ago when he was still conscious and mentally competent, he made an advance
directive stating that he would not wish to have any antibiotic under any circumstance. What would you do?
a. Tell the doctor to prescribe the medication anyway as this is in the best interest of the patient
b. Remind the doctor about the client’s wishes of not wanting to take any antibiotics and call the next of kin
c. Call the next of kin to provide substitute consent for treatment.
d. Refuse to administer the medication even if it is ordered by the physician.

59. A scholar wants to stop smoking. How do you assess his readiness to stop smoking?
a. He asks his mother to book him into a smoking cessation program
b. He books himself for a smoking cessation program held at school
c. He obtains information about existing smoking cessation program
d. His parents participate in the development of a family care plan.

60. Furosemide (Lasix) 20 mg is ordered for 0800 hours stat for a patient with CHF. At 1100 hours, you notice that on
the MAR sheet that your colleague has not administered the drug. What will be your immediate action?
a. Call the physician, document the medication error and give the medication
b. Notify the charge nurse, call the physician, document the medication error and assess the client
a. Clarify the medication error with your colleague then administer it
b. Clarify the medication error with your colleague and document the incident

61. A female client is admitted to the emergency room for abdominal bleeding. She was also shaking and appeared
very nervous. While you were collecting information about the history, the client was quiet and silent. It was the
husband who was answering the questions in behalf of the client. What would be your nursing action to determine
if she was abused?
a. Ask the husband to leave during assessment and interview
b. Use a tool or a set of guidelines in assessing abused clients
c. Continue with your assessment with both the husband and wife present.
d. Call the police

62. The grandmother has brought an infant to the clinic for a check up and has signed the consent for immunization
administration. Which of the following would the PN do first?
a. Ask who is the infant’s legal guardian
b. Notify the physician immediately
c. Administer the immunization as ordered
 d. Call the infant’s mother for verbal consent

63. A male patient diagnosed with AIDS requested the PN not to tell his wife about his diagnosis. How would the PN respond?
a. “The medical team has an obligation to tell your wife about your diagnosis. It’s for her protection”.
b. ”I will respect your request of confidentiality”
c. “Let us discuss about this issue of disclosing your diagnosis to your wife”.

64. Which of the following makes the final decision in revoking a Registered PN’s license?
a. Canadian Nurses Association
b. Registered Nurses of Ontario
c. A nurse’s regulatory body such as the College of Nurses of Ontario
d. Ontario Nurses Association

65. A PN has realized that she didn’t know how to initiate an IV line on a client whom she performed CPR previously.
What should she do in order to gain knowledge on this specific procedure?
a. Buy and read an IV therapy book
b. Ask the nursing supervisor if she could attend an IV therapy session offered in the hospital
c. Seek the help of the most senior nurse in the unit
d. Call the IV team to teach her how to start an IV line.

66. A 14-year- old female client has been placed on a “suicide watch’ after ingesting 10 tablets of Valium. Which of the
following offers best protection for the client?
a. Ensure that no sharp instrument will be at the client’s immediate environment
b. One to one watch 24 hours every day
c. Ensure that doors and windows are properly locked
d. Promote a trusting relationship with the client

67. A young couple who takes care of their 76- year- old chronically-ill mother decides to take a vacation for two weeks.
What should the PN suggest to the couple in dealing with this situation?
a. Respite care in a long-term care facility
b. Nursing home placement
c. Daycare center for seniors
d. Hospital stay for 2 weeks

68. A drunk and verbally aggressive patient arrived to the hospital accompanied by a police officer and has a deep
laceration on his forehead in which the cause of it is yet to be investigated. What is the best personal safety measure for the
PN to take while providing care for the wound?
a. Ask the police officer to restrain the patient while giving wound care
b. Ask the assistance of a colleague
c. Allow the patient to calm down first by placing him in a quiet room before administering the wound treatment
d. Go ahead and do the procedure

69. The PN collects specimen from a raped client. The client asks the PN about the purpose of the specimen collection. What
would be the best nursing response?
a. This is a policy of the hospital
b. These are legal evidences to be submitted to the court if you decide to press charges
c. These are useful for the police as reliable sources of information
d. This is routinely done for every patient

70. How would you promote safety of an elderly client with Alzheimer’s disease (early stage) in the house?
a. Lock all doors
b. Remove hazardous equipment/objects
c. Find a continuous 1:1 (24hour) care-giver
d. Keep room well lighted to reduce misperceptions

71. The PN found Tommy, a cafeteria worker giving a back massage to a patient in the unit. Which of the following nursing actions
is the most appropriate for the PN to take?
a. Inform the nurse in charge of the unit about the incident
b. Inform the supervisor of the cafeteria worker about the incident
 c. Ask the cafeteria worker to get out of the room and tell him that what he was doing was unacceptable
d. Ignore the cafeteria worker

72. A nurse has prepared the IV fluids with medications already and states that she is ready to go for her break. She asks you to hang
the IV with medications as she is running late for her scheduled break time. What should you do?
a. Hang the IV medication as requested by your colleague
b. Ask the nurse to do it herself
c. Leave the IV medication to be hung later
d. Ask her to hang the bag after her break time.

73. How would you best communicate to a client with a post CVA expressive aphasia?
a. Use written communications and signs
b. Read the client’s lips when he talks
c. Use sign languages and gestures
d. Talk slowly and in a low tone, clear voice

74. A patient suddenly became ill. The nurse rushed over to him and observed that he was not responding. What should
the PN do?
a. Open the patient’s airway
b. Place the patient in the recovery position
c. Do a thorough examination
d. Shout for help and continue to examine the patient

75. What important information will the nurse give to mothers about newborn babies?
a. Place in prone position when asleep
b. Place in side-lying position when asleep
c. Place in supine position when asleep

76. Based on the nursing assessment, which behavior indicates that the patient is no longer depressed?
a. The patient is taking his anti-depressant medications as prescribed.
b. The patient was able to perform his activities of daily living.
c. He complains that he couldn’t sleep well at night due to the pain in his knee.
d. He maintains regular social contact with his friends.

77. Mr. SD, 66 y/o has AIDS and is hospitalized with pneumonia. He has just arrived on the respiratory unit. Should Mr. SD’s nurse
take special precautionary measures?
a. No, standard (universal) precautions are sufficient.
b. Yes, gown, mask and gloves should be worn at all times.
c. Yes, it is important to wear a mask because of pneumonia.
d. No, since the risk and transmission of this disease is limited.

78. Doreen, 75 y/o lost sight in her L eye as a result of poorly controlled glaucoma. What must the PN include in Doreen’s plan of
care?
a. Place the bedside table and personal effects close to Doreen
b. Approach Doreen from the R side as much as possible
c. Maintain subdued lighting on the R side of the room
d. Position Doreen on her L side

79. Ms. Branson, 65 years old, is post-operative client who suddenly develops hematemesis. She is pale, diaphoretic and says she
feels faint. The PN asks the student nurse to take Ms. Branson vitals sign when she calls the physician. On returning to the
client rooms, the student nurse reports that the vital signs have not changed since earlier in the shift. What should the PN do?
a. Places the client in trendelenburg position.
b. Instructs the student nurse to recheck the vital signs in 10 minutes.
c. Rechecks the vital signs.
d. Administers a bolus of 200 ml of normal saline.

80. You’ll be teaching a patient’s wife how to suction his tracheostomy. When developing the teaching plan, you must,
a. assess the wife’s knowledge and skills.
b. set up a schedule to demonstrate the technique.
 c. provide the wife with written materials about the procedure.
d. establish goals and learning objectives.

81. Which of the following nursing assessments indicate that the health teaching on colostomy care was effective?
a. The patient states, ‘I was able to empty my colostomy bag once today.’
b. The patient states, ‘I will ask you to show me how I should put my colostomy bag.’
c. The patient states, ‘My mom can empty the colostomy bag for me.’
d. The patient states, ‘I am afraid that my boyfriend may leave me…’

82. A patient who sustained paraplegia stated, ‘I cannot feel when my bladder is full.’ The PN would anticipate that the patient
will
a. be taught how to do self-catheterization.
b. have condom catheter.
c. be taught how to perform keagal exercise.
d. have his bladder massage.

83. Ms. Mills receives Demerol and Atropine Sulfate pre-operatively. Which of the following should the nurse recognize as the
expected outcome of these medications?
a. The effectiveness of the anesthesia was increased.
b. There was no postoperative dehydration.
c. The tone of smooth muscle was improved, thus preventing hemorrhage.
d. The respiratory secretions were reduced during surgery.

84. A colleague’s license expired a week ago. She says she forgot to renew it. She is working with you on the evening shift. What
are you required to do?
a. Notify the registration organization.
b. Notify the nursing supervisor.
c. Notify the doctor.
d. Remind the nurse that she must get it done.

85. A native Aboriginal teenager asked you where he could avail a place to stay after being devastated of knowing his positive HIV
result. He further told you, “You don’t understand the situation I am in right now.” What would be your best nursing response?
a. Make an arrangement to the nearest Friendship community center.
b. Refer him to a psychologist and a social worker.
c. Contact the community health center for an immediate follow up.
d. Inform the medical doctor for another consultation.

86. An elderly male individual with COPD is living with his wife and his younger son in an apartment. Everyone of them is
smoking. As a community health nurse, how will you plan your health teaching to this family in preventing respiratory illnesses
and infection?
a. Ask the family what they do in preventing infection.
b. Encourage and offer them an annual flu vaccination.
c. Encourage the family to take multivitamins daily and to increase their daily fluid intake.

87. What is your best health teaching to a group of IV drug users in fighting against AIDS?
a. Avoid exchanging and sharing needles.
b. Abstain from drugs.
c. Emphasize rehabilitation programs.
d. Provide reading materials on drug cessation.

88. A conscious male individual is found on the scene of a car accident with a large laceration on his leg. You are the first person to
witness. What should you do?
a. call for help
b. open airway
c. immobilize leg
d. apply pressure

89. Provision of fluid hydration is one of your nursing goals for an Alzheimer’s patient in the nursing home. What is the best nursing
action to implement to improve his fluid intake?
 a. Encourage him to take1,500 mls. of fluid in 24 hours
b. Assist and encourage him to increase his fluid intake
c. Let him take a large amount of fluids during the early part of the day.
d. Start giving intravenous fluid.

90. A patient who has been on Elavil for 3 days complains of not feeling better. How should the PN respond?
a. Suggest to the patient to report it to the doctor.
b. Suggest to the patient to stop taking the medication.
c. Encourage the patient to continue taking the medication.
d. Record the patient’s response to the medication.

91. How will you promote sensory stimulation to an unconscious female child?
a. Give the child her favorite toy.
b. Ask her mother to help you with the care.
c. Give medications as ordered.
d. Talk to her while giving care.

92. A patient is complaining to the PN that he didn’t have enough sleep last night because his roommate was too noisy. What
would the best nursing action to this?
a. Draw the curtain that divides the two patients.
b. Transfer the patient to a quiet room once available.
c. Inform the doctor about the patient’s concerns.
d. Inform the doctor for some medication to help relieve the patient’s insomnia.

93. Roy tells his nurse that he has multiple sexual partners and usually does not use condom. He tells his PN that he will die soon.
What is the PN’s best response?
a. “Would you like to talk to someone who works the same with your case?”
b. “Where there is a problem, there is a solution.”
c. “You have a long way to go, Roy.”
d. “Not everyone who has HIV-positive develops AIDS and die.”

94. Rogers who had a stroke is going to be discharged soon and is going to have some rehabilitation after discharge. The wife of
the patient has been complaining that she couldn’t handle taking care of her husband anymore. Which among the following
statements made by the wife signifies that Rogers is ready for rehabilitation?
a. “I have been working in a rehabilitation institution for 20 years now.”
b. “My son is a carpenter and he said he is going to help me with his father.”
c. “My sister will come every Thursday to help me out and I can go out to buy groceries.”

95. In conducting a seminar for a group of people with ages10-14, which of the following will you include in your health teachings
about safety?
a. proper wearing of helmet when riding bicycles
b. proper wearing of seatbelt
c. Keeping all poisonous substance away from the house
d. proper wearing of hiking gears

96. While the other nurse is on her break, you were asked by one of her patients to change the IV bag as it was almost finished.
What should you do?
a. Change the bag according to doctor’s orders.
b. Remind the patient to use a call bell next time.
c. Wait for the other nurse to come back from her break and then let the other nurse change the bag.

97. Mrs. Kent has recently finished her chemotherapy for breast cancer. She is anxious to return to work as an accountant in the
bank. She expressed that she is depressed and that her therapist thinks it is premature for her to return to work. Which of the
following is the most appropriate action for the PN to take?
a. Encourage Mrs. Kent to attend the upcoming support group.
b. Facilitate ways to get her involved in community activities.
c. Call the therapist to come and observe her perform some of her duties.
d. Ask Mrs. Kent to consult another therapist.
98. You are admitting a 58-year-old female client to your unit with a history of COPD. She was brought in by family members. How
will you establish a therapeutic nurse-client relationship?
a. “Hi, my name is Carol, a registered nurse. I will be your nurse for the shift.”
b. “Hello, I am the registered nurse in the unit. Let me know if you have any problems.”
c. “Hi, just ring the bell whenever you feel like to.”
d. “Hi, my name is Carol. I will be your nurse for the shift.”

99. Mrs. Brown is about to receive her Humulin NPH and Humulin R in the morning. What is your responsibility before giving the
drug?
a. shake both vials
b. check last night’s glucometer result
c. check the expiration date on each vial
d. tell the patient about her glucometer result

100. A patient with AIDS is discharge on palliative care. However, he doesn’t have any family member to care for him at home. What
is the most appropriate care setting for this patient?
a. respite care
b. rehabilitation center
c. hospice
d. nursing home

101. Debbie died of cancer of the sigmoid colon. When you entered the patient’s room you saw the husband lying beside the patient
who died just 15 minutes ago. As a nurse, what is your best nursing action?
a. Leave them alone.
b. Tell the husband that he is not allowed to lie beside her.
c. Tell the husband to go out of the room.
d. Stay in the room and offer comfort to the husband.

102. The patient has been receiving 2500 ml of IV fluid and 300 to 400 ml of oral intake daily for 2 days.
The patient’s urine output has been decreasing and now has been less than 40 ml per hour for the past 3 hours. The PN should
immediately:
a. Catheterize the patient to empty the bladder.
b. Assess breath sounds and obtain the patient’s vital signs.
c. Check for dependent edema and continue to monitor I/O.
d. Decrease the IV flow rate and increase oral fluids to compensate.

103. Hyponatremia is defined as decreased sodium level. Which of the following reflects possible hyponatremia?
a. Vomiting
b. Hypertension
c. Sodium level of 146 mEq/L
d. Loss of weight

104. The nurse is caring for a client with uncontrolled hypertension. Which findings require immediate
nursing action?
a. lower extremity pitting edema
b. rales
c. jugular vein distension
d. weakness in left arm

105. An elderly lady has a maintenance of Inderal (beta blockers), the nurse must be aware that the medication has to be given too
which of the following critical assessment?
a. Client has no headache.
b. No verbalization of dizziness.
c. Client has a blurring vision.
d. BP 128/80.

106. A client undergoes procedure that requires the use of general anesthesia. During the postoperative period, the client is most at
risk for:
a. Atelectasis
 b. Anemia
c. Dehydration
d. Peripheral edema

107. While suctioning a client’s tracheostomy tube, the patient HR was noted to go down from 100 to 58. What should the nurse do?
a. Continue suctioning to remove the mucus
b. Stop suctioning and provide oxygen
c. Turn the client to the left side
d. Administer a precordial thump

108. A pregnant mother, on her first trimester, develops urinary tract infection (UTI). What would be the appropriate health teaching
to prevent UTI in the future?
a. Increase fluid intake
b. Drink cranberry juice
c. Limit fluid intake
d. Frequent perineal washing

109. Which of the following statement indicates that the patient requires further teaching?
a. “I will ask my friend to put sugar in my cheek when I get hypoglycemic”
b. “I will put peanut butter and sugar in my sandwich when I get hypoglycemic”
c. “I will drink a lot of orange juice when I started feeling dizzy”
d. “I will bring hard candies with me all the time”

110. A 5-year-old was admitted with asthma attack. Her grandmother is at the bedside. Oxygen 4 to 6 L/min was ordered along with
nebulizers. Following treatments, the nurse noted that the wheezing sound has already disappeared and the child is now fast
asleep. What would you tell the grandmother who called your attention?
a. Tell the grandmother that the child is a lot better now
b. Tell the grandmother that you are anticipating transfer to ICU
c. Tell the grandmother that you will stop the oxygen therapy
d. Tell the grandmother that you need to re-assess and monitor the child more frequently