PREDICTOR EXAMINATION

Compiled and Screened by: Mr. Gicar C. Magbanua, RN,MSN,USRN,HAAD-RN

1. What should the nurse do to assess the neurovascular status of 6. Which statement by a client with type 2 diabetes indicates to
an extremity casted from the ankle to the thigh? the nurse that additional teaching about the diet is needed?

A. Palpate the femoral artery. A. “I can eat as much dietetic fruit as i want.”
B. Assess for a positive Homan sign. B. “ I can have a lettuce salad whenever I want it.”
C. Compress and release the client’s toenails. C. “ I know that half of my diet should be carbohydrates.”
D. Instruct the client to flex and extend the knee. D. “ I need to reduce the amounts of saturated fats in my
diet.”
2. A nurse is assessing a client who is experiencing
postmenopausal bleeding. The tentative diagnosis is 7. A child is found to be allergic to dust. The nurse is preparing a
endometrial cancer. Which findings in the client's history are risk teaching plan for the parents. What should the nurse include in
factors associated which endometrial cancer? Select all that the plan?
apply.
A. Housework must be done by professional house
A. Obesity cleaners.
B. Multiparity B. Damp-dusting the house will help limit dust particles in
C. Cigarette Smoking the air.
D. Early onset of menopause C. The condition must be accepted because dust in a
E. Family history of endometrial cancer house cannot be limited.
F. Previous hormone replacement therapy D. The house must be redecorated because the
environment must be dust-free.
3. A client who has breast cancer had post lumpectomy
chemotherapy and is now scheduled for radiation on an 8. A client who has just started on a regimen of haloperidol
outpatient basis. What is an important nursing intervention (Haldol) is observed pacing and shifting weight from one foot to
while the client is receiving radiation? another. What side effect does the nurse document in the client's
chart?
A. Assess the radiated site daily for redness or irritation.
B. Rinse the radiated site with an antibacterial solution A. Akathisia
after each treatment. B. Parkinsonism
C. Instruct the client to apply lotion twice daily to the skin C. Tardive dyskinesia
on the radiated area. D. Acute dystonic reaction
D. Encourage the client to wear a snug-fitting bra between
radiation treatments. 9. A client who has been on a psychiatric unit for several talks
about delusional material. What response by the nurse is most
4. A client's problem with ineffective control of type 1 diabetes is therapeutic?
identified when a sudden decrease in blood glucose level is
followed by rebound hyperglycemia. What should the nurse do A. Ask the client to explain the delusion.
when this event occurs? B. Allow the client to maintain the delusion.
C. Encourage the client to focus on reality issues.
A. Give the client a glass of orange juice. D. Explain to the client why the thoughts are not true.
B. Seek an order to increase the insulin dose at bedtime.
C. Encourage the client to eat smaller, more frequent 10. A nurse admits an adolescent to the psychiatric unit with the
meals. diagnosis of anorexia nervosa. What is the primary gain a client
D. Collaborate with the health care provider to alter the with anorexia achieves from this disorder?
insulin prescription.
A. Reduction of anxiety through control over food.
5. A client with severe preeclampsia is hospitalized. What should B. Separation from parents secondary to hospitalization.
a nurse do first to ensure her physical safety? C. Release from school responsibilities because of illness.
D. Increased parental attentiveness related to massive
A. Decrease environmental stimuli. weight loss.
B. Place her on seizure precautions.
11. A nurse is caring for a newborn with a myelomeningocele.
C. Administer the prescribed sedatives. What should immediate nursing care for this infant include?
D. Strictly monitor her intake and output

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Compiled and Screened by: Mr. Gicar C. Magbanua, RN,MSN,USRN,HAAD-RN

A. Changing diapers immediately when moist. D. High protein and kilocalories

B. Placing the infant in the reverse Trendelenburg
position. 17. A person sustains deep partial-thickness burns while working
C. Applying sterile, moist, non adherent dressings to the on a boat in a town marina and seeks advice from the nurse in
sac. the first aid station. The nurse encourages the client to seek
D. Positioning the infant prone with the legs slightly medical attention, but the client refuses. The nurse advises the
adducted. person to go to a health care provider if:

12. Oxytocin (Pitocin) augmentation via IV piggyback (IVPB) is A. Blisters appear.

prescribed for a client in labor after a period of ineffective B. Urinary output decreases.
uterine contractions. What nursing interventions are most C. Edema and redness occur.
important if strong contractions that last 90 seconds or longer D. Low-grade fever develops.
occur ? Select all that apply.
18. A nurse is working with a client who has the diagnosis of
A. Stop the infusion borderline personality disorder with antisocial behavior. What
B. Turn the client on her side. personality traits should the nurse expect the client to exhibit ?
C. Notify the health care provider. Select all that apply.
D. Verify the length of contractions
A. Engaging
13. The cervix of a client in labor is dilated 8 cm. She tells a B. Indecisive
nurse that she has a desire to push and is becoming C. Withdrawn
increasingly uncomfortable. She requests pain medication. How D. Manipulative
should the nurse respond? E. Perfectionistic

A. Help her to panting breaths. 19. What is the most important test the nurse should check to
B. Prepare the birthing bed for the birth. determine whether a transplanted kidney is functioning?
C. Assist her out of bed to the bathroom.
D. Administer the prescribed butorphanol (Stadol). A. Renal ultrasound
B. Serum creatinine level
14. A nurse administers an intramuscular injection of vitamin K C. White blood cell count
to a newborn. What is the purpose of the injection? D. Twenty four hour urinary output

A. Maintains the intestinal floral count. 20. A pregnant adolescent at 10 weeks gestation visits the
B. Promotes proliferation of intestinal flora. prenatal clinic for the first time. The nutrition interview indicates
C. Stimulates vitamin K production in the baby. that her dietary intake consists mainly of soft drinks, candy,
D. Provides protection until intestinal flora is established. french fries, and potato chips. Why does the nurse consider this
diet inadequate?
15. A child with acute poststreptococcal glomerulonephritis
requests a snack. Which is the most therapeutic selection of A. Caloric content will result in too great a weight gain.
food the nurse can provide? B. Ingredients in soft drinks and candy can be teratogenic
in early pregnancy.
A. Peanuts C. Salt in this diet will contribute to the development of
B. Pretzels gestational hypertension
C. Bananas D. Nutritional composition of the diet places her at risk for
D. Applesauce a low-birth-weight infant

16. A client reports experiencing nausea, dyspnea, and right 21. A nurse in the prenatal clinic is assessing a woman at 34
upper quadrant pain unrelieved by antacids. The pain occurs weeks gestation. The client's blood pressure is 166/100 mm Hg
most often after eating in fast-food restaurants. Which diet and her urine is +3 for protein. She states that she has a severe
should the nurse instruct the client to follow? headache and occasional blurred vision. Her baseline blood
pressure was 100/62 mm Hg. What is the priority nursing
A. Low fat action?
B. Low carbohydrate
C. Soft-textured and bland A. Arrange transportation to the hospital.
B. Obtain a prescription for an antihypertensive.

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Compiled and Screened by: Mr. Gicar C. Magbanua, RN,MSN,USRN,HAAD-RN

C. Recheck the blood pressure within half an hour. C. Hoarseness

D. Obtain a prescription for acetaminophen to relieve the D. Barking Cough
headache E. Inspiratory Stridor

22. A child has cystic fibrosis, Which statement by the parents
about their plan for the child's dietary regimen provides
evidence that they understand the nurse's instructions?
A. “ I will restrict fluids during mealtimes.”
B. “ I will discontinue the use of salt when cooking.”
C. “ I should provide high-calorie foods between meals.”
D. “ I should eliminate whole-milk products from the diet.”
23. A client is admitted to the hospital with a diagnosis of an
exacerbation of asthma. What should the nurse plan to do to
best help this client?
A. Determine the client’s emotional state.
B. Give prescribed drugs to promote bronchial dilation.
C. Provide education about the impact of a family history.
D. Encourage the client to use an incentive spirometer
routinely.
28. An IV infusion of magnesium sulfate is prescribed for a client
with severe preeclampsia. The dose is twice the usual adult dose.
When a nurse questions the dosage, the health care provider
insists that it is the desired dose and directs the nurse to
administer the medication. How should the nurse respond to this
directive?
A. Administer the dose and monitor the client.
B. With hold the dose and notify the nurse manager.
C. Administer the dose and document it on the client’s
record.
D. Withhold the dose and notify the director of the
obstetric department.
29. A client who is lying in the supine position while inactive
labor has an IV oxytocin (Pitocin) infusion and external monitors
in place. Using the monitoring strips below, identify the
appropriate nursing interventions. Select all that apply.

24. A health care provider orders daily sputum specimens to be A. Administer oxygen.
collected from a client. When is the most appropriate time for B. Turn the client on the side.
the nurse to collect these specimens? C. Increase the rate of infusion.
D. Discontinue the oxytocin infusion.
A. After activity E. Request a prescription for an antibiotic.
B. Before meals
C. On awakening
D. Before a respiratory treatments

25. Which factor is essential to consider when a nurse evaluates

whether a unit environment is conducive to psychological safety
for a confused client with dementia?

A. Needs are met entirely.

B. Nursing care is flexible.
C. Realistic limits and controls are set.
D. Physical surroundings are clean and orderly.

26. A client os extubated in the postanesthesia care unit after

surgery. For which common response should the nurse be alert
when monitoring the client for acute respiratory distress?

A. Restlessness
B. Bradycardia
C. Constricted pupils
D. Clubbing of the fingers
30. Which nursing action should be included in the plan of care
27. What clinical findings does a nurse expect when assessing a for a child with acute poststreptococcal glomerulonephritis?
child with acute laryngotracheobronchitis. Select all that apply.
A. Encouraging fluids.
A. Fever B. Monitoring for seizures.
B. Crackless C. Measuring abdominal girth

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 PREDICTOR EXAMINATION
Compiled and Screened by: Mr. Gicar C. Magbanua, RN,MSN,USRN,HAAD-RN

D. Checking for pupillary reactions. C. Abdominal respirations

D. Decreased respiratory rate
31. A nurse is caring for an underweight adolescent girl who is
diagnosed with anorexia nervosa. What are common 37. A nurse is assessing a newborn. What finding indicates the
characteristic of girl with this disorder that the nurse should need for follow up care?
identify when obtaining a health history and performing a
physical assessment? Select all that apply. A. Babinski reflex is positive
B. Head circumference is 33 cm.
A. Fatigue C. Hips are abducted at 30 degrees.
B. Pyrexia D. Umbilical cord has three vessels.
C. Tachycardia
D. Heat intolerance 38. A nurse is assessing a group of older adults. Which should
E. Secondary amenorrhea the nurse consider to be least likely to be affected by aging?

32. A client with major depression is admitted to the hospital. A. Sense of taste or smell
What is the most therapeutic initial nursing intervention? B. Gastrointestinal motility
C. Muscle or motor strength
A. Introducing the client to one other client. D. Strategies to handle stress
B. Requiring participation in therapy sessions.
C. Encouraging interaction with others in small groups. 39. Nurses who care for the terminally ill apply the theories of
D. Conveying an attitude of concern that is not intrusive Kubler-Ross in planning care. According to Kubler-Ross,
individuals who experience a terminal illness go through a
33. During the first trimester, a client tells a nurse at the prenatal grieving process. Place the stages of this process in the order
clinic that she frequently feels nauseated. What should the nurse identified by Kubler-Ross.
teach her about reducing the nausea?
A. Anger
A. Eat small frequent smalls. B. Denial
B. Take an antacid between meals. C. Bargaining
C. Drink cinnamon tincture before rising. D. Depression
D. Take dimenhyDRINATE (Dramamine) at bedtime. E. Acceptance

40. A client who uses ritualistic behavior taps other clients on the
shoulders three times while going through the ritual. The nurse
34. A new parent ask a nurse how to care for the baby's umbilical infers that this client has a:
cord stump. What should the nurse include in the teaching?
A. Blurred personal identity.
A. Expect a moderate amount of drainage. B. Poor control of sudden urges.
B. Keep the area moist with sterile normal saline. C. Disturbance in spatial boundaries.
C. Provide sponge baths until the stump falls off. D. Reduced ability to adapt to life's stresses.
D. Cover the sire with a small sterile dressing twice a day.
41. A pregnant client with severe preeclampsia is receiving IV
35. Using Piaget's theory of cognitive development, what should magnesium sulfate. What should the nurse keep at the bedside
the nurse expect a 6 month old infant to demonstrate? to prepare for the possibility of magnesium sulfate toxicity?

A. Early traces of memory. A. Oxygen

B. Beginning sense of time. B. Naloxone
C. Repetitious reflex responses. C. Calcium Gluconate
D. Beginning of object permanence. D. Suction equipment

36. During a newborn assessment a nurse reports a sign of 42. A person who is hospitalized for alcoholism becomes
respiratory distress. What clinical manifestation did the nurse boisterous and belligerent and verbally threatens the nurse.
identify? What is the most appropriate response by the nurse?

A. Flaring nares A. Place the client in restraints.

B. Rapid heart rate B. Sedate and place the client in a controlled environment.

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Compiled and Screened by: Mr. Gicar C. Magbanua, RN,MSN,USRN,HAAD-RN

C. Encourage the client to play Ping Pong with another A. Repair tissues
client. B. Slows peristalsis
D. Set firm limits on the client’s behavior and enforce C. Corrects the anemia
adherence to them. D. Improves muscle tone

43. A family of a client with myasthenia gravis asks the nurse 48. A nurse is caring for a client experiencing an acute episode of
whether the client will be an invalid. What is the nurse's best bronchial asthma. What outcome should be achieved?
response?
A. Raising mucous secretions from the chest.
A. “Medications will mask the signs of the disease.” B. Curing the client’s condition permanently.
B. “With continuous treatment, the progression of the C. Limiting pulmonary secretions by decreasing fluid
disease usually can be controlled.” intake.
C. “There will be periods when bed rest will be necessary D. Convincing the client that the condition is emotionally
and times when regular activity will be possible.” based.
D. “The progression generally is slow, so people with
myasthenia will spend their younger life with few 49. A nursing assistant interrupts the performance of a ritual by a
problems.” client with obsessive compulsive disorder. What is the most likely
client reaction?
44. A client in a psychiatric hospital with the diagnosis of major
depression is tearful and refuses to eat dinner after a visit with a A. Anxiety
friend. What is the most therapeutic nursing action? B. Hostility
C. Aggression
A. Allow the client to skip the meal. D. Withdrawal
B. Offer an opportunity to discuss the visit.
C. Reinforce the importance of adequate nutrition. 50. When a nurse is working with a client with psychiatric
D. Provide the client with adequate quiet thinking time. problems, a primary goal is the establishment of a therapeutic
nurse-client relationship. What is the major purpose of this
45. A person with a history of alcoholism states, "I have been relationship?
drinking since last Friday to celebrate my son's graduation from
college." What defense mechanism does the nurse identify the A. Increase nonverbal communication.
client is using? B. Present an outlet for suppressed hostile feelings.
C. Assist the client in acquiring more effective behavior.
A. Projection D. Provide the client with someone who can make
B. Suppression decisions.
C. Identification
D. Rationalization 51. An African-American woman is diagnosed with primary
hypertension. She asks, "Is hypertension a disease of African-
46. A client who has a phobia about dogs is about to begin American people?" What is the nurse's best response?
systematic desensitization. The client asks what the treatment will
involve. What is the nurse's best response? A. “The prevalence of hypertension is about equal for
women ofall races.”
A. “You will be exposed to dogs until you no longer feel B. “The higher-risk population is composed of African-
anxious.” American men and women.”
B. “Reward will be given when you do not become C. “The highest risk population consists of older
anxious around dogs.” Caucasian-American men and women.”
C. “Your contact with dogs will increase while using D. “The prevalence of hypertension is greater for African -
relaxation techniques.” American women than for African-American men.”
D. “There will be in depth discussions to identify what
caused your phobia.” 52. A health care provider prescribes a diuretic for a client with
hypertension. What should the nurse include in the teaching
47. A nurse is providing dietary teaching for a client who is when explaining how diuretics reduce blood pressure?
receiving a high-protein diet while recovering from an acute
episode of colitis. What should the nurse include is the rationale A. Facilitates vasodilation
for this diet? B. Promotes smooth muscle relaxation
C. Reduces the circulating blood volume

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Compiled and Screened by: Mr. Gicar C. Magbanua, RN,MSN,USRN,HAAD-RN

D. Blocks the sympathetic nervous system

59. Gold salts may be used to treat rheumatoid arthritis . A
53. A nurse is caring for a client who is receiving a thiazide serious side effect of this drug is:
diuretic for hypertension. Which food selected by the client A. kidney damage
indicates to the nurse that dietary teaching about thiazide B. persistent nausea
diuretics was effective? C. pulmonary emboli
D. cardiac decompression
A. Apples
B. Broccoli 60. A client with rheumatoid arthritis is receiving
C. Cherries aurothioglucose , a gold compound. It is most important
D. Cauliflower that the nurse monitor the client for:
A. hypertension
54. A nurse is caring for a client who attempted suicide. What is B. cutaneous lesions
the most desirable short term client outcome during this crisis C. thrombocytopenia
situation? D. elevated blood glucose

A. Strengthening coping skills 61. The physician orders antibiotic therapy for a client receiving
B. Establishing a no suicide contract chemotherapy because these agents destroy rapidly
C. Learning problem solving techniques growing cells in the:
D. Recognizing why suicide was attempted A. liver
B. blood
55. A client with adrenal insufficiency reports feeling weak and C. lymph nodes
dizzy, especially in the morning. What should the nurse D. bone marrow
determine is the most probable cause of these symptoms?
62. During chemotherapy for cancer of the lung, the nurse
A. A lack of potassium expects the client to develop soreness of the mouth and
B. Postural hypertension anus because:
C. A hypoglycemic reaction
D. Increased extracellular A. these tissues are poorly nourished because the client is
anorectic
56. A client is admitted to the hospital with a diagnosis of chronic B. the entire GIT is involved because of the direct irritating
kidney failure. For signs of what electrolyte imbalance should the effects of chemotherapy
nurse monitor the client? C. these tissues normally divide rapidly and are damaged
by the chemotherapeutic agent
A. Hypokalemia D. the side effects of the chemotherapeutic agents used
B. Hypocalcemia tend to concentrate in these body areas
C. Hypernatremia
D. Hyperglycemia 63. A client is to receive leucovorin calcium before receiving
methotrexate. This drug is being administered to:
57. A client has a history of hypothyroidism. Which skin condition
should the nurse expect when performing a physical assessment? A. provide levels of folic acid required by blood – forming
organs
A. Dry B. provide the metabolite required for destruction of
B. Moist cancer cells
C. Flushed C. provide folic acid, which acts synergistically with
D. Smooth antineoplastic drugs to destroy cancer cells
D. increase production of phagocytic cells required to
58. The nurse administers desmopressin acetate to a client with remove debris liberated by disintegration cancer cells
diabetes insipidus. To evaluate the effectiveness of the drug the
nurse should monitor the client’s: 64. While a client is receiving dexamethasone , the nurse should
test the client’s blood glucose level because the drug:
A. pulse rate
B. serum glucose A. has a glucose component
C. arterial blood pH B. accelerates glucose metabolism
D. intake and output C. mobilizes liver stores of glycogen

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Compiled and Screened by: Mr. Gicar C. Magbanua, RN,MSN,USRN,HAAD-RN

D. lowers the renal threshold for glucose A. Roasted chicken

B. Salami
65. To assist the medical team in prescribing an effective C. Fresh fish
antibiotic, the most valuable test is the: D. Hamburger

A. serologic test 71. The nurse is providing care for a client undergoing opiate
B. sensitivity test withdrawal. Opiate withdrawal causes severe physical discomfort
C. susceptibility test and can be life-threatening. To minimize these effects, opiate
D. tissue culture test users are commonly detoxified with:
A. Barbiturates
66. After receiving streptomycin sulfate for 2 weeks as part of B. Methadone
the medical regimen for TB , the client states, “ I feel like I C. Amphetamines
am walking like a drunken seaman.” The nurse withholds the D. Benzodiazepines
drug and promptly reports the problem to the physician
because the signs maybe a result of the drug’s effect on the: 72. A female client is brought by ambulance to the hospital
emergency room after taking an overdose of barbiturates is
A. cerebellar tissue comatose. The nurse should be especially alert for which of the
B. peripheral motor end plates following?
C. internal capsule and pyramidal tracts A. Epilepsy
D. vestibular branch of the 8th CN B. Renal failure
C. Acute liver failure
67. The nurse suggests an antacid containing aluminum and D. Respiratory distress
magnesium hydroxide such Maalox instead of baking soda.
This response is based on the fact that antacids such as 73. A client is admitted to the substance abuse unit for alcohol
Maalox: detoxification. Which of the following medications is the nurse
most likely to administer to reduce the symptoms of alcohol
A. contain little if any sodium withdrawal?
B. are readily absorbed by the stomach mucosa
C. have no direct effect on systemic acid – base balance A. Naloxone (Narcan)
when taken as directed B. Haloperidol (Haldol)
D. cause few side – effects such as diarrhea or constipation C. Magnesium sulfate
when they are used properly D. Chlordiazepoxide (Librium)

68. A client reports taking calcium carbonate frequently. The
client should be advised that this practice may lead to:
A. diarrhea
B. water retention
C. rebound hyperacidity
D. bone demineralization
69. Which of the following statements by a chemotherapy
patient would indicate a need for further teaching?
A. “My lips are dry and cracking. I need some lubricant
B. “My husband and I have been using vaginal
lubrication before intercourse.”
C. “I check my mouth and teeth after each meal”
D. “I’ve been very constipated and I need an enema.”
70. When teaching a client with atypical depression about foods
to avoid while taking phenelzine, which of the following would
the nurse in charge include?
74. When assessing a female client who is receiving tricyclic
antidepressant therapy, which of the following would alert the
nurse to the possibility that the client is experiencing
anticholinergic effects?
A. Urine retention and blurred vision
B. Respiratory depression and convulsion
C. Delirium and sedation
D. Tremors and cardiac arrhythmias
75. Which of the following drugs may be abused because of
tolerance and physiologic dependence?
A. lithium (Lithobid) and divalproex (Depakote).
B. verapamil (Calan) and chlorpromazine (Thorazine)
C. alprazolam (Xanax) and phenobarbital (Luminal)
D. clozapine (Clozaril) and amitriptyline (Elavil)
76. A client receiving haloperidol (Haldol) complains of a stiff jaw
and difficulty swallowing. The nurse’s first action is to:
A. reassure the client and administer as needed
lorazepam (Ativan) I.M.
B. administer as needed dose of trihexyphenydil
(Artane) as ordered.

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C. administer as needed dose of lioresal (Baclofen) as dose of the drug that the client will receive per oral
ordered. administration?
D. administer as needed dose of haloperidol (Haldol) by A. 1000 mg tid
mouth. B. 500 mg tid
C. 1,500 mg tid
77. A client is diagnosed with amphetamine psychosis and was D. 50 mg tid
admitted in the emergency room. The nurse should most likely
prepare to administer which of the following medication? 84. If a patient has a dopamine drip of 800 mg in 500 ml D5W,
A. Librium the concentration is:
B. Ativan A. 0.16 mg/ml
C. Valium B. 1.6mg/ml
D. Haldol C. 16mg/ml
D. 160mg/ml
78. An antihypertensive agent , minoxidil 5 mg p.o. is ordered.
Stock is 2.5mg/tab. How many tablets should be 85. The doctor writes an order for 2 liters of lactated ringer’s
administered? solution to be infused over 16 hours . the drop factor is 20
A. 1 tablet gtt/ml. What should the drip rate be?
B. 2 tablets
C. 3 tablets A. 25 gtt/minute
D. 4 tablets B. 33 gtt/min
C. 20gtt/min
79. Order is cefadroxil (Duricef) 500mg PO, b.i.d.. Available stock D. 42 gtt/min
is Duricef 250mg/5ml. How many ml should the client
receive per dose? 86. The doctor writes a single dose order for Toradol 15 mg I.V.
A. 5ml for pain. Toradol is available in a vial containing 60mg/2ml.
B. 10ml How many milliliters should the nurse administer?
C. 2.5ml A. 0.5ml
D. 20ml B. 5ml
C. 0.2ml
80. Cyclophosphamide 2mg/kg PO q.d. is ordered. Client D. 2ml
weighs 143 lbs. How much does the client weigh in
kilograms? 87. The nurse is to administer Rocephin 2 g in 500 ml over 10
A. 55 kg hours. What hourly flow rate should the nurse set the
B. 60 kg infusion pump to deliver?
C. 65 kg
D. 70 kg A. 50ml/hour
81. How many mg should the client receive?(refer to question B. 65ml/hour
#80) C. 35ml/hour
A. 130 mg D. 15ml/hour
B. 100 mg
C. 30 mg 88. The child weighing 15 pounds is to receive an antibiotic. The
D. 150mg recommended adult dose is 500mg. How many mg should
the nurse administer?
82. Order is valproic acid (Depakene) 8 mg/kg/day in four A. 110 mg
divided doses. Client weighs 165 lbs. How much Depakene B. 50 mg
should be administered per dose ? C. 500 mg
A. 100mg/dose D. 10 mg
B. 50mg/dose
C. 600mg/dose 89. Lab results indicate that the client’s serum aminophylline
D. 150mg/dose level is at 17mcg/ml. The nurse recognizes that the
aminophylline level is :
83. Rudolf is diagnosed with amoebiasis and is to receive A. within therapeutic range
metronidazole(Flagyl) tablets 1.5 gm daily in 3 divided doses B. too high and should be reported
for 7 consecutive days. Which of the following is the correct C. questionable and should be repeated
D. too low to be therapeutic
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Compiled and Screened by: Mr. Gicar C. Magbanua, RN,MSN,USRN,HAAD-RN

90. A client with cancer received platelet infusions 24 hours ago. B. Write up a counseling record with objective data and
Which of the following assessment findings would indicate give it to the manager.
the most therapeutic effect from the transfusions? C. Complete the delegated tasks and do nothing about
A. an Hgb level increase from 8.9 to 10.6 the insubordination.
B. a temperature reading of 99.4 degree Fahrenheit D. Address the UAP to discuss why the tasks are not being
C. a WBC count of 11,000 done as requested.
D. a decrease in oozing of blood from the IV site
96. The primary nurse informs the shift manager one of the
91. The nurse is caring for a client receiving chemotherapy who unlicensed assistive personnel (UAPs) is falsifying vital signs.
is experiencing neutropenia. Which intervention would be Which action should the shift manager implement first?
most appropriate to include in the client’s plan of care?
A. assess the client’s temperature every 4 hours due to risk
A. Notify the unit manager of the potential situation of
of hypothermia
falsifying vital signs.
B. instruct the client to avoid large crowds and people
B. Take the assigned client’s vital signs and compare with
who are sick the UAP’s results.
C. instruct the client in the use of a soft toothbrush C. Talk to the UAP about the primary nurse’s allegation.
D. assess the client for hematuria D. Complete a counseling record and place in the UAP’s
92. A client with cancer becomes emaciated, requiring TPN to file.
provide adequate nutrition. The nurse finds the TPN bag
empty. Which fluid would the nurse select to hang until 97. The nurse hung the wrong intravenous antibiotic for the
another bag is prepared in the pharmacy? postoperative client. Which intervention should the nurse
A. lactated ringer’s implement first?
B. normal saline
C. D10 water A. Assess the client for any adverse reactions.
D. Normosol R B. Complete the incident or adverse occurrence report.
C. Administer the correct intravenous antibiotic
93. The new graduate working on a medical unit night shift is medication.
concerned that the charge nurse is drinking alcohol on duty. On D. Notify the client’s healthcare provider.
more than one occasion, the new graduate has smelled alcohol
when the charge nurse returns from a break. Which action 98. The nurse, a licensed practical nurse (LPN), and an unlicensed
should the new graduate nurse implement first? assistive personnel (UAP) are caring for clients in a critical care
unit. Which task would be most appropriate for the nurse to
A. Confront the charge nurse with the suspicions. assign/delegate?
B. Talk with the night supervisor about the concerns.
C. Ignore the situation unless the nurse cannot do her job. A. Instruct the UAP to obtain the client’s serum glucose
D. Ask to speak to the nurse educator about the problem. level.
B. Request the LPN to change the central line dressing.
94. The charge nurse observes two unlicensed assistive personnel C. Ask the LPN to bathe the client and change the bed
(UAPs) arguing in the hallway. Which action should the nurse linens.
implement first in this situation? D. Tell the UAP to obtain urine output for the 12-hour
shift.
A. Tell the manager to check on the UAPs.
B. Instruct the UAPs to stop arguing in the hallway. 99. Which task should the critical care nurse delegate to the
C. Have the UAPs go to a private room to talk. unlicensed assistive personnel (UAP)?
D. Mediate the dispute between the UAPs.
A. Check the pulse oximeter reading for the client on a
95. The graduate nurse is working with unlicensed assistive ventilator.
personnel (UAP) who has been an employee of the hospital for B. Take the client’s sterile urine specimen to the
12 years. However, tasks delegated to the UAP by the graduate laboratory.
nurse are frequently not completed. Which action should the C. Obtain the vital signs for the client in an Addisonian
graduate nurse take first? crisis.
D. Assist the HCP with performing a paracentesis at the
A. Tell the charge nurse the UAP will not do tasks as bedside.
delegated by the nurse.
100. Which situation would prompt the healthcare team to utilize

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the client’s advance directive when needing to make decisions B. Instruct her to go to the local emergency room.
for the client? C. Tell her to complete an occurrence report.
D. Recommend that she apply an ice pack to the back.
A. The client with a head injury who is exhibiting
decerebrate posturing. 105. The female client with osteoarthritis is 6 weeks postoperative
B. The client with a C-6 spinal cord injury (SCI) who is on a for open reduction and internal fixation of the right hip. The
ventilator. home health (HH) aide tells the HH nurse the client will not get in
C. The client in chronic renal disease who is being placed the shower in the morning because she “hurts all over.” Which
on dialysis. action would be most appropriate by the HH nurse?
D. The client diagnosed with terminal cancer who is
mentally retarded. A. Tell the HH aide to allow the client to stay in bed until
the pain goes away.
101. The nurse is caring for clients on a skilled nursing unit. Which B. Instruct the HH aide to get the client up to a chair and
task should not be delegated to the unlicensed assistive give her a bath.
personnel (UAP)? C. Explain to the HH aide the client should get up and take
a warm shower.
A. Instruct the UAP to apply sequential compression D. Arrange an appointment for the client to visit her
devices to the client on strict bed rest. healthcare provider.
B. Ask the UAP to assist the radiology tech to perform a
STAT portable chest x-ray. 106. The home health (HH) nurse is discussing the care of a client
C. Request the UAP to prepare the client for a wound with the female HH aide. Which task should the HH nurse
debridement at the bedside. delegate to the HH aide?
D. Tell the UAP to obtain the intakes and outputs (I&Os)
for all the clients on the unit. A. Instruct her to assist the client with a shower.
B. Ask her to prepare the breakfast meal for the client.
102. The nurse is assigned to a quality improvement committee C. Request her to take the client to an HCP’s appointment.
to decide on a quality improvement project for the unit. Which D. Tell her to show the client how to use a glucometer.
issue should the nurse discuss at the committee meetings?
107. The unlicensed assistive personnel (UAP) is preparing to
A. Systems that make it difficult for the nurses to do their provide postmortem care to a client with a questionable
job. diagnosis of anthrax. Which instruction is priority for the nurse to
B. How unhappy the nurses are with their current pay provide to the UAP?
scale.
C. Collective bargaining activity at a nearby hospital. A. The UAP is not at risk for contracting an illness.
D. The number of medication errors committed by an B. The UAP should wear a mask, gown, and gloves.
individual nurse. C. The UAP may skip performing postmortem care.
D. Ask whether the UAP is pregnant before she enters the
103. The clinic manager is discussing osteoporosis with the clinic client’s room.
staff. Which activity is an example of a secondary nursing
intervention when discussing osteoporosis? 108. The client on a medical unit died of a communicable disease.
Which information should the nurse provide to the mortuary
A. Obtain a bone density evaluation test on a female client workers?
older than 50.
B. Perform a spinal screening examination on all female A. No information can be released to the mortuary service.
clients. B. The nurse should tell the funeral home the client’s
C. Encourage the client to walk 30 minutes daily on a hard diagnosis.
surface. C. Ask the family for permission to talk with the mortician.
D. Discuss risk factors for developing osteoporosis. D. Refer the funeral home to the HCP for information.

104. The female home health (HH) aide calls the office and 109. The new graduate nurse is assigned to work with an
reports pain after feeling a pulling in her back when she was unlicensed assistive personnel (UAP) to provide care for a group
transferring the client from the bed to the wheelchair. Which of clients. Which action by the nurse is the best method to
priority action should the HH nurse tell the HH aide? evaluate whether delegated care is being provided?

A. Explain how to perform isometric exercises. A. Check with the clients to see whether they are satisfied.

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B. Ask the charge nurse whether the UAP is qualified.
C. Make rounds to see that the clients are being turned.
D. Watch the UAP perform all the delegated tasks.
110. The charge nurse is making assignments on a pediatric unit.
Which client should be assigned to the licensed practical nurse
(LPN)?
A. The 6-year-old client diagnosed with sickle cell crisis.
B. The 8-year-old client diagnosed with biliary atresia.
C. The 10-year-old client diagnosed with anaphylaxis.
D. The 11-year-old client diagnosed with pneumonia.
111. The nurse is caring for the following clients on a medical unit.
Which client should the nurse assess first?
A. The client with disseminated intravascular coagulation
(DIC) who has blood oozing from the intravenous site.
B. The client with benign prostatic hypertrophy (BPH) who
is complaining of terminal dribbling and inability to
empty bladder.
C. The client with renal calculi who is complaining of
severe flank pain and has hematuria.
D. The client with Addison’s disease who has bronze skin
pigmentation and hypoglycemia.
112. The charge nurse is making assignments in the day surgery
center. Which client should be assigned to the most experienced
nurse?
A. The client who had surgery for an inguinal hernia and
who is being prepared for discharge.
B. The client who is in the preoperative area and who is
scheduled for laparoscopic cholecystectomy.
C. The client who has completed scheduled chemotherapy
treatment and who is receiving two units of blood.
D. The client who has end-stage renal disease and who
has had an arteriovenous fistula created.
113. The charge nurse of a critical care unit is making assignments
for the night shift. Which client should be assigned to the
graduate nurse who has just completed an internship?
A. The client diagnosed with a head injury resulting from a
motor vehicle accident (MVA) whose Glasgow Coma
Scale score is 13.
B. The client diagnosed with inflammatory bowel disease
(IBD) who has severe diarrhea and has a serum K+ level
of 3.2 mEq/L.
C. The client diagnosed with Addison’s disease who is
lethargic and has a BP of 80/45, P of 124, and R rate of
28.
D. The client diagnosed with hyperthyroidism who has
undergone a thyroidectomy and has a positive
Trousseau’s sign.
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114. The nurse on a medical unit has just received the evening
shift report. Which client should the nurse assess first?
A. The client diagnosed with a deep vein thrombosis (DVT)
who has a heparin drip infusion and a PTT of 92.
B. The client diagnosed with pneumonia who has an oral
temperature of 100.2°F.
C. The client diagnosed with cystitis who complains of
burning on urination.
D. The client diagnosed with pancreatitis who complains of
pain that is an 8.
115. The 75-year-old client has undergone an open
cholecystectomy for cholelithiasis 2 days ago and has a t-tube
drain in place. Which intervention should the nurse delegate to
the unlicensed assistive personnel (UAP)? Select all that apply.
A. Explain the procedure for using the patient-controlled
analgesia (PCA) pump.
B. Check the client’s abdominal dressing for drainage.
C. Take and record the client’s vital signs.
D. Empty the client’s indwelling catheter bag at the end of
the shift.
E. Assist the client to ambulate in the hallway three to four
times a day.
116. The surgical unit has a low census and is overstaffed. Which
staff member should the house supervisor notify first and request
to stay home?
A. The nurse who has the most vacation time.
B. The nurse who requested to be off.
C. The nurse who has the least experience on the unit.
D. The nurse who has called in sick the previous 2 days.
117. The nurse and the unlicensed assistive personnel (UAP) are
caring for residents in a long-term care facility. Which task
should the nurse delegate to the UAP?
A. Apply a sterile dressing to a Stage IV pressure wound.
B. Check the blood glucose level of a resident who is weak
and shaky.
C. Document the amount of food the residents ate after a
meal.
D. Teach the residents how to play different types of
bingo.
118. The director of nurses in a long-term care facility observes
the licensed practical nurse (LPN) charge nurse explaining to an
unlicensed assistive personnel (UAP) how to calculate the
amount of food a resident has eaten from the food tray. Which
action should the director of nurses implement?
 PREDICTOR EXAMINATION
Compiled and Screened by: Mr. Gicar C. Magbanua, RN,MSN,USRN,HAAD-RN

A. Ask the charge nurse to teach all the other UAPs. D. The 10-year-old child who is thirsty all the time and has
B. Encourage the nurse to continue to work with the UAP. lost weight.
C. Tell the charge nurse to discuss this in a private area.
D. Give the UAP a better explanation of the procedure. 124. Which statement is an example of community-oriented,
population-focused nursing?
119. The wound care nurse in a long-term care facility asks the
unlicensed assistive personnel (UAP) for assistance. Which task A. The nurse cares for an older adult client who had a
should not be delegated to the UAP? kidney transplant and who livesnin the community.
B. The nurse develops an educational program for the
A. Apply the wound debriding paste to the wound. type 2 diabetics in the community.
B. Keep the resident’s heels off the surface of the bed. C. The nurse refers a client with Cushing’s syndrome to the
C. Turn the resident at least every 2 hours. registered dietician.
D. Encourage the resident to drink a high-protein shake. D. The nurse provides the client chronic renal disease with
pamphlets.
120. The older adult client becomes confused and wanders in the
hallways. Which fall precaution intervention should the nurse 125. The home health (HH) agency director of nursing is making
implement first? assignments for the nurses. Which client should be assigned to
the HH nurse new to HH nursing?
A. Place a Posey vest restraint on the client.
B. Move the client to a room near the station. A. The client diagnosed with AIDS who is dyspneic and
C. Ask the HCP for an antipsychotic medication. confused.
D. Raise all four side rails on the client’s bed. B. The client who does not have the money to get
prescriptions filled.
121. The clinic nurse is caring for a client diagnosed with C. The client with full-thickness burns on the arm who
osteoarthritis. The client tells the nurse, “I am having problems needs a dressing change.
getting in and out of my bathtub.” Which intervention should the D. The client complaining of pain who is diagnosed with
clinic nurse implement first? diabetic neuropathy.

A. Determine whether the client has grab bars in the
bathroom.
B. Encourage the client to take a shower instead of a bath.
C. Initiate a referral to a physical therapist for the client.
D. Discuss whether the client takes nonsteroidal anti-
inflammatory drugs (NSAIDs).
122. The employee health nurse has cared for six clients who
have similar complaints. The clients have a fever, nausea,
vomiting, and diarrhea. Which action should the nurse
implement first after assessing the clients?
A. Have another employee drive the clients home.
B. Notify the public health department immediately.
C. Send the clients to the emergency department.
D. Obtain stool specimens from the clients.
123. The clinic nurse is caring for clients in a pediatric clinic.
Which client should the nurse assess first?
A. The 4-year-old child who fell and is complaining of left
leg pain.
B. The 3-year-old child who is drooling and does not want
to swallow.
C. The 8-year-old child who has complained of a
headache for 2 days.
126. The home health (HH) nurse along with an HH aide is caring
for a client who is 3 weeks postoperative for open reduction and
internal fixation of a right hip fracture. Which task would be
appropriate for the nurse to delegate to the aide?
A. Instruct the HH aide to palpate the right pedal pulse.
B. Ask the HH aide to change the right hip dressing.
C. Tell the HH aide to elevate the right leg on two pillows.
D. Request the HH aide to mop the client’s bedroom floor.
127. The charge nurse has received laboratory data for clients in
the medical department. Which client would require intervention
by the charge nurse?
A. The client diagnosed with a myocardial infarction (MI)
who has an elevated troponin level.
B. The client receiving the IV anticoagulant heparin who
has a partial thromboplastin time (PTT) of 68 seconds.
C. The client diagnosed with end-stage liver failure who
has an elevated ammonia level.
D. The client receiving the anticonvulsant phenytoin
(Dilantin) who has levels of 24 mg/dL.
128. Which client would most benefit from acupuncture, a
traditional Chinese medicine considered complementary
alternative medicine?

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A. The client who is diagnosed with deep vein thrombosis. A. Tolerance to the drug develops readily.
B. The client who is diagnosed with Alzheimer’s disease. B. One third to one half the usual dose should be
C. The client diagnosed with reactive airway disease. prescribed.
D. The client diagnosed with osteoarthritis. C. Opioids may interfere with the secretion of thyroid
hormones.
129. The home health (HH) nurse notes the 88-year-old female D. Sedation will have a paradoxical effect, causing
client is unable to cook for herself and mainly eats frozen foods hyperactivity.
and sandwiches. Which intervention should the nurse
implement? 134. What must the nurse emphasize to the family when
preparing a child with persistent asthma for discharge?
A. Discuss the situation with the client’s family.
B. Refer the client to the HH occupational therapist. A. A cold, dry environment is desirable.
C. Request the HH aide to cook all the client’s meals. B. Limits should not be placed on the child’s behavior.
D. Contact the community’s Meals on Wheels. C. The health problem is gone when symptoms subside.
D. Medications must be continued even when
130. Which legal intervention should the nurse implement on the asymptomatic.
initial visit when admitting a client to the home healthcare
agency? 135. The parents of a child with a fever, headache and stiff neck
express concern that the child be tested for meningitis. Which
A. Discuss the professional boundary-crossing policy with test should the nurse explain to the parents is used to confirm
the client. the diagnosis of meningitis?
B. Provide the client with a copy of the NAHC Bill of
Rights. A. Myelogram
C. Tell the client how many visits the client will have while B. Blood culture
on service.
D. Explain that the client must be homebound to be C. Lumbar puncture
eligible for home healthcare. D. Peripheral skin smear

136. A CBC, urinalysis, and x-ray examination of the chest are

131. The unlicensed assistive personnel (UAP) accidentally pulled ordered for a client before surgery. The client asks why these
the client’s chest tube out while assisting the client to the tests are done. Which is the best reply by the nurse?
bedside commode (BSC). Which intervention should the nurse
implement first? A. “Don’t worry; these tests are routine.”
B. “They are done to identify other health risks.”
A. Securely tape petroleum gauze over the insertion site. C. “They determine whether surgery will be safe.”
B. Instruct the UAP how to move a client with a chest tube. D. “I don’t know; your healthcare provider ordered them.”
C. Assess the client’s respirations and lung sounds.
D. Obtain a chest tube and a chest tube insertion tray. 137. A client is scheduled for emergency abdominal surgery.
What is the priority preoperative nursing objective when caring
132. The nurse and licensed practical nurse (LPN) have been for this client?
assigned to care for clients on a pediatric unit. Which nursing
task should be assigned to the LPN? A. Recording accurate vital signs
B. Alleviating the client’s anxiety
A. Administer PO medications to a client diagnosed with C. Teaching about early ambulation
gastroenteritis. D. Maintaining the client’s nutritional status
B. Take the routine vital signs for all the clients on the
pediatric unit. 138. A healthcare provider prescribes famotidine (Pepcid) for a
C. Transcribe the HCP’s orders into the computer. client with dyspepsia. What is important to include about this
D. Assess the urinary output of a client diagnosed with medication in a teaching program for this client?
nephrotic syndrome.
A. Lowers the stress level
133. A nurse is caring for a client which myxedema who has B. Neutralizes gastric acidity
undergone abdominal surgery. What should the nurse consider C. Reduces gastrointestinal peristalsis
when administering opioids to this client? D. Decreases secretions in the stomach

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139. Although a nurse is unable to identify any obvious signs or

symptoms of bleeding, a client repeatedly has tested positive for 145. A nurse is caring for a 3-year old child with meningitis. For
occult blood in the stool. Which laboratory result is a concern what signs and symptoms of increased intracranial pressure
considering this client’s history? should the nurse assess the child? Select all that apply.

A. Iron level 100 mcg/dL A. Vomiting

B. Uric acid level 6.5 mg/dL B. Headache
C. Hemoglobin level 8.5 g/dL C. Irritability
D. Transferrin level 300 mg/dL D. Tachypnea
E. Hypotension
140. Which clinical findings should the nurse expect when
assessing a client with hyperthyroidism? Select all that apply. 146. A male client receiving hemodialysis undergoes surgery to
create an arteriovenous fistula. Before discharge, the nurse
A. Lethargy discusses care at home with the client and his wife. Which
B. Tachycardia statement by the client’s wife indicates that further teaching is
C. Weight gain required?
D. Constipation
E. Exophthalmos A. “I must touch the shunt several times a day to feel for
the bruit.”
141. A nurse is assessing a client with a major depression. Which B. “I have to take his blood pressure every day in the arm
clinical manifestation reflects a disturbance in affect related to with the fistula.”
depression? C. “He will have to be very careful at night not to lie on the
arm with the fistula.”
A. Echolalia D. “We really should check the fistula every day for a signs
B. Delusions of redness and swelling.”
C. Confusions
D. Hopelessness 147. A client is admitted to the hospital with a diagnosis of
myasthenia gravis. For which common early clinical finding
142. A client undergoes cardiac catheterization via the femoral should the nurse assess the client?
artery because of a history of bilateral mastectomies, What is the
most important nursing action after the procedure? A. Tearing
B. Blurring
A. Provide a bed cradle C. Diplopia
B. Check for a pulse deficit D. Nystagmus
C. Elevate the head of the bed
D. Assess the groin for bleeding 148. A hospitalized client is receiving pyridostigmine (Mestinon)
for control of myasthenia gravis. In the middle of the night, the
143. A client with heart failure is on a drug regimen of digoxin nurse finds the client weak and barely able to move. Which
(Lanoxin) and furosemide (Lasix). The client dislikes oranges and additional clinical findings support the conclusion that these
bananas. Which fruit should the nurse encourage the client to responses are related to pyridostigmine? Select all that apply.
eat?
A. Respiratory depression
A. Apples B. Distention of the bladder
B. Grapes C. Decreased blood pressure
C. Apricots D. Fine tremor of the fingers
D. Cranberries E. High-pitched gurgling bowel sounds

144. A client whom sexual dysfunction is diagnosed comments to 149. A client is in the intensive care unit after sustaining a T2
the nurse, “Well, I guess my sex life is over.” What is the most spinal cord injury. Which priority interventions should the nurse
appropriate response by the nurse? include in the client’s plan of care? Select all that apply.

A. “I'm sorry to hear that.” A. Minimizing environmental stimuli

B. “Oh, you have a lot of good years left.” B. Assessing for respiratory complications
C. “You are concerned about your sex life?” C. Initiating a bowel and bladder training program
D. “Have you asked your health care provider about that?” D. Discussing long term treatment plans with the family

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D. Low in residue
150. A nurse is assessing a male newborn. Which characteristics
should alert the nurse to conclude that the newborn is a preterm 156. What gross motor skills should the nurse expect a
infant? Select all that apply. developmentally appropriate 3-year old child to perform? Select
all that apply.
A. Wrinkled, thin skin
B. Multiple sole creases A. Skipping on alternate feet
C. Small breast and bud size B. Riding online on a small bicycle
D. Presence of scrotal rugae C. Standing on one foot for a few seconds
E. Pinna remaining flat when bolded D. Alternating the feet when walking upstairs
E. Jumping rope by lifting both feet simultaneously
151. A pregnant client complains of constipation. Which strategies
should the nurse recommend? Select all that apply. 157. An older adult is hospitalized for weight loss and
dehydration because of nutritional deficits. What should the
A. Exercise regularly nurse consider when caring for this client?
B. Take a mild laxative before breakfast
C. Drink at least one caffeinated beverage daily A. Financial resources usually are unrelated to nutritional
D. Add a few tablespoons of wheat bran to cereal at status.
breakfast B. An older adult’s daily fluid intake must be markedly
E. Plan to have a bowel movement at the same time every increased.
day C. The client’s diet should be high in carbohydrates and
low in proteins.
152. A client with schizophrenia, paranoid type, is admitted D. The nutritional needs of an older adult are unchanged
involuntarily to the hospital because family members state that except for a decreased need for calories.
he has threatened to harm them physically. When exploring
feelings about the readmission, the client angrily shouts, “ You’re 158. A healthcare provider orders peak and trough levels of an
one of them. Leave me alone!” How should the nurse respond? antibiotic for a client who is receiving vancomycin IV piggyback
(IVPB). When should a blood sample be obtained to determine a
A. “Try not to be afraid. I will not hurt you.” peak level of the antibiotic?
B. “I can see you are upset. We can talk more later.”
C. “I am not one of them, and I am here to help you.” A. Anytime it is convenient for the client
D. “Your family and the staff are trying to help you .” B. Between 30 and 60 minutes after a dose
C. Halfway between two doses of the drug
153. A postoperative client is diagnosed as having atelectasis. D. At 30 minutes before the medication is administered
Which nursing assessment supports this diagnosis?
159. A nurse is admitting a client with a history of bipolar
A. Productive cough disorder. The nurse determines that the client is in the manic
B. Clubbing of the fingertips phase. Which signs and symptoms contribute to the nurse’s
C. Crackles at the height of inhalation conclusion? Select all that apply.
D. Diminished breath sounds on auscultation
A. Irritability
154. What is important nursing care for children with leukemia on B. Grandiosity
chemotherapeutic protocols? C. Pressured speech
D. Thought blocking
A. Preventing physical activity E. Psychomotor retardation
B. Checking their vital signs every two hours
C. Having them avoid contact with infected persons 160. A nurse is caring for a client with addison disease. What
D. Reducing unnecessary stimuli in their environment should the nurse teach the client to do regarding an appropriate
155. A client is receiving vinCRIStine. What should the nurse diet?
expect the dietary plan to include to minimize the side effects of
vinCRIStine? A. Add extra salt to food
B. Limit intake to 1200 calories
A. Low in fat C. Omit protein foods at each meal
B. High in iron D. Restrict the daily intake if fluids to 1 liter
C. High in fluids

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161. A nurse is caring for a 12 month old infant with a diagnosis D. Anti-rejection medications
of failure to thrive. The infant’s weight is below the third
percentile, and development is delayed. Which behaviors of the 166. A nurse is caring for a client who is receiving a unit of
child suggest to the nurse the possibility of parental neglect? packed RBCs. Which findings lead the nurse to suspect a
Select all that apply. transfusion reaction caused by incompatible blood? Select all
that apply.
A. Stiff
B. Withdrawn A. Cyanosis
C. Easily satisfied B. Backache
D. Minimal smiling C. Shivering
E. Responsive to touch D. Bradycardia
F. Little interest in the environment E. Hypertension

162. A client who was in an automobile collision is admitted to 167. A client is admitted to a medical unit with the diagnosis of
the hospital with multiple injuries. Approximately 14 hours after acute kidney failure. The nurse reviews the client’s laboratory
admission, the client begins to experience signs and symptoms data, performs a physical assessment, and obtains the client’s
of withdrawal from alcohol. Which of these signs and symptoms vital signs. What should the nurse conclude the client is most
should the nurse relate to alcohol withdrawal? Select all that likely experiencing?
apply.
A. Hyperkalemia
A. Fatigue B. Hyponatremia
B. Anxiety C. Hypouricemia
C. Runny nose D. Hypercalcemia
D. Diaphoresis
E. Psychomotor agitation 168. A nurse is caring for a client with chronic kidney failure.
What should the nurse teach the client to limit the intake of to
163. A health care provider diagnoses that a client has acute help control uremia associated with end-stage renal disease
cholecystitis with biliary colic. What clinical findings should the (ESRD)?
nurse expect when performing a health history and physical
assessment? Select all that apply. A. Fluid
B. Protein
A. Diarrhea with black feces C. Sodium
B. Intolerance to foods high in fat D. Potassium
C. Vomiting of coffee-ground emesis
D. Gnawing pain when the stomach is empty 169. What should the nurse do when caring for a client who is
E. Pain in the upper right quadrant of the abdomen receiving peritoneal dialysis?

164. A healthcare provider informs a client that a T-tube will be in A. Maintain the client in the supine position during the
place after an abdominal cholecystectomy and a procedure.
choledochostomy. What should the nurse include in the B. Position the client from side to side if fluid is not
preoperative teaching for this client regarding the primary draining adequately.
reason why a T-tube is necessary? C. Remove the cannula at the end of the procedure and
apply a dry, sterile dressing.
A. Drains bile from the cystic duct. D. Notify the health care provider if there is a deficit of 200
B. Keeps the common bile duct patent. ml in the drainage return.
C. Prevents abscess formation at the surgical site.
D. Provides a port for contrast dye in a cholangiogram 170. A nurse in an emergency department is assessing a client
who was beaten and sexually assaulted. Which is the nurse’s
165. Three weeks after a kidney transplant, a client develops priority assessment?
leukopenia. Which factor should the nurse conclude is the most
probable cause of the leukopenia? A. The family’s feeling about the attack
B. The client’s feeling of social isolation
A. Bacterial infection C. Disturbance in the client’s thought processes
B. High creatinine levels D. The client’s ability to cope with the situation
C. Rejection of the kidney

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171. A healthcare provider orders oxygen therapy via nasal E. Listlessness

cannula at 2L/min for an older, confused client with heart failure.
Which nursing action is the priority? 176. A 7 year old child with juvenile idiopathic arthritis has
difficulty getting ready for a school in the morning because of
A. Maintaining the client on bed rest joint pain and stiffness. Which recommendation should the nurse
B. Determining whether the client is agitated make to the family?
C. Obtaining a cannula of appropriate size for the client
D. Investigating whether the client has chronic obstructive A. Administer acetaminophen before bedtime
pulmonary disease B. Ice the joints that are painful in the evening
C. Encourage a program of active exercise after awakening
172. A parent of three young children has contracted D. Provide warm, moist heat to the affected joints before
tuberculosis. Which should the nurse expect the healthcare arising.
provider to prescribe for members of the family who have a
positive reaction to the tuberculin skin test and are candidates 177. A client who weighs 176 pounds is being immunosuppressed
for treatment? by daily maintenance doses of cycloSPORINE (Sandimmune) to
prevent organ transplant rejection. The dose prescribed is 8
A. Isoniazid (INH) mg/kg each day. How many milligrams should the nurse
B. Multiple puncture tests (MPTs) administer each day? Record your answer using a whole number.
C. Bacille calmette-guerin (BCG)
D. Purified protein derivative (PPD) Answer: __________mg

173. A nurse is caring for a client with a diagnosis of varicose 178. Which of the following best describes a steady state within
veins. Which clinical findings can the nurse expect to identify the body?
when assessing this client? Select all that apply.
A. homeostasis
A. Discolored toenails B. constancy
B. Reports of leg fatigue C. adaptation
C. Localized heat in a calf D. stress
D. Reddened areas on a leg
E. Tortuous veins in the legs 179. According to the classification of hypertension diagnosed in
F. Pain in lower extremities when standing the older adult, that can be attributed to an underlying
cause is termed:
174. A client is receiving epoetin (epogen) for the treatment of
anemia associated with chronic renal failure. Which client A. primary
statement indicates to the nurse that further teaching about this B. essential
medication is necessary? C. secondary
D. isolated systolic
A. “I realize it is important to take this medication because
it will cure my anemia.” 180. Which refers to the decrease in lens flexibility that occurs
B. “I know many ways to protect myself from injury with age, resulting in the near point of focus getting farther
because I am risk for seizures.” away?
C. “I recognize that i may still need blood transfusions if
my blood values are very low.” A. presbyopia
D. “I understand that i will still have to take supplemental B. presbycusis
iron therapy with this medication.” C. cataract
D. glaucoma
175. A healthcare provider diagnoses that a 2 ½ year old child
has acute nonlymphoid leukemia. The child is admitted to the 181. Why are IV solutions usually given at a slower rate to older
hospital. What clinical manifestations of the disease should the adults?
nurse except when assessing the child? Select that all apply.
A. older adults may have poor skin turgor
A. Anorexia B. veins of older adults tend to be rigid
B. Petechiae C. older adults often find infusions painful
C. Irritability D. older adults may have cardiac or renal disorders
D. Skin pallor

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Compiled and Screened by: Mr. Gicar C. Magbanua, RN,MSN,USRN,HAAD-RN

182. Which of the following is an age-related change in the B. Dependence

respiratory system? C. Tolerance
D. balanced analgesia
A. increased blood pressure
B. decreased gas exchange 189. Prostaglandins are chemical substances with which of the
C. loss of muscle strength and size following properties?
D. difficulty swallowing
A. increased sensitivity of pain receptors
183. Which of the following distinguishes normal aging from B. reduction of the perception of pain
pathological changes associated with aging? C. inhibition of the transmission of pain
D. inhibition of the transmission of noxious stimuli
A. universality
B. confidentiality 190. Which of the following is a true statement regarding
C. morality placebos?
D. spirituality
A. a placebo effect is an indication that the person does
184. Age- related changes associated with the cardiovascular not have pain.
system include: B. Placebos should never be used to test the person’s
truthfulness about pain.
A. decreased cardiac output C. A placebo should be used as the first line of treatment
B. decreased blood pressure for the patient.
C. increased compliance of heart muscle D. A positive response to a placebo indicates that the
D. thinness of heart valve person’s pain is not real.

185. Which of the following is the leading cause of death in the 191. The preferred route of administration of pain medication in
elderly? the most acute care situations is through which of the
following routes?
A. cancer
B. heart disease A. epidural
C. osteoporosis B. intravenous
D. pneumonia C. subcutaneous
D. intramuscular
186. Which of the following is an age – related changed
associated with the nervous system? 192. The nurse needs to carefully monitor a patient with
traumatic injuries. How often should the nurse check and
A. cerebral hypertrophy document the patient’s pain?
B. postural hypotension
C. increased cerebral function A. on admission and discharge of the patient
D. increased nerve impulse conduction B. an hour after analgesics are administered
C. everytime the patient’s vital signs are assessed
187. Which of the following is a true statement regarding D. after every meal consumed by the patient
pharmacologic aspects of aging?
193. Which of the following nursing interventions should a nurse
A. elderly have a decreased percentage of body fat perform when caring for a patient who is prescribed opiate
B. potential for drug-drug reactions decreases with the therapy for pain?
number of drugs prescribed
C. absorption maybe affected by changes in gastric pH A. avoid caffeine or other stimulants
D. aged population tends to be compliant with their B. monitor weight, vital signs, and serum glucose
medication regimen level
C. do not administer if respirations are less than 12
188. When a person who has been taking opioids becomes less per minute
sensitive to the drug’s analgesic properties, that person I D. monitor blood counts and liver function tests
said to have developed a/an:
194. Which of the following is a heightened response seen after
A. Addiction exposure to a noxious stimulus?

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 PREDICTOR EXAMINATION
Compiled and Screened by: Mr. Gicar C. Magbanua, RN,MSN,USRN,HAAD-RN

B. direct warming lights to the patient’s body

A. pain tolerance C. administer prescribed antipyretics
B. sensitization D. administer a tepid sponge bath
C. pain threshold
D. dependence

195. Which stage of shock is best described as that stage when

the mechanisms that regulate blood pressure fall to sustain
a systolic pressure above 90 mm Hg?

A. refractory
B. compensatory
C. irreversible
D. progressive

196. When the nurse observes that the patient’s systolic BP is less
than 80 to 90 mmHg, respirations are rapid and shallow,
heart rate is over 150 bpm, and urine output is less than 30
cc per hour, the nurse recognizes that the patient is
demonstrating which stage of shock?

A. compensatory
B. progressive
C. refractory
D. irreversible

197. In the treatment of shock, which of the following vasoactive

drugs results in reduced preload and afterload, reducing the
oxygen demand of the heart?

A. dopamine
B. nitroprusside
C. epinephrine
D. methoxamine
198. The nurse anticipates that the immunosuppressed
patient is at greatest risk for which type of shock?

A. neurogenic
B. septic
C. cardiogenic
D. anaphylactic

199. Which of the following colloids is expensive but rapidly

expands plasma volume?

A. albumin
B. dextran
C. lactated ringer’s
D. hypertonic saline

200. Which of the following nursing interventions helps

minimize the risk for hypothermia in a patient in shock?

A. administer prescribed adrenergic and

bronchodilating drugs

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