1. Management of Gastroesohageal reflux (GERD) begins on teaching the client to

avoid situations that cause decrease lower esophageal sphincter pressure and
esophageal irritation. Which statement by a client who has received education about
GERD indicates that the nurse may need to provide additional teaching? 
*
1/1

A. "I will take antacids before I eat."

B. "I should have my big meal at lunchtime."
 
C. "I am going to quit smoking today."
D. "I should use two pillows to sleep on at night."

 
2. Which snack choice by a client with gastroesophageal reflux disease (GERD)
indicates that the nurse's teaching about appropriate diet has been effective? 
*
1/1

A. Chocolate pudding
B. Peppermint tea
C. Cheese sandwich
D. Dried apples
 
 
3. Boy, 54 years old is diagnosed of Esophageal Cancer. Which information about a
client who has Esophageal cancer being admitted for an Esophagogastrectomy is of
most concern to the nurse? 
*
0/1

A. The client complains of odynophagia.

 
B. The client has difficulty swallowing soft foods.
C. The client has had radiation for 6 weeks.
D. The client’s serum albumin level is 1.7 mg/dL.

 
4. Another client who was admitted with Acute Gastritis with nausea and vomiting has
been on NPO (nothing by mouth) for 2 days. The client has a new "diet as tolerated"
order. What should the nurse offer to the client? 
*
1/1

A. Tomato juice
B. Tossed salad
C. Cherry gelatin
 
D. Nonfat milk

 
5. Nurse Mich received a new female client. Fifteen minutes after eating, a client who
has had a Gastrojejunostomy complains of abdominal cramping and palpitations. Which
action should the nurse take? 
*
1/1

A. Administer prn metoclopramide (Reglan).

B. Have the client lie down.
 
C. Place the client on NPO status for 24 hours.
D. Notify the physician.

 
Situation: A client with a history of Peptic Ulcer disease is admitted to the
emergency department with massive vomiting of blood. 

6. Nurse Josie prepares which of the following diagnostic studies to confirm the real
cause of the problem: 
*
1/1

A. an esophagogastroduodenoscopy (EGD).
 
B. an upper gastrointestinal (GI) tract x-ray series.
C. blood testing for Helicobacter pylori.
D. stool testing for occult blood.

 
7. Nurse Josie is caring for a client who returned to the nursing unit 6 hours ago after
having an Esophagogastrectomy. Which nursing action should be included in the plan
of care at this time? 
*
1/1

A. Keep head of bed elevated to 30 degrees.

 
B. Initiate tube feedings at 30 mL/hr.
C. Reposition nasogastric tube as needed for abdominal distention.
D. Report bloody nasogastric drainage to the physician stat.

 
8. Which information about a client who is taking a full liquid diet 6 days after an
Esophagogastrectomy should nurse Josie report immediately to the Physician? 
*
1/1

A. The client refuses to take more than 100 mL.

B. The client has hypotonic bowel sounds.
C. The client’s blood pressure is 88/46 mm Hg.
 
D. The client has bibasilar fine lung crackles.

 
9. Phia a charge nurse is preparing the client with a Peptic Ulcer and has Ranitidine
(Zantac) scheduled for 10:00 AM. What time should Nurse Phia administer the ordered
30 mL of calcium carbonate–magnesium carbonate (Mylanta)? 
*
1/1

A. 9:00 AM
 
B. 9:30 AM
C. 10:00 AM
D. 11:00 AM

 
10. Nurse Phia has another client with duodenal ulcer. Which information about a client
admitted with a Duodenal ulcer should the Nurse Angel report immediately to the
Physician?
*
0/1

A. The client’s abdomen is rigid and painful.

B. The client is complaining of intermittent nausea.
C. The client’s NG drainage has a coffee-ground appearance.
 
D. The client reports drinking approximately 10 beers every day.

 
Situation: Cancer ranks third in the leading cause of morbidity and mortality in
our country. Early detection increases the survival rate. Lani an Oncology nurse
is responsible for screening and educating clients with Cancer.

11. A client who has been diagnosed with gastric cancer tells nurse Lani, "I am so
afraid!" Which response by the nurse is most appropriate? 

*
1/1

A. "Can you tell me more about why you are afraid?"

 
B. "Do you think that an anti-anxiety medication would help?"
C. "Perhaps talking to a clergyman would help decrease your fear."
D. "It is quite common for people with your diagnosis to be fearful."

 
12. Fecal occult blood testing (FOBT) is indicated as part of the routine colon cancer
screening for a client in the outpatient clinic. For FOBT, the nurse will plan to:
*
0/1

A. perform testing on stool obtained during the rectal examination.

 
B. schedule the client for multiple clinic appointments.
C. teach the client how to do home guaiac-based testing.
D. test stool samples for carcinoembryonic antigen (CEA) levels.

 
13. A client calls the outpatient surgery department the day after having Cryosurgery for
Cervical Cancer in situ. Which information about the client is of most concern to the
nurse?
*
0/1

A. The client is very anxious about the cancer diagnosis.

B. The client complains of cramping abdominal pain.
C. The client has serous vaginal discharge.
 
D. The client’s temperature is 101.9 degrees F.

 
14. A client has been told she needs a Hysterectomy for Cervical Cancer is upset about
being unable to have more children. What should the nurse do? 
*
0/1

A. evaluate her willingness to pursue adoption

B. encourage her to focus on her own recovery
 
C. emphasize that she does have two children already
D. ensure that all treatment options have been explored

 
15. When a 32-year-old woman has a family history of breast cancer, the most
appropriate intervention by Nurse Lani is to: 
*
1/1

A. emphasize the importance of genetic testing.

B. teach the client that she should avoid oral contraceptives.
C. discuss the reasons for frequent breast screening examinations.
 
D. educate the client about the effects of hormone replacement therapy (HRT).

 
Situation: Chemotherapy is used to cure and to increase the survival time.

16. When caring for a male client who is to receive Chemotherapy for a cancerous
condition, the nurse understands that spermatogenesis occurs:
*
1/1

A. at the time of puberty

 
B. at any time after birth
C. immediately following birth
D. during embryonic development

 
17. After receiving the results of a breast biopsy that was positive for cancer, the nurse
observes that Mrs. Fe, 49 years old does not mention the biopsy results when talking
with her husband. Which initial response by the nurse is appropriate? 
*
1/1

A. Obtain a mental health referral from the client’s physician.

B. Suggest that the client ask her physician for an antidepressant.
C. Ask the client if she understands what the biopsy results mean.
 
D. Offer to assist the client in discussing the results with her husband.

 
18. In order to help determine the effectiveness of therapy for Mrs. Fe with stage III
Metastatic Breast cancer, the nurse plans to monitor: 
*
0/1

A. CA-125 levels.
B. mammogram findings.
C. BRCA1 and BRCA2 results.
 
D. level of HER-2/neu expression.

 
19. Mrs. Fe is admitted to the hospital after 6 months with metastatic cancer and is
experiencing abdominal pain, a temperature of 100.4°F, and distended abdomen. The
client asks the nurse, “Do you think that I’m going to have surgery?” The statement by
the nurse that best helps to establish a therapeutic relationship is: 
*
1/1
A. “You seem concerned about having surgery.”
 
B. “Some people with your problem have surgery.”
C. “I really don’t know. You’ll have to ask your doctor.”
D. “Has someone talked to you about your scheduled surgery?”

 
20. Another client with chronic Myelogenous Leukemia (CML) has a white blood cell
(WBC) count of 322,000. The nurse anticipates the need to prepare the client for: 
*
1/1

A. splenectomy.
B. leukapheresis.
 
C. red blood cell transfusion.
D. stem cell transplant.

 
Situation: Mr. Noli is an Emergency room nurse and he is treating an old woman
for soft-tissue injuries that the medical team suspects might be caused by
physical abuse. The daughter-in-law states that her mother-in-law is forgetful and
confused and that she fell.

21. A mental examination indicates that the client is properly oriented when it comes to
person, place, and time, and the client does not make any comment when asked
directly how the bruises and abrasions occurred. The nurse should now: 
*
1/1

A. recommend that the client be admitted for further assessment of the situation
 
B. believe the daughter-in-law until further data prove her information to be untrue
C. act on instinct and report the abuse to the appropriate state agency for investigation
D. refer the client’s record to the hospital ethics committee for analysis and recommendations

 
22. After 30 minutes another client is brought to the emergency room a 35-year-old
client for a bee sting. The client has a history of allergies to bees and is having trouble
breathing. The nurse is aware that this client could die from: 
*
1/1

A. ischemia
B. asphyxia
 
C. lactic acidosis
D. antihistamines

 
23. Nurse Noli admitted another client who is allergic to peanuts and he understands
that the symptoms experienced by a client during an anaphylactic reaction to peanuts
are the result of: 
*
1/1

A. increased cardiac output and hypertension

B. respiratory depression and cardiac standstill
C. constriction of capillaries and decreased cardiac output
D. bronchial constriction and decreased peripheral resistance
 
 
24. Another client with benign prostatic hyperplasia (BPH) arrives at the hospital at 8:00
AM for his scheduled transurethral resection of the prostate (TURP). Which information
about the client is most important to communicate to the Physician before surgery? The
client:
*
1/1

A. Ate dinner last night at 7 PM.

B. Takes one Aspirin daily.
 
C. Has a family history of BPH.
D. Has had hematuria.

 
25. A 40-year-old man who wishes to have children has a decreased urinary stream and
nocturia caused by Benign Prostatic Hyperplasia (BPH). When the client is considering
surgery for this disorder, the nurse anticipates teaching that:
*
0/1
A. retrograde ejaculation caused by all surgeries for BPH causes decreased fertility.
B. open surgical procedures cause fewer problems with erectile dysfunction.
 
C. transurethral resection of the prostate (TURP) does not affect fertility.
D. infertility is less likely with transurethral incision of the prostate (TUIP).

 
Situation: Immediately after a storm has passed, the rescue team with which the
nurse is working is searching for injured people. A victim lying next to a broken
natural gas main is not breathing and is bleeding heavily from a wound on the
foot.

26. Based on the Principles of Disaster Management the nurse’s first step should be to: 
*
0/1

A. treat the victim for shock

B. start rescue breathing immediately
C. apply surface pressure to the foot wound
 
D. remove the victim for the immediate vicinity

 
27. The nurse is responding to the needs of victims at the collapsed building soon after
an earthquake. The principle that guides the nurse’s priorities during this disaster is: 
*
1/1

A. hemorrhage necessitates immediate care to save the most lives

B. those requiring minimal care are treated first so that they can help others
 
C. clients with head injuries should be treated first because the care is most complex
D. children should receive the highest priority because they have the greatest life expectancy

 
28. The emergency department triage nurse admits the following four clients. Which one
is the highest priority for rapid evaluation and treatment by the Physician? 
*
1/1

A. A 21-year-old with the sudden onset of severe scrotal pain

 
B. A 34-year-old with scrotal bruising and pain after vasectomy
C. A 45-year-old with an ulcerated lesion on the glans of the penis
D. A 60-year-old with hematuria after a prostatectomy a week ago

 
29. During intravenous emergency fluids are given to clients to correct electrolytes
imbalance. The Physician has prescribed 35mEq if Potassium Chloride to be added to a
primary intravenous infusion of 1000ml of D5W and run for 24 hours. The vial of
potassium chloride is labelled 40 mEq=10 ml.  The factor of infusion set is 10. How
many ml of Potassium Chloride 40 mEq /10ml should be added to the 1000ml of D5
Water?
*
1/1

A. 9.9.ml
B. 8.8. ml
 
C. 7.7. ml
D. 6.6 ml

 
30. What is the hourly rate of absorption should be?
*
1/1

A. 22 ml/ hour
B. 32 ml / cc
C. 42 ml/ hour
 
D. 52 ml / cc

 
Situation: In a Medical ward there are clients with potential or actual disorders of
fluids and electrolytes disturbance and homeostatic mechanisms.

 
31. The nurse is caring for a client with chronic kidney failure. The nurse understands
that ammonia is normally exerted by the kidney to help maintain:
*
1/1

A. osmotic pressure of the blood

B. acid-base balance of the body
 
C. low bacterial level in the urine
D. normal red blood cell production

 
32. Which finding best suggests that nursing interventions for a client with an excess
fluid volume have been effective? 
*
0/1

A. clear breath sounds

B. positive pedal pulses
C. normal potassium level
 
D. increased urine specific gravity

 
33. The nurse understands that a client with albuminuria has edema because of: 
*
0/1

A. fall in tissue hydrostatic pressure

B. rise in plasma hydrostatic pressure
 
C. rise in tissue colloid osmotic pressure
D. fall in plasma colloid oncotic pressure

 
34. When the nurse uses the clamp on the administration set to manually adjust the flow
of IV fluid into a client by gravity, what change in energy takes place? 
*
1/1

A. potential energy is converted to kinetic energy

 
B. kinetic energy is converted to potential energy
C. chemical energy is converted to kinetic energy
D. potential energy is converted to chemical energy
 
35. The client with which condition has an increased risk for developing Hyperkalemia? 
*
1/1

A. Crohn’s disease
B. Cushing’s syndrome
C. Chronic heart failure
D. End-stage renal disease
 
 
Situation: Nurse Gringo is attending to varied clients with fluids and electrolytes
problems.

 
36. The nurse adds potassium chloride 20 mEq to the IV solution of a client with
Diabetic Ketoacidosis. What is the primary purpose for administering this drug? 
*
1/1

A. treatment for hyperpnea

B. prevention of flaccid paralysis
C. replacement of excessive losses
 
D. treatment of cardiac dysrhythmias

 
37. The nurse is caring for a client with fluid and electrolyte imbalance. Which is the
most important means of maintaining fluid and electrolyte balance that should be
understood by the nurse? 
*
1/1

A. aldosterone
B. the urinary system
 
C. the respiratory system
D. antidiuretic hormone

 
38. Which of the following nursing actions included in the plan of care for a client with
Gastroenteritis will the Head nurse delegate to the nursing aid? 
*
1/1

A. Apply a moisture barrier to the perianal skin.

 
B. Advance the client’s diet as tolerated.
C. Teach the client handwashing technique.
D. Monitor the appearance of the stools.

 
39. Another 65 year old male client has Ascites and is experiencing shortness of breath.
This a form of edema that accumulates in the peritoneal cavity. Nurse Gringo
understands that Ascites can be related to which problem? 
*
0/1

A. portal hypertension
 
B. kidney malfunction
C. diminished plasma protein levels
D. decreased production of potassium

 
40. While a client with Ascites is receiving albumin, the planned therapeutic effect will
be greater if the nurse regulates the infusion to flow: 
*
0/1

A. slowly, and restrict fluid intake

B. rapidly, and withholds fluid intake
C. rapidly, and encourages fluid intake
 
D. slowly, and encourages liberal fluid intake

 
Situation: Mr. Pao, emergency room nurse assumes responsibility for
systematically assessing the needs of the patients when disaster and crisis
occurs. The nurse may treat clients who experience hysteria first.  
41. Which of the following person or persons to be cared for immediately?  
*
1/1

A. Panic
 
B. Coma
C. Euphoria
D. Depression

 
42. A client with hypothermia is brought to the emergency department. Nurse Pao
should explain to the family members that treatment will include: 
*
0/1

A. core rewarming with warm fluids

B. ambulation to increase metabolism
 
C. frequent oral temperature assessment
D. gastric tube feedings to increase fluids

 
43. A 72-year old unresponsive man is admitted to the emergency department after
playing tennis on a hot, humid day. The initial nursing assessment reveals that he has
hot, dry skin; a RR= 36 breaths/min; and a HR= 128 beats/min. Which is Nurse Pao’s
initial action? 
*
0/1

A. suction the airway

B. remove all clothing
C. offer cool oral fluids
 
D. prepare for intubation

 
44. Nurse Donayre is working in a busy Emergency department on a hot summer day
and four near-drowning victims are admitted. Which near – drowning victim should the
nurse assess for signs of Hypovolemia?
*
1/1

A. 72-year-old rescued from a lake

B. 2-year-old rescued from a bath tub
C. 50-year-old rescued from the ocean
 
D. 17-year-old rescued from a backyard pool

 
45. Nurse Pao has been notified that a client who has suffered large full-thickness burns
is expected to arrive at the hospital in about 1 minute. Which equipment is most
important to obtain
*
1/1

A. Intravenous catheter
 
B. Retention catheter
C. Morphine sulfate
D. Nasogastric tube

 
Situation: The Immune system functions as the body’s defense mechanism
against invasion of microorganisms. The nurse is caring for a client with an
impaired immune system.
46. When caring for this client, the nurse understands that the blood protein associated
with the immune system is: 
*
1/1

A. albumin
B. globulin
 
C. thrombin
D. hemoglobin

 
47. A client who was exposed to Hepatitis A is given Gamma Globulin. The nurse
understands that this will provide passive immunity because it: 
*
0/1
A. increases production of short-lived antibiotics
B. provides antibodies that neutralize the antigen
C. accelerates antigen-antibody union at the hepatic sites
 
D. stimulates the lymphatic system to produce large numbers of antibodies

 
48. Another client is admitted to the emergency department with a contaminated wound.
The client is poor historian, and is impossible to determine whether the client is
immunized against Tetanus. Which of the following is the preparation of choice that will
permit this client to produce passive immunity for several weeks with minimal danger of
allergic reactions? 
*
0/1

A. DTaP vaccine
B. tetanus toxoid
 
C. tetanus antitoxin
D. tetanus immune globulin

 
49. Last December, Manila experienced a very cold climate. A homeless person is
brought to the emergency department after prolonged exposure to cold weather. The
nurse should assess the client for hypothermia, which is manifested by: 
*
1/1

A. Stupor
 
B. Erythema
C. Increased anxiety
D. Rapid respirations

 
50. A client with Rheumatoid Arthritis asks the nurse why the Physician is going to inject
Hydrocortisone into the knee joint. The nurse explains that the most important reason
for the injection is to: 
*
1/1
A. lubricate the joint
B. reduce inflammation
 
C. provide physiotherapy
D. prevent ankylosis of the joint

 
Situation: Autoimmune disorders, such as SLE, need astute nursing skills in
order to manage the care needed for these patients.

51.   The nurse will expect which of the following assessment findings in a patient with
SLE, except:
*
0/1

a. Positive antinuclear antibody test

b. Malar rash
c. Elevated erythrocyte sedimentation rate
 
d. Positive Tzanck smear

 
52.   In teaching the client with SLE about self-care, the nurse advices the client against:
*
0/1

a. Consumption of high vitamin and high iron diet

 
b. Use of mild soap and prescribed ointments/creams
c. Consumption of high protein diet
d. Use of visor during exposure to sunlight

 
53.   Which of the following is the single most important medication available for
treatment of SLE?
*
1/1

a. Antimalarial agents
b. Corticosteroids
 
c. Alkylating medications
d. Monoclonal Antibodies

 
54.   The nurse refers the patient to the nutritionist for counseling about:
*
0/1

a. Diabetic Plate Method

b. Low Protein Diet
c. DASH diet
d. BRAT diet
 
 
55.   CREST syndrome is a variety of symptoms experienced by patients with:
*
0/1

a. Scleroderma
 
b. Polymyositis
c. Rheumatoid arthritis
d. Systemic lupus erythematosus

 
Situation: EMERGENCY- Triage Trauma to facilitate care of clients in the
emergency room, various management strategies have been devised to address
the survival needs of patients. As an ER nurse you should be equipped with
knowledge, skills and attitude to cope with unexpected problems.

 
56. You are assigned as the triage nurse in the ER. Four patients injured in a vascular
accident were brought to the Emergency room at the same time. To whom will you
assign the highest priority?
*
1/1

a. Lorna, with maxillofacial injury and gurgling respiration

 
b. Alba, with severe head injury but no perceptible blood pressure
c. Harriet, with lumbar spinal cord injury with lower extremity paralysis
d. Bibi, 8 months pregnant with premature labor contractions

 
57.   Waltz, a MERALCO wireman, fell from a height of 5 meters. His head hit the
concrete pavement. According to a witness, Waltz was unconscious for a while but
regained his consciousness as if nothing happened. You are the nurse in the
emergency room, if increased intracranial pressure is suspected what would be the
sign?
*
1/1

a. Involuntary posturing
b. Irregular breathing pattern
c. Pupillary asymmetry
d. Alteration in level of consciousness
 
 
  58. You are the nurse caring for Waltz who sustained multiple injuries following a fall.
Your initial assessment revealed that he is oriented to a person and place but is rather
confused as to time. He complains of severe headache and drowsiness. His pupils are
both equal and reactive to light. Your critical nursing intervention would be:   
*
0/1

a.Prevent unnecessary movement

b.Prepare to administer furosemide
c. Keep Waltz alert and responsive
 
d. Monitor for signs of increased intracranial pressure

 
  59. She is admitted into the Emergency room following as assault where she was
beaten in the face and head. Based on She’s history, which of the following
interventions should be performed first?  
*
0/1

a.Immediate intubation of the patient

b.Give 100% oxygen mask
 
c. insert an intravenous catheter
d.Obtain arterial blood gases

 
  60. Lawrence loses consciousness after he had seizures. You should prepare for
which of the following first?  
*
0/1

a.Place nasogastric tube

b.CT scan on the head
 
c.Endotracheal intubation or surgical airway management
d.Place a second IV line

 
  SITUATION: Laryngeal cancer is common among patients who have abusive
behaviors to their throat. The following situations apply. 

 61. In the carcinogenesis of laryngeal cancer, which of the following will result to the
damage of the DNA?  
*
1/1

a. Smoking
 
b. Blunt trauma
c. GERD
d. Thick mucus secretions

 
  62. Which among the following is not an early sign of laryngeal cancer?  
*
1/1

a. Hoarseness of voice
b. Cough and hemoptysis
c. Dysphagia
d. Enlarged inguinal lymph nodes
 
 
  63. A singer approached the nurse and asks what could be the reason why she
developed laryngeal cancer. The nurse’s best response would be?  
*
0/1

a. Singing with no rests in between concerts

b. Drinking cold water after a show
 
c. Singing very high notes
d. Singing in varying voice registers

 
  64. Which among the following phases of the carcinogenesis of laryngeal cancer
causes permanent conversion of laryngeal tissues to malignant tissues?  
*
0/1

a. Initiation
b. Promotion
c. Malignant conversion
d. Progression
 
 
  65. Mang Bert, a 50 packs/year smoker, approached a nurse and was asking what
would be the end point of medical intervention in the event that he will have a laryngeal
cancer. The nurse’s best response would be?  
*
1/1

a. Permanent placement of a tracheostomy tube

 
b. Radiation Therapy
c. Chemotherapy
d. Endotracheal tube insertion

 
  SITUATION: You are assigned to take care of Saira who will be receiving a
radium implant. You should be aware of the safety and protective measures to
prevent untoward incidents. 
66. While caring for Saira who has an implant, the following protective factors can easily
be controlled except  
*
1/1

a. Time spent with Saira

b. Distance kept from Saira
c. Shielding used
d. Your physical status
 
 
  67. As you care for Saira, you should remember that:  
*
1/1

a. No special handling techniques are required for linen or equipment

b. Special radiation resistant linen must be used
c. Rubber gloves must be used while in contact with the bed linen and Irma
d. Linen and equipment should not be removed from Saira’s room until it is free from radiation
contamination
 
 
  68. Where should Saira be placed in?  
*
0/1

a. Double room with her bed against an internal wall

b. Single room with her bed against an external wall
 
c. Double room with her bed located away from the other patient
d. Single room with her bed located near the hall

 
  69. What type of diet should Saira receive?  
*
0/1

a. High fiber
 
b. Low residue
c. Full-liquid
d. Clear liquid

 
  70. While caring for the client, your most important nursing intervention is to keep  
*
0/1

a. Any visitor three feet way from Saira

 
b. The lead container in Saira’s room
c. The radium source in place
d. Saira as comfortable as possible

 
  Situation: Clients with renal and urinary problems are admitted in the ward. 

71. The doctor ordered a straight catheterization be done for Mr. Zantua, who was
unable to void for the past 24 hours. During the process, the nurse ensures that the
bladder is emptied gradually to prevent   
*
0/1

a. Possible shock
b. Atrophy of bladder musculature
 
c. Abdominal cramping
d. Renal failure

 
  72. Leo, diagnosed with End Stage Renal Disease, asks the nurse to tell him the
purpose of the treatment. Which of the following is the most appropriate response of the
nurse?   
*
1/1

a. “Hemodialysis removes excess fluids and waste products and restores electrolyte balance.”
 
b. “Hemodialysis uses the principles of diffusion and ultrafiltration to remove electrolytes.”
c. “Blood is pumped through a semipermeable capillary in a hemodialyzer.”
d. “Hemodialysis is one of several renal replacement therapy.”
 
  73. Which of the following pre-dialysis care is done by the nurse to be able to
determine the effectiveness of treatment with regards to excess fluid volume?  
*
1/1

a. Assess integumentary status

b. Assess vascular site
c. Have patient empty bladder prior to treatment
d. Record weight and vital signs
 
 
  74. The nurse understands that a client with albuminuria has edema because of:  
*
0/1

a. fall in tissue hydrostatic pressure

b. rise in plasma hydrostatic pressure
 
c. rise in tissue colloid osmotic pressure
d. fall in plasma colloid oncotic pressure

 
  75. Prior to insertion of the catheter for peritoneal dialysis, what instruction should the
nurse give to the patient?  
*
1/1

a. Limit food intake for at least 8 hours prior to the dialysis.

b. Splint the abdomen and perform diaphragmatic breathing.
c. Empty the bladder and bowel.
 
d. Inhale and hold breath until the catheter is inserted through the peritoneum.

 
  Situation: Isolated emergency cases are rampant in the communities. Though
not involving the mass population, prompt treatment is still considered to prevent
the emergency case from progressing to a lifethreatening situation.
 76. A patient with suspected massive hemorrhage was brought to the ED of your
institution. Which of these actions done by the ER nurse would require you to
intervene?  
*
0/1

a. Using two large-gauge intravenous catheters for fluid resuscitation.

 
b. Initiating transfusion of PRBCs directly from the commercialized cooler.
c. Inserting an indwelling catheter if not contraindicated
d. Maintaining the patient in supine position until hemodynamic stability is achieved.

 
  77. Which of these would indicate proper insertion of an oropharyngeal airway?  
*
0/1

a. Oropharyngeal airway should measure from the nose to the ear.

 
b. The artificial airway should be inserted with the tip facing down, facing the tongue, until it
reaches the uvula.
c. The distal end of the oropharyngeal airway should be in the hypopharynx, and the flange is
approximately at the patient’s lips.
d. Displace the tongue by rotating the airway 90 degrees during insertion into the pharynx

 
  78. A client goes unconscious to the floor after minutes of choking on an obstruction
from his meal. You perform Heimlich maneuver correctly by which of these actions?
Select all that apply. 
i. Turn the client to prone position before the maneuver. 
ii. Kneel close to the patient’s thighs, facing his head iii. Place the heel of one hand
directly on the xiphoid process with the other hand on top of it 
iv. Press the abdomen with an inward and downward thrust.   
*
0/1

a. iii
b. ii, iv
 
c. ii, iii
d. ii
 
  79. A patient who sustained a snake bite approximately one hour ago was brought to
the ER. Which of these is your priority action?  
*
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a. Administer IV prednisone to reduce inflammation.

b. Immobilize and elevated the affected extremity above the level of the heart.
c. Apply cold compress on the bite and the area around it.
 
d. Instruct the patient to remain lying down.

 
  80. Antivenin polyvalent was prescribed for the patient who had a snake bite. Which of
these signs and symptoms should alert you for a possible serum sickness that may lead
to neuropathy?  
*
1/1

a. Arthralgia
 
b. Increased lethargy
c. Vomiting
d. Diarrhea

 
  Situation: The Gastrointestinal System is susceptible to many health problems,
impaired motility and infection. Nurse Mak is admitting a client with
Gastroesophageal Reflux. 

81. Management of Gastroesohageal reflux (GERD) begins on teaching the client to

avoid situations that cause decrease lower esophageal sphincter pressure and
esophageal irritation. Which statement by a client who has received education about
GERD indicates that the nurse may need to provide additional teaching?  
*
0/1

A. "I will take antacids before I eat."

B. "I should have my big meal at lunchtime."
 
C. "I am going to quit smoking today."
D. "I should use two pillows to sleep on at night."

 
  82. Which snack choice by a client with gastroesophageal reflux disease (GERD)
indicates that the nurse's teaching about appropriate diet has been effective?   
*
1/1

A. Chocolate pudding
B. Peppermint tea
C. Cheese sandwich
D. Dried apples
 
 
  83. Emmy, 54 years old is diagnosed of Esophagel Cancer. Which information about a
client who has Esophageal cancer being admitted for an Esophagogastrectomy is of
most concern to the nurse?   
*
0/1

A. The client complains of odynophagia.

 
B. The client has difficulty swallowing soft foods.
C. The client has had radiation for 6 weeks.
D. The client’s serum albumin level is 1.7 mg/dL.

 
  84. Another client who was admitted with Acute Gastritis with nausea and vomiting has
been on NPO (nothing by mouth) for 2 days. The client has a new "diet as tolerated"
order. What should the nurse offer to the client?   
*
1/1

A. Tomato juice
B. Tossed salad
C. Cherry gelatin
 
D. Nonfat milk

 
  85. Nurse Mak received a new female client. Fifteen minutes after eating, a client who
has had a Gastrojejunostomy complains of abdominal cramping and palpitations. Which
action should the nurse take?  
*
1/1

A. Administer prn metoclopramide (Reglan).

B. Have the client lie down.
 
C. Place the client on NPO status for 24 hours.
D. Notify the physician.

 
  Situation: Mr. Bob is an Emergency room nurse and he is treating an old woman
for soft-tissue injuries that the medical team suspects might be caused by
physical abuse. The daughter-in-law states that her mother-inlaw is forgetful and
confused and that she fell. 

86. A mental examination indicates that the client is properly oriented when it comes to
person, place, and time, and the client does not make any comment when asked
directly how the bruises and abrasions occurred. The nurse should now:   
*
1/1

A. recommend that the client be admitted for further assessment of the situation
 
B. believe the daughter-in-law until further data prove her information to be untrue
C. act on instinct and report the abuse to the appropriate state agency for investigation
D. refer the client’s record to the hospital ethics committee for analysis and recommendations

 
  87. After 30 minutes another client is brought to the emergency room a 35-year-old
client for a bee sting. The client has a history of allergies to bees and is having trouble
breathing. The nurse is aware that this client could die from:   
*
1/1

A. ischemia
B. asphyxia
 
C. lactic acidosis
D. antihistamines

 
  88. Nurse Bob admitted another client who is allergic to peanuts and he understands
that the symptoms experienced by a client during an anaphylactic reaction to peanuts
are the result of:   
*
1/1

A. increased cardiac output and hypertension

B. respiratory depression and cardiac standstill
C. constriction of capillaries and decreased cardiac output
D. bronchial constriction and decreased peripheral resistance
 
 
  89. Another client with benign prostatic hyperplasia (BPH) arrives at the hospital at
8:00 AM for his scheduled transurethral resection of the prostate (TURP). Which
information about the client is most important to communicate to the Physician before
surgery? The client:   
*
1/1

A. Ate dinner last night at 7 PM.

B. Takes one Aspirin daily.
 
C. Has a family history of BPH.
D. Has had hematuria.

 
  90. A 40-year-old man who wishes to have children has a decreased urinary stream
and nocturia caused by Benign Prostatic Hyperplasia (BPH). When the client is
considering surgery for this disorder, the nurse anticipates teaching that:   
*
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A. retrograde ejaculation caused by all surgeries for BPH causes decreased fertility.
B. open surgical procedures cause fewer problems with erectile dysfunction.
 
C. transurethral resection of the prostate (TURP) does not affect fertility.
D. infertility is less likely with transurethral incision of the prostate (TUIP).

 
  Situation: In a Medical ward there are clients with potential or actual disorders of
fluids and electrolytes disturbance and homeostatic mechanisms.

 91. The nurse is caring for a client with chronic kidney failure. The nurse understands
that ammonia is normally exerted by the kidney to help maintain:  
*
1/1

A. osmotic pressure of the blood

B. acid-base balance of the body
 
C. low bacterial level in the urine
D. normal red blood cell production

 
  92. Which finding best suggests that nursing interventions for a client with an excess
fluid volume have been effective?  
*
0/1

A. clear breath sounds

B. positive pedal pulses
C. normal potassium level
 
D. increased urine specific gravity

 
  93. The nurse understands that a client with albuminuria has edema because of:   
*
0/1

A. fall in tissue hydrostatic pressure

B. rise in plasma hydrostatic pressure
 
C. rise in tissue colloid osmotic pressure
D. fall in plasma colloid oncotic pressure

 
  94. When the nurse uses the clamp on the administration set to manually adjust the
flow of IV fluid into a client by gravity, what change in energy takes place?  
*
1/1

A. potential energy is converted to kinetic energy

 
B. kinetic energy is converted to potential energy
C. chemical energy is converted to kinetic energy
D. potential energy is converted to chemical energy

 
  95. The client with which condition has an increased risk for developing
Hyperkalemia?  
*
1/1

A. Crohn’s disease
B. Cushing’s syndrome
C. Chronic heart failure
D. End-stage renal disease
 
 
  Situation: A mother with the diagnosis of AIDS states that she has been caring
for her baby even though she has not been feeling well. 

 96. What important information should the nurse determine?  

*
1/1

A. is she has kissed the baby

B. if the baby is breastfeeding
 
C. when the baby last received antibiotics
D. how long she has been caring for the baby

 
  97. The nurse is planning to provide discharge teaching to the family of a client with
AIDS. Which statement should the nurse include in the teaching plan?  
*
0/1

A. “Wash the dishes in hot soap as you usually do.”

B. “Let the dishes soak in hot water overnight before washing.”
C. “You should boil the client’s dishes for 30 minutes after use.”
D. “have the client eat from paper plates so they can be discharged.”
 
 
  98. During an AIDS education class a client states, “Vaseline works great when I use
condoms.” Which conclusions about the client’s knowledge of condom use can the
nurse draw this statement?  
*
0/1

A. an understanding of safer sex

 
B. an ability to assume self-responsibility
C. ignorance concerning correct condom use
D. ignorance concerning the transmission of HIV

 
  99. The client with AIDS is experiencing nausea and vomiting. The Nurse would make
which of the following dietary alterations for this client to enhance nutritional intake?   
*
1/1

A. Avoid dairy products and red meat

 
B. Plan large nutritious meals
C. Add spices to food to enhance flavor
D. Serve foods while they are warm

 
  100. The Physician orders a Paracentesis. How should the nurse instruct the client to
prepare for the radiograph?  
*
1/1

A. void before the procedure

 
B. a laxative the evening before the procedure
C. nothing by mouth for 8 hours before the procedure
D. a low soapsuds enema the morning of the procedure