ANSWER KEY

1) What is the name of the virus that causes COVID-19?

A. SARS-CoV-1

B. HCoV-Co43

C. MERS-CoV

D. SARS-CoV-2

2.) How is COVID-19 PRIMARILY spread to others?

A. Airborne

B. Droplet

C. Blood

D. Fecal-oral

3.) Which of the following is a common side effect of Spironolactone?

A. Renal failure

B. Hyperkalemia

C. Hypokalemia

D. Dry cough

4.) Which of the following is a late sign of heart failure?

A. Shortness of breath

B. Orthopnea

C. Edema

D. Frothy-blood-tinged sputum

5.) These drugs are used as first-line treatment of heart failure. They work by allowing more blood to
flow to the heart which decreases the work load of the heart and allows the kidneys to secrete sodium.
However, some patients can develop a nagging cough with these types of drugs. This description
describes?

A. Beta-blockers

B. Vasodilators

C. Angiotensin II receptor blockers

D. Angiotensin-converting-enzyme inhibitors

6. Which of the following tests/procedures are NOT used to diagnose heart failure?
A. Echocardiogram

B. Brain natriuretic peptide blood test

C. Nuclear stress test

D. Holter monitoring

7.) Which statement below is incorrect about a deep vein thrombosis (DVT)?*

A. "Veins that are most susceptible to a deep vein thrombosis are the peroneal, posterior tibial,
popliteal and superficial femoral."

B. "DVTs tend to mostly occur in the lower extremities but can occur in the upper extremities too."

C. "A deep vein thrombosis in the lower extremity has a low probability of becoming a pulmonary
embolism."

D. "A DVT is a type of venous thromboembolism (VTE), which is a blood clot that starts in the vein."

8.) You are about to hang a bag of intravenous Vancomycin for a patient who has severe pneumonia.
Which statement by the patient causes you to hold the bag of Vancomycin and notify the doctor
immediately?

A. “I’m seeing yellow halos around the light.”

B. “My mouth tastes like metal.”

C. “My head hurts.”

D. “I have this constant ringing in my ears.”

9. A patient is being discharged home on Doxycycline for treatment of pneumonia. Which statement by
the patient indicates they understood your education material?

A. “I will wear sunscreen when outdoors.”

B. “I will avoid green leafy vegetables while taking this medication.”

C. “I will monitor my blood glucose regularly due to the side effects of hypoglycemia.”

D. “I will take this medication with a full glass of milk.”

10.) A 25-year-old female patient with pneumonia is prescribed Doxycycline. What question is
important to ask the patient prior to administration of this medication?

A. “Do you take birth control pills?”

B. “What vitamins are you taking?”

C. “Are you allergic to eggs?”

D. “Do you have a history of diabetes?”

11.) A patient was admitted to the intensive care unit 48 hours ago for treatment of a gunshot wound.
The patient has recently developed a productive cough and a fever of 104.3 ‘F. The patient is breathing
on their own and doesn’t require mechanical ventilation. On assessment, you note coarse crackles in the
right lower lobe. A chest x-ray shows infiltrates with consolidation in the right lower lobe. Based on this
specific patient scenario, this is known as what type of pneumonia?

A. Aspiration pneumonia

B. Ventilator acquired pneumonia

C. Hospital-acquired pneumonia

D. Community-acquired pneumonia

12.) A patient is presenting with mild symptoms of pneumonia. The doctor diagnoses the patient with
"walking pneumonia". From your nursing knowledge, you know this type of pneumonia is caused by
what type of infectious agent?

A. Fungi

B. Streptococcus pneumoniae

C. Mycoplasma pneumoniae

D. Influenza

13.) 2. A 55-year-old male patient is admitted with an active tuberculosis infection. The nurse will place
the patient in ___________________ precautions and will always wear _____________________ when
providing patient care?

A. droplet, respirator

B. airborne, respirator

C. contact and airborne, surgical mask

D. droplet, surgical mask

14.) Which statement is correct regarding mycobacterium tuberculosis?

A. This bacterium is an anaerobic type of bacteria.

B. It is an alkali bacterium that stains bright red during an acid-fast smear test.

C. It is known as being an aerobic type of bacteria.

D. It’s an acid-fact bacterium that stains bright green during an acid-fast smear test.

15.) Your patient with a diagnosis of latent tuberculosis infection needs a bronchoscopy. During
transport to endoscopy, the patient will need to wear?

A.      N95 mask

B.      Surgical mask

C.      No special PPE is needed

D.      Face mask with shield

16.) The contraction phrase of the heart so blood can be pumped through the body’s system and lungs is
known as?

A. Diastole
B. Systole
C. Pericardial closure
D. Repolarization

17.) 3. A 23-year-old patient is admitted with suspected appendicitis. The patient states he is having
pain around the umbilicus that extends into the lower part of his abdomen. In addition, he says that the
pain is worst on the right lower quadrant. The patient points to his abdomen at a location which is
about a one-third distance between the anterior superior iliac spine and umbilicus. This area is known
as what?

A. Rovsing's Point

B. Hamman's Point

C. McBurney's Point

D. Murphy's Point

18.) You're providing education to a group of nursing students about the care of a patient with
appendicitis. Which statement by a nursing student requires re-education about your teaching?*

A. "After an appendectomy the patient may have a nasogastric tube to remove stomach fluids and
swallowed air."

B. "Non-pharmacological techniques for a patient with appendicitis include application of heat to the
abdomen and the side-lying position."

C. "The nurse should monitor the patient for signs and symptoms of peritonitis which includes
increased heart rate, respirations, temperature, abdominal distention, and intense abdominal pain."

D. "It is normal for some patients to have shoulder pain after a laparoscopic appendectomy.”

19.)  A patient is recovering after having an appendectomy. The patient is 48 hours post-opt from
surgery and is tolerating full liquids. The physician orders for the patient to try solid foods. What types
of foods should the patient incorporate in their diet?

A. Foods high in fiber

B. Foods low in fiber

C. Foods high in carbohydrates

D. Foods low in protein

20.)  A patient is scheduled for appendectomy at noon. While performing your morning assessment,
you note that the patient has a fever of 103.8 ‘F and rates abdominal pain 9 on 1-10. In addition, the
abdomen is distended and the patient states, “I was feeling better last night but it seems the pain has
become worst.” The patient is having tachycardia and tachypnea. Based on the scenario, what do you
suspect the patient is experiencing?

A. Pulmonary embolism

B. Colon Fistulae

C. Peritonitis

D. Hemorrhage

21.) Your patient is 4 days post-opt from an appendectomy. Which assessment finding requires further
evaluation?

A. The patient reports their last bowel movement was the day before surgery.

B. The patient reports incisional pain.

C. The patient coughs and deep breathes while splinting the abdominal incision.

D. Options A and C

22.) A patient with emphysema may present with all of the following symptoms EXCEPT?*

A. Barrel chest

B. Hyperinflation of the lungs

C. Hypoventilation

D. Hypercapnia

23.) The term" blue bloaters" is used to describe patients with?

A. Pulmonary hypertension

B. Left-sided heart failure

C. Chronic Bronchitis

D. Emphysema

24.) A (PN) parenteral nutrition cares for the client who is semi-comatose 6 days after a post
intracerebral hemorrhage. The client has a nasogastric tube in place and was just started on parenteral
nutrition (PN). Which action should the nurse take to prevent the development of a fluid volume
deficit?

A. Administer water through the NG tube.

B. Monitor the client's blood glucose levels every 6 hours.

C. Monitor the client's input and output (I&O) at every shift change.
D. Determine if the client's extremities look swollen.

25.) The nurse assesses a client with Parkinson’s disease. The client reports moderate weight loss and
episodes of coughing that interrupt meals. The nurse should take steps to have the client evaluated by
which professional?

A. Psychiatrist

B. Speech therapist

C. Respiratory therapist

D. Dentist

26.) The main goal of treatment for acute glomerulonephritis is to:

A. encourage activity.

B. encourage high protein intake.

C. maintain fluid balance.

D.teach intermittent urinary catheterization.

27.). Nursing diagnoses mostly differ from medical diagnoses; in that they are:

A. dependent upon medical diagnoses for the direction of appropriate interventions.

B. primarily concerned with caring, while medical diagnoses are primarily concerned with curing.

C. primarily concerned with human response, while medical diagnoses are primarily concerned with
pathology.

D. Primarily concerned with psychosocial parameters, while medical diagnoses are primarily concerned
with physiologic parameters.

28.) A patient who received spinal anesthesia four hours ago during surgery is transferred to the surgical
unit and, after one and a half hours, now reports severe incisional pain. The patient's blood pressure is
170/90 mm Hg, pulse is 108 beats/min, temperature is 99oF (37.2oC), and respirations are 30
breaths/min. The patient's skin is pale, and the surgical dressing is dry and intact. The most appropriate
nursing intervention is to:

A. medicate the patient for pain.

B. place the patient in a high Fowler position and administer oxygen.

C. place the patient in a reverse Trendelenburg position and open the IV line.

D. report the findings to the provider.

29.) To prevent a common, adverse effect of prolonged use of phenytoin sodium (Dilantin), patients
taking the drug are instructed to:

A. avoid crowds and obtain an annual influenza vaccination.

B. drink at least 2 L of fluids daily, including 8 to 10 glasses of water.

C. eat a potassium-rich, low sodium diet.

D. Practice good dental hygiene and report gum swelling or bleeding.

30.) The most common, preventable complication of abdominal surgery is:

A. atelectasis.

B. fluid and electrolyte imbalance.

C. thrombophlebitis.

D. urinary retention.

31.) A 78-year-old patient is scheduled for transition to home after treatment for heart disease. The
patient's spouse, who has chronic obstructive pulmonary disease, plans to care for the patient at home.
The spouse says that their grown children, who live nearby, will help. The best approach to discharge
planning is to:

A. arrange nursing home placement for the couple.

B. consult the spouse's healthcare provider about the spouse's ability to care for the patient.

C. contact the children to ascertain their commitment to help.

D. discuss community resources with the spouse and offer to make referrals.

32.) During an assessment of a patient who sustained a head injury 24 hours ago, the medical-surgical
nurse notes the development of slurred speech and disorientation to time and place. The nurse's initial
action is to:

A. continue the hourly neurologic assessments.

B. inform the neurosurgeon of the patient's status.

C. prepare the patient for emergency surgery.

D. recheck the patient's neurologic status in 15 minutes.

33.) For the evaluation feedback process to be effective, the medical-surgical nurse who is a manager:

A. conducts weekly meetings with staff members.

B. considers staff members' interests and abilities when delegating tasks.

C. informs staff members regularly of how well they are performing their jobs.

D. provides goals for staff members to meet.

34.) An 80-year-old patient is placed in isolation when infected with methicillin-resistant Staphylococcus
aureus. The patient was alert and oriented on admission, but is now having visual hallucinations and can
follow only simple directions. The medical-surgical nurse recognizes that the changes in the patient's
mental status are related to:
A. a fluid and electrolyte imbalance.

B. a stimulating environment.

C. sensory deprivation.

D. sundowning.

35.) To prepare a patient on the unit for a bronchoscopy procedure, the medical-surgical nurse
administers the IV sedative. The nurse then instructs the licensed practical/vocational nurse to:

A. educate the patient about the pending procedure.

B. give the patient small sips of water only.

C. measure the patient's blood pressure and pulse readings.

D. take the patient to the bathroom one more time.

36.) Which physiological response is often associated with surgery-related stress?

A. Bronchial constriction.

B. Decreased cortisol levels.

C. Peripheral vasodilation.

D. Sodium and water retention.

37.) Which statement by a patient with diabetes mellitus indicates an understanding of the medication
insulin glargine (Lantus)?

A. "Lantus causes weight loss."

B."Lantus is used only at night."

C. "The duration of Lantus is six hours."

D. "There is no peak time for Lantus."

38.) Which action occurs primarily during the evaluation phase of the nursing process?

A. Data collection.

B. Decision-making and judgment.

C. Priority-setting and expected outcomes.

D. Reassessment and audit.

39.) Which action best describes a sentinel event alert?

A. Documenting the breakdown in communication during a shift report.

B. Indicating that a community or institution is unsafe.

C. Recording the harm done when a medication error occurs.

D. Signaling the need for immediate investigation and response.

40.) Which is primarily a developmental task of middle age?

A. Learning and acquiring new skills and information.

B. Rediscovering or developing satisfaction in one's relationship with a significant other.

C. Relying strongly upon spiritual beliefs.

D. Risk taking and its perceived consequences.

41.) The medical-surgical nurse, who is caring for a patient with a new diagnosis of cancer, observes the
patient becoming angry with the physicians and nursing staff. The best approach to diffuse the
emotionally charged discussion is to:

A. allow the patient and family members time to be alone.

B. arrange time for the patient to speak with another patient with cancer.

C. direct the discussion and validation of emotion, without false reassurance.

D. request a consultation from a social worker on the oncology unit.

42). It is hospital policy to assess and record a patient's pulse before administering digoxin (Lanoxin). By
auditing the nursing records to determine the frequency of compliance with this policy, the quality
assessment and improvement committee is conducting:

A. a process analysis.

B. a quality analysis.

C. a system analysis.

D. an outcome analysis.

43.) The nursing diagnosis for a patient with a myocardial infarction is activity intolerance. The plan of
care includes the patient outcome criterion of:

A. agreeing to discontinue smoking.

B. ambulating 50 feet without experiencing dyspnea.

C. experiencing no dyspnea on exertion.

D. tolerating activity well.

44.) A nursing department in an acute care setting decides to redesign its nursing practice based on a
theoretical framework. The feedback from patients, families, and staff reflects that caring is a key
element. Which theorist best supports this concept?

A. Erikson.

B. Maslow.

C. Rogers.

D. Watson.

45.) Which statement by a patient demonstrates an accurate understanding about herbal supplements?

A. "Herbs may interact with prescribed medications but not other herbs."

B. "Most herbs have been tested and found to be safe and therapeutic."

C. "The Food and Drug Administration regulates herbs and allows advertising."

D. "There is no standardization among the manufacturers of herbs in this country."

46). For a patient with Crohn's disease, the medical-surgical nurse recommends a diet that is:

A. high in fiber, and low in protein and calories.

B. high in potassium.

C. low in fiber, and high in protein and calories.

D. low in potassium.

47.) When examining a patient who is paralyzed below the T4 level, the medical-surgical nurse expects
to find:

A. flaccidity of the upper extremities.

B. hyperreflexia and spasticity of the upper extremities.

C. impaired diaphragmatic function requiring ventilator support.

D. independent use of upper extremities and efficient cough.

48). After completing a thorough neurological and physical assessment of a patient who is admitted for a
suspected stroke, the medical-surgical nurse anticipates the next step in the immediate care of this
patient to include:
A. administering tissue plasminogen activator.

B. obtaining a computed tomography scan of the head without contrast.

C. obtaining a neurosurgical consultation.

D. preparing for carotid Doppler ultrasonography.

49.) The first step in applying the quality improvement process to an activity in a clinical setting is to:

A. assemble a team to review and revise the activity.

B. collect data to measure the status of the activity.

C. select an activity for improvement.

D. set a measurable standard for the activity.

50.) A patient has contracted chlamydia through unprotected sex. Which of the following is the most
appropriate response?

A. “There is no treatment for this disease.”

B. “You should abstain from sex until marriage.”

C. “Do not let anyone know you have this; it can ruin your reputation.”

D. “It is a bacterial infection and can be treated with antibiotics.”