Nursing Now Todays Issues Tomorrows Trends Catalano 6th Edition Test Bank Download

Nursing Now Today’s Issues, Tomorrows Trends Catalano 6th Edition Test Bank
Nursing Now Today’s Issues, Tomorrows Trends

Catalano 6th Edition Test Bank
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Chapter 10: How to Take and Pass Tests
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. Based on accepted standards of care for documentation, identify the element that the nurse should
avoid placing in the client’s medical record.
a. Blank spaces between the lines for late entries
b. Date and time on all entries
c. Observation about the client’s behaviors
d. Direct quotes from the family
____ 2. An otherwise healthy 40-year-old woman who is brought into the emergency room (ER) with an
overdose is declared brain dead and evaluated for organ donation. On her driver’s license, the
“Organ Donor” box is checked and there is a legal witness signature present. Identify the action to be
taken next by the ER nurse.
a. Prepare the body for transfer to the operating room for organ removal.
b. Order appropriate tests for tissue typing.
c. Contact the organ procurement organization.
d. Pack the body in ice to lower metabolism and prevent deterioration of the organs.
____ 3. A psychiatric nurse employed in a busy outpatient psychiatric clinic notes that the foreign-born
psychiatrist who covers the clinic in the afternoons regularly bills clients for 60-minute sessions that
only last 30 to 40 minutes. Under the Federal False Claims Act, select what the nurse must report
concerning the physician.
a. Upcoding
b. Overbilling
c. False representation of services
d. Medicare fraud
____ 4. The hospital administration has just notified all the unit managers that the care delivery model is to
be changed from team nursing to modular nursing because of budget restraints. Identify the action by
the unit managers that is essential to the successful implementation of the modular nursing care
model.
a. Hire nurses who are self-directed and concerned with consistency of care.
b. Obtain the cooperation and input from respiratory therapy, radiology, dietary,
laboratory, and other support services.
c. Develop total quality management (TQM) studies to determine risk areas.
d. Initiate a training program for ancillary health workers, such as nurse aides and
orderlies.
____ 5. An HIV-positive client with pneumocystis carinii pneumonia (PCP) is confused and keeps removing
the intravenous piggyback (IVPB) needle during the administration of his
trimethoprim-sulfamethoxazole (Bactrim). Select the instructions by the charge RN to the LPN
administering medications that would best rectify this situation.
a. Give the client his as-needed (PRN) sedative a half hour before the IVPB
medication.
b. Assign one of the certified nursing assistants (CNAs) to stay with the client during
the medication administration.
c. During the 30 minutes the medication infuses, place the client in bilateral wrist
restraints.
d. Call the physician and request the medication by mouth.
____ 6. After her first week on a busy medical surgical unit, the new charge nurse notes that the individual
nurses are highly competent but seem to be unable to function productively as a team. Select the
action by the charge nurse that would best facilitate team building among the staff.
a. Provide an opportunity for the nurses to expresses feelings and emotions.
b. Hire more staff to reduce stress and fatigue from understaffing.
c. Allow the staff more input into important policy decision making.
d. Give the staff more time to adjust to the change in charge nurses.
____ 7. The nurses on the 7 a.m. to 3 p.m. shift have been complaining to the head nurse that the nurses on
the 11 p.m. to 7 a.m. shift have not been doing the ordered client daily weights, and the physicians
are very upset when they make their early morning rounds. Identify the initial action the head nurse
should take to resolve this conflict.
a. Post a stern memo that reminds the night shift nurses to do the daily weights.
b. Review the daily weight flow sheet.
c. Change the time for daily weights to the late morning.
d. Hold a meeting with the physicians to discuss their attitudes.
____ 8. Select the statement by a unit manager to the vice president for nursing during a budget meeting that
would be most effective in decreasing the staffing ratio on her unit from one nurse to nine clients to
one nurse to seven clients.
a. “This proposed change will have a positive effect on the usage of institutional
resources.”
b. “This proposed change will better meet current national standards of practice.”
c. “This proposed change will help with the recruitment of new nurses to the
facility.”
d. “This proposed change will improve the quality of care for the clients on the unit.”
____ 9. A particularly vocal staff nurse on a busy obstetrical unit has been complaining to the other nurses
about the unit manager’s preferential treatment of the night-shift nurses. Select the action the unit
manager should take to resolve this problem that best demonstrates the use of the assertive approach
to conflict resolution.
a. Note that the vocal staff nurse is not intelligent enough to understand the situation
and disregard her comments as worthless.
b. Arrange for the transfer of the staff nurse to the night shift.
c. Set up a time and place for a one-on-one meeting with the staff nurse.
d. Wait until there is an opportunity to use the incident to confront the staff nurse in
front of her colleagues.
____ 10. The oxygen saturation on a client with acute infective bronchitis drops to 84%, and he develops
severe dyspnea. There is a standing order for a handheld nebulizer (HHN) treatment PRN for
shortness of breath, and respiratory therapy is designated to give all respiratory treatments in the
facility. When the nurse calls the respiratory therapist, he states that he has several more treatments
to give and should be there in 10 or 15 minutes. Select the action by the nurse that would be most
appropriate at this time.
a. Increase the flow rate of the client’s oxygen until the respiratory therapist can
arrive.
b. Call the respiratory therapist back and insist that he come NOW.
c. Go ahead and give the HHN treatment by herself.
d. Give the client a prescribed PRN sedative to reduce anxiety.
____ 11. A client infected with hepatitis C becomes confused, pulls out his IV catheter, and bleeds profusely
on the bed rail and floor. Select the instructions by the nurse to the housekeeper that would best
prevent the spread of the infection.
a. Clean the area with 70% alcohol.
b. Mop the floor with a strong ammonia solution.
c. Let the blood dry before cleaning to limit the spread of the infection.
d. Wipe all contaminated surfaces with a 5% chlorine bleach solution.
____ 12. An 8-year-old girl is brought by her mother to the outpatient clinic with complaints of abdominal
cramping and greenish diarrhea. A diagnosis of shigellosis is made after a stool culture. Identify the
discharge instruction by the nurse that best explains the requirement for enteric precautions at home.
a. Enteric precautions only have to be maintained until the diarrhea stops.
b. The child must remain on enteric precautions until she has three stool cultures
negative for Shigella.
c. After the child has been taking the antibiotics for 48 hours, you can stop the enteric
precautions.
d. The child must remain on enteric precautions for 30 days or until her viral titer is
normal.
____ 13. Select the instructions given by the nurse to a preoperative client going for a hiatal hernia repair
about the use of an incentive spirometer that best describes its use postoperatively.
a. If you use it as prescribed, you won’t need a nasogastric tube.
b. You will not need as much postoperative pain medication if used every 2 hours.
c. Using it every 2 hours will help increase your respiratory effectiveness.
d. You will be able to begin eating much sooner if you use it every 4 hours.
____ 14. Select the instructions by the nurse that would best prevent postoperative complications in a client
who has just undergone a stapedectomy for a bone-conduction hearing loss.
a. Leave the mouth open when sneezing.
b. Use a soft, cotton-tipped applicator to clean the blood and drainage from the
affected ear to prevent infection.
c. Bend over very slowly during the first 48 hours post-operation.
d. Keep the head of the bed flat for the first 24 hours.
____ 15. Identify the position in which an adult client in the recovery room should be placed when he or she
complains of a sore throat and is lethargic after a tonsillectomy.
a. Side-lying
b. High Fowler’s
c. Trendelenburg’s
d. Batrachian
____ 16. After eye surgery, a client is alert and oriented and has eye patches over both eyes. Select the action
by the nurse that would have the highest priority in preventing injury to this client.
a. Keep the client restrained to prevent him from falling out of bed.
b. Walk the client around the room so he knows where the obstacles are located.
c. Make sure the bed is in the low position with the side rails down so that the client
can exit the bed more easily.
d. Show the client how to use the call bell signal and place it within easy reach.
____ 17. After a bicycle accident that caused a fractured tibia, a client has a fiberglass cast applied and is
discharged to home with crutches. Select the instructions by the nurse about climbing stairs with
crutches that would best prevent an additional injury.
a. Place the unaffected leg on the first step, then move the crutches and injured leg up
to the step together.
b. Move the injured leg to the first step, then place the crutches and uninjured leg on
the step together.
c. Place the injured leg and the crutch on the opposite side on the first step, then
move the injured leg and the other crutch up to the step.
d. Place both crutches on the first step together, then swing through both legs to the
next step.
____ 18. During a well-child visit to the clinic, the nurse notes that a 4-month-old girl is alert and responsive
and has a positive Moro reflex. Identify the statement by the nurse to the mother about the child’s
growth and development that is most appropriate.
a. Your child is developing normally, so bring her back in 1 month for a checkup.
b. There appears to be a neurological delay in your child’s development. We will
need to refer her to a pediatrician.
c. Your child needs more stimulation at home. Play lively music when she is in her
crib.
d. Your child has a severe developmental delay due to lack of proper care. I’m going
to have to report you to social services.
____ 19. The parents of a 10-year-old boy ask the nurse about his acting-out behavior. Select the behavior that
best identifies when a child this age requires professional help.
a. Peer relationships are affected.
b. Family relationships are affected.
c. Multiple aspects of the child’s life are affected.
d. The child’s grades in school show a decline.
____ 20. A 15-year-old girl is brought by her mother to the pediatric clinic because she has not yet started her
menstrual cycles and shows minimal physical development typical of puberty. When the diagnosis
of delayed puberty is made, the girl begins to cry, stating, “Everybody at school makes fun of me
because I’m so flat.” Select the response by the nurse that best addresses the girl’s concerns.
a. “Don’t worry. This a very common problem and you will soon catch up with your
classmates.”
b. “You are a very beautiful girl just the way you are. You’ll probably get zits when
you start your development.”
c. “If you keep busy in band and sports, you won’t worry so much about how you
look.”
d. “Let’s see if we can figure out what type of clothes you can wear that won’t accent
your lack of physical development so much.”
____ 21. A 42-year-old man comes to the outpatient clinic with complaints of joint swelling in his knees and
pain in his feet. Select the type of arthritis that is most common in men in the 30- to 50-year age
range.
a. Gouty arthritis
b. Rheumatoid arthritis
c. Osteoarthritis
d. Septic arthritis
____ 22. During her routine annual physical examination, a 48-year-old woman tells the nurse that she
worries about her health all the time, spends 8 to 10 hours at the health center every week, and has
spent a larger than usual amount of money on cosmetics over the past 6 months. Select the most
appropriate response by the nurse to this client.
a. “Your concerns and actions are normal because you are trying to maintain your
health and youth.”
b. “How are you doing at your work? Did you get that promotion you wanted?”
c. “Is your husband still helping with the household chores? Support systems are very
important.”
d. “You seem very healthy. You should avoid excessive exercise because it can cause
more damage in the long run.”
____ 23. A 72-year-old woman is injured in a fall down a flight of steps at home and is placed on bedrest in
the hospital. Select the interventions by the nurse for this client that best prevent the complications
of immobility.
a. Limiting the fluid intake to 200 mL per shift to prevent dependent edema.
b. Giving the client a full-bed bath and feeding her all meals to reduce potential
injury to fragile bones.
c. Massaging bony prominences and turning the client every 2 hours.
d. Ambulating the client to the bathroom instead of using the bedpan.
____ 24. During a “Health Promotion” class at a senior citizen center, one of the elderly attendees asks the
nurse teaching the class, “I know older persons fall frequently. What types of fractures are most
common in people in our age group?” Select the type of fracture the elderly most often experience.
a. Pelvis
b. Lumbar spine
c. Hand and wrist
d. Tibia
____ 25. While climbing over a barbed wire fence, a 22-year-old man received a deep laceration on his arm
and hand. After washing and dressing the laceration with an antibiotic ointment, the emergency
department nurse notes that the client has had all his immunizations, with his last tetanus at age 18
for another injury. Select the action that should be taken by the nurse at this time.
a. Instruct the client on care of the laceration at home.
b. Give a tetanus toxoid injection.
c. Order a serum tetanus titer test.
d. Advise the client to get another tetanus immunization in 2 years.
____ 26. A couple that has been unable to conceive seeks counseling from the nurse in a family planning
clinic. In discussing solutions to the couples’ difficulties, identify what information the nurse should
emphasize.
a. Care for health problems not related to pregnancy
b. Data supporting the incidences of pregnancy in their age and ethnic groups
c. How the couple can better improve their communication skills
d. New positions and techniques to use during intercourse
____ 27. At the family planning clinic, a 19-year-old woman who has recently become HIV positive is given
counseling by the clinic nurse. Identify the instructions by the nurse that are most effective in
preventing the transmission of HIV during sexual intercourse.
a. You can have unprotected sex if both you and your partner(s) are HIV positive.
b. The use of contraceptive measures, such as birth control pills and hormone
injections, will limit the spread of the virus.
c. The only way to prevent the transmission of HIV is to have an IUD placed.
d. Using a latex condom with a potent spermicide during intercourse is one of the
best ways to prevent the spread of HIV.
____ 28. A 24-year-old woman comes to the family planning clinic with dysuria, purulent vaginal drainage,
and perineal pruritus and has a positive culture for a sexually transmitted disease (STD). Identify the
STD that the nurse is required to report to the public health department.
a. Genital herpes
b. Vaginal warts
c. Gonorrhea
d. Chlamydia
____ 29. Select the instructions given by the nurse that are most accurate for a woman who is HIV positive
and 3 months pregnant who comes to the prenatal clinic for care.
a. You will need a C-section to prevent the transmission of the virus to your baby.
b. There is a good chance that your baby will not be infected with the virus if you
take your medications.
c. In a large percentage of cases, the virus is transmitted through the placenta.
d. Your baby will be very ill from the HIV infection when it is born.
____ 30. During the assessment of a 35-week gestation client admitted to the obstetrics unit in active labor,
the nurse notes the following: estimated fetal weight less than 2500 grams; membranes ruptured 12
hours ago; blood type AB negative; positive rubella titer; positive vaginal culture for Group B
streptococcus; current vital signs: T 99.2°F, P 104, R 26, B/P 128/88. Identify the most appropriate
action by the nurse at this time.
a. Administer a MMR vaccine.
b. Call the on-call pediatrician to warn him about a premature infant delivery.
c. Order a type and cross-match for two units of blood.
d. Administer an ordered IV antibiotic.
____ 31. Select the instruction by the nurse that is most helpful in relieving the pain from an episiotomy in a
1-day postpartum client.
a. Increase fluid intake to 2000 mL per day.
b. Keep the head of the bed elevated 45 degrees.
c. Apply an ice pack to your perineum.
d. Use a sitz bath twice a day.
____ 32. Select the recommendation given by a nurse to a group of clients at a cancer prevention seminar that
is most effective in reducing the risk for colon cancer in persons who have a family history of the
illness.
a. Avoiding obesity and losing weight reduces the incidence of colon cancer.
b. Limit or stop smoking because it places a person at a high risk for colon cancer.
c. There is a direct link between using saccharin-containing products and colon
cancer, so avoid using the sweetener.
d. Limit alcohol intake to one glass of wine per day.
____ 33. The nurse in an outpatient clinic notes that a client with a persistent nagging cough has come in for
treatment after hearing about the seven signs of cancer on the television show Oprah. Identify the
statement by the nurse that best reinforces this client’s understanding of the warning signs of cancer.
a. All the signs have to be present in order to detect cancer.
b. Other signs to look for include indigestion, difficulty swallowing, and changes in
the size or shape of a mole.
c. If you develop persistent nausea, skin rash, or acute pain, you are at high risk for
having a cancer.
d. The warning signs you hear about are just to scare people who do not schedule
regular appointments into visiting the physician.
____ 34. While evaluating a post–colon cancer surgery client who has a new colostomy, the nurse notes that
the client is in the denial stage of the grieving process. Select the response by the nurse that best
facilitates the client’s progression through the grieving process.
a. Interpret the denial for the client and point out that it is part of the grieving
process.
b. Confront the client’s denial as an unrealistic response.
c. Support the client in his denial.
d. Accept the denial as one of the stages in the grieving process.
____ 35. Identify the nursing action that best prevents autonomic dysreflexia in a client with a spinal cord
injury.
a. Giving the client his PRN dose of oxazepam (Serax) before the muscle spasms
begin
b. Maintaining the patency of the Foley catheter
c. Keeping the client in the sitting position as much as possible
d. Monitoring the client’s electrolyte levels
____ 36. Using crisis intervention theory in the care of a 26-year-old woman who was raped 1 week ago,
select the intervention by the nurse that best achieves successful treatment.
a. Preventing rape trauma syndrome
b. Helping the woman grow to a higher level of functioning
c. Referring the woman to a rape victims’ group therapy session
d. Restoring the woman to her pre-rape level of functioning
____ 37. A 22-year-old man is recovering from injuries obtained in an automobile accident in which he was
the driver and his 20-year-old girlfriend was killed. His parents have requested that information
about the girl’s death be withheld from the client, including restricting visitors and phone calls.
While bringing the client a PRN pain medication, the nurse notices that the local television lead
news story is about the accident. Select the best action by the nurse in response to this situation.
a. Talk loudly to the client so that he will not be able to hear the news.
b. Turn off the television, stating that the pain medication will work better with less
environmental stimuli.
c. Leave the television on and then answer any questions the client has.
d. “Accidentally” change the channel while raising the head of the bed.
____ 38. A 32-year-old man who is HIV positive and in the later stages of AIDS is hospitalized for treatment
of Pneumoncystis carinii pneumonia. While the nurse is administering the IV medication, the client
begins to cry and states: “None of my friends and relatives visit or call me anymore because of this
disease.” Select the response by the nurse that best promotes a positive self-concept for this client.
a. “I’ll talk with your physician and arrange a consultation with a psychologist so you
can deal with these negative feelings.”
b. “You seem very down today. Let’s talk about what’s going on.”
c. “I’m sure they want to visit and call, but they may be afraid they’ll say the wrong
thing. I can call them for you.”
d. “It sure seems that if they don’t call or visit, they are not really friends to begin
with. Just forget about them.”
____ 39. A 34-year-old mother of three young children who works as an administrative assistant at a
university comes to the crisis center due to the inability to sleep, increasing disorganization at her
job, and feelings of guilt about her ability to care for her children and house. She tells the nurse that
her husband used to help with the children and house a lot, but because of a recent job promotion
and additional work hours required, he can no longer do this. The client feels that they cannot afford
a full-time housekeeper and has become overwhelmed and depressed over the condition of her
house. Select the therapeutic technique to be used by the nurse that best helps this client deal with
her altered role performance.
a. Environmental modification
b. Anticipatory guidance
c. Confrontation
d. Cognitive restoration
____ 40. A 48-year-old woman had become increasingly depressed since her youngest son left for college 4
months ago. She has been a stay-at-home mother who has focused most of her time and energy on
her children and now has little to do. Identify the response by the nurse that best helps the client deal
with the spiritual aspects of her concerns.
a. “You need to find other outlets for your energy, such as helping at the church soup
kitchen.”
b. “What is it that sustains you when all else fails? You need to rely on yourself for
your happiness.”
c. “You need to focus your anger away from yourself onto a harmless third party.”
d. “Once you begin to take antidepressants, you will feel better in about a week.”
____ 41. A 5-foot-5-inch-tall, 15-year-old girl who weighs 88 pounds is admitted to the hospital with a
diagnosis of anorexia nervosa. After the second day in the hospital, she gains 1 pounds. Select the
nurse’s response to the weight gain that most enhances the girl’s recovery.
a. “Now that little amount of weight didn’t kill you!”
b. “If you follow your diet plan and the goals we established, you will be back to
normal in no time.”
c. “It must be scary for you to think that you gained that much weight.”
d. “Your family and I are very happy and pleased about your weight gain.”
____ 42. A 22-year-old man who is diagnosed with obsessive-compulsive disorder (OCD) that includes a
compulsion to check all faucets to make sure they do not drip is hospitalized when he is no longer
able to function at home or work due to his behavior. In the psychiatric unit, his actions consume a
major part of his waking hours, and often he misses meals and other scheduled activities. Identify the
intervention by the nurse that is most likely to precipitate a panic attack in this client.
a. Asking the client about his repressed feelings after he completes his ritual
b. Requiring the client to participate in scheduled meal times even if his rituals are
not complete
c. Pointing out to the client that his actions are meaningless
d. Using thought stopping and aversion therapy to block the ritualistic actions
____ 43. Identify the initial intervention by the nurse that is most effective in treating a 23-year-old woman
who is diagnosed with a dependent personality disorder.
a. Encouraging the client to make more decisions, starting with simple ones like what
to select from a menu
b. Teaching the client about the nature of the disorder and what the usual treatments
are for it
c. Placing the client in a group therapy session with other clients who have dependent
personality disorder
d. Working with the client to identify and express feelings of anger
____ 44. A client with an antisocial personality disorder is caught shoplifting and as part of his probation
agreement is required to spend 1 month at a psychiatric facility for treatment. Select the intervention
by the nurse that has the highest probability of success in treating this disorder.
a. Using daily one-on-one sessions with the nurse
b. Placing the client in group peer therapy with strong external controls
c. Initiating treatment with antianxiety medications
d. Quickly placing the client in isolation when he acts out
____ 45. Identify the intervention by the nurse that would be most therapeutic for a client diagnosed with
schizophrenia who has delusions about extraterrestrial spacecraft invading the earth.
a. Use distraction to reduce the client’s focus on the delusions.
b. Ask the client to talk about the delusion and his feelings when he is having it.
c. Agree with the delusion to prevent angering the client.
d. Point out the absurdity of the delusion and refocus in reality.
____ 46. Identify the action by the nurse that is most appropriate when caring for a client hospitalized with
chronic schizophrenia who has been taking clozapine (Clozaril) for the past 2 weeks.
a. Limit the client’s fluid intake to 500 mL per day.
b. Check the client’s white blood cell count and differential every week.
c. Obtain a serum cholesterol every month.
d. Make sure the client spends at least 30 minutes outside in the sun each day.
____ 47. Identify the intervention by the nurse that best maintains a safe hospital environment for a client
diagnosed with Korsakoff’s syndrome who is hospitalized because of several falls due to an
unsteady gait.
a. Reinforcing activity restrictions by repeating instructions frequently
b. Placing the client in a quiet, nonstimulating room away from the busy nurses’
station
c. Providing assistance as needed, including walkers or cane, when the client
ambulates
d. Limiting the client’s visitors to immediate family only
____ 48. Choose the instructions to an elderly woman with osteoarthritis that best help her maintain normal
activities of daily living (ADLs) and complete her usual household chores.
a. Try to complete all of your chores before lunch because the pain and soreness is
less serious in the morning.
b. If you rest in the morning and afternoon, you will be able to complete your chores
in the evening with less discomfort.
c. Make sure you do warm-up and stretching exercises before you do your chores to
maximize your agility.
d. Do your chores at a pace that is comfortable for you, resting frequently after
periods of activity.
____ 49. Identify the intervention by the nurse that has the highest priority when assisting a client diagnosed
with multiple myeloma with ADLs.
a. Keep the client on oxygen by nasal cannula at all times.
b. Use great care in transferring the client from bed to chair to prevent bone injury.
c. Allow the client to rest for 10 minutes before and after each activity.
d. Encourage the client to be as independent as possible.
____ 50. Select the recommendation by the nurse that is most helpful in restoring a normal sleep pattern to a
58-year-old man who has chronic insomnia.
a. A regular waking time in the morning will help re-establish your circadian sleep
cycle.
b. Using an occasional sleeping pill will be of some benefit.
c. A light snack before bed will help encourage sleep.
d. I am going to refer you to a sleep specialist for further evaluation.
____ 51. Identify the best response by the nurse to a physician’s prescription for temazepam (Restoril) 15 mg
PO, PRN for a hospitalized client.
a. Question the order because the dose is too large.
b. Give it as ordered when the client is restless.
c. Schedule the medication for before bed.
d. Question the order because the dose is too small.
____ 52. Identify the dietary teaching by the nurse that best promotes the comfort of a client in the late stages
of cirrhosis who has ascites.
a. You must increase your daily fluid intake to 3 liters per day to avoid dehydration.
b. Your protein intake should be between 100 and 120 grams per day.
c. Keep your sodium intake to 1 to 2 grams per day.
d. Extra fats in your diet are necessary to maintain your energy levels.
____ 53. Identify the diet change recommendation by the nurse that best helps reduce the cramping
experienced by a client who is diagnosed with chronic renal failure and has severe abdominal and
leg cramping during hemodialysis treatments.
a. You need to increase your fluid intake between treatments to 4 liters per day.
b. Restrict your potassium intake to 80 mEq per meal.
c. Your fluid intake should not exceed 1 liter per 24 hours.
d. Low biological quality protein foods will help reduce muscle spasms.
____ 54. A 14-year-old girl is admitted to the ER with a suspected overdose of an unknown drug. Arterial
blood gasses (ABG) are drawn with the following results: pH 7.31, PO2 88, PCO2 59, HCO3 22.
Identify the initial action to be taken by the nurse.
a. Insert a large-gauge nasogastric tube for gastric lavage.
b. Insert a Foley catheter and obtain a urine for drug screen.
c. Use a manual ventilator (ambu-bag) to assist with ventilation.
d. Attach the client to a cardiac monitor and watch for dysrhythmia.
____ 55. Select the statement by the nurse that is most accurate when instructing a client with a newly formed
permanent colostomy on how to use the irrigation set to prevent constipation.
a. Make sure the irrigation bag is above the level of your head for best results.
b. Insert the lubricated catheter 2 to 4 inches into the stoma.
c. Dilate the stoma prior to beginning the procedure by using one finger.
d. Use cold water to best stimulate colon peristalsis.
____ 56. Identify the instructions about the care of urinary system the nurse should give to a 44-year-old
hospitalized woman who has an indwelling urinary catheter and IV who insists on going to the
smoking room for a cigarette every few hours.
a. Place the drainage bag on the floor when you are sitting to prevent pulling on the
catheter.
b. Clamp the catheter before you leave and unclamp it when you return.
c. Loop the drainage tubing around the IV pole to keep it in place.
d. Hang the drainage bag on the pole at a level to keep it below your bladder at all
times.
____ 57. Identify the action the nurse should take when he notes that a client who is receiving captopril
(Capoten) for congestive heart failure has developed hyperkalemia.
a. Give the next dose with a full 240 mL glass of water.
b. Hold the next dose and notify the physician.
c. Increase the client’s intake of fresh fruits and vegetables.
d. Reduce the dose by half and give both a.m. and p.m.
____ 58. A 73-year-old man receives hydralazine (Apresoline) 20 mg PO at 0800. When the nurse checks his
blood pressure at 0900, she obtains a reading of 72/44 mm Hg. The client has been taking this same
dose of medication for 3 years. The nurse finds all of the following data in the client’s chart. Identify
the finding that is most significant for producing the client’s current blood pressure.
a. Pedal pulses 1 + and weak
b. 24-hour fluid intake 1000 mL  3 days
c. Serum potassium 3.3 mEq/L
d. Apical pulse 150 BPM, slightly irregular
____ 59. Select the medication that the ER nurse should give to an unconscious client experiencing a severe
hypoglycemic reaction.
a. Hydrocortisone
b. D50W
c. Sodium bicarbonate
d. Glucagon
____ 60. Prior to discharge, a client diagnosed with a gastric ulcer is given prescriptions for cimetidine
(Tagamet) and aluminum-magnesium complex (Riopan). Identify the instructions that the nurse
should emphasize to the client about these two medications.
a. To achieve maximum effectiveness, take them at the same time.
b. Take the Riopan with meals and the Tagamet on an empty stomach.
c. Make sure to take the medications with a full 8-ounce glass of orange juice.
d. The Tagamet can be taken with meals; then wait 1 to 2 hours to take the Riopan.
____ 61. Select the response by the nurse to a 22-year-old woman that best answers her question on why she
must take two antibiotics, ceftriaxone (Rocephin) and doxycycline (Vivox), for a gonorrhea
infection.
a. These two antibiotics taken together lessen the side effects of each other.
b. Many people who have gonorrhea also have a Chlamydia infection, and these two
medications will eliminate both.
c. The medications potentiate each other and are stronger together than separately.
d. The course of treatment can be shortened to 5 days when two antibiotics are used.
____ 62. Select the discharge instructions by the nurse to a client diagnosed with pruritus that most increase
the effectiveness of a prescribed emollient.
a. Apply the medication at night before you go to bed.
b. To keep it in contact with the skin longer, wrap the area with a gauze dressing after
applying the cream.
c. Apply the cream immediately after a bath or shower.
d. To protect your skin from the drying effects of hot water, apply the cream just
before you take a bath or shower.
____ 63. Identify the statement by the public health nurse that most accurately describes treatment with
immune globulin for the wife and two children of a client who was diagnosed with hepatitis A.
a. One injection provides immunity for life.
b. If the family has not been in close contact with the client, they do not need the
medication.
c. The medication conveys active immunity.
d. If administered more than 2 weeks after exposure, it may not be effective.
____ 64. Select the best time for the nurse to administer a PRN dose of morphine sulfate, 5 mg IV, to a client
who is experiencing leg pain after an open reduction for a fractured femur.
a. When the pain is in the moderate to severe range
b. When the pain first starts, before it becomes severe
c. No more than every 6 hours to prevent morphine addiction
d. Regularly every 4 hours
____ 65. A client with a urinary tract infection is given a prescription for sulfamethoxazole (Gantanol), 1
gram by mouth three times a day. Choose the common side effects that can be expected after 3 days.
a. Diarrhea and gastrointestinal bloating
b. Anxiety and inability to concentrate
c. Drowsiness and dizziness
d. Headache and hyperactivity
____ 66. Identify the teaching point that has the highest priority when the nurse is instructing a client about
the home use of respiratory medications for treatment of his emphysema.
a. If you stop taking expectorants suddenly, there will be a rebound effect.
b. Avoid driving your car for 2 hours after using the nasal decongestant.
c. Never use glass, stainless steel, or plastic when taking mucolytics.
d. Be sure to use water either orally or inhaled with mucous secretions to decrease the
amount of the secretions.
____ 67. A client with a history of prolapsed mitral valve complains to the ER nurse that he is having
palpitations (pounding heart) even at rest. Identify the discharge instructions by the nurse that are
most effective in reducing future episodes of this symptom.
a. Make sure you eat foods high in potassium, like oranges and bananas.
b. You will need to increase your fluid intake to 2 to 3 liters per day.
c. Avoid beverages that contain caffeine, like coffee and colas.
d. Limit your activity as much as possible.
____ 68. A client with myeloid metaplasia is experiencing joint pain, guiac-positive stools, and a platelet
count of 31,000 per mm3. If a PRN dose of meperidine (Demerol) is ordered by all of the following
routes, choose the route the nurse should avoid using to give the medication.
a. Intramuscular
b. Intravenous
c. Oral
d. Subcutaneous
____ 69. Identify the discharge instructions by the nurse that best help prevent potential complications related
to the pacemaker for a 65-year-old man who received an implanted ventricular demand pacemaker
for treatment of a complete AV block secondary to an anterior myocardial infarction.
a. Avoid all activities that require raising your arms over your head.
b. When a microwave oven is in use, stay out of the room.
c. You will not be able to fly because the airport metal detectors will disrupt the
pacemaker function.
d. Inform you dentist that you have the device.
____ 70. Identify the instructions by the nurse in charge of a diabetic clinic about exercises that are most
effective in maintaining the cardiovascular system integrity of a newly diagnosed diabetic client.
a. You should avoid all isometric exercises because they place too much demand on
your heart.
b. You should exercise at least five to seven times a week for best effect.
c. Exercising at least three times a week will help meet the goals of weight and blood
sugar maintenance.
d. Only vigorous aerobic exercises for an hour at a time will help you maintain your
blood pressure and heart rate.
____ 71. Identify the nutrient that the nurse should increase in the diet of a client’s who is 3 days
postoperative after a thyroidectomy and is experiencing muscle twitching and tremors.
a. Potassium
b. Calcium
c. Magnesium
d. Iodine
____ 72. A client’s throat was sprayed with a topical local anesthetic prior to a bronchoscopy. Select the
action that the nurse should take when the client returns from the procedure and has an absent gag
reflex.
a. Use an oral airway to maintain a patent airway.
b. Place the client in the side-lying position to facilitate respirations.
c. Hold his breakfast tray and all fluids.
d. Position the client in a low Fowler’s position.
____ 73. Identify the instructions by the nurse to a client with a history of pancreatitis that best aids in the
prevention of discomfort associated with diet.
a. Drink 2 liters of fluid at each meal and eat a high-fat diet.
b. Avoid caffeine beverages and eat a low-fat diet.
c. You need to keep your energy levels up by eating a high-carbohydrate and high-fat
diet.
d. A high-sodium, high-protein diet best prevents abdominal discomfort.
____ 74. Identify the action by the nurse in the care of a client with cervical cancer who has a vaginal
applicator of radioactive material in place that poses the highest risk potential for a radiation hazard.
a. Giving the client a complete bed bath each morning
b. Maintaining the client on strict bedrest
c. Checking the applicator for placement every 4 hours
d. Elevating the head of the bed 30 degrees for meals
____ 75. Select the instructions by the clinic nurse that are most effective in preventing back injury for a
client with chronic low back pain.
a. Stand close to a heavy object before attempting to lift it.
b. Use your arms to lift objects to prevent back strain.
c. A narrow base of stance is most effective for lifting.
d. Make sure to bend at the waist when lifting objects more than 30 pounds.
Chapter 10: How to Take and Pass Tests
Answer Section
MULTIPLE CHOICE
1. ANS: A PTS: 1 DIF: Medium

KEY: Client Need: Safe and effective care environment | Cognitive Domain: Analysis | Integrated Process:
Intervention
2. ANS: C PTS: 1 DIF: Medium
Intervention
KEY: Client Need: Safe and effective care environment | Cognitive Domain: Application | Integrated
Process: Intervention
4. ANS: B PTS: 1 DIF: Medium
Intervention
Intervention
8. ANS: D PTS: 1 DIF: Hard
KEY: Client Need: Safe and effective care environment | Cognitive Domain: Judgment | Integrated Process:
Intervention
10. ANS: C PTS: 1 DIF: Hard
Intervention
11. ANS: D PTS: 1 DIF: Medium
Intervention
Intervention
Intervention
Intervention
KEY: Client Need: Health promotion and maintenance | Cognitive Domain: Judgment | Integrated Process:
Intervention
KEY: Client Need: Health promotion and maintenance | Cognitive Domain: Application | Integrated Process:
Intervention
KEY: Client Need: Health promotion and maintenance | Cognitive Domain: Analysis | Integrated Process:
Intervention
21. ANS: A PTS: 1 DIF: Hard
Problem identification
22. ANS: B PTS: 1 DIF: Hard
Intervention
Intervention
Process: Assessment
Intervention
Intervention
Intervention
Identification
KEY: Client Need: Health promotion and maintenance | Cognitive Domain: Synthesis | Integrated Process:
Intervention
KEY: Client Need: Health promotion and maintenance | Cognitive Domain: Judgment | Integrated Process:
Intervention
Intervention
Intervention
Intervention
KEY: Client Need: Psychosocial integrity | Cognitive Domain: Synthesis | Integrated Process: Problem
identification
KEY: Client Need: Psychosocial integrity | Cognitive Domain: Application | Integrated Process: Intervention
KEY: Client Need: Psychosocial integrity | Cognitive Domain: Analysis | Integrated Process: Intervention
KEY: Client Need: Health promotion and maintenance | Cognitive Domain: Comprehension | Integrated
KEY: Client Need: Psychosocial integrity | Cognitive Domain: Judgment | Integrated Process: Intervention
KEY: Client Need: Psychosocial integrity | Cognitive Domain: Synthesis | Integrated Process: Intervention
KEY: Client Need: Physiological integrity | Cognitive Domain: Application | Integrated Process: Intervention
KEY: Client Need: Physiological integrity | Cognitive Domain: Judgment | Integrated Process: Problem
identification
KEY: Client Need: Physiological integrity | Cognitive Domain: Comprehension | Integrated Process:
Intervention
KEY: Client Need: Physiological integrity | Cognitive Domain: Analysis | Integrated Process: Intervention
KEY: Client Need: Physiological integrity | Cognitive Domain: Synthesis | Integrated Process: Intervention
KEY: Client Need: Physiological integrity | Cognitive Domain: Analysis | Integrated Process: Problem
identification
KEY: Client Need: Physiological integrity | Cognitive Domain: Judgment | Integrated Process: Evaluation
62. ANS: C PTS: 1 DIF: Easy
KEY: Client Need: Physiological integrity | Cognitive Domain: Comprehension | Integrated Process:
KEY: Client Need: Physiological integrity | Cognitive Domain: Synthesis | Integrated Process: Problem
identification
KEY: Client Need: Physiological integrity | Cognitive Domain: Evaluation | Integrated Process: Intervention
KEY: Client Need: Physiological integrity | Cognitive Domain: Application | Integrated Process: Problem
identification
73. ANS: B PTS: 1 DIF: Easy
KEY: Client Need: Physiological integrity | Cognitive Domain: Application | Integrated Process: Problem
Nursing Now Today’s Issues, Tomorrows Trends Catalano 6th Edition Test Bank
identification
75. ANS: A PTS: 1 DIF: Easy
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