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    Exam Review

    1. The nurse identifies the client problem of Impaired Verbal Communication for a client following a stroke who exhibits expressive aphasia. An appropriate nursing intervention to help the client to communicate is to:
      A)
      develop a list of simple words that the client can read and practice saying.
      B)
      ask simple yes or no questions.
      C)
      practice facial and tongue exercises to improve motor control.
      D)
      change the subject if the client does not respond in a timely manner.
    2. The nurse notices a yellow stain around fluid dripping from a patient's ear who sustained a traumatic brain injury. The nurse's priority intervention will be as follows:
      A)
      hang intravenous (IV) fluids to replace fluids lost and prevent dehydration.
      B)
      prevent the drainage by applying a tight pressure dressing.
      C)
      administer antibiotics due to increased risk of infection.
      D)
      allow fluid to drain from the patient's ear onto gauze and notify provider.
    3. A client has sustained a crush injury to the abdomen as the result of an industrial accident. The initial assessment and interventions have been carried out. The vital signs are stable, and the family is at the bedside. The client is complaining of bilateral flank pain. What is the priority nursing action for this client now?
      A)
      Determine if there are any allergies to food or drugs
      B)
      Administer antibiotics as ordered after culture results are available
      C)
      Obtain a clean-catch urine specimen
      D)
      Prepare for immediate abdominal surgery
    4. A nurse is preparing to administer hydrocortisone sodium succinate 350 mg via IV bolus every 6 hr. Available is hydrocortisone sodium succinate 1000 mg/8 mL. How many mL should the nurse administer? (Round the Answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
      Correct Answer:2.8 mL
    Page 1 of 19

    Exam Review

    1. The nurse is performing an assessment on a client. How would the nurse best evaluate improvement or deterioration in the neurologic status?
      A)
      Performing a mini mental status exam on admission and discharge
      B)
      Obtaining vital signs every four hours while hospitalized
      C)
      Assessing pupils for reactivity, equality, symmetry and accommodation
      D)
      Performing serial Glasgow Coma Scale exams during hospitalization
    2. The nurse is caring for a patient who is 24 hours post pacemaker insertion. Which nursing intervention is most appropriate at this time?
      A)
      Reinforcing the pressure dressing as needed.
      B)
      Assessing the incision for any redness, swelling, or discharge.
      C)
      Encouraging range-of-motion exercises of the involved arm.
      D)
      Applying wet-to-dry dressings every 4 hours to the insertion site.
    3. Which of the following are risk factors associated with kidney cancer? (SELECT ALL THAT APPLY)
      (SATA)
      A)
      Exposure to asbestos
      B)
      Smoking
      C)
      Consumption of green tea
      D)
      History of kidney stones
      E)
      Obesity
      F)
      Regular consumption of citrus fruits
      G)
      Hypertension
      H)
      Regular exercise
    4. The nurse caring for a client with severe sepsis suspects the client may be developing disseminated intravascular coagulation (DIC). Which of the following signs and symptoms would support the diagnosis of DIC?
      A)
      sudden onset of chest pain and copious sputum
      B)
      foul smelling, concentrated urine
      C)
      oozing blood form the IV sites
      D)
      reddened, inflamed central line catheter site
    Page 2 of 19

    Exam Review

    1. The nurse assesses the adult patient who weighs 132lb and discovers the following areas to be affected by burns: anterior trunk, anterior and posterior right leg, and anterior and posterior right arm. Using the Rule of Nines and the Parkland Formula, calculate the total volume of isotonic fluids this patient requires during the first 8 hours of treatment.
      A)
      9,720mL
      B)
      5,400mL
      C)
      10,800mL
      D)
      4,860mL
    2. The nurse is caring for a patient with severe, major burns who is receiving fluid resuscitation per protocol. Which of the following assessments indicate a positive outcome?
      A)
      Blood pressure 80/46 (MAP 58)
      B)
      Heart rate 132 beats per minute
      C)
      Serum sodium level 149mEq/L (normal 135-145)
      D)
      Urine output of 0.5-1mL/kg/hr
    3. The nurse is caring for a client immediately following the insertion of a permanent pacemaker. Which intervention should be included in the plan of care?
      A)
      Teach the client how to change the pacemaker dressing
      B)
      Monitor urine output every two hours
      C)
      Arrange for ancillary personnel to feed the client
      D)
      Immobilize the affected arm using a sling
    4. The client with glaucoma asks the nurse is complete vision will return. The most appropriate response is:
      A)
      "Your vision will never return to normal. This is a permanent condition"
      B)
      "Your vision loss is temporary and will return in about 3-4 weeks after treatment begins."
      C)
      "Although some vision has been lost and cannot be restored, further loss may be prevented by adhering to the treatment plan."
      D)
      "Your vision will return back to normal as soon as the medications begin to work."
    Page 3 of 19

    Exam Review

    1. Which of the following are primary prevention methods for lung cancer? (Select all that apply)
      A)
      Using sunscreen
      B)
      Reducing exposure to air pollutants
      C)
      Regular CT scans
      D)
      Vaccination against HPV
      E)
      Smoking cessation
      F)
      Chemotherapy
    2. Which of the following are common manifestations of brain tumors? (SELECT ALL THAT APPLY)
      A)
      Progressively worsening headaches
      B)
      High fever
      C)
      Balance problems
      D)
      Visual changes
      E)
      Rapid onset of seizures
      F)
      Rash
    3. What is the primary goal of nursing care for the patient who is diagnosed with any type of shock? To manage and treat:
      A)
      inadequate tissue perfusion.
      B)
      fluid overload or deficit.
      C)
      vasoconstriction of vasculature.
      D)
      increased cardiac output.
    4. The nurse is caring for a 35-year-old man that is diagnosed with epididymitis. Which statement would indicate the client understands teaching about this condition?
      A)
      "I should use a heating pad for the pain."
      B)
      "My sexual partner needs to be treated with antibiotics."
      C)
      "Epididymitis usually resolves without any treatment."
      D)
      "After radiation treatment, I will make sure that I am meticulous about skin care."
    Page 4 of 19

    Exam Review

    1. The client is prescribed pantoprazole 8mg/hour after a bolus dose is given. The standard concentration from the pharmacy is 80mg in 200ml. How many hours will one bag take to infuse? (Round to the nearest whole number. Do not use training zeros.)
    2. At 2100, a client meets sepsis criteria BP 98/52, HR 132, RR 33, core temp 102.1 (38.9 C), pulse ox 92% on 4L with a serum lactate of 4.5. The patient weighs 176.3 pounds. IV 0.9 NSS is prescribed 30 mL/kg over 3 hours. What is the total volume the patient should receive in 3 hours? (Round to the nearest whole number, do not use trailing zeros.)
    3. The following occurrence would be considered a high risk body fluid exposure:
      A)
      Allowing a patient with multi drug resistant organism to use the nurse's pen
      B)
      Gastric content from an enteral nutrition tube is present on wrist end of a glove.
      C)
      A puncture with a used syringe left on a food tray from an unidentified client
      D)
      IV fluid dripped on the nurse's scrub top while priming a new IV line.
    4. The nurse cannot auscultate bowel sounds during the assessment of a client who has had a repair of an abdominal aortic aneurysm four days ago. The client is complaining of severe abdominal pain and the abdomen is distended. What action should the nurse take at this time?
      A)
      Continue to monitor the client as a paralytic ileus is possible
      B)
      Report the assessment findings to the surgeon
      C)
      Administer the PRN stool softener to the client
      D)
      Obtain an order to insert a nasogastric tube set to low suction
    Page 5 of 19

    Exam Review

    1. The nurse is caring for a patient with wheezes, shortness of breath, urticaria and itching after receiving a new antibiotic. The nurse understands that the epinephrine in this situation would be administered intramuscularly (IM) rather than intravenously (IV) because:
      A)
      IM epinephrine is the fastest route of administration.
      B)
      IV epinephrine is only administered during cardiac arrest.
      C)
      IM epinephrine is less concentrated than IV.
      D)
      Epinephrine would not be administered in this situation.
    2. When using an ECG rhythm strip to quickly estimate the ventricular rate for a client, the nurse should:
      A)
      print a 1-minute ECG strip and count the number of QRS complexes.
      B)
      calculate the number of small squares between one QRS complex and the next one and divide by 1500.
      C)
      count the number of large squares in the R-R interval and divide by 300.
      D)
      use the 3 second markers to count the number of QRS complexes in 6 seconds and multiply by 10.
    3. A client is admitted to the telemetry unit with a diagnosis of unstable angina. What information should the nurse expect the client to report?
      A)
      Chest pain occurs in the middle of the night
      B)
      Lying flat in bed causes shortness of breath
      C)
      Chest palpitations occur while exercising
      D)
      Chest pain occurs during sexual intercourse
    4. Which finding in the breast of a client suspected of having breast cancer supports the diagnosis?
      A)
      Presence of an inverted nipple
      B)
      Palpation of a mobile mass
      C)
      Report of dull, achy pain in the affected breast
      D)
      Area of skin discoloration
    Page 6 of 19