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    Exam Review

    1. When the nurse is obtaining health history during an annual physical examination, the client reports having difficulty with erections for the past 8 months. Which information in the client's history should the nurse consider as a potential reason for erectile dysfunction?
      A)
      A lifestyle with minimal physical activity.
      B)
      Works more than 12 hours in a day.
      C)
      History of type 2 diabetes mellitus.
      D)
      A phosphodiesterase inhibitor on the medication list.
    2. The nurse is doing a health assessment of a client who smoked three packs of cigarettes every day for the last twenty years before quitting two years ago. How should the nurse document the client's pack-years? (Enter the numerical value only.)
      Correct Answer:60 pack-years
    3. When assessing an older adult client with a history of cardiovascular disease, dyspnea, and peripheral edema, which method is best for the nurse to use to assess the client's pulse rate?
      A)
      Palpate the radial pulses in both arms for a deficit.
      B)
      Use the stethoscope to listen over the carotid artery.
      C)
      Feel the volume of the dorsalis pedis and posterior tibialis pulses.
      D)
      Auscultate the apical pulse at the point of maximal impulse.
    4. When assessing heart sounds of a client with rheumatic valvular heart disease, where should the nurse place the stethoscope to auscultate the tricuspid valve?
      A)
      Left fifth intercostal space, midclavicular line.
      B)
      Third left intercostal space.
      C)
      Left fourth intercostal space next to left sternal border.
      D)
      Second right intercostal space.
    Page 1 of 15

    Exam Review

    1. The nurse is performing oral inspection of a client with dark pigmented skin. The nurse observes a patchy discoloration of the buccal mucosa. Which action should the nurse take?
      A)
      Document this finding in the medical record.
      B)
      Ask if the client recently received any antibiotics.
      C)
      Ask the client about use of irritating chemical agents.
      D)
      Schedule an appointment with a dermatologist.
    2. A client asks the nurse to look at a mole located on the back. The client tells the nurse that the mole has changed from brown to black and enlarged in size. Which is the priority nursing action?
      A)
      Advise the client to see his healthcare provider for immediate evaluation.
      B)
      Ask the client if he often spends time outside in the sun without a shirt.
      C)
      Encourage the client to keep checking the mole with a magnifying mirror.
      D)
      Offer to teach a family member how to monitor the skin around the mole.
    3. The nurse is assessing a client with gallstones for jaundice. Which action should the nurse perform to confirm this information?
      A)
      Examine client's sclera for icterus.
      B)
      Review recent serum bilirubin levels.
      C)
      Observe the client's urine for dark orange color.
      D)
      Assess conjunctival sacs of lower lids for pallor.
    4. An older adult client is being evaluated for admission to an assisted living facility. During the health assessment, the nurse implements which technique to determine the client's ability to reside in this environment?
      A)
      Screen client for alcohol or controlled drug abuse.
      B)
      Evaluate client for side effects of routine medications.
      C)
      Instruct client to demonstrate activities of daily living.
      D)
      Focus questions to evaluate long term memory.
    Page 2 of 15

    Exam Review

    1. When preparing a female client for an abdominal examination, the nurse should provide her with which instruction?
      A)
      "Refrain from eating or drinking for at least thirty minutes."
      B)
      "Lie in a prone position with slightly flexed knees."
      C)
      "Exhale slowly through your mouth then hold your breath."
      D)
      "Empty your bladder just prior to the examination."
    2. The school nurse is interviewing a 13-year-old girl who wants to go home from school because of "back pain." Which question should the nurse ask the adolescent first?
      A)
      "What were you doing when you first noticed the problem?"
      B)
      "Have you taken any medications to relieve the pain?"
      C)
      "Does changing your position make the pain worse?"
      D)
      "Do you remember ever having this type of pain in the past?"
    3. The nurse detects a possible extra heart sound while assessing an adult client. To verify this finding, which action should the nurse take?
      A)
      Listen to the heart sounds using the bell of a stethoscope.
      B)
      Use a Doppler ultrasound to hear the heartbeat.
      C)
      Obtain a pulse oximeter reading from two extremities.
      D)
      Auscultate for one minute with the stethoscope's diaphragm.
    4. The nurse observes that a client who is intoxicated has an ataxic gait. Which finding does the nurse expect to be positive upon further assessment of the client?
      A)
      Battle sign.
      B)
      Chvostek's sign.
      C)
      Romberg sign.
      D)
      Babinski sign.
    Page 3 of 15

    Exam Review

    1. Patient Data Exhibits Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.
    2. When conducting a physical examination, the nurse is assessing a client's abdomen and identifies a centrally localized distention that is pulsating. This finding should direct the nurse to consider which pathology?
      A)
      Hernia.
      B)
      Aneurysm.
      C)
      Tympany.
      D)
      Appendicitis.
    3. Which finding, obtained during a skin assessment, should the school nurse report to the healthcare provider?
      A)
      Multiple maculopapular pustules over forehead and chin on an adolescent.
      B)
      Bilateral patellar abrasions with eschar formation on a preschool-aged child.
      C)
      Red, swollen, painful nodule located on upper back on a school-aged boy.
      D)
      Small, white flecks on the hair shafts throughout scalp on a school-aged girl.
    4. A nurse performs a Tinetti assessment on an older adult client and calculates a balance score of 12 and a gait score of 8. Which do these results indicate?
      A)
      Increased risk for falling.
      B)
      Expected results for an older adult.
      C)
      Need for a walker to aid in ambulation.
      D)
      Likely onset of Parkinson's disease.
    Page 4 of 15

    Exam Review

    1. The nurse reviews a client's laboratory results for a client admitted with gastrointestinal (GI) bleeding who has no visible hemorrhoids on inspection of the anal area. Which laboratory test indicates that the client's bleeding is not yet resolved? Reference Range: Hematocrit (Hct) [42% to 52% (0.42 to 0.52 volume fraction)] Prothrombin time (PT) [11.0 to 12.5 seconds (85%-100%)] Glycosylated hemoglobin (A1C) [4% to 5.9%]
      A)
      Hematocrit changes from 36% to 32%.
      B)
      Hemoglobin A1C changes from 10% to 8%.
      C)
      Prothrombin time (PT) changes from 12 seconds to 18 seconds.
      D)
      Guaiac test changes from positive to negative.
    2. Which question by the nurse is likely to elicit the most information regarding a client's use of medications to treat a chronic cough?
      A)
      What medications have you taken for your cough?
      B)
      Have you been prescribed any medications for your cough?
      C)
      Have you tried any generic brands of cough syrup?
      D)
      What medications are you currently taking?
    3. The nurse is obtaining a health history for a client being admitted for new onset seizures. Which action should the nurse implement to accurately record the health history findings?
      A)
      Enter subjective data in the note section of the client's electronic medical record.
      B)
      Document the client's history that is directly related to current admission diagnoses.
      C)
      Enter the information in the electronic medical record at the client's bedside.
      D)
      Document the assessment findings on the computer at the nursing station.
    4. An adult male client tells the nurse that he smokes approximately one pack of cigarettes daily. How can the nurse expect smoking to affect this client's sleep?
      A)
      Decrease the need for rapid eye movement (REM) sleep.
      B)
      He would sleep soundly during the first half of the night, with increased arousals during the second half.
      C)
      Increase sleep latency, and reduce total sleep time.
      D)
      He would have difficulty falling to sleep, and sleep very lightly with more frequent arousals.
    Page 5 of 15

    Exam Review

    1. A 20-year-old nulliparous female college student sees the nurse because she has missed her last two menstrual periods. She reports she has not had sexual intercourse in one month. The nurse requests a pregnancy test, which is negative. Based on this client's history, which assessment is most important for the nurse to obtain?
      A)
      Vaginal discharge, presence of genital warts, abdominal tenderness.
      B)
      Breast tenderness, tremors, high blood pressure.
      C)
      Body weight, hirsutism, thyroid enlargement.
      D)
      Urinary frequency, unsteady gait, dental enamel erosion.
    2. While completing an admission assessment for a client with rectal bleeding, the nurse observes dried, dark red blood on the surface of a purple, shiny tissue mass that extrudes from the anal opening. When documenting in the client's electronic medical record (EMR), which finding should the nurse enter in the client's physical assessment?
      A)
      Anal mucosa prolapse and loose sphincter tone.
      B)
      Dried dark red blood on swollen external hemorrhoids.
      C)
      Serosanguineous and purulent exudate from anus.
      D)
      Tears of the anal mucosa with old blood around anus.
    3. The college health clinic nurse is preparing a seminar on testicular self-examination (TSE). Which instruction should be included in the content for this seminar?
      A)
      Manipulate the testicles upon rising.
      B)
      Inspect the testicles using a mirror.
      C)
      Examine the testicles during bathing.
      D)
      Compare both testicles concurrently.
    4. The nurse learns in report that a client is stuporous. Which assessment should the nurse perform to confirm this report?
      A)
      Observe for any facial asymmetry.
      B)
      Determine the response to stimuli.
      C)
      Assess for a positive Romberg sign.
      D)
      Check the pupillary response to light.
    Page 6 of 15