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    Exam Review

    1. Which instruction should the nurse include in the discharge teaching plan for an adult client with hypernatremia?
      A)
      Monitor daily urine output volume.
      B)
      Use salt tablets after strenuous exercise.
      C)
      Review food labels for sodium content.
      D)
      Drink plenty of water whenever thirsty.
    2. The healthcare provider prescribes bismuth subsalicylate, metronidazole, tetracycline, and pantoprazole for a client with H. pylori. Prior to administering the H. pylori treatment regimen, the nurse should review the client’s medication list for which medication?
      A)
      Ipratropium.
      B)
      Aspirin.
      C)
      Famotidine.
      D)
      Loperamide.
    3. The nurse is admitting a client with possible tuberculosis (TB). The client is placed in a private room with airborne precautions pending diagnostic test results.Which diagnostic test should the nurse review to confirm the diagnosis of TB?
      A)
      Chest X-ray or computed tomography (CT).
      B)
      Hemoccult test on sputum collected from hemoptysis.
      C)
      Positive purified protein derivative (PPD) skin test.
      D)
      Sputum culture positive for Mycobacterium tuberculosis.
    4. A client receives a prescription for vancomycin 500 mg IV every 8 hours. The medication is provided in “500 mg per 100 mL of dextrose 5% in water.”. To administer the medication over an hour, the nurse should set the infusion pump to deliver how many mL/hr? (Enter numerical value only.)
      Correct Answer:100 mL/hr
    Page 1 of 15

    Exam Review

    1. The nurse is preparing a teaching plan for a group of well-educated clients who were found to be HIV positive within the last year.The nurse should explain that the human immunodeficiency virus (HIV) acts in which way to suppress the immune system?
      A)
      Increase in B-lymphocytes and IgM.
      B)
      Destruction of helper T-cells and CD4 cells.
      C)
      Deficiency of cytotoxic T cells.
      D)
      Proliferation of suppressor T-cells.
    2. Which technique should the nurse use when assessing for early signs of rheumatoid arthritis?
      A)
      Palpate large joints for nodules.
      B)
      Observe the skin for lesions.
      C)
      Observe the client’s fingers.
      D)
      Palpate the lymph nodes.
    3. A client presents to the emergency department with muscle aches, headache, fever, and describes a recent loss of taste and smell.The nurse obtains a nasal swab for COVID-19 testing.Which action is most important for the nurse to take?
      A)
      Isolate the client from other clients, family, and healthcare workers not wearing proper personal protective equipment (PPE).
      B)
      Report the COVID-19 result to the local health department according to Centers for Disease Control and Prevention (CDC) guidelines.
      C)
      Teach the client to wear a mask, hand wash, and social distance to prevent spreading the virus.
      D)
      Counsel family members to monitor for illness symptoms for 2 weeks after last contact with the patient.
    4. Which information should the nurse include when giving discharge instructions to a client following a left eye cataract extraction with a lens implant?
      A)
      Observe pupil response of the right eye.
      B)
      Sleep flat in a supine position.
      C)
      Turn, cough, and deep breathe every 2 hours.
      D)
      Administer a stool softener.
    Page 2 of 15

    Exam Review

    1. Following discharge teaching, a client with a duodenal ulcer tells the nurse of plans to eat plenty of dairy products to help coat and protect the duodenal ulcer.Which is the best follow-up action by the nurse?
      A)
      Review with the client the need to avoid foods that are rich in milk and cream.
      B)
      Suggest that the client also plan to eat frequent small meals to reduce discomfort.
      C)
      Remind the client that it is also important to switch to decaffeinated coffee and tea.
      D)
      Reinforce the teaching by asking the client to make a list of snack foods high in dairy content.
    2. Which approach is best for the nurse to use when directing a client with Huntington’s disease to the hospital cafeteria?
      A)
      Provide step-by-step verbal directions.
      B)
      Escort the client to the cafeteria.
      C)
      Orient the client to the color-coding system used for locating hospital services.
      D)
      Use the hospital map to show the client where the cafeteria is located.
    3. A client who was admitted yesterday with bilateral pneumonia has congested breath sounds, an oxygen saturation of 94%, a weak cough effort, and is using accessory muscles to breathe.Which intervention should the nurse implement first?
      A)
      Suction to clear secretions from the airway.
      B)
      Offer a prescribed PRN analgesic.
      C)
      Obtain arterial blood gases.
      D)
      Administer a prescribed antipyretic.
    4. A client with a history of asthma and bronchitis arrives at the clinic with shortness of breath and a productive cough with thickened, tenacious mucus.The client reports difficulty walking up a flight of stairs without experiencing breathlessness.Which action is most important for the nurse to instruct the client about self-care?
      A)
      Teach anxiety reduction methods for feelings of suffocation.
      B)
      Increase the daily intake of oral fluids to liquefy secretions.
      C)
      Call the clinic if undesirable side effects of medications occur.
      D)
      Avoid crowded enclosed areas to reduce pathogen exposure.
    Page 3 of 15

    Exam Review

    1. A client who has had a laryngectomy and tracheostomy frequently expectorates copious amounts of purulent secretions.When changing the ties of the tracheostomy tube, which action is most important for the nurse to take?
      A)
      Secure tracheostomy ties by making knots close to the tube.
      B)
      Remove ties to secure a disposable, soft foam collar with hook and loop fastener.
      C)
      Leave the old ties in place until the new ones are secure.
      D)
      Place knots of the ties laterally to prevent irritation and pressure.
    2. The nurse is planning care for a client with a direct (sliding) hiatal hernia.Nursing actions should be planned to meet which goal?
      A)
      Promote effective swallowing.
      B)
      Maintain intact oral mucosa.
      C)
      Prevent esophageal reflux.
      D)
      Increase intestinal peristalsis.
    3. A client with chronic cirrhosis has esophageal varices.It is most important for the nurse to monitor the client for the onset of which problem?
      A)
      Hematemesis.
      B)
      Anorexia.
      C)
      Clay-colored stool.
      D)
      Brown, foamy urine.
    4. A client with open-angle glaucoma asks the nurse how long the prescribed eye drops will need to be used.Which response made by the nurse is accurate?
      A)
      For long-term control of normal eye pressure.
      B)
      Until a smaller angle can be restored.
      C)
      For long-term control of pain and swelling.
      D)
      Until the excess pressure is reduced.
    Page 4 of 15

    Exam Review

    1. A teenage client is admitted to the emergency department following a bee sting.The client arrives with a body rash and 30 of 40 breaths per minute and a blood pressure of 90/52 mm Hg. The client is exhibiting clinical manifestations of which type of immune reaction?
      A)
      Autoimmune response.
      B)
      IgE response hypersensitivity.
      C)
      Cell-mediated hypersensitivity.
      D)
      Type II hypersensitivity.
    2. Before administering a newly prescribed dose of terbinafine HCL to a client with a fungal toenail infection, which assessment finding is most important for the nurse to address?
      A)
      Reported history of alcoholism.
      B)
      Toenails appear thick and yellow.
      C)
      Employed as a construction worker.
      D)
      White blood cell count of 8,500/mm³ (8.5 x 10⁹/L). .
    3. A client diagnosed with chronic obstructive pulmonary disease (COPD) is given a new prescription for tiotropium via an inhalation device.Which statement indicates the client understands the instructions for using this medication?
      A)
      I should use this medication in its handihaler every day.
      B)
      I will use my other inhaler in between uses.
      C)
      When I cough up sputum, the secretions should be less thick.
      D)
      If I have sudden shortness of breath, I will use this inhaler.
    4. When performing postural drainage on a client with chronic obstructive pulmonary disease (COPD), which approach should the nurse use?
      A)
      Explain that the client may be placed in five positions.
      B)
      Perform the drainage immediately after meals.
      C)
      Obtain an arterial blood gas (ABG) prior to the procedure.
      D)
      Instruct the client to breathe shallow and fast.
    Page 5 of 15

    Exam Review

    1. The nurse is performing a routine dressing change for a client with a stage 3 pressure injury that is red with significant granulation.The wound has a gauze dressing covering the area.Which action should the nurse implement?
      A)
      Increase the frequency of the dressing changes.
      B)
      Leave the dressing off until consulting with the healthcare provider.
      C)
      Apply a hydrocolloidal gel dressing.
      D)
      Replace the gauze with a transparent dressing.
    2. A client with newly diagnosed Crohn’s disease asks the nurse about dietary restrictions.How should the nurse respond?
      A)
      Explain that the need to restrict fluids is the primary limitation.
      B)
      Advise the client to limit foods that are high in calcium and iron.
      C)
      Describe the use of an elimination diet to find trigger foods.
      D)
      Instruct the client to avoid foods with gluten, such as wheat bread.
    3. A client has been administered lactulose for several days.Which therapeutic response should the nurse expect for a client with hepatic encephalopathy?
      A)
      Improved mental status.
      B)
      Reduction in number of liquid stools.
      C)
      Ability to ambulate independently.
      D)
      Increase in urine output.
    4. A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler.Which action indicates to the nurse that additional teaching is needed?
      A)
      Stores the medication at room temperature.
      B)
      Attaches spacer device to the inhaler.
      C)
      Rinses the mouth after each use.
      D)
      Primes the inhaler with 7 pumps.
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