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    Exam Review

    1. A nurse performs the Snellen test on a client and obtains these results: Left eye 20/40, Right eye 20/30. What conclusion can the nurse make in regard to the client's vision based on these results?
      A)
      Client is legally blind in the right eye.
      B)
      Vision is worse in the right eye than the left eye.
      C)
      The larger the bottom number, the worse the visual acuity.
      D)
      Glasses are needed by the client for farsightedness
    2. During an instruction session on breast self-examination, the nurse would instruct a client to perform the exam at which time?
      A)
      Immediately before the menstrual period begins
      B)
      Three days after the menstrual period begins
      C)
      On the 14th day of the menstrual period
      D)
      Right after the menstrual period ends
    3. Lacking physical activities in older adult could cause which of the followings.
      A)
      protein deficiency.
      B)
      vitamin deficiency.
      C)
      joint infection
      D)
      muscle weakness
    4. A client is concerned about a right breast lump. What questions are appropriate for reviewing of this system? Select all that apply.
      (SATA)
      A)
      "Are you menstruating when the lump is present?"
      B)
      "Did you have any joint pain"
      C)
      "Is there any discharge from the lump?"
      D)
      "Are you allergic to Aspirin"
      E)
      "Is there pain with the lump?"
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    Exam Review

    1. The nurse plans to assess an adult client's kidneys for tenderness. The nurse should assess the area at the
      A)
      right upper quadrant.
      B)
      external oblique angle.
      C)
      left upper quadrant.
      D)
      costovertebral angle.
    2. A woman asks about the risk for developing breast cancer. Which of the following are considered as risk factors? Select all that apply.
      (SATA)
      A)
      Breast feeding at age of 35
      B)
      Family history of breast cancer
      C)
      Menopause at age 56
      D)
      Birth of first child at age 20
    3. Which of the following statement is best to describe clinical judgement?
      A)
      Clinical judgement helps nurses work through the data collection, analysis, and to develop hypotheses
      B)
      Clinical judgement does not involve the client in decisions
      C)
      The benefit of clinical judgement is that it empowers nurses not to follow the doctor's orders
      D)
      Clinical judgement uses nursing diagnosis to implement nursing interventions
    4. The nurse is assessing a client's hearing and gathers the following data: speaks very softly, denies hearing loss, has never had and cannot afford additional hearing tests, fails whisper test. What is your hypothesis for this patient?
    Page 2 of 15

    Exam Review

    1. A nurse assesses the skin of an older adult's forearms and observes purpura. What is the most likely cause of this skin condition?
    2. List one tool that is used to assess the depression status in older adult.
    3. A 78-year-old client is brought to the emergency department via ambulance after experiencing difficulty speaking and weakness in the left arm and leg. What disorder are these symptoms most likely caused by?
    4. When auscultating the lungs, the nurse listens over symmetrical lung fields for which of the following?
      A)
      One quiet full inspiration through pursed lips
      B)
      One deep inspiration and expiration through the open mouth
      C)
      Two full breaths every 10 seconds through the nose
      D)
      Two full breaths in through the mouth and out through the nose
    Page 3 of 15

    Exam Review

    1. Which of the following would the nurse identify after completing data collection and analysis?
      A)
      Outcome evaluation
      B)
      Interventions
      C)
      Making hypotheses
      D)
      Plan of care
    2. What is the normal finding when percussing the posterior lung fields?
    3. During the physical examination of a client's breast, which finding should the nurse suspect of a malignant tumor?
      A)
      Retracted nipple
      B)
      Tenderness of breast
      C)
      Stretch marks on breast
      D)
      Well-defined mobile lump
    4. A nurse should perform an ongoing assessment of which system throughout the entire examination?
    Page 4 of 15

    Exam Review

    1. What is Katz Activities of Daily Living Tool assessing?
    2. The nurse has clustered assessment data on a client with cirrhosis of the liver that has altered the mental status due to the accumulation of ammonia toxins. What type of priority would be indicated for this client?
      A)
      An actual problem.
      B)
      A risk problem.
      C)
      A wellness problem.
      D)
      A standard problem.
    3. A nurse is providing nutritional teaching for a client with a body mass index (BMI) of 30. What teaching should the nurse provide?
      A)
      "Decrease your daily caloric intake and increase your physical activity."
      B)
      "Decrease your daily physical activity and increase your caloric intake."
      C)
      "Continue with your current food intake and exercise regimen."
      D)
      "Increase your daily physical activity and calories by 500 a day."
    4. The nurse is assessing a client and notes and noted the lymph node on the submental area is less than 1 cm with no redness or tenderness. What is the nurse's best action?
      A)
      Refer the client to a dentist.
      B)
      Document the finding.
      C)
      Suspect infection.
      D)
      Notify the healthcare provider.
    Page 5 of 15

    Exam Review

    1. The nurse is performing the technique shown below. What is the nurse assessing?
      A)
      Lung consolidation
      B)
      Chest expansion
      C)
      Tactile fremitus
    2. A nurse is assessing a client's nutritional status. Which of the followings should be included? Select all that apply
      A)
      Obtain a 24-hour dietary information
      B)
      Obtain vaccination history
      C)
      Obtain height and weight measurements
      D)
      Obtain a health history
    3. During a physical examination of an adult client, the nurse is preparing to auscultate the client's abdomen. The nurse should
      A)
      palpate the abdomen before auscultation.
      B)
      use the diaphragm of the stethoscope.
      C)
      listen in each quadrant for 15 seconds.
      D)
      begin auscultation in the left upper quadrant.
    4. The nurse identifies that the client has a positive Obturator sign. What is the most likely cause of this finding?
    Page 6 of 15