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    Exam Review

    1. A 54 year old client is admitted with an exacerbation of COPD. The patient weighs 95kg. The healthcare provider orders theophylline IV per protocol: Loading dose 6 mg/kg. The pharmacy sends you 250 mg/10 ml of theophylline. Calculate the ml for the loading dose of theophylline.
      Correct Answer:22.8 mL.
    2. An order to start a heparin drip is received from a physician. The order is for 1,000 units heparin per hour. The solution strength is 20,000 units in 500 ml. D5NS. What should the electronic pump be set for?
      Correct Answer:25 mL/hr
    3. The nurse is assessing a patient with chest tubes connected to a drainage system. What should the first action be when the nurse observes excessive bubbling in the water seal chamber?
      A)
      Place the head of the patient's bed flat.
      B)
      Notify the healthcare provider.
      C)
      Milk the chest tube.
      D)
      Disconnect the system and get another.
    4. Which diet would be most appropriate for a client with chronic obstructive pulmonary disease (COPD)?
      A)
      High-calorie, high-protein diet
      B)
      Bland, soft diet
      C)
      Low-fat, low-cholesterol diet
      D)
      Low-sodium, high calorie diet
    Page 1 of 12

    Exam Review

    1. Which is the expected outcome of pursed-lip breathing?
      A)
      to strengthen the intercostal muscles
      B)
      to promote oxygen intake
      C)
      to strengthen the diaphragm
      D)
      to promote carbon dioxide elimination
    2. Which of the following assessment findings would be expected in a client with chronic hypoxemia due to chronic obstructive pulmonary disease (COPD)?
      A)
      Scattered rhonchi and crackles with an elevated WBC count
      B)
      Clubbing of the fingers and polycythemia
      C)
      Copious amounts of rust-colored sputum with cyanosis
      D)
      Distended neck veins and dependent edema
    3. A 28 y.o. female presents to the ED with sudden onset of chest pain and difficulty breathing after a fall from her bicycle. She reports a history of smoking. On examination, decreased breath sounds and unequal chest excursion.
      A)
      What condition is this client experiencing?
      B)
      Pleural effusion
      C)
      Asthma exacerbation
      D)
      Pneumothorax
      E)
      Pulmonary embolism
    4. After receiving an albuterol nebulizer, a client complains of feeling anxious and shaky. Which response by the nurse is best?
      A)
      "The next scheduled nebulizer treatment will be skipped."
      B)
      "This is an expected side effect, but let me take your pulse."
      C)
      "I will hold the respiratory medication for 24 hours."
      D)
      "I will request medication for anxiety from the healthcare provider."
    Page 2 of 12

    Exam Review

    1. The client with COPD presents in the ER with complaints of worsening SOB since last night. His ABG results are below. How should these results be interpreted? pH: 7.33 PaCO2: 60 HCO3-:31 PaO2: 75 SaO2: 91%
      A)
      Compensated metabolic acidosis with hypoxemia
      B)
      Partially compensated metabolic alkalosis
      C)
      Partially compensated respiratory acidosis with hypoxemia
      D)
      Fully compensated respiratory acidosis
    2. The nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which requires immediate intervention?
      A)
      Speaking in short phrases or sentences.
      B)
      Distant heart sounds.
      C)
      Diminished lung sounds.
      D)
      Pursed-lip breathing.
    3. A client with chronic obstructive pulmonary disease (COPD) is experiencing dyspnea and has a low PaO2 level. The nurse plans to administer oxygen as prescribed. Which statement is true concerning oxygen administration to a client with COPD?
      A)
      Administration of oxygen is contraindicated in clients who are using bronchodilators.
      B)
      High oxygen concentrations will cause coughing and dyspnea.
      C)
      Increased oxygen use will cause the client to become dependent on the oxygen.
      D)
      High oxygen concentration may inhibit the hypoxic stimulus to breathe.
    4. Which assessment finding indicates a tension pneumothorax, a complication of untreated pneumothorax?
      A)
      Symmetrical chest expansion.
      B)
      Tracheal deviation away from the affected side.
      C)
      Increased breath sounds on the affected side.
      D)
      Hyperresonance to percussion on the affected side.
    Page 3 of 12

    Exam Review

    1. While caring for a client with a chest tube, which nursing assessment would alert the nurse to a possible complication?
      A)
      Bloody drainage is observed in the collection chamber.
      B)
      Skin around tube is pink.
      C)
      Absence of bloody drainage in the anterior/upper tube
      D)
      The tissues around the tube give a crackling sensation when palpated.
    2. The nurse is teaching the client newly diagnosed with systemic lupus erythematous about the condition. Which statement by the client indicates teaching was effective?
      A)
      "My energy level will increase over time."
      B)
      "I need to avoid prolonged sun exposure."
      C)
      "My medications will ultimately correct my problem"
      D)
      "I do not need to make changes in my diet."
    3. A nurse is preparing discharge instructions for a client recently diagnosed with active pulmonary tuberculosis (TB). The client lives in a multigenerational household with three family members and expresses eagerness to return to work at a local daycare center. Which teaching point is most important for the nurse to emphasize?
      A)
      The importance of adhering closely to the prescribed medication regimen
      B)
      The client should wear a surgical mask in public for a year following diagnosis due to latent TB
      C)
      The client may return to work once symptoms improve and they feel well enough.
      D)
      Household members should begin prophylactic antibiotic treatment immediately
    4. A nurse is assessing a client who has a long history of untreated HIV infection. The client presents with multiple painless, purplish skin lesions on the lower extremities and oral mucosa. Based on this finding, which of the following conditions should the nurse suspect?
      A)
      Kaposi Sarcoma
      B)
      Atopic Dermatitis
      C)
      Herpes simplex virus type 2
      D)
      Oral candidiasis
    Page 4 of 12

    Exam Review

    1. A client is admitted to the medical-surgical unit with a 3-week history of a productive cough, night sweats, low-grade fever, and unexplained weight loss. The client reports feeling fatigued and has decreased appetite. Based on these assessment findings, which intervention should the nurse implement first?
      A)
      Placing the client in airborne isolation
      B)
      Obtaining sputum cultures
      C)
      Monitoring the client's fluid intake and output
      D)
      Assessing the client's temperature every 8 hours
    2. A client with HIV is being discharged home and will begin receiving care in the home setting. During discharge education, which aspect of self-care should the nurse emphasize as the priority to help prevent complications?
      A)
      Avoiding crowded places such as public transportation during peak hours
      B)
      Appropriate use of prophylactic antibiotics
      C)
      Taking prescribed medications with food to reduce gastrointestinal upset
      D)
      Maintaining strict personal hygiene practices
    3. Which of the following best describes the pathophysiology of HIV/AIDS and its impact on the immune system?
      A)
      HIV targets macrophages, resulting in decreased phagocytic activity and antigen presentation
      B)
      HIV primarily targets T lymphocytes, leading to decreased production of antibodies.
      C)
      HIV infects B lymphocytes, impairing the body's ability to recognize and respond to pathogens.
      D)
      HIV infects CD4+ T lymphocytes, causing progressive depletion of these cells and weakening the immune system.
    4. A nurse is caring for a client hospitalized with AIDS. A friend comes to visit the client and privately asks the nurse about the risk of contracting HIV when visiting the client. What is the nurse's best response?
      A)
      "AIDS isn't transmitted by casual contact."
      B)
      "You can't normally contract AIDS in a hospital setting."
      C)
      "Your immune system is likely very healthy."
      D)
      "Do you think that you might already have HIV?"
    Page 5 of 12

    Exam Review

    1. A client is receiving external radiation therapy for cancer treatment. During a teaching session, the nurse evaluates the client's understanding of radiation safety. Which statement by the client indicates the need for further teaching?
      A)
      "I'll not use my heating pad during my treatment."
      B)
      "I'll wear protective clothing when outside."
      C)
      "I'll wash my skin with mild soap and water only."
      D)
      "I'm worried I'll expose my family members to radiation."
    2. A client receives a positive Mantoux tuberculin skin test with an induration measuring 12 mm. The client is asymptomatic and has no history of prior tuberculosis (TB) exposure or vaccination. Which action should the nurse anticipate next?
      A)
      Schedule a chest x-ray to evaluate for active pulmonary tuberculosis
      B)
      Instruct the client to begin a full course of antitubercular medications immediately
      C)
      Repeat the Mantoux test in 3 months to confirm the result
      D)
      Document the result as negative since the client has no symptoms
    3. A client diagnosed with cancer is receiving chemotherapy. The nurse should assess which diagnostic laboratory value while the client is receiving chemotherapy?
      A)
      pancreatic enzymes
      B)
      Helicobacter Pylori results
      C)
      kidney function values
      D)
      cells produced in the bone marrow
    4. The clinic nurse is caring for an adult oncology client who reports extreme fatigue and weakness after the first week of radiation therapy. Which response by the nurse would best reassure this client?
      A)
      "These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory studies and test results."
      B)
      "Even though it is uncomfortable, this is a good sign. It means that only the cancer cells are dying."
      C)
      "Try not to be concerned about these symptoms. Every client feels this way after having radiation therapy."
      D)
      "These symptoms are part of your disease and are an unfortunately inevitable part of living with cancer."
    Page 6 of 12