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    Exam Review

    1. The nurse working in the ED has triaged a client who presented with chest pain, SOB, a productive cough and reports of night sweats. The client has a health hx of AIDS and recent labs show a low CD4+ count. Which of the following actions should the nurse take next?
      A)
      Check the client's temp
      B)
      Assess the client for shingles
      C)
      Obtain a throat culture
      D)
      Initiate airborne precautions
    2. The newly hired nurse is developing a plan of care for a client who has acquired AIDS and was just diagnosed with PJP. Which of the following interventions should the nurse preceptor question?
      A)
      Offering the client foods high in calories and protein
      B)
      Instructing the client to drink at least 2–3 L of fluid throughout the day
      C)
      Wearing a surgical mask when standing within 3 ft of the client
      D)
      Auscultating the client's breath sounds for crackles at least once per shift
    3. The nurse is caring for a patient who has AIDS and has just been diagnosed with toxoplasmosis encephalitis. Which of the following actions should the nurse take?
      A)
      Thicken the patient's liquids to honey consistency
      B)
      Initiate airborne precautions for the next 72 hrs
      C)
      Ask the client if they ingested undercooked meat
      D)
      Monitor the client's level of orientation
    4. The nurse working in a community health center has instructed a group of clients who have AIDS about ways to prevent infection. Which of the following statements by a client indicates the need for additional teaching?
      A)
      I should clean my toothbrush by running it through the dishwasher once a week
      B)
      I will avoid eating undercooked fruits and veggies
      C)
      I will notify my provider if my temp is greater than 101°F
      D)
      I will avoid drinking water that has been standing for longer than an hour
    Page 1 of 13

    Exam Review

    1. The nurse is admitting a client who has AIDS and has developed an infection caused by cryptosporidium. Which of the following client statements is consistent with the diagnosis?
      A)
      I have lost 5 lbs this past week
      B)
      I have developed a persistent dry cough
      C)
      I have noticed that my speech has become slurred
      D)
      I have noticed that my food does not taste the same
    2. The nurse is caring for a client who had a heart transplant 10 years ago. Which findings from the box below require follow-up by the nurse? (Select all that apply)
      (SATA)
      A)
      Prolonged prothrombin time (PT)
      B)
      Activity intolerance
      C)
      Weight gain of 3 lbs
      D)
      Shortness of breath
      E)
      Hypotension
      F)
      Irritability
    3. The nurse attended a conference about kidney transplantations. Which of the following clients who had end-stage renal disease (ESRD) does the nurse recognize as being a transplant candidate?
      A)
      A 35-yr-old client reporting burning with urination and receiving abdominal radiation
      B)
      A 42-yr-old client sobbing after receiving a new diagnosis of ovarian cancer
      C)
      A 24-yr-old client receiving neck radiation and reporting xerostomia
      D)
      A 56-yr-old client receiving chest radiation with developed changes in taste
    4. The nurse is caring for a client who had a liver transplant 48 hours ago. It is a priority for the nurse to notify the PHCP if the client has:
      A)
      An increasing bilirubin level
      B)
      Scant amounts of serosanguinous drainage from the incision
      C)
      A urine output that has decreased from 65 to 45 mL/hr since surgery
      D)
      An increase in BP from 115/68 to 122/74
    Page 2 of 13

    Exam Review

    1. The nurse is caring for a client who had a lung transplant 10 days ago. It is a priority for the nurse to notify the PHCP if the client has:
      A)
      Only used the incentive spirometer once since last evening
      B)
      Developed sputum that is yellow-tinged
      C)
      A pain rating of 7/10 when taking a deep breath
      D)
      Refused high-frequency chest wall oscillation for the past 24 hrs
    2. The nurse is caring for a client who had a kidney transplant 2 weeks ago. Which findings should the nurse correlate to possible organ rejection? (Select all that apply)
      A)
      Blood pressure of 116/66
      B)
      Serum creatinine level of 2.5
      C)
      Urinalysis positive for protein
      D)
      Serum potassium level of 5.8
      E)
      Blood urea nitrogen (BUN) level of 30
    3. A client develops swelling of the eyes, anxiety, SOB, and dizziness 5 minutes after a routine immunization. Which action should the nurse take first?
      A)
      Elevate the client's feet and legs
      B)
      Perform a respiratory assessment
      C)
      Prepare to administer diphenhydramine
      D)
      Obtain a full set of vital signs
    4. A client presents with stridor, dyspnea, and bronchospasm after being stung by a bee. After notifying the ED provider, which action should the nurse take next?
      A)
      Administer an albuterol nebulizer treatment
      B)
      Initiate oxygen via a nonrebreather mask
      C)
      Remove the bee sting from the site
      D)
      Prepare to administer a corticosteroid
    Page 3 of 13

    Exam Review

    1. A newly hired nurse attended a conference on anaphylaxis. Which statement indicates the need for further education?
      A)
      The client may present with widespread hives and hypoxia
      B)
      The client may present with swollen lips and tongue
      C)
      The client may report new-onset abdominal cramping with hyperreflexia
      D)
      The client may have audible wheezes and cyanosis
    2. The nurse is assessing a client who has systemic lupus erythematosus (SLE). Which findings require follow-up? (Select all that apply)
      A)
      Prolonged capillary refill
      B)
      Cardiac murmurs
      C)
      Butterfly rash
      D)
      Joint pain
      E)
      Oliguria
    3. The nurse is teaching a 32-year-old female client with SLE about self-care practices. Which statement indicates the need for additional teaching?
      A)
      I should inspect my skin daily for rashes
      B)
      I should carefully consider whether I should get pregnant again
      C)
      I should limit my exposure to direct sunlight to 30 continuous minutes each day
      D)
      I should check my temp on a regular basis
    4. The nurse in the ED is caring for a group of clients. Which client should the nurse see first?
      A)
      35-yr-old with SLE reporting temp of 100.8°F and increasing fatigue
      B)
      54-yr-old with AIDS reporting new purplish-brown skin lesions
      C)
      48-yr-old diagnosed with Lyme disease 3 weeks ago reporting palpitations and neck stiffness
      D)
      30-yr-old in a bicycle accident with bruising on the left flank and BP of 80/55
    Page 4 of 13

    Exam Review

    1. A 40-yr-old client reports a family history of colon cancer during a routine physical. Which action should the nurse take next?
      A)
      Obtain information about which family members have the history
      B)
      Teach the client about home testing for fecal occult blood
      C)
      Inform the PHCP of the client's family history
      D)
      Provide instructions regarding dietary changes
    2. Which client is at the greatest risk for breast cancer?
      A)
      44-yr-old African American female with bilateral oophorectomy at age 30 who recently quit smoking
      B)
      54-yr-old Caucasian female who entered menopause at 43 and uses HRT
      C)
      66-yr-old Jewish female who had her first child at age 38 and has a BMI of 33
      D)
      34-yr-old Hispanic female with 2 alcoholic drinks/week whose maternal grandmother had breast cancer
    3. Which client is at the greatest risk for developing the identified cancer?
      A)
      42-yr-old Caucasian female with uterine polyps and diabetes — cervical cancer risk
      B)
      48-yr-old Latino male with renal calculi and undescended testicle — prostate cancer risk
      C)
      21-yr-old Caucasian male with HIV whose brother has testicular cancer — testicular cancer risk
      D)
      32-yr-old Latino female using an IUD who had intercourse at age 16 — uterine cancer risk
    4. The nurse is assessing a client suspected of having lung cancer. Which findings are consistent with this diagnosis? (Select all that apply)
      A)
      Weight gain
      B)
      Persistent cough
      C)
      Rust-colored sputum
      D)
      Recurrent pleural effusions
      E)
      Petechiae on the anterior chest wall
    Page 5 of 13

    Exam Review

    1. A client is receiving chemotherapy with potential to cause alopecia. Which action best supports the client's self-esteem?
      A)
      Inform the client that hair usually grows back after chemotherapy
      B)
      Encourage the client to purchase a wig or hat to wear
      C)
      Teach the client to wash hair gently with mild shampoo to minimize loss
      D)
      Suggest the client wear a snug-fitting headband around the scalp
    2. A client scheduled for teletherapy (external) radiation of the chest makes which statement indicating the need for further teaching?
      A)
      I will stay in the shade if I go outdoors during peak sun hours
      B)
      I will cleanse my irradiated areas with mild soap and water
      C)
      I will gently remove my ink markings with a washcloth
      D)
      I will wear soft clothing over my skin at the irradiated site
    3. Which client situation should the oncology nurse initially assess?
      A)
      Platelet count of 100,000 mm³ requesting an enema for constipation
      B)
      Gastric cancer preparing to eat pickled foods brought by a family member
      C)
      Reports of back pain with painful urination receiving IV chemotherapy
      D)
      Tumor lysis syndrome with a potassium level of 4.6 mEq/dL
    4. A client has Hct 30%, Hgb 9 g/dL, WBC 4,000 mm³, Platelets 30,000 mm³. Which finding is the priority for follow-up?
      A)
      Petechiae on the anterior abdomen
      B)
      Ulcers on the mucous membrane
      C)
      Reports of activity intolerance and fatigue
      D)
      Reports of increased nausea and vomiting
    Page 6 of 13