Exam Review

The school nurse is performing the corneal light reflex test on a child she suspects has strabismus. Which of the following does she know is a sign of this condition?
A)
Symmetrical pin-point light on each pupil
B)
Red reflex in both eyes
C)
Asymmetrical pin-point lights on the pupils
D)
Sun setting sign
The nurse is monitoring a 10-year-old patient status post-tonsillectomy. Which of the following observations should be immediately reported to the healthcare provider?
A)
Drooling
B)
Frequent swallowing
C)
Sneezing
D)
Moaning
The licensed practical/vocational nurse (LPN/VN) is caring for a client receiving digoxin. When examining the client's laboratory data, the nurse should closely review the client's serum
A)
potassium.
B)
calcium.
C)
sodium.
D)
phosphorus.
The LPN is preparing to distribute teaching handouts about developmental milestones to the parents of a 6-month-old male. He was born at 28 weeks gestation. Which of the following handouts are appropriate for their son’s development?
A)
Developmental milestones for 6-month-olds
B)
Developmental milestones for 3-month-olds
C)
Developmental milestones for 4-month-olds
D)
Developmental milestones for 1-month-olds

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Exam Review

The LPN is aware that which of the following maternal infections can increase the risk of congenital heart defects in the fetus?
A)
Parainfluenza
B)
Adenovirus
C)
Rubella
D)
Measles
The LPN is reinforcing discharge instructions to the parents of a 6-year-old girl with chickenpox. The LPN knows that the parents understand when they make which of the following statements?
A)
“Once she has been without a fever for a day, she can go back to school.”
B)
“She will still be infectious for 14 days, so we should let the school know she will be out for 2 weeks.”
C)
“After antibiotics have been started, she can go back to school in 48 hours.”
D)
“Once all of her sores are crusted over, it will be safe for her to go back to school.”
The nurse is collecting data on a client who has a suspected retinal detachment. Which of the following client statements would be consistent with this diagnosis?
A)
“My vision has a cloudy appearance.”
B)
“I have intense pain above my eyebrow.”
C)
“I am having trouble with my peripheral vision.”
D)
“I can see bright flashes of light.”
The nurse is caring for a post-operative client at risk for a pressure ulcer. Which intervention should the nurse include in the plan of care?
A)
Apply sequential compression devices
B)
Apply an extra sheet to the bed
C)
Position the client on a donut pillow
D)
Encourage the consumption of high-protein foods

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Exam Review

7-year-old female arrives with her parents with reports of a rash on her back and chest that started two days ago. The parents state that she has been itching the area incessantly and that she reports a burning pain in the area. The parents say that her appetite has decreased, and she had a temperature of 100° F (37.8° C) the day prior.
The client has no medical history or hospitalizations. Her parents state it is unknown that she has been around anyone who has been sick because she does attend school and an after-school program regularly.
On exam, she has erythemic papules and vesicles on her back and torso. She states they 'burn and itch' and denies any other symptoms. Her skin is hot and appears dry.
All other physical exam findings were unremarkable.
Blood Pressure 104/72 mm Hg
Temperature 101.5° F (38.6° C)
Heart rate 93/minute
Respiratory rate 19/minute
Oxygen saturation 96% on room air
Varicella
- Acetaminophen 325 mg PO x 1 dose
- Diphenhydramine 25 mg PO x 1 dose
- Discharge client home
The nurse reviews the history and physical and vital signs
➢ Which findings are most significant? Select all that apply
(SATA)
A)
Temperature
B)
Papules and vesicles
C)
Reports of burning and itching
D)
Blood pressure
E)
Location of the lesions
7-year-old female arrives with her parents with reports of a rash on her back and chest that started two days ago. The parents state that she has been itching the area incessantly and that she reports a burning pain in the area. The parents say that her appetite has decreased, and she had a temperature of 100° F (37.8° C) the day prior.
The client has no medical history or hospitalizations. Her parents state it is unknown that she has been around anyone who has been sick because she does attend school and an after-school program regularly.
On exam, she has erythemic papules and vesicles on her back and torso. She states they 'burn and itch' and denies any other symptoms. Her skin is hot and appears dry.
All other physical exam findings were unremarkable.
Blood Pressure 104/72 mm Hg
Temperature 101.5° F (38.6° C)
Heart rate 93/minute
Respiratory rate 19/minute
Oxygen saturation 96% on room air
Varicella
- Acetaminophen 325 mg PO x 1 dose
- Diphenhydramine 25 mg PO x 1 dose
- Discharge client home
➢ Complete the following sentence by choosing from the list of options
(SATA)
A)
aerosolized droplets.
B)
contaminated water.
C)
surfaces of objects.
D)
immunization.
E)
a prescription for valacyclovir.
F)
screening those in the household.
7-year-old female arrives with her parents with reports of a rash on her back and chest that started two days ago. The parents state that she has been itching the area incessantly and that she reports a burning pain in the area. The parents say that her appetite has decreased, and she had a temperature of 100° F (37.8° C) the day prior.
The client has no medical history or hospitalizations. Her parents state it is unknown that she has been around anyone who has been sick because she does attend school and an after-school program regularly.
On exam, she has erythemic papules and vesicles on her back and torso. She states they 'burn and itch' and denies any other symptoms. Her skin is hot and appears dry.
All other physical exam findings were unremarkable.
Blood Pressure 104/72 mm Hg
Temperature 101.5° F (38.6° C)
Heart rate 93/minute
Respiratory rate 19/minute
Oxygen saturation 96% on room air
Varicella
- Acetaminophen 325 mg PO x 1 dose
- Diphenhydramine 25 mg PO x 1 dose
- Discharge client home
➢ The nurse determines that if the client's itching is not controlled, which complication may develop?
A)
Cellulitis
B)
Pneumonia
C)
Encephalitis
D)
Desquamation
7-year-old female arrives with her parents with reports of a rash on her back and chest that started two days ago. The parents state that she has been itching the area incessantly and that she reports a burning pain in the area. The parents say that her appetite has decreased, and she had a temperature of 100° F (37.8° C) the day prior.
The client has no medical history or hospitalizations. Her parents state it is unknown that she has been around anyone who has been sick because she does attend school and an after-school program regularly.
On exam, she has erythemic papules and vesicles on her back and torso. She states they 'burn and itch' and denies any other symptoms. Her skin is hot and appears dry.
All other physical exam findings were unremarkable.
Blood Pressure 104/72 mm Hg
Temperature 101.5° F (38.6° C)
Heart rate 93/minute
Respiratory rate 19/minute
Oxygen saturation 96% on room air
Varicella
- Acetaminophen 325 mg PO x 1 dose
- Diphenhydramine 25 mg PO x 1 dose
- Discharge client home
The nurse receives orders and prescriptions from the primary healthcare provider
➢ Complete the following sentence by choosing from the list of options
A)
pruritus.
B)
pyrexia.
C)
skin lesions.
D)
decrease symptoms of pruritus.
E)
decrease the pyrexia.
F)
prevent viral replication.

Page 3 of 38

Exam Review

7-year-old female arrives with her parents with reports of a rash on her back and chest that started two days ago. The parents state that she has been itching the area incessantly and that she reports a burning pain in the area. The parents say that her appetite has decreased, and she had a temperature of 100° F (37.8° C) the day prior.
The client has no medical history or hospitalizations. Her parents state it is unknown that she has been around anyone who has been sick because she does attend school and an after-school program regularly.
On exam, she has erythemic papules and vesicles on her back and torso. She states they 'burn and itch' and denies any other symptoms. Her skin is hot and appears dry.
All other physical exam findings were unremarkable.
Blood Pressure 104/72 mm Hg
Temperature 101.5° F (38.6° C)
Heart rate 93/minute
Respiratory rate 19/minute
Oxygen saturation 96% on room air
Varicella
- Acetaminophen 325 mg PO x 1 dose
- Diphenhydramine 25 mg PO x 1 dose
- Discharge client home
The nurse reinforces discharge teaching to the client
➢ Click to specify the information the nurse should reinforce? Select all that apply
A)
Your child may return to school once all the lesions have crusted.
B)
Warm baths with baking soda or oats may help with the itching.
C)
Contact the school to report your child’s infection.
D)
Watch for signs of skin infection including swelling, drainage, and pain.
E)
To treat the fever, you may alternate between acetaminophen and aspirin.
1345 – Client presents with a concern for intermittent palpitations. He reports they come on suddenly and that he also gets dizzy, short of breath, and fatigued. He indicated that they last anywhere from twenty to thirty minutes. He reports experiencing three episodes of palpations in the past week. He reports he has not taken any new medications or an increase in stress. He reports full adherence to all his prescribed medications. The client is alert and oriented. Denies any pain. Skin is dry and flaky, especially around the elbows and knees. Lungs are clear bilaterally. S1/S2 heart tones auscultated. Peripheral pulses are palpable and irregular. He reports feeling fatigued. Normoactive bowel sounds in all quadrants. Denies any nausea or vomiting. No edema was observed—no jugular venous distention.
Oral Temperature 99.2^o F (37.3^o C)
Heart rate 73/minute; irregular rhythm
Respirations 15/minute
Blood pressure 139/78 mm Hg
Oxygen saturation 95% on room air
Myocardial infarction
Psoriasis
Hypertension
Urolithiasis
Hemorrhoids
12-lead electrocardiogram: Atrial fibrillation
Diltiazem-XR 120 mg PO Daily
Warfarin 2 mg PO Daily
➢ Which two (2) client findings require follow-up?
A)
Blood pressure
B)
Irregular pulse
C)
S1/S2 heart tones
D)
Palpable peripheral pulses
E)
Reports of palpitations
F)
Dry and flaky skin
1345 – Client presents with a concern for intermittent palpitations. He reports they come on suddenly and that he also gets dizzy, short of breath, and fatigued. He indicated that they last anywhere from twenty to thirty minutes. He reports experiencing three episodes of palpations in the past week. He reports he has not taken any new medications or an increase in stress. He reports full adherence to all his prescribed medications. The client is alert and oriented. Denies any pain. Skin is dry and flaky, especially around the elbows and knees. Lungs are clear bilaterally. S1/S2 heart tones auscultated. Peripheral pulses are palpable and irregular. He reports feeling fatigued. Normoactive bowel sounds in all quadrants. Denies any nausea or vomiting. No edema was observed—no jugular venous distention.
Oral Temperature 99.2^o F (37.3^o C)
Heart rate 73/minute; irregular rhythm
Respirations 15/minute
Blood pressure 139/78 mm Hg
Oxygen saturation 95% on room air
Myocardial infarction
Psoriasis
Hypertension
Urolithiasis
Hemorrhoids
12-lead electrocardiogram: Atrial fibrillation
Diltiazem-XR 120 mg PO Daily
Warfarin 2 mg PO Daily
➢ Which potential problems is the client at risk for developing? Select all that apply.
A)
Atrial fibrillation
B)
Bacteremia
C)
Cerebrovascular accident (CVA)
D)
Infective endocarditis
E)
Pericarditis
F)
Pneumothorax
1345 – Client presents with a concern for intermittent palpitations. He reports they come on suddenly and that he also gets dizzy, short of breath, and fatigued. He indicated that they last anywhere from twenty to thirty minutes. He reports experiencing three episodes of palpations in the past week. He reports he has not taken any new medications or an increase in stress. He reports full adherence to all his prescribed medications. The client is alert and oriented. Denies any pain. Skin is dry and flaky, especially around the elbows and knees. Lungs are clear bilaterally. S1/S2 heart tones auscultated. Peripheral pulses are palpable and irregular. He reports feeling fatigued. Normoactive bowel sounds in all quadrants. Denies any nausea or vomiting. No edema was observed—no jugular venous distention.
Oral Temperature 99.2^o F (37.3^o C)
Heart rate 73/minute; irregular rhythm
Respirations 15/minute
Blood pressure 139/78 mm Hg
Oxygen saturation 95% on room air
Myocardial infarction
Psoriasis
Hypertension
Urolithiasis
Hemorrhoids
12-lead electrocardiogram: Atrial fibrillation
Diltiazem-XR 120 mg PO Daily
Warfarin 2 mg PO Daily
➢ Complete the following sentence by choosing from the list of options
A)
atrial fibrillation
B)
infective endocarditis
C)
pneumothorax
D)
congestive heart failure
E)
irregular pulse.
F)
lung sounds.
G)
S1 and S2 heart tones.
H)
temperature.

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Exam Review

1345 – Client presents with a concern for intermittent palpitations. He reports they come on suddenly and that he also gets dizzy, short of breath, and fatigued. He indicated that they last anywhere from twenty to thirty minutes. He reports experiencing three episodes of palpations in the past week. He reports he has not taken any new medications or an increase in stress. He reports full adherence to all his prescribed medications. The client is alert and oriented. Denies any pain. Skin is dry and flaky, especially around the elbows and knees. Lungs are clear bilaterally. S1/S2 heart tones auscultated. Peripheral pulses are palpable and irregular. He reports feeling fatigued. Normoactive bowel sounds in all quadrants. Denies any nausea or vomiting. No edema was observed—no jugular venous distention.
Oral Temperature 99.2^o F (37.3^o C)
Heart rate 73/minute; irregular rhythm
Respirations 15/minute
Blood pressure 139/78 mm Hg
Oxygen saturation 95% on room air
Myocardial infarction
Psoriasis
Hypertension
Urolithiasis
Hemorrhoids
12-lead electrocardiogram: Atrial fibrillation
Diltiazem-XR 120 mg PO Daily
Warfarin 2 mg PO Daily
The nurse reviews the diagnostic result and the medication orders from the physician
The nurse plans to administer the prescribed warfarin and diltiazem-XR to the client
➢ For each prescribed medication, specify the appropriate nursing intervention
A)
Obtain pulse and blood pressure before administering
B)
Implement seizure precautions after administering
C)
Review the client’s potassium level prior to administering
D)
Obtain a baseline aPTT
E)
Obtain a baseline platelet count
F)
Obtain a baseline PT/INR
1345 – Client presents with a concern for intermittent palpitations. He reports they come on suddenly and that he also gets dizzy, short of breath, and fatigued. He indicated that they last anywhere from twenty to thirty minutes. He reports experiencing three episodes of palpations in the past week. He reports he has not taken any new medications or an increase in stress. He reports full adherence to all his prescribed medications. The client is alert and oriented. Denies any pain. Skin is dry and flaky, especially around the elbows and knees. Lungs are clear bilaterally. S1/S2 heart tones auscultated. Peripheral pulses are palpable and irregular. He reports feeling fatigued. Normoactive bowel sounds in all quadrants. Denies any nausea or vomiting. No edema was observed—no jugular venous distention.
Oral Temperature 99.2^o F (37.3^o C)
Heart rate 73/minute; irregular rhythm
Respirations 15/minute
Blood pressure 139/78 mm Hg
Oxygen saturation 95% on room air
Myocardial infarction
Psoriasis
Hypertension
Urolithiasis
Hemorrhoids
12-lead electrocardiogram: Atrial fibrillation
Diltiazem-XR 120 mg PO Daily
Warfarin 2 mg PO Daily
The nurse reinforces the discharge instructions with the client
➢ Complete the following sentences by choosing from the list of options
A)
Saw Palmetto
B)
Vitamin B12
C)
Magnesium Oxide
D)
folic acid rich foods.
E)
vitamin K rich foods.
F)
iron rich foods.
G)
2-3.
H)
3-4.
I)
2.5-3.5.
The nurse is caring for a client experiencing septic shock. The client's blood pressure is unstable and requires multiple intravenous (IV) vasopressor support.
➢ To determine if the client is meeting the treatment goals, the nurse anticipates the primary healthcare provider (PHCP) will order
A)
an arterial line.
B)
a chest tube.
C)
mechanical ventilation.
D)
an indwelling urinary catheter.
The nurse reinforces teaching to a client with Addison's disease. The nurse should encourage the client to consume a diet that is Select all that apply.
A)
low in potassium.
B)
high in sodium.
C)
high in potassium.
D)
low in sodium.
E)
high in magnesium.

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Exam Review

The nurse is reinforcing teaching to students about the causes of hypokalemia. Which of the following conditions should the nurse identify as being a cause of this electrolyte imbalance? Select all that apply.
A)
Diabetic ketoacidosis
B)
Addison’s disease
C)
Metabolic alkalosis
D)
Chronic renal failure
E)
Cushing’s syndrome
The nurse is providing education to a family with a 1-year-old diagnosed with phenylketonuria (PKU). The mother states, 'I think we should just stick to the formula. I am too scared to feed him other foods.' The nurse should review which of the following foods this family should avoid.
Select all that apply.
A)
Pork tenderloin
B)
Green beans
C)
Cheese omelets
D)
Pears
E)
Peas
The LPN works in a community health clinic with new mothers and infants. Which of the following is accurate regarding expected growth in infants?
Select all that apply.
A)
Infants should triple their birth weight by 12 months of age.
B)
Infants should double their birth weight by 6 months of age.
C)
Infants should triple their birth weight by 6 months of age.
D)
Infants should double their birth weight by 12 months of age.
E)
Infants should gain one pound month until 12 months of age or weight doubles
The LPN is reinforcing education to a group of parents after an outbreak of pediculosis capitis at the local elementary school. Which of the following points should be included?
Select all that apply.
A)
Teach your children not to share hats or combs to prevent the spread of lice.
B)
It is important to apply the permethrin cream once as soon as you can.
C)
Parents will need to manually remove the lice and nits with a fine-tooth comb 2-3 times/day until there are no visible lice.
D)
Anyone can get lice, it is not indicative of a dirty house.
E)
Stress the importance of washing all bed linens and clothing that the child has recently used in hot water.

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