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1. The nurse understands that the first activity of daily living that should be taught to a developmentally disabled child is:

A.     Toileting

B.      Dressing

C.     Self-feeding

D.     Combing hair


2.      To be most therapeutic when giving a 3-year-old toddler an intramuscular injection, the nurse should approach the child and say:

A.     “Act like a big child and we can be done quickly.”

B.      “You are afraid of having a shot because of the pain.”

C.     “I know this might hurt, but it’s important that you hold still.”

D.     “I brought another nurse along to help me give your medicine.”


3.      The most common area for bleeding to developing to develop in a child with hemophilia is the:

A.     Brain

B.      Joints

C.     Abdomen

D.     Pericardium


4.      After the repair of a diaphragmatic hernia, the nurse would assess that the infant’s respiratory condition is improving when:

A.     The infant stops crying

B.      The blood PH decreases to 7.31

C.     Breath sounds are heard bilaterally

D.     1 oz of formula is ingested and retained


5.      The nurse understands that dialysis will be necessary when a child with chronic kidney disease exhibit:

A.     Hypotension

B.      Hypokalemia

C.     Hypervolemia

D.     Hypercalcemia

6.      A primigravida complains of morning sickness. The nurse should plan to teach her to:

A.     Increase fluid intake

B.      Increase calcium in her diet

C.     Eat three small meals a day

D.     Avoid long period without food


7.      When performing an assessment of a client with worsening preeclampsia, the nurse should expect to find:

A.     Diuresis

B.      Vaginal spotting

C.     Proteinuria of 3+

D.     Blood pressure of 130/80 mm Hg


8.      After a mastectomy or hysterectomy many clients feel incomplete as women. The statement that should alert the nurse to the nurse to this feeling in a client following a total hysterectomy would be:

A.     “I can’t wait to see all my friends again.”

B.      “I feel washed out; there isn’t much left.”

C.     “I can’t wait to get home to see my grand child.”

D.     “My husband plans for me to recuperate at our daughter’s home.”


9.      The nurse is aware that a common adaptation during pregnancy is:

A.     Increase ovarian activity

B.      Increased pulmonary capacity

C.     Decreased glomerular filtration rate

D.     Decreased gastrointestinal motility


10.  When developing the plan of care for a multigravid client with class III heart disease, which of the following areas would the nurse expect to assess frequently?

A.     Dehydration

B.      Nausea and vomiting

C.     Iron-deficiency anemia

D.     Tachycardia


11.When assessing a client with osteoporosis, the nurse should recognize that most observable changes will occur in:

A. Facial bone

B. The long bones

C. The vertebral column

D. Joints of the hands and feet


12.  When planning care to prevent deformities and contractures in a client with burns, the nurse should expect to begin range-of-motion exercises when the client’s

A.     Pain has lessened

B.      Vital signs are stable

C.     Skin grafts are healed

D.     Emotional status stabilizers


13.  The person at highest risk of developing prostate cancer is a

A.     55-year-old Black male

B.      55-year-old Asian male

C.     45-year-old Hispanic male

D.     45-year-old Caucasian male


14.  The major objective during the emergent phase of a burn is to

A.     Relieve pain

B.      Prevent infection

C.     Replace blood loss

D.     Restore fluid volume


15.  A client’s burns are being treated with silver nitrate 0.5% solution. A week after treatment is begun, the nurse notes that the client’s sodium level is 135 mEq/L and the potassium level is 3.0 mEq/L. The nurse should notify the physician and expect to:

A.     Add KCL to current IV of Ringer’s lactate

B.      Add NaCl to current IV of Ringer’s lactate

C.     Change the NaCl with 20 mEq KCL to 5%D/W

D.     Change the 5%D/W


16.  A client with rheumatoid arthritis asks the nurse about ways to decrease morning stiffness. The nurse should suggest:

A.     Wearing loose but warm clothing

B.      Avoiding excessive physical stress and fatigue

C.     Taking a hot tub bath or shower in the morning

D.     Planning a rest break periodically for about 15 minutes


17.  A client who is heavy smoker is placed on a high-calorie, high-protein diet. In light of the history of smoking the client should also encouraged to eat foods high in

A.     Niacin

B.      Thiamin

C.     Vitamin C

D.     Vitamin B12


18.  After a thyroidectomy the client should be placed in the:

A.     Prone position

B.      Supine position

C.     Left Sims’ position

D.     Semi-Fowler’s position


19.  The nurse might expect a client with multiple sclerosis to complain about the most common initial symptom, which is:

A.     Diarrhea

B.      Headache

C.     Skin infections

D.     Visual disturbances


20.  When assessing a client for signs of right ventricular failure the nurse should expect to note:

A.     A slowed pulse rate

B.      A pleural friction rub

C.     Neck vein distention

D.     Increasing hypotension


21.   To promote perineal would healing after an abdominoperineal resection, the nurse encourage the client to assume the:

A.     Knee-chest position

B.      Left or right Sim’s position

C.     Dorsal recumbent position

D.     Left or right side-lying position


22.   If the client who was admitted for MI develops cardiogenic shock, which characteristic sign should the nurse expect to observe?

A.     Oliguria

B.      Bradycardia

C.     Elevated blood pressure

D.     Fever


23.  The primary purpose of the Shilling test is to measure the client’s ability to

A.     store vitamin B12

B.      digest vitamin B12

C.     absorb vitamin B12

D.     produce vitamin B12


24.  The nurse understands that a priority nursing diagnosis for the client with hypertension would be

A.     Pain

B.      Deficient Fluid Volume

C.     Impaired Skin Integrity

D.     Ineffective Health Maitainace


25.  Which of the following diets would be most appropriate for a client with COPD?

A.     Low-fat, low-cholesterol diet

B.      Bland, soft diet

C.     Low-sodium diet

D.     High-calorie, high-protein diet


26.  A young child has a history of frequent temper tantrums. The mother asks how to limit this actingout behavior. The nurse’s most therapeutic response would focus on:

A.     Restraining the child whenever a tantrum begin

B.      Moving the child to a quiet area before the tantrum begins

C.     Telling the mother to ignore the tantrum whenever possible

D.     Asking the physician to order medication for behavior control


27.  The nurse discuss the plan of care with a depressed client whose husband has recently died. The nurse recognizes it would be most helpful to:

A.     Involve the client in group outdoor games each morning

B.      Encourage the client to talk about and plan for the future

C.     Encourage the client interact with male clients and the staff

D.     Talk with the client about her husband and the details of his death


28.  A 3-year-old’s parents have been unable to visit since the child was admitted to the hospital. The toddler has become quiet and withdrawn. To best help the child at this time, the nurse should:

A.     Bring the child a doll or stuffed animal to cuddle

B.      Encourage the child to play games with the other child

C.     Assign the same nurse to care for the child when ever possible

D.     Contact the child’s parents and tell them to come immediately to visit


29.  Without knocking, the nurse enters the room of a young male client with the diagnosis of panic disorder and observe him mastur- bating. The nurse should:

A.     Say, “Excuse me,” and leave the room

B.      Tactfully assess why he needs to masturbate

C.     Pretend nothing was seen and carry out whatever task needs to be done

D.     Explain in a calm, quiet manner that his behavior is inappropriate in the hospital

30.  Two days after admission to the detoxif- ication program, a client with a long history of alcohol abuse tells the nurse, “I don’t know why I came here.”

A.     “You feel you don’t need this program?”

B.      “You did admit yourself into the program.”

C.     “You realize you are trying to avoid your program.”

D.     “Don’t you remember why you decided to come here?”


31.  A school-age child is brought to the clinic by the mother, who states, “Something is very wrong. My child never seems happy and refuses to play.” When assessing this child for depressed behavior, the nurse should initially begin with the statement:

A.     “Tell me about yourself.”

B.      “Let’s talk about what you do after school.”

C.     “Can you tell me what is making you so unhappy?”

D.     “Why does your mother think that you are unhappy?’’


32.  A nurse on the pediatric unit is assigned to care for a 2-year-old with a history of abuse. The nurse should expect the child to

A.     Smile readily at anyone who enters the room

B.      Be way of physical contact initiated by anyone

C.     Pay little attention to the nurse standing at the bedside

D.     Begin to cry and scream as the nurse nears the bedside


33.  A male client is brought to the psychiatric emergency room after attempting to jump off a bridge. The client’s wife statements that he lost his job several months ago and has been unable to get another job. The primary nursing intervention at this time would be to assess for:

A.     A past history of depression

B.      Feelings of excessive failure

C.     Current plans to commit suicide

D.     The presence of marital difficulties


34.  The symptoms that distinguish posttra- umatic stress disorders from other anxiety disorders are:

A.     Lack of interest in family and others

B.      Reexperiencing the trauma in dreams or flashbacks

C.     Avoidance of situations and certain activities that resemble the stress

D.     Depression and a blunted affect when discussing the traumatic situation


35.  The husband of a rape victim arrives at the hospital after being called by the police. After reassuring him about his wife’s condition, the nurse should give priority to:

A.     Discussing with him his own feelings about the situation

B.      Calling the rape counselor in to immediately meet with the wife

C.     Helping him to understand how his wife feels about the situation

D.     Making him comfortable until the physician has completed examining his wife


3  36. While admitting a young client with severe anorexia nervosa to the unit, the nurse finds a bottle of assorted pills in the client’s luggage. The client tells the nurse they are antacids for stomach pains. The best initial response by the nurse would be:

A. “Let’s talk about your drug use.”

B. “These pills don’t look like antacids”

C. “Tell me more about these stomach pains.”

D. “Some adolescents take pills to lose weight.”


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