Professional Nursing Exam 1

Question 1 1 Point A client has renal colic due to renal lithiasis. What is the nurse's priority in managing care for this client? 1. Do not allow the client to ingest fluids 2. Encourage the client to drink at least 500 mL of water each hour 3. Administer an opioid analgesic as prescribed 4. Request the central supply department to send supplies for straining urine Question 2 1 Point A nurse is reviewing the blood urea nitrogen (BUN) and creatinine levels of an older adult client admitted for acute renal failure as a result of obstructive renal calculi. The nurse should expect which of the following laboratory findings? 1. BUN 12 mg/dL and creatinine 0.6 mg/dL 2. BUN 34 mg/dL and creatinine 5.2 mg/dL 3. BUN 9 mg/dL and creatinine 0.7 mg/dL 4. BUN 21 mg/dL and creatinine 1.0 mg/dL Question 3 1 Point A nurse is caring for a client who has been admitted for an exacerbation of Crohn's disease. An NG tube has been placed and is to suction, and the client is currently receiving an infusion of total parenteral nutrition via a peripherally inserted central catheter (PICC) line. Which of the following actions should the nurse take? 1. Remove unused parenteral nutrition after 12 hours of use. 2. Monitor laboratory values and assess for abnormal respiratory or cardiac functioning. 3. Monitor the flow rate of the parenteral nutrition carefully and increase the rate as needed if it falls behind. 4. Place the parenteral nutrition solution on a warming device during infusion. Question 4 1 Point The client has the following arterial blood gas (ABG) results: pH 7.48, HCO3: 35mEq/L, PaCO2: 46 mm Hg. The nurse correlates these values to which clinical situation in the client? 1. 15 liquid stools daily for 7 days 2. Shallow respirations of 5/minute 3. Anxiety induced hyperventilation 4. Tracheostomy suctioning every hour for thick, copious secretions Question 5 1 Point A nurse is caring for a client whose arterial blood gas (ABG) results show a pH of 7.36, HCO3: 30 mEq/L, PaCO2: 50 mm Hg. The nurse correctly interprets these results as which of the following? 1. Normal ABG result 2. Uncompensated respiratory acidosis 3. Fully compensated metabolic acidosis 4. Fully compensated respiratory acidosis Question 6 1 Point A client with renal failure who has been taking aluminum hydroxide/magnesium hydroxide suspension at home for indigestion is somnolent and has decreased deep tendon reflexes. Which action should the nurse take first? 1. Notify the client's health care provider 2. Check the chart for the most recent (blood urea nitrogen) BUN and creatinine levels 3. Administer magnesium IV replacement as ordered 4. Review the magnesium level on the client's chart Question 7 1 Point The nurse just received change of shift report on all of the following clients. Which one should the nurse assess first? 1. A 29-year-old client who had a colon resection yesterday, Foley catheter removed 12 hours ago, has been receiving morphine sulfate for pain, and has not voided for 14 hours. 2. A 53-year-old client with chronic renal failure. The client has a blood pressure of 104/61 mm Hg, a serum creatinine level of 5.6 mg/dL, and is scheduled for hemodialysis today. 3. A 57-year-old client admitted today with hematuria and possible bladder cancer. The client is scheduled for cystoscopy in 2 hours. 4. A 23-year-old adult male admitted with pyelonephritis, a temperature of 100.1 F, and a white blood cell (WBC) count of 13,500 cells/mcL. Question 8 1 Point A client is admitted to the emergency room with a respiratory rate of 6 breaths/min. Arterial blood gases (ABGs) have been drawn and reveal the following values: pH 7.22, PaCO2: 68 mm Hg, HCO3: 25 mEq/L. Which of the following is an appropriate analysis of these ABGs? 1. Uncompensated metabolic acidosis 2. Partially compensated metabolic alkalosis 3. Uncompensated respiratory acidosis 4. Partially compensated respiratory alkalosis Question 9 1 Point A 10-year-old with a history of recent respiratory infection has swelling around the eyes in the morning and dark urine. What question should the nurse ask first? 1. "Has the child had a rash and a fever?" 2. "Does the child have any allergies?" 3. "Does the child drink a lot of liquids?" 4. "Has the child had a sore throat?" Question 10 1 Point A client with a calcium level of 14 mg/dL is being cared for on the medical unit. Nursing actions included in the care plan will include which of the following? 1. Maintaining the client on bed rest 2. Encouraging increased fluid intake daily 3. Auscultating lung sounds every 4 hours 4. Monitoring for bounding pulses Question 11 1 Point Immediately after having surgery to create an ileostomy, which goal has the highest priority? 1. Providing relief from constipation 2. Maintaining fluid and electrolyte balance 3. Assisting the client with self-care activities 4. Minimizing odor formation Question 12 1 Point A nurse is assessing a client who states she has leakage of small amounts of urine when attempting to get out of bed. The nurse should associate these findings with which of the following type of urinary incontinence? 1. Stress incontinence 2. Reflex incontinence 3. Urge incontinence 4. Functional incontinence Question 13 1 Point The nurse is assessing an elderly client receiving IV fluids. Which of the following would not indicate fluid volume overload? 1. Weak and thready pulses 2. Distended neck veins when positioned at 4 degrees 3. Course crackles in the lung fields 4. Pitting edema of the lower extremities Question 14 1 Point Which client being managed for dehydration does the nurse consider at greatest risk for possible reduced kidney function? 1. An 80-year-old man who has benign prostatic hyperplasia 2. A 62-year-old woman with a known allergy to contrast media 3. A 45-year-old man receiving oral and IV fluid therapy 4. A 48-year-old woman with established urinary incontinence Question 15 1 Point The nurse is assessing the client who has started to complain of muscle cramps and paresthesia in his hands and feet. The nurse notes a positive Chvostek sign upon assessment and knows this result is associated with which electrolyte disorder? 1. Hypophosphatemia 2. Hypercalcemia 3. Hyperkalemia 4. Hypocalcemia Question 16 1 Point When teaching the client with a urinary tract infection about taking a prescribed antibiotic for 7 days, the nurse should tell the client to report which symptom to the healthcare provider (HCP)? (Select all that apply.) 1. Rash 2. Cloudy urine during first few days of treatment 3. New onset of blood in the urine 4. Mild nausea 5. Urinating every 3 to 4 hours 6. Fever above 100F Question 17 1 Point Which assessment finding would alert the nurse to a client's worsening hypernatremia? 1. The client's deep tendon reflexes have increased from 1+ to 2+ 2. The client's diastolic blood pressure has decreased by 8mm Hg 3. The client has an altered mental status 4. The client has an irregular heart rhythm Question 18 1 Point A nurse is preparing to Infuse a 400 mL unit of packed red blood cells (PRBCs) over 4 hours. The drop factor of the manual IV tubing is 15 gtts/mL. What is the infusion rate in gtts/min? (Round the answer to the nearest whole number. Do not use a trailing zero.) 25 1. Blank 1 Question 19 1 Point The nurse is caring for a client with a bleeding duodenal ulcer who was admitted to the hospital after vomiting bright red blood. Which condition does the nurse anticipate when the client develops a sudden, sharp pain in the mid-epigastric region and a rigid, board-like abdomen? 1. Ulcer perforation 2. Small bowel obstruction 3. Pancreatitis 4. Development of additional ulcers 2. Question 20 1 Point The nurse is planning to teach a client with gastroesophageal reflux disease (GERD) about substances to avoid. Which items should the nurse include on the list? 1. Chocolate 2. Scrambled eggs 3. Baked chicken 4. Nonfat milk 3. Question 21 1 Point The nurse writes the nursing problem of "fluid volume excess" (FVE). Which intervention should be included in the plan of care? 1. Restrict the client's sodium in the diet. 2. Monitor blood glucose levels. 3. Prepare the client for hemodialysis. 4. Change the IV fluid from 0.9% normal saline to D5W. 4. Question 22 1 Point The community nurse is talking with a group of individuals about colorectal cancer risk factors. Which community participant is at the highest risk for development of colorectal cancer? 1. A 23-year-old vegetarian 2. A 46-year-old with a genetic predisposition to cancer 3. A 39-year-old with no family history of cancer 4. A 30-year-old with Crohn's disease 5. Question 23 1 Point The nurse is caring for an older adult client who experiences an exacerbation of ulcerative colitis with severe diarrhea that has lasted a week. For which complication will the nurse assess? (Select all that apply.) 1. Hyperkalemia 2. Deep vein thrombus 3. Hypokalemia 4. Skin breakdown 5. Dehydration 6. Question 24 1 Point The nurse obtains all of the following assessment data about a client with deficient fluid volume caused by dehydration. Which of the following assessment data will be of greatest concern? 1. There is prolonged skin tenting over the sternum 2. Oral fluid intake is 100 ml for the last 8 hours 3. Urine output is 30 ml over the last hour 4. The blood pressure is 88/40 mm Hg 7. Question 25 1 Point The provider ordered a continuous IV infusion of normal saline (NS) with 20 mEq of potassium chloride (KCl)/liter to infuse at 50 mL/hr. The first 1-liter bag was hung at 0200. What time does the nurse anticipate needing to hang the second bag of IV fluids? (Record answer in military time.) 2200 1. Blank 1 Question 26 1 Point Which blood laboratory value does the nurse need to evaluate to determine whether the client's acidosis has a respiratory origin or metabolic origin? 1. PaCO2 2. pH 3. Potassium 4. Lactic acid 2. Question 27 1 Point The primary goal of nursing care for a client with stress incontinence is which of the following? 1. Decrease the number of incontinence episodes 2. Eliminate all episodes of incontinence 3. Help the client adjust to the frequent episodes of incontinence 4. Prevent the development of urinary tract infections 3. Question 28 1 Point The nurse has just received change-of-shift report for four clients. Based on this report, the nurse should assess which client first? 1. A 52-year-old with pneumonia and chronic back pain who is requesting pain medication for severe pain 2. An 84-year-old with left-sided weakness who is slightly confused and has been awake most of the night 3. A 38-year-old who is 2 days post-mastectomy due to breast cancer, having difficulty coping with the diagnosis 4. A 35-year-old admitted after motor vehicle accident whose urine output has totaled 30 mL over the last 2 hours 4. Question 29 1 Point The nurse is to administer ampicillin 500 mg orally to a client with a ruptured appendix. The nurse checks the capsule in the client's medication box, located inside the client's room. The medication dosage is not labeled, but the nurse recognizes the color and shape of the capsule. Which of the following should the nurse do next? 1. Notify the unit manager to report the problem 2. Contact the pharmacy to bring a properly labeled medication 3. Administer the medication to maintain blood levels of the drug 4. Ask another registered nurse (RN) to verify that the capsule is ampicillin 5. Question 30 1 Point A nurse enters a client's semiprivate room and prepares to administer the 0900 medications. Place the steps in chronological sequence, indicating the measures to take to administer the medications safely. 1) Open the unit dose packages 2) Confirm the client's identity 3) Administer the medications 4) Check the client's medication administration record (MAR) for the 0900 medications 5) Obtain the correct unit dose medications 1. 4, 5, 2, 1, 3 2. 2, 5, 1, 4, 3 3. 5, 1, 4, 2, 3 4. 5, 4, 3, 2, 1 6. Question 31 1 Point The nurse will anticipate preparing an older client who is vomiting "coffee-ground" emesis for which of the following? 1. Endoscopy 2. Angiography 3. Gastric analysis 4. Barium studies 7. Question 32 1 Point A client is receiving 250 mL of a 3% sodium chloride solution intravenously for severe hyponatremia. Which signs or symptoms indicate to the nurse that this therapy is effective? 1. Blood pressure has increased from 100/50 mm Hg to 112/70 mm Hg 2. Serum potassium level has decreased from 4.4 mEq/L to 4.2 mEq/L 3. The client reports hand swelling 4. Bowel sounds are present in all four abdominal quadrants 8. Question 33 1 Point The nurse is evaluating the fluid volume status of a client after ileostomy surgery. Which finding indicates that adequate fluid replacement has been achieved in the client? 1. Blood pressure of 90/40 mm Hg 2. Urine output greater than 30mL/hr 3. Fluid intake less than urinary output 4. An increase in body weight 9. Question 34 1 Point A nurse is providing teaching to a client about measures to prevent urinary tract infections (UTIs). Which of the following client statements indicates a need for further teaching? 1. "I will need to drink apple cider vinegar each day." 2. "I will need to empty my bladder regularly and completely." 3. "I will need to wipe my perineal area from back to front after urination." 4. "I need to drink 8 cups of liquid each day." 10. Question 35 1 Point A nurse is admitting a client with suspected appendicitis. The nurse understands that this client will most likely identify pain at which of the following locations? 1. Left lower quadrant (LLQ), Chvostek's point 2. Left upper quadrant (LUQ), Trousseau's point 3. Right lower quadrant (RLQ), McBurney's point 4. Right upper quadrant (RUQ), Blarney's point 11. Question 36 1 Point A client has the following arterial blood gas (ABG) results: pH 7.30, HCO3: 17 mEq/L, PaCO2: 25 mm Hg, PO2: 98 mm Hg. Which intervention by the nurse is most appropriate? 1. Place the client on 2L oxygen via nasal cannula. 2. These are normal findings; document and continue to assess. 3. Prepare to administer the ordered albuterol nebulizer treatment. 4. Assess the client and notify the physician using SBAR communication. 12. Question 37 1 Point A client has the following arterial blood gas (ABG) results: pH 7.30, HCO3: 22 mEq/L, PaCO2: 67 mm Hg, PaO2: 66 mm Hg. Which intervention by the nurse takes priority? 1. Provide oxygen via nasal cannula 2. Assess the client's airway 3. Administer mucolytic 4. Administer bronchodilator 13. Question 38 1 Point Before the nurse administers IV replacement of 5% dextrose in water with potassium chloride, what action is appropriate for the nurse to take? 1. Priming tubing using sterile technique 2. Checking the rate for IV push administration 3. Evaluating laboratory results for electrolytes 4. Adding potassium chloride to the bag at the bedside 14. Question 39 1 Point A nurse is preparing to administer intravenous ciprofloxacin 400 mg IV to her client diagnosed with a urinary tract infection. The medication is available as 400 mg/100 mL normal saline solution. The order is to infuse the 100 mL bag in 30 minutes. What is the rate (in mL/hr) the nurse must infuse the medication at? (Round the answer to the nearest whole number. Do not use a trailing zero) 25 1. Blank 1 Question 40 1 Point The student nurse studying stomach disorders learns that the risk factors for acute gastritis include which of the following? (Select all that apply.) 1. Alcohol 2. Caffeine 3. Corticosteroids 4. Nonsteroidal anti-inflammatory drugs (NSAIDs) 5. Fruit juice 2. Question 41 1 Point A nurse assesses a client with a mechanical bowel obstruction who reports intermittent abdominal pain. An hour later, the client reports constant abdominal pain. Which action would the nurse take next? 1. Position the client with knees to chest. 2. Insert a nasogastric tube for decompression. 3. Assess the client's bowel sounds. 4. Administer intravenous opioid medications. 3. Question 42 1 Point The nurse is evaluating the arterial blood gas (ABG) results of her clients. Which of the following ABG results exhibits partially compensated respiratory alkalosis? 1. PH 7.33, PaCO2: 55 mm Hg, HCO3: 30 mEq/L 2. PH 7.50, PaCO2: 50 mm Hg, HCO3: 38 mEq/L 3. PH 7.55, PaCO2: 30 mm Hg, HCO3: 19 mEq/L 4. PH 7.24, PaCO2: 33 mm Hg, HCO3: 26 mEq/L 4. Question 43 1 Point A nurse is providing teaching for a client who has experienced an acute episode of gastritis. Which of the following instructions should the nurse include in the teaching? 1. Avoid drinking alcohol. 2. Take nonsteroidal anti-inflammatory drugs (NSAIDs) for pain. 3. Limit drinking milk. 4. Limit strenuous exercise. 5. Question 44 1 Point A nurse is caring for a client who has a postoperative ileus and a nasogastric (NG) tube that has drained 2,500 mL in the past 6 hr. Which of the following electrolyte imbalances should the nurse expect and monitor for in this client? 1. Elevated sodium level 2. Elevated magnesium level 3. Elevated potassium level 4. Decreased potassium level 6. Question 45 1 Point A nurse is teaching a client who has fluid overload about recognizing symptoms associated with his condition. Which of the following client statements indicates the teaching was understood? (Select all that apply.) 1. "If my resting heart rate is elevated, that means the condition may be worsening." 2. "If my legs have edema, this could mean I am retaining fluid." 3. "Increased blood pressure may indicate a worsening problem." 4. "If I have gained 1 pound in a week, I need to call my doctor." 5. “If my respirations fall below 18 per minute, I need to call my doctor." 7. Question 46 1 Point Which client is at greatest risk for the development of hyperkalemia? 1. A male with type 2 diabetes taking an oral antidiabetic agent 2. A female with hypertension using a salt substitute 3. A female taking nonsteroidal anti-inflammatory drugs daily 4. A male taking a thiazide diuretic for heart failure 8. Question 47 1 Point A client with a serum sodium level of 113 mEq/L has been receiving 3% sodium chloride IV infusion at 50 mL/hr for 16 hours. The client feels tired and short of breath. Which of the following is a priority? 1. Notify the physician 2. Assess for signs of fluid overload 3. Obtain order to decrease infusion 4. Check the latest sodium level 9. Question 48 1 Point Which client is at greatest risk for development of hypercalcemia? 1. A middle-aged adult with chronic end-stage kidney disease 2. An older adult taking a nonsteroidal anti-inflammatory drug 3. An older adult with lactose intolerance 4. A middle-aged adult with a thyroid disorder 10. Question 49 1 Point A new nurse is working with a preceptor on an inpatient medical-surgical unit. The preceptor advises the student that which is the priority when working as a professional nurse? 1. Ensuring client safety 2. Attending to holistic client needs 3. Providing client-focused care 4. Not making medication errors 11. Question 50 1 Point The nurse is caring for a client who has been diagnosed with esophageal cancer. The client appears anxious and asks the nurse, "Does this mean I'm going to die?" Which nursing response is appropriate? (Select all that apply.) 1. "No, surgery can cure you." 2. "You can beat this disease if you just put your mind to it." 3. "Let me call the hospital chaplain to talk with you." 4. "Let me sit with you for a while, and we can discuss how you're feeling about this." 5. "It sounds like death frightens you."