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101. If the school-age child is not given the opportunity to engage in tasks and activities he can carry through to completion, he is likely to develop feelings of:

❍ A. Guilt

❍ B. Shame

❍ C. Stagnation

❍ D. Inferiority

102. The physician has ordered 2 units of whole blood for a client following surgery. To provide for client safety, the nurse should:

❍ A. Obtain a signed permit for each unit of blood

❍ B. Use a new administration set for each unit transfused

❍ C. Administer the blood using a Y connector

❍ D. Check the blood type and Rh factor three times before initiat-ing the transfusion

103. A client with B positive blood is scheduled for a transfusion of whole blood. Which finding requires nursing intervention?

❍ A. The available blood has been banked for 2 weeks.

❍ B. The blood available for transfusion is Rh negative.

❍ C. The client has a peripheral IV of D5 1/2 normal saline.

❍ D. The blood available for transfusion is type O positive.

104. The nurse is reviewing the lab results of a client’s arterial blood gases. The PaCO2 indicates effective functioning of the: ❍ A. Kidneys

❍ B. Pancreas

❍ C. Lungs

❍ D. Liver

105. The autopsy results in SIDS-related death will show the following consis-tent findings:

❍ A. Abnormal central nervous system development

❍ B. Abnormal cardiovascular development ❍ C. Intraventricular hemorrhage and cerebral edema

❍ D. Pulmonary edema and intrathoracic hemorrhages

106. The nurse is caring for a newborn who is on strict intake and output. The used diaper weighs 73.5gm. The diaper’s dry weight was 62gm. The newborn’s urine output is: ❍ A. 10ml

❍ B. 11.5ml

❍ C. 10gm

❍ D. 12gm

107. The nurse is teaching the parents of an infant with osteogenesis imper-fecta. The nurse should explain the need for:

❍ A. Additional calcium in the infant’s diet

❍ B. Careful handling to prevent fractures

❍ C. Providing extra sensorimotor stimulation

❍ D. Frequent testing of visual function

108. A newborn is diagnosed with respiratory distress syndrome (RDS). Which position is best for maintaining an open airway?

❍ A. Prone, with his head turned to one side

❍ B. Side-lying, with a towel beneath his shoulders ❍ C. Supine, with his neck slightly flexed

❍ D. Supine, with his neck slightly extended

109. A client with bipolar disorder is discharged with a prescription for Depakote (divalproex sodium). The nurse should remind the client of the need for:

A. Frequent dental visits B.Frequent lab work

C. Additional fluids

D. Additional sodium

110.The physician’s notes state that a client with cocaine addiction has formication. The nurse recognizes that the client has:

A.Tactile hallucinations B.Irregular heart rate C.Paranoid delusions D.Methadone tolerance

111.The nurse is preparing a client with gastroesophageal reflux disease (GERD) for discharge. The nurse should tell the client to:

❍ A. Eat a small snack before bedtime

❍ B. Sleep on his right side ❍ C. Avoid carbonated beverages

❍ D. Increase his intake of citrus fruits

112. A client with a C3 spinal cord injury experiences autonomic hyperreflexia. After placing the client in high Fowler’s position, the nurse’s next action should be to:

❍ A. Notify the physician ❍ B. Make sure the catheter is patent

❍ C. Administer an antihypertensive

❍ D. Provide supplemental oxygen

113. A client is to receive Dilantin (phenytoin) via a nasogastric (NG) tube. When giving the medication, the nurse should:

❍ A. Flush the NG tube with 2–4mL of water before giving the medication

❍ B. Administer the medication, flush with 5mL of water, and clamp the NG tube

❍ C. Flush the NG tube with 5mL of normal saline and administer the medication

❍ D. Flush the NG tube with 2–4oz of water before and after giving the medication

114. When assessing the client with acute arterial occlusion, the nurse would expect to find:

❍ A. Peripheral edema in the affected extremity

❍ B. Minute blackened areas on the toes

❍ C. Pain above the level of occlusion

❍ D. Redness and warmth over the affected area

115. The nurse is assessing a client following the removal of a pituitary tumor. The nurse notes that the urinary output has increased and that the urine is very dilute. The nurse should give priority to:

❍ A. Notifying the doctor immediately

❍ B. Documenting the finding in the chart

❍ C. Decreasing the rate of IV fluids

❍ D. Administering vasopressive medication

116. The physician has ordered Coumadin (sodium warfarin) for a client with a history of clots. The nurse should tell the client to avoid which of the following vegetables?

❍ A. Lettuce

❍ B. Cauliflower

❍ C. Beets

❍ D. Carrots

117. The nurse is caring for a child in a plaster-of-Paris hip spica cast. To facilitate drying, the nurse should:

❍ A. Use a small hand-held hair dryer set on medium heat

❍ B. Place a small heater near the child’s bed

❍ C. Turn the child at least every 2 hours

❍ D. Allow one side to dry before changing positions

118. The local health clinic recommends vaccination against influenza for all its employees. The influenza vaccine is given annually in:

❍ A. November

❍ B. December

❍ C. January

❍ D. February

119. A client is admitted with suspected Hodgkin’s lymphoma. The diagnosis is confirmed by the:

❍ A. Overproliferation of immature white cells

❍ B. Presence of Reed-Sternberg cells

❍ C. Increased incidence of microcytosis

❍ D. Reduction in the number of platelets

120. The nurse is caring for a client following a laryngectomy. The nurse can best help the client with communication by:

❍ A. Providing a pad and pencil

❍ B. Checking on him every 30 minutes

❍ C. Telling him to use the call light

❍ D. Teaching the client simple sign language

121. A client has recently been diagnosed with open-angle glaucoma. The nurse should tell the client to avoid taking:

❍ A. Aleve (naprosyn)

❍ B. Benadryl (diphenhydramine)

❍ C. Tylenol (acetaminophen)

❍ D. Robitussin (guaifenesin)

122. The nurse is caring for a client with an endemic goiter. The nurse recog-nizes that the client’s condition is related to:

❍ A. Living in an area where the soil is depleted of iodine

❍ B. Eating foods that decrease the thyroxine level ❍ C. Using aluminum cookware to prepare the family’s meals

❍ D. Taking medications that decrease the thyroxine level

123. A client with a history of schizophrenia is seen in the local health clinic for medication follow-up. To maintain a therapeutic level of medication, the nurse should tell the client to avoid:

❍ A. Taking over-the-counter allergy medication ❍ B. Eating cheese and pickled foods

❍ C. Eating salty foods

❍ D. Taking over-the-counter pain relievers

124. The nurse is formulating a plan of care for a client with a goiter. The pri-ority nursing diagnosis for the client with a goiter is:

❍ A. Body image disturbance related to swelling of neck

❍ B. Anxiety-related changes in body image

❍ C. Altered nutrition, less than body requirements, related to dif-ficulty in swallowing

❍ D. Risk for ineffective airway clearance related to pressure on the trachea

125. Upon arrival in the nursery, erythomycin eyedrops are applied to the newborn’s eyes. The nurse understands that the medication will:

❍ A. Make the eyes less sensitive to light

❍ B. Help prevent neonatal blindness

❍ C. Strengthen the muscles of the eyes

❍ D. Improve accommodation to near objects

126. A client has a diagnosis of discoid lupus erythematosus (DLE). The nurse recognizes that discoid lupus differs from systemic lupus erythematosus because it:

❍ A. Produces changes in the kidneys

❍ B. Is confined to changes in the skin

❍ C. Results in damage to the heart and lungs

❍ D. Affects both joints and muscles

127. A client sustained a severe head injury to the occipital lobe. The nurse should carefully assess the client for:

❍ A. Changes in vision

❍ B. Difficulty in speaking ❍ C. Impaired judgment

❍ D. Hearing impairment

128. The nurse observes a group of toddlers at daycare. Which of the follow-ing play situations exhibits the characteristics of parallel play?

❍ A. Lindie and Laura sharing clay to make cookies

❍ B. Nick and Matt playing beside each other with trucks

❍ C. Adrienne working a puzzle with Meredith and Ryan

❍ D. Ashley playing with a busy box while sitting in her crib

129. Which of the following statements is true regarding language development of young children?

❍ A. Infants can discriminate speech from other patterns of sound.

❍ B. Boys are more advanced in language development than girls of the same age.

❍ C. Second-born children develop language earlier than first-born or only children.

❍ D. Using single words for an entire sentence suggests delayed speech development.

130. A mother tells the nurse that her daughter has become quite a collector filling her room with Beanie babies, dolls, and stuffed animals. The nurse recognizes that the child is developing:

❍ A. Object permanence

❍ B. Post-conventional thinking

❍ C. Concrete operational thinking

❍ D. Pre-operational thinking

131. According to Erikson, the developmental task of the infant is to establish trust. Parents and caregivers foster a sense of trust by:

❍ A. Holding the infant during feedings

❍ B. Speaking quietly to the infant

❍ C. Providing sensory stimulation

❍ D. Consistently responding to needs

132. The nurse is preparing to walk the postpartum client for the first time since delivery. Before walking the client, the nurse should:

❍ A. Give the client pain medication

❍ B. Assist the client in dangling her legs

❍ C. Have the client breathe deeply

❍ D. Provide the client additional fluids

133. To minimize confusion in the elderly hospitalized client, the nurse should

❍ A. Provide sensory stimulation by varying the daily routine

❍ B. Keep the room brightly lit and the television on to provide orientation to time

❍ C. Encourage visitors to limit visitation to phone calls to avoid overstimulation

❍ D. Provide explanations in a calm, caring manner to minimize anxiety

134. A client diagnosed with tuberculosis asks the nurse when he can return to work. The nurse should tell the client that:

❍ A. He can return to work when he has three negative sputum cultures. ❍ B. He can return to work as soon as he feels well enough.

❍ C. He can return to work after a week of being on the medication.

❍ D. He should think about applying for disability because he will no longer be able to work.

135. The physician has ordered lab work for a client with suspected dissemi-nated intravascular coagulation (DIC). Which lab finding would provide a definitive diagnosis of DIC?

❍ A. Elevated erythrocyte sedimentation rate

❍ B. Prolonged clotting time

❍ C. Presence of fibrin split compound

❍ D. Elevated white cell count

136. The nurse is caring for a client with rheumatoid arthritis. The nurse knows that the client’s symptoms will be most improved by:

❍ A. Taking a warm shower upon awakening

❍ B. Applying ice packs to the joints

❍ C. Taking two aspirin before going to bed

❍ D. Going for an early morning walk

137. A client with schizophrenia has been taking Clozaril (clozapine) for the past 6 months. This morning the client’s temperature was elevated to 102°F. The nurse should give priority to:

❍ A. Placing a note in the chart for the doctor

❍ B. Rechecking the temperature in 4 hours

❍ C. Notifying the physician immediately

❍ D. Asking the client if he has been feeling sick

138. Which one of the following clients is most likely to develop acute respira-tory distress syndrome?

❍ A. A 20-year-old with fractures of the tibia

❍ B. A 36-year-old who is HIV positive

❍ C. A 40-year-old with duodenal ulcers

❍ D. A 32-year-old with barbiturate overdose

139. The complete blood count of a client admitted with anemia reveals that the red blood cells are hypochromic and microcytic. The nurse recog-nizes that the client has:

❍ A. Aplastic anemia

❍ B. Iron-deficiency anemia

❍ C. Pernicious anemia

❍ D. Hemolytic anemia

140. While performing a neurological assessment on a client with a closed head injury, the nurse notes a positive Babinski reflex. The nurse should:

❍ A. Recognize that the client’s condition is improving

❍ B. Reposition the client and check reflexes again

❍ C. Do nothing because the finding is an expected one

❍ D. Notify the physician of the finding

141. The doctor has ordered neurological checks every 30 minutes for a client injured in a biking accident. Which finding indicates that the client’s con-dition is satisfactory?

❍ A. A score of 13 on the Glascow coma scale

❍ B. The presence of doll’s eye movement

❍ C. The absence of deep tendon reflexes

❍ D. Decerebrate posturing

142. The nurse is developing a plan for bowel and bladder retraining for a client with paraplegia. The primary goal of a bowel and bladder retraining program is:

❍ A. Optimal restoration of the client’s elimination pattern

❍ B. Restoration of the client’s neurosensory function

❍ C. Prevention of complications from impaired elimination

❍ D. Promotion of a positive body image

143. When checking patellar reflexes, the nurse is unable to elicit a knee-jerk response. To facilitate checking the patellar reflex, the nurse should tell the client to:

❍ A. Pull against her interlocked fingers

❍ B. Shrug her shoulders and hold for a count of five ❍ C. Close her eyes tightly and resist opening

❍ D. Cross her legs at the ankles

144. The nurse is performing a physical assessment on a client. The last step in the physical assessment is:

❍ A. Inspection

❍ B. Auscultation

❍ C. Percussion

❍ D. Palpation

145.A client with schizophrenia spends much of his time pacing the floor, rocking back and forth, and moving from one foot to another. The client’s behaviors are an example of:

A. Dystonia

B.Tardive dyskinesia C.Akathisia

D.Oculogyric crisis

146.The nurse is assessing a recently admitted newborn. Which finding should be reported to the physician?

❍ A. The umbilical cord contains three vessels.

❍ B. The newborn has a temperature of 98°F.

❍ C. The feet and hands are bluish in color.

❍ D. A large, soft swelling crosses the suture line.

147. Which statement is true regarding the infant’s susceptibility to pertussis? A.If the mother had pertussis, the infant will have immunity. passive

B.Most infants and children are highly susceptible from birth.

C.The newborn will be immune to pertussis for the first few months of life.

D.Infants under 1 year of age seldom get pertussis.

148.A client in labor has been given epidural anesthesia with Marcaine (bupivacaine). To reverse the hypotension associated with epidural anesthesia, the nurse should have which medication

❍ A. Narcan (naloxone)

❍ B. Dobutrex (dobutamine)

❍ C. Romazicon (flumazenil)

❍ D. Adrenalin (epinephrine)

149. The physician has prescribed Gantrisin (sulfasoxazole) 1g in divided doses for a client with a urinary tract infection. The nurse should admin-ister the medication:
❍ A. With meals or a snack ❍ B. 30 minutes before meals
❍ C. 30 minutes after meals ❍ D. At bedtime

150. A client with a history of depression is treated with Parnate (tranyl-cypromine), an MAO inhibitor. Ingestion of foods containing tyramine while taking an MAO inhibitor can result in: ❍ A. Extreme elevations in blood pressure
❍ B. Rapidly rising temperature
❍ C. Abnormal movement and muscle spasms
❍ D. Damage to the eighth cranial nerve

151. A client is admitted to the emergency room after falling down a flight of stairs. Initial assessment reveals a large bump on the front of the head and a 2-inch laceration above the right eye. Which finding is consistent with injury to the frontal lobe?
❍ A. Complaints of blindness
❍ B. Decreased respiratory rate and depth
❍ C. Failure to recognize touch
❍ D. Inability to identify sweet taste

152. The nurse is evaluating the intake and output of a client for the first 12 hours following an abdominal cholecystectomy. Which finding should be reported to the physician?
❍ A. Output of 10mL from the Jackson-Pratt drain
❍ B. Foley catheter output of 285mL
❍ C. Nasogastric tube output of 150mL
❍ D. Absence of stool

153. A community health nurse is teaching healthful lifestyles to a group of senior citizens. The nurse knows that the leading cause of death in per-sons 65 and older is:
❍ A. Chronic pulmonary disease
❍ B. Diabetes mellitus
❍ C. Pneumonia
❍ D. Heart disease

154. A client suspected of having Alzheimer’s disease is evaluated using the Mini-Mental State Examination. At the beginning of the evaluation, the examiner names three objects. Later in the evaluation, he asks the client to name the same three objects. The examiner is testing the client’s:
❍ A. Attention
❍ B. Orientation
❍ C. Recall
❍ D. Registration

155. A client with end stage renal disease is being managed with peritoneal dialysis. If the dialysate return is slowed the nurse should tell the client to:
❍ A. Irrigate the dialyzing catheter with saline
❍ B. Skip the next scheduled infusion
❍ C. Gently retract the dialyzing catheter
❍ D. Change position or turn side to side

156. The nurse is the first person to arrive at the scene of a motor vehicle accident. When rendering aid to the victim, the nurse should give priority to:
❍ A. Establishing a patent airway
❍ B. Checking the quality of respirations
❍ C. Observing for signs of active bleeding
❍ D. Determining the level of consciousness

157. A client hospitalized with renal calculi complains of severe pain in the right flank. In addition to complaints of pain, the nurse can expect to see changes in the client’s vital signs that include:
❍ A. Decreased pulse rate ❍ B. Increased blood pressure
❍ C. Decreased respiratory rate
❍ D. Increased temperature

158. The nurse is using the Glascow coma scale to assess the client’s motor response. The nurse places pressure at the base of the client’s fingernail for 20 seconds. The client’s only response is withdrawal of his hand. The nurse interprets the client’s response as:
❍ A. A score of 6 because he follows commands
❍ B. A score of 5 because he localizes pain
❍ C. A score of 4 because he uses flexion
❍ D. A score of 3 because he uses extension

159. A 4-year-old is admitted to the hospital for treatment of Kawasaki’s dis-ease. The medication commonly prescribed for the treatment of Kawasaki’s disease is:
❍ A. Aspirin (acetylsalicylic acid)
❍ B. Benadryl (diphenhydramine)
❍ C. Polycillin (ampicillin) ❍ D. Betaseron (interferon beta)

160. The nurse is caring for a client with bulimia nervosa. The nurse recog-nizes that the major difference in the client with anorexia nervosa and the client with bulimia nervosa is the client with bulimia:
❍ A. Is usually grossly overweight.
❍ B. Has a distorted body image.
❍ C. Recognizes that she has an eating disorder.
❍ D. Struggles with issues of dependence versus independence.

161. The Mantoux text is used to determine whether a person has been exposed to tuberculosis. If the test is positive, the nurse will find a:
❍ A. Fluid-filled vesicle
❍ B. Sharply demarcated erythema
❍ C. Central area of induration
❍ D. Circular blanched area

162. The physician has ordered continuous bladder irrigation for a client fol-lowing a prostatectomy. The nurse should:
❍ A. Hang the solution 2–3 feet above the client’s abdomen
❍ B. Allow air from the solution tubing to flow into the catheter
❍ C. Use a clean technique when attaching the solution tubing to the catheter
❍ D. Clamp the solution tubing periodically to prevent bladder dis-tention

163. A pediatric client is admitted to the hospital for treatment of diarrhea caused by an infection with salmonella. Which of the following most like-ly contributed to the child’s illness?
❍ A. Brushing the family dog
❍ B. Playing with a turtle
❍ C. Taking a pony ride
❍ D. Feeding the family cat

164. Which one of the following infants needs a further assessment of growth?
❍ A. 4-month-old: birth weight 7lb, 6oz; current weight 14lb, 4oz
❍ B. 2-week-old: birth weight 6lb, 10oz; current weight 6lb, 12oz
❍ C. 6-month-old: birth weight 8lb, 8oz; current weight 15lb
❍ D. 2-month-old: birth weight 7lb, 2oz; current weight 9lb, 6oz

165. The physician has ordered Pyridium (phenazopyridine) for a client with urinary urgency. The nurse should tell the client that:
❍ A. The urine will have a strong odor of ammonia.
❍ B. The urinary output will increase in amount.
❍ C. The urine will have a red–orange color.
❍ D. The urinary output will decrease in amount.

166. The nurse is teaching the mother of an infant with eczema. Which of the following instructions should be included in the nurse’s teaching?
❍ A. Dress the infant warmly to prevent undue chilling
❍ B. Cut the infant’s fingernails and toenails regularly
❍ C. Use bubble bath instead of soap for bathing
❍ D. Wash the infant’s clothes with mild detergent and fabric softener

167. Skeletal traction is applied to the right femur of a client injured in a fall. The primary purpose of the skeletal traction is to:
❍ A. Realign the tibia and fibula
❍ B. Provide traction on the muscles
❍ C. Provide traction on the ligaments
❍ D. Realign femoral bone fragments

168. The home health nurse is visiting a client with an exacerbation of rheumatoid arthritis. To prevent deformities of the knee joints, the nurse should:
❍ A. Tell the client to walk without bending the knees ❍ B. Encourage movement within the limits of pain
❍ C. Instruct the client to sit only in a recliner
❍ D. Remain in bed as long as the joints are painful

169. The physician has ordered Dextrose 5% in normal saline for an infant admitted with gastroenteritis. The advantage of administering the infant’s IV through a scalp vein is:
❍ A. The infant can be held and comforted more easily. ❍ B. Dextrose is best absorbed from the scalp veins.
❍ C. Scalp veins do not infiltrate like peripheral veins.
❍ D. There are few pain receptors in the infant’s scalp.

170. A newborn diagnosed with bilateral choanal atresia is scheduled for sur-gery soon after delivery. The nurse recognizes the immediate need for surgery because the newborn:
❍ A. Will have difficulty swallowing
❍ B. Will be unable to pass meconium
❍ C. Will regurgitate his feedings
❍ D. Will be unable to breathe through his nose

171. The most appropriate means of rehydration of a 7-month-old with diar-rhea and mild dehydration is:
❍ A. Oral rehydration therapy with an electrolyte solution
❍ B. Replacing milk-based formula with a lactose-free formula
❍ C. Administering intraveneous Dextrose 5% 1⁄4 normal saline

❍ D. Offering bananas, rice, and applesauce along with oral fluids

172. The nurse is caring for an infant receiving intravenous fluid. Signs of fluid overload in an infant include:
❍ A. Swelling of the hands and increased temperature ❍ B. Increased heart rate and increased blood pressure
❍ C. Swelling of the feet and increased temperature ❍ D. Decreased heart rate and decreased blood pressure

173. The nurse is providing care for a 10-month-old diagnosed with Wilms tumor. Most parents of infants with Wilms tumor report finding the mass when:
❍ A. The infant is diapered or bathed
❍ B. The infant is unable to use his arms
❍ C. The infant is unable to follow a moving object
❍ D. The infant is unable to vocalize sounds

174. An obstetrical client has just been diagnosed with cardiac disease. The nurse should give priority to:
❍ A. Instructing the client to remain on strict bed rest ❍ B. Telling the client to monitor her pulse and respirations
❍ C. Instructing the client to check her temperature in the evening
❍ D. Telling the client to weigh herself monthly

175. The nurse is caring for a client receiving supplemental oxygen. The effec-tiveness of the oxygen therapy is best determined by:
❍ A. The rate of respirations
❍ B. The absence of cyanosis
❍ C. Arterial blood gases
❍ D. The level of consciousness

176. A client having a colonoscopy is medicated with Versed (midazolam). The nurse recognizes that the client:
❍ A. Will be able to remember the procedure within 2–3 hours
❍ B. Will not be able to remember having the procedure done
❍ C. Will be able to remember the procedure within 2–3 days
❍ D. Will not be able to remember what occurred before the pro-cedure

177. The nurse is assessing a client with an altered level of consciousness. One of the first signs of altered level of consciousness is:
❍ A. Inability to perform motor activities
❍ B. Complaints of double vision
❍ C. Restlessness
❍ D. Unequal pupil size

178. Four clients are to receive medication. Which client should receive med-ication first?
❍ A. A client with an apical pulse of 72 receiving Lanoxin (digoxin) PO daily
❍ B. A client with abdominal surgery receiving Phenergan (promethazine) IM every 4 hours PRN for nausea and vomiting
❍ C. A client with labored respirations receiving a stat dose of IV Lasix (furosemide)
❍ D. A client with pneumonia receiving Polycillin (ampicillin) IVPB every 6 hours

179. The nurse is caring for a cognitively impaired client who begins to pull at the tape securing his IV site. To prevent the client from removing the IV, the nurse should:
❍ A. Place tape completely around the extremity, with tape ends out of the client’s vision
❍ B. Tell him that if he pulls out the IV, it will have to be restarted
❍ C. Slap the client’s hand when he reaches toward the IV site
❍ D. Apply clove hitch restraints to the client’s hands

180. A client is admitted to the emergency room with complaints of subster-nal chest pain radiating to the left jaw. Which ECG finding is suggestive of acute myocardial infarction?
❍ A. Peaked P wave
❍ B. Changes in ST segment ❍ C. Minimal QRS wave
❍ D. Prominent U wav

181. The nurse is assessing a client with a closed reduction of a fractured femur. Which finding should the nurse report to the physician?
❍ A. Chest pain and shortness of breath.
❍ B. Ecchymosis on the side of the injured leg.
❍ C. Oral temperature of 99.2°F.
❍ D. Complaints of level two pain on a scale of five.

182. According to the American Heart Association (2005) guidelines the com-pression-to-ventilation cardiopulmonary resuscita-tion is:
❍ A. 10:1
❍ B. 20:2
❍ C. 30:2
❍ D. 40:1

183. A client is admitted with a diagnosis of renal calculi. The nurse should give priority to:
❍ A. Initiating an intraveneous infusion
❍ B. Encouraging oral fluids
❍ C. Administering pain medication
❍ D. Straining the urine

184. The Joint Commission for Accreditation of Hospital Organizations (JCAHO) specifies that two client identifiers are to be used before admin-istering medication. Which method is best for identifying patients using two patient identifiers?
❍ A. Take the medication administration record (MAR) to the room and compare it with the name and medical number recorded on the armband. ❍ B. Compare the medication administration record (MAR) with the client’s room number and name on the armband.
❍ C. Request that a family member identify the client and then ask the client to state his name.
❍ D. Ask the client to state his full name and then to write his full name.

185. A client complains of sharp, stabbing pain in the right lower quadrant that is graded as level 8 on a scale of 10. The nurse knows that pain of this severity can best be managed using:
❍ A. Aleve (naproxen sodium)
❍ B. Tylenol with codeine (acetaminophen with codeine)
❍ C. Toradol (ketorolac)
❍ D. Morphine sulfate (morphine sulfate)

186. A client has had diarrhea for the past 3 days. Which acid/base imbalance would the nurse expect the client to have?
❍ A. Respiratory alkalosis ❍ B. Metabolic acidosis
❍ C. Metabolic alkalosis
❍ D. Respiratory acidosis

187. A home health nurse finds the client lying unconscious in the doorway of her bathroom. The nurse checks for responsiveness by gently shaking the client and calling her name. When it is determined that the client is nonresponsive, the nurse should:
❍ A. Start cardiac compression
❍ B. Give two slow, deep breaths
❍ C. Open the airway using head-tilt, chin-lift maneuver ❍ D. Call for help

188. The nurse is reviewing the lab reports of a client who is HIV positive. Which lab report provides information regarding the effectiveness of the client’s medication regimen?
❍ A. ELISA
❍ B. Western Blot
❍ C. Viral load
❍ D. CD4 count

189. A client with AIDS-related cytomegalovirus is started on Cytovene (ganciclovir). The nurse should tell the client that the medication will be needed:
❍ A. Until the infection clears
❍ B. For 6 months to a year ❍ C. Until the cultures are normal
❍ D. For the remainder of life

190. The nurse is caring for a client with suspected AIDS dementia complex. The first sign of dementia in the client with AIDS is:
❍ A. Changes in gait
❍ B. Loss of concentration ❍ C. Problems with speech ❍ D. Seizures

191. The physician has ordered Activase (alteplase) for a client admitted with a myocardial infarction. The desired effect of Activase is:
❍ A. Prevention of congestive heart failure
❍ B. Stabilization of the clot ❍ C. Increased tissue oxygenation
❍ D. Destruction of the clot

192. The mother of a 2-year-old asks the nurse when she should schedule her son’s first dental visit. The nurse’s response is based on the knowledge that most children have all their deciduous teeth by:
❍ A. 15 months
❍ B. 18 months
❍ C. 24 months
❍ D. 30 months

193. The nurse is caring for a child with Down syndrome. Which characteristics are commonly found in the child with Down syndrome? ❍ A. Fragile bones, blue sclera, and brittle teeth
❍ B. Epicanthal folds, broad hands, and transpalmar creases
❍ C. Low posterior hairline, webbed neck, and short stature
❍ D. Developmental regression and cherry-red macula

194. After several hospitalizations for respiratory ailments, a 6-monthold has been diagnosed as having HIV. The infant’s respiratory ailments were most likely due to:
❍ A. Pneumocystis carinii ❍ B. Cytomegalovirus
❍ C. Cryptosporidiosis
❍ D. Herpes simplex

195. A client has returned from having a bronchoscopy. Before offering the client sips of water, the nurse should assess the client’s:
❍ A. Blood pressure
❍ B. Pupilary response
❍ C. Gag reflex
❍ D. Pulse rate

196. The physician has ordered injections of Neumega (oprellvekin) for a client receiving chemotherapy for prostate cancer. Which finding suggests that the medication is having its desired effect? ❍ A. Hct 12.8g
❍ B. Platelets 250,000mm3 ❍ C. Neutrophils 4,000mm3 ❍ D. RBC 4.7 million

197. A child suspected of having cystic fibrosis is scheduled for a quantitative sweat test. The nurse knows that the quantitative sweat test will be ana-lyzed using:
❍ A. Pilocarpine iontophoresis
❍ B. Choloride iontophoresis
❍ C. Sodium iontophoresis ❍ D. Potassium iontophoresis

198. The nurse is caring for a client with a Brown-Sequard spinal cord injury. The nurse should expect the client to have:
❍ A. Total loss of motor, sensory, and reflex activity ❍ B. Incomplete loss of motor function
❍ C. Loss of sensory function with potential for recovery
❍ D. Loss of sensation on the side opposite the injury

199. A client with cirrhosis has developed signs of heptorenal syndrome. Which diet is most appropriate for the client at this time?
❍ A. High protein, moderate sodium
❍ B. High carbohydrate, moderate sodium
❍ C. Low protein, low sodium
❍ D. Low carbohydrate, high protein

200. The nurse is caring for a client with a basal cell epithelioma. The primary cause of basal cell epithelioma is:
❍ A. Sun exposure
❍ B. Smoking
❍ C. Ingestion of alcohol
❍ D. Food preservatives