Comprehensive review questions

Comprehensive Examination

Review Questions

1. The nurse sees a 22-yr-old client in the clinic. The client has been taking tetracycline drug for months for her acne. She is now trying to conceive a child. The nurse understands that which of the following is essential for the client to know about tetracycline therapy?

1. its use in pregnancy is not established
2. any tetracycline can cause discoloration and mottling of fetal teeth and, therefore, cannot be used in pregnancy
3. the client should notify her doctor but should continue the drug as usual
4. this drug is dangerous and causes fetal deaths

2. The nurse understands that the purpose of treating a client in labor with naloxone (Narcan) is to---

1. increase the effects of narcotics
2. depress the activity of the central nervous system (CNS) in the woman who received narcotics
3. blocked the effects of narcotics on the CNS
4. withdraw narcotics from the body

3. Methylergonovine maleate (methergine) is ordered for a client following a normal vaginal delivery. The nurse would recognize which of the following as a side effect of this drug?

1. marked oliguria
2. severe hypoglycemia
3. sudden hypertension
4. uterine rupture

4. A 27-yr-old client states that she frequently uses over-the-counter antihistamine preparations for her small child. The nurse would place priority on teaching the mother---

1. recommend safe dosage for children
2. signs of antihistamine poisoning
3. the importance of keeping an antihistamine antidote on hand
4. the necessity of safe storage precaution

5. The parents of a four-yr-old client with asthma ask the nurse about possible medications. The nurse understands which of the following is an appropriate medication for a pediatric client?

1. metaproterenol
2. cromolyn
3. isoproterenol
4. aminophylline

6. An eight-yr-old boy with asthma is placed on cromolyn (intal) via metered dose inhaler. After client teaching, which statement by the child’s parents indicates the need for more instructios?

1. “I will give my son a dose as soon as he starts wheezing.”
2. “My son needs to rinse out his mouth after using the inhaler.”
3. “My son should breathe in slowly while depressing the canister.”
4. “If my son has difficulty breathing in the dose, I can use a spacer.”

7. A newborn has a cleft palate. The nurse understands the best plan for feeding is to have the mother

1. come to the nursery to feed the baby
2. observe while the baby is fed in nursery
3. go with the father to feed the baby the best they can, in private
4. feed her in her room while the nurse remains with her

8. A client is admitted with a T2-T3 spinal cord transaction. Nursing care for a client includes a care for what type of paralysis?

1. hemiplegia
2. paraplegia
3. quadriplegia
4. paresthesia

9. Which coping or mental mechanism is being used wherein a nurse is covering for real or imagined inadequacies in his work by developing what he considers the desirable traits of observation, listening and reporting?

1. compensation
2. denial
3. projection
4. rationalization

10. Select the strategy that will allow practical/vocational nurse to practice situational leadership---

1. tell subordinates what to do
2. put subordinates first before the policies of the nursing home
3. seek input from employees for emergency situations during actual situation
4. evaluate the situation in the work environment and vary leadership style to meet the occasion

11. The fight-for-flight response of the sympathetic nervous system would have which of the following effects?

1. decreased strength of heart beat
2. dilation of bronchi lungs
3. dilation of digestive organ blood vessels
4. emptying of the urinary bladder

12. A client has just arrived on your unit with herpes zoster and is complaining of pain. Which nursing intervention should be completed first?

1. administering analgesics
2. encourage the client to express his or her feelings
3. order a nutritious meal for the client
4. place the client in a private room on infection control precautions

13. Following a lumbar puncture, which nursing intervention is appropriate?

1. administering antipyretics
2. keeping the client NPO
3. instructing the client to remain flat for 6 hrs
4. ambulating the client within 2 hrs

14. To prevent further injury in patients with spinal cord injuries, members of the healthcare team should---

1. elevate the feet to prevent shock
2. monitor for increased intracranial pressure
3. offer emotional support
4. stabilize the head, neck, & spinal cord

15. A client with spinal cord injury and paraplegia has sudden increase in blood pressure, has flushed skin, and diaphoretic. The nurse’s first intervention should be to---

1. check client for bladder distention
2. nothing, because the symptoms are temporary
3. call for the crash cart
4. call the physician immediately

16. A client is scheduled to receive antabuse therapy. Which of the following should the nurse communicate immediately to the physician?

1. the client had his last drink of alcohol about 35 hrs ago
2. the client had a recent experience of left-sided weakness
3. the client has a strong family history of alcohol abuse
4. the client’s wife is pregnant and in her second trimester

17. A client has delivered 45 minutes ago comes into the transitional nursery to see her infant. She ask the nurse, “My baby’s head is shaped like a cone. Will is stay like that?” Which of following responses by the nurse is most acute?

1. “That is called a caput. It usually lasts for 3-4 day.”
2. “This is called molding. It usually last for a few days.”
3. “That is called a cephalhematoma. It usually lasts for a weeks.”
4. “That is called a nevus. It usually lasts several months.”

18. The nurse enters the room of a breastfeeding client who delivered 3 hrs ago and who is in tears. “I just don’t know what I’m doing wrong!” she sobs. “I can’t get my baby to take the nipple!” Which of the following nursing diagnoses would be most appropriate in this case?

1. altered parenting RT difficulty in breastfeeding
2. altered comfort RT sore nipples
3. altered bonding process RT maternal frustration
4. knowledge deficit RT breastfeeding techniques

19. During the vaginal examination of the client in labor, the obstetrician determines that the biparietal diameter of the fetal head has reached the level of the ischial spines. How should the nurse document fetal station?

1. -1
2. 0
3. +1
4. +2

20. During which of the following stages of labor would the nurse expect crowning to occur?

1. first
2. second
3. third
4. fourth

21. Which of the following descriptions best fits Braxton Hicks contractions?

1. contractions beginning irregularly, becoming regular and predictable
2. contractions causing cervical effacement and dilation
3. contractions felt initially in the lower back and radiating to the abdomen in a wavelike motion
4. contractions that begin and remains irregular

22. Which of following descriptions best fit the term effacement?

1. enlargement of the cervical canal
2. expulsion of the mucus plug
3. shortening & thinning of the cervical area
4. downward movement of the fetal head

23. A nurse enters a client’s room and notes that the client’s lawyer is present, and that the client is preparing a living will. The living will requires that the client’s signature is witnessed and the client asks the nurse to witness the signature. Which of the following is the most appropriate nursing action?

1. sign the living will as a witness to signature only
2. sign the will clearly identifying credentials and employment agency
3. decline from signing the will
4. call the hospital lawyer before signing the will

24. A client with a chronic renal failure is undergoing peritoneal dialysis. Which nursing measure will help most to promote outflow drainage of the dialyzing solution?

1. turn the client from side to side
2. push the peritoneal catheter in approximately one inch further
3. elevate the height of the dialysate bag
4. apply manual pressure to the client’s lower abdomen

25. In assessing a client with addison’s disease, the nurse recognizes that a classic, characteristic sign associated with addison’s disease is---

1. hirsutism
2. intention tremors
3. skin discoloration
4. petechiae

26. A client diagnosed with Cushing’s disease. The nurse recognizes that the manifestations of Cushing’s disease are primarily related to what endocrine dysfunction?

1. adrenal hyperfunction
2. thyroid hyperfunction
3. pituitary hypofunction
4. parathyroid hypofunction

27. In treating diabetic ketoacidosis (DKA), the nurse is aware that the goal of treatment is to correct which imbalance?

1. hypoglycemia
2. dehydration
3. hyperkalemia
4. respiratory acidosis

28. A client is post-craniotomy & is progressing well. While he is sitting in a chair, the nurse notices that he begins to experience a grand mal seizure. The most important nursing action is to---

1. provide oxygen
2. restrain the client
3. insert an airway
4. lower the client to the floor

29. Successfully passing the NCLEX-PN examination means that a graduate nurse

1. can independently develop nursing care plans and evaluate their outcomes
2. meets the advanced competencies to work in a specialty unit in a facility
3. has graduated from very good nursing school
4. meets entry-level competencies for practice

30. If, after obtaining licensure in one state, e nurse decides to move to another state, he or she must

1. apply to the new state for a reciprocal license
2. retake the NCLEX for the new state
3. do nothing specific, the examination was national
4. work as a nursing assistant until he or she can get a waiver for her license

31. Which of the following is an inappropriate job for a LPN/LVN?

1. school nurse
2. correctional facilities nurse
3. pharmaceutical sales representative
4. same-day surgery nurse

32. The graduate nurse can look for jobs---

on the internet

in career directories supplied by professional journals

on bulletin boards in healthcare facilities

all of the above

33. Which of following leadership styles is used by a charge nurse who relies on established policies and protocols?

1. autocratic leadership
2. bureaucratic leadership
3. democratic leadership
4. laissez-faire leadership

34. The LPN/LVN who will be taking on a charge nurse role in an external-care facility would be wise to learn about which of the following before taking this role?

1. third-party reimbursement issues
2. medicare issues
3. Medicaid issues
4. all of the above

35. The muscle located at the end of the esophagus that guards the stomach opening is the

1. epiglottis
2. cardiac sphincter
3. pyloric sphincter
4. jejunum

36. Bile is necessary for the digestion of fat because it---

1. supplies the coloring material for feces
2. breaks the fat into smaller particles for action enzymes
3. breaks down carbohydrate into monosaccharides by fatty acids
4. stimulates the flow of pancreatic juices to breakdown vitamins in the liver

37. Intrinsic factor is secreted by cells in the stomach. Its function is to

1. secrete gastric lipase
2. absorb vitamin B12
3. absorb bile salts
4. secrete gastrin

38. A non-lifestyle factor that predisposes a person to gastric or duodenal ulcers is

1. smoking
2. stress
3. alcohol abuse
4. age

39. Gastric cancer may be suspected if the client has coffee-ground emesis with no free hydrochloric acid in the stomach and---

1. dysphagia
2. dyspepsia
3. peritonitis
4. diarrhea

40. Immediate nursing care of an abdominal evisceration would include---

1. asking the nurse’s aide to obtain a complete set of vital signs on the patient
2. notifying the charge nurse
3. covering the wound with a saline-soaked gauze pad
4. gently placing the abdominal contents back in the abdominal cavity

41. The cerebral hemispheres communicate with each other via the---

1. neurons
2. thalamus
3. dura mater
4. corpus callosum

42. A nurse is observing a child diagnosed with autism. The nurse knows that the primary characteristic(s) of autism include which of the following?

1. consistent imitation of others action
2. normal social play
3. lack of social interaction and awareness
4. normal verbal but abnormal nonverbal communication

43. A child is scheduled for a tonsillectomy. Which of the following would present the highest risk of aspiration during surgery?

1. difficulty in swallowing
2. the presence of loose teeth
3. bleeding during surgery
4. exudates in the throat area

44. A nurse is instructing a mother of a child with cystic fibrosis (CF) about the appropriate dietary measures. Which of the following diets will be included in the instructions?

1. low-calorie, low-fat diet
2. high-calorie, high-protein diet
3. high-calorie, low-protein diet
4. low-calorie, restricted fat

45. A nurse reviews the result of a Mantoux test performed on a 3-yr-old child. The results indicate an induration measuring 10mm. The nurse would interpret these results as---

1. negative
2. positive
3. inconclusive
4. definitive requiring a repeat test

46. A nurse is caring for an infant with tetralogy of fallot. The nurse recognizes that the infant is experiencing a hypercyanotic episodes. The initial nursing action is to---

1. ask the secretary to call the MD
2. place the infant in a knee-chest position
3. elevate the head of the bed
4. monitor the infant

47. After delivery, a nurse checks the height of the uterine fundus. The nurse expects that the position of the fundus would most likely be noted---

1. at the level of the umbilicus
2. above the level of the umbilicus
3. one fingerbreadth above the symphysis pubis
4. to the right of the abdomen

48. A nurse assisting in planning care for the postpartum woman who has small vulvar hematomas. To assist to reducing the swelling, the nurse suggests to---

1. check signs every 4 hrs
2. prepare a heat pack for application to the area
3. measure the fundal height every 4 hrs
4. prepare an icepack for application

49. A nurse is assigned to care for a client after a caesarean section. To prevent thrombophlebitis, the nurse encourages the woman to---

1. ambulate frequently
2. apply warm moist packs to the legs
3. remain on be rest with the legs elevated
4. wear support stockings

50. The nurse planning care for a preschooler postoperatively would identify which behavior as characteristic of pain response in this age group?

1. demanding explanations
2. stoic behavior
3. clinging to parents
4. stalling behaviors

51. The nurse knows that ritualistic behavior provides security for which age group?

1. infant
2. toddler
3. preschooler
4. adolescent