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$ront
%a&k
#.The nurse is ,onitoring a client who is
receiving o"ytocin (itocin to induce labor. The
nurse should be prepared for which ,aternal
adverse reactions-Select all that apply
#. Hypertension
/. 0aundice
3. 1ehydration
&. Fluid overload
%. 2terine tetany
. )radycardia
#. #4 &4 %
/. 5 client who is /6 weeks pregnant co,es to
the labor and delivery unit. She states that she7s
having contractions every 8 ,inutes. The client
is also 3 c, dilated. 9hich ,edications can the
nurse e"pect to ad,inister-
Select all that apply#. Folic acid (Folvite
/. Terbutaline ()rethine
3. )eta,ethasone
&. !ho (1 i,,une globulin (!hoga,
%. :.;. fluids
. <eperidine (1e,erol
/. /4 34 %
3. The nurse is evaluating a client who is 3&
weeks pregnant for pre,ature rupture of the
,e,branes (!O<. 9hich findings indicate
that !O< has occurred-
Select all that apply
#. Fernlike pattern when vaginal fluid is placedon a glass slide and allowed to dry
/. 5cidic pH of fluid when tested with nitra=ine
paper
3. resence of a,niotic fluid in the vagina
&. 'ervical dilation of c,
%. 5lkaline pH of fluid when tested with nitra=ine
paper
. 'ontractions occurring every % ,inutes
3. #4 34 %
public
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&. 9hat infor,ation should the nurse include
when teaching postcircu,cision care to parents
of a neonate before discharge fro, the
hospital-
Select all that apply
#. The infant ,ust void before being discharged
ho,e./. etroleu, >elly should be applied to the glans
of the penis with each diaper change.
3. The infant can take tub baths while the
circu,cision heals.
&. 5ny blood noted on the front of the diaper
should be reported.
%. The circu,cision will re?uire care for / to &
days after discharge.
&. #4 /4 %
%. 5 /8@year@old client is ad,itted with
infla,,atory bowel syndro,e ('rohn7s
disease. 9hich therapies should the nurse
e"pect to be part of the care plan-
Select all that apply#. Aactulose therapy
/. High@fiber diet
3. High@protein ,ilkshakes
&. 'orticosteroid therapy
%. 5ntidiarrheal ,edications
%. &4 %
. The nurse is assisting in the discharge
planning for a client with alcoholis,. 9hich of
the following should be included in the
discharge plan-
Select all that apply
#. Strongly encourage participation in 5lcoholics
5nony,ous (55./. rovide nutritional infor,ation and
counseling.
3. +stablish an e"ercise progra,.
&. 1iscuss relapse prevention.
%. Have the client introduce hi,self slowly to
people fro, his for,er lifestyle.
. #4 /4 34 &
B. The nurse receives a change@of@shift report
for a B@year@old client who had a total hip
replace,ent. The client is not oriented to ti,e4
place4 or person and is atte,pting to get out of
bed and pull out an :.;. line that7s supplying
hydration and antibiotics. The client has a vest
restraint and bilateral soft wrist restraints. 9hichaction by the nurse would be appropriate-
Select all that apply
#. 5ssess and docu,ent the behavior that
re?uires continued use of restraints.
/. Tie the restraints in ?uick@release knots.
3. Tie the restraints to the side rails of the bed.
&. 5sk the client if he needs to go to the
bathroo, and provide range@of@,otion
B. #4 /4 &
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e"ercises every / hours.
%. osition the vest restraints so that the straps
are crossed in the back.
8. The nurse is perfor,ing a 1enver
1evelop,ental Screening Test :: on a & #$/@
year@old child. 9hat behaviors should the nursee"pect the child to de,onstrate-
Select all that apply
#. He balances on each foot for at least
seconds.
/. He copies a s?uare using straight lines and
s?uare corners.
3. He prepares his own cereal without help.
&. He copies a circle that7s closed or very nearly
closed.
%. He speaks clearly.
. He draws a person with at least three body
parts.
8. 34 &4 %4
6. The nurse is caring for a &%@year@old ,arriedwo,an who has undergone he,icolecto,y for
colon cancer. The wo,an has two children.
9hich concepts about fa,ilies should the nurse
keep in ,ind when providing care for this client-
Select all that apply
#. :llness in one fa,ily ,e,ber can affect all
,e,bers.
/. Fa,ily roles don7t change because of illness.
3. 5 fa,ily ,e,ber ,ay have ,ore than one
role at a ti,e in a fa,ily.
&. 'hildren typically aren7t affected by adult
illness.
%. The effects of an illness on a fa,ily dependon the stage of the fa,ily7s life cycle.
. 'hanges in sleeping and eating patterns ,ay
be signs of stress in a fa,ily.
6. #4 34 %4
#C.5 client is receiving chlordia=epo"ide
(Aibriu, to control the sy,pto,s of alcohol
withdrawal. The chlordia=epo"ide has been
ordered as needed. 9hich sy,pto, ,ay
indicate the need for an additional dose of this
,edication-
Select all that apply
#. Tachycardia
/. <ood swings
3. +levated blood pressure and te,perature&. iloerection
%. Tre,ors
. :ncreasing an"iety
#C. #4 34 %4
##. The nurse is assisting in the discharge
planning for a client with alcoholis,. 9hich of
the following should be included in the
discharge plan-
##. #4 /4 34 &
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Select all that apply
#. Strongly encourage participation in 5lcoholics
5nony,ous (55.
/. rovide nutritional infor,ation and
counseling.
3. +stablish an e"ercise progra,.&. 1iscuss relapse prevention.
%. Have the client introduce hi,self slowly to
people fro, his for,er lifestyle.
#/. The nurse is caring for a client with anore"ia
nervosa who has a nursing diagnosis of
:,balanced nutrition Aess than body
re?uire,ents related to dysfunctional eating
patterns. 9hich of the following interventions
would be supportive for this client-
Select all that apply
#. rovide s,all4 fre?uent ,eals.
/. <onitor weight gain.3. 5llow the client to skip ,eals until the
antidepressant levels are therapeutic.
&. +ncourage the client to keep a >ournal.
%. <onitor the client during ,eals and for # hour
after ,eals.
. +ncourage the client to eat three substantial
,eals per day.
#/.. #4 /4 &4 %
#3. 9hen assessing a client diagnosed with
i,pulse control disorder4 the nurse observes
violent4 aggressive4 and assaultive behavior.
9hich assess,ent is the nurse also likely to
find-
Select all that apply
#. The client functions well in other areas of his
life.
/. The degree of aggressiveness is out of
proportion to the stressor.
3. The violent behavior is ,ost often >ustified by
a stressor.
&. The client has a history of parental alcoholis,
and chaotic abusive fa,ily life.
%. The client has no re,orse about the inability
to control his behavior.
#3. #4 /4 &
#& .5 /8@year@old client is ad,itted withinfla,,atory bowel syndro,e ('rohn7s
disease. 9hich therapies should the nurse
e"pect to be part of the care plan-
Select all that apply
#. Aactulose therapy
/. High@fiber diet
3. High@protein ,ilkshakes
#&. &4 %
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&. 'orticosteroid therapy
%. 5ntidiarrheal ,edications
#%. 9hich findings are co,,on in neonates
born with esophageal atresia-
Select all that apply#. 1ecreased production of saliva
/. 'yanosis
3. 'oughing
&. :nade?uate swallow
%. 'hoking
. :nability to cough
#%. /4 34 %
#. 9hile preparing a client for an upper D:
endoscopy (esophagogastroduodenoscopy4
the nurse should i,ple,ent which
interventions-
Select all that apply
#. 5d,inister a preparation to cleanse the D:tract4 such as Dolytely or Fleets hospha@Soda.
/. Tell the client he shouldn7t eat or drink for to
#/ hours before the procedure.
3. Tell the client he ,ust be on a clear li?uid diet
for /& hours before the procedure.
&. :nfor, the client that he7ll receive a sedative
before the procedure.
%. Tell the client that he ,ay eat and drink
i,,ediately after the procedure.
#. /4 &
#B. 5 client with a retroperitoneal abscess is
receiving genta,icin (Dara,ycin. 9hich signs
should the nurse ,onitor-
Select all that apply
#. Hearing
/. 2rine output
3. He,atocrit (H'T
&. )lood urea nitrogen ()2N and creatinine
levels
%. Seru, calciu, level
#B. #4 /4 &
#8.The nurse is e"plaining the )ill of !ights for
psychiatric patients to a client who has
voluntarily sought ad,ission to an inpatient
psychiatric facility. 9hich of the following rights
should the nurse include in the discussion-
Select all that apply
#. !ight to select health care tea, ,e,bers
/. !ight to refuse treat,ent
3. !ight to a written treat,ent plan
&. !ight to obtain disability
%. !ight to confidentiality
. !ight to personal ,ail
#8. /4 34 %4
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#6. :n the e,ergency depart,ent4 a client
reveals to the nurse a lethal plan for co,,itting
suicide and agrees to a voluntary ad,ission to
the psychiatric unit. 9hich infor,ation will the
nurse discuss with the client to answer the
?uestion4 EHow long do : have to stay here-E
Select all that apply
#. Eou ,ay leave the hospital at any ti,e
unless you are suicidal.E
/. EAet7s talk ,ore after the health tea, has
assessed you.E
3. EOnce you7ve signed the papers4 you have no
say.E
&. E)ecause you could hurt yourself4 you ,ust
be safe before being discharged.E
%. Eou need a lawyer to help you ,ake that
decision.E
. EThere ,ust be a court hearing before you
leave the hospital.E
#6. #4 /4 &
/C. The nurse has developed a relationship with
a client who has an addiction proble,. 9hich
infor,ation would indicate that the therapeutic
interaction is in the working stage-
Select all that apply
#. The client addresses how the addiction has
contributed to fa,ily distress.
/. The client reluctantly shares the fa,ily history
of addiction.
3. The client verbali=es difficulty identifying
personal strengths.
&. The client discusses the financial proble,srelated to the addiction.
%. The client e"presses uncertainty about
,eeting with the nurse.
. The client acknowledges the addiction7s
effects on the children.
/C. #4 34
/#.The nurse is assessing a client7s e"traocular
eye ,ove,ents as part of the neurologic
e"a,ination. 9hich cranial nerves are the
nurse assessing-
Select all that apply Ncle" S5T5
#. 'ranial nerve ::
/. 'ranial nerve :::3. 'ranial nerve :;
&. 'ranial nerve ;
%. 'ranial nerve ;:
. 'ranial nerve ;:::
/#. /4 34 %
//. The nurse is assessing a /@year@old client
diagnosed with bacterial ,eningitis. 9hich of
the following signs and sy,pto,s of ,eningeal
//. /4 34 &4
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irritation is the nurse likely to observe-
Select all that apply Ncle" S5T5
#. Denerali=ed sei=ures
/. Nuchal rigidity
3. ositive )rud=inski7s sign
&. ositive Gernig7s sign%. )abinski refle"
. hotophobia
/3. The nurse is assessing the level of
consciousness of a client who suffered a head
in>ury. She uses the Dlasgow 'o,a Scale and
deter,ines that the client7s score is #%. 9hich
responses did the nurse assess in this client-
Select all that apply Ncle" S5T5
#. Spontaneous eye opening
/. Tachypnea4 bradycardia4 and hypotension
3. 2ne?ual pupil si=e
&. Orientation to person4 place4 and ti,e%. <otor response to pain locali=ed
. :nco,prehensible sounds
/3. #4 &
/&. The nurse is caring for a client with a
co,plete T% spinal cord in>ury. 2pon
assess,ent4 the nurse notes flushed skin4
diaphoresis above T%4 and a blood pressure of
#/$6 ,, Hg. The client reports a severe4
pounding headache. 9hich nursing
interventions would be appropriate for this
client-
Select all that apply Ncle" S5T5#. +levating the head of the bed 6C degrees
/. Aoosening constrictive clothing
3. 2sing a fan to reduce diaphoresis
&. 5ssessing for bladder distention and bowel
i,paction
%. 5d,inistering antihypertensive ,edication
. lacing the client in a supine position with
legs elevated
/&. #4 /4 &4 %
/%. The nurse is preparing a fe,ale client with
tonic@clonic sei=ure disorder for discharge.
9hich instructions should the nurse include
about phenytoin (1ilantin-
Select all that apply Ncle" S5T5
#. E<onitor for skin rash.E
/. E<aintain ade?uate a,ounts of fluid and fiber
in the diet.E
3. Eerfor, good oral hygiene4 including daily
brushing and flossing.E
&. E!eceive necessary periodic blood work.E
%. E!eport to the physician any proble,s with
/%. #4 34 &4 %
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walking4 coordination4 slurred speech4 or
nausea.E
. EFeel safe about taking this drug4 even during
pregnancy.E
Signs and sy,pto,s of Tuberculosis
9aking up sweating at night
Aow grade fever 1ull aching chest pain
'ough streaked with blood
9eight loss
5nore"ia
Fatigue
Signs and sy,pto,sof )acterial <eningitis
N I ;
Sei=ures
Stiff Neck
hotophobia
ositive )rudin=ki sign
Signs and sy,pto,s of 1G5
Fruity breath Odor
Oliguria Gaus,all )reathing (deep I nonlabored
Ovarian 'ancer
!isk factors
Ovarian dysfunction
;aginal use of talcu, powder
5lcohol
!ace @ 9hite wo,en I fa,ily history
:nfertility
5ge @ eakJ%th decade of life
Nulliparity
Denetic predisposition
Site For :< :n>ection 5dult
1eltoid
;entrogluteal ;astus Aateralis
Dluteus <a"i,us
Signs and sy,pto,s of Aiver 'irrhosis
Nausea I ;o,iting
+de,a
5scites
)ladder 'a
!isk Factors
H" of s,oking
+"posure to radiation
9orking in industrial Factory
9hat to avoid when taking 1ilantin
do not floss throughout the day
do not use hard bristled toothbrush
Dingivitis
Signs and sy,pto,s of Hydrocephalus 5nterior fontanel bulges I nonpulsating
)ones of head separated (cracked pot sound
'heck for sun@setting eyes
:ncrease :'
+vidence of Frontal )ossing
Failure to thrive
:rritability
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High@pitched cry
1iabetic <ellitus Foot 'are
<eticulous care to feet
9ash feet with war, water not hot I dry
'an use lotion but No lotion in between toes
9ear socks to keep feet war,
5void ther,al baths4 heating pads 1o not soak feet
:nspect feet daily
1o not treat corns4 blisters
9ear loose socks and no barefoot
'hange into clean cotton socks daily
)reak in new shoes gradually
2se e,ery board
1o not s,oke
1o not wear sa,e pair of shoes / days in a
row
Nor,al :n 8 <onths Old 'hild
can sit without support
can roll fro, front to back
can hold a bottle closure of ant. fontanel
can say ,a,a and dada
/ teeth present
Signs and sy,pto,s of 5cute ancreatitis
5bdo,inal ain severe Kacute s"
'o,plication Shock4Hypovole,ia
Ai,ited fat I protein intake
+S!1 1:+T
!estricted protein intake
:ncrease 'HO
Aow G4
!estrict Na
Signs and sy,pto,s of H+!TH!O:1:S<
Soft s,ooth skin I hair
<ood swings
HN
1iaphoresis
:ntolerance to heat
T2 drug to block thyroid synthesis
<anage,ent of 5N5HA5'T:' !+5'T:ON
Stop ,edication
<aintain airway
Notify <1
<aintain :; access of C.6 NSS
lace in supine position with legs elevated
<onitor ;S
5d,inister prescribed e,ergency drugs
Signs and sy,pto,s of 2A'+!5T:;+ 'OA:T:S Severe diarrhea with blood I ,ucus
5bdo,inal tenderness I cra,ping
5nore"ia
9t. Aoss
;it. G deficiency
5ne,ia
1ehydration
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+lectrolyte i,balance
Aow residue I high protein diet
Signs and sy,pto,s of S2+!:O! ;+N5
'5;5 O''A2S:ON
S" occur in the ,orning
+de,a of face4 eyes I tightness of
shirt$ (StokeLs sign
Aate s" ede,a of ar,s4 hands4dyspnea4 erythe,a4 epista"is
'+!;:'5A '5N'+!
!isk Factors
5frican@ 5,erican$ Native wo,en
)ehavior (Se"ual pro,iscuity
'hronic instru,entation of cervi"
1isease KST1
+arly age of Se"
High arity
oor Hygiene
Aow econo,ic status
<ultiple se"ual partners
artner with rostate '5
Signs and sy,pto,s of 5!G:NSONS
Tre,ors4 akinesia4 rigidity 9eakness4 M,otori=ed propulsive gait
Slurred speech4 dysphagia4 drooling
<onotonous speech
<ask like e"pression
Teach a,bulation ,odification goose
stepping walk (,arching4 !O< e"ercises
5ctivities should be scheduled for late ,orning
when energy level is highest
+ncourage finger e"ercises.
ro,ote fa,ily understanding of disease
intellect$sight$ hearing not i,paired4
#. The nurse is planning care for a client withhyperthyroidis,. 9hich nursing interventions
are appropriate-
Select all that apply
#. :nstill isotonic eye drops4 as necessary.
/. rovide several s,all4 well@balanced ,eals.
3. rovide rest periods.
&. Geep the environ,ent war,.
%. +ncourage fre?uent visitors and
conversation.
. 9eigh the client daily.
#. 5nswer #4 /4 34
/. The nurse is caring for a client with
e,physe,a. 9hich nursing interventions are
appropriate-Select all that apply Ncle" S5T5
#. !educe fluid intake to less than /4%CC ,l$day.
/. Teach diaphrag,atic4 pursed@lip breathing.
3. 5d,inister low@flow o"ygen.
&. Geep the client in a supine position as ,uch
as possible.
%. +ncourage alternating activity with rest
periods.
/. 5nswer /4 34 %4
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. Teach use of postural drainage and chest
physiotherapy.
3. The nurse is caring for a client who
underwent surgical repair of a detached retina
of the right eye. 9hich interventions should the
nurse perfor,-Select all that apply Ncle" S5T5
#. lace the client in a prone position.
/. 5pproach the client fro, the left side.
3. +ncourage deep breathing and coughing.
&. 1iscourage bending down.
%. Orient the client to his environ,ent.
. 5d,inister a stool softener.
3. 5nswer /4 &4 %4
&. The client has a tu,or of the posterior
pituitary gland. The nurse planning his care
should include which interventions-
Select all that apply Ncle" S5T5
#. Take daily weight.
/. !estrict fluids.3. 5ssess urine specific gravity.
&. +ncourage intake of coffee or tea.
%. <onitor intake and output.
&. 5nswer #4 34 %
%. The nurse is developing a care plan for a
client with in>ury to the frontal lobe of the brain.
9hich interventions should be part of the care
plan-
Select all that apply Ncle" S5T5
#. Geep instructions si,ple and brief because
the client will have difficulty concentrating.
/. Speak clearly and slowly because the client
will have difficulty hearing.3. 5ssist the client with bathing because he will
have vision disturbances.
&. Orient the client to person4 place4 and ti,e as
needed because of ,e,ory proble,s.
%. 5ssess vital signs fre?uently because vital
bodily functions are affected.
%. 5nswer #4 &
. The nurse is caring for a client whose cultural
background is different fro, her own. 9hich
actions are appropriate-
Select all that apply Ncle" S5T5
#. 'onsider that nonverbal cues4 such as eye
contact4 ,ay have a different ,eaning in
different cultures./. !espect the client7s cultural beliefs.
3. 5sk the client if he has cultural or religious
re?uire,ents that should be considered in his
care.
&. +"plain the nurse7s beliefs so that the client
will understand the differences.
%. 2nderstand that all cultures e"perience pain
in the sa,e way.
. 5nswer #4 /4 3
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B. 5 /@year@old client has >ust been diagnosed
with ter,inal cancer and is being transferred to
ho,e hospice care. The client7s daughter tells
the nurse4 E: don7t know what to say to ,y
,other if she asks ,e if she7s going to die.E
9hich of the following responses by the nurse
would be appropriate-Select all that apply Ncle" S5T5
#. E1on7t worry4 your ,other still has so,e ti,e
left.E
/. EAet7s talk about your ,other7s illness and
how it will progress.E
3. Eou sound like you have so,e ?uestions
about your ,other dying. Aet7s talk about that.E
&. E1on7t worry4 hospice will take care of your
,other.E
%. ETell ,e how you7re feeling about your ,other
dying.E
B. 5nswer /4 34 %
8. 5 /@year@old client has >ust been diagnosed
with ter,inal cancer and is being transferred toho,e hospice care. The client7s daughter tells
the nurse4 E: don7t know what to say to ,y
,other if she asks ,e if she7s going to die.E
9hich of the following responses by the nurse
would be appropriate-
Select all that apply Ncle" S5T5
#. E1on7t worry4 your ,other still has so,e ti,e
left.E
/. EAet7s talk about your ,other7s illness and
how it will progress.E
3. Eou sound like you have so,e ?uestions
about your ,other dying. Aet7s talk about that.E&. E1on7t worry4 hospice will take care of your
,other.E
%. ETell ,e how you7re feeling about your ,other
dying.E
8. 5nswer #4 /4 &
6. 9hile providing care to a /@year@old ,arried
fe,ale4 the nurse notes ,ultiple ecchy,otic
areas on her ar,s and trunk. The color of the
ecchy,otic areas ranges fro, blue to purple to
yellow. 9hen asked by the nurse how she got
these bruises4 the client responds4 EOh4 :
tripped.E How should the nurse respond-
Select all that apply Ncle" S5T5
#. 1ocu,ent the client7s state,ent andco,plete a body ,ap indicating the si=e4 color4
shape4 location4 and type of in>uries.
/. !eport suspicions of abuse to the local
authorities.
3. 5ssist the client in developing a safety plan
for ti,es of increased violence.
&. 'all the client7s husband to discuss the
situation.
6. 5nswer #4 34
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%. Tell the client that she needs to leave the
abusive situation as soon as possible.
. rovide the client with telephone nu,bers of
local shelters and safe houses.
#C. 5 nurse is working with the fa,ily of a client
who has 5l=hei,er7s disease. The nurse notesthat the client7s spouse is too e"hausted to
continue providing care all alone. The adult
children live too far away to provide relief on a
weekly basis. 9hich nursing interventions
would be ,ost helpful-
Select all that apply Ncle" S5T5
#. 'alling a fa,ily ,eeting to tell the absent
children that they ,ust participate in helping the
client.
/. Suggesting the spouse seek psychological
counseling to help cope with e"haustion
3. !eco,,ending co,,unity resources for
adult day care and respite care
&. +ncouraging the spouse to talk about thedifficulties involved in caring for a loved one with
5l=hei,er7s disease.
%. 5sking whether friends or church ,e,bers
can help with errands or provide short periods
of relief.
. !eco,,ending that the client be placed in a
long@ter, care facility.
#C. 5nswer 34 &4 %
age of #
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