1. A client with AIDS has a viral load of 200 copies per ml. The nurse should interpret this finding as:

• The client is at risk for opportunistic diseases.
• The client is no longer communicable.
• The client’s viral load is extremely low so he is relatively free of circulating virus.

2. The physician has prescribed Nexium (esomeprazole) for a client with erosive gastritis. The nurse should administer the medication:

• 30 minutes before a meal
• With each meal
• In a single dose at bedtime
• 30 minutes after meals

3. The home health nurse is visiting a client with autoimmune thrombocytopenic purpura(ATP). The client’s platelet count currently is 80,000. It will be most important to teach the client and family about:

• Bleeding precautions
• Prevention of falls
• Oxygen therapy
• Conservation of energy

4. What would the nurse expect the admitting assessment to reveal in a client with glomerulonephritis?

• Hypertension
• Lassitude
• Fatigue
• Vomiting and diarrhea

5. A client with osteoarthritis has a prescription for Celebrex (celecoxib). Which instruction should be included in the discharge teaching?

• Take the medication with milk.
• Report chest pain.
• Remain upright after taking for 30 minutes.
• Allow six weeks for optimal effects.

6. The client is admitted following cast application for a fractured ulna. Which finding should be reported to the doctor?

• Pain at the site
• Warm fingers
• Pulses rapid
• Paresthesia of the fingers

7. The nurse is caring for the client following a laryngectomy when suddenly the client becomes nonresponsive and pale, with a BP of 90/40. The initial nurse’s action should be to:

• Place the client in Trendelenburg position.
• Increase the infusion of normal saline.
• Administer atropine intravenously.
• Move the emergency cart to the bedside.

8. A client has cancer of the pancreas. The nurse should be most concerned about which nursing diagnosis?

• Alteration in nutrition
• Alteration in bowel elimination
• Alteration in skin integrity
• Ineffective individual coping

9. The client admitted two days earlier with a lung resection accidentally pulls out the chest tube. Which action by the nurse indicates understanding of the management of chest tubes?

• Order a chest x-ray.
• Reinsert the tube.
• Cover the insertion site with a Vaseline gauze.
• Call the doctor.

10. The client with AIDS should be taught to:

• Avoid warm climates.
• Refrain from taking herbals.
• Avoid exercising.
• Report any changes in skin color.

11. The best method of evaluating the amount of peripheral edemais:

• Weighing the client daily
• Measuring the extremity
• Measuring the intake and output
• Checking for pitting

12. A client has had a unilateral adrenalectomy to remove a tumor. The most important measurement in the immediate post-operative period for the nurse to take is:

• The blood pressure
• The temperature
• The urinary output
• The specific gravity of the urine

13. The client with suspected meningitis is admitted to the unit. The doctor is performing an assessment to determine meningeal irritation and spinal nerve root inflammation. A positive Kernig’s sign is charted if the nurse notes:

• Pain on flexion of the hip and knee
• Nuchal rigidity on flexion of the neck
• Pain when the head is turned to the left side
• Dizziness when changing positions

14. The client has surgery for removal of a Prolactinoma. Which of the following interventions would be appropriate for this client?

• Place the client in Trendelenburg position for postural drainage.
• Encourage coughing and deep breathing every two hours.
• Elevate the head of the bed 30°.
• Encourage the Valsalva maneuver for bowel movements.

15. A 25-year-old client with a goiter is admitted to the unit. What would the nurse expect the admitting assessment to reveal?

• Slow pulse
• Anorexia
• Bulging eyes
• Weight gain

16. A client is admitted to the unit two hours after an explosion causes burns to the face. The nurse would be most concerned with the client developing which of the following?

• Hypovolemia
• Laryngeal edema
• Hypernatremia
• Hyperkalemia

17. A client is diagnosed with hepatitis A. which of the following statements made by client indicates understanding of the disease

• Sexual intimacy and kissing is not allowed
• Does require hospitalization
• Transmitted only through blood transfusions
• Any planned surgery need to be postponed

18. The nurse is teaching the client with polycythemia vera about prevention of complications of the disease. Which of the following statements by the client indicates a need for further teaching?

• “I will drink 500ml_ of fluid or less each day.”
• “I will wear support hose.”
• “I will check my blood pressure regularly.”
• “I will report ankle edema.”

19. The nurse is caring for a client with uremic frost. The nurse is aware that uremic frost is often seen in clients with:

• Severe anemia
• Arteriosclerosis
• Liver failure
• Parathyroid disorder

20. A client with a fractured tibia has a plaster-of-Paris cast applied to immobilize the fracture. Which action by the nurse indicates understanding of a plaster-of-Paris cast? The nurse:

• Handles the cast with the fingertips
• Petals the cast
• Dries the cast with a hair dryer
• Allows 24 hours before bearing weight

21. During the initial interview, the client reports that she has a lesion on the perineum. Further investigation reveals a small blister on the vulva that is painful to touch. The nurse is aware that the most likely source of the lesion is:

• Syphilis
• Herpes
• Gonorrhea
• Condylomata

22. The client is admitted to the hospital with hypertensive crises. Diazoxide (Hyperstat) is ordered. During administration, the nurse should:

• Utilize an infusion pump.
• Check the blood glucose level.
• Place the client in Trendelenburg position.
• Cover the solution with foil.

23. The nurse is teaching the mother regarding treatment for pedicalosis capitis. Which instruction should be given regarding the medication?

• Treatment is not recommended for children less than 10 years of age.
• Bed linens should be washed in hot water.
• Medication therapy will continue for one year.
• Intravenous antibiotic therapy will be ordered.

24. A client with Addison’s disease has been admitted with a history of nausea and vomiting for the past three days. The client is receiving IV glucocorticoids (SoluMedrol). Which of the following interventions would the nurse implement?

• Glucometer readings as ordered
• Intake/output measurements
• Evaluating the sodium and potassium levels
• Daily weights

25. A client has autoimmune thrombocytopenic purpura. To determine the client’s response to treatment, the nurse would monitor:

• Platelet count
• White blood cell count
• Potassium levels
• Partial prothrombin time (PTT)

26. The five-year-old is being tested for enterobiasis (pinworms). Which symptom is associated with enterobiasis?

• Rectal itching
• Nausea
• Oral ulcerations
• Scalp itching

27. The teenager with a fiberglass cast asks the nurse if it will be okay to allow his friends to autograph his cast. Which response would be best?

• “It will be alright for your friends to autograph the cast.”
• “Because the cast is made of plaster, autographing can weaken the cast.”
• “If they don’t use chalk to autograph, it is okay.”
• “Autographing or writing on the cast in any form will harm the cast.”

28. A 21-year-old male with Hodgkin’s lymphoma is a senior at the local university. He is engaged to be married and is to begin a new job upon graduation. Which of the following diagnoses would be a priority for this client?

• Sexual dysfunction related to radiation therapy
• Anticipatory grieving related to terminal illness
• Tissue integrity related to prolonged bed rest
• Fatigue related to chemotherapy

29. A client in the family planning clinic asks the nurse about the most likely time for her to conceive. The nurse explains that conception is most likely to occur when:

• Estrogen levels are low
• Lutenizing hormone is high
• The endometrial lining is thin
• The progesterone level is low

30. The rationale for inserting a French catheter every hour for the client with epidural anaesthesia is:

• The bladder fills more rapidly because of the medication used for the epidural.
• Her level of consciousness is such that she is in a trancelike state.
• The sensation of the bladder filling is diminished or lost.
• She is embarrassed to ask for the bedpan that frequently.

31. The elderly client is admitted to the emergency room. Which symptom is the client with a fractured hip most likely to exhibit?

• Pain
• Disalignment
• Cool extremity
• Absence of pedal pulses

32. The physician has ordered a histoplasmosis test for the elderly client. The nurse is aware that histoplasmosis is transmitted to humans by:

• Cats
• Dogs
• Turtles
• Birds

33. The client is admitted with left-sided congestive heart failure. In assessing the client for edema, the nurse should check the:

• Feet
• Neck
• Hands
• Sacrum

34. A client with a total hip replacement requires special equipment. Which equipment would assist the client with a total hip replacement with activities of daily living?

• High-seat commode
• Recliner
• TENS unit
• Abduction pillow

35. The nurse working the organ transplant unit is caring for a client with a white blood cell count of 450. During evening visitation, a visitor brings a basket of fruit. What action should the nurse take?

• Allow the client to keep the fruit.
• Place the fruit next to the bed for easy access by the client.
• Offer to wash the fruit for the client.
• Ask the family members to take the fruit home.

36. Where is the best site for examining for the presence of petechiae in an African client?

• The abdomen
• The thorax
• The earlobes
• The soles of the feet

37. Your patient has Diverticulitis for about a decade now. You have assessed her to be having soft stools of Type 4/5. Which of the following will need urgent intervention?

• She is losing a lot of electrolytes in her body, and this needs to be replaced.
• There is no urgency in this case, because patients with Diverticulitis are expected to have soft to loose stools.
• She needs to be prescribed with fluid retention pills.
• There is no urgency in this case because the stool is quite hard, and it should be fine.

38. The nurse is aware that the best way to prevent post-operative wound infection in the surgical client is to:

• Administer a prescribed antibiotic.
• Wash her hands for two minutes before care.
• Wear a mask when providing care.
• Ask the client to cover her mouth when she coughs.

39. Ms. Karen is to have a pelvic exam, which of the following should the nurse do first

• Have the client remove all her clothes, socks & shoes
• Have the client go to the bathroom & void saving a sample
• Place the client in lithotomy position on the exam table
• Assemble all the equipment needed for the examination

40. Which of the following instructions should be included in the nurse’s teaching regarding oral contraceptives?

• Weight gain should be reported to the physician.
• An alternate method of birth control is needed when taking antibiotics.
• If the client misses one or more pills, two pills should be taken per day for one week.
• Changes in the menstrual flow should be reported to the physician.

41. A client is admitted to the hospital with a temperature of 99.8°F, complaints of blood tinged hemoptysis, fatigue, and night sweats. The client’s symptoms are consistent with a diagnosis of:

• Pneumonia
• Reaction to antiviral medication
• Tuberculosis
• Superinfection due to low CD4 count

42. A client with diabetes asks the nurse for advice regarding methods of birth control. Which method of birth control is most suitable for the client with diabetes?

• Intrauterine device
• Oral contraceptives
• Diaphragm
• Contraceptive sponge

43. A client with leukemia is receiving Trimetrexate. After reviewing the client’s chart, the physician orders Wellcovorin (leucovorin calcium). The rationale for administering leucovorin calcium to a client receiving Trimetrexate is to:

• Treat iron-deficiency anemia caused by chemotherapeutic agents
• Create a synergistic effect that shortens treatment time
• Increase the number of circulating neutrophils
• Reverse drug toxicity and prevent tissue damage

44. A client with a diagnosis of HPV is at risk for which of the following?

• Hodgkin’s lymphoma
• Cervical cancer
• Multiple myeloma
• Ovarian cancer

45. A client tells the nurse that she plans to use the rhythm method of birth control. The nurse is aware that the success of the rhythm method depends on the:

• Age of the client
• Frequency of intercourse
• Regularity of the menses
• Range of the client’s temperature

46. The client presents to the clinic with a serum cholesterol of 275mg/dL and is placed on rosuvastatin (Crestor). Which instruction should be given to the client taking rosuvastatin (Crestor)?

• Report muscle weakness to the physician.
• Allow six months for the drug to take effect.
• Take the medication with fruit juice.
• Report difficulty sleeping.

47. Which roommate would be most suitable for the six-year-old male with a fractured femur in Russell’s traction?

• 16-year old female with scoliosis
• 10-year old male with sarcoma
• 6-year old male with osteomylitis

48. A client with hemophilia has a nosebleed. Which nursing action is most appropriate to control the bleeding?

• Place the client in a sitting position.
• Administer acetaminophen (Tylenol).
• Pinch the soft lower part of the nose.
• Apply ice packs to the forehead

49. The client is seen in the clinic for treatment of migraine headaches. The drug Imitrex (sumatriptan succinate) is prescribed for the client. Which of the following in the client’s history should be reported to the doctor?

• Diabetes
• Prinzmetal’s angina
• Cancer
• Cluster headaches

50. Which action is contraindicated in the client with epiglottis?

• Ambulation
• Oral airway assessment using a tongue blade
• Placing a blood pressure cuff on the arm
• Checking the deep tendon reflexes.