1. A client being treated with sodium warfarin (Coumadin) has a Protime of 120 seconds. Which intervention would be most important to include in the nursing care plan?
Assess for signs of abnormal bleeding.
Anticipate an increase in the Coumadin dosage.
Instruct the client regarding the drug therapy.
Increase the frequency of neurological assessments.
2. The primary reason for rapid continuous rewarming of the area affected by frostbite is to:
Lessen the amount of cellular damage
Prevent the formation of blisters
Promote movement
Prevent pain and discomfort
3. You were on your rounds with one of the carers. You were turning a patient from his left to his right side. What would you do?
Both of you can stay on one side of the bed as you turn your patient
You go on the opposite side of the bed and use the bed sheet to turn your patient
You keep the bed as low as possible because the patient might fall
You go on the opposite side and grab the slide sheet to use
4. A client hospitalized with MRSA is placed on contact precautions. Which statement is true regarding precautions for infections spread by contact?
The client should be placed in a room with negative pressure.
Infection Requires close contact; therefore, the door may remain open.
Transmission is highly likely, so the client should wear a mask at all times.
Infection Requires skin-to-skin contact and is prevented by hand washing, gloves, and a gown.
5. Which of the following would be an appropriate strategy in reorienting a confused patient to where her room is?
Place picture of her family on the bedside stand
Put her name in a large letter on her forehead
Remind the patient where her room is
Let the other residents know where the patient's room is
6. Which of the following is not a component of end of life care?
resuscitation and defibrillation
reduce pain
maintain dignity
provide family support
7. A client with bladder cancer is being treated with iridium seed implants. The nurse’s discharge teaching should include telling the client to:
Strain his urine
Increase his fluid intake
Report urinary frequency
Avoid prolonged sitting
8. A client tells the nurse that she is allergic to eggs, dogs, rabbits, and chicken feathers. Which order should the nurse question?
TB skin test
Rubella vaccine
ELISA test
Chest x-ray
9. The client with colour blindness will most likely have problems distinguishing which of the following colours?
Orange
Violet
Red
White
10. What is primary care?
The accident and emergency room
GP practices, dental practices, community pharmacies and high street optometrists
First aid provided on the street
11. Severe bleeding is best characterised by:
moist skin and pinkish nailbeds
dry skin and pinkish nailbeds
moist skin and bluish nailbeds
dry skin and bluish nailbeds
12. Which of the following client should the nurse deal with first
A client who needs to be suctioned
A client who needs her dressing changed
A client who needs to be medicated for incisional pain
A client who is incontinent & needs to be cleaned
13. The nurse is monitoring a client following a lung resection. The hourly output from the chest tube was 300mL. The nurse should give priority to:
Turning the client to the left side
Milking the tube to ensure patency
Slowing the intravenous infusion
Notifying the physician
14. The first techniques used to examine the abdomen of a client is:
Palpation
Auscultation
Percussion
Inspection
15. The client has recently returned for having a thyroidectomy. The nurse should keep which of the following at the bedside?
A trachotomy set
A padded tongue blade
An endotracheal tube
An airway
16. A patient got admitted to hospital with a head injury. Within 15 minutes, GCS was assessed and it was found to be 15. After initial assessment, a nurse should monitor neurological status
Every 15 minutes
30 minutes
40 minutes
60 minutes
17. After 2 hours in A and E, Susan is now ready to be moved to another ward. You went back to tell her about this plan and noticed she was not responding. What is your next action as a priority
Assess for signs of life
Shout for help
Perform CPR
Keep the airway open
18. A client with pancreatic cancer has an infusion of TPN (Total Parenteral Nutrition). The doctor has ordered for sliding-scale insulin. The most likely explanation for this order is:
Total Parenteral Nutrition leads to negative nitrogen balance and elevated glucose levels.
Total Parenteral Nutrition cannot be managed with oral hypoglycemics.
Total Parenteral Nutrition is a high-glucose solution that often elevates the blood glucose levels.
Total Parenteral Nutrition leads to further pancreatic disease.
19. Which of the following diet instructions should be given to the client with recurring urinary tract infections?
Increase intake of meats.
Avoid citrus fruits.
Perform pericare with hydrogen peroxide.
Drink a glass of cranberry juice every day.
20. Early ambulation prevents all complications except:
Chest infection and lung collapse
Muscle wasting
Thrombosis
Surgical site infection
21. You believe that an adult you know and support has been a victim of physical abuse that might be considered a criminal offence. What should you do to support the police in an investigation?
Question the adult thoroughly to get as much information as possible
Take photographs of any signs of abuse or other potential evidence before cleaning up the victim or the crime scene
Explain to the victim that you cannot speak to them unless a police officer is present
Make an accurate record of what the person has said to you
22. The physician has prescribed ranitidine (Zantac) for a client with erosive gastritis. The nurse should administer the medication:
30 minutes before meals
With each meal
In a single dose at bedtime
60 minutes after meals
23. A client with cystic fibrosis is taking pancreatic enzymes. The nurse should administer this medication:
Once per day in the morning
Three times per day with meals
Once per day at bedtime
Four times per day
24. Correct position for abdominal paracentesis.
Lie the patient supine in bed with the head raised 45-50 cm with a backrest
Sitting upright at 45 to 60°
Sitting upright at 60 to 75°
Sitting upright at 75 to 90°
25. Cataracts result in opacity of the crystalline lens. Which of the following best explains the functions of the lens?
The lens controls stimulation of the retina.
The lens orchestrates eye movement.
The lens focuses light rays on the retina.
The lens magnifies small objects.
26. If your patient is unable to reposition themselves, how often should their position be changed?
1 hourly
2 hourly
3 hourly
As often as possible
27. A client with an abdominal cholecystectomy returns from surgery with a Jackson-Pratt drain. The chief purpose of the Jackson-Pratt drain is to:
Prevent the need for dressing changes
Reduce edema at the incision
Provide for wound drainage
Keep the common bile duct open
28. You are monitoring a patient in the ICU when suddenly his consciousness drops and the size of one his pupil becomes smaller what should you do?
Refer to neurology team
Continue to monitor patient using GCS and record
Consider this as an emergency, prioritize abc & Call the doctor
29. The nurse is preparing to discharge a client with a long history of polio. The nurse should tell the client that:
Taking a hot bath will decrease stiffness and spasticity.
A schedule of strenuous exercise will improve muscle strength.
Rest periods should be scheduled throughout the day.
Visual disturbances can be corrected with prescription glasses.
30. A temporary colostomy is performed on the client with colon cancer. The nurse is aware that the proximal end of a double barrel colostomy:
Is the opening on the client’s left side
Is the opening on the distal end on the client’s left side
Is the opening on the client’s right side
Is the opening on the distal right side
31. How can risk be reduced in the healthcare setting?
By setting targets which measure quality
Healthcare professionals should be encouraged to fill in incident forms; this will create a culture of "no blame"
Healthcare will always involve risks so incidents will always occur, we need to accept this
By adopting a culture of openness & transparency & exploring the root causes of patient safety incidents.
32. When a patient is being monitored in the PACU, how frequently should blood pressure, pulse and respiratory rate be recorded?
Every 5 minutes
Every 15 minutes
Once an hour
Continuously
33. MRSA means
Methilinase - Resistant Streptococcus Aureus
Methicillin-Resistant Streptococcus Aureus
Methilinase - Resistant Staphylococcus Aureus
Methicillin-Resistant Staphylococcus Aureus
34. The client with a pacemaker should be taught to:
Report ankle edema
Check his blood pressure daily
Refrain from using a microwave oven
Monitor his pulse rate
35. A client who has glaucoma is to have miotic eyedrops instilled in both eyes. The nurse knows that the purpose of the medication is to:
Anesthetize the cornea
Dilate the pupils
Constrict the pupils
Paralyze the muscles of accommodation
36. The physician has ordered a minimal-bacteria diet for a client with neutropenia. The client should be taught to avoid eating:
Fruits
Salt
Pepper
Ketchup
37. The nurse is preparing a client for cataract surgery. The nurse is aware that the procedure will use:
Mydriatics to facilitate removal
Miotic medications such as Timoptic
A laser to smooth and reshape the lens
Silicone oil injections into the eyeball
38. Why are physiological scoring systems or early warning scoring system used in clinical practice?
These scoring systems are carried out as part of a national audit so we know how sick patients are in the UK
They enable nurses to call for assistance from the outreach team or the doctors via an electronic communication system
They help the nursing staff to accurately predict patient dependency on a shift by shift basis
The system provides an early accurate predictor of deterioration by identifying physiological criteria that alert the nursing staff to a patient at risk
39. What are the most common effect of inactivity?
Social isolation, loss of independence, exacerbation of symptoms, rapid loss of strength in Ig muscles, de-conditioning of cardiovascular system leading to an increased risk of chest infection and pulmonary embolism
Loss of weight, frustration and deep vein thrombosis
Deep arterial thrombosis, respiratory infection, fear of movement, loss of consciousness, de-conditioning of cardiovascular system leading to an increased risk of angina
Pulmonary embolism, UTI, & fear of people
40. Mrs. B is posted for CT scan. Patient is afraid cancer will reveal during her scan. She asks "why is this test". What will be your response as a nurse?
Tell her that you will arrange a meeting with a doctor after the procedure
Give a health education on cancer prevention
Ignore her question and take her for the procedure
Understand her feelings and tell the patient that it is normal procedure.
41. During a home visit, a client with AIDS tells the nurse that he has been exposed to measles. Which action by the nurse is most appropriate?
Administer an antibiotic.
Contact the physician for an order for immune globulin.
Administer an antiviral.
Tell the client that he should remain in isolation for two weeks.
42. Which strategy could the nurse use to avoid disparity in health care delivery?
Campaign for fixed nurse-patient ratios.
Care for more patients even if quality suffers
Request more health plan options
Recognize the cultural issue related to patient care.
43. The nurse is providing discharge teaching for the client with leukemia. The client should be told to avoid:
Using oil or cream-based soaps
Flossing between the teeth
The intake of salt
Using an electric razor
44. Nurses are not using a hoist to transfer patient. They said it was not well maintained. What would you do?
make a written report
complain verbally
take a picture for evidence
Do nothing
45. If you witness or suspect there is a risk to the safety of people in your care and you consider that there is an immediate risk of harm, you should:
Report your concerns immediately, in writing to the appropriate person - Escalating concerns NMC
Ask for advice from your professional body if unsure on what actions to take
Protect client confidentiality
Refer to your employer’s whistleblowing policy
Keep an accurate record of your concerns and action taken
All of the above
46. What is the preferred position for abdominal Paracenthesis?
Supine with head slightly elevated
Supine with knees bent
Prone
Side-lying
47. The client with enuresis is being taught regarding bladder retraining. The nurse should advise the client to refrain from drinking after:
1900
1200
1000
0700
48. Population groups at higher risk of having a low vitamin D status include the following except:
People who have darker skin
People who have high exposure to the sun
People who have low exposure with the sun
People who cover their skin for cultural reasons
49. Mrs B is 89 years old and very frail. She has renal impairment and history of myocardial infarction. She needs support from staff to meet her nutritional needs. Which IV fluids are recommended for Mrs B?
consider prescribing less fluid
consider prescribing more fluid
either of the above
none of the above
50. Following a heart transplant, a client is started on medication to prevent organ rejection. Which category of medication prevents the formation of antibodies against the new organ?