The nurse is teaching a mother whose daughter has iron deficiency anemia.

The nurse determines the parent understood the

dietary modifications, if she selects?

a) Bread and coffee

b) Fish and Pork meat
c) Cookies and milk
d) Oranges and green leafy vegetables

2.Which of the following is the most common clinical manifestation of G6PD following ingestion of aspirin?

a) Kidney failure
b) Acute hemolytic anemia
c) Hemophilia A
d) Thalassemia

3.The nurse assesses a client with an ileostomy for possible development of which of the following acid-base imbalances?

a) Respiratory acidosis
b) Metabolic acidosis
c) Metabolic alkalosis
d) Respiratory alkalosis

4.The nurse anticipates which of the following responses in a client who develops metabolic acidosis.

a) Heart rate of 105 bpm

b) Urinary output of 15 ml
c) Respiratory rate of 30 cpm
d) Temperature of 39 degree Celsius

5. A client has a phosphorus level of 5.0mg/dL. The nurse closely monitors the client for?

a)

Signs of tetany

b) Elevated blood glucose

c)

Cardiac dysrhythmias

d) Hypoglycemia

6. A nurse is caring for a child with pyloric stenosis. The nurse would watch out for symptoms of?

a) Vomiting large amounts

b) Watery stool
c)

Projectile vomiting

d) Dark-colored stool

7.The nurse responder finds a patient unresponsive in his house. Arrange steps for adult CPR.

a) Assess consciousness
b) Give 2 breaths
c) Perform chest compression
d) Check for serious bleeding and shock
e) Open patients airway
f)

Check breathing

___, ___, ___, ___, ___, ___

8.Which of the following has mostly likely occurred when there is continuous bubbling in the water seal chamber of the
closed chest drainage system?

a) The connection has been taped too tightly

b) The connection tubes are kinked
c)

Lung expansion

d) Air leak in the system

9.Which if the following young adolescent and adult male clients are at most risk for testicular cancer?

a) Basketball player who wears supportive gear during basketball games

b) Teenager who swims on a varsity swim team
c) 20-year-old with undescended testis
d) Patient with a family history of colon cancer

10.The nurse plans to frequently assess a post-thyroidectomy patient for?

a) Polyuria
b) Hypoactive deep tendon reflex
c)

Hypertension

d) Laryngospasm

11.An 18-month-old baby appears to have a rounded belly, bowlegs and slightly large head. The nurse concludes?

a) The child appears to be a normal toddler

b) The child is developmentally delayed
c) The child is malnourished
d) The childs large head may have neurological problems.

12. A nurse is going to administer 500mg capsule to a patient. Which is the correct route?

(.A

(.B

(.C

(.D

13.An appropriate instruction to be included in the discharge teaching of a patient following a spinal fusion is?

a) Dont use the stairs

b) Dont bend at the waist
c) Dont walk for long hours
d) Swimming should be avoided

14.A nurse is preparing to give an IM injection of Iron Dextran that is irritating to the subcutaneous tissue. To prevent
irritation to the tissue, what is the best action to be taken?

a) Apply ice over the injection site

b) Administer drug at a 45 degree angle
c) Use a 24-gauge-needle
d) Use the z-track technique

15.What should a nurse do prior to taking the patients history?

a) Offer the patient a glass of water

b) Establish rapport
c) Ask the patient to disrobe and put on gown
d) Ask pertinent information for insurance purposes

16.A pregnant woman is admitted for pre-eclampsia. The nurse would include in the health teaching that magnesium will be
part of the medical management to accomplish the following?

a)

Control seizures

b) promote renal perfusion

c)

To decrease sustained contractions

d) Maintain intrauterine homeostasis

17.A nurse is going to administer ear drops to a 4-year-old child. What is the correct way of instilling the medicine after
tilting the patients head sidewards?

a) Pull the pinna back then downwards

b) Pull the pinna back then upwards
c) Pull the pinna up then backwards
d) Pull the pinna down then backwards

18.A nursing student was intervened by the clinical instructor if which of the following is observed?

a) Inserting a nasogastric tube

b) Positioning the infant in a sniffing position
c) Suctioning first the mouth, then the nose
d) Squeezing the bulb syringe to suction mouth

19.Choose amongst the options illustrated below that best describes the angle for an intradermal injection?

20.During a basic life support class, the instructor said that blind finger sweeping is not advisable for infants. Which among
the following could be the reason?

a) The mouth is still too small

b) The object may be pushed deeper into the throat
c) Sharp fingernails might injure the victim
d) The infant might bite

21.A nurse enters a room and finds a patient lying on the floor. Which of the following actions should the nurse perform first?

a) Call for help

b) Establish responsiveness of patient

c) Ask the patient what happened

d) Assess vital signs

22.A patient with complaints of chest pain was rushed to the emergency department. Which priority action should the nurse
do first?

a) Administer morphine sulfate intravenously

b) Initiate venous access by performing venipunture
c) Administer oxygen via nasal cannula
d) Complete physical assessment and patient history

23.A rehab nurse reviews a post-stroke patients immunization history. Which immunization is a priority for a 72-year-old
patient?

a) Hepatitis A vaccine
b) Hepatitis B vaccine
c) Rotavirus Vaccine
d) Pneumococcal Vaccine

24.Several patients from a reported condominium fire incident were rushed to the emergency room. Which should the nurse
attend to first?

a) A 15-year-old girl, with burns on the face and chest, reports hoarseness of the voice
b) A 28-year-old man with burns on all extremities
c) A 4-year-old child who is crying inconsolably and reports severe headache
d) A 40-year-old woman with complaints of severe pain on the left thigh

25.The doctor ordered 1 pack of red blood cells (PRBC) to be transfused to a patient. The nurse prepares the proper IV
tubing. The IV tubing appropriate for blood transfusion comes with?

a) Air vent
b) Microdrip chamber
c) In-line filter
d) Soluset

26.The expected yet negative (harmful ) result for posthemodialysis is a decrease in?

a) Creatinine
b) BUN
c) Phosphorus
d) Red blood cell count

27.A patient was brought to the emergency room after she fell down the stairs. Which of the following is the best indicator for
increased intracranial pressure in head and spinal injury?

a) Inability to move extremities

b) Decreased respiratory rate
c) Increase in pulse and blood pressure
d) Decrease level of consciousness

28.A new nurse is administering an enema to a patient. The senior nurse should intervene if the new nurse?

a) Hangs the enema bag 18 inches above the anus

b) Positions the client on the right side
c) Advances the catheter 4 inches into the anal canal
d) Lubricates 4 inches of the catheter tip

29.The medication nurse is going to give a patient his morning medications. What is the primary action a nurse should do
before administering the medications?

a) Provide privacy
b) Raise head of the bed
c) Give distilled water
d) Check clients identification bracelet

30.A 30-year-old client is admitted with inflammatory bowel syndrome (Crohns disease). Which of the following instructions
should the nurse include in the health teaching? Select all that apply

a) Corticosteroid medication is part of the treatment

b) Include milk in the diet
c) Aspirin should be administered
d) Antidiarrheal medication can help

1.) Answer: D

Dark green leafy vegetables are good sources of iron. Oranges are good sources of vitamin C that enhances iron absorption in
the small intestines.

2.) Answer: B

Individuals with G6PD may exhibit hemolytic anemia when exposed to infection, certain medications or chemicals.
Salicylates such as Aspirin damages plasma membranes of erythrocytes, leading to hemolytic anemia.

3.) Answer: B

Lower GI fluids are alkaline in nature and can be lost via ileostomy. Thus, loss of HCO3, results to metabolic acidosis.

4.) Answer: C

Initially, respiratory system will try to compensate metabolic acidosis. Patients with metabolic acidosis have high respiratory
rate.

5.) Answer: A

Normal phosphorus level is 2.5 4.5 mg/dL .The level reflects hyperphosphatemia which is inversely proportional to
calcium. Client should be assessed for tetany which is a prominent symptom of hypocalcemia.

6.) Answer: C

Clinical manifestations of pyloric stenosis include projectile vomiting, irritability, constipation, and signs of dehydration,
including a decrease in urine output.

7.) Answer: A, E, F, C, B, D

In accordance with the new guidelines, remember AB-CABS. A-airway B-breathing normally? C-chest compression Aairway open B-breathing for patient S-serious bleeding, shock, spinal injury. The nurse should first assess consciousness of
the patient. Next, open patients airway to check for breathing. When there is no breathing, immediately perform chest
compression then give 2 breaths, do the cycle of care over. Finally, check for serious bleeding, shock, and spinal injury.

8.) Answer: D

Continuous bubbling seen in water-seal bottle/ chamber indicates an air leak or loose connection, and air is sucked
continuously into the closed chest drainage system.

9.) Answer: C

Testicular cancer is most likely to affect males in late adolescence. Undescended testis is also one major risk for testicular
cancer.

10.) Answer: D

Hypocalcemia occurs when there is accidental removal or destruction of parathyroid tissue during surgical removal of the
thyroid gland. Laryngospasm is one of the clinical manifestations of tetany, an indicator of hypocalcemia.

11.) Answer: A

Its normal for a toddler to have bowlegs and a protruding belly. The head still appears somewhat large in proportion from the
rest of the body.

12.) Answer: D

13.) Answer: B

There is 6-8 months activity restriction following a spinal fusion. Sitting, lying, standing, normal stair climbing, walking, and
gentle swimming is allowed. Bending and twisting at the waist should be avoided, along with lifting more than 10 lbs.

14.) Answer: D

Z-track technique is used to administer drugs especially irritating to the subcutaneous tissue. This method promotes
absorption of the drug by preventing drug leakage into the subcutaneous layer.

15.) Answer: B

Establishing rapport is a way to gain trust that will lead for a patient to relax. You can get more insights and information from
a patient when rapport is established.

16.) Answer: A

Low magnesium (hypomagnesemia) produces clinical manifestations like increased reflexes, tremors, and seizures.
Magnesium Sulfate is the drug of choice to prevent seizures in pre-eclampsia and eclampsia.

17.) Answer: C

Ear canal of children ages 3years and above can be straightened by pulling the pinna up then backwards. For children below 3
years of age, the ear canal can be straightened by pulling the pinna down then backwards.

18.) Answer: A

Infants are nose breathers. A gastric tube may be inserted to facilitate lung expansion and stomach decompression, but not a
nasogastric tube as it can occlude the nare, thus, making breathing difficult for the infant.

19.) Answer: B

20.) Answer: B

Blind finger sweeps are not recommended in all CPR cases especially for infants and children because the foreign object may
be pushed back into the airway.

21.) Answer: B

First step in cardiopulmonary resuscitation (CPR) is assessing responsiveness of the patient.

22.) Answer: C

Priority nursing action is to administer oxygen to patients with chest pain. Chest pain is caused by insufficient myocardial
oxygenation.

23.) Answer: D

Pneumococcal Vaccine is a priority immunization for the elderly. Seniors, ages 65 years old and above, have higher risk for
serious pneumococcal infection and likely have low immunity. This is administered every 5 years.

24.) Answer: A

Burns on the face and neck can cause swelling of the respiratory mucosa that can lead to airway obstruction manifested by
hoarseness of voice and difficulty in breathing. Maintaining an airway patency is the main concern.

25.) Answer: C

An in-line filter is required for blood transfusions.

26.) Answer: D

Negative outcome: Hemodialysis decreases red blood cell count which worsens anemia, because RBCs are lost in dialysis
from anticoagulation during the procedure, and from residual blood that is left in the dialyzer.

27.) Answer: D

Decrease in level of consciousness and headache are early signs of increase in intracranial pressure (ICP). Altered level of
consciousness is the most common symptom that indicates a deficit in brain function.

28.) Answer: B

Recall the anatomy of the colon. The appropriate position is left lateral to facilitate flow of enema by gravity into the colon.

29.) Answer: D

Recall the 12 Rights of administration. Checking the patients name is critical for client-safety.

30.) Answer: A , D

Crohns disease is a chronic inflammation of the colon with symptoms of diarrhea, abdominal pain, and weight loss.
Corticosteroid is a treatment for Crohns disease. Antidiarrheal can give relief to diarrheal episodes. Aspirin should be
avoided as it can worsen inflammation. Those with Crohns disease are mostly lactose intolerant, so choice no. (2) is
incorrect.

SECOND EXAM TEST

1. A resident often carries a doll with her, treating it like her baby. One day she is wandering around crying
that she cant find her baby. The nurse aide should
(A) ask the resident where she last had the doll.
(B) ask the activity department if they have any other dolls.
(C) offer comfort to the resident and help her lookfor her baby.
(D) let the other staff know the resident is very confused and should be watched closely.
2. A nurse aide is asked to change a urinary drainage bag attached to an indwelling urinary catheter. The
nurse aide has never done this before. The best response by the nurse aide is to
(A) change the indwelling catheter at the same time.
(B) ask another nurse aide to change the urinary drainage bag.
(C) change the bag asking for help only if the nurse aide has problems.
(D) ask a nurse to watch the nurse aide change the bag since it is the first time.
3. Before feeding a resident, which of the following is the best reason to wash the residents hands?
(A) The resident may still touch his/her mouth or food.
(B) It reduces the risk of spreading airborne diseases.
(C) It improves resident morale and appetite.
(D) The resident needs to keep meal routines.
4. Which of the following is a job task performed by the nurse aide?
(A) Participating in resident care planning conferences
(B) Taking a telephone order from a physician
(C) Giving medications to assigned residents
(D) Changing sterile wound dressings
5. Which of the following statements is true about range of motion (ROM) exercises?
(A) Done just once a day
(B) Help prevent strokes and paralysis
(C) Require at least ten repetitions of each exercise
(D) Are often performed during ADLs such as bathingor dressing
6. While the nurse aide tries to dress a resident who is confused, the resident keeps trying to grab a
hairbrush. The nurse aide should
(A) put the hairbrush away and out of sight.
(B) give the resident the hairbrush to hold.

(C) try to dress the resident more quickly.

(D) restrain the residents hand.
7. A resident who is lying in bed suddenly becomes short of breath. After calling for help, the nurse
aides next action should be to
(A) ask the resident to take deep breaths.
(B) takethe residents vital signs.
(C) raise the head of the bed.
(D) elevate the residents feet.
8. A resident who has cancer is expected to die within the next couple of days. Nursing care for this
resident should focus on
(A) helping the resident through the stages of grief.
(B) providing for the residents comfort.
(C) keeping the residents care routine, such as for bathing.
(D) giving the resident a lot of quiet time and privacy.
9. While giving a bedbath, the nurse aide hears thealarm from a nearby door suddenly go off. The nurse
aide should
(A) wait a few minutes to see if the alarm stops.
(B) report the alarm to the charge nurse immediately.
(C) make the resident being bathed safe and go check the door right away.
(D) stop the bedbath and go check on the location of all assigned residents.
10. Gloves should be worn for which of the following procedures?
(A) Emptying a urinary drainage bag
(B) Brushing a residents hair
(C) Ambulating a resident
(D) Feeding a resident
11. When walking a resident, a gait or transfer belt is often
(A) worn around the nurse aides waist for back support.
(B) used to keep the resident positioned properly in the wheelchair.
(C) used to help stand the resident, and then removed before walking.
(D) put around the residents waist to provide a way to hold onto the resident.

12. Which of the following statements is true aboutresidents who are restrained?
(A) They are at greater risk for developing pressure sores.
(B) They are at lower risk of developing pneumonia.
(C) Their posture and alignment are improved.
(D) They are not at risk for falling.
13. A resident has diabetes. Which of the followingis a common sign of a low blood sugar?
(A) Fever
(B) Shakiness
(C) Thirst
(D) Vomiting
14. When providing foot care to a resident it is important for the nurse aide to
(A) remove calluses and corns.
(B) check the feet for skin breakdown.
(C) keep the water cool to prevent burns.
(D) apply lotion, including between the toes.
15. When feeding a resident, frequent coughing can be a sign the resident is
(A) choking.
(B) getting full.
(C) needs to drink more fluids.
(D) having difficulty swallowing.
16. When a person is admitted to the nursing home, the nurse aide should expect that the resident will
(A) have problems related to incontinence.
(B) require a lot of assistance with personal care.
(C) experience a sense of loss related to the life change.
(D) adjust more quickly if admitted directly from the hospital.
17. A resident gets dressed and comes out of his room wearing shoes that are from two different pairs.
The nurse aide should
(A) tease the resident by complimenting the residents sense of style.
(B) ask if the resident realizes that the shoes do not match.
(C) remind the resident that the nurse aide can dress the resident.
(D) ask if the resident lost some of his shoes.

18. A residents wife recently died. The resident is now staying in his room all the time and eating very
little.
The best response by the nurse aide is to
(A) remind the resident to be thankful for the years he shared with his wife.
(B) tell the resident that he needs to get out of his room at least once a day.
(C) understand the resident is grieving and give him chances to talk.
(D) avoid mentioning his wife when caring for him.
19. When a resident refuses a bedbath, the nurse aide should
(A) offer the resident a bribe.
(B) wait awhile and then ask the resident again.
(C) remind the resident that people who smell donthave friends.
(D) tell the resident that nursing home policy requires daily bathing.
20. When a resident is combative and trying to hit the nurse aide, it is important for the nurse aide to
(A) show the resident that the nurse aide is in control.
(B) call for help to make sure there are witnesses.
(C) explain that if the resident is not calm a restraint may be applied.
(D) step back to protect self from harm while speaking in a calm manner.
21. During lunch in the dining room, a resident begins yelling and throws a spoon at the nurse aide. The
best response by the nurse aide is to
(A) remain calm and ask what is upsetting the resident.
(B) begin removing all the other residents from thedining room.
(C) scold the resident and ask the resident to leave the dining room immediately.
(D) remove the residents plate, fork, knife, and cup so there is nothing else to throw.
22. Which of the following questions asked to the resident is most likely to encourage conversation?
(A) Are you feeling tired today?
(B) Do you want to wear this outfit?
(C) What are your favorite foods?
(D) Is this water warm enough?
23. When trying to communicate with a resident who speaks a different language than the nurse aide,
the nurse aide should

(A) use pictures and gestures.

(B) face the resident and speak softly when talking.
(C) repeat words often if the resident does not understand.
(D) assume when the resident nods his/her head thatthe message is understood.
24. While walking down the hall, a nurse aide looksinto a residents room and sees another nurse aide
hitting a resident. The nurse aide is expected to
(A) contact the state agency that inspects the nursing facility.
(B) enter the room immediately to provide for the residents safety.
(C) wait to confront the nurse aide when he/she leaves the residents room.
(D) check the resident for any signs of injury after the nurse aide leaves the room.
25. Before touching a resident who is crying to offer comfort, the nurse aide should consider
(A) the residents recent vital signs.
(B) the residents cultural background.
(C) whether the resident has been sad recently.
(D) whether the resident has family that visits routinely.
26. When a resident is expressing anger, the nurse aide should
(A) correct the residents misperceptions.
(B) ask the resident to speak in a kinder tone.
(C)listen closely to the residents concerns.
(D) remind the resident that everyone gets angry.
27. When giving a backrub, the nurse aide should
(A) apply lotion to the back directly from the bottle.
(B) keep the resident covered as much as possible.
(C) leave extra lotion on the skin when completing the procedure.
(D) expect the resident to lie on his/her stomach.
28. A nurse aide finds a resident looking in the refrigerator at the nurses station at 5 a.m. The resident,
who is confused, explains he needs breakfast beforehe leaves for work. The best response by the nurse
aide is to
(A) help the resident back to his room and into bed.
(B) ask the resident about his job and if he is hungry.
(C) tell him that residents are not allowed in the nurses station.

(D) remind him that he is retired from his job and in a nursing home.
29. Which of the following is true about caring fora resident who wears a hearing aid?
(A) Apply hairspray after the hearing aid is in place.
(B) Remove the hearing aid before showering.
(C) Clean the earmold and battery case with water daily, drying completely.
(D) Replace batteries weekly.
30. Residents with Parkinsons disease often require assistance with walking because they
(A) become confused and forget how to take steps without help.
(B) have poor attention skills and do not notice safety problems.
(C) have visual problems that require special glasses.
(D) have a shuffling walk and tremors.
31. A resident who is inactive is at risk of constipation. In addition to increased activity and exercise,
which of the following actions helps to prevent constipation?
(A) Adequate fluid intake
(B) Regular mealtimes
(C) High protein diet
(D) Lowfiber diet
32. A resident has an indwelling urinary catheter. While making rounds, the nurse aide notices that there
is no urine in the drainage bag. The nurse aide should first
(A) ask the resident to try urinating.
(B) offer the resident fluid to drink.
(C) check for kinks in the tubing.
(D) obtain a new urinary drainage bag.
33. A resident who is incontinent of urine has an increased risk of developing
(A) dementia.
(B) urinary tract infections.
(C) pressure sores.
(D) dehydration.
34. When cleansing the genital area during perineal care, the nurse aide should
(A) cleanse the penis with a circular motion starting from the base and moving toward the tip.

(B) replace the foreskin when pushed back to cleanse an uncircumcised penis.
(C) cleanse the rectal area first, before cleansingthe genital area.
(D) use the same area on the washcloth for each washing and rinsing stroke for a female resident.
35. Which of the following is considered a normal agerelated change?
(A) Dementia
(B) Contractures
(C) Bladder holding less urine
(D) Wheezing when breathing
36. A resident is on a bladder retraining program. The nurse aide can expect the resident to
(A) have a fluid intake restriction to prevent sudden urges to urinate.
(B) wear an incontinent brief in case of an accident.
(C) have an indwelling urinary catheter.
(D) have aschedule for toileting.
37. A resident who has stress incontinence
(A) will have an indwelling urinary catheter.
(B) should wear an incontinent brief at night.
(C) may leak urine when laughing or coughing.
(D) needs toileting every 12 hours throughout the day.
38. The doctor has told the resident that his cancer is growing and that he is dying. When the resident
tells the nurse aide that there is a mistake, the nurse aide should
(A) understand that denial is a normal reaction.
(B) remind the resident the doctor would not lie.
(C) suggest the resident ask for more tests.
(D) ask if the resident is afraid of dying.
39. A slipknot is used when securing a restraint so that
(A) the restraint cannot be removed by the resident.
(B) the restraint can be removed quickly when needed.
(C) body alignment is maintained while wearing the restraint.
(D) it can be easily observed whether the restraintis applied correctly.
40. When using personal protective equipment (PPE) the nurse aide correctly follows Standard

Precautions when wearing

(A) double gloves when providing perineal care to aresident.
(B) a mask and gown while feeding a resident that coughs.
(C) gloves to remove a residents bedpan.
(D) gloves while ambulating a resident.
41. To help prevent resident falls, the nurse aide should
(A) always raise siderails when any resident is in his/her bed.
(B) leave residents beds at the lowest level when care is complete.
(C) encourage residents to wear largersized, loosefitting clothing.
(D) remind residents who use call lights that they need to wait patiently for staff.
42. As the nurse aide begins his/her assignment, which of the following should the nurse aide do first?
(A) Collect linen supplies for the shift
(B) Check all the nurse aides assigned residents
(C) Assist a resident that has called for assistance to get off the toilet
(D) Start bathing a resident that has physical therapy in one hour
43. Which of the following would affect a nurse aides status on the states nurse aide registry and also
cause the nurse aide to be ineligible to work in a nursing home?
(A) Having been terminated from another facility for repeated tardiness
(B) Missing a mandatory infection control inservicetraining program
(C) Failing to show for work without calling to report the absence
(D) Having a finding for resident neglect
44. To help prevent the spread of germs between patients, nurse aides should
(A) wear gloves when touching residents.
(B) hold supplies and linens away from their uniforms.
(C) wash hands for at least two minutes after each resident contact.
(D) warn residents that holding hands spreads germs.
45. When a sink has handcontrol faucets, the nurse aide should use
(A) a paper towel to turn the water on.
(B) a paper towel to turn the water off.
(C) an elbow, if possible, to turn the faucet controls on and off.
(D) bare hands to turn the faucet controls both on and off.

46. When moving a resident up in bed who is able to move with assistance, the nurse aide should
(A) position self with knees straight and bent at waist.
(B) use a gait or transfer belt to assist with the repositioning.
(C) pull the resident up holding onto one side of the drawsheet at a time.
(D) bend the residents knees and ask the resident to push with his/her feet.
47. The residents weight is obtained routinely as a way to check the residents
(A) growth and development.
(B) adjustment to the facility.
(C) nutrition and health.
(D) activity level.
48. Which of the following is a right that is included in the Residents Bill of Rights?
(A) To have staff available that speak different languages on each shift
(B) To have payment plan options that are based on financial need
(C) To have religious services offered at the facility daily
(D) To make decisions and participate in own care
49. Which of the following, if observed as a sudden change in the resident, is considered a possible
warning sign of a stroke?
(A) Dementia
(B) Contractures
(C) Slurred speech
(D) Irregular heartbeat
50. Considering the residents activity, which of the following sets of vital signs should be reported to
the
charge nurse immediately?
(A) Resting: 98.69832
(B) After eating: 97.06424
(C) After walking exercise: 98.29828
D) While watching television: 98.87214
Answer key
1C

2D
3A
4A
5D
6B
7C
8B
9C
10 A
11 D
12 A
13 B
14 B
15 D
16 C
17 B
18 C
19 B
20 D
21 A
22 C
23 A
24 B
25 B
26 C
27 B
28 B
29 B
30 D
31 A
32 C
33 C
34 B
35 C
36 D
37 C

38 A
39 B
40 C
41 B
42 C
43 D
44 B
45 B
46 D
47 C
48 D
49 C
50 A
Third section medical surgical
The main goal of treatment for acute glomerulonephritis is to:
encourage activity.
encourage high protein intake.
maintain fluid balance.
teach intermittent urinary catheterization.

2. Nursing diagnoses mostly differ from medical diagnoses in that they are:
dependent upon medical diagnoses for the direction of appropriate interventions.
primarily concerned with caring, while medical diagnoses are primarily concerned with curing.
primarily concerned with human response, while medical diagnoses are primarily concerned with
pathology.
primarily concerned with psychosocial parameters, while medical diagnoses are primarily concerned with
physiologic parameters.

3. A patient who received spinal anesthesia four hours ago during surgery is transferred to the surgical unit and,
after one and a half hours, now reports severe incisional pain. The patient's blood pressure is 170/90 mm Hg,
pulse is 108 beats/min, temperature is 99oF (37.2oC), and respirations are 30 breaths/min. The patient's skin is
pale, and the surgical dressing is dry and intact. The most appropriate nursing intervention is to:

medicate the patient for pain.

place the patient in a high Fowler position and administer oxygen.
place the patient in a reverse Trendelenburg position and open the IV line.
report the findings to the provider.

4. To prevent a common, adverse effect of prolonged use of phenytoin sodium (Dilantin), patients taking the drug
are instructed to:
avoid crowds and obtain an annual influenza vaccination.
drink at least 2 L of fluids daily, including 8 to 10 glasses of water.
eat a potassium-rich, low sodium diet.
practice good dental hygiene and report gum swelling or bleeding.

5. The most common, preventable complication of abdominal surgery is:

atelectasis.
fluid and electrolyte imbalance.
thrombophlebitis.
urinary retention.

6. A 78-year-old patient is scheduled for transition to home after treatment for heart disease. The patient's spouse,
who has chronic obstructive pulmonary disease, plans to care for the patient at home. The spouse says that their
grown children, who live nearby, will help. The best approach to discharge planning is to:
arrange nursing home placement for the couple.
consult the spouse's healthcare provider about the spouse's ability to care for the patient.
contact the children to ascertain their commitment to help.
discuss community resources with the spouse and offer to make referrals.

7. During an assessment of a patient who sustained a head injury 24 hours ago, the medical-surgical nurse notes
the development of slurred speech and disorientation to time and place. The nurse's initial action is to:
continue the hourly neurologic assessments.
inform the neurosurgeon of the patient's status.
prepare the patient for emergency surgery.

recheck the patient's neurologic status in 15 minutes.

8. For the evaluation feedback process to be effective, a manager:

conducts weekly meetings with staff members.
considers staff members' interests and abilities when delegating tasks.
informs staff members regularly of how well they are performing their jobs.
provides goals for staff members to meet.

9. An 80-year-old patient is placed in isolation when infected with methicillin-resistant Staphylococcus aureus.
The patient was alert and oriented on admission, but is now having visual hallucinations and can follow only
simple directions. The medical-surgical nurse recognizes that the changes in the patient's mental status are related
to:
a fluid and electrolyte imbalance.
a stimulating environment.
sensory deprivation.
sundowning.

10. To prepare a patient on the unit for a bronchoscopic procedure, a medical-surgical nurse administers the IV
sedative. The medical-surgical nurse then instructs the licensed practical nurse to:
educate the patient about the pending procedure.
give the patient small sips of water only.
measure the patient's blood pressure and pulse readings.
take the patient to the bathroom one more time.

11. Which physiological response is often associated with surgery-related stress?

Bronchial constriction
Decreased cortisol levels
Peripheral vasodilation
Sodium and water retention

12. A patient's family does not know the patient's end-of-life care preferences, but assumes that they know what
is best for the patient under the circumstances. This assumption reflects:
justice.
paternalism.
pragmatism.
veracity.

13. Which statement by a patient with diabetes mellitus indicates an understanding of the medication insulin
glargine (Lantus)?
"Lantus causes weight loss."
"Lantus is used only at night."
"The duration of Lantus is six hours."
"There is no peak time for Lantus."

14. Which action occurs primarily during the evaluation phase of the nursing process?
Data collection
Decision-making and judgment
Priority-setting and expected outcomes
Reassessment and audit

15. Which action best describes a sentinel event alert?

Documenting the breakdown in communication during a shift report
Indicating that a community or institution is unsafe
Recording the harm done when a medication error occurs
Signaling the need for immediate investigation and response

16. Which is primarily a developmental task of middle age?

Learning and acquiring new skills and information
Rediscovering or developing satisfaction in one's relationship with a significant other
Relying strongly upon spiritual beliefs

Risk taking and its perceived consequences

17. A medical-surgical nurse, who is caring for a patient with a new diagnosis of cancer, observes the patient
becoming angry with the physicians and nursing staff. The best approach to diffuse the emotionally charged
discussion is to:
allow the patient and family members time to be alone.
arrange time for the patient to speak with another patient with cancer.
direct the discussion and validation of emotion, without false reassurance.
request a consultation from a social worker on the oncology unit.

18. It is hospital policy to assess and record a patient's pulse before administering digoxin (Lanoxin). By auditing
the nursing records to determine the frequency of compliance with this policy, the quality assessment and
improvement committee is conducting:
a process analysis.
a quality analysis.
a system analysis.
an outcome analysis.

19. The nursing diagnosis for a patient with a myocardial infarction is activity intolerance. The plan of care
includes the patient outcome criterion of:
agreeing to discontinue smoking.
ambulating 50 feet without experiencing dyspnea.
experiencing no dyspnea on exertion.
tolerating activity well.

20. A nursing department in an acute care setting decides to redesign its nursing practice based on a theoretical
framework. The feedback from patients, families, and staff reflects that caring is a key element. Which theorist
best supports this concept?
Erikson
Maslow
Rogers
Watson

21. Which statement by a patient demonstrates an accurate understanding about herbal supplements?
"Herbs may interact with prescribed medications but not other herbs."
"Most herbs have been tested and found to be safe and therapeutic."
"The Food and Drug Administration regulates herbs and allows advertising."
"There is no standardization among the manufacturers of herbs in this country."

22. For a patient with Crohn's disease, the medical-surgical nurse recommends a diet that is:
high in fiber, and low in protein and calories.
high in potassium.
low in fiber, and high in protein and calories.
low in potassium.

23. When examining a patient who is paralyzed below the T4 level, the medical-surgical nurse expects to find:
flaccidity of the upper extremities.
hyperreflexia and spasticity of the upper extremities.
impaired diaphragmatic function requiring ventilator support.
independent use of upper extremities and efficient cough.

24. After completing a thorough neurological and physical assessment of a patient who is admitted for a
suspected stroke, a medical-surgical nurse anticipates the next step in the immediate care of this patient to
include:
administering tissue plasminogen activator.
obtaining a computed tomography scan of the head without contrast.
obtaining a neurosurgical consultation.
preparing for carotid Doppler ultrasonography.

25. The first step in applying the quality improvement process to an activity in a clinical setting is to:
assemble a team to review and revise the activity.
collect data to measure the status of the activity.

select an activity for improvement.

set a measurable standard for the activity.
Question 1
The right answer was maintain fluid balance..
Question 2
The right answer was primarily concerned with human response, while medical diagnoses are
primarily concerned with pathology..
Question 3
The right answer was medicate the patient for pain..
Question 4
The right answer was practice good dental hygiene and report gum swelling or bleeding..
Question 5
The right answer was atelectasis..
Question 6
The right answer was discuss community resources with the spouse and offer to make referrals..
Question 7
The right answer was inform the neurosurgeon of the patient's status..
Question 8
The right answer was informs staff members regularly of how well they are performing their jobs..
Question 9
The right answer was sensory deprivation..
Question 10
The right answer was measure the patient's blood pressure and pulse readings..
Question 11
The right answer was Sodium and water retention.
Question 12
The right answer was paternalism..
Question 13
The right answer was "There is no peak time for Lantus.".
Question 14
The right answer was Reassessment and audit.
Question 15
The right answer was Signaling the need for immediate investigation and response.

Question 16
The right answer was Rediscovering or developing satisfaction in one's relationship with a significant
other.
Question 17
The right answer was direct the discussion and validation of emotion, without false reassurance..
Question 18
The right answer was a process analysis..
Question 19
The right answer was ambulating 50 feet without experiencing dyspnea..
Question 20
The right answer was Watson.
Question 21
The right answer was "There is no standardization among the manufacturers of herbs in this country.".
Question 22
The right answer was low in fiber, and high in protein and calories..
Question 23
The right answer was independent use of upper extremities and efficient cough..
Question 24
The right answer was obtaining a computed tomography scan of the head without contrast..
Question 25
The right answer was select an activity for improvement..

Prometric Exam Questions

1. A resident often carries a doll with her, treating it like her baby. One day she is wandering around crying
that she cant find her baby. The nurse aide should
(A) ask the resident where she last had the doll.
(B) ask the activity department if they have any other dolls.
(C) offer comfort to the resident and help her lookfor her baby.
(D) let the other staff know the resident is very confused and should be watched closely.
2. A nurse aide is asked to change a urinary drainage bag attached to an indwelling urinary catheter. The nurse
aide has never done this before. The best response by the nurse aide is to
(A) change the indwelling catheter at the same time.
(B) ask another nurse aide to change the urinary drainage bag.
(C) change the bag asking for help only if the nurse aide has problems.
(D) ask a nurse to watch the nurse aide change the bag since it is the first time.
3. Before feeding a resident, which of the following is the best reason to wash the residents hands?
(A) The resident may still touch his/her mouth or food.
(B) It reduces the risk of spreading airborne diseases.
(C) It improves resident morale and appetite.
(D) The resident needs to keep meal routines.
4. Which of the following is a job task performed by the nurse aide?

(A) Participating in resident care planning conferences

(B) Taking a telephone order from a physician
(C) Giving medications to assigned residents
(D) Changing sterile wound dressings
5. Which of the following statements is true about range of motion (ROM) exercises?
(A) Done just once a day
(B) Help prevent strokes and paralysis
(C) Require at least ten repetitions of each exercise
(D) Are often performed during ADLs such as bathingor dressing
6. While the nurse aide tries to dress a resident who is confused, the resident keeps trying to grab a hairbrush.
The nurse aide should
(A) put the hairbrush away and out of sight.
(B) give the resident the hairbrush to hold.
(C) try to dress the resident more quickly.
(D) restrain the residents hand.
7. A resident who is lying in bed suddenly becomes short of breath. After calling for help, the nurse aides next
action should be to
(A) ask the resident to take deep breaths.
(B) takethe residents vital signs.
(C) raise the head of the bed.
(D) elevate the residents feet.
8. A resident who has cancer is expected to die within the next couple of days. Nursing care for this resident
should focus on
(A) helping the resident through the stages of grief.
(B) providing for the residents comfort.
(C) keeping the residents care routine, such as for bathing.
(D) giving the resident a lot of quiet time and privacy.
9. While giving a bedbath, the nurse aide hears thealarm from a nearby door suddenly go off. The nurse aide
should
(A) wait a few minutes to see if the alarm stops.
(B) report the alarm to the charge nurse immediately.
(C) make the resident being bathed safe and go check the door right away.
(D) stop the bedbath and go check on the location of all assigned residents.
10. Gloves should be worn for which of the following procedures?
(A) Emptying a urinary drainage bag
(B) Brushing a residents hair
(C) Ambulating a resident
(D) Feeding a resident
11. When walking a resident, a gait or transfer belt is often
(A) worn around the nurse aides waist for back support.
(B) used to keep the resident positioned properly in the wheelchair.
(C) used to help stand the resident, and then removed before walking.
(D) put around the residents waist to provide a way to hold onto the resident.
12. Which of the following statements is true aboutresidents who are restrained?
(A) They are at greater risk for developing pressure sores.
(B) They are at lower risk of developing pneumonia.
(C) Their posture and alignment are improved.
(D) They are not at risk for falling.

13. A resident has diabetes. Which of the followingis a common sign of a low blood sugar?
(A) Fever
(B) Shakiness
(C) Thirst
(D) Vomiting
14. When providing foot care to a resident it is important for the nurse aide to
(A) remove calluses and corns.
(B) check the feet for skin breakdown.
(C) keep the water cool to prevent burns.
(D) apply lotion, including between the toes.
15. When feeding a resident, frequent coughing can be a sign the resident is
(A) choking.
(B) getting full.
(C) needs to drink more fluids.
(D) having difficulty swallowing.
16. When a person is admitted to the nursing home, the nurse aide should expect that the resident will
(A) have problems related to incontinence.
(B) require a lot of assistance with personal care.
(C) experience a sense of loss related to the life change.
(D) adjust more quickly if admitted directly from the hospital.
17. A resident gets dressed and comes out of his room wearing shoes that are from two different pairs. The
nurse aide should
(A) tease the resident by complimenting the residents sense of style.
(B) ask if the resident realizes that the shoes do not match.
(C) remind the resident that the nurse aide can dress the resident.
(D) ask if the resident lost some of his shoes.
18. A residents wife recently died. The resident is now staying in his room all the time and eating very
little.
The best response by the nurse aide is to
(A) remind the resident to be thankful for the years he shared with his wife.
(B) tell the resident that he needs to get out of his room at least once a day.
(C) understand the resident is grieving and give him chances to talk.
(D) avoid mentioning his wife when caring for him.
19. When a resident refuses a bedbath, the nurse aide should
(A) offer the resident a bribe.
(B) wait awhile and then ask the resident again.
(C) remind the resident that people who smell donthave friends.
(D) tell the resident that nursing home policy requires daily bathing.
20. When a resident is combative and trying to hit the nurse aide, it is important for the nurse aide to
(A) show the resident that the nurse aide is in control.
(B) call for help to make sure there are witnesses.
(C) explain that if the resident is not calm a restraint may be applied.
(D) step back to protect self from harm while speaking in a calm manner.
21. During lunch in the dining room, a resident begins yelling and throws a spoon at the nurse aide. The
best response by the nurse aide is to
(A) remain calm and ask what is upsetting the resident.
(B) begin removing all the other residents from thedining room.

(C) scold the resident and ask the resident to leave the dining room immediately.
(D) remove the residents plate, fork, knife, and cup so there is nothing else to throw.
22. Which of the following questions asked to the resident is most likely to encourage conversation?
(A) Are you feeling tired today?
(B) Do you want to wear this outfit?
(C) What are your favorite foods?
(D) Is this water warm enough?
23. When trying to communicate with a resident who speaks a different language than the nurse aide, the nurse
aide should
(A) use pictures and gestures.
(B) face the resident and speak softly when talking.
(C) repeat words often if the resident does not understand.
(D) assume when the resident nods his/her head thatthe message is understood.
24. While walking down the hall, a nurse aide looksinto a residents room and sees another nurse aide hitting a
resident. The nurse aide is expected to
(A) contact the state agency that inspects the nursing facility.
(B) enter the room immediately to provide for the residents safety.
(C) wait to confront the nurse aide when he/she leaves the residents room.
(D) check the resident for any signs of injury after the nurse aide leaves the room.
25. Before touching a resident who is crying to offer comfort, the nurse aide should consider
(A) the residents recent vital signs.
(B) the residents cultural background.
(C) whether the resident has been sad recently.
(D) whether the resident has family that visits routinely.
26. When a resident is expressing anger, the nurse aide should
(A) correct the residents misperceptions.
(B) ask the resident to speak in a kinder tone.
(C)listen closely to the residents concerns.
(D) remind the resident that everyone gets angry.
27. When giving a backrub, the nurse aide should
(A) apply lotion to the back directly from the bottle.
(B) keep the resident covered as much as possible.
(C) leave extra lotion on the skin when completing the procedure.
(D) expect the resident to lie on his/her stomach.
28. A nurse aide finds a resident looking in the refrigerator at the nurses station at 5 a.m. The resident, who is
confused, explains he needs breakfast beforehe leaves for work. The best response by the nurse aide is to
(A) help the resident back to his room and into bed.
(B) ask the resident about his job and if he is hungry.
(C) tell him that residents are not allowed in the nurses station.
(D) remind him that he is retired from his job and in a nursing home.
29. Which of the following is true about caring fora resident who wears a hearing aid?
(A) Apply hairspray after the hearing aid is in place.
(B) Remove the hearing aid before showering.
(C) Clean the earmold and battery case with water daily, drying completely.
(D) Replace batteries weekly.
30. Residents with Parkinsons disease often require assistance with walking because they
(A) become confused and forget how to take steps without help.

(B) have poor attention skills and do not notice safety problems.
(C) have visual problems that require special glasses.
(D) have a shuffling walk and tremors.
31. A resident who is inactive is at risk of constipation. In addition to increased activity and exercise, which of
the following actions helps to prevent constipation?
(A) Adequate fluid intake
(B) Regular mealtimes
(C) High protein diet
(D) Lowfiber diet
32. A resident has an indwelling urinary catheter. While making rounds, the nurse aide notices that there is no
urine in the drainage bag. The nurse aide should first
(A) ask the resident to try urinating.
(B) offer the resident fluid to drink.
(C) check for kinks in the tubing.
(D) obtain a new urinary drainage bag.
33. A resident who is incontinent of urine has an increased risk of developing
(A) dementia.
(B) urinary tract infections.
(C) pressure sores.
(D) dehydration.
34. When cleansing the genital area during perineal care, the nurse aide should
(A) cleanse the penis with a circular motion starting from the base and moving toward the tip.
(B) replace the foreskin when pushed back to cleanse an uncircumcised penis.
(C) cleanse the rectal area first, before cleansingthe genital area.
(D) use the same area on the washcloth for each washing and rinsing stroke for a female resident.
35. Which of the following is considered a normal age related change?
(A) Dementia
(B) Contractures
(C) Bladder holding less urine
(D) Wheezing when breathing
36. A resident is on a bladder retraining program. The nurse aide can expect the resident to
(A) have a fluid intake restriction to prevent sudden urges to urinate.
(B) wear an incontinent brief in case of an accident.
(C) have an indwelling urinary catheter.
(D) have aschedule for toileting.
37. A resident who has stress incontinence
(A) will have an indwelling urinary catheter.
(B) should wear an incontinent brief at night.
(C) may leak urine when laughing or coughing.
(D) needs toileting every 1 2 hours throughout the day.
38. The doctor has told the resident that his cancer is growing and that he is dying. When the resident tells the
nurse aide that there is a mistake, the nurse aide should
(A) understand that denial is a normal reaction.
(B) remind the resident the doctor would not lie.
(C) suggest the resident ask for more tests.
(D) ask if the resident is afraid of dying.
39. A slipknot is used when securing a restraint so that

(A) the restraint cannot be removed by the resident.

(B) the restraint can be removed quickly when needed.
(C) body alignment is maintained while wearing the restraint.
(D) it can be easily observed whether the restraintis applied correctly.
40. When using personal protective equipment (PPE) the nurse aide correctly follows Standard Precautions
when wearing
(A) double gloves when providing perineal care to aresident.
(B) a mask and gown while feeding a resident that coughs.
(C) gloves to remove a residents bedpan.
(D) gloves while ambulating a resident.
41. To help prevent resident falls, the nurse aide should
(A) always raise siderails when any resident is in his/her bed.
(B) leave residents beds at the lowest level when care is complete.
(C) encourage residents to wear larger sized, loose fitting clothing.
(D) remind residents who use call lights that they need to wait patiently for staff.
42. As the nurse aide begins his/her assignment, which of the following should the nurse aide do first?
(A) Collect linen supplies for the shift
(B) Check all the nurse aides assigned residents
(C) Assist a resident that has called for assistance to get off the toilet
(D) Start bathing a resident that has physical therapy in one hour
43. Which of the following would affect a nurse aides status on the states nurse aide registry and also cause
the nurse aide to be ineligible to work in a nursing home?
(A) Having been terminated from another facility for repeated tardiness
(B) Missing a mandatory infection control inservicetraining program
(C) Failing to show for work without calling to report the absence
(D) Having a finding for resident neglect
44. To help prevent the spread of germs between patients, nurse aides should
(A) wear gloves when touching residents.
(B) hold supplies and linens away from their uniforms.
(C) wash hands for at least two minutes after each resident contact.
(D) warn residents that holding hands spreads germs.
45. When a sink has handcontrol faucets, the nurse aide should use
(A) a paper towel to turn the water on.
(B) a paper towel to turn the water off.
(C) an elbow, if possible, to turn the faucet controls on and off.
(D) bare hands to turn the faucet controls both on and off.
46. When moving a resident up in bed who is able to move with assistance, the nurse aide should
(A) position self with knees straight and bent at waist.
(B) use a gait or transfer belt to assist with the repositioning.
(C) pull the resident up holding onto one side of the drawsheet at a time.
(D) bend the residents knees and ask the resident to push with his/her feet.
47. The residents weight is obtained routinely as a way to check the residents
(A) growth and development.
(B) adjustment to the facility.
(C) nutrition and health.
(D) activity level.
48. Which of the following is a right that is included in the Residents Bill of Rights?

(A) To have staff available that speak different languages on each shift
(B) To have payment plan options that are based on financial need
(C) To have religious services offered at the facility daily
(D) To make decisions and participate in own care
49. Which of the following, if observed as a sudden change in the resident, is considered a possible warning
sign of a stroke?
(A) Dementia
(B) Contractures
(C) Slurred speech
(D) Irregular heartbeat
50. Considering the residents activity, which of the following sets of vital signs should be reported to the
charge nurse immediately?
(A) Resting: 98.69832
(B) After eating: 97.06424
(C) After walking exercise: 98.2 98 28
D) While watching television: 98.8 72 14
Answer key
C1
D2
A3
A4
D5
B6
C7
B8
C9
A 10
D 11
A 12
B 13
B 14
D 15
C 16
B 17
C 18
B 19
D 20
A 21
C 22
A 23
B 24
B 25
C 26
B 27
B 28
B 29
D 30

A 31
C 32
C 33
B 34
C 35
D 36
C 37
A 38
B 39
C 40
B 41
C 42
D 43
B 44
B 45
D 46
C 47
D 48
C 49
A 50
PRACTICE TEST FOR PROMETRIC(CardioVascular Disorders)

1. Which of the following is the most common symptom of myocardial infarction?

a. Chest pain
b. Dyspnea
c. Edema
d. Palpitations
2. When do coronary arteries primarily receive blood flow?
a.
b.
c.
d.

During inspiration
During diastole
During expiration
During systole

3. Which of the following illnesses is the leading cause of death in the US?
a.
b.
c.
d.

Cancer
Coronary artery disease
Liver failure
Renal failure

4. Which of the following conditions most commonly results in CAD?

a. Atherosclerosis
b. DM
c. MI
d. Renal failure
5. Atherosclerosis impedes coronary blood flow by which of the following mechanisms?
a. Plaques obstruct the vein
b. Plaques obstruct the artery
c. Blood clots form outside the vessel wall
d. Hardened vessels dilate to allow the blood to flow through

6. Which of the following risk factors for coronary artery disease cannot be corrected?
a. Cigarette smoking
b. DM
c. Heredity d.
HPN
7. Exceeding which of the following serum cholesterol levels significantly increases the risk of coronary artery disease?
a. 100 mg/dl b.
150 mg/dl c.
175 mg/dl d.
200 mg/dl
8. Which of the following actions is the first priority care for a client exhibiting signs and symptoms of coronary artery
disease?
a. Decrease anxiety
b. Enhance myocardial oxygenation
c. Administer sublignual nitroglycerin
d. Educate the client about his symptoms
9. Medical treatment of coronary artery disease includes which of the following procedures?
a. Cardiac catheterization
b. Coronary artery bypass surgery
c. Oral medication administration
d. Percutaneous transluminal coronary angioplasty
10. Prolonged occlusion of the right coronary artery produces an infraction in which of the following areas of the heart?
a.Anterir
b. Apical
c.Inferior
d. Lateral
11. Which of the following arteries primarily feeds the anterior wall of the heart?
a.
b.
c.
d.

Circumflex artery
Internal mammary artery
Left anterior descending artery
Right coronary artery

12. Which of the following landmarks is the corect one for obtaining an apical pulse?
a. Left intercostal space, midaxillary line
b. Left fifth intercostal space, midclavicular line
c. Left second intercostal space, midclavicular line
d. Left seventh intercostal space, midclavicular line
13. Which of the following systems is the most likely origin of pain the client describes as knifelike chest pain that
increases in intensity with inspiration?
a. Cardiac
b. Gastrointestinal
c. Musculoskeletal
d. Pulmonary
14. A murmur is heard at the second left intercostal space along the left sternal border.
Which valve area is this?
a. Aortic
b. Mitral
c. Pulmonic

d. Tricuspid
15. Which of the following blood tests is most indicative of cardiac damage?
a. Lactate dehydrogenase
b. Complete blood count c.
Troponin I
d. Creatine kinase
16. What is the primary reason for administering morphine to a client with myocardial infarction?
a. To sedate the client
b. To decrease the client's pain
c. To decrease the client's anxiety
d. To decrease oxygen demand on the client's heart
17. Which of the followng conditions is most commonly responsible for myocardial infarction?
a. Aneurysm
b. Heart failure
c. Coronary artery thrombosis
d. Renal failure
18. What supplemental medication is most frequently ordered in conjuction with furosemide (Lasix)? a. Chloride
b. Digoxin c.
Potassium d.
Sodium
19. After myocardial infarction, serum glucose levels and free fatty acids are both increase. What type of physiologic
changes are these?
a. Electrophysiologic
b. Hematologic
c.Mechanical
d. Metabolic
20. Which of the following complications is indicated by a third heart sound (S3)?
a.
b.
c.
d.

Ventricular dilation
Systemic hypertension
Aortic valve malfunction
Increased atrial contractions

21. After an anterior wall myocardial infarction, which of the following problems is indicated by auscultation of
crackles in the lungs?
a. Left-sided heart failure
b. Pulmonic valve malfunction c.
Right-sided heart failure
d. Tricuspid valve malfunction
22. Which of the following diagnostic tools is most commonly used to determine the location of myocardial
damage?
a. Cardiac catheterization
b. Cardiac enzymes
c. Echocardiogram
d. Electrocardiogram
23. What is the first intervention for a client experiencing myocardial infarction?
a. Administer morphine
b. Administer oxygen

c. Administer sublingual nitroglycerin

d. Obtain an electrocardiogram
24. What is the most appropriate nursing response to a myocardial infarction client who is fearful of dying?
a. "Tell me about your feeling right now."
b. "When the doctor arrives, everything will be fine." c. "This is a
bad situation, but you'll feel better soon."
d. "Please be assured we're doing everything we can to make you feel better."
25. Which of the following classes of medications protects the ischemic myocardium by blocking catecholamines
and sympathetic nerve stimulation?
a. Beta-adrenergic blockers
b. Calcium channel blockers
c. Narcotics
d. Nitrates
26. What is the most common complication of a myocardial infarction?
a.
b.
c.
d.

Cardiogenic shock
Heart failure
Arrhythmias
Pericarditis

27. With which of the following disorders is jugular vein distention most prominent?
a. Abdominal aortic aneurysm
b. Heart failure
c. Myocardial infarction
d. Pneumothorax
28. What position should the nurse place the head of the bed in to obtain the most accurate reading of jugular vein
distention?
a. High-fowler's
b. Raised 10 degrees
c. Raised 30 degrees
d. Supine position
29. Which of the following parameters should be checked before administering digoxin?
a.
b.
c.
d.

Apical pulse
Blood pressure
Radial pulse
Respiratory rate

30. Toxicity from which of the following medications may cause a client to see a green halo around lights?
a. Digoxin
b. Furosemide
c. Metoprolol
d. Enalapril
31. Which ofthe following symptoms is most commonly associated with left-sided heart failure?
a. Crackles
b. Arrhythmias

c. Hepatic engorgement
d. Hypotension
32. In which of the following disorders would the nurse expect to assess sacral eddema in bedridden client?
a. DM
b. Pulmonary emboli c.
Renal failure
d. Right-sided heart failure
33. Which of the following symptoms might a client with right-sided heart failure exhibit?
a.
b.
c.
d.

Adequate urine output

Polyuria
Oliguria
Polydipsia

34. Which of the following classes of medications maximizes cardiac performance in clients with heat failure by
increasing ventricular contractility?
a. Beta-adrenergic blockers
b. Calcium channel blockers c.
Diuretics
d. Inotropic agents
35. Stimulation of the sympathetic nervous system produces which of the following responses?
a.
b.
c.
d.

Bradycardia
Tachycardia
Hypotension
Decreased myocardial contractility

36. Which of the following conditions is most closely associated with weight gain, nausea, and a decrease in urine output?
a. Angina pectoris b.
Cardiomyopathy
c. Left-sided heart failure
d. Right-sided heart failure
37. What is the most common cause of abdominal aortic aneurysm?
a.
b.
c.
d.

Atherosclerosis
DM
HPN
Syphilis

38. In which of the following areas is an abdominal aortic aneurysm most commonly located?
a. Distal to the iliac arteries
b. Distal to the renal arteries
c. Adjacent to the aortic branch
d. Proximal to the renal arteries
39. A pulsating abdominal mass usually indicates which of the following conditions?
a.
b.
c.
d.

Abdominal aortic aneurysm

Enlarged spleen
Gastic distention
Gastritis

40. What is the most common symptom in a client with abdominal aortic aneurysm?

a. Abdominal pain
b. Diaphoresis
c. Headache
d. Upper back pain
41. Which of the following symptoms usually signifies rapid expansion and impending rupture of an abdominal aortic
aneurysm?
a. Abdominal pain
b. Absent pedal pulses
c. Angina
d. Lower back pain
42. What is the definitive test used to diagnose an abdominal aortic aneurysm?
a.
b.
c.
d.

Abdominal X-ray
Arteriogram
CT scan
Ultrasound

43. Which of the following complications is of greatest concern when caring for a preoperative abdominal aneurysm client?
a. HPN
b. Aneurysm rupture
c. Cardiac arrythmias
d. Diminished pedal pulses
44. Which of the following blood vessel layers may be damaged in a client with an aneurysm?
a.
b.
c.
d.

Externa
Interna
Media
Interna and Media

45. When assessing a client for an abdominal aortic aneurysm, which area of the abdomen is most commonly palpated?
a. Right upper quadrant
b. Directly over the umbilicus
c. Middle lower abdomen to the left of the midline
d. Midline lower abdomen to the right of the midline
46. Which of the following conditions is linked to more than 50% of clients with abdominal aortic aneurysms?
a. DM
b. HPN
c. PVD
d. Syphilis
47. Which of the following sounds is distinctly heard on auscultation over the abdominal region of an abdominal aortic
aneurysm client?
a. Bruit
b. Crackles
c. Dullness
d. Friction rubs
48. Which of the following groups of symptoms indicated a ruptured abdominal aneurysm?
a. Lower back pain, increased BP, decreased RBC, increased WBC
b. Severe lower back pain, decreased BP, decreased RBC, increased WBC
c. Severe lower back pain, decreased BP, decreased RBC, decreased WBC

d. Intermittent lower back pain, decreased BP, decreased RBC, increased WBC
49. Which of the following complications of an abdominal aortic repair is indicated by detection of a hematoma in the
perineal area?
a. Hernia
b. Stage 1 pressure ulcer
c. Retroperitoneal rupture at the repair site
d. Rapid expansion of the aneurysm
50. Which hereditary disease is most closely linked to aneurysm?
a.
b.
c.
d.

Cystic fibrosis
Lupus erythematosus
Marfan's syndrome
Myocardial infarction

51. Which of the following treatments is the definitive one for a ruptured aneurysm?
a. Antihypertensive medication administration
b. Aortogram
c. Beta-adrenergic blocker administration
d. Surgical intervention
52. Which of the following heart muscle diseases is unrelated to other cardiovascular disease?
a. Cardiomyopathy
b. Coronary artery disease c.
Myocardial infarction
d. Pericardial Effusion
53. Which of the following types of cardiomyopathy can be associated with childbirth?
a.
b.
c.
d.

Dilated
Hypertrophic
Myocarditis
Restrictive

54. Septal involvement occurs in which type of cardiomyopathy?

a.
b.
c.
d.

Congestive
Dilated
Hypertrophic
Restrictive

55. Which of the following recurring conditions most commonly occurs in clients with cardiomyopathy?
a. Heart failure
b. DM
c. MI
d. Pericardial effusion
56. What is the term used to describe an enlargement of the heart muscle?
a.
b.
c.
d.

Cardiomegaly
Cardiomyopathy
Myocarditis
Pericarditis

57. Dyspnea, cough, expectoration, weakness, and edema are classic signs and symptoms of which of the following
conditions?
a.
b.
c.
d.

Pericarditis
Hypertension
Obliterative
Restricitve

59. Which of the following cardiac conditions does a fourth heart sound (S4) indicate?
a. Dilated aorta
b. Normally functioning heart
c. Decreased myocardial contractility
d. Failure of the ventricle to eject all the blood during systole
60. Which of the following classes of drugs is most widely used in the treatment of cardiomyopathy?
a. Antihypertensive
b. Beta-adrenergic blockers
c. Calcium channel blockers
d. Nitrates
ANSWER KEYS:
1-a
2-b
3-b
4-a
5-b
6-c
7-d
8-b
9-c
10-c
11-c
12- b
13-d
14-c
1516-d
17-c
18-c
19-d

20-a
21-a
d-22
b-23
a-24
a-25
c-26
b-27
c-28
a-29
a-30
a-31
d-32
c-33
d-34
b-35
d-36
a-37
b-38
a-39
a-40
d-41
b-42
b-43
c-44
c-45
46-b
47 -a
b-48
c-49
c-50

d-51
a-52
a-53
c-54
a-55
a-56
d-57
b-58
d-59
b-60

1. Mode of transmission of Pertussis:

(a) Vector transmission (b) Through contaminated water
(c) Droplet infection (d) Faecoaral
2. Time required to measure the Mantaux test:
(a) 2448 hrs (b) 4872 hrs (c) 1012 hrs (d) 24 hrs
3. Name of the oral Polio Vaccine:
(a) BCG (b) TAB (c) Salk (d) Sabin
4. The following are the standard tuberculosis drug except:
(a) Chloromycin (b) Streptomycin (c) INH (d) PAS
5. Combination of Tripple Antigen:
(a) DPT (b) BCG (c) TAB (d) ECG
6. The time interval between infection of suspected person and the
appearance of signs and symptom of the disease is called
(a) Quarrentine (b) Recovery period
(c) Incubation (d) Isolation period
7. Route of transmission of Hepatitis B:
(a) Oral (b) Potential (c) Faeco oral (d) Contaminated water
8. Mode of transmission of typhoid fever:
(a) Intravenous (b) Oro faceal (c) Respiratory (d) Droplet
9. Causative organism of diphtheria:
(a) Mycobacteria (b) Streptococcus
(c) Coryne Bacterium diphtheria (d) Staphylococcus
10. Incubation period of measles:
(a) 17 days (b) 714 days (c) 1421 days (d) 2128 days
11. Site for mantaux test:
(a) Outer and upper quadrant of gluteus maximus (b) Deltoid region
(c) Posterior left forearm (d) Anterior left forearm
12. Media of transmission of bovine type of tubercle bacilli:
(a) Milk (b) Water (c) Air (d) Food
13. Painful Micturition:
(a) Eneuresis (b) Dysuria (c) Rentention of urine (d) Diarrhoea
14. Amount of solution used for evacuant enema in adults:
(a) 100250 ml (b) 250350ml (c) 5001000ml (d) 10001500 ml
15. Drugs used to relieve pain:
(a) Anti inflammatory (b) Antipyretics (c) Antibiotics (d) Analgesics
16. Hormone secreted by the testes:
(a) Oestrogen (b) Pitocin (c) Androgens (d) Progesterone
17. One teaspoon contains ............. ml

(a) 2ml (b) 5ml (c) 10ml (d) 15ml

18. One ml contains ........... drops
(a) 5 drops (b) 10 drops (c) 15 drops (d) 20 drops
19. Average weight of a new born baby:
(a) 2 kg (b) 4 Kg (c) 3kg (d) 5kg
20. How much salt must be added to one litre of water to make a solution of normal saline?
(a) 2 grams (b) 5 grams (c) 6 grams (d) 9 grams
21. Number of vertebra in the sacrum:
(a) 5 (b) 3 (c) 4 (d) 1
22. Number of chromosome in a cell:
(a) 23 (b) 44 (c) 46 (d) 40
23. A trial septal defect occurs due to the persistence of:
(a) Formen ovale (b) Ductus arteriosis (c) Ductus venosus (d) Mitral valve
24. .......... is a water soluble vitamin:
(a) Vitamin A (b) Vitamin K (c) Vitamin B (d) Vitamin D
25. Quickening means:
(a) Hearing of the fetal heart sound (b) Sudden cessation of Menstruation
(c) The movement of the feuts in the uterus felt by the mother (d) Nausa and vomiting in the morning
26. Cholera is caused by a kind of bacterium called:
(a) Tubercle bacillus (b) Vibrio cholerae (c) Protozoa (d) Entamoeba histolytica
27. Drinking of alcohol will severely effects the
(a) Kidney (b) Brain (c) Stomach (d) Liver
28. The disease in which the patients blood does not clot easily is:
(a) Sickle cell anaemia (b) Haemophilia (c) Rabies (d) Diabetes
29. Discolouration of teeth is caused by a kind of antibiotics called
(a) Streptomycin (b) Neomycin (c) Tetracycline (d) Penicillin
30. ........... is caused by the fungus
(a) Malaria (b) Athletes foot (c) Filariasis (d) Typhus fever
31. The Filariasis is transmitted by ........
(a) Anopheles female mosquito (b) Anopheles male mosquito (c) Culex female mosquito (d) Culex male mosquito
32. The blood group contain no antibodies:
(a) A (b) B (c) O (d) AB
33. The disease that spread through sexual contact is ..........
(a) Leprosy (b) AIDS (c) Itches (d) Scabies
34. Typhoid is transmitted through -(a) Water and food (b) Air (c) Touch (d) Personal contact

35. ............ is example for the disease caused by bacteria:

(a) Cold (b) Typhoid (c) Typhus fever (d) Chicken pox
36. ......... is the immunity get by the body after the first attack of disease.
(a) Natural immunity (b) Passive immunity (c) Artificial immunity (d) Acquired immunity
37. The cells that are responsible for the production of antibodies are .......
(a) Red blood cells (b) Platelets (c) Plasma (d) White blood cells
38. A healthy person can donate blood ...... or ..... times a year.
(a) Six or seven (b) Five or six (c) Three or four (d) Two or three
39. Radio active cobalt and radium are used for the treatment of --diseases.
(a) Cholera (b) Haemophilia (c) Cancer (d) Sickle cell anaemia
40. World health day is on .......
(a) May 12th (b) April 7th (c) April 30th (d) December 18th
41. To relieve from dyspnoea the appropriate position to be used is:
(a) Prone position (b) Supine position (c) Side lying position (d) Fowler's position
42. Protein requirement for a pregnant woman per day:
(a) 50grams (b) 55 grams (c) 60 grams (d) 65 grams
43. The findus is at the level of umbilicus during .......... week pregnancy
(a) 16 (b) 20 (c) 24 (d) 28
44. Total weight gain during pregnancy is
(a) 78 kg (b) 1011 kg (c) 1314 kg (d) 1516 kg
45. The birth weight of the baby doubles at the age of
(a) 3 months (b) 6months (c) 9months (d) 12months
46. Infancy period is from
(a) Birth to one month (b) One month to 1 year (c) 1 years to 3 years (d) 3 years to 5 years
47. The following are the signs of dehydration except:
(a) Sunken tearless eyes (b) Loss of skin elasticity (c) Diuresis (d) depressed fintenelle
48. The following are the contests of ORS except:
(a) Sodium chloride (b) Sugar (c) Potassium Chloride (d) Calcium Carbonate
49. The most common from of malnutrition are the following except
(a) Beri-beri (b) Protein energy malnutrition (c) Marasmus (d) Kwashiorkor
50. The first course of oral pills should be stared on the ..... day of menstrual cycle.
(a) 2nd (b) 7th (c) 5th (d) 10th
51. The following are the natural method of contraception except:
(a) Foam tablet (b) Basal metabolic temperature (c) Rhythm method (d) Safe period
52. ......... is the permanent method of sterilization.
(a) MTP (b) Diaphragm (c) Tubectomy (d) D & C

53. The following organs are situated in the abdominal cavity except:
(a) Stomach (b) Oesophagus (c) liver (d) Spleen
54. The system of body which helps for the removal of waste matter from body:
(a) Digestive system (b) Endocrine system (c) Respiratory system (d) Excretory system
55. Total number of bones in human body:
(a) 306 (b) 206 (c) 106 (d) 406
56. Eruption of teeth starts at the age of ....... month
(a) 4 months (b) 6 months (c) 8 months (d) 10 months
57. The never, which carries messages from the brain and spinal cord muscles and glands:
(a) Motor nerve (b) Sensory nerve (c) Mixed nerve (d) Autonomic nerve
58. Speech centre is situated in:
(a) Perietal lobe (b) Frontal lobe (c) Occipital lobe (d) Temporal lobe
59. Largest gland in the body:
(a) Pituitary gland (b) Adrenal gland (c) Liver (d) Gall bladder
60. Head control of the infant occurs at the age of ...... month
(a) 2 (b) 3 (c) 5 (d) 6
61. Peurparium is the period begins:
(a) As soon as the placenta is expelled and last for 6 to 8 weeks (b) As soon as the baby is expelled and last for 6 to 8
weeks
(c) As soon as the membrane ruptures and last for 6 to 8 weeks (d) As soon as the placenta is expelled and last for 10 to 12
weeks
62. When the umbilical cord lies in front of the presenting part and the membranes are intact it is known as:
(a) Cord prolapse (b) Cord presentation (c) Cord pulsation (d) Cord delivery
63. Starting of menstrual cycle is called:
(a) Ovulation (b) Menstruation (c) Menarche (d) Menopause
64. Normal blood urea level is:
(a) 4060 mg% (b) 2040 mg% (c) 1020 mg% (d) 80120 mg%
65. One gram of carbohydrate yields:
(a) 4 calories (b) 8 calories (c) 9 calories (d) 1 calorie
66. A method of making the victim to breath passively
(a) Artificial respiration (b) Spontaneous respiration (c) Deep breathing (d) Kusmal breathing
67. Minute, this walled blood vessels between the ends of the arteries and beginning of veins is called:
(a) Arteries (b) Veins (c) Capillaries (d) Alveoli
68. A waste gas produced by the body and exhaled through the lungs is:
(a) Carbon dioxide (b) Carbon monoxide (c) Nitrogen peroxide (d) Oxygen
69. A condition characterized by moving of bones out joint:
(a) Fracture (b) Sprain (c) Strain (d) Dislocation

70. A tube of muscular tissue carrying ingested food from the mouth to stomach:
(a) Oesophagus (b) Duodenum (c) Trachea (d) Pharynx
71. A red pigment in the blood cells which combines with oxygen and carbon dioxide for carrying them:
(a) Red blood cells (b) Haemoglobin (c) Platelet (d) Plasma
72. Information given by the sufferer about his illness:
(a) Sign (b) Symptom (c) Observation (d) Diagnosis
73. Normal respiratory rate in adults is:
(a) 2040/min (b) 4060/min (c) 1620/min (d) 1015/min
74. The normal body temperature is ........ 0C.
(a) 350C (b) 370C (c) 400C (d) 420C
75. Characteristic of the blood flow due to arterial bleeding is the following except:
(a) Bright red in colour (b) Spunts at each cartrachian of the heart
(c) Flow is pulsatile (d) Dark red in colour
76. An agent that has power to kill Micro-organism:
(a) Bacteriostat (b) Bacteriocide (c) Antiseptic (d) Bacteriostasis
77. Strength of savlon forcleaning of wounds:
(a) 1:10 (b) 1:100 (c) 1:1000 (d) 1:10000
78. Inflammation of the tongue:
(a) Glossitis (b) Gingivitis (c) Stomatitis (d) Parotitis
79. Following are predisposing cause for bedsore except:
(a) Impaired circulation (b) Lowered vitality (c) Emaciation (d) Anorexia
80. Inability to sleep is termed as:
(a) Dyspepsia (b) Dyspnaea (c) Anorexia (d) Insumania
81. Tobacco contains a poisonous substance called
(a) Nicotine (b) Narcotics (c) Alcohol (d) Caffeine
82. A disease caused by allergic disease is called
(a) Asthma (b) Tuberculosis (c) Cancer (d) Gastroenteritis
83. An adult has ...... litres of blood in his body.
(a) 7-8 (b) 5-6 (c) 9-10 (d) 2-3
84. Several persons in a town got the attack of leukemia. Which of the following can be possible reason for that?
(a) Exposed to radiation (b) Drinking polluted water (c) Smoking (d) Breathing in impure air
85. The energy value of ......... is more than that of others
(a) Fats (b) Starch (c) Protein (d) Sugar
86. The product formed when amino acid molecules combine together is called
(a) Nucleic acid (b) Starch (c) Carbohydrate (d) Proteins
87. Women having normal limbs may sometimes give birth to babies with deformed limbs. This must be due to:
(a) Spontaneous generation (b) Mutation (c) Inheritance of acquired character (d) Natural selection

88. Hormones are transported to all parts of the body through the
(a) Nerves (b) Blood (c) Lymph (d) Muscles
89. Deficiency of ....... in food causes simple goiter.
(a) Sodium (b) Iron (c) Iodine (d) Calcium
90. Cortisone is used as an effective anti-inflamatory drug in the treatment of ..........
(a) High blood pressure (b) Arteroisclerosis (c) Arthritis (d) Diabetes
91. Deficiency of thyroxin in adults leads to a condition called:
(a) Tetani (b) Cretinism (c) Myxoedema (d) Graves diseases
92. The hormone that is injected to pregnant women at the time of delivery is
(a) Vasopressin (b) Oxytocin (c) Androgen (d) Oestrogen
93. The outer layer of the eye ball is
(a) Sclera (b) Choroids (c) Retina (d) Conjunctiva
94. The smallest bone in the human body is
(a) Malleus (b) Incus (c) Stapes (d) Sternum
95. Central nervous system includes:
(a) The brain and cranial nerves (b) The cranial nerves and spinal cord
(c) The spinal nerves and brain (d) The spinal nerves and brain
96. Short sightedness can be corrected by using spectacles with ..... lens.
(a) Concave (b) Convex (c) Cylindrical (d) Opaque
97. Normal sugar level in our blood is:
(a) 95125 mg/100ml (b) 65130 mg/100ml (c) 80120 mg/100ml (d) 90140 mg/100 ml
98. Labour takes place after ...... days of last menstrual period
(a) 300 (b) 280 (c) 365 (d) 240
99. Signs of true labour are the following except:
(a) Painful rhythmic uterine contraction (b) Dilatation of the OS
(c) Fetal movement (d) Show
100. Signs of separation of placenta are the following except:
(a) Lengthening of the cord at vulva (b) Gush of blood is seen
(c) Fundus risas upto umbilicus (d) Temperature rises
Answers:
1 C 11 D 21 A 31 C 41 D 51 A 61 A 71 B 81 A 91 C
2 B 12 A 22 C 32 D 42 B 52 C 62 B 72 B 82 A 92 B
3 D 13 B 23 A 33 B 43 C 53 B 63 C 73 C 83 B 93 D
4 A 14 C 24 C 34 A 44 C 54 D 64 B 74 B 84 A 94 C
5 A 15 D 25 C 35 B 45 B 55 B 65 A 75 D 85 A 95 C
6 C 16 C 26 B 36 D 46 B 56 B 66 A 76 B 86 D 96 A
7 B 17 B 27 D 37 D 47 C 57 A 67 C 77 A 87 B 97 C
8 B 18 C 28 B 38 C 48 D 58 A 68 A 78 A 88 B 98 B
9 C 19 C 29 C 39 C 49 A 59 C 69 D 79 D 89 C 99 C
10 B 20 D 30 B 40 B 50 C 60 C 70 A 80 D 90 C 100 D

Prometric exam
1. Disease caused by viruses are
a) Diphtheria b) Tetanus
c) Pertussis d) Measles
2. Mumps is a virus infection. It affects the
a) Parotid gland b) Pituitary gland
c) Thyroid gland d) Adrenal gland
3. Cholera is an acute communicable disease caused by
a) Bacilli b) Virus
c) Mycobacterium d) Vibriyo
4. Infection of hepatitis affects the
a) Spleen b) Stomach
c) Liver d) Intestine
5. Calories are the unit to measure
a) Growth b) Heat
c) Energy d) Development
6. Vitamin B12 is also needed for producing
a) White blood cells b) Red blood cells
c) Plasma d) None of these
7. Capsules are made up of
a) Tablets b) Gelatin
c) Liquid d) Powder
8. Fracture in which one side of a bone is broken, and the other side is bent is called
a) Compound fracture b) Simple fracture
c) Greenstick fracture d) Depressed fracture
9. Unconscious is a condition in which there is depression of cerebral function called
a) stupor of coma b) convulsions
c) concussion d) intracranial hemorrhage
10. This method is suitable for enamel, metal glass
a) boiling b) filtering
c) chemicals d) dry heat
II. State whether the following statements are
True or False 10 x 1 = 10
11. Water borne, food borne diseases are measles and common cold.
12. Sign and symptom of typhoid fever is high fever more than a weak.
13. Protein deficiency is called marasmus.
14. Sources of carbohydrates are Rice, wheat, cereals and root vegetables.

15. Bacteria causing diseases are cholera, Typhoid, Dysentery.

16. Vibrio BACILLI cause Typhoid fever.
17. INFLAMMATION of the tongue is called stomatitis.
18. Glossitis means inflammation of the mouth.
19. Kwashiorker is due to deficiency of carbohydrates.
20. Disinfection is the process of killing the pathogenic micro-organisms.
III. Fill in the blanks 20 x 1 = 20
21. Till 1950 _____________ was considered to be a major health problem in India.
22. _____________ by 1990 was part of a global effort, coordinated by the world
health organization.
23. In every school a fully equipped _____________ box should be available at
hand.
24. _____________ is the back bone of public health Nursing.
25. National AIDS control programme was launched is INDIA in theyear
_____________
26. In English The Word midwife means _____________ (the person with the
women who is in labour)
27. _____________ is a passage of menstrual flow and is the exit of the foetus
during delivery.
28. The ovaries produce ovum and the female hormones _____________
29. _____________ produces a thin lubricating fluid which enters the urethra
through ducts.
30. _____________ is primarily responsible for stimulating the ovaries to secrete
corpusleuteum.
31. _____________ is primarily responsible for stimulating the corpusleuteum for
production of progesterone.
32. _____________ is the end of a woman reproductive.
33. In _____________ the foetus floats.
34. _____________ is important for the promotion of adequate foetal growth.
35. _____________ is the removal of urine by means of catheter.
36. _____________ Operation involves a large surface area of the body.
37. _____________ Organisms are those which produce disease
38. _____________ are plant like organisms.
39. _____________ are animal type of organisms.
40. _____________ are smaller than bacteria.
IV. Match the following 10 x 1 = 10

41. Protozoa - Plant type of organisms

42. Fungi - Rod shaped organisms
43. Bacilli - Triple antigen
44. B.C.G. - Cholera
45. D.P.T. - Animal type of organisms
46. Epidemic - Vaccine against tuberculosis
47. Mosquito - The germs live in a soil and cowdung
48. Air borne disease - Malaria
49. Tetanus - Water borne disease
50. Typhoid - Common cold, measles
PART - B
V. Answer the fifteen questions in two lines each 15 x 2 = 30
51. What are the reasons for majority of death and illness?
52. What is infection?
53. What are all the diseases spread by droplet infection?
54. Write two signs and symptoms of upper respiratory infections?
55. What is the complication of mumps?
56. What is poliyomylitis?
57. What is Asepsis?
58. What are the nutrients materials present in food?
59. What are the staple food?
60. What are the sources of proteins?

61. What is the benefits of vitamin A?

62. What are the sources and deficiency of Iron?
63. What do you mean by dietary food?
64. Define medication.
65. What is Analgesic?
66. What is Antidotes?
67. What are the reasons for Paratiditis?
68. What is gastritis?
69. What is appendicitis?
70. What is constipation?
PART - C
VI. Answer any five questions in 100 words each
from 72 - 77 (Question No. 71 is compulsory) 6 x 5 = 30
71. What are the principles of administering medicines?
( or )
Write the wars of administration of the drugs?
72. What are the types of hepatitis?
73. Write the signs and symptoms of tuberculosis?
74. What are the types of fracture?
75. Write about the immunization schedule?
76. What are the common accidents in children?
77. Write the deficiency of proteins?
PART - D
VII. Answer any four questions in 200 words each 4 x 10 = 40
78. Write the principles of isolation technique?
79. How will you handle the sterile articles?

80. Describe about the sterilizing methods?

81. Write the differences between good nutrition and malnutrition?
82. Write the procedure of Ryles tube feeding?
83. What are the side effects of drugs?
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
Question 1
The nurse prepares for a Denver Screening of a 3 year-old child in the clinic. The mother asks the nurse to explain the
purpose of the test. What is the nurses best response about the purpose of the Denver?
A) "It measures a childs intelligence."
B) "It assesses a child's development."
C) "It evaluates psychological responses."
D) " It helps to determine problems."
Review Information: The correct answer is B: "It assesses a child''s development."
The Denver Developmental Test II is a screening test to assess children from birth through 6 years in personal/social, fine
motor adaptive, language and gross motor development. A child experiences the fun of play during the test.
Question 2
In planning care for a child diagnosed with minimal change nephrotic syndrome, the nurse should understand the
relationship between edema formation and
A) increased retention of albumin in the vascular system
B) decreased colloidal osmotic pressure in the capillaries
C) fluid shift from interstitial spaces into the vascular space
D) reduced tubular reabsorption of sodium and water
Review Information: The correct answer is B: decreased colloidal osmotic pressure in the capillaries
The increased glomerular permeability to protein causes a decrease in serum albumin, which results in decreased colloidal
osmotic pressure.
Question 3
Based on principles of teaching and learning, what is the best initial approach to pre-op teaching for a client scheduled for
coronary artery bypass?
A) Touring the coronary intensive unit
B) Mailing a video tape to the home
C) Assessing the client's learning style
D) Administering a written pre-test
Review Information: The correct answer is C: Assessing the client''s learning style
As with any anticipatory teaching, assess the client''s level of knowledge and learning style first.
Question 4
A client is admitted with a diagnosis of hepatitis B. In reviewing the initial laboratory results, the nurse would expect to
find elevation in which of the following values?
A) Blood urea nitrogen
B) Acid phosphatase
C) Bilirubin
D) Sedimentation rate

Review Information: The correct answer is C: Bilirubin

In the laboratory data provided, the only elevated level expected is bilirubin. Additional liver function tests will confirm the
diagnosis.
Question 5
The nurse is caring for a toddler with atopic dermatitis. The nurse should instruct the parents to
A) Dress the child warmly to avoid chilling
B) Keep the child away from other children for the duration of the rash
C) Clean the affected areas with tepid water and detergent
D) Wrap the child's hand in mittens or socks to prevent scratching
Review Information: The correct answer is D: Wrap the child''s hand in mittens or socks to prevent scratching
A toddler with atopic dermatitis needs to have fingernails cut short and covered so the child will not be able to scratch the
skin lesions, thereby causing new lesions and possibly a secondary infection.
Question 6
The nurse is planning to give a 3 year-old child oral digoxin. Which of the following is the best approach by the nurse?
A) "Do you want to take this pretty red medicine?"
B) "You will feel better if you take your medicine."
C) "This is your medicine, and you must take it all right now."
D) "Would you like to take your medicine from a spoon or a cup?"
Review Information: The correct answer is D: "Would you like to take your medicine from a spoon or a cup?"
At 3 years of age, a child often feels a loss of control when hospitalized. Giving a choice about how to take the medicine
will allow the child to express an opinion and have some control.
Question 7
Which of the actions suggested to the registered nurse (RN) by the practical nurse (PN) during a planning conference for a
10 month-old infant admitted 2 hours ago with bacterial meningitis would be acceptable to add to the plan of care?
A) measure head circumference
B) place in airborne isolation
C) provide passive range of motion
D) provide an over-the-crib protective top
Review Information: The correct answer is A: measure head circumference
In meningitis, assessment of neurological signs should be done frequently. Head circumference is measured because
subdural effusions and obstructive hydrocephalus can develop as a complication of meningitis. The client will have already
been on airborne precautions and crib top applied to the bed on admission to the unit.
Question 8
During the evaluation phase for a client, the nurse should focus on
A) All finding of physical and psychosocial stressors of the client and in the family
B) The client's status, progress toward goal achievement, and ongoing re-evaluation
C) Setting short and long-term goals to insure continuity of care from hospital to home
D) Select interventions that are measurable and achievable within selected timeframes
Review Information: The correct answer is B: The client''s status, progress toward goal achievement, and ongoing reevaluation
The evaluation step of the nursing process focuses on the client''s status, progress toward goal achievement and ongoing reevaluation of the plan of care. The other possible answers focus on other steps of the nursing process.
Question 9
The nurse would expect the cystic fibrosis client to receive supplemental pancreatic enzymes along with a diet
A) high in carbohydrates and proteins
B) low in carbohydrates and proteins
C) high in carbohydrates, low in proteins
D) low in carbohydrates, high in proteins

Review Information: The correct answer is A: high in carbohydrates and proteins

Provide a high-energy diet by increasing carbohydrates, protein and fat (possibly as high as 40%). A favorable response to
the supplemental pancreatic enzymes is based on tolerance of fatty foods, decreased stool frequency, absence of
steatorrhea, improved appetite and lack of abdominal pain.
Question 10
The nurse enters a 2 year-old child's hospital room in order to administer an oral medication. When the child is asked if he
is ready to take his medicine, he immediately says, "No!". What would be the most appropriate next action?
A) Leave the room and return five minutes later and give the medicine
B) Explain to the child that the medicine must be taken now
C) Give the medication to the father and ask him to give it
D) Mix the medication with ice cream or applesauce
Review Information: The correct answer is A: Leave the room and return five minutes later and give the medicine
Since the nurse gave the child a choice about taking the medication, the nurse must comply with the child''s response in
order to build or maintain trust. Since toddlers do not have an accurate sense of time, leaving the room and coming back
later is another episode to the toddler.
Question 11
A 4 year-old child is recovering from chicken pox (varicella). The parents would like to have the child return to day care as
soon as possible. In order to ensure that the illness is no longer communicable, what should the nurse assess for in this
child?
A) All lesions crusted
B) Elevated temperature
C) Rhinorrhea and coryza
D) Presence of vesicles
Review Information: The correct answer is A: All lesions crusted
The rash begins as a macule, with fever, and progresses to a vesicle that breaks open and then crusts over. When all lesions
are crusted, the child is no longer in a communicable stage.
Question 12
The nurse is providing instructions to a new mother on the proper techniques for breast feeding her infant. Which statement
by the mother indicates the need for additional instruction?
A) "I should position my baby completely facing me with my baby's mouth in front of my nipple."
B) "The baby should latch onto the nipple and areola areas."
C) "There may be times that I will need to manually express milk."
D) " I can switch to a bottle if I need to take a break from breast feeding."
Review Information: The correct answer is D: " I can switch to a bottle if I need to take a break from breast feeding."
Babies adapt more quickly to the breast when they are not confused about what is put into their mouths and its purpose.
Artificial nipples do not lengthen and compress the way the human nipples (areola) do. The use of an artificial nipple
weakens the baby''s suck as the baby decreases the sucking pressure to slow fluid flow. Babies should not be given a bottle
during the learning stage of breast feeding.
Question 13
A victim of domestic violence tells the batterer she needs a little time away. How would the nurse expect that the batterer
might respond?
A) With acceptance and views the victims comment as an indication that their marriage is in trouble
B) With fear of rejection causing increased rage toward the victim
C) With a new commitment to seek counseling to assist with their marital problems
D) With relief, and welcomes the separation as a means to have some personal time
Review Information: The correct answer is B: With fear of rejection causing increased rage toward the victim
The fear of rejection, abandonment, and loss only serve to increase the batterers rage at the partner.

Question 14
The nurse, assisting in applying a cast to a client with a broken arm, knows that the
A) cast material should be dipped several times into the warm water
B) cast should be covered until it dries
C) wet cast should be handled with the palms of hands
D) casted extremity should be placed on a cloth-covered surface
Review Information: The correct answer is C: wet cast should be handled with the palms of hands
Handle cast with palms of the hands and lift at 2 points of the extremity. This will prevent stress at the injury site and
pressure areas on the cast.
Question 15
A recovering alcoholic asked the nurse, "Will it be ok for me to just drink at special family gatherings?" Which initial
response by the nurse would be best?
A) "A recovering person has to be very careful not to lose control, therefore, confine your drinking only to family
gatherings."
B) "At your next AA meeting discuss the possibility of limited drinking with your sponsor."
C) "A recovering person needs to get in touch with their feelings. Do you want a drink?"
D) "A recovering person cannot return to drinking without starting the addiction process over."
Review Information: The correct answer is D: "A recovering person cannot return to drinking without starting the addiction
process over."
Recovery requires total abstinence from all drugs.
Question 16
The nurse is assessing a child for clinical manifestations of iron deficiency anemia. Which factor would the nurse
recognize as the cause of the findings?
A) Decreased cardiac output
B) Tissue hypoxia
C) Cerebral edema
D) Reduced oxygen saturation
Review Information: The correct answer is B: Tissue hypoxia
When the hemoglobin falls sufficiently to produce clinical manifestations, the findings are directly attributable to tissue
hypoxia, resulting from a decrease in the oxygen carrying capacity of the blood.
Question 17
A nurse is assigned to a client who is newly admitted for treatment of a frontal lobe brain tumor. Which history offered by
the family members would be recognized by the nurse as associated with the diagnosis, and communicated to the provider?
A) "My partner's breathing rate is usually below 12."
B) "I find the mood swings and the change from a calm person to being angry all the time hard to deal with."
C) "It seems our sex life is nonexistent over the past 6 months."
D) "In the morning and evening I hear complaints that reading is next to impossible from blurred print."
Review Information: The correct answer is B: "I find the mood swings and the change from a calm person to being angry
all the time hard to deal with."
The frontal lobe of the brain controls affect, judgment and emotions. Dysfunction in this area results in findings such as
emotional lability, changes in personality, inattentiveness, flat affect and inappropriate behavior.
Question 18
Immediately following an acute battering incident in a violent relationship, the batterer may respond to the partners
injuries by
A) seeking medical help for the victim's injuries
B) minimizing the episode and underestimating the victims injuries
C) contacting a close friend and asking for help
D) being very remorseful and assisting the victim with medical care

Review Information: The correct answer is B: minimizing the episode and underestimating the victims injuries
Many batterers lack an understanding of the effects of their behavior on the victim and use excessive minimization and
denial.
Question 19
The client who is receiving enteral nutrition through a gastrostomy tube has had 4 diarrhea stools in the past 24 hours. The
nurse should
A) review the medications the client is receiving
B) increase the formula infusion rate
C) increase the amount of water used to flush the tube
D) attach a rectal bag to protect the skin
Review Information: The correct answer is A: review the medications the client is receiving
Antibiotics and medications containing sorbitol may induce diarrhea.
.
Question 20
A postpartum mother is unwilling to allow the father to participate in the newborn's care, although he is interested in doing
so. She states, "I am afraid the baby will be confused about who the mother is. Baby raising is for mothers, not fathers."
The nurse's initial intervention should be what focus?
A) Discuss with the mother sharing parenting responsibilities
B) Set time aside to get the mother to express her feelings and concerns
C) Arrange for the parents to attend infant care classes
D) Talk with the father and help him accept the wife's decision
Review Information: The correct answer is B: Set time aside to get the mother to express her feelings and concerns
Non-judgmental support for expressed feelings may lead to resolution of competitive feelings in a new family. Cultural
influences may also be clarified.
Question 21
The nurse is discussing nutritional requirements with the parents of an 18 month-old child. Which of these statements
about milk consumption is correct?
A) May drink as much milk as desired
B) Can have milk mixed with other foods
C) Will benefit from fat-free cow's milk
D) Should be limited to 3-4 cups of milk daily
Review Information: The correct answer is D: Should be limited to 3-4 cups of milk daily
More than 32 ounces of milk a day considerably limits the intake of solid foods, resulting in a deficiency of dietary iron, as
well as other nutrients.
Question 22
Which of these parents comments about a newborn would most likely reveal an initial finding of a suspected pyloric
stenosis?
A) "I noticed a little lump a little above the belly button."
B) "The baby seems hungry all the time."
C) "Mild vomiting turned into vomiting that shot across the room."
D) "We notice irritation and spitting up immediately after feedings."
Review Information: The correct answer is C: "Mild vomiting turned into vomiting that shot across the room."
Mild regurgitation or emesis that progresses to projectile vomiting is a pattern associated with pyloric stenosis as an initial
finding. The other findings are present, though not immediately.

Question 23
The nurse is talking with a client. The client abruptly says to the nurse, "The moon is full. Astronauts walk on the moon.
Walking is a good health habit." The clients remarks most likely indicate
A) neologisms
B) flight of ideas
C) loose associations
D) word salad
Review Information: The correct answer is C: loose associations
Though the clients statements are not typical of logical communication, remarks 2 and 3 contain elements of the preceding
sentence (moon, walk). Option A refers to making up words that have personal meaning to the client, and option B flight
of ideas defines nearly continuous flow of speech, jumping from one unconnected topic to another. Option D word salad
refers to stringing together real words into nonsense sentences that have no meaning for the listener.
Question 24
The nurse is performing an assessment on a child with severe airway obstruction. Which finding would the nurse
anticipate?
A) Retractions in the intercostal tissues of the thorax
B) Chest pain aggravated by respiratory movement
C) Cyanosis and mottling of the skin
D) Rapid, shallow respirations
Review Information: The correct answer is A: Retractions in the intercostal tissues of the thorax
Slight intercostal retractions are normal, however in disease states, especially in severe airway obstruction, retractions
become extreme.
Question 25
A Hispanic client in the postpartum period refuses the hospital food because it is "cold." The best initial action by the nurse
is to
A) have the unlicensed assistive personnel (UAP) reheat the food if the client wishes
B) ask the client what foods are acceptable or are unacceptable
C) encourage her to eat for healing and strength
D) schedule the dietitian to meet with the client as soon as possible
Review Information: The correct answer is B: ask the client what foods are acceptable or are unacceptable
Many Hispanic women subscribe to the balance of hot and cold foods in the post partum period. What defines "cold" can
best be explained by the client or family.
Question 26
The nurse should recognize that physical dependence is accompanied by what findings when alcohol consumption is first
reduced or ended?
A) Seizures
B) Withdrawal
C) Craving
D) Marked tolerance
Review Information: The correct answer is B: Withdrawal
The early signs of alcohol withdrawal develop within a few hours after cessation or reduction of alcohol intake. Seizure
activity is one withdrawal symptom but there are many others, like nausea and tremor.

Question 27
The nurse is preparing a 5 year-old for a scheduled tonsillectomy and adenoidectomy. The parents are anxious and
concerned about the child's reaction to impending surgery. Which nursing intervention would best prepare the child?
A) Introduce the child to all staff the day before surgery
B) Explain the surgery 1 week prior to the procedure
C) Arrange a tour of the operating and recovery rooms
D) Encourage the child to bring a favorite toy to the hospital
Review Information: The correct answer is B: Explain the surgery 1 week prior to the procedure
A 5 year-old can understand the surgery, and should be prepared well before the procedure. Most of these procedures are
"same day" surgeries and do not require an overnight stay.
Question 28
The nurse is monitoring the contractions of a woman in labor. A contraction is recorded as beginning at 10:00 A.M. and
ending at 10:01 A.M. Another begins at 10:15 A.M. What is the frequency of the contractions?
A) 14 minutes
B) 10 minutes
C) 15 minutes
D) Nine minutes
Review Information: The correct answer is C: 15 minutes
Frequency is the time from the beginning of one contraction to the beginning of the next contraction.
Question 29
The nurse is assigned to a client who has heart failure . During the morning rounds the nurse sees the client develop sudden
anxiety, diaphoresis and dyspnea. The nurse auscultates, crackles bilaterally. Which nursing intervention should be
performed first?
A) Take the client's vital signs
B) Place the client in a sitting position with legs dangling
C) Contact the health care provider
D) Administer the PRN antianxiety agent

Review Information: The correct answer is B: Place the client in a sitting position with legs dangling
Place the client in a sitting position with legs dangling to pool the blood in the legs. This helps to diminish venous return to
the heart and minimize the pulmonary edema. The result will enhance the clients ability to breathe. The next actions would
be to contact the heath care provider, then take the vital signs and then the administration of the antianxiety agent.
Question 30
A client with emphysema visits the clinic. While teaching about proper nutrition, the nurse should emphasize that the client
should
A) eat foods high in sodium to increase sputum liquefaction
B) use oxygen during meals to improve gas exchange
C) perform exercise after respiratory therapy to enhance appetite
D) cleanse the mouth of dried secretions to reduce risk of infection
Review Information: The correct answer is B: use oxygen during meals to improve gas exchange
Clients with emphysema breathe easier when using oxygen while eating.
Question 31
A home health nurse is caring for a client with a pressure sore that is red, with serous drainage, is 2 inches in diameter with
loss of subcutaneous tissue. The appropriate dressing for this wound is
A) transparent film dressing
B) wet dressing with debridement granules

C) wet to dry with hydrogen peroxide

D) moist saline dressing
Review Information: The correct answer is D: moist saline dressing
This wound is a stage III pressure ulcer. The wound is red (granulation tissue) and does not require debridement. The
wound must be protected for granulation tissue to proliferate. A moist dressing allows epithelial tissues to migrate more
rapidly.
Question 32
The father of an 8 month-old infant asks the nurse if his child's vocalizations are normal for his age. Which of the
following would the nurse expect at this age?
A) Cooing
B) Imitation of sounds
C) Throaty sounds
D) Laughter
Review Information: The correct answer is B: Imitation of sounds
Imitation of sounds such as "da-da" is expected at this time.
Question 33
A mother asks about expected motor skills for a 3 year-old child. Which of the following would the nurse emphasize as
normal at this age?
A) Jumping rope
B) Tying shoelaces
C) Riding a tricycle
D) Playing hopscotch

Review Information: The correct answer is C: Riding a tricycle

Coordination is gained through large muscle use. A child of 3 has the ability to ride a tricycle.
Question 34
An 18 month-old has been brought to the emergency room with irritability, lethargy over 2 days, dry skin, and increased
pulse. Based upon the evaluation of these initial findings, the nurse would assess the child for additional findings of
A) septicemia
B) dehydration
C) hypokalemia
D) hypercalcemia
Review Information: The correct answer is B: dehydration
Clinical findings of dehydration include lethargy, irritability, dry skin, and increased pulse.
Question 35
In taking the history of a pregnant woman, which of the following would the nurse recognize as the primary
contraindication for breast feeding?
A) Age 40 years
B) Lactose intolerance
C) Family history of breast cancer
D) Use of cocaine on weekends
Review Information: The correct answer is D: Use of cocaine on weekends
Binge use of cocaine can be just as harmful to the breast fed newborn as regular use.

Question 36
The school nurse suspects that a third grade child might have attention deficit hyperactivity disorder (ADHD). Prior to
referring the child for further evaluation, the nurse should
A) observe the child's behavior on at least 2 occasions
B) consult with the teacher about how to control impulsivity
C) compile a history of behavior patterns and developmental accomplishments
D) compare the child's behavior with classic signs and symptoms
Review Information: The correct answer is C: compile a history of behavior patterns and developmental accomplishments
A complete behavioral, and developmental history plays an important role in determining the diagnosis.
Question 37
In evaluating the growth of a 12 month-old child, which of these findings would the nurse expect to be present in the
infant?
A) Increased 10% in height
B) 2 deciduous teeth
C) Tripled the birth weight
D) Head > chest circumference
Review Information: The correct answer is C: Tripled the birth weight
The infant usually triples his birth weight by the end of the first year of life. Height usually increases by 50% from birth
length. A 12 month- old child should have approximately 6 teeth. ( estimate number of teeth by subtracting 6 from age in
months, ie 12 6 = 6). By 12 months of age, head and chest circumferences are approximately equal.
Question 38
A client who has been drinking for five years states that he drinks when he gets upset about "things" such as being
unemployed or feeling like life is not leading anywhere. The nurse understands that the client is using alcohol as a way to
deal with
A) recreational and social needs
B) feelings of anger
C) lifes stressors
D) issues of guilt and disappointment
Review Information: The correct answer is C: lifes stressors
Alcohol is used by some people to manage anxiety and stress. The overall intent is to decrease negative feelings and
increase positive feelings, but substance abuse itself eventually increases negative feelings.
Question 39
A client is receiving nitroprusside IV for the treatment of acute heart failure with pulmonary edema. What diagnostic lab
value should the nurse monitor when a client is receiving this medication?
A) Potassium level
B) Arterial blood gasses
C) Blood urea nitrogen
D) Thiocyanate
Review Information: The correct answer is D: Thiocyanate
Thiocyanate levels rise with the metabolism if nitroprusside is taken, and this can cause cyanide toxicity. Thiocyanate
should not be over 1 millimole/liter.
Question 40
A nurse is doing preconception counseling with a woman who is planning a pregnancy. Which of the following statements
suggests that the client understands the connection between alcohol consumption and fetal alcohol syndrome?
A) "I understand that a glass of wine with dinner is healthy."
B) "Beer is not really hard alcohol, so I guess I can drink some."
C) "If I drink, my baby may be harmed before I know I am pregnant."
D) "Drinking with meals reduces the effects of alcohol."

Review Information: The correct answer is C: "If I drink, my baby may be harmed before I know I am pregnant."
Alcohol has the greatest teratogenic effect during organogenesis, in the first weeks of pregnancy. Therefore women
considering a pregnancy should not drink.
When a client has left-sided weakness, what part of a sweater is put on first?
(A) Both sleeves
(B) Left sleeve
(C) Clients choice
(D) Right sleeve
Answer: (B) Left sleeve
Exercises that move each muscle and joint are called:
(A) adduction
(B) range of motion
(C) abduction
(D) rotation
Answer: (B) range of motion
The Heimlich maneuver (abdominal thrust) is used for a client who has:
(A) a blocked airway
(B) a bloody nose
(C) fallen out of bed
(D) impaired eyesight
Answer: (A) a blocked airway
Which of the following is a correct measurement of urinary output?
(A) 40 oz
(B) 2 cups
(C) 300 cc
(D) 1 quart
Answer: (C) 300 cc
BEFORE taking the oral temperature of a client who has just finished a cold drink, the nurse aide should wait:
(A) 10 to 20 minutes
(B) 25 to 35 minutes
(C) 45 to 55 minutes
(D) at least 1 hour
Answer: (A) 10 to 20 minutes
These are just some sample testing questions for the CNA exam. We will be offering full sample CNA exams shortly that
you will be able to download and study at your leisure.

1. Which of the following disorders is characterized by joint inflammation that is usually accompanied by pain and
frequently accompanied by changes in structure?
a. Synovitis

b. Arthritis
c. Bursitis
d. Tendinitis
2. Which term refers to the expectoration of blood from the respiratory tract?
a. A hemorrhage
b. Hematopoiesis
c. Hemoptysis
d. Hemopexis
3. Which term describes lack of coordination in performing planned, purposeful movements, resulting from a neurologic
deficit?
a. Apraxia
b. Ataxia
c. Fasciculation
d. Myokymia
4. An elevation in the partial pressure of carbon dioxide in arterial blood (PaCO2) indicates that the patient has:
a. Hypernatremia
b. Hypocalcemia
c. Hypoxemia
d. Hypercapnia
5. The latest laboratory values indicate that the patient has thrombocytopenia. The combining form penia means:
a. Rupture
b. Deficiency
c. Formation
d. Stupor
6. A patient is admitted to the hospital with a urine specific gravity of 1.030, a temperature of 102F (38.9 C), and flushed,
dry skin. Based on these data, the nurse writes which of the following nursing diagnoses?

a. Potential for impaired skin integrity

b. Fluid volume deficit related to fever
c. Potential for fluid volume deficit caused by fever
d. Altered cardiopulmonary tissue perfusion related to fluid excess
7. The guidelines for writing an appropriate nursing diagnosis include all of the following except:
a. State the diagnosis in terms of a problem, not a need
b. Use nursing terminology to describe the patients response
c. Use statements that assist in planning independent nursing interventions
d. Use medical terminology to describe the probable cause of the patients response
8. Based on a physicians order for oxygen by nasal catheter at 3 liters/ minute, an appropriate nursing order would be:
a. Cover the tip of the catheter with a water-soluble lubricant before insertion.
b. Measure the length of the catheter from the tip of the patients nose to the tip of the earlobe before insertion
c. Add sterile distilled water to the humidification container, as needed
d. All of the above
9. A nurse observes a dazed and apparently confused co-worker taking two diazepam (Valium) tablets by mouth as the coworker is about to pour medications. What should the nurse do?
a. Call the head nurse immediately before the co-worker pours and administers the medications
b. Pour the medications for the co-worker while she goes for a cup of coffee
c. Report the co-worker to hospital security because she may be addicted to drugs
d. Watch the co-worker closely and report the incident to the head nurse at the end of the day.
10. A nurse manager notices that one of the staff nurses is always 15 to 20 minutes late. When the nurse manager discusses
the problem with her, the nurse says that she has been late because her sons nursery school does not open until 7 am.
The nurse manager should respond by telling her to:
a. Ask one of the night nurses to cover for her
b. See if a neighbor can take the child to school
c. Find out if other schools open earlier
d. Find some way to solve the problem and be on time

11. A nurse has just moved to a new state, where she has accepted employment in a hospital-based hemodialysis unit. She
needs information about her specific duties in caring for hemodialysis patients. She will find this information in:
a. Policy statements set by the National Kidney Foundation
b. The states nurse practice act
c. Medicare and Medicaid regulations
d. The hospitals procedure manual
12. Which of the following is an example of nursing malpractice?
a. The nurse administers penicillin to a patient with a documented history of allergy to the drug. The patient
experiences an allergic reaction and has cerebral damage resulting from anoxia.
b. The nurse applies a hot water bottle or a heating pad to the abdomen of a patient with abdominal cramping
c. The nurse assists a patient out of bed with the bed locked in position; the patient slips and fractures his right
humerus
d. The nurse administers the wrong medication to a patient and the patient vomits. This information is
documented and reported to the physician and the nursing supervisor
13. Therapeutic communication is a significant aspect of patient care. Which of the following statements
most clearly defines this concept?
a. Therapeutic communication conveys feelings of warmth, acceptance, and empathy from the nurse to the
patient in a nonjudgmental atmosphere
b. Therapeutic communication is a reciprocal interaction based on trust and aimed at identifying patient needs
and developing mutual goals
c. Therapeutic communication is the assessment component of the nursing process, in which the nurse gathers
health history information from the patients perspective
d. Therapeutic communication is an interactional process in which the nurse purposefully reviews and assesses
the conversation and its potential outcomes
14. Many factors can become barriers to communication. In which of the following situations would communication least
likely be hindered?
a. Mr. S., a 30-year-old Vietnamese immigrant, is admitted to the hospital with a fractured tibia; he speaks
limited English
b. Ms. M., age 58 and unmarried, is admitted to the hospital for breast surgery
c. Mrs. R, age 26, is admitted to the hospital for a scheduled cesarean section; this is her first admission
d. Mr. G., age 78, arrives at the hospital by ambulance after suffering a stroke at home

15. The assessment component of the nursing process requires effective communication to elicit a complete, relevant
history from the patient and to identify patient problems. What role does communication play in the other areas of the
nursing process?
a. In the planning phase, effective therapeutic communication helps to establish nursing care priorities and
patient-oriented goals
b. During the implementation phase, communication skills allow the nurse to assess the patients response to
planned interventions
c. During the evaluation phase, effective communication allows the nurse to find out from the patient if he is
responding to treatment or if changes in treatment are necessary
d. All of the above
16. All of the following would be considered objective assessment data for a patient admitted with diabetes mellitus
except:
a. + 2 urine glucose level; negative urine acetone level
b. Chemstrip reading of 240 mg/dl
c. Patient complaints of polydipsia
d. Serum glucose level of 263 mg/dl
17. Which of the following statements about bowel sounds is accurate?
a. Peristalsis causes bowel sounds
b. Rapid, high-pitched, hyperactive bowel sounds indicate increased peristalsis
c. Decreased bowel sounds can be a symptom of paralytic ileus
d. All of the above
18. Independent nursing intervention commonly used for immobilized patients include all of the following except:
a. Active or passive ROM exercises, body repositioning, and activities of daily living (ADLs) as tolerated
b. Deep-breathing and coughing exercises with change of position every 2 hours
c. Diaphragmatic and abdominal breathing exercises and increased hydration
d. Weight bearing on a tilt table, total parenteral nutrition, and vitamin therapy
19. Independent nursing interventions commonly used for patients with pressure ulcers include:
a. Changing the patients position regularly to minimize pressure

b. Applying a drying agent such as an antacid to decrease moisture at the ulcer site
c. Debriding the ulcer to remove necrotic tissue, which can impede healing
d. Placing the patient in a whirlpool bath containing povidone-iodine solution as tolerated
20. A female patient has gained 24 lb after being admitted to the hospital. Im such a horse; I just cant stand myself like
this, she tells the nurse. After assessing the patient, the nurse writes the following nursing diagnosis: Body image
disturbance. To arrive at this diagnosis, the nurse should include which of the following assessment findings?
a. The patients perception of her body before the hospitalization and weight gain
b. The significance the patient places on these changes
c. The patients feelings about her body
d. All of the above
21. Stressors cause the release of the mineralocorticoid aldosterone, which regulates sodium absorption and potassium
excretion in the renal tubules, resulting in:
a. The need for supplemental potassium
b. The need for a low-sodium (500-mg) diet
c. The conservation of water and maintenance of blood volume
d. Increased diuresis
22. In planning the care of a patient who is exposed to multiple stressors such as separation from loved ones, anxiety about
impending surgery, and concern about potential complications or death, the nurse must:
a. Use both a structured and an unstructured format when interviewing the patient
b. Know the stressors affecting the patient
c. Develop the expected outcomes for each nursing diagnosis written for this patient
d. All of the above
23. An accurate method of calculating the daily urine output of an incontinent patient wearing pads or diapers is to:
a. Estimate the urine output
b. Count the number of urine saturated pads
c. Weigh a dry pad and each urine saturated pad and use a conversion calibration to calculate the urine output
d. Weigh all the urine-saturated pads together and use a conversion calibration to calculate the urine output

24. A fashion model is admitted via the emergency room with facial and chest burns. Her hospital stay includes 10 days in
the intensive care unit and 5 days on the regular hospital unit. The patient has not been eating or sleeping and refuses
to perform her activities of daily living (ADLs). She refuses to work with speech and physical therapists. Which of the
following nursing diagnoses might appears on the patients current care plan?
a. Potential for noncompliance: Self-harm related to disturbed body image
b. Self-care deficit related to knowledge deficit and disturbed body image
c. Disturbance in self-concept: Personal identifying related to self-esteem
d. Disturbance in self-concept related to altered thought process
25. White the nurse is providing a patients personal hygiene, she observes that his skin is excessively dry. During this
procedure the patient tells her that he is very thirsty. An appropriate nursing diagnosis would be:
a. Potential for impaired skin integrity related to altered gland function
b. Potential for impaired skin integrity related to dehydration
c. Impaired skin integrity relate to dehydration
d. Impaired skin integrity related to altered circulation

View Questions
1.

Answer B. Arthritis is characterized by joint inflammation that is usually accompanied by pain and frequently
accompanied by changes in structure. Synovitis is the inflammation of the synovial membrane, typically resulting
from a traumatic injury or an aseptic wound. Bursitis is the inflammation of a bursa, typically one located between a
bony prominence and a muscle or tendon. Tendinitis is the inflammation of tendon.

2.

Answer C. Hemoptysis is the expectoration of blood from the respiratory tract. A hemorrhage is abnormal internal
or external bleeding. Hematopoiesis is blood cell formation. Hemopexis is blood coagulation.

3.

Answer B. Ataxia is lack of coordination in performing planned, purposeful movements, typically resulting from a
neurologic deficit. Apraxia is the inability to perform purposeful movements even though no neuromuscular deficit

exists. Fasciculations are fine twitching movements. Myokymia is a transient, spontaneous movement that occurs in
muscle groups after strenuous exercise.
4.

Answer D. Hypercapnia is an elevation in the partial pressure of carbon dioxide in arterial blood (PaCO2).
Hypernatremia is an elevated level of sodium in venous blood (more than 145 mEq/liter). Hypocalcemia is a
decreased level of calcium in venous blood (less than 9 mg/dl). Hypoxemia is a reduced level of oxygen in arterial
blood (less than 80 mm Hg while breathing room air).

5.

Answer B. The combining form penia means deficiency, as in thrombocytopenia (deficiency in the number of
circulating blood plates). Rrhexis is a combining form meaning rupture, as in enterorrhexis (rupture of the intestine).
Plast is a combining form meaning formation, as in rhino-plasty (formation of a nose using plastic surgery). Narco is a
combining form meaning stupor, as in narcolepsy (a condition marked by recurrent attacks of drowsiness and sleep).

6.

Answer B. Fluid volume deficit related to fever is the appropriate nursing diagnosis based on this assessment.
Potential for impaired skin integrity states a possible patient response. Potential for fluid volume deficit caused by
fever implies a cause-and-effect relationship, which a nursing diagnosis should never do. Altered cardiopulmonary
tissue perfusion related to fluid excess is an incorrect diagnosis based on a misinterpretation of the data.

7.

Answer D. A nursing diagnosis is a statement about a patients actual or potential health problem that is within the
scope of independent nursing intervention. Medical terminology is never a part of the nursing diagnosis. An
appropriate nursing diagnosis would be ineffective breathing pattern related to chest pain rather than ineffective
breathing pattern caused by angina.

8.

Answer D. A water-soluble lubricant must be applied to the tip of the catheter to decrease friction and the risk of
injury to the patients nasal mucosa. (If petrolatum or mineral oil were applied to the catheter and then aspirated, the
patient could develop a lipoid pneumonia) The distance from the tip of the nose to the tip of the earlobe is the
approximate distance from the point of insertion to the oropharynx. Sterile distilled water must be used to humidity
the oxygen because oxygen administered by itself is a dry gas that can irritate the mucosa.

9.

Answer A. Patient safety is the major concern in this situation. According to the International Council of Nurses
Code for Nurses: The nurse [should] take appropriate action to safeguard the individual when his or her care is
endangered by a co-worker or any other person. In this case, talking with the head nurse immediately would be the
best way to safeguard the patients safety. The nurse isnt necessarily an addict, she may be abusing a prescription
medication.

10. Answer D. It is the staff nurses responsibility to be on time. The nurse manager should not assume a responsibility
that belongs to the nurse.
11. Answer D. Although Medicare and Medicaid regulations and suggestions made by such groups as the National
Kidney Foundation may serve as guidelines, a hospitals procedure manual details how the nurse should perform her
specific duties. A states nurse practice act defines the scope of practice within that state, but not the specifics for each
area of practice.
12. Answer A. The three elements necessary to establishes nursing malpractice are nursing error (administering
penicillin to a patient with a documented allergy to the drug), injury (cerebral damage), and proximal cause
(administering the penicillin caused the cerebral damage). Applying a hot water bottle or healing pad to a patient
without a physicians order does not include the three required components. Assisting a patient out of bed with the bed
locked in position is the correct nursing practice; therefore, the fracture was not the result of malpractice.
Administering an incorrect medication is a nursing error; however, if such action resulted in a serious illness or
chronic problem, the nurse could be sued for malpractice.

13. Answer B. Therapeutic communication is a two way, deliberative interaction between the patient and nurse in which
they establish mutually acceptable, achievable goals of care. Before the patient can feel comfortable discussing his
problems, however, and atmosphere of trust and acceptance must be established.
14. Answer C. Many variables affect patient nurse communication, including the patients cultural beliefs,
experiences with hospitalization, age, emotional needs, and problems with speech, hearing, or comprehension. A
patient admitted to the hospital for the first time for a scheduled cesarean section is probably anxious, but she had
time to plan for the procedure, does not bring negative experiences from previous hospitalizations, and in most cases
looks forward to the birth.
15. Answer D. Therapeutic communication is a fundamental component at all phases of the nursing process. In the
planning phase, it allows the patient and nurse to formulate mutually acceptable and patient-oriented goals, which are
the basis for developing an individualized care plan. In the implementation phase, effective communication is
necessary for teaching the patient, motivating him to achieve goals, and assessing patient outcomes. Finally, in the
evaluation phase, it is required to determine how well the patient has responded to interventions.
16. Answer C. Objective data are those which can be measured, like glucose levels. A complaint of polydipsia is
subjective information obtained from the patient.
17. Answer D. Peristalsis is the muscular, rhythmic movement in the bowel wall that pushes food along the digestive
tract distally. Increased bowel motility is indicated by rapid, high-pitched, hyperactive bowel sounds. Decreased
bowel sounds, caused by decreased bowel motility, can be the initial sign of paralytic ileus (adynamic intestinal
obstruction resulting from the lack of peristalsis), a common occurrence following abdominal surgery.
18. Answer D. The use of a tilt table for weight-beating exercises, parenteral nutrition, and vitamin therapy are not
independent nursing interventions because they require a physicians order. Unless specifically contraindicated, the
independent nursing interventions listed in A, B, and C may be part of the nursing care plan for an immobilized
patient.
19. Answer A. Independent nursing interventions for a patient with pressure ulcers commonly include changing his
position several times each day to avoid pressure to any part of his body, especially the involved area. Drying agents,
which are prescribed by a physician, are contraindicated because wounds need moisture to heal. Whirlpool therapy
and chemical debridement must be prescribed, and surgical debridement is done by the physician.
20. Answer D. All of the choices will help the nurse determine the extent of the problem. For example, asking how the
patient felt about her body before hospitalization will help the nurse determine whether the disturbed body image is a
crisis brought on by the weight gain or a long-standing problem. Asking what the change means to her will reveal
whether she feels she has control over what is happening or believes the change is permanent. Body image is also
related to how we think we compare to others or whether others find us attractive.
21. Answer C. Because aldosterone regulates the bodys sodium and potassium levels, it acts as an adaptive mechanism
in maintaining blood volume and conserving water. Supplemental potassium usually is given to a patient with a low
serum potassium level or one who is receiving a diuretic or other medication such as digoxin that has a mild
diuretic effect. A low-sodium diet is usually prescribed for a patient with a high serum sodium level, as in congestive
heart failure (CHF), hypertension, or prolonged episodes of edema. Diuresis is increased naturally when a healthy
patient increases his intake of fluids, especially those containing caffeine. Patients receiving diuretics also experience
increased diuresis.
22. Answer D. Interviewing the patient in both a structured and an unstructured format is an important part of the
initial nursing assessment. The structured format uses questions that require a yea-or-no answer to help the nurse
obtain information; the unstructured format uses open-ended questions that allow the patient to express himself more
fully. The interview helps the nurse and patient identify the stressors and develop appropriate outcomes.

23. Answer C. Calculating the difference in weight between a dry pad and a urine saturated pad using conversion
calibration will provide an accurate measure of urine output. For example, if the difference between the dry pad and
the urine-saturated pad is 200 g, the urine output would be 200 ml (1g = 1 ml). The other methods will provide only
an estimate of urine output.
24. Answer C. Disturbances in self-concept may manifest themselves as signs and symptoms of depression, such as
changes in sleep patterns, eating habits, and energy levels. The other nursing diagnoses are not supported by the given
situation.
25. Answer C. An appropriate nursing diagnosis for a patient with excessively dry skin is Impaired skin integrity (actual
not potential) in this case, related to dehydration because the patient complains of thirst. Altered circulation is not
usually an etiologic factor for dry skin.
1.
a.
b.
c.
d.

Which intervention is an example of primary prevention?

Administering digoxin (Lanoxicaps) to a patient with heart failure
Administering a measles, mumps, and rubella immunization to an infant
Obtaining a Papanicolaou smear to screen for cervical cancer
Using occupational therapy to help a patient cope with arthritis

2. The nurse in charge is assessing a patients abdomen. Which examination technique should the nurse use first?
a. Auscultation
b. Inspection
c. Percussion
d. Palpation
3. Which statement regarding heart sounds is correct?
a. S1 and S2 sound equally loud over the entire cardiac area.
b. S1 and S2 sound fainter at the apex
c. S1 and S2 sound fainter at the base
d. S1 is loudest at the apex, and S2 is loudest at the base
4. The nurse in charge identifies a patients responses to actual or potential health problems during which step of the
nursing process?
a. Assessment
b. Nursing diagnosis
c. Planning
d. Evaluation
5. A female patient is receiving furosemide (Lasix), 40 mg P.O. b.i.d. in the plan of care, the nurse should emphasize
teaching the patient about the importance of consuming:
a. Fresh, green vegetables
b. Bananas and oranges
c. Lean red meat
d. Creamed corn
6. The nurse in charge must monitor a patient receiving chloramphenicol for adverse drug reaction. What is the most
toxic reaction to chloramphenicol?
a. Lethal arrhythmias
b. Malignant hypertension
c. Status epilepticus
d. Bone marrow suppression
7. A female patient is diagnosed with deep-vein thrombosis. Which nursing diagnosis should receive highest priority at
this time?
a. Impaired gas exchanges related to increased blood flow
b. Fluid volume excess related to peripheral vascular disease

c. Risk for injury related to edema

d. Altered peripheral tissue perfusion related to venous congestion
8. When positioned properly, the tip of a central venous catheter should lie in the:
a. Superior vena cava
b. Basilica vein
c. Jugular vein
d. Subclavian vein
9. Nurse Margareth is revising a clients care plan. During which step of the nursing process does such revision take
place?
a. Assessment
b. Planning
c. Implementation
d. Evaluation
10. A 65-year-old female who has diabetes mellitus and has sustained a large laceration on her left wrist asks the nurse,
How long will it take for my scars to disappear? which statement would be the nurses best response?
a. The contraction phase of wound healing can take 2 to 3 years.
b. Wound healing is very individual but within 4 months the scar should fade.
c. With your history and the type of location of the injury, its hard to say.
d. If you dont develop an infection, the wound should heal any time between 1 and 3 years from now.
11.
a.
b.
c.
d.

One aspect of implementation related to drug therapy is:

Developing a content outline
Documenting drugs given
Establishing outcome criteria
Setting realistic client goals

12. A female client is readmitted to the facility with a warm, tender, reddened area on her right calf. Which contributing
factor would the nurse recognize as most important?
a. A history of increased aspirin use
b. Recent pelvic surgery
c. An active daily walking program
d. A history of diabetes
13.
a.
b.
c.
d.

Which intervention should the nurse in charge try first for a client that exhibits signs of sleep disturbance?
Administer sleeping medication before bedtime
Ask the client each morning to describe the quantity of sleep during the previous night
Teach the client relaxation techniques, such as guided imagery, medication, and progressive muscle relaxation
Provide the client with normal sleep aids, such as pillows, back rubs, and snacks

14. While examining a clients leg, the nurse notes an open ulceration with visible granulation tissue in the wound. Until
a wound specialist can be contacted, which type of dressings is most appropriate for the nurse in charge to apply?
a. Dry sterile dressing
b. Sterile petroleum gauze
c. Moist, sterile saline gauze
d. Povidone-iodine-soaked gauze
15. A male client in a behavioral-health facility receives a 30-minute psychotherapy session, and provider uses a current
procedure terminology (CPT) code that bills for a 50-minute session. Under the False Claims Act, such illegal behavior is
known as:
a. Unbundling
b. Overbilling
c. Upcoding
d. Misrepresentation
16. A nurse assigned to care for a postoperative male client who has diabetes mellitus. During the assessment interview,
the client reports that hes impotent and says that hes concerned about its effect on his marriage. In planning this clients

care, the most appropriate intervention would be to:

a. Encourage the client to ask questions about personal sexuality
b. Provide time for privacy
c. Provide support for the spouse or significant other
d. Suggest referral to a sex counselor or other appropriate professional
17.
a.
b.
c.
d.

Using Abraham Maslows hierarchy of human needs, a nurse assigns highest priority to which client need?
Security
Elimination
Safety
Belonging

18. A male client is on prolonged bed rest has developed a pressure ulcer. The wound shows no signs of healing even
though the client has received skin care and has been turned every 2 hours. Which factor is most likely responsible for the
failure to heal?
a. Inadequate vitamin D intake
b. Inadequate protein intake
c. Inadequate massaging of the affected area
d. Low calcium level
19. A female client who received general anesthesia returns from surgery. Postoperatively, which nursing diagnosis takes
highest priority for this client?
a. Acute pain related to surgery
b. Deficient fluid volume related to blood and fluid loss from surgery
c. Impaired physical mobility related to surgery
d. Risk for aspiration related to anesthesia
20.
a.
b.
c.
d.

Nurse Cay inspects a clients back and notices small hemorrhagic spots. The nurse documents that the client has:
Extravasation
Osteomalacia
Petechiae
Uremia

21.
a.
b.
c.
d.

Which document addresses the clients right to information, informed consent, and treatment refusal?
Standard of Nursing Practice
Patients Bill of Rights
Nurse Practice Act
Code for Nurses

22. If a blood pressure cuff is too small for a client, blood pressure readings taken with such a cuff may do which of the
following?
a. Fail to show changes in blood pressure
b. Produce a false-high measurement
c. Cause sciatic nerve damage
d. Produce a false-low measurement
23. Nurse Danny has been teaching a client about a high-protein diet. The teaching is successful if the client identifies
which meal as high in protein?
a. Baked beans, hamburger, and milk
b. Spaghetti with cream sauce, broccoli, and tea
c. Bouillon, spinach, and soda
d. Chicken cutlet, spinach, and soda
24. A male client is admitted to the hospital with blunt chest trauma after a motor vehicle accident. The first nursing
priority for this client would be to:
a. Assess the clients airway
b. Provide pain relief
c. Encourage deep breathing and coughing
d. Splint the chest wall with a pillow

25. A newly hired charge nurse assesses the staff nurses as competent individually but ineffective and nonproductive as a
team. In addressing her concern, the charge nurse should understand that the usual reason for such a situation is:
a. Unhappiness about the charge in leadership
b. Unexpected feeling and emotions among the staff
c. Fatigue from overwork and understaffing
d. Failure to incorporate staff in decision making
26. A male client blood test results are as follows: white blood cell (WBC) count, 100ul; hemoglobin (Hb) level, 14 g/dl;
hematocrit (HCT), 40%. Which goal would be most important for this client?
a. Promote fluid balance
b. Prevent infection
c. Promote rest
d. Prevent injury
27. Following a tonsillectomy, a female client returns to the medical-surgical unit. The client is lethargic and reports
having a sore throat. Which position would be most therapeutic for this client?
a. Semi-Fowlers
b. Supine
c. High-Fowlers
d. Side-lying
28. Nurse Berri inspects a clients pupil size and determines that its 2 mm in the left eye and 3 mm in the right eye.
Unequal pupils are known as:
a. Anisocoria
b. Ataxia
c. Cataract
d. Diplopia
29. The nurse in charge is caring for an Italian client. Hes complaining of pain, but he falls asleep right after his
complaint and before the nurse can assess his pain. The nurse concludes that:
a. He may have a low threshold for pain
b. He was faking pain
c. Someone else gave him medication
d. The pain went away
30. A female client is admitted to the emergency department with complaints of chest pain shortness of breath. The
nurses assessment reveals jugular vein distention. The nurse knows that when a client has jugular vein distension, its
typically due to:
a. A neck tumor
b. An electrolyte imbalance
c. Dehydration
d. Fluid overload

1.

2.

Answer B. Immunizing an infant is an example of primary prevention, which aims to prevent health problems.
Administering digoxin to treat heart failure and obtaining a smear for a screening test are examples for secondary
prevention, which promotes early detection and treatment of disease. Using occupational therapy to help a
patient cope with arthritis is an example of tertiary prevention, which aims to help a patient deal with the residual
consequences of a problem or to prevent the problem from recurring.
Answer B. Inspection always comes first when performing a physical examination. Percussion and palpation of
the abdomen may affect bowel motility and therefore should follow auscultation.

3.

Answer D. The S1 soundthe lub soundis loudest at the apex of the heart. It sounds longer, lower, and
louder there than the S2 sounds. The S2the dub soundis loudest at the base. It sounds shorter, sharper,
higher, and louder there than S1.

4.

Answer B. The nurse identifies human responses to actual or potential health problems during the nursing
diagnosis step of the nursing process. During the assessment step, the nurse systematically collects data about the
patient or family. During the planning step, the nurse develops strategies to resolve or decrease the patients
problem. During the evaluation step, the nurse determines the effectiveness of the plan of care.

5.

Answer B. Because furosemide is a potassium-wasting diuretic, the nurse should plan to teach the patient to
increase intake of potassium-rich foods, such as bananas and oranges. Fresh, green vegetables; lean red meat;
and creamed corn are not good sources of potassium.

6.

Answer D. The most toxic reaction to chloramphenicol is bone marrow suppression. Chloramphenicol is not
known to cause lethal arrhythmias, malignant hypertension, or status epilepticus.

7.

Answer D. Altered peripheral tissue perfusion related to venous congestion takes highest priority because
venous inflammation and clot formation impede blood flow in a patient with deep-vein thrombosis. Option A is
incorrect because impaired gas exchange is related to decreased, not increased, blood flow. Option B is
inappropriate because no evidence suggest that this patient has a fluid volume excess. Option C may be
warranted but is secondary to altered tissue perfusion.

8.

Answer A. When the central venous catheter is positioned correctly, its tip lies in the superior vena cava, inferior
vena cava, or the right atriumthat is, in central venous circulation. Blood flows unimpeded around the tip,
allowing the rapid infusion of large amounts of fluid directly into circulation. The basilica, jugular, and
subclavian veins are common insertion sites for central venous catheters.

9.

Answer D. During the evaluation step of the nursing process the nurse determines whether the goals established
in the care plan have been achieved, and evaluates the success of the plan. If a goal is unmet or partially met the
nurse reexamines the data and revises the plan. Assessment involves data collection. Planning involves setting
priorities, establishing goals, and selecting appropriate interventions.

10. Answer C. Wound healing in a client with diabetes will be delayed. Providing the client with a time frame could
give the client false information.
11. Answer B. Although documentation isnt a step in the nursing process, the nurse is legally required to document
activities related to drug therapy, including the time of administration, the quantity, and the clients reaction.
Developing a content outline, establishing outcome criteria, and setting realistic client goals are part of planning
rather than implementation.
12. Answer B. The client shows signs of deep vein thrombosis (DVT). The pelvic area is rich in blood supply, and
thrombophlebitis of the deep vein is associated with pelvic surgery. Aspirin, an antiplatelet agent, and an active
walking program help decrease the clients risk of DVT. In general, diabetes is a contributing factor associated
with peripheral vascular disease.
13. Answer D. The nurse should begin with the simplest interventions, such as pillows or snacks, before
interventions that require greater skill such as relaxation techniques. Sleep medication should be avoided
whenever possible. At some point, the nurse should do a thorough sleep assessment, especially if common sense
interventions fail.
14. Answer C. Moist, sterile saline dressings support would heal and are cost-effective. Dry sterile dressings adhere
to the wound and debride the tissue when removed. Petroleum supports healing but is expensive. Povidoneiodine can irritate epithelial cells, so it shouldnt be left on an open wound.
15. Answer C. Upcoding is the practice of using a CPT code thats reimbursed at a higher rate than the code for the
service actually provided. Unbundling, overbilling, and misrepresentation arent the terms used for this illegal
practice.
16. Answer D. The nurse should refer this client to a sex counselor or other professional. Making appropriate
referrals is a valid part of planning the clients care. The nurse doesnt normally provide sex counseling.
Therefore, providing time for privacy and providing support for the spouse or significant other are important, but
not as important as referring the client to a sex counselor.
17. Answer B. According to Maslow, elimination is a first-level or physiological need, and therefore takes priority
over all other needs. Security and safety are second-level needs; belonging is a third-level need. Second- and
third-level needs can be met only after a clients first-level needs have been satisfied.
18. Answer B. A client on bed rest suffers from a lack of movement and a negative nitrogen balance. Therefore,
inadequate protein intake impairs wound healing. Inadequate vitamin D intake and low calcium levels arent
factors in poor healing for this client. A pressure ulcer should never be massaged.

19. Answer D. Risk for aspiration related to anesthesia takes priority for thins client because general anesthesia may
impair the gag and swallowing reflexes, possibly leading to aspiration. The other options, although important, are
secondary.
20. Answer C. Petechiae are small hemorrhagic spots. Extravasation is the leakage of fluid in the interstitial space.
Osteomalacia is the softening of bone tissue. Uremia is an excess of urea and other nitrogen products in the
blood.
21. Answer B. The Patients Bill of Rights addresses the clients right to information, informed consent, timely
responses to requests for services, and treatment refusal. A legal document, it serves as a guideline for the nurses
decision making. Standards of Nursing Practice, the Nurse Practice Act, and the Code for Nurses contain nursing
practice parameters and primarily describe the use of the nursing process in providing care.
22. Answer B. Using an undersized blood pressure cuff produces a falsely elevated blood pressure because the cuff
cant record brachial artery measurements unless its excessively inflated. The sciatic nerve wouldnt be damaged
by hyperinflation of the blood pressure cuff because the sciatic nerve is located in the lower extremity.
23. Answer A. Baked beans, hamburger, and milk are all excellent sources of protein. The spaghetti-broccoli-tea
choice is high in carbohydrates. The bouillon-spinach-soda choice provides liquid and sodium as well as some
iron, vitamins, and carbohydrates. Chicken provides protein but the chicken-spinach-soda combination provides
less protein than the baked beans-hamburger-milk selection.
24. Answer A. The first priority is to evaluate airway patency before assessing for signs of obstruction, sternal
retraction, stridor, or wheezing. Airway management is always the nurses first priority. Pain management and
splinting are important for the clients comfort, but would come after airway assessment. Coughing and deep
breathing may be contraindicated if the client has internal bleeding and other injuries.
25. Answer B. The usual or most prevalent reason for lack of productivity in a group of competent nurses is
inadequate communication or a situation in which the nurses have unexpected feeling and emotions. Although
the other options could be contributing to the problematic situation, theyre less likely to be the cause.
26. Answer B. The client is at risk for infection because WBC count is dangerously low. Hb level and HCT are
within normal limits; therefore, fluid balance, rest, and prevention of injury are inappropriate.
27. Answer D. Because of lethargy, the post tonsillectomy client is at risk for aspirating blood from the surgical
wound. Therefore, placing the client in the side-lying position until he awake is best. The semi-Fowlers, supine,
and high-Fowlers position dont allow for adequate oral drainage in a lethargic post tonsillectomy client, and
increase the risk of blood aspiration.
28. Answer A. Unequal pupils are called anisocoria. Ataxia is uncoordinated actions of involuntary muscle use. A
cataract is an opacity of the eyes lens. Diplopia is double vision.
29. Answer A. People of Italian heritage tend to verbalize discomfort and pain. The pain was real to the client, and he
may need medication when he wakes up.
30. Answer D. Fluid overload causes the volume of blood within the vascular system to increase. This increase
causes the vein to distend, which can be seen most obviously in the neck veins. A neck tumor doesnt typically
cause jugular vein distention. An electrolyte imbalance may result in fluid overload, but it doesnt directly
contribute to jugular vein distention.

1. A 65-year-old patient with pneumonia is receiving garamycin (Gentamicin). It would be MOST important for a nurse to
monitor which of the following laboratory values in this patient?
(A) Hemoglobin and hematocrit.
(B) BUN and creatinine.
(C) Platelet count and clotting time.
(D) Sodium and potassium.

2. A 22-year-old man is admitted to the hospital with complaints of fatigue and weight loss. Physical examination reveals
pallor and multiple bruises on his arms and legs. The results of the patients tests reveal acute lymphocytic leukemia and
thrombocytopenia. Which of the following nursing diagnoses MOST accurately reflects his condition?
(A) Potential for injury.
(B) Self-care deficit.
(C) Potential for self-harm.
(D) Alteration in comfort.
3. To enhance the percutaneous absorption of nitroglycerine ointment, it would be MOST important for the nurse to select
a site that is
(A) muscular.
(B) near the heart.
(C) non-hairy.
(D) over a bony prominence.
4. A man is admitted to the Telemetry Unit for evaluation of complaints of chest pain. Eight hours after admission, the
patient goes into ventricular fibrillation. The physician defibrillates the patient. The nurse understands that the purpose of
defibrillation is to:
(A) increase cardiac contractility and cardiac output.
(B) cause asystole so the normal pacemaker can recapture.
(C) reduce cardiac ischemia and acidosis.
(D) provide energy for depleted myocardial cells.
5. A patient is to receive 3,000 ml of 0.9% NaCl IV in 24 hours. The intravenous set delivers 15 drops per milliliter. The
nurse should regulate the flow rate so that the patient receives how many drops of fluid per minute?
(A) 21
(B) 28
(C) 31
(D) 42

ANSWERS AND RATIONALE

1. The correct answer is B.
Question: Which lab values should you monitor for a patient receiving Gentamicin?
Needed Info: Gentamicin: broad spectrum antibiotic. Side effects: neuromuscular blockage, ototoxic to eighth cranial nerve
(tinnitus, vertigo, ataxia, nystagmus, hearing loss), nephrotoxic. Nursing responsibilities: monitor renal function, force
fluids, monitor hearing acuity. Draw blood for peak levels 1 hr. after IM and 30 min 1 hr. after IV infusion, draw blood
for trough just before next dose.
(A) Hemoglobin and hematocrit can cause anemia; less common
(B) BUN and creatinine CORRECT: nephrotoxic; will see proteinuria, oliguria, hematuria, thirst, increased BUN,
decreased creatine clearance
(C) Platelet count and clotting time do not usually change
(D) Sodium and potassium hypokalemia infrequent problem
2. The correct answer is A.
Question: What nursing diagnosis is seen with acute lymphocytic leukemia and thromocytopenia?

Needed Info: Thromocytopenia: decreased platelet count increases the patients risk for injury, normal count: 200,000400,000 per mm3. Leukemia: group of malignant disorders involving overproduction of immature leukocytes in bone
marrow. This shuts down normal bone marrow production of erythrocytes, platelets, normal leukocytes. Causes anemia,
leukopenia, and thrombocytopenia leading to infection and hemorrhage. Symptoms: pallor of nail beds and conjunctiva,
petechiae (small hemorrhagic spot on skin), tachycardia, dyspnea, weight loss, fatigue. Treatment: chemotherapy,
antibiotics, blood transfusions, bone marrow transplantation. Nursing responsibilities: private room, no raw fruits or vegs,
small frequent meals, O2, good skin care.
(A) Potential for injury CORRECT: low platelet increases risk of bleeding from even minor injuries. Safety
measures: shave with an electric razor, use soft tooth brush, avoid SQ or IM meds and invasive procedures (urinary
drainage catheter or a nasogastric tube), side-rails up, remove sharp objects, frequently assess for signs of bleeding,
bruising, hemorrhage.
(B) Self-care deficit may feel weak, doesnt address condition
(C) Potential for self-harm implies risk for purposeful self-injury, not given any info, assumption
(D) Alteration in comfort patient is not comfortable, and comfort measures would address problem
3. The correct answer is C.
Question: What is the best site for nitroglycerine ointment?
Strategy: Think about each site.
Needed Info: Nitroglycerine: used in treatment of angina pectoris to reduce ischemia and relieve pain by decreasing
myocardial oxygen consumption; dilates veins and arteries. Side effects: throbbing headache, flushing, hypotension,
tachycardia. Nursing responsibilities: teach appropriate administration, storage, expected pain relief, side effects. Ointment
applied to skin; sites rotated to avoid skin irritaion. Prolonged effect up to 24 hours.
(A) muscular not most important
(B) near the heart not most important
(C) non-hairy CORRECT: skin site free of hair will increase absorption; avoid distal part of extremities due to
less than maximal absorption
(D) over a bony prominence most important is that the site be non-hairy
4. The correct answer is B.
Question: Why is a patient defibrillated?
Strategy: Think about each answer choice.
Needed Info: Defibrillation: produces asystole of heart to provide opportunity for natural pacemaker (SA node) to resume
as pacer of heart activity.
(A) increase cardiac contractility and cardiac output inaccurate
(B) cause asystole so the normal pacemaker can recapture CORRECT: allows SA node to resume as pacer of heart
activity
(C) reduce cardiac ischemia and acidosis inaccurate
(D) provide energy for depleted myocardial cells inaccurate
5. The correct answer is C.
Question: How should you regulate the IV flow rate?
Strategy: Use formula and avoid making math errors.
Needed Info: total volume x the drop factor divided by the total time in minutes.

(A) 21 inaccurate
(B) 28 inaccurate
(C) 31 CORRECT: 3,000 x 15 divided by 24 x 60
(D) 42 inaccurate
Psychosocial Integrity
1. An adolescent male being treated for depression arrives with his family at the Adolescent Day Treatment Center
for an initial therapy meeting with the staff. The nurse explains that one of the goals of the family meeting is to
encourage the adolescent to:
(A) trust the nurse who will solve his problem.
(B) learn to live with anxiety and tension.
(C) accept responsibility for his actions and choices.
(D) use the members of the therapeutic milieu to solve his problems.
2. A 23-year-old-woman comes to the emergency room stating that she had been raped. Which of the following
statements BEST describes the nurses responsibility concerning written consent?
(A) The nurse should explain the procedure to the patient and ask her to sign the consent form.
(B) The nurse should verify that the consent form has been signed by the patient and that it is attached to her chart.
(C) The nurse should tell the physician that the patient agrees to have the examination.
(D) The nurse should verify that the patient or a family member has signed the consent form.
3. The nurse cares for an elderly patient with moderate hearing loss. The nurse should teach the patients family to
use which of the following approaches when speaking to the patient?
(A) Raise your voice until the patient is able to hear you.
(B) Face the patient and speak quickly using a high voice.
(C) Face the patient and speak slowly using a slightly lowered voice.
(D) Use facial expressions and speak as you would normally.
4. A 52-year-old man is admitted to a hospital after sustaining a severe head injury in an automobile accident. When
the patient dies, the nurse observes the patients wife comforting other family members. Which of the following
interpretations of this behavior is MOST justifiable?
(A) She has already moved through the stages of the grieving process.
(B) She is repressing anger related to her husbands death.
(C) She is experiencing shock and disbelief related to her husbands death.
(D) She is demonstrating resolution of her husbands death.
5. After two weeks of receiving lithium therapy, a patient in the psychiatric unit becomes depressed. Which of the
following evaluations of the patients behavior by the nurse would be MOST accurate?
(A) The treatment plan is not effective; the patient requires a larger dose of lithium.
(B) This is a normal response to lithium therapy; the patient should continue with the current treatment plan.
(C) This is a normal response to lithium therapy; the patient should be monitored for suicidal behavior.
(D) The treatment plan is not effective; the patient requires an antidepressant.

ANSWERS AND RATIONALE

1. The correct answer is C.

Question: What is the goal of family therapy?
Needed Info: Symptoms of depression: a low self-esteem, obsessive thoughts, regressive behavior, unkempt appearance, a
lack of energy, weight loss, decreased concentration, withdrawn behavior.
(A) trust the nurse who will solve his problem not realistic
(B) learn to live with anxiety and tension minimizes concerns
(C) accept responsibility for his actions and choices CORRECT
(D) use the members of the therapeutic milieu to solve his problems must do it himself
2. The correct answer is B.
Question: What is your responsibility concerning informed consent?
Needed Info: Physicians responsibility to obtain informed consent.
(A) The nurse should explain the procedure to the patient and ask her to sign the consent form Physician should get
patient to sign consent
(B) The nurse should verify that the consent form has been signed by the patient and that it is attached to her chart
CORRECT
(C) The nurse should tell the physician that the patient agrees to have the examination Physician should explain
procedure and get consent form signed
(D) The nurse should verify that the patient or a family member has signed the consent form must be signed by patient
unless unable to do
3. The correct answer is C.
Question: What should you do to communicate with a person with a moderate hearing loss?
Needed Info: Presbycusis: age-related hearing loss due to inner ear changes. Decreased ability to hear high sounds.
(A) Raise your voice until the patient is able to hear you would result in high tones patient unable to hear
(B) Face the patient and speak quickly using a high voice usually unable to hear high tones
(C) Face the patient and speak slowly using a slightly lowered voice CORRECT: also decrease background noise;
speak at a slow pace, use nonverbal cues
(D) Use facial expressions and speak as you would normally nonverbal cues help, but need low tones
4. The correct answer is C.
Question: What is the reason for the wifes behavior?
Needed Info: Stages of grief: 1) shock and disbelief, 2) awareness of pain and loss, 3) restitution. Acute period: 4-8 weeks,
usual resolution: 1 year.
(A) She has already moved through the stages of the grieving process takes one year
(B) She is repressing anger related to her husbands death not accurate; second stage: crying, regression
(C) She is experiencing shock and disbelief related to her husbands death CORRECT: denial first stage; inability to
comprehend reality of situation
(D) She is demonstrating resolution of her husbands death too soon
5. The correct answer is C.
Question: Is the depression normal, or something to be concerned about?

(A) The treatment plan is not effective; the patient requires a larger dose of lithium not accurate
(B) This is a normal response to lithium therapy; the patient should continue with the current treatment plan does not
address safety needs
(C) This is a normal response to lithium therapy; the patient should be monitored for suicidal behavior CORRECT:
delay of 1-3 weeks before med benefits seen
(D) The treatment plan is not effective; the patient requires an antidepressant normal response
(Foundation of Nursing)
1. The most important nursing intervention to correct skin dryness is:
a. Avoid bathing the patient until the condition is remedied, and notify the physician
b. Ask the physician to refer the patient to a dermatologist, and suggest that the patient wear home-laundered
sleepwear
c. Consult the dietitian about increasing the patients fat intake, and take necessary measures to prevent infection
d. Encourage the patient to increase his fluid intake, use nonirritating soap when bathing the patient, and apply
lotion to the involved areas
2. When bathing a patients extremities, the nurse should use long, firm strokes from the distal to the proximal areas. This
technique:
a. Provides an opportunity for skin assessment
b. Avoids undue strain on the nurse
c. Increases venous blood return
d. Causes vasoconstriction and increases circulation
3. Vivid dreaming occurs in which stage of sleep?
a. Stage I non-REM
b. Rapid eye movement (REM) stage
c. Stage II non-REM
d. Delta stage
4. The natural sedative in meat and milk products (especially warm milk) that can help induce sleep is:
a. Flurazepam
b. Temazepam
c. Tryptophan
d. Methotrimeprazine

5. Nursing interventions that can help the patient to relax and sleep restfully include all of the following except:
a. Have the patient take a 30- to 60-minute nap in the afternoon
b. Turn on the television in the patients room
c. Provide quiet music and interesting reading material
d. Massage the patients back with long strokes
6. Restraints can be used for all of the following purposes except to:
a. Prevent a confused patient from removing tubes, such as feeding tubes, I.V. lines, and urinary catheters
b. Prevent a patient from falling out of bed or a chair
c. Discourage a patient from attempting to ambulate alone when he requires assistance for his safety
d. Prevent a patient from becoming confused or disoriented
7. Which of the following is the nurses legal responsibility when applying restraints?
a. Document the patients behavior
b. Document the type of restraint used
c. Obtain a written order from the physician except in an emergency, when the patient must be protected from
injury to himself or others
d. All of the above
8. Kubler-Rosss five successive stages of death and dying are:
a. Anger, bargaining, denial, depression, acceptance
b. Denial, anger, depression, bargaining, acceptance
c. Denial, anger, bargaining, depression acceptance
d. Bargaining, denial, anger, depression, acceptance
9. A terminally ill patient usually experiences all of the following feelings during the anger stage except:
a. Rage
b. Envy
c. Numbness
d. Resentment

10. Nurses and other health care provides often have difficulty helping a terminally ill patient through the
necessary stages leading to acceptance of death. Which of the following strategies is most helpful to the nurse in
achieving this goal?
a. Taking psychology courses related to gerontology
b. Reading books and other literature on the subject of thanatology
c. Reflecting on the significance of death
d. Reviewing varying cultural beliefs and practices related to death
11. Which of the following symptoms is the best indicator of imminent death?
a. A weak, slow pulse
b. Increased muscle tone
c. Fixed, dilated pupils
d. Slow, shallow respirations
12. A nurse caring for a patient with an infectious disease who requires isolation should refers to guidelines published by
the:
a. National League for Nursing (NLN)
b. Centers for Disease Control (CDC)
c. American Medical Association (AMA)
d. American Nurses Association (ANA)
13. To institute appropriate isolation precautions, the nurse must first know the:
a. Organisms mode of transmission
b. Organisms Gram-staining characteristics
c. Organisms susceptibility to antibiotics
d. Patients susceptibility to the organism
14. Which is the correct procedure for collecting a sputum specimen for culture and sensitivity testing?
a. Have the patient place the specimen in a container and enclose the container in a plastic bag
b. Have the patient expectorate the sputum while the nurse holds the container

c. Have the patient expectorate the sputum into a sterile container

d. Offer the patient an antiseptic mouthwash just before he expectorate the sputum
15. An autoclave is used to sterilize hospital supplies because:
a. More articles can be sterilized at a time
b. Steam causes less damage to the materials
c. A lower temperature can be obtained
d. Pressurized steam penetrates the supplies better
16. The best way to decrease the risk of transferring pathogens to a patient when removing contaminated gloves is to:
a. Wash the gloves before removing them
b. Gently pull on the fingers of the gloves when removing them
c. Gently pull just below the cuff and invert the gloves when removing them
d. Remove the gloves and then turn them inside out
17. After having an I.V. line in place for 72 hours, a patient complains of tenderness, burning, and swelling. Assessment of
the I.V. site reveals that it is warm and erythematons. This usually indicates:
a. Infection
b. Infiltration
c. Phlebitis
d. Bleeding
18. To ensure homogenization when diluting powdered medication in a vial, the nurse should:
a. Shake the vial vigorously
b. Roll the vial gently between the palms
c. Invert the vial and let it stand for 1 minute
d. Do nothing after adding the solution to the vial
19. The nurse is teaching a patient to prepare a syringe with 40 units of U-100 NPH insulin for self-injection. The patients
first priority concerning self-injection in this situation is to:
a. Assess the injection site

b. Select the appropriate injection site

c. Check the syringe to verify that the nurse has removed the prescribed insulin dose
d. Clean the injection site in a circular manner with and alcohol sponge
20. The physicians order reads Administer 1 g cefazolin sodium (Ancef) in 150 ml of normal saline solution in 60
minutes. What is the flow rate if the drop factor is 10 gtt = 1 ml?
a. 25 gtt/minute
b. 37 gtt/minute
c. 50 gtt/minute
d. 60 gtt/minute
21. A patient must receive 50 units of Humulin regular insulin. The label reads 100 units = 1 ml. How many milliliters
should the nurse administer?
a. 0.5 ml
b. 0.75 ml
c. 1 ml
d. 2 ml
22. How should the nurse prepare an injection for a patient who takes both regular and NPH insulin?
a. Draw up the NPH insulin, then the regular insulin, in the same syringe
b. Draw up the regular insulin, then the NPH insulin, in the same syringe
c. Use two separate syringe
d. Check with the physician
23. A patient has just received 30 mg of codeine by mouth for pain. Five minutes later he vomits. What should the nurse do
first?
a. Call the physician
b. Remedicate the patient
c. Observe the emesis
d. Explain to the patient that she can do nothing to help him
24. A patient is characterized with a #16 indwelling urinary (Foley) catheter to determine if:

a. Trauma has occurred

b. His 24-hour output is adequate
c. He has a urinary tract infection
d. Residual urine remains in the bladder after voiding
25. A staff nurse who is promoted to assistant nurse manager may feel uncomfortable initially when supervising her former
peers. She can best decrease this discomfort by:
a. Writing down all assignments
b. Making changes after evaluating the situation and having discussions with the staff.
c. Telling the staff nurses that she is making changes to benefit their performance
d. Evaluating the clinical performance of each staff nurse in a private conference
1. Answer D. Dry skin will eventually crack, ranking the patient more prone to infection. To prevent this, the nurse
should provide adequate hydration through fluid intake, use nonirritating soaps or no soap when bathing the patient,
and lubricate the patients skin with lotion. Bathing may be limited but need not be avoided entirely. The attending
physician and dietitian may be consulted for treatment, but home-laundered items usually are not necessary.
2. Answer C. Washing from distal to proximal areas stimulates venous blood flow, thereby preventing venous stasis. It
improves circulation but does not result in vasoconstriction. The nurse can assess the patients condition throughout
the bath, regardless of washing technique, and should feel no strain while bathing the patient.
3. Answer B. Other characteristics of rapid eye movement (REM) sleep are deep sleep (the patient cannot be awakened
easily), depressed muscle tone, and possibly irregular heart and respiratory rates. Non-REM sleep is a deep, restful
sleep without dreaming. Delta stage, or slow-wave sleep, occurs during non-REM Stages III and IV and is often
equated with quiet sleep.
4. Answer C. Tryptophan is a natural sedative; flurazepam (Dalmane), temazepam (Restoril), and methotrimeprazine
(Levoprome) are hypnotic sedatives.
5. Answer A. Napping in the afternoon is not conductive to nighttime sleeping. Quiet music, watching television,
reading, and massage usually will relax the patient, helping him to fall asleep.
6. Answer D. By restricting a patients movements, restraints may increase stress and lead to confusion, rather than
prevent it. The other choices are valid reasons for using restraints.
7. Answer D. When applying restraints, the nurse must document the type of behavior that prompted her to use them,
document the type of restraints used, and obtain a physicians written order for the restraints.
8. Answer C. Kubler-Rosss five successive stages of death and dying are denial, anger, bargaining, depression, and
acceptance. The patient may move back and forth through the different stages as he and his family members react to
the process of dying, but he usually goes through all of these stages to reach acceptance.
9. Answer C. Numbness is typical of the depression stage, when the patient feels a great sense of loss. The anger stage
includes such feelings as rage, envy, resentment, and the patients questioning Why me?

10. Answer C. According to thanatologists, reflecting on the significance of death helps to reduce the fear of death and
enables the health care provider to better understand the terminally ill patients feelings. It also helps to overcome the
belief that medical and nursing measures have failed, when a patient cannot be cured.
11. Answer C. Fixed, dilated pupils are sign of imminent death. Pulse becomes weak but rapid, muscles become
weak and atonic, and periods of apnea occur during respiration.
12. Answer B. The Center of Disease Control (CDC) publishes and frequently updates guidelines on caring for patients
who require isolation. The National League of Nursings (NLNs) major function is accrediting nursing education
programs in the
United States. The American Medical Association (AMA) is a national organization of physicians. The American
Nurses Association (ANA) is a national organization of registered nurses.

13. Answer A. Before instituting isolation precaution, the nurse must first determine the organisms mode of
transmission. For example, an organism transmitted through nasal secretions requires that the patient be kept in
respiratory isolation, which involves keeping the patient in a private room with the door closed and wearing a mask, a
grown, and gloves when coming in direct contact with the patient. The organisms Gram-straining characteristics
reveal whether the organism is gram-negative or gram-positive, an important criterion in the physicians choice for
drug therapy and the nurses development of an effective plan of care. The nurse also needs to know whether the
organism is susceptible to antibiotics, but this could take several days to determine; if she waits for the results before
instituting isolation precautions, the organism could be transmitted in the meantime. The patients susceptibility to the
organism has already been established. The nurse would not be instituting isolation precautions for a noninfected
patient.
14. Answer C. Placing the specimen in a sterile container ensures that it will not become contaminated. The other
answers are incorrect because they do not mention sterility and because antiseptic mouthwash could destroy the
organism to be cultured (before sputum collection, the patient may use only tap water for nursing the mouth).
15. Answer D. An autoclave, an apparatus that sterilizes equipment by means of high-temperature pressured steam, is
used because it can destroy all forms of microorganisms, including spores.
16. Answer C. Turning the gloves inside out while removing them keeps all contaminants inside the gloves. They should
than be placed in a plastic bag with soiled dressings and discarded in a soiled utility room garbage pail (double
bagged). The other choices can spread pathogens within the environment.
17. Answer C. Tenderness, warmth, swelling, and, in some instances, a burning sensation are signs and symptoms of
phlebitis. Infection is less likely because no drainage or fever is present. Infiltration would result in swelling and
pallor, not erythema, near the insertion site. The patient has no evidence of bleeding.
18. Answer B. Gently rolling a sealed vial between the palms produces sufficient heat to enhance dissolution of a
powdered medication. Shaking the vial vigorously can break down the medication and alter its pharmacologic action.
Inverting the vial or leaving it alone does not ensure thorough homogenization of the powder and the solvent.
19. Answer C. When the nurse teaches the patient to prepare an insulin injection, the patients first priority is to validate
the dose accuracy. The next steps are to select the site, assess the site, and clean the site with alcohol before injecting
the insulin.
20. Answer A. 25 gtt/minute
21. Answer A. 0.5 ml

22. Answer B. Drugs that are compatible may be mixed together in one syringe. In the case of insulin, the shorter-acting,
clear insulin (regular) should be drawn up before the longer-acting, cloudy insulin (NPH) to ensure accurate
measurements.
23. Answer C. After a patient has vomited, the nurse must inspect the emesis to document color, consistency, and
amount. In this situation, the patient recently ingested medication, so the nurse needs to check for remnants of the
medication to help determine whether the patient retained enough of it to be effective. The nurse must then notify the
physician, who will decide whether to repeat the dose or prescribe an antiemetic.
24. Answer B. A 24-hour urine output of less than 500 ml in an adult is considered inadequate and may indicate kidney
failure. This must be corrected while the patient is in the acute state so that appropriate fluids, electrolytes, and
medications can be administered and excreted. Indwelling catheterization is not needed to diagnose trauma, urinary
tract infection, or residual urine.
25. Answer B. A new assistant nurse manger should not make changes until she has had a chance to evaluate staff
members, patients, and physicians. Changes must be planned thoroughly and should be based on a need to improve
conditions, not just for the sake of change. Written assignments allow all staff members to know their own and others
responsibilities and serve as a checklist for the manager, enabling her to gauge whether the unit is being run
effectively and whether patients are receiving appropriate care. Telling the staff nurses that she is making changes to
benefit their performance should occur only after the nurse has made a thorough evaluation. Evaluations are usually
done on a yearly basis or as needed.
1) Which is not a quality of a self-actualised person?
a) Humor
b) Dependent
c) Good relationship
d) Problem centered in approach

2) Anxiety is always present and accompanied by a feeling of dread is termed as;

a) Signal anxiety
b) Anxiety state
c) Free Floating anxiety
d) Anxiety trait
3) Which is not a part of the rehabilitation plan of the mentally ill patients?
a) Regular medication
b) Avoiding crisis support
c) Skills training
d) Specialized training for vocation
4) Intelligent quotient ( IQ)level of 20-34 indicates?
a) Mild mental retardation
b) Moderate mental retardation
c) Profound mental retardation
d) Severe mental retardation
5) Which drug is found to be most useful in the treatment of bipolar affective disorder(BPAD)?
a) Chlorpromazine

b) Lithium carbonate
c) Librium
d) Pecitane
6) Persistent recurrence of unwanted and often distressing thoughts is;
a) Obsessive compulsive disorder (OCD)
b) Depression
c) Compulsion
d) Obsession
) To maintain adequate cerebral perfusion pressure (CPP), which of the following is true;
a) ICP less than 15 mm of Hg, MAP above 50 mm of Hg
b) ICP more than 15 mm of Hg, MAP below 50 mm of Hg
c) ICP lmore than 25 mm of Hg, MAP below 70 mm of Hg
d) ICP lmore than 30 mm of Hg, MAP below 40 mm of Hg

2) Which of the following is malignant tumor?

a) Glicoma
b) Neurofibroma
c) Thyroid tumor
d) Kaposi's sacroma
3) Haemophilia type A & b are:
a) Autosomal dominant traits
b) Dominant sex linked traits
c) Autosomal recessive traits
d) Recessive sex linked traits
4) When is the most appropriate time for a women to perform breast self examination?
a) The first day of the menstrual period
b) One week after the start of the menstrual period
c) Just before the time of intercourse
d) Any convenient time of the month
5) A client receiving recieving rifampicin should be taught that the effect of the drug could cause;
a) Reddish orange color of urine, saliva and sputum
b) Eighth cranial nerve damage
c) Brain
d) vestibular dysfunction
6) Which of the following is an unlikely assessment for a client with a diagnosis of hepatic encephalopathy;
a) Muscular pain
b) Muscle twitching
c) Exophthamos
d) Decreased level of consciousnes

1) Which is the most important nurse's responsibility on the day of surgery?

a) Remove all clothing's
b) Send blood for investigations
c) Teach deep breathing exercises
d) Administer Pre-anesthetic medications

2) The purpose of post-operative deep deep breathing and coughing exercises are to:
a) Reduce pain
b)Prevent wound infection
c) Prevent Apnea
d) prevent atelectasis
3) Soft systolic ejection murmur heard in elder person is commonly due to:
a) Sclerotic changes of aortic leaflets
b) left ventricle become smaller
c) Decreased elasticity & widening of aorta
d) Increased Blood pressure
4) Gerontology is the study of
a) Old age
b) care of old
c) Diseases related to aging
d) Aging process
5) Which of the following manifestations would a nurse expect to observe in a patient immediately following a tonic-clonic
generalized seizure?
a) Apnea
b) Tachypnoea
c) Lethargy
d) Hypersalivation
6) The precipitating factor for myasthenic crisis is;
a) Increase intake of fatty acids
b) Omitted doses of medication
c) Weight lifting
d) Excess medication
When caring for a client with continuous bladder irrigation, the nurse should,
a) Record output every hour
b) Monitor urinary speific gravity
c) Subtract irrigant from output to determine urine volume
d) Include irrigating solution in any 24 hour urine tests order

* The nurse can prevent the contamination from Mrs. Jacinta's retention catheter by:
a) Irrigating the catheter
b) Perineal cleansing
c) Encouraging fluids
d) Cleansing around the meatus periodically
* The major reasons for treating severe emotional disorders with tranquilizers is to;
a) Reduce the neurotic syndrome
b) Prevent secondary complication
c) Make the client amenable to physiotherapy
d) Prevent destructiveness by the client
* The most important factor in rehabilitation of a client addicted to alcohol is;
a) The Clients emotional or motivational readiness
b) The availability of community resources
c) The qualitative level of the clients physical state
d) The accepting attitude of client's family
* Which of the following activities would cause her a risk in the increase of intracranial pressure?
a) Exercise
b) Coughing
c) Turning
d) Sleeping
* Which of the following drug may be given to reduce increase intracranial pressure?
a) Mannitol
b) Scopalamine
c) Lanoxin
d) Calmpose
* Which of the following is a form of active, focused, emotional environmental first aid for patients in crisis?
a) Attitude therapy

b) Psychotherapy
c) Re motivation technique
d) Crisis intervention
* The major treatment for ascities calls for;
a) Increased potassium
b) High protein
c) Restricted fluids
d) Restricted sodium
* The major influence of eating habits of the early school-aged child is;
a)Spoon feeding
b) Availability of food selections
c) Smell and appearance of food
d) Example of parents at meal time

1) Basic Principles of fundamentals of nursing

a) Cleaning
b) Disinfection
c) Sterilization
d) All the above

2) Example for second class lever

a) Scissors
b) Trolley
c) O2 tank carrier
d) None of the above
3) Radio active cobalt is used
a) For surgery

b) For Drug
c) Locally treating
d) None of the above
4) SOS means
a) Once a day
b) 4 times a day
c) If necessary
d) At night
5) Elements of primary health care
a) Promotion of food supply & proper nutrition
b) Adequate supply of safe water & sanitation
c) Maternal and child health care
d) All the above
6) The technique is used to open O2 cylinder
a) Clock wise
b) Anti clock wise
c) Upwards
d) Downwords
* Parentral administration of drug is
a) IM
b) IV
c) Subcutaneous
d) all the above

* Nursing diagnosis means

a) Equal to doctor diagnosis
b) Different from medical diagnosis
c) Done by the docto

d) None of the above

* How will you identify the sensitivity of the drug
a) IM dose
b) IV dose
c) Test dose
d) Lethal dose
* Every trained nurse must be registered in
a) Medical council
b) Nursing council
c) Health council
d)None of the above
* Rh factor contains
a) Antigen A
b) Antigen C
c) Antigen D
d) Antigen B
* Responsibilities of graduate Nurses
a) Patient care
b) Doctor
c) Hospital
d) Director
* The drugs are used for steam inhalations
a) TR Benzine
b) Eucalyptus
c) Menthol
d) Camphor
e) All the above

* The steps of Nursing process

a) Assessment
b) Planning
c) Implementation
d) Evaluation
Ischial tuberosity helps for
a) Normal labour
b) Normal walking
c) Normal standing
d) Bearing of body weight while sitting

* Injury to pelvic floor

a) Sometimes occurs in first stage of labour
b) Sometimes occur in second stage of labour
c) Does not arise
d)During first and second stage of labour
* Morulla is a ball of cells
a) Indication of conception
b) It is a benign tumor
c) Indication of ca. cervix
d) It is a cavity filled with abnormal cells
* The fetal heart pumps an amount of blood through the placenta per minute
a) 300 ml
b) 1000 ml
c) 800 ml
d)500 ml
* Signs of fetal death

a) The uterus increases in the size

b) A brownish discharge per vagina
c) Fetal heart sounds present
d) Fetal moments absent
* Largest diameter of the fetal skull is
a) Sub mento vertical
b) Mento Occipital
c) Mento vertical
d)Sub occipito frontal

* The nurse takes the following pledge

a) Nightingale pledge
b) Christian pledge
c) Hippocrates pledge
d) Catholic pledge

* A brief description of an accident

a) Work report

b) Anecdotal report

c) Self development

d) All the above

* Number of patients in the hospital at mid night or before 6 a.m. is called
a) Time report
b) Work report
c) Lencess report
d) None of the above

* Change nurse is
a) Nursing superintendent
b) Head nurse
c) Staff nurse
d) ANM
* Most important records in the hospitals

a) Patients clinical report

b) Treatment, admission and discharge record

c) Ward equipment record

d) All the above

* The following is responsible for 24 hours nursing care in the hospital

a) Student nurse

b) Staff nurse

c) Head nurse

d) Nursing superintendent
* Organized institute for care of sick & injured

a) Hospital

b) Blood bank

c) Office

d) None of the above

* Well planned schedule of duty hours

a) Time schedule

b) Duty Roaster

c) Rotation

d) None of the above

*Prevention of psychological reaction is in
a) Primary prevention
b) Secondary prevention
c) Tertiary prevention
d) All the above
* In electro convulsive therapy (BPST -Brief pulse stimulating therapy) 90 to 20 volts of 150 cycles alternating
current passed through electrodes which are applied bi-temporally for
a) 0.3 to 0.7 seconds
b) 10-15 seconds
c) 1 minute
d) 16 seconds
* The illness of melancholia is characterized by symptoms of
a) Sadness of mood
b) Poverty of ideas
c) None of the above
d) None of the above
* When a person having abnormally aggressive, and antisocial behavior is known as
a) Psychopathy
b) Socio therapy
c) Physiotherapy
d) None of the above
* Indications for psychotherapy
a) Anxiety neurosis

b) Psychosomatic illness
c) Schizophrenia, depression, mania
d) All the above
* Unexplained and irrational morbid tears about animate and/or in animate objects is known as
a) Tension
b) Ideopathy
c) Phobias
d) None of the abo
Exact heart rate found at
a) radial artery
b) Apex of the heart
c) Temporal vein
d) Femoral vein

* Specific gravity of urine

a) 1.010-1.020
b) 1.000-1.005
c) 1.030-1.010
d) 800-1000
* The temperature of retained enema
a) 100 F
b) 90 F
c) 98.6 F
d) 92 F

* The correct position for giving enema

a) Left lateral
b) Sims

c) prone
d) Sitting
* The route of insulin injection
a) Subcutaneus
b) IV
c) IM
d)Intrathecal
* The universal blood donor is
a) AB
b) B
c) A
d) O
* Cardiac rest used for
a) Asthma
b) Cirrhosis of liver
c) Pain abdomen
d) Cardiac patient

* Immediate treatment of dog bite

a) Send the hospital
b) Application of antiseptic
c) Wash the wound with soap and water
d) Suturing
* Dislocation is diagnosed by the features
a) Pain over the joint
b) Swelling of the joint
c) Deformity
d) All the above

* HS means
a) Thrice a day
b) At bed time
c) Twice a day
d) None of the above
* One pint equal to
a) 30 ounce
b) 400 ml
c) 20 ounce or 500 ml
d)None of the above
* Indian Nursing council was established in the year
a) 1965
b) 1918
c) 1960
d) 1950

The incidents of schizophrenia is very high in

a) Normal child
b) Uniovular twins
c) Bi ovular twins
d) None of the above

* How can you recognize a mentally ill person

a) Rowdy, violent
b) Anxiety, tension
c) Abusive, homicidal behaviors

d) All the above

* The branch of medicine which deals with the diagnosis, treatment and prevention of mental illness.
a) Psychology
b) Sociology
c) Psychiatry
d)None of the above

The spinal nerves are

a) 30 pairs
b) 31 pairs
c) 41 pairs
d) 20 pairs

* Ovulation day is
a) 14 days of menses
b) 10th day of menses
c) 9th day of menses
d) 20th day of menses
* Number of milk teeth

a) 20
b) 30
c) 32
d) 28
* Shape of the body of thoracic vertebrae

a) kidney shape
b) Heart shape
c) Bean shape
d) Pea nut shape
* Smallest bone present in the body
a) Head
b) Leg
c) Ear
d) Hand
* Cardiac sphincter is situated at
a) Heart
b) Cardiam
c) End of esophagus
d) End of stomach
* Voice produced by
a) Pharynx
b) Larynx
c) Vocal cords
d)Thyroid cartilage
* Function of the blood
a) Carry carbon dioxide to the blood
b) Carry nutrients to all parts of the body
c) Carry antibodies to sites of infection
d) All the above
* Which is the biggest artery in the body
a) Brachial artery
b) Aorta

c) Femoral artery
d)Tibial artery
* Life span of RBC
a) 100 days
b) 120 days
c) 1 year
d) 60 days
* The heart is situated in the
a) abdominal cavity
b) Thoracic cavity
c) Pelvic cavity
d)Cranial cavity
* Normal sperm count should be
a) 20 million or above/ml
b) 5 million or less
c) 50 thousands
d) None of the above

* Sex hormones are

a) Thyroxine
b) Insulin
c) Growth Hormone
d)Testosterone
* Antero posterior diameter of the gynaecoid pelvic outlet is
a) 11 cm
b) 10 cm
c) 13 cm
d) 12 cm

* Difficult labour is called as

a) Dyspepsia
b) Dysparenia
c) Dyspnoea
d)Dystocia
* Quickening is first felt by the mother at
a) 10 weeks
b) 24 weeks
c) 20 weeks
d) 36 weeks
* Ovum has the pair of sex chromosomes
a) XXX
b) XY
c) XX
d)None of the above
* Anaemia is commonly seen in the following women
a) Child bearing women
b) Multi parity women
c) Lower income group
d) all the above
* The denominator in face presentation
a) occiput
b) Sacrum
c) Mentum
d)Acromion process
* During 3rd week of pregnancy
a) The ovum is without villi

b) The ovaries covered with chorionic villi

c) The ovum is absent
d) None of the above
* Fertilization of ovam & sperm takes place
a) In uterus
b) Cervix
c) Vagina
d) Ampulla of fallopian tube
* The vaginal vault is devided into
a) 6 fornices
b) 3 fornices
c) 4 fornices
d) 8 fornices
* Pelvic bones are
a) Femur
b) Radius
c) Sacrum and coccyx
d) Humerus
* Gynaecoid pelvis has
a) Oval shape brim
b) Wedge shaped
c) Flat shape brim
d) None of the above
* Infective hepatitis virus is present in
a) Saliva
b) Sputum
c) Faces & blood

d) All above

* Coal dirt causes

a) Anthracosis
b) Silicosis
c) Bagassosis
d) Byssinosis
* The stools of cholera are
a) Green
b) yellow
c) Rice water
d) Normal
* Rabies is transmitted by the bite of
a) Anopheles mosquito
b) Culex mosquito
c) Flies
d) A rabid dog
* Vaccine produces
a) Passive immunity
b) Active immunity
c) Active and passive immunity
d) All above
* Important objectives of health services are
a) Prevention of diseases
b) Promotion of health
c) Cure from the diseases
d) Above all

* Audio visual aids are classified in to

a) Auditory
b) Visual
c) Combined
d) All above
* Year of 1981 was declares as year of
a) Immunization
b) Handicapped
c) youth
d) Nurses
* Copper T is contra indicated during
a) Pregnancy
b) Pelvic infections
c) Heart diseases
d) All above
* Lung volumes may be determined by
a) Barometer
b) Spirometry
c) Sphigmomanometer
d) Lactometer

* Echocardiography is done for the following

a) To assess the size of the cardiac chambers
b) To assess the valvular function
c) To detect septal defects
d) All the above
* Definition of 'MI' is
a) Irritation of the covering of the heart

b) Atherosclerosis of the coronary arteries

c) Distraction of mitral valve
d) Death of heart muscle
* Deficiency of sodium in the blood is known as
a) Hyper natraemia
b) Hyper kalemia
c) Hypo natraemia
d) Hypo kalemia