CARE OF PEDIATRIC CLIENT

1. The nurse is caring for a child with neutropenia. Which beverage is unsuitable the
client with a low neutrophil count?

A. 2% milk

B. Fresh squeezed lemonade

C. Kool aid

D. Ginger ale

Answer :

The answer is B. Client with a low neutrophil count should adhere to a low bacteria
diet. Fresh squeezed lemonade can be contaminated from bacteria on the lemon rind.
Answers A, C and D are suitable for the client with neutropenia therefore they are
correct.

2. While caring for an 18-month old with intussusceptions, the nurse notes the passage
of a soft formed brown stool. The nurse should ...
a. Prepare the child for surgery
b. Document the finding only
c. Notify the physician
d. Palpate the child’s abdomen

RATIONAL:

Answer C is correct. The passage of a soft formed brown stool is an indication that
the intussusceptionsis resolving. Answer A is incorrect because the condition is
resolving without surgery. Answer B is incorrect because the physician should be
notified in addition to documenting the finding. Answer D is incorrect because the
nurse should not palpate the abdomen of a chils recovering from intussusceptions.

3. The physician has ordered a sweat test for a child suspected of having cystic fibrosis.
A positive sweat test is based on:
 A. Chloride level

B. Potassium transport

C. Serum sodium

D. Calcium level

Answer :

Answer A is correct. A positive sweat test is reflected by elevations in the chloride

level. Answers B,C and D are not measured by the sweat test; therefore, they are
incorrect.

4. A 15-month-old is admitted with a diagnosis of bronchiolitis. Which medication is

recognized as the only efective treatment for bronchiolitis ?

A. Ribavirin

B. Respigam

C. Sandimmune

D. Synagis

Answer :

Answer A is correct. The only effective treatment of bronchiolitis is ribavirin.

Because many bronchiolitis caused by the virus so to reduce the severity of the disease
can be given antivirus ribavirin. Ribavirin is an inhibitor of viral activity. Answer B
and D are incorrect because they are used prophylactically, not as atreatment for
bronchiolitis. Sandimmune, an immunosupressive drug, is not used for treating
bronchiolitis, therefore, Answer C is incorrect.

5. The nurse is teaching the parents of a child with hemophilia regarding bleeding
episodes. The nurse should emphasize that the greatest danger from bleeding is due to

A. bleeding into the joins

B. cutaneous bleeding
 C. bleeding into the oral cavity

D. intracranial bleeding

Answer :

Answer D is correct. the greatest danger from bleeding in the child with hemophilia
is intracranial bleeding. the situations in Answer A,B, and C do not pose the greatest
danger from bleeding therefore, they are incorrect.

6. During a rountine well-child check up,the mother of a toddler asks when she should
her child’s first denal visit. The nurse’s response is based on he knowledge that most
children have all their permanent teeth by age:

A. 12 Month

B. 18 Month

C. 24 Month

D. 30 Month

Answer :

Answer D is correct. Most children have all their primary teeth by age 30 months.
Answers A,B and C are incorrect because tooth eruption is not complete.

LEGAL ISSUES IN NURSING PRACTICE

1. The client returns to the unit from surgery with a blood pressure of 100/50, pulse 122, and
respirations 30. whch action by the nurse should receive priority?
a. Continue to monitor the vital signs
b. Contact the physician
c. Ask the client how he feels
d. Ask the LPN to continue the postop care
Answer B is correct.
 The vital signs are abnormal and should be reported immediately. Continuing to monitor
the vital signs can result in deterioration of the client’s condition, so answer A is
incorrect. Asking the client how he feels would supply only subjective data, so answer
C is incorrect. The LPN is not the best nurse to be assigned to this client because he is
unstable, so answer D is incorrect.

2. The nurse is found to have charted blood glucose results without actually performing the
procedure. After talking to the nurse, the charge nurse should do which of the following
a. Call the board of nursing
b. File a formal reprimand and monitor the nurse
c. Terminate the nurse
d. Charge the nurse with a tort
Answer B is correct.
The next action after discussing the problem with the nurse is to document the incident.
If the behavior continues or if harm has resulted to the client, the nurse might be
terminated and reported to the board of nursing, so answer a, and c are incorrect. A tort
is wrongful act to the client or her belongings, so answer d is incorrect.

3. The charge nurse witnesses the nursing assistant being abusive to a client in the nursing
home facility. The nursing assistant can be charged with which of the following?
a. Negligence
b. Tort
c. Assault
d. Malpractice
Answer C is correct.
Assault is defined as striking or touching the client inappropriately. Negligence is failing
to perform care for the client, so answer A is incorrect. A tort is a wrongful act
committed on the client or his belongings, so answer B is incorrect. Malpractice is
failing to perform an act that the nurse knows shpuld be done or doing something wrong
that causes harm to the client, so answer D is incorrect.
4. The emergency room is flooded with clients injured in tornado. Which clients can be
assigned to share a room in the emergency departmen during the disaster?
a. A schizophrenic client having visual and auditory hallucination and the client with
ulcerative colitis.
b. The client who is six months pregnent with abdominal pain and the client with facial
lacerations and a broken arm
c. A client whose pupils are fixed and dilated and his parents and client with a frontal head
injury
d. The client who arrives with a large puncture wound to the abdomen and the client with
chest pain
Answer B is correct.
Out of all these client, it is best to hold the pregnant client. And the client with the broken
arm and faciel lacerration in the same room. The other clients need to be placed
inseparate rooms, so answer A,C, and D are incorrect.

5. The nurse is planning room assignments for the day. Which client should be assigned to
the only private room?
a. The client with Cushing’s disease
b. The client with Diabetes
c. The client with Acromegaly
d. The client with Myxedema
Answer A is correct.
The client with Cushing’s disease has adrenocortical hypersecretion. This increase in
the level of cortisone causes the client to be immunosuppressed. The client with
diabetes poses no risk to other clients and is not immunosuppressed, so answer B is
incorrect. The client in answer C, has an increase in growth hormone and poses no risk
to himself or others, so the answer is incorrect. The client in answer D has
hyperthyroidism or myxedema and poses no risk to others or himself, so it is incorrect.

6. Which assigment is outside the realm of nursing practice for the licensed practical nurse?
a. inserting a foley catheter
 b. discontinuing a nasogatric tube
c. obtaining a sputum specimen
d. starting a blood transfusion
Answer D is correct.
The LPN can be assigned to insert Foley and French urinary chateters, discontinue
Levin and gavage tubes, and obtain all types of specimens.

Care of Psychiatric

1. During a home visit, the nurse discovers that the client is less verbal, less active, less responsive
to directions, severly anxious, and more stuporous. The nurse interprets these findings as
indicating that the client is having an exacerbation of which of the following types of
schizophrenia?

A. Disorganized

B. Paranoid

C. Undifferentiated

D. Catatonic

Answer is D. the client is exhibiting symptoms of becoming immobilized that are classic
pecursors to catatonic behaviors. Disorganized schizophrenia is characterized by disorganized
speech and behaviors. Paranoid schizophrenia is increased suspiciousness. Undifferentiated
schizophrenia is charactherized by increased halucinations and delusions.

2. A client walks in to the mental health outpatient center and states, I ve had it. I can’t go on any
longer. You’ve got to help me.” The nurse asks the client to be seated in a private interview
room. Which action should the nurse take next?

A. Reassure the client that someone will help him soon

B. Assess the cllient’s insurace coverage.

C. Find out more about what is happening to the client.

D. Call the client’s family to come and provide support

 Answer is : C

Rational : The nurse must assess the client and his situation before the appropriate action can
be determined.

3. Which of the following statements by a client with delusions indicates to the nurse that the
client is improving?

A. “ I don’t feel those crawling buys anymore”

B. “ I won’t talk about my crazy thoughts at work”
C. “ I feel less jumpy inside”
D. “ I must check my room for bugs”

Answer is B

Rational :

B. Improvement in relation to delusional content includes a reduction in the disturbing quality

of the delusion and the client’s ability to control and/or not respond to them

A. This would indicate a respone to a tactile hallucination

C. This would not be a feature of delusions and may indicate agitation or akathisia

D. This would indicate that the client is responding to a delusional belief that is room is
“bugged”

4. A client sttes that she hears God’s voice telling her that she has sinned and needs to be punished.
Wich of the following nursing diagnoses would be most appropriate?

A. Distrubed sensory perception related to guilt as evidanced by auditory hallucinations

B. Social Isolation related to mistrust, as evidence by withdrawal behaviors

C. Distrubed thought processes relater to increased anxiety as evidenced by delusional

thinking

D. Impaired verbal communiccation related to disordered thinking as evidenced by loose

associations
 Answer is A. The client is describing an auditory hallucination that is most likely related to
unresolved guilt about a perceived “sin”. Sosial isolation would be supported by evidence
indicating that the lientt refuses to come out of her room. Distrubed thought processes would
be evidenced, for example, by the client’s saying that someone in her life is trying to punish
her. Loose associations are reflectionsof racing thoughts, not problems with verbal
communication.

5, When developing the plan care for a client with suicidal ideation, which of the following would
the nurse anticipate as the priority?

A. Self-esteem

B. Sleep

C. Hygiene

D. Safety

Answer D is correct

For the client with suicidal ideation, client safety is the priority. The nurse protects the client from
self-harm or self-destruction. Although self-esteem, sleep, and hygiene are common areas that
require intervension for a client with suicidal ideation, ensuring the client’s safety is the most
immediate and serious consern.

6. A client with dysthymia has a nursing diagnosis of self-esteem disturbance related to feelings
of worthlessness. Which goal reflects an increase in the client’s self-esteem?
A. The client identifies two personal behaviors that alienate others.
B. The client attends and participates in morning goal-setting activities.
C. The client eats in the cafetaria with other clients from the unit.
D. The client identifies one or two positive self-attributes.

Answer D is correct. An increase in the client’s self-esteem is evidenced by the fact that he/she
can recognize positive self attributes. Answer A, B, and C are incorrect because they do not
reflect an increase in self-esteem
COMMUNITY HEALTH NURSING

1. When developing a community-based service progam for client with cronic mental
illnesses, which of the following would be of least importance?

a. Partial program

b. Phychiatric home care

c. Residental service

d. Long-term hospitals

Answer D is correct. For a community-based program. The need for long term
hospitalization is least likely if the other services, such as partial program. Phyciatric home
care and residential services, are available and accessible.

2. Which step in community organizing involves training of potential leaders in the

community?
a. Integration
b. Community organization
c. Community study
d. Core group formation

Answer: (D) Core group formation. In core group formation, the nurse is able to transfer
the technology of community organizing to the potential or informal community leaders
through a training program.

3. A 10 years old child proudly tells the nurse that brushing and flossing her teeth is her
responbilitty. How does the nurse interpret the statement ?
a. She is too young to be given this responbility
b. She is most likely capable of this responbility
c. She should have assumed this responbility much sooner
d. She is probably just exagerating the responbility

Answer B is correct. because the child has understand what she enough and she did.
Answer A is incorrect because the child of 10 years old should have to better understand
 what is the responbillity especially for her. Answer C and D are incorrect because the child
doesn’t has many responbillities.

4. When the occupational health nurse employs ergonomic principles, she is performing
which of her roles?
a. Health care provider
b. Health educator
c. Health care coordinator
d. Environmental manager

Answer: (D) Environmental manager. Ergonomics is improving efficiency of workers by

improving the worker’s environment through appropriately designed furniture, for
example.

5. Inadequate intake by the pregnant women of which vitamin may cause neural tube defects?
a. niacin
b. riboflavin
c. folic acid
d. thiamine

Answer is C Folic acid. It is estimated that the incidence of neural tube defects can be
reduced drastically if pregnant women have an adequate intake of folic acid.

6. What is of primary facilities?

a. They are usually goverment-run
b. Their services are provided on an out patient basis
c. hey are training facilities for health profesionalis
d. A community hospital is an example of this issue of health facilitaties

Answer is B. Primary facilitaties goverment and non goverment facilitaties that provide
basic but patient services
Cultural Practices Influensing Nursing Care

1. The nurse is assisting a client from Iraq with her bath. The nurse notices that the client
uses only her left hand to bathe her genital area. Which of the following is the correct
assessment of this behavior?

A. The client’s dominant hand is her left one.

B. The client is using her nondominant hand to more easily cleanse the perineum.

C. The client believes that the right hand is reserved for eating and touching others and
that the left hand is the dirty hand.

D. The client has in some way injured her right hand, making it difficult to use it.

Rationale :
Answer C is correct. In the Islamic religion, the left hand is reserved for toileting. The right
hand is considered clean and is used to eat and touch others. There is no data to support
that the client is left handed or that the right hand might be injured, so answer A, B, and D
are incorrect.
2. Which medication will most likely be refused by a muslim client?
A. Insulin
B. Cough syrup
C. NSAIDs
D. Antacids
Rationale :
Answer B is correct. Most cough syrups contain alcohol, which is forbidden in the islamic
religion. Attempts should be made to obtain a cough suppressant that does not contain
alcohol. The client will most likely take insulin, nonsteroidal anti inflammtory drugs, and
antacids, so answer A, C and D are incorrect.
3. a japanese client refuses to eat the ice cream or drink the milk on his tray. Which action by
the nurse would indicate an understing of the client’s needs ?
A. She obtains yogurt for the client instead
B. She obtains an order for lactaid dietary supplement
 C. She removes the milk from thr tray and says nothing to the client
D. She asks the client why he will not drink the milk

Rationale :

Answer B is correct. Many of japanese descent are lactose intolerant- it is not that milk is
not allowed in their culture. Yogurt alsocauses gas and bloating, so answer A is incorrect.
Removing the items from the tray does not provide the needed calcium in the diet, so
answer C is incorrect. It is inappropriate to ask “why” in most culturest, so answer D is
incorrect.

4. The client is a practicing Hindu. Which food should be removed from the client’s tray?
A. Bread
B. Cabbage
C. Steak
D. Apple

Rationale :

Answer C is correct, in the Hindu religion beef is prohibited. All breads, vegetables, and
fruits are allowed, so answer A, B, and C are incorrect.

5. An 88-year-old female Jewish client is addmitted to the hospital and diagnosed with
diabetes. Which type of insulin is refused by this client?
A. Beef
B. Fork
C. Synthetic
D. Fish

Rationale :

Answer B is correct. Fork is not allowed in the diet or medication of Jewish clients. Both
synthetic and beef insulins are allowed, so answer A and C is incorret. There is no such
thing as fish insulin, so answer D incorrect.
6. The condition of an Arab clien who is terminally ill deteriorates and death seems imminent.
If the client is hospitalized in the mainland United States, the nurse should position the bed
facing which direction ?
a. Northeast
b. Southeast
c. West
d. South

Rationale :

Answer B is correct. At the time of death, the muslim client will wish to be positioned
facing Mecca, which is to the southeast of the United States. Answers A,C and D are
therefore incorrect.

EMERGENCY CARE NURSING

1. An unresponsive client is admitted to the emergency room with a history of dm. the
client's skin is cold and clammy, and her blood pressure reading is 82/56. the frist step in
emergency treatment of the of the client's symptoms would be?
a. checking the client client blood sugar
b. administering intravenoun dextrose
c. intubation and ventilator support
d. administering regular insulin
RATIONAL :

answers a is correct . the client has symptoms of insulin shock and the first step is to
check the client blood sugar. if indicated, the client should be treated with intravenous
dexstrose . answers b is wrong because it is not the first step the nurse should take.
answers c is wrong because it does not apply to the client symptoms. answers d is
wrong because it would be used for diabetic ketoacidosis, not insulin shock.

2. direct pressure to a deep laceration on the client lower leg has failed to stop the bleeding.
the nurse's next action should be able to:
 a. place a tourniquet proximal to the laceration
b. elevate the leg above the level of the heart
c. cover the laceration and apply an ice compress
d. apply pressure to the femoral artery

ANSWERS: B is correct

RATIONAL :

if bleeding does not subside with direct pressure. the nurse should elevate the
exetremity above the level of the heart. answers a and d are done only if other measures
are ineffective, so they are incorrect. answers c would slow the bleeding, but will not stop
it, so it's incorrect

3. A pediatric client is admitted after ingesting a bottle of vitamins wich iron.

Emergency care would include treatment with…

a. Acetylcysteine
b. Deferoxamine
c. Calcium disodium acetate
d. British anti-lewisite

Answer B is correct.

Deferoxamine is the antidote for iron poisoning.

Answer A is the antidote for acetaminophen overdose, making it wrong

Answer C and D are antidotes for lead poisoning, so they are wrong

4. A client is to receive antivenin following a snake bite. Before administering the antivenin,
the nurse should give priority to?
A. Administering a local anesthetic
B. Checking for an allergic response
C. Administering an anxiolytic
D. Withholding fluids for 6-8 hours
 The Answer
Answer B is correct. The nurse should perform the skin or eye test before administering
antivenin. Answer A and D are unnecessary and therefore incorrect. Answer C would help
calm the client but is not priority before giving the antivenin, making it incorrect.

5. Emergency department triage is an important nursing function. A nurse working the

evening shift ispresented with four patients at the same time. Which of the following
patients should be assigned thehighest priority?
a. A patient with low-grade fever, headache, and myalgias for the past 72 hours
b. A patient who is unable to bear weight on the left foot, with swelling and bruising
following a runningaccident.
c. A patient with abdominal and chest pain following a large, spicy meal.
d. A child with a one-inch bleeding laceration on the chin but otherwise well
after falling while jumping on his bed.
Answer: C
Emergency triage involves quick patient assessment to prioritize the need for further
evaluation andcare. Patients with trauma, chest pain, respiratory distress, or acute
neurological changes are alwaysclassified number one priority. Though the patient with chest
pain presented in the question recentlyate a spicy meal and may be suffering from heartburn,
he also may be having an acute myocardialinfarction and require urgent attention. The patient
with fever, headache and muscle aches (classic flusymptoms) should be classified as non-
urgent. The patient with the foot injury may have sustained asprain or fracture, and the limb
should be x-rayed as soon as is practical, but the damage is unlikely toworsen if there is
a delay. The child's chin laceration may need to be sutured but is also non-urgent.

NEONATAL AND CHILDBEARING

1. A new mother asks, “When will the soft spot near the front my baby’s head close?” Which
of the following ages would the nurse include when responding to the mother about closure
of the anterior fontanel?
a. 2 to 3 months
b. 6 to 8 months
 c. 9 to 10 months
d. 12 to 18 months
Answer : D. 12 to 18 months
Rationale : Normally, the anterior fontanel closes between ages 12 and 18 months.
2. The pregnant client with AIDS is diagnosed with cytomegalovirus. The nurse is aware that
the client probably contracted cytomegalovirus from
A. Blood or body fluid exposure to the virus
B. Emptying her cat's litter fox
C. Contamined food or water
D. Pigeon feces
Answer A is correct. Cytomegalovirus, virus is transmitted predominantly by blood or
body fluid exposure to the virus.
3. Which of the following assessment findings neonate would cause the nurse to notify
thepediatrician?
A. Absence of tears
B. Unequally sized corneas
C. Pupillary constrictions to bright light.
D. Red circle on pupils with ophthalmoscopy examination
Answer is (B) cornea of unequally sized should be reported because this may indicate
congenital glaucoma.
4. The client visits the prenatal clinic stating she believes she is pregnant. A pregnancy test is
done to detect elevated levels of :
A. Prolactin
B. Human chrorionic gonadotropin
C. Lecithin sphingomyelin
D. Estrisol
Answer B is correct. HCG levels elevate rapidly and can be detectedas early two days after
the missede period.
5. When developing the teaching plan for a new mother about the neonates need for sensory
and visual stimulation, information about which of the following as the most highly
developed sense in the neonate would the nurse expect include?
 A. Taste
B. Hearing
C. Touch
D. vision
Answer C is correct. The sense of touch is belived to be the most highly developed sense
at birth. Is is probably for the reason that neonates respond well to touch
6. The client is diagnosed with genital herpes. Which medication is used to treat genital
herpes?
a. Acyclovir (Zovirax)
b. Podophyllin
c. AZT (Retrovir)
d. Isoniazid (Lanzid)
Answer A is correct. Acyclovir is used to treat genital herpes. Answer B is incorrect
bacause podophyllin is use to treat condyloma acuminata(Venereal warts). Answer C is
incorrect because AZT( Retrovir) is used prevent HIV transmission from mother to baby.
Answer D is incorrect because isoniazed is used to treat tuberculosis not herpes.