Comprehension

1. The client with trigeminal neuralgia asks the nurse what causes the painful episodes associated with the
condition. The nurse’s response is based on an understanding that the symptoms can be triggered by
a. Stimulation of the affected nerve by pressure and temperature
b. A hypoglycemic effect on the cranial nerve
c. Release of catecholamines with infection or stress
d. A local reaction to nasal stuffiness
2. The client is experiencing chronic insomnia. The nurse interprets that which of the following areas of the
nervous system is involved?
a. Hippocampus and frontal lobe
b. Temporal lobe and frontal lobe
c. Reticular activating system and cerebral hemispheres
d. Limbic system and cerebral hemispheres
3. The nurse is caring for an unconscious client who is experiencing persistent hyperthermia with no signs and
symptoms of infection. The nurse interprets that there may be damage to the client’s thermoregulatory center
in the
a. Cerebrum
b. Cerebellum
c. Hippocampus
d. Hypothalamus
4. The client with acute prostatitis has difficulty voiding, which is accompanied by pain. The client asks the nurse,
“Can’t you just put a catheter in so I won’t be in this misery when I try to go?” The nurse’s response is based on
the understanding that catheterization
a. Will prolong the course of the inflammation
b. Could result in obstruction from rebound edema once the catheter is removed
c. Is avoided whenever possible to avoid pushing organisms up into the bladder
d. Could puncture the prostate gland because it is so inflamed
5. A nursing assistant collects urine specimen from a client and is planning to deliver the specimen to the
laboratory after completing morning care to other assigned clients. The RN instructs the nursing assistant to
place the collected specimen in the unit lab refrigerator. The nursing assistant asks the RN about the reason
that the urine needs refrigeration. The RN bases the response on the fact that when urine is allowed to stand
unrefrigerated
a. The urine becomes more acidic
b. Bacteria and WBC decompose
c. The urine clumps
d. The pH decreases
6. The clinic nurse is performing an assessment on a client who is complaining of shortness of breath. The client
tells the nurse that he is a cigarette smoker and admits to smoking one pack of cigarettes per day for the last 10
years. The nurse determines that the client has a smoking history of how many pack years?
a. 7.5
b. 10
c. 15
d. 20
7. The clinic nurse notes that following several eye examinations, the physician has documented a diagnosis of legal
blindness in the client’s chart. The nurse reviews the results of the Snellen’s chart test expecting to note which
finding?
a. 20/20 vision
b. 20/40 vision
c. 20/60 vision
d. 20/200 vision
8. Tonometry is performed on the client with a suspected diagnosis of glaucoma. The nurse analyzes the test
results as documented in the client’s chart and understands that normal IOP is
a. 2 to 7 mmHg
 b. 10 to 21 mmHg
c. 22 to 30 mmHg
d. 31 to 35 mmHg
9. The nurse is reviewing the electrolyte results of a client who is taking a potassium supplement. The nurse would
determine that a therapeutic effect is present if which of the following potassium results is noted?
a. 2.8 mEq/L
b. 3 mEq/L
c. 3.3 mEq/L
d. 4 mEq/L
10. The nurse is reviewing the lab results of a client who is seen in the health care clinic. The nurse would
determine that the sodium level is normal if which of the following values is noted?
a. 130 mEq/L
b. 140 mEq/L
c. 150 mEq/L
d. 160 mEq/L
11. The nurse is reviewing the results of a urinalysis performed on a client in the health care clinic. The nurse would
determine that the specific gravity of the urine is normal if which of the following values is noted?
a. 1.001
b. 1.0116
c. 1.035
d. 1.04
12. The nurse is reviewing the record of a client admitted to the nursing unit and notes that the client has a history
of Laennec’s cirrhosis. The nurse plans care knowing that this type of cirrhosis is caused most commonly by
long term
a. Alcohol abuse
b. Cardiac disease
c. Exposure to chemicals
d. Obstruction to biliary ducts
13. The nurse is reviewing the electrocardiogram rhythm strip obtained on a client with a diagnosis of myocardial
infarction. The nurse notes that the PR interval is 0.20 seconds. The nurse determines that this is
a. A normal finding
b. Indicative of atrial flutter
c. Indicative of impending reinfarction
d. Indicative of atrial fibrillation
14. A nurse is reviewing the laboratory results on an adult client admitted to the hospital with acute abdominal
pain. The nurse would determine that the serum amylase level is normal if which of the following results were
noted?
a. 10 units/dL
b. 100 units/dL
c. 300 units/dL
d. 500 units/dL
15. A nurse is reviewing the lab results of a client seen in the health care clinic. The nurse would determine that
the serum ammonia level is normal if which of the following test results was noted?
a. 5 mcg/dL
b. 10 mcg/dL
c. 40 mcg/dL
d. 80 mcg/dL
16. A nurse is caring for a client who has been admitted to the hospital with a diagnosis of angina pectoris. The
client is receiving oxygen via nasal cannula at 2L/min. The client asks the nurse why the oxygen is necessary.
The nurse bases the response on which of the following?
a. Oxygen will assist in calming the client
b. Oxygen will prevent the development of any thrombus formation
c. Oxygen dilates the blood vessels, supplying more nutrients to the heart muscle
 d. The pain associated with the angina occurs because of the decreased oxygen supply to the heart cells
17. A nurse in the gynecological clinic is reviewing the record of a pregnant woman after the first prenatal visit. The
nurse notes that the physician has documented that the woman has a platypelloid pelvis. Based on this
documentation, the nurse plans care knowing that this type of pelvis
a. Is a normal female pelvis
b. Has a flat shape
c. Has an oval shape
d. Has a heart shape
18. During a home visit, the nurse speaks with the client and establishes mutual goals to help the client become
more independent. In this role the nurse is functioning as
a. A researcher
b. A resource linker
c. An advocate
d. A collaborator
19. As a home health case manager the nurse functions as a coordinator of client care. The nurse understands that
in this role the nurse will
a. Report to all members of the client’s health care team daily to advise of the plans
b. Teach the client and significant others daily about the case management process
c. Plan weekly meetings with all individuals involved in the care to assess status
d. Organize, manage, and balance health care services needed for the client
20. A nurse is teaching the mother of a newborn infant measures to maintain health in the infant. The nurse
identifies which of the following as an example of primary prevention activities for the infant?
a. Selective placement of the infant
b. Phenylketonuria testing at birth
c. Administration of an antibiotic for an umbilical cord staphylococcal infection
d. Periodic well-baby examinations
21. A mental health nurse is reviewing the discharge plan of a hospitalized client. The nurse reviews the plan,
bearing in mind that the most prominent problem in the management of a client with mental health problem in
the community is the
a. Client’s non-compliance with medication therapy
b. Family’s reaction to keeping the client in the community
c. Opposition of the community members
d. Increased incidence of social problems
22. The mother of a 1 month old infant is bottle feeding her infant and asks the nurse about the stomach capacity
of an infant. The nurse responds, knowing that the stomach capacity for a 1 month old is about
a. 10 to 20 mL
b. 30 to 90 mL
c. 75 to 100 mL
d. 90 to 150 mL
23. A nursing student is preparing a clinical conference, and the topic of discussion is the immune system. The
nursing student prepares a handout and places on the handout that the function of B lymphocytes (B cells) is to
a. Make antibodies
b. Attack and kill target cells directly
c. Activate T cells
d. Initiate phagocytosis
24. A nurse is planning care for a client with an immune disorder. The nurse plans care knowing that the immune
system consists of specific major types of cells. The nurse understands that which of the following types of cells
is unassociated with the immune system?
a. B lymphocytes
b. Helper T lymphocytes
c. Dendritic cells
d. RBC
25. A nurse is describing the phases of the immune response to another nurse newly employed on the nursing unit.
The nurse understands that which of the following is not a specific phase of the immune response?
a. Recognition phase
b. Activation phase
c. Effector phase
d. Memory phase
26. A client is admitted to the hospital with a diagnosis of parasitic worms. The nurse plans care knowing that the
primary cell type that will attack these foreign particles is the
a. Dendritic cells
b. Basophils
c. Neutrophils
d. Eosinophils
27. A nursing student is assigned to care for a client with an immune disorder. The student is reviewing information
related to the immune response and the classes of human antibodies. The student plans care, knowing that the
major serum antibody is which of the following?
a. Immunoglobulin G
b. Immunoglobulin A
c. Immunoglobulin M
d. Immunoglobulin E
28. A nursing instructor asks the nursing student to identify the classes of antibodies and asks the student which
antibody is the first that is produced in response to an antigen. The student responds correctly by telling the
nursing instructor that the antibody produced first in response to an antigen is
a. Immunoglobulin G
b. Immunoglobulin A
c. Immunoglobulin M
d. Immunoglobulin E
29. A nursing student is enrolled in an anatomy and physiology course and presently is studying the immune
system. The student understands that a nonspecific immune response can include physical barriers and
chemical barriers. The student understands that an example of a chemical barrier is which of the following?
a. The skin
b. The mucous membranes
c. The cilia lining the respiratory tract
d. Acids and enzymes found in body fluids
30. Tetanus toxoid is prescribed for a client who sustained a food laceration from a piece of metal while walking
barefoot on the beach. The nurse prepares the injection, knowing that the prescribed toxoid is
a. A toxin produced by bacteria that has been altered so that it is not longer toxic
b. An attenuated bacteria
c. A nonattenuated virus
d. A specific antibody that will prevent infection
31. A nursing student is conducting a clinical conference and is discussing active and passive immunity. The student
tells the group that active immunity
a. Lasts much longer than passive immunity
b. Is less effective at preventing subsequent infections
c. Provides protection immediately
d. Has a half life of about 30 days
32. A nursing instructor asks the nursing student about the organs of the immune system. The instructor asks the
student where Kupffer’s cells are located. The student responds correctly by telling the instructor that these
types of cells are located in the
a. Tonsils
b. Spleen
c. Bone marrow
d. Liver
33. A nursing instructor asks a nursing student to identify the location of Peyer’s patches. The student responds
correctly by telling the instructor that these are located in the
a. Liver
b. Tonsils
c. Small intestine
d. Spleen
34. A nursing student is reviewing information related to the inflammatory reaction. The student understands that
the primary purpose of neutrophils in the inflammatory response is to
a. Dilate the blood vessels
b. Increase fluids at the site of injury
c. Phagocytize any potentially harmful agents
d. Produce permeability of the blood vessels
35. A nursing instructor asks a nursing student to define the process of phagocytosis. The student responds
correctly by telling the instructor that this is
a. The initial reaction in the inflammatory response
b. A process by which a particle is ingested and digested by a cell
c. A protein produced in response to a viral infection
d. Required for the production of antibodies
36. A nursing student is describing the differences between specific and nonspecific immunity. The student
correctly identifies specific immunity by stating that this type of immunity is
a. The first line of defense against infection
b. The type of immunity that reacts the same to all antigens
c. The second line of defense against infection
d. Present and functioning at birth
37. A rheumatoid factor is performed on a client with a diagnosis of rheumatoid arthritis. The nurse understands
that this test measures for the presence of
a. Unusual antibodies of the immunoglobulin G and M type
b. Antigens of immunoglobulin A
c. Inflammation
d. Infection in the body
38. An erythrocyte sedimentation rate is prescribed for a client with a connective tissue disorder. The client asks
the nurse about the purpose of the test. The nurse tells the client that the test will
a. Determine the presence of antigens
b. Confirm the diagnosis of connective tissue disorders
c. Identify what additional tests need to be performed
d. Confirm inflammation or infection in the body
39. A nurse is reviewing the diagnostic tests prescribed for an assigned client. The nurse notes that a lupus cell
preparation has been ordered. The nurse understands that this test is used to screen primarily for which of the
following disorders?
a. Histoplasmosis
b. Systemic lupus erythematosus
c. Human immunodeficiency virus
d. Progressive systemic sclerosis
40. A nurse is reviewing the health care record of a client with a new diagnosis of rheumatoid arthritis. The nurse
understands that which of the following is not an early clinical manifestation of this disorder?
a. Complaints of fatigue
b. Complaints of generalized weakness
c. Anorexia
d. Weight gain
41. A client has an endocrine system dysfunction of the pancreas. The nurse plans care knowing that the client will
exhibit impaired secretion of which of the following substances?
a. Amylase
b. Lipase
 c. Trypsin
d. Insulin
42. A client has impaired function of the posterior pituitary gland. The nurse plans care knowing that the client may
exhibit altered secretion of which of the following hormones?
a. Antidiuretic hormone
b. Growth hormone
c. Follicle stimulating hormone
d. Luteinizing hormone
43. A client is diagnosed with dysfunction of the adrenal medulla. The nurse monitors for changes in client status
related to altered production and secretion of which of the following substances?
a. Cortisol
b. Epinephrine
c. Aldosterone
d. Androgens
44. A client has a tumor that is interfering with the function of the hypothalamus. The nurse would expect that the
client would exhibit which of the following clinical problems?
a. Glucocorticoid excess or deficit
b. Mineralocorticoid excess or deficit
c. Antidiuretic hormone excess or deficit
d. Melatonin excess or deficit
45. A client’s serum calcium level is high. The nurse plans care knowing that which of the following hormones is
directly responsible for maintaining the free or unbound portion of the serum calcium within normal limits?
a. Thyroid hormone
b. Parathyroid hormone
c. Follicle stimulating hormone
d. Adrenocorticotropic hormone
46. A nurse overhears a discussion about a client who has an altered production of cortisol. The nurse plans care
knowing that the client is experiencing difficulty with synthesis of which of the following types of substances?
a. Androgens
b. Catecholamines
c. Glucocorticoids
d. Mineralocorticoids
47. Client with an endocrine disorder has weight loss and tachycardia. The nurse determines that which of the
following glands is most likely responsible for these symptoms?
a. Thyroid
b. Parathyroid
c. Adrenal cortex
d. Pituitary
48. A client has abnormal amounts of circulating thyronine and thyroxine. The nurse understands that the client
may have a deficiency of which of the following dietary elements?
a. Calcium
b. Magnesium
c. Phosphorus
d. Iodine
49. A client with medullary carcinoma of the thyroid gland has an excess function of the C cells of the thyroid gland.
The nurse interprets that this client is primarily at risk of having abnormalities of which of the following
electrolytes?
a. Sodium
b. Potassium
c. Calcium
d. Magnesium
50. A client with hypovolemia experiences activation of the rennin-angiotensin system to maintain blood pressure.
The nurse knows that as part of this response, he endocrine system will have increased production and
secretion of which mineralocorticoid?
a. Aldosterone
b. Adrenocorticotropic hormone
c. Cortisol
d. Glucagon
51. A client has overactivity of the thyroid gland. The nurse anticipates that the client will experience which of the
following effects from this hormonal excess?
a. Low blood glucose levels
b. Nutritional deficiencies
c. Weight gain
d. Increased body fat stores
52. A client has been diagnosed with pheochromocytoma. The nurse anticipates that the client will exhibit which of
the following effects based on the pathophysiology of this disorder?
a. Hypertension
b. Water loss
c. Decreased cardiac output
d. Bradycardia
53. A client is diagnosed with Cushing’s syndrome. The nurse understands that this client has excesses of which of
the following substances?
a. Calcium
b. Cortisol
c. Epinephrine
d. Norepinephrine
54. A client is experiencing an episode of hypoglycemia. The nurse understands that the physiological mechanism
that should take place to combat this decline in the blood glucose level is
a. Decreased epinephrine release
b. Decreased cortisol release
c. Increased insulin secretion
d. Increased glucagon secretion
55. A client with DM who refuses to take insulin as prescribed has greatly increased blood glucose levels following a
meal. The nurse understands that which of the following initial body responses to elevated glucose levels will
worsen the situation for the client?
a. Glycogenolysis
b. Gluconeogenesis
c. Binding of glucose onto cell membranes
d. Transport of glucose across cell membranes
56. A client with DM is prone to breaking down fats for conversion to glucose. The nurse determines that this
response currently is occurring if the client has elevated levels of which of the following substances?
a. Glucose
b. Ketones
c. Glucagon
d. Lactic dehydrogenase
57. A client is diagnosed with type 1 DM. The nurse understands that which of the following factors is not believed
to be a cause of the beta cell destruction that accompanies this disorder?
a. Genetic factors
b. Autoimmune factors
c. Primary failure of glucagon secretion
d. Viruses
58. The clinical picture of a client with osteitis deformans (Paget’s disease) includes back and leg pain, a crouched
forward posture, and legs that bow outward. The nurse interprets that these manifestations are due to
disturbances of which of the following bodily processes?
 a. Bone resorption and regeneration
b. Muscle metabolism and growth
c. Joint integrity and synovial fluid production
d. Nervous system impulse transmission
59. A client has experienced a myocardial infarction. The nurse understands that the client’s chest pain is due to
tissue hypoxia in which of the following layers of the heart?
a. Parietal pericardium
b. Visceral pericardium
c. Myocardium
d. Endocardium
60. A client is admitted to the hospital with a diagnosis of mitral stenosis. The nurse understands that the
narrowing of this valve impedes circulation of blood from the
a. Left atrium to left ventricle
b. Left ventricle to aorta
c. Right atrium to right ventricle
d. Right ventricle to pulmonary artery
61. A client is admitted to the hospital with a diagnosis of aortic regurgitation. The nurse understands that the
failure of this valve to close completely allows blood flow to retrograde from the
a. Left ventricle to left atrium
b. Aorta to left ventricle
c. Right ventricle to right atrium
d. Pulmonary artery to right ventricle
62. A client is experiencing a decrease in blood pressure. The nurse anticipates that this will have which of the
following primary effects on the client’s heart?
a. Increased resistance to electrical stimulation
b. Decreased HR
c. Increased contractility
d. Decreased myocardial blood flow
63. A client’s serum calcium level is 7.9 mg/dL. The nurse is concerned immediately, knowing that this level
ultimately could lead to
a. High blood pressure
b. Stroke
c. Cardiac arrest
d. Urinary stone formation
64. A nurse is caring for a client who has lost a significant amount of blood because of complications of a surgical
procedure. The nurse understands that which of the following client measurements will provide the earliest
indication of new decreases in fluid volume?
a. Pulse rate
b. Blood pressure
c. Presence of edema
d. Lung crackles
65. A nurse is listening to a cardiologist explain the results of a cardiac catheterization to a client and family. The
physician tells the client that there is a blockage in the large blood vessel that supplies the anterior wall of the
left ventricle. The nurse interprets that the physician is referring to which of the following arteries?
a. Left anterior descending
b. Right coronary artery
c. Circumflex artery
d. Posterior descending
66. A client has been diagnosed with GERD. The nurse interprets that the client has dysfunction of which of the
following parts of the digestive system?
a. Chief cells of the stomach
b. Parietal cells of the stomach
c. Lower esophageal sphincter
 d. Upper esophageal sphincter
67. A client has experienced delayed gastric emptying. The nurse determines that which of the following structures
is responsible for the client’s symptoms?
a. Pyloric sphincter
b. Cardiac sphincter
c. Jejunum
d. ileum
68. A client who has had a gastrectomy is not producing sufficient intrinsic factor. The nurse interprets that the
client has lost the ability to absorb cyanocobalamin (Vit B 12) in the
a. Stomach
b. Small intestine
c. Large intestine
d. Colon
69. A nurse is caring for a client diagnosed with pancreatitis. The nurse anticipates that the client would not
experience an elevation of which of the following enzymes?
a. Lipase
b. Lactase
c. Amylase
d. Trypsin
70. A nurse is caring for a group of clients on the surgical nursing unit. The nurse anticipates that the client who
underwent which of the following procedures is most likely to have some long term residual difficulty with
absorption of nutrients?
a. Appendectomy
b. Colectomy
c. Ascending colostomy
d. Small bowel resection
71. A client with spinal cord injury is participating in a bowel retraining program. The plan developed by the nurse
for bowel evacuation for this client is based in part on knowledge that defecation is normally the result of
a. Stimulation of the parasympathetic reflex center at the second to fourth sacral level in the spinal cord
b. Constriction of the anal sphincter based on voluntary control
c. Sufficiently low water content in the stool
d. Low intestinal roughage that promotes easier digestion
72. A client with liver dysfunction is having difficulty with protein metabolism. The nurse anticipates that the
results of which of the following serum lab studies will be elevated?
a. Lactic acid
b. Ammonia
c. Albumin
d. Lactase
73. A client is admitted to the hospital following extreme dieting with severe weight loss. The nurse attributes the
weight loss to which of the following physiological processes that occurs in the prolonged absence of adequate
food intake?
a. Glucose metabolism
b. Glycogenolysis
c. Gluconeogenesis
d. Lactic acidosis
74. A nurse is providing the client with biliary obstruction a simple overview of the anatomy of the liver and
gallbladder. The nurse tells the client that normally the liver stores bile in the gallbladder, which is connected to
the liver by the
a. Liver canaliculi
b. Common bile duct
c. Cystic duct
d. Right hepatic duct
75. A nurse who is caring for an older client is aware that the client is at risk for prolonged medication effects as a
result of the normal aging process. The nurse would be even more concerned with this effect if the client had a
history of pathology of the
a. Stomach
b. Gallbladder
c. Liver
d. Pancreas
76. A client is diagnosed with pancreatitis. The nurse anticipates that production of which of the following
substances will be elevated in this client?
a. Amylase
b. Pepsin
c. Enterokinase
d. Lactase
77. A client who has just had an eye examination states that the results of the vision test indicate that the focal
point of the light rays falls behind the retina. The nurse concludes that this client is referring to which of the
following visual disturbances?
a. Myopia
b. Hyperopia
c. Astigmatism
d. Exophthalmos
78. A nurse notes that the client’s eyes are reddened and the client states that an eye infection has been diagnosed.
The nurse interprets that the client most likely is referring to infection of which of the following structures,
which provides a protective covering for the eye?
a. Iris
b. Lens
c. Cornea
d. Conjunctiva
79. A client who is experiencing visual difficulties has been told that the vision is impaired because the light rays are
falling in front of the retina. The nurse interprets that this client is experiencing which of the following visual
disturbances?
a. Myopia
b. Hyperopia
c. Astigmatism
d. Exophthalmos
80. A nurse overhears that a client with glaucoma has lost vision because of obstruction to aqueous humor flow by
the trabecular meshwork. The nurse interprets that this client is suffering from
a. Primary open-angle glaucoma
b. Angle –closure glaucoma
c. Low-tension glaucoma
d. Secondary glaucoma
81. A nurse is listening to a physician explain the results of an eye examination to a client. The physician states that
the client has glaucoma caused by a congenitally narrow anterior chamber angle, which suddenly has become
blocked by the base of the iris. The nurse interprets that the physician is describing which of the following
types of glaucoma?
a. Primary open-angle glaucoma
b. Angle –closure glaucoma
c. Low-tension glaucoma
d. Secondary glaucoma
82. A client is experiencing double vision, or diplopia. The nurse interprets that this client is experiencing a loss of
which of the following normal functions of the eye?
a. Optic nerve function
b. Binocular
c. Ocular muscle control
 d. Depth perception
83. A client with increased intraocular pressure is experiencing excessive production of aqueous humor of the eye
in relation to the speed of outflow. The nurse interprets that the part of the eye responsible for the production
of aqueous humor is the
a. Anterior chamber
b. Posterior chamber
c. Ciliary body
d. Trabecular meshwork
84. A complete eye examination yields the results that a client is color blind. The nurse interprets that which of the
following structures of the eye is affected?
a. Rods
b. Cones
c. Iris
d. Lens
85. A client with rheumatoid arthritis exhibits bilateral deformity of the joints of the fingers. The nurse interprets
that these symptoms are most likely the result of which cause of inflammation?
a. Endocrine
b. Metabolic
c. Allergic
d. Autoimmune
86. A nurse is assessing the status of pain on a client who was admitted recently to the hospital with a diagnosis of
chronic back pain. The nurse plans care knowing that chronic physiological responses to pain include
a. Increased PR
b. Dilated pupils
c. Dry skin
d. Perspiration
87. The nurse is assessing the status of pain on a cognitively impaired older adult. The nurse understands that
a. The prevalence of pain in this age group is about the same as clients younger than 60 years
b. Pain in the cognitively impaired older adult may require more frequent assessments than clients who are
not impaired
c. Mental images of pain are more effective means to assess pain in this group than visual representations
d. Clients in this age group are less sensitive to pain and have a greater pain tolerance
88. Parenterally administered meperidine hydrochloride (Demerol) has been prescribed postoperatively for an
older adult who has just had a right hip repair. The nurse monitors the client, knowing that in an older adult,
meperidine hydrochloride
a. Is just as effective as parenterally administered morphine sulfate
b. Is excreted more rapidly, thus necessitating more frequent dosing
c. May accumulate with repeated dosing, leading to seizures
d. Is recommended for use because of the short half-life of the medication
89. A nurse is caring for a postoperative client who had a small-bowel repair 1 day ago. The nurse is told in a report
that the client is a known opioid substance abuser and plans care knowing that
a. Opioid substance abusers are less tolerant to opioids and require decreased doses
b. These clients are at an increased risk for abrupt physiological withdrawal when mixed agonist-antagonists
and partial agonists are given
c. The client should be allowed to choose the pain medications and dosing regimen
d. Nonopioid therapies such as medication and cutaneous stimulation therapies are generally effective if used
alone
90. A patient-controlled analgesia is prescribed for a client to control pain. The nurse understands that this method
of pain relief improves pain relief and increases client satisfaction because
a. When compared with intermittent dosing, pain is relieved more effectively by increasing the amount of
opioid consumption per day
b. Overdosing is eliminated totally because the patient-controlled analgesia machine has a lockout system
c. The need for naloxone (Narcan) to reverse the effects of the opioid analgesic is eliminated
 d. Clients are empowered to initiate the administration of the medication, thus eliminating the time delay
waiting for the nurse to administer the medication
91. A client who had extensive abdominal surgery is receiving epidural analgesia. The nurse monitors the client
closely, knowing that a complication of this therapy is
a. Dislodgement of the epidural catheter because the catheter is not sutured in place
b. Chronic addiction to the epidural medication because epidural analgesia is a more powerful means of pain
relief than patient-controlled analgesia therapy
c. Permanent lower motor weakness because of the proximity of the catheter to the sciatic nerve
d. Constipation because of the location of the epidural catheter
92. A nurse is working in a long term care facility and is caring for older clients. The nurse understands that when
an older client complains of pain
a. Treating the symptom of pain immediately is better than first identifying the cause
b. One assumes that pain is a natural and expected outcome of aging
c. Nonpharmacologic relief measures such as massages and warm soaks are not effective
d. The pain indicates that something is wrong
93. A nurse is reviewing the lab results of an adult client who is being treated for metabolic acidosis. The nurse
determines that the serum potassium level is normal if which of the following results is noted?
a. 3 mEq/L
b. 4.1 mEq/L
c. 5.5 mEq/L
d. 6 mEq/L
94. A nurse is reviewing the lab results of an adult female client who takes 325mg of ASA (aspirin) daily and has
been having frequent episodes of nosebleeds. The nurse determines that the prothrombin level is normal if
which of the following results is noted?
a. 6 seconds
b. 7.5 seconds
c. 8.2 seconds
d. 9.8 seconds
95. A nurse is reviewing the lab results of a client who is receiving chemotherapy. The nurse determines that the
platelet count is normal if which of the following results is noted?
a. 90, 000 cells/µL
b. 120, 000 cells/µL
c. 300, 000 cells/µL
d. 500,000 cells/µL
96. A nurse is reviewing the lab results of an adult client with ascites. The nurse determines that the level is normal
if which of the following results is noted?
a. 1 g/dL
b. 3 g/dL
c. 4 g/dL
d. 6 g/dL
97. A nursing instructor asks a nursing student to identify suicide methods that are referred to as lower risk or
“soft” methods. The nursing instructor determines that the student understands these methods if the student
states that which of the following is a low-risk method?
a. Hanging
b. Inhaling natural gas
c. Using a gun
d. Jumping off of a bridge
98. The client is experiencing delirium. The nurse concludes that there is involvement of which of the following
areas of the nervous system?
a. Reticular activating system and cerebral hemispheres
b. Limbic system and cerebral hemispheres
c. Hippocampus and frontal lobe
d. Temporal lobe and frontal lobe
99. The client has sustained damage to Wernicke’s area in the temporal lobe from cerebrovascular accident. The
nurse understands that the client now will have difficulty
a. Understanding language
b. Articulating words
c. Recalling events in the remote past
d. Moving one side of the body
100. The client with a neurological deficit is able to identify a set of keys that is placed in the client’s hands while
the client’s eyes are closed. The nurse interprets that which of the following areas of the client’s brain is
intact?
a. Frontal lobe
b. Parietal lobe
c. Temporal lobe
d. Occipital lobe
101. The client has suffered a head injury affecting the occipital lobe of the brain. The nurse anticipates that the
client may experience difficulty with
a. Vision
b. Hearing
c. Smell
d. Taste
102. The nurse notes that the client who has suffered a brain injury has an adequate HR, BP, fluid balance, and
body temperature. The nurse concludes that which of the following areas of the client’s brain is functioning
adequately?
a. Thalamus
b. Hypothalamus
c. Reticular activating system
d. Limbic system
103. The nurse overhears a neurologist saying that a client has an aneurysm located in the circle of Willis. The
nurse interprets that the physician cannot be referring to which of the following blood vessels?
a. Anterior cerebral artery
b. Anterior communicating artery
c. Posterior cerebral artery
d. Basilar artery
104. The immobile client is at risk for disuse osteoporosis. The nurse understands that which of the following
substances plays an important role in the bond remodeling process?
a. Vitamin C
b. Vitamin A
c. Calcitonin
d. Thyroid hormone
105. The client is exhibiting muscle weakness. The nurse understands that which of the following
neurotransmitters is found at the myoneural junction to facilitate muscle stimulation and contraction?
a. Dopamine
b. Acetylcholine
c. Serotonin
d. Norepinephrine
106. When reading the product literature for a medication, the nurse notes that the medication is nephrotoxic.
The nurse interprets that this medication could cause damage to which o the following structures of the
kidney?
a. Renal artery
b. Nephron
c. Pelvis
d. Calyx
107. The client has been diagnosed with a bladder infection. The nurse understands that the client would be at
increased risk for extension of the infection to the kidneys if improper function occurred in which of the
following areas of the urinary system?
a. Urethra
b. Ureterovesical junction
c. Glomerulus
d. Nephron
108. The nurse is caring for the client whose urine output was 25 mL for consecutive hours. The nurse interprets
that which of the following client-related factors would be needed to increase the amount of blood flow to
the kidneys?
a. Release of low levels of dopamine
b. Physiological stress
c. Sympathetic nervous system stimulation
d. Release of norepinephrine
109. The client suffering from extensive vomiting has developed metabolic alkalosis. The nurse interprets that this
imbalance will be corrected primarily when the kidneys
a. Secrete sufficient potassium
b. Secrete sufficient water
c. Retain sufficient hydrogen ions
d. Retain sufficient chloride
110. The client becomes hypovolemic because of excess blood loss during surgery. The nurse interprets that which
of the following physiological responses is needed to restore adequate circulating volume?
a. Increased production of antidiuretic hormone
b. Inhibition of production of antidiuretic hormone
c. Increased production of erythropoietin
d. Inhibition of production of angiotensin
111. The client who had intracranial surgery is experiencing diabetes insipidus. The nurse understands that the
client is experiencing which of the following problems?
a. Water intoxication
b. Excess production of dopamine
c. Insufficient production of antidiuretic hormone
d. Excess production of angiotensin II
112. The client in renal failure is anemic. The nurse attributes this problem to the client’s insufficient production of
a. Rennin
b. Angiotensin I
c. Aldosterone
d. Erythropoietin
113. The nurse is caring for an older client. When evaluating the client’s renal function, the nurse recalls that which
of the following takes place as part of the normal aging process?
a. Medication are metabolized in larger amounts
b. Urine concentrating ability increases
c. Tubular reabsorption increases
d. Glomerular filtration rate diminishes
114. The client has a high potassium level. The nurse understands that the kidneys should have which of the
following responses when potassium is retained by the kidneys?
a. Increased sodium excretion
b. Increased sodium retention
c. Increased magnesium excretion
d. Increased glucose retention
115. The client’s kidneys are retaining greater amounts of sodium. The nurse anticipates that the kidneys also are
retaining greater amounts of
a. Calcium and chloride
b. Potassium and phosphates
 c. Chloride and bicarbonate
d. Aluminum and magnesium
116. The nurse is caring for the client who is at risk of fluid imbalance. In planning care for this client, the nurse is
aware that which of the following conditions will not cause the release of antidiuretic hormone?
a. Alcohol intake
b. Cold environment
c. Warm environment
d. Physiologic stress
117. The nurse is evaluating the client’s serum creatinine level. On noting that the level is high, the nurse
interprets that which of the following parts of the client’s nephrons is not secreting this substance
adequately?
a. Proximal tubule
b. Loop of henle
c. Distal tubule
d. Collecting duct
118. The nurse is performing a physical assessment on a client and notes that the client has a normal skin
condition and turgor. The nurse understands that the skin fibers responsible for the toughness and resiliency
of the skin are the
a. Collagen fibers
b. Reticular cells
c. Elastic fibers
d. Langerhans’ cells
119. A client complains of being cold, and the nurse notes the presence of gooseflesh on the client’s arms. The
nurse interprets that which of the following structures is responsible for this response?
a. Arterioles
b. Collage fibers
c. Sweat glands
d. Arrector pili muscles
120. A nurse who is bathing a client is able to see skin cells in some areas sloughing off during the bath. The nurse
interprets that these cells are the ones that are found in the layer of skin known as the stratum
a. Spinosum
b. Granulosum
c. Lucidum
d. Corneum
121. A nurse conducts a physical assessment on a client with dark skin. The nurse notes that the skin color is
determined by which of the following structures in the skin?
a. Melanocytes
b. Keratinocytes
c. Fibroblasts
d. Macrophages
122. A nurse assessing the client who has undergone chemotherapy for cancer exhibits hair loss. The nurse
documents this finding as
a. Hirsutism
b. Alopecia
c. Xerosis
d. Hyperhidrosis
123. A client has a callus formation on the plantar areas of both feet. The nurse interprets that this is the result of
which of the following processes?
a. Vitiligo
b. Apocrine gland activity
c. Hyperkeratosis
d. Melanocyte activity
124. The nurse notes that the client’s record states that the client has melasma. The nurse would anticipate that
this client will exhibit
a. Patches of skin that have loss of pigmentation
b. Blotchy brown macules across the cheeks and forehead
c. Skin that is uniformly dark
d. Pale skin with little pigmentation
125. A client who previously suffered a burn injury now exhibits keloid formation. The nurse interprets that this
condition is due to hypertrophy of which of the following parts of the dermis?
a. Nerves
b. Vasculature
c. Collagen
d. Subcutaneous tissue