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1) All of the followings are signs of HYPOXIA Except:

a) Rapid pulse
b) Cyanosis
c) Rapid shallow respiration
d) Diarrhea.

2) Hypercabnia is:
a) Bluish discoloration of the skin nails beds and mucosal membrane.
b) Inadequate alveolar ventilation can lead to hypoxia.
c) Accumulation of carbon dioxide in the blood.
d) Slow respiration rate.

3) Which position allow maximum chest expansion to the client:

a) Prone.
b) Semifolwer.
c) Supine.
d) Lateral.

4) Which one of the following its major function to supply energy:

a) Protein
b) Carbohydrates
c) Fats
d) Minerals

5) What number 18 indicate, regarding body mass index scale

(BMI):
a)Underweight
b) Morbidly obese
c) Malnourished
d) Normal

6) Which one of the following diets include only water, tea, coffee,
clear juice:
a) Clear liquid diet
b) Soft diet
c) Full liquid diet
d) Diabetic diet

7) Constipation is:
a) Fewer than 5 bowel movement per week.
b) Fewer than three bowel movement per week.
c) Passage of liquid feces and increased frequency of defecation.

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d) air or gas in GI tract

8) All of the followings are normal characteristics of feces Except:

a) Brown color.
b) Very hard and solid.
c) Amount: varies with diet.
d) Odor: affected by digested food

9) Oliguria is:
a) Production of abnormally large amount of urine by kidneys.
b) Lack of urine production, with no effective urine production.
c) voiding that either painful or difficult.
d) Low urine output, usually less than 500 ml a day, or 30 ml an hour.

10) All of the followings are normal characteristics of urine

Except:
a) Volume: 1200- 1500 ml per day
b) Straw color.
c) Sterile, no microorganisms.
d) Cloudy.

11) The drug generic name is:

a) Is the name by which the chemist knows it.
b) Is the name under which it’s listed in one in the official publication.
c) Is given for the drug to being official name.
d) Is name given by the drug manufacture.

12) The preferred site for IM injection is:

a) Ventrogluteal site.
b) Vastus latralis.
c) Dorsogluteal site.
d) Deltoid muscle.

13) The intentional wound is:

a) Occur during therapy.
b) Occur accidentally.
c) The mucous membrane or skin surface is broken.
d) The tissue is traumatized without a break in the skin.

14) The abrasion is:

a) Open wound involving skin only
b) It is due to surface scrape.

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c) It is painful wound.
d) All of the above.

15) All of the followings are risk factors for nosocomial infections
EXCEPT:
a) Poor hand washing.
b) Using sterile techniques.
c) Contamination of closed drainage system.
d) Improper procedure technique (dressing, suctioning, catherization).

16) Medical asepsis includes:

a) Hand washing.
b) Personal protective equipment (uniform, gown, gloves, face mask).
c) Cleaning, Disinfecting, Sterilizing.
d) All of the above.

17) Acute infection is:

a) Infection may occur slowly and takes long time.
b) is limited to the specific part of the body where micro organisms
remain.
c) Infection appears suddenly or in short time.
d) When micro organisms spread and damage different part of body.

18) Indirect transmission of infection includes:

a) Vehicle born transmission.
b) Vector borne transmission.
c) A only correct.
d) A and B are correct.

19) Incubation period of infection is:

a) Person is most infectious and non specific sign and symptom.
b) Organism growing and multiplying.
c) Recovery from infection.
d) Presence of specific sign and symptom.

20) All of the following libratory data indicating infection EXCEPT:

a) Increased specific type of leukocyte.
b) Increased in body temp.
c) Decreased WBC.
d) Positive culture in blood, urine or sputum.

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21) All of the followings are Signs of systematic infection EXCEPT:

a) Fever.
b) Vomiting.
c) Fatigue and loss of energy.
d) Enlargement and tenderness of lymph node.

22) All of the followings are etiologies of self care deficit EXCEPT:
a) scar and abrasions.
b) Activity intolerance or weakness.
c) Mental impairment.
d) Visual impairment.

23) Skin turgor is:

a) Decrease sensation in extremities due to nerves system disease.
b) Collection of fluids inside the tissue.
c) Elasticity by lifting and pulling the skin on an extremity.
d) Non of the above.

24) Which of the following conditions indicate long term lack of

oxygen:
a) Koilonychias.
b) Capillary refill
c) Clubbing fingers.
b) Non of the above.

26) Pressure ulcer risk factors include:

a) Immobility and inactivity.
b) Fecal and urinary incontinence.
c) Decreased mental status.
d) All of the above.

26) Complications of wound healing include:

a) Hematoma.
b) Nausea.
c) Hypertension.
d) All of the above.

27) The patient should be fasts (NPO) before the surgery for:
a) 24 hours.
b) 16 hours.
c) 6 to 8 hours.

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d) 12 hours.

28) Scrub nurse role includes:

a) Assist the surgeons.
b) Draping the client with sterile drapes.
c) Handling sterile equipments and supplies.
d) All of the above.

29) Deep- Breathing and coughing exercises in postoperation phase

are important for:
a) Prevent deep vain thrombosis (DVT).
b) Atalectasis (collapse of alveoli).
c) Hemorrhage.
d) Infection.

30)Which of the following vital signs are normal:

a) Temp: 37, RR: 22, HR: 90, BP: 135/85.
b) Temp: 36.7, RR: 18, HR: 75, BP: 125/80.
c) Temp: 38, RR: 12, HR: 110, BP: 155/90.
d) Temp: 37.2, RR: 16, HR: 50, BP: 115/65.

31)Nurse can provide care for:

a) Individual.
b) Families.
c) Communities.
d) All of the above is correct.

32)Nursing can be defined as:

a) Caring.
b) Science and art.
c) Holistic.
d) All of the above is correct.

33)Example of health promotion:

a) Immunization.
b) Direct care (give medication).
c) Stop cigarette smoking.
d) All of the above is correct.

34)Immunization is an example of:

a) Health promotion.
b) Prevent illness.

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c) Restoring health.
d) Care of the dying.

35)Health is defined as:

a) State of complete physical, social, mental, and spiritual wellbeing
and not merely absence of disease.
b) Felling of wellbeing.
c) Absence of disease.
d) State of complete physical and mental wellbeing only.

36)In which phase of nursing process the nurse collect data about the
client:
a) Diagnosis.
b) Assessment.
c) Implementation.
d) Evaluation.

37)Chief complain includes:

a) Immunization and childhood illness.
b) Hoppies and sleep pattern.
c) Risk factor for certain diseases.
d) The answer given to question “what brought you to the hospital”

38)The chief complain should be record using:

a) Nurse words.
b) Patient words.
c) Physician words.
d) None of the above.

39)Nursing diagnosis is:

a) A statement that describes actual health problem only.
b) A statement that describes potential health problem only.
c) A statement that describes actual and potential health problems.
d) Puts the nursing care plan into action.

40)The nursing diagnosis include all the following except:

a) Problem.
b) Time.
c) Sign.
d) Etiology.

41)Hyperthermia is:

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a) Body temperature between 36.4 – 37.4

b) Body temperature between 39 – 41
c) Body temperature below 36.
d) Body temperature between 38 – 40.

42)All of the following are clinical sign of fever except:

a) Palled.
b) Shivering.
c) Decrease thirst.
d) Increase heart rate.

43)All of the following factors are increase respiratory rate except:

a) Decrease temp.
b) Stress.
c) Exercise.
d) Increase altitude.

44)The most safe and non invasive site to measure the temperature
is:
a) Oral site.
b) Auxiliary site.
c) Rectal site.
d) Tympanic site.

45)The difference between rectal and auxiliary temp is:

a) 0.5 c
b) 0.8 c
c) 2 c
d) 1 c.

46)The tachycardia is :
a) Heart rate below 60.
b) Heart rate above 100.
c) Respiratory rate below 12.
d) Respiratory rate above 20.
47)Hyperventilation is:
a) Slow breathing.
b) Shallow respiration.
c) Deep respiration.
d) Fast respiratory rate.

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48)Hemoptysis is:
a) Cough with secretions.
b) Cough without secretions.
c) Difficult breathing.
d) Blood in the sputum.

B) Write the meaning of the following abbreviations:

1. PO: 6. ac:
2. pc: 7. QID:
3. Hs: 8. Rx:
4. PRN: 9. OD:
5. Stat: 10. TID: three times a day

C) Match the terms of column A with it’s meaning from column B:

Column A Column B
1. Palliative drug action.
2. Curative drug action.
3. Supportive drug action.
4. Restorative drug action.
5. Drug side effect.
6. Drug toxicity.
7. Drug allergy.
8. Drug misuse.
9. Drug interaction.
10. Drug abuse.
11. Drug dependence.
12. chemotherapy drug

Column B:
K: is an appropriate intake of substance either continually or periodically.
feeling of need.
D: occur when administration of one drug before or after alter effect of
one or both drug.
J: Is the improper use of common medications in way that lead to acute
and chronic toxicity for example laxative, antacid and vitamins
H: support body function until treatment or body response can take over
as aspirin.

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F: relieve symptom of a disease but does not affect on a disease it self as

morphine.
G: cure a disease or condition as penicillin.
A: return body health as vitamin.
L: destroy malignant cell as busulfan for leukemia.
C: is immunological reaction to a drug.
I: deleterious effect of the drug on an organism or tissue, result from
overdose or external use.
B: secondary effect of the drug is one that unintended, side effects are
usually predictable and may be either harmless.
E: is a persons reliance on or need to take drug or substance there are two
type of dependence: physiological and psychological.

D) Fill the blank with the most correct term:

Gingivitis, Glossitis, Stomatitis, Cheilosis, Dental caries, Halitosis,
Erythema, Cyanosis, Jaundice, Pallor, Hirsutism, Alopecia, Dandruff,
Puncture, Laceration, Stab wound, Pressure ulcer, Hematoma.

1) - Alopecia - hair loss.

2) - Halitosis - bad breath.
3) -- Jaundice -- yellow skin color.
4) -- Gingivitis -- inflammation of gum.
5) - Hematoma -- localized collection of blood underneath the skin.
6) --- Pressure ulcer-- any lesion caused by unrelieved pressure that
results in damage to underlying tissue.
7) - Stomatitis -- inflammation of the oral mucosa.
8) -- Stab wound -open wound, penetration of the skin and the
underlying tissues, usually unintentional.
9) -- Cyanosis -- blue skin color.
10) - Laceration -open wound edges are often jagged, tissues
torn apart.
11) -- Glossitis --inflammation of tongue.
12) -- Pallor --- white skin color.
13) - Puncture -- open wound, penetrating of the skin and often
the underlying tissues by a sharp instrument.
14) -- Cyanosis -skin redness.
15) -- Dental caries --- teeth have darkened areas.

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1- Mention three types of microorganisms can cause infection:

1. bacteria [Link]
2. viruses
3. fungus

2- The chain of infection consists of:

1. reseriour
2. port of exite
3. port of enter
4. host
5. environment

3-In skin color assessment, you may use one of the following terms.
Mention the color that terms indicate.
1. Erythema:.
2. Cyanosis:
3. Jaundice:
4. Pallor:
.

4-Mention 6 routes of medication administration:

1. intradermal 7. sublingual
2. subcutaneous 8. rectal
3. intramumscular 9. inhalation
4. intraarticular
5. intracardiac
6. orally

5-Write the meaning of the following Abbreviations:

1. PO:
2. PRN:
3. BID:

6- Mention the five steps of nursing process:

1. assessment
2. diagnosis
3. planning
4. implementation
5. evaluation

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7- Classify the followings to subjective or objective data:

Pain, blood pressure, heart rate, itching, weakness, redness, cyanosis.
Subjective Objective
pain blood pressure
itching heart rate
weakness redness
cyanosis

8-Write the component of this nursing goal.

The patient will be able to verbalize relieve pain by the end of this shift.
1. Subject: The patient 2. Verb: verbalize
3. Time: the end of this shift

9- Fill in the blank:

1. The normal range of heart rate is between ---60- and –100—
beat/min
2. The normal range of Temp is between –--36.4 and ---37.4- C.
3. Hyperpyrexia is very high temperature more than -----40.6-C.
4. In hypothermia body temperature is less than ----36.4C.
5. Auxiliary temp is less than -oral--- temp by 0.5C.

10- Mention 5 sites of pulse:

1. temporal [Link]
2. carotid [Link] pedis
3. brachial [Link] tibial
4. radial
5.. femoral

13) Write the normal range for followings:

1) Heart rate: ---60--- to ---100-- beat /min.

2) Respiratory rate: ----12---- to----20---- breath/min.

3) Temperature: ------36.4-- to----37.4----C.

4) Systolic blood pressure: -----96----- to--139-- mmHg.

5) Diastolic blood pressure: ------60------- to-----89---- mmHg.

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I- Match the following terms with their explanations (15 marks):

Answer Explanation Term

Waxy flexibility 1-social
phobia
6 Inability to fail in sleep 2- mania
11 Feeling state reported by the patient that can vary 3- Obsession
with external and internal changes
13 Mood of elation with higher that usual activity and 4-
social interaction, not as expansive as full mania hallucination
8 Inability to recognize reality or bizarre behavior or 5- catalepsy
to deal with life's demand
10 Occurs as a result of exposure to a traumatic events 6- -insomnia
that are out side the range of normal human
experience.
2 Elevated, expansive or irritable mood accompanied 7-anhedonia
by hyperactivity, grandiosity, and loss of reality
1 Fear of facing people 8- psychosis
7 Loss of pleasure and interest in activities previously 9- flight of
enjoyed, or in life itself idea
15 Ability to asses and evaluate situation, make 10- PTSD
rational decision
3 Recurrent, persistent, intrusive thoughts, impulses 11- mood
or images
4 Subjective disorder of sensory perception in one of 12- delusion
the 5 senses without found of external stimulation
14 Abrupt interruption in the flow of thoughts or idea 13-
due to a disturbance in the speed of association hypomania
9 Rapid shifting from one idea to another without 14- thought
completion of it block
12 False fixed unshakable belief 15-godjment

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II. For each of the following statements, place a (T) in the blank if it is true & (F)
if it is false:(15marks)

No. ent T or F
1- Affect is an objective data
2- Euphoria and elation is two symptoms of mania
3- Depression is a result of subjective or objective loss
4- Anxiety usually associated with tachycardia, tachypnea, and
dilated pupils.
5- PTSD occurs as a result of exposure to a traumatic events that
are out side the range of normal human experience.
6- Schizophrenia is considered the lowest psychological disorder
to occur in population.
7- Family conflicts is a factor that not lead to schizophrenia
disorder
8- Schizophrenia is a disturbance of thought and perception
9- The most hallucination to be found in schizophrenic patient is
olfactory hallucination
10- Largoctyl is the most familiar antipsychotic drug used in
psychotic disorders.
11- Bizarre posture for long time is found in catatonic
schizophrenia
12- The first line to treat an aggressive psychiatric patient is
pharmacologic drugs.
13- Hallucination and delusion are found in all psychiatric
disorder
14- When administer antipsychotic drugs the nurse must be sure
the patient swallow the medication
15- Patient who has suicidal thoughts must be admitted to
psychiatric hospital

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III- Answer 4 of the following questions the first one is obligatory:

1- List the common mental psychiatric disorder among children.

2-list the five types of schizophrenia and write what did you know about each
one( 10 marks)

2- Obsessive compulsive disorder (OCD) is one subtype of anxiety write what is

it and the kinds of management to deal with it ( 10 marks)

3- discuss the clinical manifestation of anxiety .( 10 marks)

4- Anxiety has 4 levels " mild, moderate, sever and panic" differentiate them by
singes and symptoms associated with them (10 marks)

5- Put a plan of treatment for a patient who has sever depression with suicidal
thoughts (10marks)

(Pones question)
# - Write on your own words the usefulness of mental stat examination.(3marks)

• 1 Which of the following is /are causes (etiology) of eating

disorder
a) families factors.
b) socio-cultural factors
c) biological factors
d) all of above
• 2 All of the following are clinical symptoms occur during
anorexia nervosa ECXPT.
1. behavioral symptoms
2. physical symptoms
3. psychological symptoms
4. endocrine symptoms

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• 3 Amenorrhea , slow pulse , sunken eyes are symptoms occur

during anorexia nervosa these symptoms called:
a) physical symptom
b) behavioral symptom
c) psychological symptom
d) all of the above
• 4 All of the following are indication to electro-convulsive
therapy (ECT) ECXPT
a) severe depression
b) catatonic schizophrenia
c) hyperactivity manic patients
d) epilepsy .
• 5 Which of the following is contraindications for electro-
convulsive therapy (ECT)
a) recent myocardial infraction
b) behavior disorder
c) hypertension
d) post operation

• 6 Fatima female patient 30 years, admitted to psychiatric

hospital with impulsivity , feeling emptiness , difficult being
alone ,with suicidal ideation , Fatima is experiencing:
a) borderline personality disorder
b) avoidant personality disorder
c) histrionic personality disorder
d) paranoid personality disorder

7 Chlorpromazine (Largactil) is :
a) antipsychotic
b) anti anxiety
c) anti depressant
d) anti parkinsonism

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• 8 Trithexphenidyl hydrochloride (Aatrane ) is:

1. antipsychotic
2. anti anxiety
3. anti depressant
4. anti parkinsonism
• 9 Identify which of the following medications is not anti
depressant ?
1. Clomiparmine hydrochloride (anafranil)
2. Imipramine hydrochloride (tofranil )
3. Phenelazine sulfate (nardil)
4. Amantadine hydrochlorides(symptom)
• 10 All of the following medication are anti convulsant ECXPT
a) Phenytoin
b) Carbamzepine
c) Diazepam
d) levodopa

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Answer the following questions

I- Circle the most correct answer

1- All the following interventions may be performed by you for a child
with productive cough except?
a. Encourage fluid intake
b. Administering antitussive
c. Postural drainage
d. Giving mucolytics

2- Fallot tetraology includes which of the following defects?

a. Pulmonary stenosis
b. Right ventricular hypertrophy
c. Ventricular septal defect
d. All of the above

3- The nursing care for cardiac disease child should include?

a. Bed rest
b. Provision of oxygen as needed
c. Passive stimulation
d. All of the above

4- Hyperbilirubinemia in newborn usually occurs due to?

a. Immature liver function
b. Rh incompatibility
c. ABO incompatibility
d. Hepatitis disease

5- The most dangerous complication of hyperbilirubinemia in newborn

is?
a. Lethargy
b. poor feeding
c. Kernicterus
d. Jaundice in the eyes
6 - All the following nursing measures may be done for anemic child
except?
a. Bed rest
b. Elevate head of bed
c. Large meals
d. Administration of blood

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7- Which of the following interventions may be done for iron deficiency

anemia child?
a. Bed rest
b. High iron diet
c. Brushing teeth after iron administration
d. All of the above

8- Thalassemic child care may include all of the following except?

a. Administration of blood every 3-4 weeks
b. Administration of iron chelating agent (desferal)
c. Increase physical activity
d. Possible splenectomy

7- All the following nursing measures are suitable for child with
convulsions except?
a. Keeping patent air way
b. Place child on his side
c. Restraining child’s extremities
d. Recording the events of convulsion

8 - As a nurse you should position the new born with myelomeningiocele

on?
a. Back
b. Prone
c. Supine position
d. All of the above

9 - Management of bacterial meningitis may include all the following

except?
a. Isolation
b. Oral antibiotics
c. Quiet environment
d. Monitoring convulsions and complications

10 - Which of the following CSF results not match the bacterial

meningitis?
a. High cells count
b. High sugar
c. High protein
d. Turbid CSF fluid

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11- In child with acute glumerulonephritis and impaired renal function,

you may do all the following except?
a. Bed rest
b. Record intake and out put
c. Give high fluid diet
d. Monitor blood pressure

12- Screening should be done for newborns in Gaza to early detect?

a. Hypothyroidism
b. CDH
c. PKU
d. All of the above

13 - Juvenile D.M. in children can be treated by?

a. Insulin
b. Diet
c. Oral hypoglycemic agents
d. All of the above

14 - Celiac disease child dietary management includes?

a. Low phenylalanine diet
b. Life long free gluten diet
c. Low fat soluble vitamins supplementation
d. All of the above
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1- Growth is increase in?
a. Function
b. Size
c. Quality
d. A+C

2- The adolescent age groups are influenced more by?

a. Their older brothers/sisters
b. Their peers
c. Their parents
d. Their teachers

3- Adolescents are more vulnerable to?

a. Suicide
b. Drugs addiction
c. Emotional instability
d. All of the above

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4- The Parents should ………… their child’s growth and

development?
a. Monitor
b. Facilitate
c. Understand
d. All of the above
5- The child birth weight triples at?
a. 3 months old
b. 6 months old
c. 12 months old
d. 15 months old

6- Infant starts sitting without support for the first time mostly
at?
a. 4 months age
b. 6 months age
c. 8 months age
d. 10 months age

7- The child birth weight triples at?

a. 3 months old
b. 6 months old
c. 12 months old
d. 15 months old

8- The infant walks without support at?

a. Age 8 months
b. Age 12 months
c. Age 14 months
d. Age 16 months
9- In the first year of life the length of an infant increases by
……….cm?
a. 15
b. 25
c. 35
d. 45
10- At age 5 years child’s weight should be about?
a- 12 kg
b- 15 kg
c- 18 kg
d- 21 kg

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11- The height of 3 years old child is expected to be?

a. 80 cm
b. 95 cm
c. 110 cm
d. 125 cm
12- Head circumference for a 12 months child is expected
to be?
a. 44 cm
b. 47 cm
c. 49 cm
d. 51 cm

II- Match the following:

A B
( ) Excessive salivation 1- Ascariasis
( ) Projectile vomiting 2- Unchanged diapers
( ) Colostomy 3- Imperforated anus
( ) Current-Jelly stool 4- Gastroesophageal reflux
( ) Diarrhea and vomiting 5- Esophageal atresia
( ) Constipation 6- Failure to thrive
( ) Very low weight 7- Pyloric stenosis
( ) Diaper dermatitis 8- Dehydration
( ) Urinary tract infection 9- Intussusception
( ) Contact transmission 10- Autoimmune disease
11- Female children
12- Scabies
13-Megacolon

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Put true or false in front of the following statements

( ) 1- Hirschsprung’s disease diagnosed by biopsy
( ) 2- Vomiting leads to Acidosis
( ) 3- Increase fluid intake is indicated in UTI
( ) 4- Eyes should not be protected for newborn under phototherapy
( )5- Mouth care not needed after feeding clef palate child before
surgery
( )6- IV medications for children should be given at least for a minute
( ) 7- Wheat is permitted for a celiac child while corn is not
( ) 8- Feverish child needs ice compresses
( ) 9- Hypertensive encephalopathy is the dangerous complication of
AGN
( ) 10- Poliomyelitis is a bacterial infectious disease

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1-The nurse is assessing a client experiencing motor loss as a result of a

left-sided cerebrovascular accident (CVA). Which clinical
manifestations would the nurse document?

1 Hemiparesis of the client’s left arm and apraxia.

٢ Paralysis of the right side of the body and ataxia.
3 Homonymous hemianopsia and diplopia.
٤Impulsive behavior and hostility toward family.

2 The client diagnosed with atrial fibrillation has experienced a

transient ischemic attack (TIA). Which medication would the
nurse anticipate being ordered for the client on discharge?
1. An oral anticoagulant medication.
2. A beta-blocker medication.
3. An anti-hyperuricemic medication.
4. A thrombolytic medication.

3 The client is admitted to the medical floor with a diagnosis of

closed head injury. Which nursing intervention has priority?
1. Assess neurological status.
2. Monitor pulse, respiration, and blood pressure.
3. Initiate an intravenous access.
4. Maintain an adequate airway.

4 The client has been newly diagnosed with epilepsy. Which

discharge instructions
should be taught to the client?
1. Keep a record of seizure activity.
2. Regular checkup of therapeutic drug level.
3. Avoid over-the-counter medications.
4. All of the above.
5 The client is prescribed phenytoin (Dilantin), an anticonvulsant,
for a seizure disorder. Which statement indicates the client
understands the discharge teaching concerning this medication?
1. “I will brush my teeth after every meal.”
2. “I will check my Dilantin level daily.”
3. “My urine will turn orange while on Dilantin.”
4. “I won’t have any seizures while on this
medication.”
6 When caring for the client with encephalitis, which intervention
should the nurse
implement first to determine if the client is deteriorating?
1. Examine pupil reactions to light.

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2. Assess level of consciousness.

3. Observe for seizure activity.
4. Monitor vital signs every shift.

7 The client is diagnosed with a myocardial infarction. Which

referral would be most
appropriate for the client?
1. Social worker.
2. Physical therapy.
3. Cardiac rehabilitation.
4. Occupational therapist.

8 The nurse is administering a calcium channel blocker to the

client diagnosed with a
myocardial infarction. Which assessment data would cause the
nurse to question
administering this medication?
1. The client’s apical pulse is 64.
2. The client’s calcium level is elevated.
3. The client’s telemetry shows occasional PVCs.
4. The client’s blood pressure is 90/62.

9 The male client is diagnosed with coronary artery disease (CAD)

and is prescribed
sublingual nitroglycerin. Which statement indicates the client
needs more teaching?
1. “I should keep the tablets in the dark colored bottle they came in.”
2. “If the tablets do not burn under my tongue, they are not effective.”
3. “I should keep the bottle with me in my pocket at all times.”
4. “If my chest pain is not gone with one tablet, I will go to the ER.”

10 The health-care provider has ordered an angiotensin-

converting enzyme (ACE)inhibitor for the client diagnosed with
congestive heart failure. Which discharge
instructions should the nurse include?
1 Instruct the client to take a cough suppressant if a cough
develops.
2. Teach the client how to prevent orthostatic hypotension.
3. Encourage the client to eat bananas to increase potassium level.
4. Explain the importance of taking medication with food.

11 The client is experiencing multifocal premature ventricular

contractions. Which antidysrhythmic

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medication would the nurse expect the health-care provider to

order for this client?
1. Lidocaine.
2. Atropine.
3. Digoxin.
4. Adenosine.

12 The client shows ventricular fibrillation on the telemetry at the

nurse’s station. Which
action should the telemetry nurse implement first?
1. Administer epinephrine IVP.
2. Prepare to defibrillate the client.
3. Call a STAT code.
4. Start cardiopulmonary resuscitation.

13 The client is in complete heart block. Which intervention

should the nurse implement
first?
1. Prepare to insert a pacemaker.
2. Administer atropine.
3. Obtain a STAT electrocardiogram (ECG).
4. Notify the health-care provider.

14 The client diagnosed with pericarditis is complaining of

increased pain. Which intervention should the nurse implement
first?
1. Administer oxygen via nasal cannula.
2. Evaluate the client’s urinary output.
3. Assess the client for cardiac complications.
4. Encourage the client to use the incentive spirometer.

15 Which potential complication should the nurse assess for in the

client with infective
endocarditis who has embolization of vegetative lesions from the
mitral valve?
1. Pulmonary embolus.
2. Decreased urine output.
3. Hemoptysis.

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4. Deep vein thrombosis.

16 The 66-year-old male client has his blood pressure (BP)
checked at a health fair. The B/P is 168/98. Which action should
the nurse implement first?

Recommend that the client have his

١ blood
pressure checked in one (1) month.
2. Instruct the client to see his health-care provider as soon as
possible.
3. Discuss the importance of eating a low-salt, low-fat,
low-cholesterol diet.
4. Explain that this B/P is within the normal range for an elderly
person.

17 The health-care provider prescribes an ACE inhibitor for the

client diagnosed with
essential hypertension. Which statement is the most appropriate
rationale for administering
this medication?
1. ACE inhibitors prevent the beta-receptor stimulation in the heart.
2. This medication blocks the alpha receptors in the vascular smooth
muscle.
3. ACE inhibitors prevent vasoconstriction and sodium and water
retention.
4. ACE inhibitors decrease blood pressure by relaxing vascular
smooth muscle.

18 The nurse just received the A.M. shift report. Which client
should the nurse assess first?
1. The client diagnosed with coronary artery disease who has a BP of
170/100.
2. The client diagnosed with deep vein thrombosis who is complaining
of chest pain.
3. The client diagnosed with pneumonia who has a pulse oximeter
reading of 98%.
4. The client diagnosed with ulcerative colitis who has nonbloody
diarrhea.

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19 The nurse is teaching a class on arterial essential hypertension.

Which modifiable risk factors would the nurse include when
preparing this presentation?
1. Include information on retinopathy and nephropathy.
2. Discuss sedentary lifestyle and smoking cessation.
3. Include discussions on family history and gender.
4. Provide information on a low-fiber and high-salt diet.

The client comes to the clinic complaining of muscle cramping and

٢٠pain in both legs
when walking for short periods of time. Which medical term
would the nurse document
in the client’s record?
1. Peripheral vascular disease (PVD).
2. Intermittent claudication.
3. Deep vein thrombosis (DVT).
4. Dependent rubor.

21 Which assessment data would warrant immediate intervention

in the client diagnosed with arterial occlusive disease?
1. The client has 2 pedal pulses.
2. The client is able to move the toes.
3. The client has numbness and tingling.
4. The client’s feet are red when standing.

The client asks the nurse, “My doctor just told me that
٢٢atherosclerosis is why my
hurt when I walk. What does that mean?” Which response by the
nurse would be the
best response?
1. “The muscle fibers and endothelial lining of your arteries have
become thickened.”
2. “The next time you see your HCP ask what atherosclerosis means.”
3. “The valves in the veins of your legs are incompetent so your legs
hurt.”
4. “You have a hardening of your arteries that decreases the oxygen to
your legs.”

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23 The nurse is caring for clients on an oncology unit. Which

neutropenia precautions should be implemented?
1. Hold all venipuncture sites for at least five (5) minutes.
2. Limit fresh fruits and flowers.
3. Place all clients in reverse isolation.
4. Have the client use a soft-bristle toothbrush.
24 The client with O blood is in need of an emergency transfusion but
the lab does not have any O blood available. Which potential unit of
blood could be given to the client?
1. The O unit.
2. The A unit.
3. The B unit.
4. Any Rh unit.

25 Which statement is the scientific rationale for infusing a unit of

blood in less than four
(4) hours?
1. The blood will coagulate if left out of the refrigerator for longer than
four (4) hours.
2. The blood has the potential for bacterial growth if allowed to infuse
longer.
3. The blood components begin to break down after four (4) hours.
4. The blood will not be affected; this is a laboratory procedure.

26 When assessing the client with COPD, which health promotion

information would be
most important for the nurse to obtain?
1. Number of years the client has smoked.
2. Risk factors for complications.
3. Ability to administer inhaled medication.
4. Possibility for lifestyle changes.

27 The client diagnosed with asthma is admitted to the emergency

department with difficulty
breathing and a blue color around the mouth. Which diagnostic test
will be
ordered to determine the status of the client?
1. Complete blood count.
2. Pulmonary function test.
3. Allergy skin testing.
4. Drug cortisol level.

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The nurse is discussing the care of a child diagnosed with asthma with
٢٨the parent.
Which referral would be important to include?
1. Referral to a dietitian.
2. Referral for allergy testing.
3. Referral to the developmental psychologist.
4. Referral to a home health nurse.

The nurse is preparing the client diagnosed with laryngeal cancer for a
٢٩laryngectomy
in the morning. Which intervention would have priority?
1. Take the client to the intensive care unit for a visit.
2. Explain that the client will need to ask for pain medication.
3. Demonstrate the use of an anti-embolism hose.
4. Find out if the client can read and write.

Which assessment data would support that the client has experienced a
٣٠pulmonary
embolus?
1. Calf pain with dorsiflexion of the foot.
2. Sudden onset of chest pain and dyspnea.
3. Left-sided chest pain and diaphoresis.
4. Bilateral crackles and low-grade fever.

31 The client has just been diagnosed with a pulmonary embolus.

Which intervention should the nurse implement?
1. Administer oral anticoagulants.
2. Assess the client’s bowel sounds.
3. Prepare the client for a thoracentesis.
4. Institute and maintain bed rest

32 The client is admitted to the emergency department with chest

trauma. When assessing the client, which signs/symptoms would the
nurse expect to find that support
the diagnosis of pneumothorax?
١ Bronchovesicular lung sounds and bradypnea.
2. Unequal lung expansion and dyspnea.
3. Frothy bloody sputum and consolidation.
4. Barrel chest and polycythemia.

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33The client had a right-sided chest tube inserted two (2) hours ago for
a [Link] action should the nurse take if there is no
fluctuation (tidaling) in the water-seal compartment?

1. Obtain an order for a stat chest x-ray.

2. Increase the amount of wall suction.
3. Check the tubing for kinks or clots.
4. Monitor the client’s pulse oximeter reading.

34 The client diagnosed with ARDS is transferred to the intensive care

department and
placed on a ventilator. Which intervention should the nurse implement
first?
1. Confirm that the ventilator settings are correct.
2. Verify that the ventilator alarms are functioning properly.
3. Assess the respiratory status and pulse oximeter reading.
4. Monitor the client’s arterial blood gas results.

35 The nurse suspects the client may be developing ARDS. Which

assessment data confirm the diagnosis of ARDS?
1. Low arterial oxygen when administering high concentration of oxygen.
2. The client has dyspnea and tachycardia and is feeling anxious.
3. Bilateral breath sounds clear and pulse oximeter reading is 95%.
4. The client has jugular vein distention and frothy sputum.

36 Which assessment data would indicate the client diagnosed with

ARDS has experienced a complication secondary to the ventilator?
1. The client’s urine output is 100 mL in two (2) hours.
2. The pulse oximeter reading is greater than 95%.
3. The client has asymmetrical chest expansion.
4. The telemetry reading shows sinus tachycardia.

The client with ARDS is on a mechanical ventilator. Which

٣٧intervention should be
included in the nursing care plan addressing the endotracheal tube
care?
1. Do not move or touch the ET tube.
2. Obtain a chest x-ray daily.
3. Determine if the ET cuff is deflated.
4. Ensure that the ET tube is secure.

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38 The client is prescribed prednisone, a steroid, for an acute episode

of inflammatory
bowel disease. Which intervention should the nurse discuss with the
client?
1. Take this medication on an empty stomach.
2. Notify the HCP if you experience a moon face.
3. Be sure to take this medication as prescribed.
4. Take the medication in the morning only.

39 Which assessment data support the client’s diagnosis of gastric

ulcer?

1. Presence of blood in the client’s stool for the past month.

2. Complaints of a burning sensation that moves like a wave.
3. Sharp pain in the upper abdomen after eating a heavy meal.
4. Comparison of complaints of pain with ingestion of food and sleep.

40 When planning the care for a client diagnosed with peptic ulcer
disease, which expected outcome should the nurse include?
1. The client’s pain is controlled with the use of NSAIDs.
2. The client maintains lifestyle modifications.
3. The client has no signs and symptoms of hemoptysis.
4. The client takes antacids with each meal.

41 Which assessment data would indicate to the nurse that the client’s
gastric ulcer has perforated?
1. Complaints of sudden, sharp, substernal pain.
2. Rigid, boardlike abdomen with rebound tenderness.
3. Frequent, clay-colored, liquid stool.
4. Complaints of vague abdominal pain in the right upper quadrant.

42 The client with a history of peptic ulcer disease has been admitted
into the hospital
intensive care unit with frank gastric bleeding. Which priority
intervention should the
nurse implement?
1. Maintain a strict record of intake and output.
2. Insert a nasogastric tube and begin saline lavage.
3. Assist the client with keeping a detailed calorie count.
4. Provide a quite environment to promote rest.

The 85-year-old male client diagnosed with cancer of the colon asks
٤٣the nurse, “Why

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did I get this cancer?” Which statement is the nurse’s best response?
1. Cancer of the colon is associated with a lack of fiber in the diet.
2. Cancer of the colon has a greater incidence among those younger than
age 50 years.
3. Cancer of the colon has no known risk factors.
4. Cancer of the colon is rare among male clients.

44 The client two (2) hours postoperative laparoscopic cholecystectomy

is complaining severe pain in the right shoulder. Which nursing
intervention should the nurse implement?
1. Apply a heating pad to the abdomen for 15 to 20 minutes.
2. Administer morphine sulfate intravenously after diluting with saline.
3. Contact the surgeon for an order to x-ray the right shoulder.
4. Apply a sling to the right arm that was injured in surgery.

Which nursing diagnosis would be highest priority for the client who
٤٥had an open
cholecystectomy surgery?

1. Alteration in nutrition.
2. Alteration in skin integrity.
3. Alteration in urinary pattern.
4. Alteration in comfort.

46 The client has had a liver biopsy. Which post-procedure

intervention should the nurse implement?
1. Instruct the client to void immediately.
2. Keep the client NPO for eight (8) hours.
3. Place the client on the right side.
4. Monitor blood urea nitrogen (BUN) and creatinine level.

47 Which type of hepatitis is transmitted by the fecal–oral route via

contaminated food, water, or direct contact with an infected person?
1. Hepatitis A.
2. Hepatitis B.
3. Hepatitis C.
4. Hepatitis D.

48 The nurse writes the client problem “imbalanced nutrition: less

than body requirements”for the client diagnosed with hepatitis. Which
intervention should the nurse include in the plan of care?
1. Provide a high-calorie intake diet.
2. Discuss total parenteral nutrition (TPN).

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3. Instruct the client to decrease salt intake.

4. Encourage the client to increase water intake.

The female nurse sticks herself with a dirty needle. Which action
٤٩should the nurse
implement first?
1. Notify the infection control nurse.
2. Cleanse the area with soap and water.
3. Request post-exposure prophylaxis.
4. Check the hepatitis status of the client.
50 The client is diagnosed with gastroenteritis. Which laboratory data
would warrant
immediate intervention by the nurse?
1. A serum sodium level of 137 mEq/L.
2. An arterial blood gas of pH 7.37, PaO2 95, PaCO2 43, HCO3 24.
3. A serum potassium level of 3.3 mEq/L.
4. A stool sample that is positive for fecal leukocytes.

The client is one (1) day postoperative major abdominal surgery.

٥١Which client problem
is priority?
1. Impaired skin integrity.
2. Fluid and electrolyte imbalance.
3. Altered bowel elimination.
4. Altered body image.

The client has a large abdominal wound that has eviscerated. Which
٥٢intervention
should the nurse implement?
1. Apply sterile normal saline dressing.
2. Use sterile gloves to replace protruding parts.
3. Place the client in the reverse Trendelenburg position.
4. Administer intravenous antibiotic stat.

The client has developed a paralytic illeus after abdominal surgery.

٥٣Which intervention
should the nurse include in the plan of care?
1. Administer a laxative of choice.
2. Encourage client to increase oral fluids.
3. Encourage the client to take deep breaths.
4. Maintain a patent nasogastric tube.

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54 The client has developed a paralytic ileus after abdominal surgery.

Which intervention should the nurse include in the plan of care?
1. Administer a laxative of choice.
2. Encourage client to increase oral fluids.
3. Encourage the client to take deep breaths.
4. Maintain a patent nasogastric tube.
55 The client has been experiencing difficulty and straining when
expelling feces. Which intervention should be taught to the client?
1. Explain that some blood in the stool will be normal for the client.
2. Instruct the client in manual removal of feces.
3. Encourage the client to use a cathartic laxative on a daily basis.
4. Place the client on a high-residue diet.

The client, an 18-year-old female, 54 tall, weighing 113 kg, comes to

٥٦the clinic for
wound on her lower leg that has not healed for the last two (2) weeks.
Which disease
process would the nurse suspect that the client has developed?
1. Type 1 diabetes.
2. Type 2 diabetes.
3. Gestational diabetes.
4. Acanthosis nigricans.

57 The nurse is caring for a client with long-term Type 2 diabetes and
is assessing the [Link] assessment data would warrant immediate
intervention by the nurse?
1. The client has crumbling toenails.
2. The client has athlete’s feet.
3. The client has a necrotic big toe.
4. The client has thickened toenails.

The client diagnosed with Type 2 diabetes is admitted to the intensive

٥٨care department
with hyperosmolar hyperglycemic nonketonic state coma (HHS).
Which assessment data would the nurse expect the client to exhibit?
1. Kussmaul’s respirations.
2. Diarrhea and epigastric pain.
3. Dry mucous membranes.
4. Ketone breath odor.

59 The client diagnosed with Type 1 diabetes is found lying

unconscious on the floor of
the bathroom. Which intervention should the nurse implement first?

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1. Administer 50% dextrose IVP.

2. Notify the health-care provider.
3. Move the client to the ICD.
4. Check the serum glucose level.

The client is diagnosed with cancer of the head of the pancreas. When
٦٠assessing the
patient, which signs and symptoms would the nurse expect to find?
1. Clay-colored stools and dark urine.
2. Night sweats and fever.
3. Left lower abdominal cramps and tenesmus.
4. Nausea and coffee-ground emesis.

61 The client diagnosed with hypothyroidism is prescribed the thyroid

hormone levothyroxine (Synthroid). Which assessment data indicate
the medication has been effective?
1. The client has a three (3)-pound weight gain.
2. The client has a decreased pulse rate.
3. The client’s temperature is WNL.
4. The client denies any diaphoresis.

62 The client is diagnosed with ARF. Which laboratory values are

most significant for diagnosing ARF?
1. BUN and creatinine.
2. WBC and hemoglobin.
3. Potassium and sodium.
4. Bilirubin and ammonia level.

The client diagnosed with ARF has a serum potassium level of 6.8
٦٣mEq/L. Which
collaborative treatment would the nurse anticipate for the client?
1. Administer a phosphate binder.
2. Type and cross-match for whole blood.
3. Assess the client for leg cramps.
4. Prepare the client for dialysis.

The client diagnosed with ARF is admitted to the intensive care

٦٤department and placed
on a therapeutic diet. Which diet would be most appropriate for the
client?

1. A high-potassium and low-calcium diet.

2. A low-fat and low-cholesterol diet.

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3. A high-carbohydrate and restricted-protein diet.

4. A regular diet with six (6) small feedings a day.

5The client is admitted to the emergency department after a gunshot

٦wound to the
abdomen. Which nursing intervention would the nurse implement first
to prevent ARF?
1. Administer normal saline IV.
2. Take vital signs.
3. Place client on telemetry.
4. Assess abdominal dressing.

66 The client diagnosed with end-stage renal disease (ESRD) is

experiencing metabolic acidosis. Which statement best describes the
scientific rationale for metabolic acidosis
in this client?

1. There is an increased excretion of phosphates and organic acids, which

leads to an increase in arterial blood pH.
2. A shortened life span of red blood cells because of damage secondary to
dialysis treatments. This, in turn, leads to metabolic acidosis.
3. The kidney cannot excrete increased levels of acid because the kidneys
cannot excrete ammonia or cannot reabsorb sodium bicarbonate.
4. An increase in nausea and vomiting causes a loss of hydrochloric acid
and the respiratory
system cannot compensate adequately.

67 The client is admitted to a nursing unit from a long-term care

facility with a hematocrit of 56% and a serum sodium level of 152
mEq/L. Which condition would be a cause for these findings?
1. Overhydration.
2. Anemia.
3. Dehydration.
4. Renal failure.

68 The client with chronic pyelonephritis is being admitted to a

medical unit for intensive
intravenous therapy. Which assessment data support the diagnosis of
chronic
pyelonephritis?

The client has fever, chills, flank pain,

١and dysuria.

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2. The client complains of fatigue, headaches, and increased urination.

3. The client had a group b beta hemolytic strep infection last week.
4. The client has an acute viral pneumonia infection.

69 The client diagnosed with renal calculi is admitted to the medical

unit. Which intervention should the nurse implement first?

1. Monitor the client’s urinary output.

2. Assess the client’s pain and rule out complications.
3. Increase the client’s oral fluid intake.
4. Use a safety gait belt when walking the client.

The client is taken to the emergency department with an injury to the

٧٠left arm. Which
action should the nurse take first?

1. Assess the nail beds for capillary refill time.

2. Remove the client’s clothing from the arm.
3. Call radiology for a STAT x-ray of the extremity.
4. Prepare the client for the application of a cast.

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