Twitter: nurse077 | Preparation / Abdulrahman Al-Gamdi 0533319252

1. A client with angina complains that the angina pain is prolonged and severe and
occurs at the same time each day, most often in the morning, On further
assessment a nurse notes that the pain occurs in the absence of precipitating
factors. This type of anginal pain is best described as:
a- Stable angina
b- Unstable angina
c- Variant angina
a- Nonanginal pain

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2. An alert oriented 77 year-old woman lives in a long-term care nursing home

although she is usually busy participating in the coordinated activities of the
nursing home, the nurse finds her sitting alone in the corridor. Various tests are
ordered including a urine analysis (see X-ray). Blood pressure 128/74
mmHg Heart rate 98/min Respiratory rate 26/min
Body temperature 38.3 °C oral Which additional clinical finding would
most likely be an indicator of the early onset of her problem? a- Low urea
concentration b- Acute confusion c- Increased blood pressure d- Respiratory rate>
22/minute
Which additional clinical finding would most likely be an indicator of the early
onset of her problem?
a- Low urea concentration
b- Acute confusion
c- Increased blood pressure
d- Respiratory rate> 22/minute

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A patient with bowlegs due to abnormal bone formations and deformities has .3
.calcium level of 7.5 mg/100ml

Which of the following

?to a diet

a- Organ meats
b- Whole grains
c- Egg yolks
d - Chicken meat
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A patient is one day post-operative repair of a large umbilical hernia. The patient .4
complaints of abdominal pain and describe feeling the sutures give way. Upon
assessment of the abdomen the nurse observes an evisceration. The nurse's
:IMMEDIATE response should be to

a- Medicate the patient for pain

b- Instruct the patient to cough hard
c- Have the patient perform the Valsalva maneuver
d- Cover the abdomen with a sterile saline spiked dressing
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While reviewing stress management techniques with a patient diagnosed with .5

?multiple sclerosis, what would the nurse identify as MOST appropriate

a- Relaxing in a warm bubble bath

b- Yoga in a cool room
c- Sunbathing
d- Cross-country running
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A four year - old boy presented with a firm and non- tender mass that his mother .6
had discovered in the right upper abdominal quadrant He was admitted to the
hospital and underwent complete surgical excision of a renal tumor that had
extended beyond the kidney. The child was then scheduled for radiation and
.chemotherapy treatment

?Which stage was the tumor

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 | Twitter: nurse077 Preparation / Abdulrahman Al-Gamdi 0533319252

a- I
b- II
c- III
d- IV
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When caring for a patient with an ostomy the nurse knows that extra skin .7
:protection for the personal skin is MOST important for those patients with a (an)

a- Ileostomy
b- Ascending colostomy
c- Transverse colostomy
d- Sigmoid colostomy
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The nurse is assessing the growth and development of a healthy

:child. The nurse should expect the child to be able to

a- Ride a bicycle
b- Jump rope
c- Throw a ball overhead
d- Hop on one foot
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The nurse is monitoring a patient recovering parenteral nutrition via a central line .9
catheter for the 24 hours. The patient has polyuria and complaint thirst and
.headache

Blood pressure mmHg 120/76

Heart rate min/88
Respiratory rate mm/16
Temperature 37.1°C
Oxygen Saturation an room air 99%

?What will the nurse most likely administers

a- Insulin
b- Dextrose 5% in water
c- Normal saline
d- Calcium gluconate
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A 22 year- old man suffered major injuries to the right leg in a road traffic .10
accident that resulted in an above -the- knee amputation with a rigid dressing.
Twelve hours later the patient complains of increasing pressure from the dressing
.and the feeling that something is crawling around the stump

a- Notify the physician

b- Remove and reapply the dressing
c- Remind patient phantom limb pain is normal
d- Elevate and apply ice to the residual limb
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A patient with congestive heart failure and severe peripheral edema has a
nursing diagnosis of fluid volume excess
What are the two MOST important interventions for the nurse to
initiate? a- Diuretic therapy and intake and output b- Nutritional
education and low-sodium diet c- Daily weights and intake and output

d- Low-sodium diet and elevate legs when in bed

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A nurse is providing care to a patient with a new skin graft on the leg. The patient .12
is upset and the nurse notes copious red drainage oozing around the
:dressing the nurse should immediately

a- Lift the dressing to assess the area

b- Ask if the patient is having any pain
c- Apply firm pressure for 10 to 15 minutes
d- Assess the apical pulse
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A 25 years-old male patient suffered a spinal cord injury at the T -4 level and is .13
being cared for in hospital. The nurse enters the patient's room and finds the patient
sitting upright and looking anxious and restless. He complains of sudden headache
and nausea. Sweat forms on his forehead yet his feet are cool to touch
Blood pressure mmhg 150/100
Heart rate min/55
Respiratory rate min/28
Temperature 37.1C
What nursing intervention is initially m
a- Assess for a full bladder

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 | Twitter: nurse077 Preparation / Abdulrahman Al-Gamdi 0533319252

b- Lower the head of the bed 30 degrees

c- Loosen clothing and bed sheets
d- Apply heating pad to lower extremities
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To minimize a toddler from scratching and picking at healing skin graft, the
:nurse should utilize

a- Mild sedatives
b- Hand mittens
c- Punishment for picking
d- Distractions
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A 30 year-old diabetic woman complains of blood in the urine and dull pain over .15
the left lower abdomen, middle back and above the pubic bone. She feels the urge to
urinate frequently and urgently. For the past two days, she has had nausea and
vomiting. Abdominal assessment reveals tenderness over the pubic bone; no
.guarding and bowel sounds are active in all quadrants

?Which home intervention would be most effective

a- Oral antibiotics
b- Increased fluid intake
c- Increased dietary protein
d- Cold application to left hand
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The nurse calls together an interdisciplinary team with members from medicine, .16
social service, the clergy, and nutritional services to care for a patient
.with a terminal illness

?Which of the following types of care would the team MOST likely be providing
a- Palliative
b- Curative
c- Respite
d- Preventive
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Pulse Volume Scale .17

Scale Description of pulse

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Gamdi

0 Absent pulse
1 Weak and Thready pulse
2 Normal
3 Bounding pulse
A 26 year- old female patient's radial pulse is assessed for a full minute. The nurse
notes the pulse is difficult to palpate and co
?What should the nurse chart
Blood pressure gHmm84/28
Respiratory rate nim/02
Temperature C°8.83
a- 0
b- 1
c- 2
d- 3
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A patient recently underwent coronary artery graft (CABG)

?surgery. Which of the following nursing diagnose PRIORITY
a- Anxiety
b- Impaired gas exchange
c- Acute pain
d- Sleep deprivation
‫ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A child with asthma has an order for albuterol, before administration of the .19
.medication the nurse MUST

a- Pre-oxygenate the patient

b- Assess the patient's heart rate
c- Obtain venous Access
d- Feed the patient a snack
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 52 year- old woman is scheduled to undergo an abdomino- perineal resection in .20

three days for removal of a cancer of the rectum. The nurse reviews the care plan
with the patient. The patient will receive prophylactic antibiotics and will be
given a mechanical bowel preparation the day before.
?Which additional preparation should the patient undertake at this time
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a- Wear pressure stockings

b- Perform leg strengthening exercises
c- Maintain high- protein, low- residue diet
d- Take daily ferrous iron tablets
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A 32 year- old female has an adrenocortical hormone disorder. The nurse notes .21
.the patient has thin scalp hair, a large trunk and thin extremities

Blood pressure mmHg 152/84

Heart rate min/64
Respiratory rate min/16
Temperature 37.2°C
Oxygen Saturation on room air % 98
Which clinical findings are most likely? a-
Decreased bowel sounds and muscle soreness b-
Cardiac arrhythmias and abdominal cramping c-
Headache, confusion and muscle twitching d-
Hunger, trembling and nervousness
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 62 year- old man is diagnosed with localized non cell tumor of the lung without .22
metastasis and under lobectomy. After the procedure, he is brought to Postoperative
Anesthesia Care Unit for recovery with chest tube drainage system
in place and administered by nasal cannula.
Which nursing action is initially most important?
a- Assess level of consciousness b- Attach chest
tubes to the bed sheets c- Perform deep
breathing and coughing
d- Apply elastic stockings to the legs
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 67 year-old man is admitted to the Post-anesthesia Recovery unit following .23

chest surgery. The patient has a right chest tube that is attached to low suction.
Three hours after admission to the unit, the nurse observes the drainage output
.from the chest tube is 300 milliliters

?What is the most appropriate initial intervention

a- Notify the doctor
b- Reduce IV infusion rate
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c- Strip tube with roller device

d- Re-position in left lateral decubitus
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

An elderly patient with severe degenerative joint comes to the clinic for routine .24
follow up of management. The patient reports that over the month, the pain has
begun to increase in severity patient requests an increase in dosage of the
?medication. The nurse recognizes that this is most likely due to

a- Drug addiction
b- Drug tolerance
c- An improvement in condition
d- Lack of efficacy of the current medication
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A community health nurse visits a patient who has suffered a stroke. The patient's .25
spouse explains to the nurse that the patient chokes while eating some times. Which
of the following referral orders would the nurse anticipate needing
?for this patient

a- Speech therapist
b- Dietician
c- Physical therapist
d- Neurologist
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A patient is transferred to the Intensive Care following a craniotomy. The .26

.patient is difficult to arouse and the pupils are pinpoint and non-reactive

Blood pressure mmHg 118/70

Heart rate min/58
Respiratory rate min/11
Temperature 37.2°C

?Which medication should the nurse prepare administer

a- Adrenaline
b- Thiamine
c- Naloxone
d- Dextrose 50%
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

The nurse has been assigned to care for a 60 year old critically ill patient with a .27

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triple-lumen central venous line. The doctor's orders include daily care of the
insertion site and catheter device. The nurse creates care plane based on the
.nursing diagnosis, Risk for infection related to insertion of a venous catheter

?Which intervention is most likely to prevent infection

a- Re-cap access hub after drawing blood
b- Maintain clean technique
c- Wash hands before performing catheter care
d- Clean catheter tubing with isopropyl alcohol
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A patient who underwent a right knee arthroplasty two days ago has a nursing .28
diagnosis of impaired mobile. The patient refuses to get out of bed and ambulate
.due chest pain

?Which of the following action would the nurse MOST likely implement
a- Medicate the patient prior to ambulation
b- Add a nursing diagnosis of non-compliance
c- Let the patient rest now and then try to ambulate later
d- Assess to determine the cause of the chest pain
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

Prior to providing care for a hospitalized infant the nurse who focuses on .29
.preventive measures must

a- Introduce self-parent
b- Perform hand hygiene
c- Have a witness present
d- Assess the child's developmental level
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

The nurse is inserting a nasogastric (NG) tube into patient as prescribed. The .30
nurse has advanced the into the patient's posterior pharynx. The nurse show now
?ask the patient to

a- Hold the breath

b- Stare upwards with the eyes towards the ceiling
c- Perform the Valsalva maneuver
d- Lower the chin towards the chest
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

What would be the long-term management goal for a patient with diabetes .31
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?mellitus, type II
a- Quickly lower blood glucose level by administering insulin
b- Achieve hypoglycemic state
c- Maintain daily exercise
d- Understand how to self-administer msulax
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

The nurse administered a dose of morphine sulfate, as prescribed to a patient who .32
is in the post-anesthesia care unit (PACU). The patient appears to be resting
comfortably; the respiratory rate is 8 and the O2 saturation on 2L of oxygen via
.nasal cannula is 86%. The nurse should IMMEDIETLY administer

a- Flumazenil (Romazicon)
b- Midazolam (Versed)
c- Naloxone (Narcan)
d- Ondansetron (Zofran)
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A patient is 90-minutes post-abdominal hysterectomy and complains of pain in . 33

the post anesthesia care unit (PACU). The nurse administers the prescribed dose unit
,intravenous morphine. Five minutes later, the patient is difficult to arouse
.with the following vital signs

?What should the nurse do NEXT

Respiratory rate nim/6
86% on room air Saturation
a- Document the efficacy of analgesic therapy
b- Administer naloxone (Narcan) c- Place in
supine position d- Check the surgical site for
bleeding
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

The stage of dying as identified by Dr. Elizabeth Kubler-Ross occurs in what

?order

a- Anger, depression, bargaining, denial, acceptance

b- Bargaining, denial, Anger, acceptance, depression
c- Denial, Anger, bargaining, depression, acceptance
d- Depression, denial, Anger, bargaining, acceptance
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

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Percentage of children with chronic illnesses

Which of the following statements is most accurate?

a- Girls have more ADHD than asthma
b- Boys are more frequently diagnosed with chronic illnesses
c- Boys are less frequently diagnosed with chronic illnesses d-
Girls have more other chronic illnesses than ADHD
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 42 year- old patient is in a lower body cast following a motor vehicle accident. In .36
order to minimize muscle strength loss while in the cast, the nurse will
.instruct the patient in the performance of

a- Isometric exercises
b- Passive range of motion exercises
c- Active- assistive range of motion exercises
d- Resistive range of motion exercises
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A patient has a history of severe, uncontrolled epistaxis. The patient's blood .37
pressure and platelet count are normal. To minimize the occurrence of bleeding
episodes the nurse should teach the patient to. a- Sleep with the
head elevated on at least two to three pillows b- Apply firm
pressure to the nostrils four times a day c- Apply a water- soluble
lubricant to the nasal septum twice daily d- Minimize the intake of
caffeine and increase fluids intake
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A six year-old patient has been diagnosed with acute rheumatic fever. The
:nurse knows that the antibiotic of choice for this illness is

a- Benzathine penicillin (Megacillin)

b- Amoxicillin (Amoxil)
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c- Erythromycin (Erythrosine)
d- Vancomycin (Vancocin)
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 20 year- old woman takes cyclosporine 100 mg by mouth twice per day. She had . 39
a heart transplant two months ago and complains of dizziness, shortness of
.breath, light headedness and fatigue. Capillary refill >3

Blood pressure mmHg 90/50

Heart rate, irregular min/100
Respiratory rate mm/28
Temperature 38.0°C
?What is the most likely underlying cause of the patient 's problem

a- Cyclosporine toxicity
b- Hyperkalemia
c- Organ rejection
d- Infection
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A patient is transferred to the Intensive Care Unit following a craniotomy. The .40
.patient is difficult to arouse and the pupils are pinpoint and non-reactive

Blood pressure mmHg 118/70

Heart rate min/58
Respiratory rate mm/11
Temperature 37.2°C
?Which medication should the nurse prepare to administer
a- Adrenaline
b- Thiamine
c- Naloxone
d- Dextrose 50%
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
A 23 year- old male comes to the Emergency Department in a sickle cell crisis. He .41
reports that his pain level is a 10/10 in all extremities. During the assessment, he
cannot lie still because of the pain. There is no cyanosis or clubbing in the extremities
and all examination findings are normal. The vital signs recorded were
Blood pressure mmHg 132/82
Heart rate min/110
Respiratory rate mm/18
Temperature 38.4°C
Oxygen Saturation an room air % 94
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?Which nursing diagnosis is first priority

a- Acute pain
b- Fluid volume deficit
c- Ineffective tissue perfusion
d- Ineffective airway clearance
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
A patient who underwent a right knee arthroplasty two days ago has a nursing .42
diagnosis of impaired mobility. The patient refuses to get out of bed and ambulate
.due to chest pain

?Which of the following actions would the nurse MOST likely implement
a- Medicate the patient prior to ambulation
b- Add a nursing diagnosis of non-compliance
c- Let the patient rest now and then try to ambulate
later. d- Assess to determine the cause of the chest pain
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
Upon assessment of an obese patient's back, the nurse observes a forward .43
.curvature of the lumbar spine. These findings are indicative of

a- Kyphosis
b- List
c- Lordosis
d- Scoliosis
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
A newborn was delivered pre-term weighing 2700 grams with. Apgar scores of 4 . 44
and 6, respectively. When the mother had presented to the Obstetrical Triage Unit ,
she was already 7 centimeters dilated and fully effaced. Her due date was unknown
as she had no parental care. The infant showed signs of fetal distress and was finally
delivered by Cesarean section. At birth a large, thin, membranous sac
was protruding from the umbilical base. What is
the priority nursing intervention at birth? a-
Maintain cardio respiratory stability b- Protect
the herniated viscera c- Manage fluid intake and
output d- Establish vascular access

‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A surgeon instructs a nurse to serve as a witness to an elderly patient's .45

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 | Twitter: nurse077 Preparation / Abdulrahman Al-Gamdi 0533319252

informed consent for surgery. During the surgeon's explanation to the patient, it
,becomes clear that the patient is confused and does not understand the procedure
.but reluctantly signs the consent from. The nurse should

a- Sign the form as a witness, making a notation that the patient did not appear to
understand
b- Not sign the form as a witness and notify the nurse supervisor
c- Not sign the form and answer the patient 's questions after the surgeon leaves
the room
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A child is treated for superficial (first-degree) thermal burns to the thigh. The .46
.child is in great discomfort and does not eat

?Which of the following diagnoses should receive PRIORITY

a- Altered nutrition
b- Impaired skin integrity
c- Risk for infection
d- Acute pain
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A patient is being prepared for a right breast biopsy under general anesthesia. The .47
patient asks the nurse about the surgical scar and possible postoperative
.complications

?Which of the following actions would be appropriate for the nurse to take
a- Review the postoperative risks with the patient
b- Notify the surgeon about the patient's questions
c- Compete the patient' s preoperative check list
d- Show the patient photos of breast surgical scar
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A patient who is 4 days postoperative after a total hip replacement surgery, is .48
obese and has not been able to ambulate since the surgery. The patient is now
diaphoretic, has chills, and complains of pain in the thigh. There is tenderness over
.the anteromedial surface of the thigh. The MOST likely cause is

a- Wound infection
b- Deep vein thrombosis (DVT)
c- Pulmonary edema
d- Dehydration
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
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A nurse is communicating with a moderately autistic child during a developmental .49

and behavioral assessment. The nurse uses non-verbal techniques to engage the
child's cooperation. She uses facial expressions when responding
.and simple body language to communicate commends

?What is the most likely age of the child

a- One
b- Three
c- Six
d- Nine
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 27 year- old woman presents with stomach cramping with alternating .50
constipation and diarrhea. She had been diagnosed with irritable bowel syndrome
,two years before and has so far managed the illness with lifestyle changes
.including diet and exercise

?What is the most appropriate advice

a- Increase dairy intake
b- Use antacids to relive pain
c- Increase dietary fiber
d- Avoid emotional stress triggers
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A nine year-old child has been diagnosed with external otitis. In addition to .51
.assessing severity of symptoms and need for pain relief, the nurse should assess

a- The hearing of the child

b- The tympanic temperature
c- Speech and language development
d- Ear hygiene and the need for earplugs
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 68 year-old man is admitted to the hospital with an exacerbation of chronic .52

obstructive pulmonary disorder. He has breathing difficulties, restlessness and
anxiety. He also has a moist and productive cough. The lower extremities are swollen
with pitting edema 4+. A blood gas specimen is collected and sent to the laboratory. The
patient has not been on supplemental oxygen therapy at home
)seelab results(
Blood pressure mmHg 180/90
Heart rate min/90
Respiratory rate mm/28
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| Twitter: nurse077 Preparation / Abdulrahman Al-Gamdi 0533319252

Body Temperature 37.1°C

Oxygen Saturation an room air % 86

Test Result Normal Values
ABG PCO2 7.33 kPa 4.7-6.0
PH 7.32 7.36-7.45

ABG PO2 7.73 kPa 10.6-14.2

What is the most likely percentage rate
?nasal cannula for this patient

a- 0.5-1
b- 1.5 -2
c- 2.5 -3
d- 5-6
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When performing tracheal suctioning for a client with a tracheotomy the nurse .44
: should

A. Pre-oxygenate the client before suctioning. B. Apply negative

pressure as the catheter is being inserted. C. Be sure the cuff of the

tracheotomy is inflated during suctioning. D. Instill normal saline

.into the tracheotomy prior to suctioning

‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 32 year- old man is brought to the Emergency Department by a friend with .54
whom he had been playing football with earlier that evening. His symptoms came
on after twenty minutes of the football match. He appears anxious and restless.
Auscultation of the lungs reveals wheezing on exhalation. The patient states that
he is unable to get a full breath of air. He had this problem as a child a couple of
.times after exercising in cold weather

Blood pressure mmHg 126/72

Heart rate min/90
Respiratory rate mm/28
Temperature 37.0°C
Oxygen Saturation on room air % 94
?Which position is best for this patient
a- Supine
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b- Reverse Trendelenburg's
c- Prone
d- High fowler's
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A 40 year-old woman is undergoing an elective rhinoplasty under general .55

anesthesia. The patient is in the pre-operative room and the nurse is prepared to
administer pre- operative intravenous medications. The patient states that she
.does not have any drug allergies

Which additional nursing action is most important prior to administering the

?medicine

a- Request the patient urinate

b- Perform blood typing and cross matching
c- Ensure the consent form has been signed
d- Clarify contact numbers of her family members
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A 24 year-old man was admitted to the hospital after receiving a closed head .56
injury in a motor vehicle accident. He had a Glasgow Coma Score of 6 on admission
and was being mechanically ventilated. The nurse observes the intracranial
.pressure has slowly and steadily increased over the past hour

?What is the most appropriate initial nursing action

a- Administer mannitol
b- Administer Phenobarbital
c- Increase respiratory rate
d- Reposition while maintaining neck alignment
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

The nurse is caring for a 4 year-old patient with a diagnosis of cystic fibrosis and .57
pneumonia. The child is feeling better on the 3rd day of the hospitalization
"and "wants to play

?What would be the BEST choice of entertainment

a- Blowing bubbles
b- Looking at picture books
c- Watching videos
d- Riding in a wagon
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During the immediate .58 postoperative period, a patient reveals an oxygen

saturation level of 91 %. The nurse should

a- Position the patient on the left side
b- Administer supplemental oxygen
c- Continue to provide supportive care
d- Lower the temperature of the room
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An 83 year-old woman lives in a long term care facility. During the past two weeks, .59
she has suffered two falls that resulted in minor injuries and now complains of pain
in the left shoulder. On auscultation, bowel sounds are diminished in all four
quadrants. On palpation, she has tenderness and guarding over the upper left
quadrant and complain of a feeling of fullness. What could be
?the most likely underlying cause of the finding

a- Constipation
b- Liver distention
c- Splenic rupture
d- Intestinal obstruction
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In evaluating a patient after a cerebrovascular accident (eVA), which of the .60

following is an expected outcome of the nursing diagnosis of impaired physical
mobility related to motor deficits? a- Oriented
to person, lace, and time b- Maintains body
alignment, no contractures c- Communicates
appropriately d- Voids on command at 2-hour
intervals
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A patient who has a diagnosis of multiple sclerosis speaks slowly with long .61
.pauses between syllables

?The patient is MOST likely in what stage of multiple sclerosis

a- Prodromal
b- Early
c- Middle
d- Late
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Gamdi

A 70 year-old quadriplegic man has ulceration on the left buttocks with full .62
thickness skin loss. Although several interventions have been used to promote
healing, the ulcer does not improve (see image)
Which dietary insufficiency is most likely? a-
Vitamin D
b- Calcium
c- Protein
d- Vitamin C
‫ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
In planning a lecture for a community group effect of acquired immunodeficiency .63
syndrome gerontological community, the nurse would be correct in including which
of the following stat regarding the incidence of the
illness in people be 55 and 64 years of age? a- The illness is almost
unheard of in this age group prior to 2003 b- The illness has more
than doubled between 1998 and 2003 c- There are not many people
living with the disease as it quickly fatal d- Treatment is more
effective in this age group
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
A home care nurse visits a patient who is wheelchair bound due to a recent motor .64
vehicle accident. The patient has been sitting in the wheelchair for extended periods
of time, which has resulted in the development of a stage I pressure sore
.on the right buttocks

?What is the BEST nursing intervention

a- Instruct the caretaker to change the patient 's position every 2 hours
b- Apply hydrogel to the stage I pressure sore every 8 hours c- Refer
the patient to a wound care specialist for debridement d- Encourage
the patient to consume an increased amount of calcium
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
A nurse is caring for an infant with respiratory distress syndrome. .6

?Which of the following nursing intervention is appropriate

a- Measure oxygen saturation level once a shift

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b- Suction frequently for 30-45 seconds each time

c- Monitor for symptoms of hyperglycemia d-
Maintain infant temperature 36.7° and 37.8°C
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
A patient who sustained extensive abdominal injuries in a motor vehicle accident .66
has developed a large stage II pressure ulcer on the coccyx . A new
diagnosis of alteration in skin integrity is added to the care plan.
What is the BEST short-term goal for the patient? a- Show
evidence of healing within one week b- Have no discomfort
from the pressure ulcer c- Eat at least 50% of each meal

d- Verbalize strategies to prevent further skin breakdown

‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
A nursing home resident with chronic osteoarthritis complains of knee pain. A .67
routine order of acetaminophen (Tylenol) 500 mg every 6 hours was administered 2
hours ago with no relief. The patient also has an order for ibuprofen (Motrin) 400 mg
every 6 hours as needed. The patient reports some relief, but is still
bothered by mild pain. The nurse should
a- Administer ibuprofen (Motrin) 400mg b- Educate the patient
that mild pain is expected with osteoarthritis c- Call the physician
for additional pain medication d- Administer acetaminophen
(Tylenol) 500 mg
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
A 55 year-old man has become very anxious about skin lesions he has developed. .68
On the lower right forearm, there is a well demarcated round patch of skin that he
feels could be cancerous. It is 2.5 centimeters in diameter and slightly raised. On
palpation it is scaly, dry and rough. The affected area appears sun tanned and
reddened. The condition has been persistent for the past four years
.but has only recently become itchy

?What is the most likely underlying problem

a- Seborrheic keratosis
b- Actinic keratosis
c- Eczematous dermatitis
d- Lupus erythematosus
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

Patien Age Past Medical Assessment of the normal aging process

t History
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| Twitter: nurse077 Preparation / Abdulrahman Al-Gamdi 0533319252

A years-70 Atrophic Vaginitis "?Are you abstaining from sexual activity"

old
B yearsold-76 Osteoporosis Do you spend at least ten hours testing "
"?each day

C years -81 Urinary Are you limiting your daily fluid intake "
old incontinence "?to 1000ml

D years-88 Diverticulosis "?Do you eat small frequent meals "

old
.69 A .nurse is assessing several patients who are over the age of 65 years
Which question would demonstrate the nurse's unde
?with the normal process of aging

a- Patient A
b- Patient B
c- Patient C
d- Patient D
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 65 year-old woman with a history of unstable angina and hypertension presents .70
to the Emergency Department with a dull chest pain that she describes as
similar to .heartburn The pain radiates down the left arm. She had taken
sublingual nitroglycerin tablets without .any relief An electrocardiograph is
performed and shows elevated S- T segments. The nurse is to administer a
.thrombolytic by intravenous infusion

?Which factor places this candidate at high risk for bleeding

a- Unstable angina
b- Hypertension
c- Age
d- Elevated S- T segments
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

BP Classification Systolic Blood Pressure Diastolic Blood Pressure

Normal Less than 120 More than 80
Prehypertension 120-139 80-89

Stage 1 hypertension 140-159 90-99

Stage 2 hypertension More than 160 More than 100

21
 Preparation / Abdulrahman Al- Twitter: nurse077 | 2529133350
Gamdi

The following blood pressures have been documented in the patient's chart for the .71
past six months; 124/76 mmHg, 136/83 mmHg and 128/80 mmHg. The Most
:likely diagnosis is

a- Normal blood pressure

b- Prehypertension
c- Stage 1 hypertension
d- Stage 2 hypertension
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

The nurse is performing a routine examination for a 24 year-old man with diabetes .72
mellitus. He takes insulin injections twice daily and monitors his blood sugar
regularly. He is vegetarian with a body mass index of 17. The nurse is
.concerned about his weight

Which additional information is most likely required to calculate his ideal daily
?caloric intake

a- Daily elimination pattern

b- Protein and carbohydrate intake
c- Activity and exercise level
d- HDL and LDL cholesterol levels
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A nurse is assessing a child with suspected lead poisoning. .73

?For which of the following should the nurse assess

a- Developmental delay, constipation, anorexia, clumsiness, and pallor b-

Confusion, delirium, seizures, lethargy, stupor, and coma c- Respiratory
depression, obstruction, pulmonary edema, and tachypnea d- Peripheral
circulatory collapse and heart failure
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

The following pain medications are ordered for a patient who had a right leg .74
amputation. Oxycodone 5 mg every 4 hours as needed and morphine 5 mg every 4
hours as needed. The nurse administered oxycodone 2 hours ago, but the patient
reports pain rated 8 on a scale of 0 (no pain) to 10 (severe pain) as the dressing
.change beings

After evaluating the

?nurse take

169/98 mmHg Blood pressure

Heart rate nim/211
Respiratory rate mm/22
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 | Twitter: nurse077 Preparation / Abdulrahman Al-Gamdi 0533319252

Temperature 36.7°C

a- Administer additional oxycodone 5 mg

b- Administer morphine 5 mg
c- Change the dressing quickly
d- Encourage deep breathing
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 72 year-old woman who is alert and oriented has been hospitalized with atrial .75
fibrillation. Since admission four days ago, she has been receiving digoxin
intravenous injection. Today is the first day the digoxin injection will be discontinued
and she will change to oral tablets. Although she acknowledges the
medication benefits, she refuses to take it as it makes her feel nauseous.
What is the most appropriate nursing action? a- Continue
administering by intravenous push b- Withhold medication and notify
the physician c- Withhold medication and file an incident report d-
Provide it in liquid from mixed into a drink

‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

The district nurse visits a 30 year-old woman at home following the delivery of . 76
her second child , a full term girl. Following the delivery of her first child, she had
developed a breast infection and stopped breastfeeding because of the pain. She
asks the nurse how she can best prevent it with this infant.
What is the most appropriate response? a- Provide
feedings on demand b- Apply vitamin E cream to the
nipples c- Request a prophylactic antibiotic d- Apply heat
to the breasts after feedings

‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

Problems The patient will

Altered tissue perfusion to Maintain blood pressure below 130/90
A
hypertension mmlHs
Fluid volume excess related in to Not have signs of edema or unexpected
B
lower extremity edema weight gain
Knowledge deficit to process Verbalizes understanding of disease process
C
hypertension symptoms and medication management

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 | Twitter: nurse077 Preparation / Abdulrahman Al-Gamdi 0533319252

D Alteration in comfort related Report an absence of headaches each week

chronic headaches
.77 A patient has come to the clinic for follow-up one week after being discharged
from the hospital for treatment of a hypertensive crisis. Blood pressure stabilized
at 124/78 mm hg. The patient report feeling well, has no edema, and no longer has
daily headaches. Blood pressure is 156/90 mmHg. During evaluation the patient
admits to having stopped taking medication that had been ordered because
headaches are no longer present. Unless the symptoms return, the patient states
.they will not be returning to the clinic

?What should the nurse do

a- Resolve and discontinue the entire care plan per patient request, suggest
psychology consult
b- Resolve Band D, continue A and C
c- Continue entire care plan as written
d- Add a new problem to the care plan, non-compliance and interventions to
determine potential
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A patient has returned to the medical-surgical unit after surgery for a benign .78
ovarian tumor. The nurse observes that in the first 30 minutes after admission to the
unit, the patient's abdomen is rapidly distending and the patient complains of
.increasing pain. The nurse would anticipate

a- Aspiration pneumonia
b- Surgical site infection
c- Retention of surgical supplies
d- Intra-abdominal hemorrhage
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A nurse is caring for a postoperative patient who is on subcutaneous, low-dose .79

heparin. When administering an injection on the abdomen, the nurse avoids the
.umbilicus area because of the possibility of

a- Entering a larger blood vessel

b- Causing increased pain
c- Precipitating hyperventilation
d- Umbilical infection
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
The nurse caring for a mobile patient with a destroyed tympanic membrane .80
.and an intact stapes

?What type of repair process should the nurse anticipate

24
 | Twitter: nurse077 Preparation / Abdulrahman Al-Gamdi 0533319252

a- Myringoplasty
b- Tymoanostapedopexy
c- Cavum minor
d- Tympanoplasty and fenestration of lateral semicircular canal
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
An 82 year-old woman with Alzheimer's disease had moved into a long-term care .81
facility two weeks previously. Since then, the staff has found her wondering in the
hallways in middle of the night. When approached, she is confused and
.frustrated, often forgetting where she is

?Which intervention would most likely decrease the patient's confusion

a- Administer a sleeping sedative
b- Provide full-time nursing care
c- Place a nightlight in the room
d- Provide a large meal before bed
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
A 25 year-old woman resents to the clinic with abdominal pain. She reports the .82
last bowel movement was two days previously. There is no vomiting or diarrhea and
her body temperature is normal. During percussion of the lower left quadrant
.the nurse hears tympanic sounds

?What is the most likely underlying cause for the finding

a- Gas
b- Tumor
c- Liquid
d- Feces
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 40 year-old woman present with painful leg cramps and muscle twitching, which .83
wakens her at night. Her menstrual cycles are irregular and cause painful abdominal
cramping. The hair, skin and nails appear dry and brittle (see lab
)results

Test Result Normal Values

Calcium 2.09 15-2.62mmollL .2
Phosphate, inorganic 1.69 0.82-1.51mmollL
Magnesium 0.55 0.7-1.0mmollL

What type of lifelong diet would be most beneficial

a- Increased magnesium and vitamin C
25
 | Twitter: nurse077 Preparation / Abdulrahman Al-Gamdi 0533319252

b- Increased calcium and vitamin D

c- Increased dairy and iron
d- High protein and high calorie
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A community is experiencing an outbreak of staphylococcal infections. The .84

nurse instructs residents that the MOST common mode of transmission is by
a- Respiratory droplets
b- Contaminated foods
c- Hands
d- Soil
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A home care nurse changes the dressing of a patient who has a chronic lower leg .85
ulcer and a history of leg swelling. The wound bed is 3 cm diameter, red in
color and is covered with fibrous yellow tissue (see image)
?What type of ulcer is most likely
a- Arterial
b- Venous
c- Decubitus
d- Neuropathic
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

Blood glucose level Medication

80mg/dl< Glucagon 1 mg
150-200mg/dl units of regular insulin 0
201-250mg/dl units of regular insulin 2
251-300mg/dl units of regular insulin 4
301-350mg/dl units of regular insulin 6
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 Preparation / Abdulrahman Al- Twitter: nurse077 | 2529133350
Gamdi

351-400mg/ dl units of regular insulin 8

401mg/dl> Call the physician

The home care nurse visits a diabetic patient, recently started on sliding scale .86
insulin injection. The patient is confused about how many units of regular insulin to
inject. During the home visit the patient's glucose level before their meal is 301
mg/dL
?How many units of re

a- 2 units
b- 4 units
c- 6 units
d- 8 units
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A 30 year-old woman has been prescribed albuterol PNR1 and prophylactic .87
inhaled corticosteroids to be taken once per day. She has been taking the
prophylactic as prescribed but has needed to use the albuterol more often than
.usual. She has a chronic cough and often has air hunger

?Which intervention is initially most appropriate

a- Refer for a chest X-ray
b- Administer magnesium sulfate
c- Assess peak flow measurement
d- Perform arterial blood gas analysis
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A first time mother of a three week-old breastfed baby brings the infant to the .88
clinic and complains that her child has been forcefully vomiting after feeding. He was
born at 40 weeks gestation, weighing 3.6 kilograms. He is constantly hungry and
irritable. Examination reveals a swollen abdomen and a palpable mass in the
.middle upper right quadrant

?What is the most likely health problem

a- Intussusception
b- Pyloric stenosis
c- Gastroeosophageal reflux
d- Diaphragmatic hernia
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Gamdi

A 40 year- old man present to the clinic with a weight loss of three kilograms over .89
the past month. His health problem produces moderate spastic body movements,
hyper-reflexia, muscular contractions followed by relaxation, and a positive Babinski
reflex. He has difficulty speaking due to poor muscle tone and has recently developed
swallowing difficulties. The nurse creates a care plan to
.address his developing problem

?Which is the priority nursing intervention

a- Increase caloric intake
b- Aspiration prevention
c- Infection control
d- Improved muscle control
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A 62 year-old diabetes type II patient is admitted to hospital for ampulation of the . 90

right foot due to gangrene and ischemia, Pre-operatively, the patient rates the pain as
9 (using the 1-10 pain scale). How can this patient's phantom (sprit) pain
?best be controlled

a- Post-operative elevation of limp

b- Apply pressure bandage to stump
c- Control pain pre-operatively
d- Apply ice to the site for twenty minutes
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The nurse cares for a 60 year-old woman has a history of hypertension, .91
hypothyroidism and elevated cholesterol levels. She takes tablets daily for each of the
health problems. The doctor orders a routine dual-energy X-ray absorptimetry
.test shows decreased bone density

?Which medication most likely contributed to the test results

a- Statins
b- Anti-hypertensive
c- Synthetic thyroid hormones
d- Cholesterol absorption inhibitors
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 32 year- old woman with diabetes mellitus type 1 underwent a cholecystectomy .92
and is now on day two of recovery. The patient's bowel sounds have returned and
she has resumed a normal diet but has been finishing less than half of each meal on
the tray. The nurse enters the room to perform a routine
assessment and finds the patient confused and shaky
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| Twitter: nurse077 Preparation / Abdulrahman Al-Gamdi 0533319252

Blood pressure mmHg 110/60

Heart rate min/96

Respiratory rate mm/22
Temperature 37.0°C

?What is the most appropriate initial intervention

a- Administer glucagon
b- Notify the physician
c- Given an insulin injection
d- Offer a glass of juice
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Prior to providing care for a hospitalized infant, the nurse who focuses on .93
.preventive measures must

a- Introduce self to parent

b- Perform hand hygiene
c- Have a witness present
d- Assess the child's developmental level
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A nurse is admitting .94

.a two year-old child with an umbilical hernia

Which of the following interventions does NOT meet the child's developmental
?needs

a- Allowing the child to make choices when possible

b- Providing rooming in and unlimited visitation c-
Attempting to continue rituals used house d-
Maintaining strict bed rest
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A woman who has been discharged from hospital with a permanent colostomy in .95
lace is performing irrigation at home for the first time. After five minutes from
the start of the procedure, she begins to have stomach cramps.
?Which intervention would most likely decrease the symptoms
a- Increase the flow of irrigation solution
b- Decrease the temperature of the water
c- Clamp the catheter for 1-2 minutes
d- Elevate the bag of irrigation solution
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
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Gamdi

A 17 year-old is brought to the clinic by her mother. She complains of episodes .96
during which her fingers become cold, numb and white. After this subsides, the
fingers turn red, swell and cause severe and throbbing pain. On examination, the
fingers all appear normal and the patient has no pain. The nurse performs a
.history assessment to identify potential causes

?Which trigger is most likely

a- Excessive exercise
b- Ingestion of tea
c- Exposure to cold
d- Washing up
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A patient on a medical floor is .97

.diagnosed with pneumonia

Which of the following interventions is appropriate for a nursing diagnosis of

ineffective airway clearance related to tracheobronchial secretions secondary to
?infection

a- Explain diagnostic procedures and address any of patient's

concerns b- Assess patient for signs of discomfort and pain c- Monitor
oxygen therapy and encourage to cough and deep breathe d- Monitor
patient for shock
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The nurse is inserting a nasogastric (NG) tube into a patient as prescribed. The .98
nurse has advanced the tube into the patient's posterior pharynx. The nurse
.should now ask the patient to

a- Hold the breath

b- Stare upwards with the eyes towards the ceiling
c- Perform the Valsalva maneuver
d- Lower the chin towards the chest
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A community is experiencing an outbreak of staphylococcal infections. The .99

:nurse instructs residents that the MOST common mode of transmission is by

a- Respiratory droplets
b- Contaminated foods
c- Hands
d- Soil
‫ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A patient with bacterial pneumonia reports increased pain during deep .100

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breathing and coughing exercises. To minimize the patient's pain, the nurse should
.teach the patient to

a- Take a cough suppressant prescribed P.R.N at regular time intervals

b- Turn onto the side before doing the respiratory exercises
c- Hold a pillow tightly against the chest while coughing
d- Drink warm liquids right before taking deep breaths
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A patient has an acute inflammation of the gallbladder. The physician orders

the nurse to schedule the patient for surgery
?Which of the follo

a- Pancreatectomy
b- Cholecystectomy
c- Hepatectomy
d- Cricothoracotom
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A patient with a history of chronic obstructive pulmonary disease prepares for a . 102
colonoscopy with conserve sedation. Due to the patient's history the nurse
.should very cautious about administering

a- Antibiotics
b- Sedation
c- Oxygen
d- Intravenous fluid
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 45 year-old woman is receiving chemotherapy for breast cancer. Two weeks .103
after the initial treatment she telephoned the nurse at the cancer center and reports
she has hair loss, nausea, tiredness, a body temperature is 38.1 C, and air
?hunger Which finding most likely indicates she needs to report the clinic

a- Pyrexia
b- Nausea
c- Hair loss
d- Air hunger
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A patient present to the clinic voicing a concern above being exposed to hepatitis .104
A (HA V) one week ago. Upon questioning, the nurse finds the patient
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purchased for from a person recently diagnosed with HAV. The number would be
MOST correct when instructing the patient
a- The incubation period is 3 to 5 weeks
b- HA V is spread by sexual transmission
c- HA V is spread by blood contact
d- The incubation period is 2 to 5 months
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A gravid 3, para 2 presents to the Labor and Delivery Unit with contractions .105
occurring every 3-5 minutes and lasting for 60-90 seconds. During contractions, she
closed her eyes and is focused on breathing to cope with the pain. At the end of each
contraction she opens her eyes and resumes talking with the nurse and her
?husband. What is the expected cervical dilatation in centimeters

a- 1 -3
b- 4-7
c- 8-10
d- 11- 13
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

The nurse is preparing a discharge plane for a 65 year-old man with a new .106
diagnosis of congestive heart failure. The discharge orders include furosemide 40
milligrams by mouth twice per day. The nurse recommends foods to reduce
.unwanted medication side effects

Which of the following foods would be most appropriate to include in the teaching
?plan

a- Green and leafy vegetables

b- Bananas and oranges
c- Chicken and Fish
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A patient who is scheduled for a tonsillectomy is in the preoperative unit. The .107
nurse notes an order for preanesthetic medication to be given "on call to operating
room." The nurse should give this medication. a- Immediately upon
being notified to prepare the patient for transport b- When the
operating room staff arrives to transport the patient c- Only if clearly
needed after
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

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Admission Report at 22.45(10.45 P.M) Diagnosis

14 years old Remain fibrils, maximum Bacterial
admitted 18 Temperature that shift 39.3°C(102.8°P)
hours ago Respiration rate 12 -11 per min
Blood pressure level within base line normal range
Next dose of intravenous active infective is done at
)8.00a.m(08.00

.108 .Refer to the accompanying figure

Which of the following goals should receive PRIORITY during the shift?
a- The patient will rest for 6 hours without interruption b- The patient
will consume 90% of each meal
c- The patient will perform deep breathing and coughing exercis
d- The patient will drink 1920 ml (64 ounces of fluid)
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 45 year-old man has a family history of heart disease. His father died for heart . 109
disease at the age of 61 and he is concerned that he is at high risk. He reports that he
walks for twenty minutes three times per week. He drinks three to five cup of coffee
daily and does not smoke cigarettes. His medical history includes diabetes, which is
well controlled with to sit for long periods of time (see lab
.)result

Blood pressure mmHg 138/88

Heart rate min/70
Respiratory rate min/18
Temperature 37°C
Test Result Normal Values
Cholesterol (HDL) 1.0 1.03mmolIL >
Cholesterol (LDL) 4.0 3.36mmollL<
Total Cholesterol 5.2 5.1mmollL<
Triglycerides 2.2 16mmolIL .2<
?Which lifestyle modification would most likely decrease this patient risk factor
a- Decrease stress
b- Increase exercise
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 66 year-old woman is admitted to the hospital with a history hypertension. She .110
present with breathing difficulties that worsen with activity and while sleeping, she
is generally weak and feels that her heart misses beats and that it
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sometimes beats loudly. An electrocardiogram shows atrial fibrillation, right

ventricular hypertrophy and deviation towards the right. Which
nursing intervention is most appropriate for this patient? a-
Provide a bedside commode (portable toilet) b- Place in right
side lying position c- Encourage family and friends to visit d-
Encourage independent hygienic activities

‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 66 year-old woman is admitted to the hospital with a history hypertension. She .111
present with breathing difficulties that worsen with activity and while sleeping, she
is generally weak and feels that her heart misses beats An electrocardiogram
Conform atrial fibrillation, right ventricular hypertrophy and
deviation towards the right
?What was the most likely origin of the disorder
a- Hypertension
b- Rheumatic fever
c- Atherosclerosis
d- Genetic predisposition
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 76 year- old woman present with facial drooping on the left side and muscle .112
.weakness of the left arm and leg after suffering a fall at home

?Which type of paresis is most likely

a- Monoparesis
b- Paraparesis
c- Hemiparesis
d- Quadriparesis
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

The nurse has administered an intravenous infusion of Cyclophosphamide to a 43 .113

year-old patient with breast cancer. The nurse formulates a care plan with the
nursing problem of risk for infection related to leucopenia secondary to
.chemotherapy. The patient is discharged home following treatment

?Which findings should the patient report immediately

a- Dyspnea
b- Tachycardia

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c- Sore throat
d- Discoloration of urine
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

When given postoperative discharge instruction to a patient who had abdominal .114
surgery, all of the following regarding wound healing is true EXPECT
a- Bathing to soak abdomen is preferred over showering
b- A void tight belts and clothes with seams that may rub the
wound c- Pain medication may affect ability to drive d- Irregular
bowel habits can be expected
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

An eight year-old boy has a new diagnosis of Attention Deficit Hyperactive .115
Disorder (ADHD) and begins pharmacological and psychological therapies. His
medication regimen includes short-acting methylphenidate 5 mg orally every 12
.hours

?Which side effect is most likely

a- Insomnia
b- Initial increased hyperactivity
c- Lethargy
d- Hypertension
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

The nurse is caring for a full-term new born who was delivered vaginally 5 .116
minutes ago. The infant's APGAR score was 8 at one minute and 10 at 5 minutes.
?Which of the following has the highest PRIORITY

a- Maintaining the infant in the supine

position b- Assessing the infant's red reflex c-
Preventing heat loss from the infant
d- Administering humidified oxygen to the infant
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

The district nurse attends a 73 year-old woman on a daily basis. The woman's .117
husband had passed away three years previously and she now lives alone. Besides
assisting in activities of daily living the nurse encourages the patient to talk about
.her past experiences and events

?Which theoretical frame work is most likely guiding the nurse's care plan
a- Erickson's model of psychosocial development
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b- Piaget's theory of cognitive development

c- Watson's theory of human caring
d- Roy's adaptation model
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A home care patient with chronic obstructive pulmonary disease (COPD) reports .118
an upset stomach. The patient is taking theophylline (Theo-Dur) and triamcinolone
acetonide (Azmacort), the nurse should instruct the patient to take
a- Theo-Dur on an empty stomach b- Theo-
Dur and Azmacort at the same time c- Theo-
Dur and Azmacort 12 hours apart d- Theo-
Dur with milk or crackers
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 64 year- old woman with hepatitis B has significant scarring on the liver and .119
present to the clinic with swelling around the eyes. She is disoriented to time and
place and seems confused. Her responses are slow and she has difficulty staying
.awake. A neurological assessment reveals hypoactive reflexes

Blood pressure mmHg 164/96

Heart rate min/58
Respiratory rate min shallow/22
Temperature 37.0°C tympanic
?Which of the following nursing interventions is most appropriate

a- Prevent aspiration
b- Encourage small meals

c- Administer fluid bolus d- Inject

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A patient is being followed in the clinic for hypertension, adult onset diabetes, and .120
obesity. The patient is apathetic about learning about nutritional guidelines to reach
the goals of weight loss and consumption of a healthy diet. The patient
admitted to eating "whatever is put in front of me"
Which of the following actions would the nurse take?
a- Collaborate with the patient to set goals b- Add a
nursing diagnosis of non-compliance c- Refer for
psychiatric screening for depression d- Discuss
nutritional interventions with the spouse
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
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A 16 year-old boy is in the Post-Operative Care Unit two hours after a .121
tonsillectomy. He is alert and oriented but complains of severe throat pain and
difficulty swallowing. He rates the pain at a level 7, on a scale of 1-10. The urine
.output from the folly catheter is 45 ml over the past two hours

Blood pressure mmHg 130/74

Heart rate min/64
Respiratory rate min/18
Oxygen saturation on room air % 98
?Which clinical finding is most important to report to the doctor
a- Oxygen saturation
b- Difficulty swallowing
c- Urinary output
d- Pain level
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A patient is being treated for pneumonia. Considering Maslow's hierarchy of .122

?needs, which of the following nursing diagnoses would have HIGHEST priority

a- Risk for impaired skin integrity

.b- Ineffective coughing
c- Disturbed sleep pattern
d- Ineffective breathing pattern
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A Knowledge deficit related to diabetes Mellitus

B Anxiety related to new diagnosis of diabetes Mellitus
C Altered nutrition more than body requirement
D Altered health maintenance related to elevated blood glucose
E Altered in fluid and electrolyte balance related to ketoacidosis
F Risk for infection related to chronic disease
An .123 insulin dependent diabetic patient is admitted to the hospital in

ketoacidosis. Of the nursing diagnoses shown in the table which is the two with the
?HIGHEST priority

a- A , C
b- E, F
c- D, E
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d- B , E
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A patient who is receiving chemotherapy has a platelet count of 49,000/mm3

(normal value 150,000 to 400,000/mm3)
Which of the following nursing action is necessary?
a- Minimize invasive procedures b- Crush oral
medications c- Limit intake of vitamin k rich foods
d- Monitor the temperature every 4 hours
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A child present to the emergency department with complaint of chest pain on .125
exertion, shortness of breath, and dizziness. Upon examination the nurse notes
palpitation and a systolic ejection murmur at the right upper sterna border. Skin
.color is normal. The nurse suspect

a- Aortic stenosis
b- Aortic regurgitation
c- Mitral stenosis
d- Mitral valve prolapse
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A four year- old girl was playing outside in a park when she came running to her . 126
mother crying and holding her right , upper arm, with pain and itching at the
site as well as swelling of the oral mucosa. The child seems anxious
What is the next most appropriate step in management? a-
Administer subcutaneous epinephrine
b- Maintain a patent airway
c- Administer oral diphenhydramine
d- Prepare intubation equipment
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A patient is on oxygen using a nasal cannula at home. The doctor has ordered this .127
patient to receive oxygen delivered at a concentration of 35 %. The nurse
:would set the oxygen at

a- 2L
b- 3L
c- 4L
d- 5L
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A nurse who is assigned to care for a client with dementia and agitated behaviors .128
,knows that the client worked as a housekeeper prior to becoming ill

?Which of the follow

a- Watching a movie about a house keeper b- Reading a sheet

of paper that contains stains removing tips c- Dusting
furniture in the assigned room with a cloth d- Singing songs
about cleaning
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A diabetic patient with an infected right second toe is treated with a 14 -day . 129
course of antibiotics. The patient returns for a follow- up visit after finishing the
.prescribed course of antibiotics

What can be inferred from the accompanying blood laboratory result drawn at the
?follow-up visit
Test Result Normal Value
WBC 12.0 4-10.5x109/L
HCT 0.41 0.41-0.50

Hemoglobin 153 135-171g/d1

Blood urea nitrogen 6.4 2.8-8.9nuno1/L
Creatinine clearance .106 70-103nuno1/L

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Glucose, fasting 16.6 3.5-6.5nuno1/L

a- Diabetes is effectively managed but toe infection is not managed

well b- Diabetes and toe infection are effectively managed
c- Diabetes and toe infection are effectively managed but toe infection is
effectively managed
d- Diabetes and toe infection are not effectively managed
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 60 year-old woman, with no previous medical history is diagnosed with an .130

adenocarcinoma of the duodenum head of the pancreas and the distal end of the bile
duct. Staging shows it has not grown into the large blood vessels and has not
metastasized to any lymph node or distant site. The patient undergoes surgery.
?Which post- operative clinical finding is most likely

a- Increased serum glucose

b- Constipation
c- Weight loss >15%
d- Paralytic ileus
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A 62 year-old patient has been treated for congestive heart failure and a nursing .131
diagnosis of fluid volume excess. After diuretic therapy and dietary
interventions, the patient has met all short- term goals. The nurse should. a-
Revise the care plan with a diagnosis of risk for alteration in fluid balance b-
Add a new diagnosis of risk of fluid volume deficit c- Discontinue the care
plane as the diagnosis is resolved d- Continue the care plan as written

‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

The nurse assists with a lumbar puncture on a child with suspected bacterial .132
meningitis. If the diagnosis is correct the cerebrospinal fluid should have which of
?the following qualities

a- Pink viscous appearance

b- Clear fluid appearance
c- Turbid appearance
d- Blood-tinged appearance

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Gamdi

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A patient presents with pneumonia. Which of the following intervention would

?the nurse implement to improve the patient's gas exchange

Heart rate min/80

Respiratory rate min/32
Temperature 40°C
a- Encourage the patient to increase fluid intake b-
Position the patient in an upright position c- Instruct the
patient the patient to splint when coughing d- Apply heat
and or cold to the chest as ordered
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

While providing care to a hospitalized child with third-degree burns over 20% of .134
the body, the child rapidly becomes disoriented. The nurse knows this is an
:indicator of

a- Septic shock
b- Separation anxiety
c- Dehydration
d- Depression
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A brick-layer has been diagnosed with multiple sclera. The nurse knows that .135
construction work places has increased risk of aggravated symptoms because
.exposure to

a- Dust
b- Sunlight
c- Heat
d- Heights
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 68 year-old male patient has a chest tube and properly fixed following cardiac .136
surgery. The chest tube is patent and functioning. When the nurse removes
the dressing the tube falls out of the chest. Which is the most appropriate
initial intervention the nurse should take? a- Reinsert the chest tube and
notify the surgeon b- Apply an occlusive dressing to the insertion site c-
Place the open end of the tube in 20 cm of water

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 | Twitter: nurse077 Preparation / Abdulrahman Al-Gamdi 0533319252

d- Administer O2 at 10L/min via non-rebreather mask

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During surgery requiring general anesthesia, the patient's heart stops and a .137
.carotid pulse is not palpated

?How many compressions per minute should be administered

a- 50
b- 60
c- 80
d- 100
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A 64 year-old man present with a weight gain of four kilograms in the past week. .138
A physical examination shows an enlarged liver, an enlarged abdomen with a fluid
wave, and jugular venous distension. The nurse creates a care plan based on the
following nursing diagnosis. Decreased cardiac output related to ventricular
.damage, ischemia and restriction secondary to fluid overload

?Which would be an appropriate defining characteristic

a- Altered preload
b- Altered afterload
c- Poor ventricular contractility
d- Increased pulmonary congestion
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After the nurse has administered a heparin injection. The patient is observed .139
rubbing the area. The nurse should instruct the patient to not rub the area, as it
may
.a- Increase the risk of bleeding
.b- Prevent proper absorption of the medication
.c-
Cause increased pain
.d- Result in tissue death
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A home nurse attends an obese patient, with decreased mobility. Who has .140
developed pain in her left calf muscle on examination, the leg appears swollen and
red with large superficial veins. The nurse refers the patient for investigation and
: treatment (see lab results)

Test Result Normal Values

Platelet count 49 x 10/ L 140-400
INR 1.5 1.2- 0.7

?What type of treatment is most appropriate for this patient

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a- Unfractured heparin
b- Anti-embolic stocking
c- Warm compresses and heating pads
d- Anti-inflammatory medications
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A hospitalized patient eats 20 % of the meal and states being too tired to eat
more
What should the nurse do? a- Offer to feed the
patient after short rest period. b- Encourage the
.patient to finish the fluids
c- Remove the meal tray and allow the patient to rest.
d- Encourage the patient to finish the protein portion of the meal
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The district nurse attends a mother and a girl who was born five days previously. .142
At birth, the baby had weighed 3.5 kilograms. The mother becomes worried when
she hears that the baby weighs 3.3 kilograms today. The infant is pink, alert and
active with 6-8 wet diapers and four stools per day. Blanching of
the skin shows a light yellow color of the forehead but a pink sternum.
What is the most appropriate nursing action? a- Notify the
pediatrician
b- Obtain blood for bilirubin analysis c- Reassure
the mother and continue observing d- Request
the mother go to the clinic to re-weigh
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Gamdi

A 6-month -old boy is admitted with failure to thrive Based on his growth chart
the nurse should consider
?Which of the following as the cause of the child's failure to thrive
a- Parent-child interaction
b- Malrotation of the colon
c- Genetic chromosomal abnormalities
d- Congenital heart disease
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A 40 year- old woman presents with right hip pain palpation of the pelvic girdle is .144
normal. An X-ray shows bone deformities, with osteolytic lesions and bone
enlargement. The patient has not suffered trauma and has been generally health.
?Which serum laboratory analysis would be most useful

a- Prothrombin time
b- Alkaline phosphatase
c- Acid phosphatase
d- Parathyroid hormone
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A 22 years-old man is brought to the Emergency Department after falling four .145
meters from a rooftop. He complains of coldness, numbness and tingling in the right
lower leg and foot. He is unable to move the right leg and there is an angular
deformity over the thigh muscle (see X-ray)
Blood pressure mmHg 90/68
Heart rate min/110
Respiratory rate min/26
Temperature C 36.3
Oxygen saturation on room air % 94

?Which type of intravenous fluid administration is most appropriate

a- Lactated Ringers solution
b- 5% dextrose in water solution
c- 3.3% glucose in 0.3% sodium chloride
d- 5% dextrose in 0.45% normal saline
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Gamdi

A 60 year-old man with a history of long-term alcohol use presents to the clinic .146
with an enlarged abdominal girth, hemoptysis and pruritus. His eyes and skin are
visibly yellow-coloured. Which additional finding would indicate the need for
?immediate hospital admission

a- Azotemia
b- Asterixis
c- Tachycardia
d- Lower extremity edema
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.147

Diagnosis Medication order Past medical history

Glucophage 850mg po. qd Heart failure
Dilated Imdur 60mg. po .qd DM type 2
cardiomyopathy Lasix 80mg. po. qd Peripheral vascular disease (pvd)
Zocor 40mg. po. qd primary hyperlipidemia
Based on the patient's history which of the following medication orders should the
?nurse verify

a- Glucophage
b- Zocor
c- Lasix
d- Imdur
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Patient experienced (eVA) one week ago. The doctor order the patient discharged .148
from the hospital to home health care. The visiting nurse evaluates the
.patient and notes the patient has difficulty initiating speech and forming words

?Which of the following types of aphasia is most likely in this patient

a- Receptive
b- Expressive
c- Fluent
d- Conduction
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A community health nurse assesses a68 year-old patient who lives in a group .149
home. The patient reports decreased appetite after transferring to the group home
.because the food tastes bland

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?What type of data is the nurse collecting from the above information
a- Analytical
b- Derived
c- Objective
d- Subjective
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A patient had a retinal detachment surgically repaired the nurse identifies that the.150
detachment would most likely be corrected and unlikely to reoccur if the
:retina remains attached at least

a- Three days
b- Two weeks
c- Two months
d- Three months
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A patient complains of incoordination, weakness and fatigue, double vision, and .151
slurred speech laboratory test results are normal except for magnetic resonance
imaging (MRI) scan which shows small plaques scattered throughout the white
:matter. The nurse would anticipate the diagnosis of

a- Multiple sclerosis
b- Brain metastasis
c- Amyotrophic lateral sclerosis (Lou Gehrig disease)
d- Polyradiculoneuritis( Guillain-Barre syndrome)
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A nurse is caring for child who is post- tonsillectomy and adenoidectomy. The
?nurse should plane to assess which of the following complications

a- Pulmonary hypertension
b- Hemorrhage
c- Hearing loss
d- Corpulmonale
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A home care nurse visits a diabetic patient who was started on insulin injection, .153
upon examination, the nurse observes small lumps and dents on the right upper
arm where the patient has injected insulin. What is the
BEST nursing intervention? a- Refer the patient to
dermatologist for diabetic cellulitis
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b- Instruct the patient to rotate the sites of injection

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According to information provided in the accom

colon would be expected to produce
a- Fluid feces
b- Mushy faces
c- Semi-solid faces
d- Solid faces
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A gravida 3 Para 2 presents to the Maternity Triage Unit after the amniotic .155
membranes ruptured at home. The fluid is noted to be clear. The neonate's head is
engaged into the pelvis and the patient is having contractions every 5 to 7 minutes.
Each contraction lasts for 60-90 seconds. An examination of the cervix finds 4
centimeters dilatation and 90 % effacement. She is uncomfortable during
contractions and rates the pain at a level 7, on a pain scale of 1-10
?Which finding is most indicative that she is in true labor
a- Level of pain
b- Cervical dilatation and effacement
c- Engagement of presenting part fractions
d- Frequency and length of contraction
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A patient is planning to have an elective surgical procedure to repair an umbilical .156

hernia. The patient is 68 years old. Weighs 136 kg (300 lbs.) Has diabetes mellitus.
Which of the following approaches would be the MOST beneficial in order to
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?reduce the patients surgical risk

a- Monitor blood glucose levels monthly
b- Avoid fluid overload by restricting fluids
c- Discourage any changes in routine before surgery
d- Encourage weight reduction
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The nurse is discussing the human immunodeficiency virus (HIV) with a group of .157
high - risk patients. The nurse should state that this virus is found MOST
?commonly in which of the following body fluids

a- Blood
b- Saliva
c- Breast milk
d- vaginal secretions
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The nurse has provided dietary counseling to a woman who is 12 weeks pregnant .158
with her first child. She is concerned about her nutrition as she is vegetarian. She was
advised by a friend to eat a variety of foods that contain
.proteins and asks the nurse which food might be best included in a meal plan

?Which combination would be most appropriate

a- Soya beans with carrots
b- chickpeas with whole grain bread
c- Nuts with a glass of cow's milk
d- Avocado with a slice of cheese
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After total knee replacement a patient is being discharged to home after which he .159
will ambulate with a four-prong cane. When providing patient teaching regarding
going up and down stairs with the cane, the first step in gong up stairs is
to
a- Place the unaffected extremity up on the step
b- Place the cane up on the step
c- Step-up on the affected extremity
d- Step-up on the unaffected extremity
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A nurse educates a patient about the use of incentive spirometry to prevent .160
.atelectasis after a surgery

?The nurse is performing what step of the nursing process

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a- Diagnosis
b- Assessment
c- implementation
d- evaluation
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.A 65 year-old male presents with sever iron deficiency anemia .161

Which of the following would the nurse expect to find in the initial physical
?assessment

a- Clubbing
b- Koilonychia
c- Beus line
d- Paronychia
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Palpation, there is guarding and rebound tenderness. Further investigation .162

:reveals a small stone which is trapped in the common bile duct On admission

Blood pressure mmHg 148/80

Heart rate 90min
Respiratory rate shallow 21
Temperature 37.8

Which additional clinical finding is most likely?

a- Yellowing of the sclera b- Dark and tarry
stools c- light-amber coloured urine d-
Clubbing of the fingers

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Health seeking behavior related to therapeutic regimen - intervention - the

.nurse will

A .Provide written and oral education on diabetes management

B .Evaluate the child's knowledge of disease process
C .Evaluate the Mother's knowledge of the disease process
D .Evaluate the child's cognition and readiness of learn
E .Demonstrate capillary blood testing and insulin injections

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Gamdi

F Provide opportunity for return demonstration of capillary blood testing and

.insulin injection

G .Evaluate Mother's need to control the child through disease management

A 10 year-old child with a seven year history of diabetes mellitus presents to the . 163
office with a parent for routine follow-up. The patient wants to manage capillary
blood testing and insulin injections independently. The parent believes the child is
not mature enough to manage the disease, while the child is knowledgeable about
.dietary needs and can recognize the signs of hyperglycemia and hypoglycemia

?What are the two HIGHEST priority interventions

a- A,E
b- C,G
c- B ,D
d- E,F
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A home care nurse is instructing parents to perform chest Physiotherapy (CPT) on.164
their child with cystic fibrosis the nurse has the parents place their child in a
.prone position with the body tilted downward before performing CPT

Based on this information, the nurse is instructing the pare

?which of the following Jung lobe segment

a- Upper posterior
b- Lower anterior
c- Lower posterior
d- Upper anterior
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Which of the following medications w

?weeks prior the surgery

a- Antiarrhythmic
b- Antifungal
c- Antidiabetics
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d- antiplatelet
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A Seven year-old boy presents with a fine maculopapular rash over the entire .166
body. The mother report's that prior to the rash developing there had been tiny
grey-white spot over the buccal mucosa (see clinical image).
?Which precautions would most effectively prevent transmission
.a- Private room, gloves and gown for care takers
.b- A mask over the patient's mouth and nose
.c- Negative pressure room and N95 mask for staff
.d- Hand washing and disposable patient equipment
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.A community health nurse screens a group of high-risk adults for tuberculosis .167
Which gauge needle should the n
?surface of the forearm

a- 16 gauge needle
b- 20 gauge needle
c- 22 gauge needle
d- 26 gauge needle
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A 45 year-old women is admitted for a surgical procedure. Local anesthetic .168

medication, bupivacaine, and fentanyl are administered through a tiny needle placed
into the subarachnoid space. The anesthetic is administered with the patient in an
upright and seated position. five minutes later, the nurse records the
:patients vital signs

Blood pressure 88/58mmHg

Heart rate min/110
Respiratory rate min/18

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Temperature DC tympanic 38.0

a- Blood pressure
b- Pulse rate
c- Respiratory rate
d- Body temperature
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nurse should understand that one dose of which of the following The.169
:vaccinations is recommended for this patient before the age of 65 years

a- Varicella
b- Influenza
c- Hepatitis B
d- Pneumococcal
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A home care nurse visits a patient with a new below -the-knee amputation. The .170
site of the incision is red, warm and tender with purulent yellow drainage. The
patient has a new prescription for cephalexin (Keflex) and oxycodone (OxyContin)
Which would the nurse instruct the patient to do FIRST?
a- Take oxycodone as soon as possible b- Take
cephalexin as soon as possible c- Wash the incision site
and apply bacitracin cream
.d- Wash the incision site and apply hydrocortisone
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A 44 year-old woman presents with fatigue, weakness and anorexia. She has .171
recently lost 10 kilograms in weight. She also complains that she has difficulty
concentration and that her mood swings easily between being happy and sad.
There is some hyperpigmentation of the skin (see clinical signs). The nurse
.provides nutritional counseling for the patient (see lab result)

Test
result
normal value
5 3.0 Cortisol
-25 mcg/dl
?Which dietary change is most appropriate
a- Increased sodium
b- Decrease protein
c- Low carbohydrates
d- decreased potassium
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‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

year-old male has the following vital signs the patient has received 2 unites of 172.39
packed red blood cells (PRBCs) and is intubated.
?Which of the vital signs is considered out of normal range
Blood pressure mmHg 126/78
Heart rate min/62
O2 saturation on room air % 89
Temperature oC 37

a- Heart rate
b- O 2 saturation rate
c- Core temperature
d- Blood pressure
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According to the hypothetical graph of urinary output versus time of intravenous .173
(IV) administration, at what hour of IV administration dose the urinary output
:.attain the desired output of 30 ml/hr

a- 2 hours
b- 4 hours
c- 6 hours
d- 8 hours
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A 22 year- old man presented to the Mental Health Clinic with a low-mood, a .174
general loss of interest in activities and inability to experience pleasure. He admitted
to suicidal thoughts and extreme lack of energy. He was prescribed a selective
serotonin reuptake inhibitor to be taken daily. One month later, he presented to the
-clinic and reports feeling more energetic, but still has a low
.mood

?What is the patient's level of risk committing suicide at this time

a- None
b- Low
c- Medium
d- High
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A patient requiring long-term antibiotics has a central line catheter inserted into .175
.the right subclavian vein by the physician

?Which of the following must be verified prior to the first use of the catheter
a- Blood return
b- X-ray
c- Catheter patency
d- Length of catheter
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A 35 year-old woman with excessive facial and body hair and acne has had weight .176
gain in the shoulder, upper back and face. She does not drink alcohol and does not
have diabetes. She takes glucocorticoids regularly. Which dietary plan
?would be most beneficial for this patient

a- Increased calcium
b- Decreased sodium
c- Increased potassium
d- Decreased protein
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A 45 year-old woman presents to the clinic with urinary incontinence. Point- .177
topoint testing, in which she must touch the tip of her nose with the doctor's index
finger on command, reveals slowness and uncertainty. Alternate hand movement
testing shows asymmetry, slowness and increased concentration. Rhythmic,
involuntary movements of the hands are noted at rest. During Romberg's test, the
.patient easily loses balance

?Which type of urinary incontinence treatment is most appropriate

a- Bladder retraining and anti-cholinergic agents
b- Timed voiding and biofeedback training
c- Intermittent straight catheter and biofeedback
d- Timed voiding and anti-cholinergic agents
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
A nurse is caring for an eight year- old male with cystic fibrosis. Based on the .178
nurse's understanding of the disease what nursing intervention should the nurse
?expect to perform

a- Restrict sodium and fluid intake

b- Give antidiarrheal medications
c- Discourage coughing after postural drainage

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d- Administer pancreatic enzymes with each meal

‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
A patient hospitalized with tuberculosis (TB) has a productive cough and .179
.hemoptysis

Which of the following types of isolation room would be the BEST choice for the
?patient

a- Reverse isolation
b- Standard isolation
c- Positive-pressure
d- Negative-pressure
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A 78 year-old man presents to his care provider with persistent abdominal and .180
back pain. He also occasionally has numbness and pain in the legs. On examination a
palpable mass in the lower abdominal midline is palpated. On auscultation a blowing
sound is heard over his mass. The nurse is concerned about possible
.rupture

Which additional finding most significantly indicates the patient is at an increased

?risk

a- Hypertension
b- High blood sugar
c- Constipation
d- Decreased oxygen saturation
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

When administrating an enema to an adult pa

?insert the tubing into the rectum

a- 2.2 to 4.4 cm (1 to 2 inches)

b- 4.4 to 6.6 cm (2 to 3 inches)
c- 6.6 to 8.8 cm (3 to 4 inches)
d- 8.8 to 11 cm (4 to 5 inches)
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A nurse plans to teach a group of 20 to 25 year-old women about oral .182
:contraceptives. The nurse should instruct that oral contraceptives may

a- Increase risk of pelvic inflammatory disease

b- Cause acne to worsen
c- Decrease the risk of breast and cervical cancer
d- Decrease the risk of endometriosis

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‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
A 35 year-old man twisted his right ankle. Since then, he has had swelling and .183
stiffness of the ankle in the morning hours. He presented to the clinic six months
after the injury and complains that he is in too much pain to participate in sports.
An arthroscopy reveals thickening and inflammation of the lining of the ankle
.joint

?Which treatment is most likely to be ordered for this client

a- Aspiration of fluids
b- Surgical intervention
c- Physical therapy
d- NSAID administration
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
An eight year-old boy presents with abdominal cramping and a feeling of fullness. .184
He frequently passes semi-formed stools that are light yellow colored and oily, with
an abnormally foul odor. His mother states that the child has lost his appetite lately
and is concerned about weight loss. Endoscopic examination
.reveals villous atrophy

?Which food would be most suitable for this child

a- Rye
b- Oats
c- Barley
d- Wheat
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
A three year-old child is day three on the postoperative care unit following a .185
.heart transplant. He is prescribed cyclosporine by intravenous infusion

Blood pressure mmHg 140/80

Heart rate min/100
Respiratory rate m/22
Temperature 37.0°C
Oxygen saturation on room air % 92
?Which vital sign most likely indicates an adverse medication effect
a- Hypertension
b- Decreased O2 saturation
c- Tachycardia
d- Tachypnea
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
A 6-month-old premature infant is being discharged from the neonatal intensive .186
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care unit after having no apneic periods for the past week. Although the child has
had no apneic periods for the past week, an apnea monitor will be sent home with
the parents. The BEST short term goal relating to the nursing diagnosis of
:ineffective breathing pattern related to apnea is that the

a- Apnea monitor will sound

of apnea
b- Apnea monitor will sound loudly and alert the parents to stimulate the child to
breath with episodes of apnea
c- Child will have no episodes of apnea or cyanosis while on apnea monitor
d- Child will sleep in their parent 's bed each night until there is no apnea two
weeks
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A 25 year-old female presented to the emergency room with lethargy, decreased .187
reflexes, hypoventilation, hypotension, and fixed and dilated pupils. A family member
who is accompanying the patient has an empty bottle of diazepam (Valium) which
the label states was recently refilled. The family member also
.indicates that the patient has a history of depression

?What intervention should the nurse expect to administer

a- Naloxone (Narcan)
b- Activated charcoal
c- Magnesium sulfate to reduce the risk of
seizures d - A tap water enema
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A nurse is documenting in patient records several events that occurred during .188
.home visits

Which of the following

?information

a- Patient fell walking to bathroom. Busy preparing for sterile dressing change
when patient left the room
b- Patient got out of bed without assistance. Denies any symptoms when
ambulating alone
c- Patient sitting in chair. Strict bedrest orders ignored
d- Patient showering. Electronic epidural infusion pump on floor by shower stall
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A 50 year-old man is hospitalized after presenting with long-term fatigue, weight .189
gain and hematemesis. On examination he is jaundiced and the abdomen distended
,and tense, and there is shifting dullness present. Following treatment
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the nurse provides discharge instructions.

Which instructions would be most appropriate?
a- Decrease daily iron intake b- Maintain
constant bed rest c- Consume a low protein diet
d- Restrict fluid intake

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The nurse is assessing an infant with Gastroeosophageal reflux disease (GERD). To.190
help identify any complications of GERD, what is the most important question
?the nurse should ask the infant's parents

a- Frequency of respiratory tract infection

b- Frequency of vomiting
c- Time between bowl movements
d- Time between feeds
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A patient with an unsteady gait and a history of falls has care plan interventions .191
that include keeping the walker in reach and pathways free of obstacles. On
evaluation after 1 week, the patient has had no falls, but the gait remains unsteady.
:The nurse should

a- Continue the plan of care as written b- Allow the patient to

replace the walker with a cane c- Allow the patient to ambulate
short distances without the walker d- Have the patient practice
stepping over small objects
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,A patient complains of severe menstrual cramping. Bleeding is not usually heavy .192
.and the patient has no uterine disorders

Which of the following interventions should the nurse anticipate the doctor will
?order to promote comfort

a- Acetaminophen (Tylenol)
b- Strict bed rest
c- Heating pad to the back of neck
d- Ibuprofen (Motrin)
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A patient is admitted to the emergency department with stable angina. The .193
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.physician writes an order for nitroglycerin 11150 grains sub lingually (SL)
?Which is the correct dose in milligrams (mg)
a- 0.04 mg
b- 0.4 mg
c- 4 mg
d- 40 mg
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A perimenopausal woman with a small body frame is at high risk for a condition in.194
which bone resorption exceeds the rate of bone formation. She drinks one-three cups
of coffee per day since she was 25 years old and smokes five -ten cigarettes per day
for the past 20 years. The nurse advises the patient to increase her dietary
.intake of milk and green leafy vegetables

?Which additional foods are most appropriate to recommend

a- Egg yolk, cheese
b- Peanuts, poultry
c- Whole grains, cereals
d- Lentils and black beans
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A 30 year- old woman with type 1 diabetes mellitus receives mixed type of insulin in .195
the morning and before bed time. She reports that the level of her fasting blood
.sugar is constantly high when she checks it every morning at home

?Which dose of insulin is most likely causing this problem

a- Low morning, regular insulin
b- High morning NPHI
c- High evening regular insulin
d- Low evening NPH insulin
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A patient who is preparing for hip surgery has an order for external pneumatic .196
compression devices. The nurse teaches the patient that pneumatic compression
:can help prevent

a- Upper respiratory infection

b- Decreased breath sounds
c- Deep vein thrombosis
d- Bleeding at the surgical site

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‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

Following an open-cholecystectomy, the nurse w

:expect to resume normal activities in

a- 1 to 2 weeks
b- 2 to 3 weeks
c- 4 to 6 weeks
d- 6 to 8 weeks
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A five month- old boy has been vomiting green colored vomit for ten hours. He has.198
intermittent abdominal pain during which he draws his legs up to his chest, turns
pale and cries forcefully. On observation, there is bleeding in the stool which
has a jelly-like consistency. Abdominal palpation reveals a long tube-like mass.
There is no fever, rash nor diarrhea. Bowel sounds are hyperactive in all
.quadrants

?Which is the most likely form of initial treatment

a- Manual manipulation
b- Surgical resection
c- Barium enema
d- Endoscopy
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The nurse is assisting a patient to ambulate in hall. The patient has a history of .199
coronary artery disease (CAD) and had coronary artery bypass graft surgery (CABG)
3 days ago. The patient reports chest pain rated 3 on a scale of 0 (no pain)
to 10 (severe pain). The nurse should first: a- Determine how long it has
been since the patient's last dose of aspirin b- Obtain a chair for the
patient to sit down c- Assess the patient's radial pulse

.d- Ask the patient to take several slow, deep breaths

‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 52 year-old man with congestive heart failure presents to the Emergency .200
Department with rapid and irregular heartbeats, and feeling dizzy and light-headed.
The attending physician verbally calls out an order to the nurse to administer digoxin
0.25 milligrams by intravenous injection. How will the nurse
complete the paperwork for this order?
a- Write, sign and repeat order back to the physician

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b- Ask the physician to write and sign the order

c- Write the order and ask the physician to sign
d- Verbally repeat the order and administer
drug
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An 82 year-old patient has Parkinson's disease. During the assessment, the nurse .201
would expect which of the following actions to produce the MOST tremor activity
?of the hands

a- Eating with a fork

b- Resting hands in lap
c- Standing with hands loose at sides
d- Rolling a small pill between the fingers
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A 67 year- old man was admitted to the hospital following a closed bone fracture. .202
An intramedullary nail is inserted and the patient is placed in balanced skeletal
traction. The following day, the patient becomes restless, drowsy and confused, he
.has difficulty breathing and appears very tired

?Which additional sign or symptom would require immediate intervention

a- Anxiety
b- Cold skin
c- Constipation
d- Petechiae on chest
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A patient is preparing for a total knee replacement. During the preoperative .203
.interview process the patient reports an allergic reaction to penicillin

Which of the following is considered a side effect and not a true allergy to
?medication

a- Shortness of breath
b- Tingling lips and tongue
c- Rash
d- Upset stomach
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A 54 year-old woman presented to the Emergency Department with sharp upper .204
right abdominal pain that radiates to the right scapula. While performing the
admission assessment, the patient becomes nauseous and begins vomiting. She states
that she has had pain in the upper right quadrant previously but that this
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time it was far worse. There's a positive Murphy's sign and an ultrasound confirms
gallbladder wall thickening and pericholecystic fluid collections. Which of the
?following would most likely be associated with her clinical findings

a- Relief by drinking milk

b- Alleviation with exercise
c- Triggered by fatty meal
d- Worsening on empty stomach
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
A 68 year-old woman is receiving parenteral nutrition at home. The district nurse .205
visits the woman and notes that she has gained one kilogram of weight since a health
provider had visited one week ago. There is pitting edema of 2+ of the
.lower extremities. The patient is alert, active and oriented

?Which nursing diagnosis is most appropriate

a- Non-compliance
b- Impaired gas exchange
c- Imbalanced nutrition
d- Fluid volume overload
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A patient has a central line catheter and is receiving a three-in-one total .206
parenteral nutrition that contains glucose, proteins and lipids. The pump is set to
deliver the infusion over a 12-hour period. After how many hours should the
?intravenous administration set be changed

a- 12
b- 24
c- 48
d- 72
‫ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 45 year- old man who is hospitalized feels the constant need to keep things in .207
order, particularly whilst eating. The nurse observes him arranging the food on his
plate into symmetrical and equal bite-sized pieces. He constantly worries that food
.served could be outdated and potentially cause illness

?Which nursing diagnosis is most important

a- Ineffective verbal communication
b- Self-esteem disturbance
c- Impaired social interaction

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d- Anxiety
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A 12 year- old patient had a cast removed from the left leg after wearing if for . 208
eight weeks. The patient wants to resume sports as soon as possible. In order to
regain muscle strength lost while wearing cast, the nurse will instruct the patient
:in performance of

a- Resistive range of motion exercises to left leg

b- Passive range of motion exercises to right leg
c- Active- assistive range of motion exercises to the right leg
d- Active range of motion exercises to both legs
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A three year-old has returned to the clinic 4 days after being diagnosed with .209
gastroenteritis and dehydration. A parent reports that the vomiting has stopped, and
the child is tolerating liquids, rice, applesauce, and bananas. The diarrhea persists,
but seems to be decreasing in volume. When evaluating for signs of
:dehydration, the nurse will assess the patient 's skin turgor by

a- Grasping the skin over the abdomen with two fingers and raising the skin with
two fingers
b- Grasping the skin over the forehead with two fingers and raising the skin with
two fingers
c- Holding the patient's mouth open and assessing the tongue for deep creases or
furrows
d- Drawing two tubes of blood and running a blood urea nitrogen (BUN) and
creatinine (Cr)
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A patient has had hepatitis B (HBV) and is now a chronic carrier. In planning care, .210
the nurse would explain an HBV carrier would most likely be at risk for
?developing a super infection with which other type of hepatitis

a- A
b- B
c-C
d- D
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A female patient has been advised that laboratory tests confirm herpes simplex .211
virus (HSV), type 2. The nurse should teach the patient that a Papanicolaou test
:is recommended )Pap smear(

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a- Every 6 months if symptoms persist despite

treatment b- Every year even if asymptomatic c-
Whenever symptoms recur
d- Every 3 years if other Pap smears have been negative
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 30 year-old married man presents to the clinic with complaints of feeling sad .212
for the past three months. He is unable to maintain a regular sleep routine, has lost
his appetite and has difficulty concentrating. He is prescribed a medication which
prevents the reuptake of specific neurotransmitters that could contribute to his
mental health problem. Which side effects would be most important for the nurse
?to advise the patient of

a- Polyuria
b- Photophobia
c- Fluid retention
d- Sexual dysfunction
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According to information provided in the accompany

:colostomy would be expected to produce

a- Fluid feces
b- Mushy feces
c- Semi-fluid feces
d- Solid feces
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A patient presents with pneumonia and dyspnea. The patient has an ineffective .214
.airway clearance related to excessive tracheobronchial secretions

Which of the following interventions would the nurse implement to enhance the
?patient's airway clearance

Heart rate min/80

Respiratory rate min/32
Temperature 40oC
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a- Administer oxygen as ordered

b- Maintain a comfortable position
c- Increase fluid intake
d- Administer prescribed analgesics
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The nurse assesses a patient who is 16 -weeks pregnant. The patient states that .215
she had taken isotretinoin (Accutane) , a known teratogen for acne during her third,
fourth, and fifth week of pregnancy According to the chart, the nurse CAN
:expect fetal damage to the central nervous system as well as the

.a- Palate and ears

.b- Heart, lower limbs, and palate
.c- Limbs, eyes, and teeth
.d- Heart, eyes, and limbs
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RTA. The patient appears restless confused and disoriented. He reports that he .216
had hit his head against the steering wheel of the car when it had collided with the
.car directly in front of him

Blood pressure mmHg 110/68

Heart rate min/100
Respiratory rate min/22
Body Temperature coral 37.0
Oxygen saturation on room air % 98
What is the most important next step in
.management? a- Immobilize head and neck
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.b- Administer oxygen

.c- Establish an intravenous line
.d- Arrange for an MRI scan
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

?Which of the following is a desired expected outcome 24 hours postoperatively .217

.a- Gag reflex present
b- Cerebral perfusion pressure, 68mmHg
.c- Intracranial pressure, 21mmHg
.d- Decreased lacrimation
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?What is the Proper procedure for doing a breast self-exam .218

.a- Use the palm of the hand to feel for lumps
.b- Apply three different levels of pressure to feel breast tissue
c- Stand when performing a breast self-exam.
d- Perform self-exam annually
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 45 year-old patient has had difficulty sleeping and has lost ten kilograms .219
.despite having a large appetite on examination there is a palpable thyroid gland

Blood pressure mmHg 108/58

Heart rate min/116
Respiratory rate min/22
Body temperature c oral 38.0
Height 164

Weight kilograms 50
?Which additional symptom is most likely
.a- Heart palpitations
.b- Depression
.c- Anorexia
d- Paresthesia
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Nurse prepares to delegate tasks to the nursing assistant Among her patients is a . 220
50 year-old woman who is day two of recovery following a laparoscopic resection
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:of the colon post-operative orders are follow

every six hours .Ambulate
Evaluate vital signs every two hours. Lactated Ringer's IV at 50
.ml/hour. Wound assessment every eight hours
Nasogastric tube until bowel sounds present.
?Which is most appropriate to delegate

.a- Ambulate the patient

.b- Evaluation of vital signs
.c- Change intravenous fluid bags
.d- Assess nasogastric tube placement
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

C B A D

The nurse is teaching a patient with diabetes mellitus about self- administration o
?insulin. Which syringe angle is correct when administering insulin

a- A
b- B
c- C
d- D
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The nurse is caring for a diabetic child whose 11 a.m. blood glucose monitoring -222
:check is 302 mg/dL. The physician orders the following coverage schedule

150 R
to 200 mg/dL-2 units of Humulin 201 to
250 mg/dL- 4 units of Humulin R 251 to
300 mg/dL- 6 units of Humulin R

67
 ‫‪| Twitter:‬‬ ‫‪nurse077‬‬ ‫‪Preparation / Abdulrahman Al-Gamdi 0533319252‬‬

‫‪to‬‬ ‫‪301‬‬ ‫‪R‬‬

‫‪350 mg/dL-8 units of Humulin 351 to‬‬
‫‪399 mg/dL- I0 units of Humulin R Over‬‬
‫‪400 mg/dL-call the physician‬‬
‫‪According to the coverage schedule; how many unites you would give your‬‬
‫‪:patient‬‬

‫‪a- 4 units‬‬
‫‪b- 6 units‬‬
‫‪c- 8 units‬‬
‫‪d- 10 units‬‬
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‫‪Which of the following is Pancreatitis Patients frequently feel constant pain in the-223‬‬

‫‪a. lowar right‬‬

‫‪b. upper Left‬‬
‫‪c. lowar Left‬‬
‫‪d. upper right‬‬
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‫‪Which of the following is the ileo‬‬

‫‪a. upper right‬‬
‫‪b. lowar right‬‬
‫‪c. upper Left‬‬
‫‪d. lowar Left‬‬
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‫‪What is the most probable type o‬‬

‫‪Atrial fibrillation‬‬
‫‪b- Atrial flutter‬‬
‫‪c- Ventricular fibrillation‬‬
‫‪d- Supra-ventricular fibrillation‬‬
‫‪68‬‬
 ‫‪| Twitter:‬‬ ‫‪nurse077‬‬ ‫‪Preparation / Abdulrahman Al-Gamdi 0533319252‬‬

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‫‪What is the most probable type o‬‬

‫‪Atrial fibrillation‬‬
‫‪b- Atrial flutter‬‬
‫‪c- Ventricular tachycardia‬‬
‫‪d- Supra-ventricular fibrillation‬‬
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‫‪When a patient is vomiting postoperatively, which of the following positions .227‬‬

‫‪?would the nurse use to protect the patient and prevent asparation‬‬

‫‪-c-‬‬ ‫‪a‬‬

‫‪-d‬‬ ‫‪b-‬‬
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‫‪A nurse is preparing to insert a nasogastric tube into a client . The nurse places the .228‬‬
‫‪:client in which position for insertion‬‬

‫‪a- Right side‬‬

‫‪b- Low Fowler's‬‬
‫‪c- High Fowler's‬‬
‫‪d- Supine with the head flat‬‬
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

‫‪Which of the following is the best position to increase the brain perfusion ..222‬‬
‫)‪:(cerebral perfusion‬‬

‫‪a- Prone‬‬
‫‪b- Supine‬‬
‫‪c- Semi- Fowler's‬‬
‫‪69‬‬
 | Twitter: nurse077 Preparation / Abdulrahman Al-Gamdi 0533319252

d- Trendelenburg's
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

The charge nurse enters the nursing diagnosis "Risk for ineffective airway .230
clearance related to an inability to swallow" on the client's care plan. Which nursing
?intervention is most appropriate for managing the identified problem

a- Keeping the client supine

b- Removing all head pillows
c- Performing oral suctioning
d- Providing frequent oral hygiene
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

The nurse in preparing to insert RYLE'S tube (NGT) into an infant, the nurse .231
:knows that the length of the tube should be taken as following

a- From the nose down to the chin and then to the umbilicus b-
From the nose to the earlobe and then to the xiphoid process c-
From the nose to the mouth to the xiphoid process d- From the
nose to the earlobe to the umbilicus
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

The physician has prescribed a cleansing enema to a client scheduled for colon .232
:surgery. The nurse would place the client

a- Prone
b- Supine
c- Left sim's ( left lateral)
d- Dorsal recumbent
‫ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

:Which type of isolation category is indicated for patient with diphtheria .232
a- Airborne
b- Droplet
c- Contact
d- Blood
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

Hospitalized patient eats 20% of the meal and states being too tired to eat . 235
.more

?What should the nurse do

A. offer to feed the patient after short rest period

70
 | Twitter: nurse077 Preparation / Abdulrahman Al-Gamdi 0533319252

B. encouraged the patient to finish the fluids C. Remove the meal

tray and allow the patient to rest D. Encourage the patient to
finish the protein portion of the meal
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A patient has an acute inflammation of the gallbladder. The physician orders the .237
nurse to schedule the patient for surgery . Which of the following surgical
?procedures will the physician MOST likely perform
. A. Pancreatectomy
. B. Cholecystectomy
. C. Hepatectomy
. D. Cricothoracotom
‫ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

A 31 years- old woman with diabetes type 1 presents to the clinic with fatigue, .239
blurred vision, and loss of appetite. Her breath smells like fruit and she leaves the
room twice during the examination to use the toilet . She has brought a little bottle of
water with her that she finishes while at the clinic. She reports that she has had a cold
for the past three days, but has not taken additional insulin during the illness
Blood pressure mmhg 130/70
Heart rate min/90
Respiratory rate min/20
Body temperature Coral 38.0

What is the most appropriate nursing diagnosis a- Risk

for impaired skin integrity related to circulation b-
Deficient knowledge related to illness management c-
Risk for fluid volume excess related to fluid intake d-
Imbalanced nutrition related to decreased appetite
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

Adult patient suffers from hoarseness of voice, and difficulty in speech may be .240
:suffering from an injury of which of the following cranial nerves

a- IX
b- X
c- XI
d- XII

71
 Preparation / Abdulrahman Al- Twitter: nurse077 | 2529133350
Gamdi

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Which of the following intervention would the nurse implement to enhance the . 241
? patient`s airway clearance

Heart rate nim/08

Respiratory rate nim/23
40oc Temperature
. A. Administer oxygen as ordered
. B. Maintain a comfortable position
. C. Increase fluid intake
.D. Administer prescribed analgesics
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A 34 year- old quadriplegia patient resides at home with his wife. In order .243
toprevent contractures of all extremities, the community care nurse will instructthe
:patient’s wife in performance of

. A. Active range of motion exercises

. B. Passive range of motion exercises
. C. Active- assistive range of motion exercises
. D. Resistive range of motion exercises
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A patient complains of left eye redness and itching, the doctor told you to .244
putatropine eye drops for the patient to examine his eye. The nurse should instillthe
:eye drops into

. A. The left eye

. B. The right eye
. C. Both right and left eyes
. D. Neither of the eyes
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A newborn was delivered pre-term weighing 2700 grams with. Apgar scores of 4 . 245
and 6, respectively. When the mother had presented to the Obstetrical Triage Unit,
she was already 7 centimeters dilated and fully effaced. Her due date was unknown
as she had no parental care. The infant showed signs of fetal distress and was finally
delivered by Cesarean section. At birth a large, thin, membranous sac was protruding
.from the umbilical base

What is the priority nursing intervention at birth?

a- Maintain cardio respiratory stability
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b- Protect the herniated viscera

c- Manage fluid intake and output
d- Establish vascular access
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year-old man presented to the Mental Health Clinic with a low-mood, a general -.222
loss of interest in activities and inability to experience pleasure. He admitted to
suicidal thoughts and extreme lack of energy. He was prescribed a selective serotonin
reuptake inhibitor to be taken daily. One month later, he presented to the clinic and
.reports feeling more energetic, but still has a low-mood

?What is the patient’s level of risk committing suicide at this time

a- None
b- Low
c- Medium
d- High
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client with pneumonia may appear with which of the following An elderly.248
?symptoms first

A. Altered mental status and dehydration

B. fever and chills
C. Hemoptysis and dyspnea
D. Pleuretic chest pain and coug
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A 7-year-old client is brought to the E.R. He’s tachypneic and afebrile and has a .249
respiratory rate of 36 breaths/minute and a nonproductive cough. He recently had a
?cold. From his history, the client may have which of the following

a- Acute asthma
b- Bronchial pneumonia
c- Chronic obstructive pulmonary disease (COPD)
d- Emphysem
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?The term “blue bloater” refers to which of the following conditions .250
a- Adult respiratory distress syndrome (ARDS)
b- Asthma
c- Chronic obstructive bronchitis
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‫‪d- Emphysem‬‬
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‫‪A nurse is suctioning fluids from a client via a tracheostomy tube. When -251‬‬
‫‪:suctioning, the nurse must limit the suctioning to a maximum of‬‬

‫‪a- 5 seconds‬‬
‫‪b- 10 seconds‬‬
‫‪c- 30 seconds‬‬
‫‪d- 1 minute‬‬
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‫‪Which of the following actions is the first priority of care for a client exhibiting -252‬‬
‫‪?signs and symptoms of coronary artery disease‬‬

‫‪a- Decrease anxiety‬‬

‫‪b- Enhance myocardial oxygenation‬‬
‫‪c- Administer sublingual nitroglycerin‬‬
‫‪d- Educate the client about his symptoms‬‬
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‫‪What is the first intervention for a cli‬‬

‫‪Administer morphine‬‬
‫‪b- Administer oxygen‬‬
‫‪c- Administer sublingual nitroglycerin‬‬
‫‪d- Obtain an ECG‬‬
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‫‪Toxicity from which of the following medications may cause a client to see a -254‬‬
‫‪?green-yellow halo around lights‬‬

‫‪a- Digoxin‬‬
‫)‪b- Furosemide (Lasix‬‬
‫)‪c- Metoprolol (Lopressor‬‬
‫)‪d- Enalapril (Vasotec‬‬
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‫‪Acute pulmonary edema caused by heart failure is usually a result of damage to -255‬‬
‫‪?which of the following areas of the heart‬‬

‫‪a- Left atrium‬‬

‫‪b- Right atrium‬‬

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 | Twitter: nurse077 Preparation / Abdulrahman Al-Gamdi 0533319252

c- Left ventricle
d- Right ventricle
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A nurse evaluates a patient who had a modified radical mastectomy two weeks -256
.ago

Which of the following observations would indicate that the patient is progressing
?as expected

a- Incision intact; numbness along suture line b- Affected arm

supported in sling; hand at level of the heart c- Reports
cessation of intimate contact with spouse d- Indicates plan to
replace wardress with loose fitting clothing

A pregnant woman in the three months to have a thrombus in the right leg What do -257
you expect the doctor ordered

a-Heparin
b-Insulin
c-Warfarin
d-Aspirin
Child has burns What is the nursing intervention to prevent Aspiration for this - 258
child

Child sitting put all the time

Keep the child seated 10 minutes after eating Keep baby sitting from 30-45 minutes
after eating Keep baby sitting 24 hours

A man has been experiencing night-blindness. What vitamin could he be deficient -259
?in
Vitamin A
Vitamin B
Vitamin C
Vitamin D
‫مصادر مهمه‬Vitamin A

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260-A client who has been hospitalized after experiencing a heart attack will most
likely receive a diet consisting of:
Low fat, low sodium, and high carbohydrates
Low fat, high protein, and carbohydrates
Low fat, low sodium, and low carbohydrates

226.Which of the following diets would be most appropriate for a client with COPD?
Low fat, low cholesterol
Bland, soft diet
Low-Sodium diet
High calorie, high-protein diet

262-The nurse wanted to give a child toddler described the oral madactionl
What is the right way

a. Open the baby's mouth and put medicine b.Give the

medicine spoon in a special play c.Give the medicine in
Bottles
d.Explain to the child that the medicine delicious

263-A postoperative patient has the nursing diagnosis of ineffective tissue

perfusion. To assess for tissue perfusion the nurse should check all of the
:following except
a- Skin and nail bed color
b- Temperature of extremities
c- Respiratory rate
d- Peripheral pulses

264- A one month old boy present with the head tilted towards the left side and
the chin rotated to the right side. There is a palpable mass of soft tissue on the right
side of the neck near the clavicle:
a- Passive muscle stretching

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b- Surgical release of the muscle

d.Surgical removal of the mass
e-It's a normal mass in infants

) Basal Cell Carcinoma (

)TSH(

) complete closed traverse (

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patient with penicillin reaction

‫باوجال‬
( stop second dose THEN INFOR DR )

) The older age tissue less than adult )

) incomplete open(

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Twitter: nurse077 | Preparation / Abdulrahman Al-Gamdi 0533319252
nasal airway

) Burcities (

) ventricular tachycardia. VT ( ‫باوجال‬

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) ventricular fibrillation(

) Atrial fibrillation(

) Asystole(

Bee

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Androgens

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Osteoarthritis

Osteoarthritis

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of the foods highest in vitamin C include:

broccoli
brussels sprouts
cantaloupe
mango
oranges
papaya
red and green bell pepper
strawberries
tomato
watermelon

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Dite for cushing syndrome

low sodium and high potassium

‫يجب مراجعه المذكر هال‬ 274 ‫وهذي االسلئيه المهمه فيها‬

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