1.

An HIV-positive client who has been started on highly active antiretroviral therapy
(HAART) came back for a follow-up checkup. Which of the following will be the most
helpful in determining the response to the therapy? *
1/1
A. Rapid HIV antigen test.
B. Western Blot analysis.
C. Viral load test.
 
D. White blood cell count

 
2. The nurse sustains a needle stick while recapping a needle from a patient with an
unconfirmed HIV status. What is the nurses initial action? *
1/1
A. Give consent for testing
B. Notify the supervisor
 
C. Start post exposure prophylaxis
D. Document the exposure

 
3. A male client is having a lumbar puncture performed. The nurse would plan to place
the client in which position? *
1/1
A. Side-lying, with a pillow under the hip
B. Prone, with a pillow under the abdomen
C. Prone, in slight-Trendelenburg’s position
D. Side-lying, with the legs, pulled up and head bent down onto the chest.
 
 
4. The nurse is teaching the female client with myasthenia gravis about the prevention
of myasthenic and cholinergic crises. The nurse tells the client that this is most
effectively done by *
1/1
A. Eating large, well-balanced meals
B. Doing muscle-strengthening exercises
C. Doing all chores early in the day while less fatigued
D. Taking medications on time to maintain therapeutic blood levels
 
 
5. A nurse caring for a patient has been exposed to HIV-infected blood through an
accidental needle stick. ccording to the Centers for Disease Control and Prevention
(CDC), when does prophylactic treatment need to start following exposure to HIV? *
1/1
A. Within 92 hours
B. Within 72 hours
 
C. Within 2 months
D. Within 6 months

 
6. You are teaching your patient diagnosed with myasthenia gravis about treatments.
Which of the following statements, if made by the patient indicates the need for further
teaching? *
1/1
A. Plasmapheresis is way to reduce symptoms but will need to be done every day
 
B. A thymectomy is a removal of my thymus gland and will show some immediate relieving of my
symptoms
C. Corticosteroids can be used for short periods of time to help improve my symptoms, but it isn't
good for long periods of time
D. I need to take my Mestinon four times a day at the same time each day.
Option 5

 
7. In an outpatient facility, the nurse obtaining information on a patient newly
diagnosed with HIV is aware that many patients with HIV utilize various alternative or
complementary therapies. The nurse addresses complementary or alternative therapy
by stating: *
1/1
A. “Complementary therapies such as acupuncture or herbal therapy are dangerous to patients
with HIV and we discourage you from exploring them.”
B. “Researchers have not looked at the benefits of alternative therapy for patients with HIV, so we
suggest that you stay away from these therapies until there is solid research data available.”
C. “We see many patients with HIV who are using some type of alternative therapy and there are
benefits and risks. Are there any types of alternative or complementary therapies that you follow
or are there any herbs that you take?”
 
D. “You do not take herbs or practice some type of alternative medicine such as acupuncture,
message therapy, hypnosis or diet therapy, do you?”

 
8. A client with myasthenia gravis ask the nurse why the disease has occurred. The
nurse bases the reply on the knowledge that there is: *
1/1
A. A genetic defect in the production acetylcholine
B. A reduced amount of neurotransmitter acetylcholine
C. A decreased number of functioning acetylcholine receptor sites
 
D. An inhibition of the enzyme ACHE leaving the end plates folded

 
9. A male client is hospitalized with Guillain-Barre Syndrome. Which assessment
finding is the most significant? *
0/1
A. Even, unlabored respirations
 
B. Soft, non distended abdomen
C. Urine output of 50 ml/hr
D. Warm skin

 
10. The nurse is teaching a group of college students about correct condom use.
Which of the following is the correct condom application technique? *
0/1
A. Attach the condom prior to erection.
B. A condom may be reused with the same partner if ejaculation has not occurred.
C. Hand lotion is an acceptable form of lubricant.
D. Hold the condom by the cuff upon withdrawal
 
 
11. Helen is diagnosed with myasthenia gravis and pyridostigmine bromide (Mestinon)
therapy is started. The Mestinon dosage is frequently changed during the first week.
While the dosage is being adjusted, the nurse’s priority intervention is to: *
0/1
A. Administer the medication exactly on time
B. Administer the medication with food or mild
C. Evaluate the client’s muscle strength hourly after medication
 
D. Evaluate the client’s emotional side effects between doses

 
12. A client who was tested for human immunodeficiency virus (HIV) after a recent
exposure had a negative result. During the post-test counseling session, the nurse
tells the client which of the following? *
1/1
A. the test should be repeated in 6 months
 
B. this ensures that the client is not infected with the HIV virus
C. the client no longer needs to protect himself from sexual partners
D. the client probably has immunity to the human immunodeficiency virus

 
13. A client with SLE is taking corticosteroid therapy to lessen and
preventreoccurrence of symptoms. What is the priority nursing intervention for `the
client when in the hospital? *
1/1
A. Elevate head of bead
B. Place client with isolation precaution
 
C. Provide for structured activities
D. Seizure precautions and monitoring

 
14. The nurse is teaching a female client with multiple sclerosis . When teaching the
client how to reduce fatigue , the nurse should tell the client to: *
1/1
A. Take a hot bath.
B. Rest in an air-conditioned room.
 
C. Increase the dose of muscle relaxants.
D. Avoid naps during the day

 
15. Which treatment is least likely given to patients with systemic lupus
erythematosus, and should be questioned by the nurse when administering it to the
patient? *
0/1
A. antibiotics
B. antimalarial
C. NSAIDs
D. steroids
 
 
16. A patient with an acute exacerbation of of systemic lupus erythematosus is
hospitalized with incapacitating fatigue, acute hand and wrist pain and proteinuria.The
physician prescribes prednisone (Deltasone) 40mg twice daily. Which nursing action
should be included in the plan of care? *
0/1
A. Institute seizure precautions
B. Reorient to time, place and person as needed
 
C. Monitor intake and output
D. Place on cardiac monitor

 
17. A 20 year - old patient who is taking azathioprine for SLE has a check - up before
leaving for a long trip. The physician writes all of these following orders.Which one
should the nurse question? *
0/1
A. Naproxen (Alevel) 200 mg twice a day
B. Give MMR immunization
C. Draw anti - DNA titer
 
D. Famotidine (Pepcid) 20mg once daily

 
18. A patient with SLE has a facial rash and alopecia tells the nurse “I hate the wayI
look! I never go anyplace except here to the clinic.” An appropriate nursing diagnosis
for the patient is: *
1/1
A. Activity Intolerance related to fatigue and inactivity
B. Impaired Skin Integrity related to itching and skin sloughing
C. Social Isolation related to embarrassment about the effects of SLE
 
D. Impaired Social Interaction related to fear of outside interaction

 
19. The nurse determines that baclofen (Lioresal) is accomplishing its intended
purpose for a client with multiple sclerosis when it achieves which of the following: *
1/1
A. Induces sleep
B. Stimulates the client’s appetite
C. Relieves muscular spasticity
 
D. Reduces the urine bacterial count

 
20. A client has MS for 15 years and has received various drug therapies. What isthe
primary reason why the nurse has found it difficult to evaluate the effectiveness of the
drugs that the client has used? Clients with MS: *
1/1
A. Exhibit intolerance to many drugs
B. Experience spontaneous remissions from time to time
 
C. Require multiple drugs simultaneously
D. Endure long periods of exacerbations before the illness responds to a particular drug

 
21. A client has just been prescribed with Methotrexate (Trexall) for the treatment of
rheumatoid arthritis who did not respond to any other treatment. An important
reminder for the client is to? *
1/1
A. Clay-colored stool is a normal response of the treatment.
B. Pregnancy is not contraindicated with the use of the medication.
C. Strict hand washing.
 
D. Get a daily source of sunlight during the day.

 
22. Mr. Rodriguez with rheumatoid arthritis is about to begin aspirin therapy to reduce
inflammation. When teaching the client about aspirin, the nurse discusses adverse
reactions to prolonged aspirin therapy. These include: *
0/1
A. weight gain.
B. fine motor tremors.
C. respiratory acidosis.
 
D. bilateral hearing loss.

 
23. A nurse is caring for a client with osteoarthritis. The nurse performs an
assessment knowing that which of the following is a clinical manifestation associated
with the disorder? *
1/1
A. Pain that is most severe later in the day
B. An elevated platelet count
C. Dull aching pain in the affected joints
 
D. Elevated antinuclear antibody level

 
24. Heberden’s nodes are a common sign of osteoarthritis. Which of the following
statement is correct about this deformity? *
0/1
A. It appears only in men
B. It appears on the distal interphalangeal joint
C. It appears on the proximal interphalangeal joint
D. It appears on the dorsolateral aspect of the interphalangeal joint.
 
 
25. Mrs. Reyes uses a cane for assistance in walking. Which of the following
statements is true about a cane or other assistive devices? *
0/1
A. A walker is a better choice than a cane.
 
B. The cane should be used on the affected side
C. The cane should be used on the unaffected side
D. A client with osteoarthritis should be encouraged to ambulate without the cane

 
26. A client who has breast cancer had postlumpectomy chemo¬therapy and is now
scheduled for radiation on an outpatient basis. What is an important nursing
intervention while the client is receiving radiation? *
0/1
A. Assess the radiated site daily for redness or irritation.
B. Rinse the radiated site with an antibacterial solution after each treatment.
 
C. Instruct the client to apply lotion twice daily to the skin on the radiated area.
D. Encourage the client to wear a snug-fitting bra between radiation treatments
Feedback
Answer: A

 
27. A patient with a small, well-defined breast nodule asks the nurse about her
treatment options. Which treatments would be considered for this patient? *
0/1
A. Lumpectomy and radiation
B. Partial mastectomy and radiation
C. Partial mastectomy and chemotherapy
 
D. Total mastectomy and chemotherapy

 
28. The nurse is speaking to a group of women about early detection of breast cancer.
The average age of the women in the group is 47. Following the American Cancer
Society guidelines, the nurse should recommend that the women: *
1/1
A. perform BSE annually.
B. have a mammogram annually.
 
C. have a hormonal receptor assay annually.
D. have a practitioner conduct a clinical examination every 2 years.

 
29. The nurse is teaching a client about the risk factors associated with colorectal
cancer. The nurse determines that further teaching is necessary related to colorectal
cancer if the client identifies which item as an associated risk factor? *
1/1
A. Age younger than 50 years
 
B. History of colorectal polyps
C. Family history of colorectal cancer
D. Chronic inflammatory bowel disease

 
30. During admission a client appears anxious and says to the nurse, “The doctor told
me I have lung cancer. My father died from cancer. I wish I had never smoked.” What
is the nurse’s best response? *
0/1
A. “You are concerned about your diagnosis.”
B. “You are feeling guilty about your smoking.”
C. “There have been advances in lung cancer therapy.”
 
D. “Trust your doctor, who is very competent in treating cancer.”

 
31. Before discharge, a client who had a colostomy for colorectal cancer questions the
nurse about resuming activity. What should the nurse teach the client about activity? *
0/1
A. “With guidance, a near-normal lifestyle, including com¬plete sexual function, is
possible.”
B. “Activities of daily living should be resumed as quickly as possible so you avoid being
depressed.”
C. “Most sports activities, except for swimming, can be resumed based on your overall physical
condition.”
D. “After surgery, changes in activities must be made to accommodate for the physiologic
changes caused by the operation.”
 
 
32. The nurse is caring for a client with lung cancer and bone metastasis. What signs
and symptoms would the nurse recognize as indications of a possible oncological
emergency? *
1/1
A. Facial edema in the morning
B. Serum calcium levelof12 mg/dL(3.0 mmol/L)
C. Numbness and tingling of the lower extremities
D. All of the above.
  
33. After a right lower lobectomy for lung cancer, a patient returns to her room with a
chest tube in place. The nurse formulates a care plan with a primary nursing diagnosis
of Impaired gas exchange related to lung surgery. Which expected outcome is
appropriate for this diagnosis? *
1/1
A. The patient will sit upright, leaning slightly forward.
B. The patient will request pain medication as needed.
C. The patient will maintain a pulse oximetry level above 93%.
 
D. The patient will be pain-free.

 
34. The nurse performs a nutritional assessment on a patient with lung cancer who is
in the postoperative period after a lobectomy. Which of the following could be an early
sign of malnutrition? *
0/1
A. A retinal-binding protein level of 2.0 mg/dL
B. Dry, flaky, discolored skin and brittle nails
C. A body mass index (BMI) of 20
D. An albumin level of 3.0 g/dL
 
 
35. The nurse performs a physical assessment on a client with type 2 diabetes
mellitus. Findings include a fasting blood glucose level of 120 mg/dL (6.8 mmol/L),
temperature of 101 °F (38.3 °C), pulse of 102 beats/minute, respirations of 22
breaths/minute, and blood pressure of 142/72 mm Hg. Which finding would be the
priority concern to the nurse? *
1/1
A. Pulse
B. Respiration
C. Temperature
 
D. Blood pressure

 
36. The nurse performs a physical assessment on a client with type 2 diabetes
mellitus. Findings include a fasting blood glucose level of 120 mg/dL (6.8 mmol/L),
temperature of 101 °F (38.3 °C), pulse of 102 beats/minute, respirations of 22
breaths/minute, and blood pressure of 142/72 mm Hg. Which finding would be the
priority concern to the nurse? *
1/1
A. Pulse
B. Respiration
C. Temperature
 
D. Blood pressure

 
37. A 4-year-old child is admitted to the hospital for abdominal pain. The mother
reports that the child has been pale and excessively tired and is bruising easily. On
physical examination, lymphadenopathy and hepatosplenomegaly are noted.
Diagnostic studies are being performed because acute lymphocytic leukemia is
suspected. The nurse determines that which laboratory result confirms the
diagnosis? *
1/1
A. Lumbar puncture showing no blast cells
B. Bone marrow biopsy showing blast cells
 
C. Platelet count of 350,000 mm3
D. White blood cell count 4500 mm3

38. The nurse is monitoring a client who was diagnosed with type 1 diabetes mellitus
and is being treated with NPH and regular insulin. Which is not a manifestation that
would alert the nurse to the presence of a possible hypoglycemic reaction? *
0/1
A. Tremors
B. Anorexia
C. Irritability
 
D. Nervousness

 
39. A client with type 1 diabetes mellitus calls the nurse to report recurrent episodes of
hypoglycemia with exercising. Which statement by the client indicates an adequate
understanding of the peak action of NPH insulin and exercise? *
0/1
A. “I should not exercise since I am taking insulin.”
B. “The best time forme to exercise is after breakfast.”
C. “The best time for me to exercise is mid- to late afternoon.”
 
D. “NPH is a basal insulin, so I should exercise in the evening.”

 
40. The home health nurse visits a client with a diagnosis of type 1 diabetes mellitus.
The client relates a history of vomiting and diarrhea and tells the nurse that no food
has been consumed for the last 24 hours.Which additional statement by the client
indicates a need for further teaching? *
1/1
A. “I need to stop my insulin.”
 
B. “I need to increase my fluid intake.”
C. “I need to monitor my blood glucose every 3 to 4 hours.”
D. “I need to call the health care provider (HCP) because of these symptoms.”

41. The nurse is preparing a plan of care for a client with diabetes mellitus who has
hyperglycemia. The nurse places priority on which client problem? *
1/1
A. Lack of knowledge
B. Inadequate fluid volume
 
C. Compromised family coping
D. Inadequate consumption of nutrients

 
42. The nurse is monitoring a client newly diagnosed with diabetes mellitus for signs of
complications. Which sign or symptom, if exhibited in the client, indicates that the
client is at risk for chronic complications of diabetes if the blood glucose is not
adequately managed? *
0/1
A. Polyuria
B. Diaphoresis
C. Pedal edema
D. Decreased respiratory rate

43. A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA).

The initial blood glucose level is 950 mg/dL (54.2 mmol/L). A continuous intravenous
(IV) infusion of short-acting insulin is initiated, along with IV rehydration with normal
saline. The serum glucose level is now decreased to 240 mg/dL (13.7 mmol/L). The
nurse would next prepare to administer which medication? *
0/1
A. An ampule of 50% dextrose
 
B. NPH insulin subcutaneously
C. IV fluids containing dextrose
D. Phenytoin for the prevention of seizures

 
44. The nurse provides instructions to a client newly diagnosed with type 1 diabetes
mellitus. The nurse recognizes accurate understanding of measures to prevent
diabetic ketoacidosis when the client makes which statement? *
1/1
A. “I will stop taking my insulin if I’m too sick to eat.”
B. “I will decrease my insulin dose during times of illness.”
C. “I will adjust my insulin dose according to the level of glucose in my urine.”
D. “I will notify my health care provider (HCP) if my blood glucose level is higher than 250 mg/dL
(14.2 mmol/L).”
 
 
45. A client with diabetes mellitus demonstrates acute anxiety when admitted to the
hospital for the treatment of hyperglycemia. What is the appropriate intervention to
decrease the client’s anxiety? *
1/1
A. Administer a sedative.
B. Convey empathy, trust, and respect toward the client.
 
C. Ignore the signs and symptoms of anxiety, anticipating that they will soon disappear.
D. Make sure that the client is familiar with the correct medical terms to promote understanding of
what is happening.

 
46. The nurse instructs a 22-year-old female patient with diabetes mellitus about a
healthy eating plan. Which statement made by the patient indicates that teaching was
successful? *
1/1
A. "If I use an insulin pump, I will not need to limit the amount of saturated fat in my diet."
B. "I should include more fiber in my diet than a person who does not have diabetes."
C. "I may have a hypoglycemic reaction if I drink alcohol on an empty stomach."
 
D. "I plan to lose 25 pounds this year by following a high-protein diet."

 
47. On a clinic visit a client who has a relative with cancer, is asking about the warning
signs that may relate to cancer. The nurse correctly identifies the warning signs of
cancer by responding: *
1/1
A. Presence of dry cough is one of the warning signs of cancer.
B. A lump located only in the breast area may suggest the presence of cancer.
C. Sudden weight loss of unexplained etiology can be a warning sign of cancer.
 
D. If a sore healing took a month or more to heal, cancer should be suspected.

 
48. Radiation protection is very important to implement when performing nursing
procedures. When the nurse is not performing any nursing procedures what distance
should be maintained from the client? *
1/1
A. 2 feet
B. 1 feet
C. 3 feet
 
D. 2.5 feet

 
49. Which patient with type 1 diabetes mellitus would be at the highest risk for
developing hypoglycemic unawareness? *
1/1
A. A 73-year-old patient who takes propranolol (Inderal)
 
B. A 58-year-old patient with diabetic retinopathy
C. A 24-year-old patient with a hemoglobin A1C of 8.9%
D. A 19-year-old patient who is on the school track team

 
50. The nurse is teaching a 60-year-old woman with type 2 diabetes mellitus how to
prevent diabetic nephropathy. Which statement made by the patient indicates that
teaching has been successful? *
1/1
A. "I should have yearly dilated eye examinations by an ophthalmologist."
B. "I will avoid hypoglycemia by keeping my blood sugar above 180 mg/dL."
C. "I can help control my blood pressure by avoiding foods high in salt."
 
D. "Smokeless tobacco products decrease the risk of kidney damage."