PREBOARD 1 – NP 4

1. The patient describes a burning sensation in the leg. The health care provider tells the nurse that a
medication will be prescribed for neuropathic pain secondary to chemotherapy. The nurse is most likely to
question the prescription of which drug? *
a. Imipramine
b. Carbamazepine
c. Gabapentin
d. Morphine

2. A patient who has cancer will need ongoing treatment for pain. Which brochure is the nurse most likely to
prepare that addresses questions related to the first-line treatment of cancer pain? *
a. “An Illustrated Guide to the Analgesic Ladder”
b. “Common Questions About Radiation Therapy”
c. “How to Make Preparations for Your Cancer Surgery”
d. “How Nerve Blocks Can Help to Manage Cancer Pain”

3. Which nurse is demonstrating the first step in managing cancer pain by using the ABCDE (ask, believe,
choose, deliver, and empower) clinical approach to pain management as recommended by the Agency for
Healthcare Researchand Quality? *
a. Nurse J asks if the time of the prescribed dose of medication can be changed.
b. Nurse K asks the patient to describe pain and uses a numerical pain scale.
c. Nurse L asks the patient to participate and to contribute in pain management.
d. Nurse M asks about pain management options that are appropriate for the patient.

4. The nurse assesses the patient and determines that the patient is having frequent breakthrough cancer
pain. Which member of the health care team is the nurse most likely to contact first? *
a. Physical therapist to reevaluate physical therapy routines
b. Health care provider to review medication, dosage, and frequency
c. Unlicensed assistive personnel to provide more assistance with activities of daily living
d. Psychiatric clinical nurse specialist to evaluate psychogenic pain

5. The night shift nurse tells the oncoming dayshift nurse that the cancer patientis on around-the-clock
dosing of morphine but that the patient might be having end-of-dose pain. Which question is the most
important to ask the night shift nurse? *
a. “How many times did you have to give a bolus dose of morphine?”
b. “Did the patient tell you that the pain was greater than a 5/10?”
c. “Did you notify the health care provider (HCP), and were changes prescribed?”
d. “Did you try any nonpharmaceutical therapies or adjuvant medications?

6. The nurse is caring for a patient with esophageal cancer. Which task could be delegated to nursing
assistant? *
a. Assisting the patient with oral hygiene
b. Observing the patient's response to feedings
c. Facilitating expression of grief or anxiety
d. Initiating daily weights

7. A 56-year-old patient comes to the walk-in clinic reporting scant rectal bleeding and intermittent diarrhea
and constipation for the past several months. There is a history of polyps and a family history of colorectal
cancer.While the nurse is trying to teach about colonoscopy, the patient becomes angry and threatens to
leave. What is the priority nursing concept to consider in responding to this patient? *
a. Elimination c. Cellular regulation
b. Patient education d. Anxiety

8. Which patient is at greatest risk for pancreatic cancer? *

a. An older African-American man who smokes
b. A young white obese woman with gallbladder disease
c. A young African-American man with type 1 diabetes
d. An elderly white woman who has pancreatitis
9. Patients receiving chemotherapy are at risk for thrombocytopenia related to chemotherapy or disease
processes. Which actions are inappropriate for patients who must be placed on bleeding precautions? *
a. Provide mouthwash with alcohol for oral rinsing.
b. Use paper tape on fragile skin.
c. Provide a soft toothbrush or oral sponge.
d. Gently insert rectal suppositories

10. When care assignments are being made for patients with alterations related to gastrointestinal (GI)
cancer, which patient would be the most appropriate to assign to a newbie RN who has no experience with
IVT under the supervision of a team leader RN? *
a. A patient with severe anemia secondary to GI bleeding
b. A patient who needs enemas and antibiotics to control GI bacteria
c. A patient who needs preoperative teaching for bowel resection surgery
d. A patient who needs central line insertion for chemotherapy

11. A community health center is preparing a presentation on the prevention and detection of cancer.
Which task would be best to assign to a student RN? *
a. Explain screening examinations and diagnostic testing for common cancers.
b. Discuss how to plan a balanced diet and reduce fats and preservatives.
c. Prepare a poster on the seven warning signs of cancer.
d. Describe strategies for reducing risk factors such as smoking and obesity.

12. The health care provider (HCP) tells the patient with cancer that there will be an initial course of
treatment with continued maintenance treatments and ongoing observation for signs and symptoms over a
prolonged period of time. Which patient statement is cause for greatest concern? *
a. “My symptoms will eventually be cured; I’m so happy that I don’t have to worry any longer.”
b. “My doctor is trying to help me control the symptoms; I am grateful for the extension of time with my
family.”
c. “My pain will be relieved, but I am going to die soon; I would like to have control over my own life and
death.”
d. “Initially, I may have to take some time off work for my treatments; I can probably work full time in the
future.”

13. For a patient who is experiencing side effects of radiation therapy, which task would be the most
appropriate to delegate to A NURSING ASSISTANT? *
a. Helping the patient to identify patterns of fatigue
b. Recommending participation in a walking program
c. Reporting the amount and type of food consumed from the tray
d. Checking the skin for redness and irritation after the treatment

14. An older patient needs treatment and relief for severe localized pain related to postherpetic neuralgia
that developed during chemotherapy. The nurse is most likely to question the prescription of which type of
medication? *
a. Lidocaine patch c. Capsaicin patch
b. Gabapentinoid d. Tricyclic antidepressant

15. For a patient receiving the chemotherapeutic drug vincristine, which side effect should be reported to
the health care provider (HCP)? *
a. Fatigue c. Paresthesia
b. Nausea d. Anorexia

16. An experienced nurse is precepting a newly hired nurse who has 2 years of medical-surgical
experience but limited experience with patients who have cancer. The new hire seems to be consistently
under medicating the patients’ pain. What should the preceptor do first? *
a. Reassess all of the patients and administer additional pain medication asneeded.
b. Write an incident report and inform the nurse manager about the nurse's performance.
c. Determine the new nurse's understanding and beliefs about cancer pain and treatments.
d. Ask the new nurse about past experience in administering pain medications.
17. For a patient who is receiving chemotherapy, which laboratory result is of particular importance? *
a. White blood cell count c. Electrolyte levels
b. Prothrombin time d. Blood urea nitrogen level

18. When staff assignments are made for the care of patients who are receiving chemotherapy, what is the
major consideration regarding chemotherapeutic drugs? *
a. Administration of chemotherapy requires precautions to protect self and others.
b. Many chemotherapeutic drugs are vesicants.
c. Chemotherapeutic drugs are frequently given through central venous access devices.
d. Oral and venous routes of administration are the most common.

19. The nurse is monitoring a patient who is at risk for spinal cord compressionrelated to tumor growth.
Which patient statement is most likely to suggest an early manifestation? *
a. “Last night my back really hurt, and I had trouble sleeping.”
b. “My leg has been giving out when I try to stand.”
c. “My bowels are just not moving like they usually do.”
d. “When I try to pass urine, I have difficulty starting the stream.”

20. For a patient with osteogenic sarcoma, which laboratory value causes themost concern? *
a. Sodium level of 135 mEq/L (135 mmol/L)
b. Calcium level of 13 mg/dL (3.25 mmol/L)
c. Potassium level of 4.9 mEq/L (4.9 mmol/L)
d. Hematocrit of 40%

21. The RN is admitting a client with benign prostatic hyperplasia (BPH) to an acute care unit. The client
describes an oral intake of about 1400 mL/day. What is the RN's priority concern? *
a. Ask the client about his or her bowel movements.
b. Have the client complete a diet diary for the past 2 days.
c. Instruct the client to increase oral intake to 2 to 3 L/day.
d. Ask the client to describe his urine output.

22. The client has fluid volume deficit related to excessive fluid loss. Which action related to fluid
management should be delegated by the RN to NURSING ASSISTANT? *
a. Administering IV fluids as prescribed by the physician
b. Providing straws and offering fluids between meals
c. Developing a plan for added fluid intake over 24 hours
d. Teaching family members to assist the client with fluid intake

23. The NA reports to the nurse that a client's urine output for the past 24 hours has been only 360 mL.
What is the nurse's priority action at this time? *
a. Place an 18-gauge IV in the nondominant arm.
b. Elevate the client's head of bed at least 45 degrees.
c. Instruct the UAP to provide the client with a pitcher of ice water.
d. Contact and notify the health care provider immediately.

24. The client described in question 23 is also at risk for poor perfusion related to decreased plasma
volume. Which assessment finding supports this risk? *
a. Flattened neck veins when the client is in the supine position
b. Full and bounding pedal and post-tibial pulses
c. Pitting edema located in the feet, ankles, and calves
d. Shallow respirations with crackles on auscultation

25. The health care provider has written these orders for a client with a diagnosis of pulmonary edema. The
client's morning assessment reveals bounding peripheral pulses, weight gain of 2 lb, pitting ankle edema,
and moist crackles bilaterally. Which order takes priority at this time? *
a. Weigh the client every morning.
b. Maintain accurate intake and output records.
c. Restrict fluids to 1500 mL/day.
d. Administer furosemide 40 mg IV push.
26. Which statement by a client with hypovolemia related to dehydration is thebest indicator to the nurse of
the need for additional teaching? *
a. “I will drink 2 to 3 L of fluids every day.”
b. “I will drink a glass of water whenever I feel thirsty.”
c. “I will drink coffee and cola drinks throughout the day.”
d. “I will avoid drinks containing alcohol.”

27. The nurse has been floated to the telemetry unit for the day. The monitor technician informs the nurse
that the client has developed prominent U waves. Which laboratory value should be checked
immediately? *
a. Sodium
b. Potassium
c. Magnesium
d. Calcium

28. A client's potassium level is 6.7 mEq/L (6.7 mmol/L). Which intervention should the nurse delegate to
the first-year student nurse whom he or she is supervising? *
a. Administer sodium polystyrene sulfonate 15 g orally.
b. Administer spironolactone 25 mg orally.
c. Assess the electrocardiogram (ECG) strip for tall T waves.
d. Administer potassium 10 mEq (10 mmol/L) orally.

29. What is the expected acid base imbalance to patients who suffer GBS? *
A. Respiratory alkalosis C. hypocalcemia
B. respiratory Acidosis D. hyperkalemia

30. A client is admitted to the unit with a diagnosis of syndrome of inappropriate antidiuretic hormone
secretion (SIADH). For which electrolyte abnormality would the nurse be sure to monitor? *
a. Hypokalemia c. Hyponatremia
b. Hyperkalemia d. Hypernatremia

31. The charge nurse assigned the care of a client with acute kidney failure and hypernatremia to a new-
graduated RN. Which actions can the new-graduate RN delegate to the nursing assistant except? *
a. Providing oral care every 3 to 4 hours
b. Monitoring for indications of dehydration
c. Record urine output when client voids
d. Help the client change position every 2 hours

32. An experienced LPN/LVN reports to the RN that a client's blood pressure and heart rate have
decreased, and when his face was assessed, one side twitches. What action should the RN take at this
time? *
a. Reassess the client's blood pressure and heart rate.
b. Review the client's morning calcium level.
c. Request a neurologic consult today.
d. Check the client's pupillary reaction to light.

33. The nurse is preparing to discharge a client whose calcium level was low but is now just barely within
the normal range (9 to 10.5 mg/dL [2.25 to 2.63 mmol/L]). Which statement by the client indicates the need
for additional teaching? *
a. “I will call my doctor if I experience muscle twitching or seizures.”
b. “I will make sure to take my vitamin D with my calcium each day.”
c. “I will take my calcium citrate pill every morning before breakfast.”
d. “I will avoid dairy products, broccoli, and spinach when I eat.”

34. Which order prescribed for a client with hypercalcemia would the nurse be sure to question? *
a. 0.9% saline at 50 mL/hr IV
b. Furosemide 20 mg orally each morning
c. Apply cardiac telemetry monitoring
d. Hydrochlorothiazide (HCTZ) 25 mg orally each morning
35. The unlicensed assistive personnel (UAP) asks the nurse why the client with a chronically low
phosphorus level needs so much assistance with activities of daily living. What is the RN's best response? *
a. “The client's low phosphorus is probably due to malnutrition.”
b. “The client is just worn out from not getting enough rest.”
c. “The client's skeletal muscles are weak because of the low phosphorus.”
d. “The client will do more for himself when his phosphorus level is normal.”

36. The RN is reviewing the client's morning laboratory results. Which of these results is of most concern? *
a. Serum potassium level of 5.2 mEq/L (5.2 mmol/L)
b. Serum sodium level of 134 mEq/L (134 mmol/L)
c. Serum calcium level of 10.6 mg/dL (2.65 mmol/L)
d. Serum magnesium level of 0.8 mEq/L (0.4 mmol/L)

37. Which client would the charge nurse assign to the step-down unit nurse who was floated to the
intensive care unit for the day? *
a. A 68-year-old client on a ventilator with acute respiratory failure andrespiratory acidosis
b. A 72-year-old client with chronic obstructive pulmonary disease (COPD)
c. and normal blood gas values who is ventilator dependent
d. A newly admitted 56-year-old client with diabetic ketoacidosis receiving aninsulin drip
e. A 38-year-old client on a ventilator with narcotic overdose and respiratoryalkalosis

38. The client with respiratory failure is receiving mechanical ventilation and continues to produce arterial
blood gas results indicating respiratory acidosis. Which change in ventilator setting should the nurse expect
to correct this problem? *
a. Increase in ventilator rate from 6 to 10 breaths/min
b. Decrease in ventilator rate from 10 to 6 breaths/min
c. Increase in oxygen concentration from 30% to 40%
d. Decrease in oxygen concentration from 40% to 30%

39. Which actions should the nurse delegate to nursing assistant for the client with diabetic ketoacidosis
except? *
a. Checking fingerstick glucose results every hour
b. Recording intake and output every hour
c. Measuring vital signs every 15 minutes
d. Assisting the client to reposition every 2 hours

40. The nurse is admitting an older adult client to the acute care medical unit. Which assessment factor
alerts the nurse that this client has a risk for acidbase imbalances? *
a. History of myocardial infarction (MI) 1 year ago
b. Antacid use for occasional indigestion
c. Shortness of breath with extreme exertion
d. Chronic renal insufficiency

41. The nurse is providing care for a patient diagnosed with laryngeal cancer who is receiving radiation
therapy. The patient tells the nurse that he is experiencing hoarseness and difficulty with speaking. What is
the nurse's best response? *
a. “Let's elevate the head of your bed and see if that helps.”
b. “Your voice should improve in 6 to 8 weeks after completion of the radiation.”
c. “Sometimes patients also experience dry mouth and difficulty with swallowing.”
d. “I will call your health care provider and let him know about this.”

42. The nurse is supervising a nursing student providing care for a patient with shortness of breath who has
expressed interest in smoking cessation. Which questions would the nurse suggest the student ask to
determine nicotine dependence, except? *
a. How soon after you wake up in the morning do you smoke?
b. Do other members of your family smoke?
c. Do you smoke when you are ill?
d. Do you wake up in the middle of your sleep time to smoke?
43. The RN clinical instructor is discussing a patient's oxygen-hemoglobin dissociation curve with a student.
The student states that the patient's oral body temperature is elevated at 100.8°F (38.2°C). Which
statement by the student indicates correct understanding of this patient's curve shift? *
a. “When a patient's body temperature is elevated, there is no change in the oxygen-hemoglobin
dissociation curve.”
b. “When a patient's body temperature is elevated, there is a shift to the left because the oxygen tension
level is lower.”
c. “When a patient's body temperature is elevated, there is no shift in the curve because the patient is using
less oxygen.”
d. “When the patient's body temperature is elevated, there is a shift to the right so that hemoglobin will
dissociate oxygen faster.”

44. An experienced LPN/LVN, under the supervision of the team leader RN, is assigned to provide nursing
care for a patient with a respiratory problem. Which actions are appropriate to the scope of practice of an
experienced RN, except? *
a. Auscultating breath sounds
b. Administering medications via metered-dose inhaler (MDI)
c. Completing in-depth admission assessment
d. Checking oxygen saturation using pulse oximetry

45. The nurse is evaluating and assessing a patient with a diagnosis of chronic emphysema. The patient is
receiving oxygen at a flow rate of 5 L/min by nasal cannula. Which finding concerns the nurse
immediately? *
a. Fine bibasilar crackles
b. Respiratory rate of 8 breaths/min
c. The patient sitting up and leaning over the nightstand
d. A large barrel chest

46. The NA tells the nurse that a patient who is receiving oxygen at a flow rate of 6 L/min by nasal cannula
is reporting nasal passage discomfort. What intervention should the nurse suggest to the NA to improve the
patient's comfort for this problem? *
a. Humidify the patient's oxygen.
b. Use a simple face mask instead of a nasal cannula.
c. Provide the patient with an extra pillow.
d. Have the patient sit up in a chair at the bedside.

47. The RN is teaching a NURSING ASSISTANT to check oxygensaturation by pulse oximetry. What will
the nurse be sure to tell the NA about patients with darker skin? *
a. “Be aware that patients with darker skin usually show a 3% to 5% higher oxygen saturation compared
with light-skinned patients.”
b. “Usually dark-skinned patients show a 3% to 5% lower oxygen saturation by pulse oximetry than light-
skinned patients.”
c. “With a dark-skinned patient, you may get more accurate results by measuring pulse oximetry on the
patient's toes.”
d. “More accurate results may result from continuous pulse oximetry monitoring than spot checking when a
patient has darker skin.”

48. The nurse is caring for a patient after thoracentesis. Which actions can be delegated from the nurse to
the NA EXCEPT? *
a. Assess puncture site and dressing for leakage.
b. Check vital signs every 15 minutes for 1 hour.
c. Remind the patient to take deep breaths.
d. Take the specimens to the laboratory.

49. The nurse is supervising a student nurse who is performing tracheostomy care for a patient. Which
action by the student would cause the nurse to intervene? *
a. Suctioning the tracheostomy tube before performing tracheostomy care
b. Removing old dressings and cleaning off excess secretions
c. Removing the inner cannula and cleaning using standard precautions
d. Replacing the inner cannula and cleaning the stoma site
50. The nurse is supervising an RN who floated from the medical-surgical unit to the emergency
department. The float nurse is providing care for a patient admitted with anterior epistaxis (nosebleed).
Which directions would the supervising nurse clearly provide to the RN, EXCEPT? *
a. Position the patient supine and turned on his side.
b. Apply direct lateral pressure to the nose for 5 minutes.
c. Maintain standard body substance precautions.
d. Apply ice or cool compresses to the nose.
e. Instruct the patient not to blow the nose for several hours.
f. Teach the patient to avoid vigorous nose blowing.

51. A patient with a diagnosis of sleep apnea has a problem with sleep deprivation related to a disrupted
sleep cycle. Which action should the nurse delegate to the NA? *
a. Discussing weight-loss strategies such as diet and exercise with the patient
b. Teaching the patient how to set up the bilevel positive airway pressure (BiPAP) machine before sleeping
c. Reminding the patient to sleep on his side instead of his back
d. Administering modafinil to promote daytime wakefulness

52. The nurse is acting as preceptor for a newly-graduated RN during the second week of orientation. The
nurse would assign and supervise the new RN to provide nursing care for which patients, EXCEPT? *
a. A 38-year-old patient with moderate persistent asthma awaiting discharge
b. A 63-year-old patient with a tracheostomy needing tracheostomy care every shift
c. A 56-year-old patient with lung cancer who has just undergone left lower lobectomy
d. A 69-year-old patient with emphysema to be discharged tomorrow

53. The nurse is providing care for a patient with recently diagnosed asthma. Which key points would the
nurse be sure to include in the teaching plan for this patient, EXCEPT? *
a. Avoid potential environmental asthma triggers such as smoke.
b. Use the inhaler 30 minutes before exercising to prevent bronchospasm.
c. Wash all bedding in cold water to reduce and destroy dust mites.
d. Be sure to get at least 8 hours of rest and sleep every night.
e. Avoid foods prepared with monosodium glutamate (MSG).
f. Keep a symptom and intervention diary to learn specific triggers for your asthma.

54. The nurse is assigned to provide nursing care for a patient receiving mechanical ventilation. Which
action should the nurse delegate to an experienced NA? *
a. Assessing the patient's respiratory status every 4 hours
b. Taking vital signs and pulse oximetry readings every 4 hours
c. Checking the ventilator settings to make sure they are as prescribed
d. Observing whether the patient's tube needs suctioning every 2 hours

55. A patient has chronic obstructive pulmonary disease (COPD). Which intervention for airway
management should the nurse delegate to the NA? *
a. Assisting the patient to sit up on the side of the bed
b. Instructing the patient to cough effectively
c. Teaching the patient to use incentive spirometry
d. Auscultating breath sounds every 4 hours

56. After the respiratory therapist performs suctioning on a patient who is intubated, the NA measures vital
signs for the patient. Which vital sign value should the UAP be instructed to report to the RN immediately? *
a. Heart rate of 98 beats/min c. Blood pressure of 168/90 mm Hg
b. Respiratory rate of 24 breaths/min d. Tympanic temperature of 101.4°F (38.6°C)

57. A patient with chronic obstructive pulmonary disease (COPD) tells the NA that he did not get his annual
flu shot this year and has not had a pneumonia vaccination. Which vital sign change will be most important
for the nurse to instruct the NA to report? *
a. Blood pressure of 152/84 mm Hg
b. Respiratory rate of 27 breaths/min
c. Heart rate of 92 beats/min
d. Oral temperature of 101.2°F (38.4°C)
58. The nurse is responsible for the care of a postoperative patient with a thoracotomy. Which action
should the nurse delegate to the NA? *
a. Instructing the patient to alternate rest and activity periods
b. Encouraging, monitoring, and recording nutritional intake
c. Monitoring cardiorespiratory response to activity
d. Planning activities for periods when the patient has the most energy

59. The nurse is supervising a nursing student who is providing care for a thoracotomy patient with a chest
tube. What finding would the nurse clearly instruct the nursing student to report immediately? *
a. Chest tube drainage of 10 to 15 mL/hr
b. Continuous bubbling in the water-seal chamber
c. Reports of pain at the chest tube site
d. Chest tube dressing dated yesterday

60. After change of shift, the nurse is assigned to care for the following patients. Which patient should the
nurse assess first? *
a. A 68-year-old patient on a ventilator for whom a sterile sputum specimen must be sent to the laboratory
b. A 57-year-old patient with chronic obstructive pulmonary disease (COPD) and a pulse oximetry reading
from the previous shift of 90% saturation
c. A 72-year-old patient with pneumonia who needs to be started on IV antibiotics
d. A 51-year-old patient with asthma who reports shortness of breath after using a bronchodilator inhaler

61. The nurse is initiating a nursing care plan for a patient with pneumonia. Which intervention for cough
enhancement should the nurse delegate to the NA? *
a. Teaching the patient about the importance of adequate fluid intake and hydration
b. Assisting the patient to a sitting position with neck flexed, shouldersrelaxed, and knees flexed
c. Reminding the patient to use an incentive spirometer every 1 to 2 hours while awake
d. Encouraging the patient to take a deep breath, hold it for 2 seconds, and then cough two or three times
in succession

62. The NA is assisting with feeding for a patient with severe end-stage chronic obstructive pulmonary
disease (COPD). Which instruction will the nurse provide the NA? *
a. Encourage the patient to eat foods that are high in calories and protein.
b. Feed the patient as quickly as possible to prevent early satiety.
c. Offer lots of fluids between bites of food.
d. Try to get the patient to eat everything on the tray.

63. The charge nurse is making assignments for the next shift. Which patient should be assigned to the
fairly new nurse (6 months of experience) floated from the surgical unit to the medical unit? *
a. A 58-year-old patient on airborne precautions for tuberculosis (TB)
b. A 65-year-old patient who just returned from bronchoscopy and biopsy
c. A 72-year-old patient who needs teaching about the use of incentive spirometry
d. A 69-year-old patient with chronic obstructive pulmonary disease (COPD) who is ventilator dependent

64. When a patient with tuberculosis (TB) is being prepared for discharge, which statement by the patient
indicates a need for further teaching? *
a. “Everyone in my family needs to go and see the doctor for TB testing.”
b. “I will continue to take my isoniazid until I am feeling completely well.”
c. “I will cover my mouth and nose when I sneeze or cough and put my used tissues in a plastic bag.”
d. “I will change my diet to include more foods rich in iron, protein, and vitamin C.”

65. The nurse is admitting a patient for whom a diagnosis of pulmonary embolus must be ruled out. The
patient's history and assessment reveal all of these findings. Which finding supports the diagnosis of
pulmonary embolus? *
a. The patient was recently in a motor vehicle crash.
b. The patient participated in an aerobic exercise program for 6 months.
c. The patient gave birth to her youngest child 1 year ago.
d. The patient was on bed rest for 6 hours after a diagnostic procedure.
66. The nurse is making a home visit to a 50-year-old patient who was recently hospitalized with a right leg
deep vein thrombosis and a pulmonary embolism (venous thromboembolism). The patient's only
medication is enoxaparin subcutaneously. Which assessment information will the nurse need to
communicate to the health care provider? *
a. The patient says that her right leg aches all night.
b. The right calf is warm to the touch and is larger than the left calf.
c. The patient is unable to remember her husband's first name.
d. There are multiple ecchymotic areas on the patient's abdomen

67. A patient with a pulmonary embolus is receiving anticoagulation with IV heparin. What instructions
would the nurse give the NA who will help the patient with activities of daily living (ADLs) EXCEPT?. *
a. Use a lift sheet when moving and positioning the patient in bed.
b. Use an electric razor when shaving the patient each day.
c. Use a soft-bristled toothbrush or tooth sponge for oral care.
d. Use a rectal thermometer to obtain a more accurate body temperature.
e. Be sure the patient's footwear has a firm sole when the patient ambulates.

68. A patient with chronic obstructive pulmonary disease (COPD) tells the nurse that he is always tired.
What advice would the nurse give this patient to cope with his fatigue, EXCEPT? *
a. Do not rush through your morning activities of daily living.
b. Avoid working with the arms raised.
c. Eat three large meals every day focusing on calories and protein.
d. Organize your work area so that what you use most is easy to reach.

69. A patient with acute respiratory distress syndrome (ARDS) is receiving oxygen by nonrebreather mask,
but arterial blood gas measurements continue to show poor oxygenation. Which action does the nurse
anticipate that the health care provider will prescribe? *
a. Perform endotracheal intubation and initiate mechanical ventilation.
b. Immediately begin continuous positive airway pressure (CPAP) via the patient's nose and mouth.
c. Administer furosemide (Lasix) 100 mg IV push immediately (STAT).
d. Call a code for respiratory arrest.

70. The nurse is the preceptor for an RN who is undergoing orientation to the intensive care unit. The RN is
providing care for a patient with acute respiratory distress syndrome (ARDS) who has just been intubated in
preparation for mechanical ventilation. The preceptor observes the RN performing all of these actions. For
which action must the preceptor intervene immediately? *
a. Assesses for bilateral breath sounds and symmetrical chest movement
b. Uses an end-tidal carbon dioxide detector to confirm endotracheal tube (ET) position
c. Marks the tube 1 cm from where it touches the incisor tooth or nares
d. Orders chest radiography to verify that tube placement is correct

Situation: Nurse Anne is handling Patient Lian with de Quervain’s disease. The following questions apply.

71. De Quervain’s disease is also known as: *

a. Subacute granulomatous thyroiditis c. Subacute lymphocytic thyroiditis
b. Silent thyroiditis d. Chronic thyroiditis

72. Patient Lian asked you what is the demographic affectation of De Quervain’s disease. You will explain
that the disease mostly affects: *
a. Women, ages 30-50 years old c. Men, ages 30-50 years old
b. Women, ages 40-50 years old d. Men, ages 40-50 years old

a. NSAIDsb. Acetylsalicylic acidc. Beta blockersd. Corticosteroids73. Upon physical examination, which of
the following signs are expected to be manifested by Patient Isaac? *
a. Myalgias, pharyngitis, low grade fever, fatigue
b. Anterior neck pain and swelling, fever, dysphonia
c. Irritability, bruit, thrill
d. Hemoptysis, DOB, weight loss
74. Which of the following medications, if prescribed to Patient Lian, should be reported to the doctor for
reconsideration? *
a. NSAIDs
b. Acetylsalicylic acid
c. Beta blockers
d. Corticosteroids

75. Patient Lian asked why he wasn’t prescribed with anti-thyroid agents, which were prescribed to his
cousin with hyperthyroidism. The correct response is that: *
a. De Quervain’s thyroiditis causes hypothyroidism instead of hyperthyroidism
b. Different patients have different management, for his case the drug will cause anaphylaxis
c. These drugs are not effective to the patient since the cause of thyroiditis comes from the released stored
thyroid hormones
d. These drugs are not indicated for the patient since the thyroid gland produces lesser thyroid hormones
which causes decreased synthesis of T3 and T4

Situation: Nurse Ana conducts health teaching on PCOS in Barangay Niregla. The following questions
apply.

76. One of the major topics to be discussed is the nature of PCOS. Nurse Ana should be accurate in
discussing that PCOS is: *
a. Is a common condition which presents irregular periods, unwanted hair growth, absence of acne
vulgaris, and weight problems
b. This disorder affects the hypothalamic pituitary and ovarian network or axis
c. This disorder results to chronic over ovulation and clinical androgen excess
d. This disorder affects 5-10% of women of non-child bearing age

77. Nurse Ana screens the women residents of Barangay Niregla to determine possible cases of PCOS.
Which of the following features would be signs of PCOS? *
a. Overweight, normal menstruation patterns, 40-50 years old
b. Hirsutism, 60-70 years of age, underweight
c. Insulin resistance, dyslipidemia, sleep apnea, infertility
d. Irregular menstrual patterns, normal weight, androgen deficit

78. Nurse Ana knows that all but one are the management for PCOS: *
a. Metformin c. surgical removal of large cysts
b. Weight management d. avoid Clomid (clomiphene) medication

79. Nurse Ana should be careful in prescribing oral contraceptives in patients with PCOS because: *
a. Most of the patients affected are of child-bearing age
b. Oral contraceptives can destroy the normal menstrual patterns
c. Oral contraceptives are not allowed by the church
d. Oral contraceptives are found to be the major cause of PCOS

80. Which of the following conditions is the greatest complication that may arise from PCOS? *
a. Infertility c. Hypoinsulinemia
b. Metabolic syndrome d. Suicidal tendencies

81. Nurse Joe knows that Pneumoconiosis is one of the leading causes of Occupational disorders. All but
one are examples of Pneumoconiosis: *
a. Silicosis c. Coal worker’s disease
b. Asbestosis d. Hairdresser’s disease

82. Nurse Joe would know that patient Mark’s condition progressed from acute silicosis to chronic silicosis
if which of the following signs are seen? *
a. Dyspnea, fever, cough, weight loss
b. Progressive symptoms indicative of hypoxemia, severe airflow obstruction, right sided heart failure
c. Progressive dyspnea, persistent dry cough, mild to moderate chest pain, anorexia, weight loss, malaise,
clubbing of fingers
d. Chronic cough, dyspnea, expectoration of black or gray sputum
83. Nurse Joe knows that all but one of the following occupations can be a risk factor in developing
Silicosis: *
a. Shipbuilding c. Foundry work
b. Glass manufacturing d. Stone cutting

84. The patient asked Nurse Joe regarding the goal of medical management of his condition. Nurse Joe
knows that Pneumoconiosis is: *
a. Treatable by nature and that goal of the medical management is return of optimal lung functioning
b. Not preventable due to the exposure to several different types of agents such as toxic fumes, biologic
dusts that are present in the atmosphere
c. Irreversible once they develop; thus goal of treatment is of supportive therapy and aimed at preventing
infections and further complication
d. Related only to the nature of the occupation of the patient

85. Given the nature of the disorder, occupational health nurses play an important role in the workplace. All
but one are the roles of the nurses in preventing the disease except, *
a. Patient advocate c. Ostomy Nurse
b. Nurse anaesthesiologist d. Diabetic Nurse

86. Which among the following items used on the patient will need sterilization after use? *
a. Stethoscope c. Scalpel
b. Spoon and fork d. A and C

87. Which among the following precautions is best for the patient? *
a. Airborne precaution
b. Contact precaution
c. Droplet precaution
d. Reverse isolation precaution

88. The family is asking the nurse if they can visit the patient. Nurse Dexter’s best response will be: *
a. “I’m afraid the patient cannot entertain visitors because of his condition.”
b. “You need to put on masks to prevent transmission of the bacteria via airborne droplets.”
c. “Wearing gloves and gowns, especially if you have skin breaks, is needed before entering the patient’s
room.”
d. “I am not sure if that is allowed. Let me call the doctor to explain it to you.”

89. In disposing the patient’s linen and trash, Nurse Dexter should tie the knot at the ____ of the linen and
trash bags: *
a. Top c. Upper sides
b. Posterior surface d. Any part

90. Which among the following will indicate that the patient has also developed a parasitic infection? *
a. Neutrophil count 75%
b. Lymphocytes 20%
c. Eosinophils 3%
d. Eosinophils 8%

SITUATION 8: Nurse Alice is currently conducting a research study as a requirement in her Master’s
degree. She wants to determine the intellectual quotient of Down’s syndrome residents of Ms. Peregrine’s
Home for Special Children.

91. After identifying the research problem, Nurse Alice should? *

a. Establish the blueprint of the research study.
b. Review relevant literature and studies.
c. Determine the appropriate tool for data collection.
d. Identify the appropriate sample size.

92. This research of Nurse Alice can be classified as: *

a. Applied c. Action
b. Pure d. Methodological
93. What is the independent variable in this study? *
a. IQ level
b. Resident with Down’s syndrome
c. Down’s syndrome
d. Special Children of Ms. Peregrine’s

94. The sampling technique that may be used in the study to identify the subjects among the residents of
Ms. Peregrine’s Home for Special Children with Down’s syndrome is: *
a. Convenience
b. Simple
c. Purposive
d. Snowball

95. Nurse Alice’s research would like to accomplish what purpose? *

a. To develop a learning module for IQ improvement
b. To establish an activity that would improve the behaviour of the clients
c. To serve as a reference for planning program development for Down’s syndrome clients
d. To compare the IQ of Down’s syndrome clients with those having other syndrome

SITUATION 9: Julius, a nurse researcher, is conducting a study on the differences between the skill
performance of emergency room nurses from private and government-based hospitals in Metro Manila. He
wanted to have all the ER nurses from the randomly selected hospitals.

96. The most appropriate sampling technique that he may use for his study to achieve the required sample
is: *
a. Purposive Sampling Technique
b. Cluster Sampling Technique
c. Incidental Sampling Technique
d. Simple Random Sampling Technique

97. One of the factors that may affect Julius’ study is the education and competency enhancement of the
ER nurses, which may not be prevented during the process of the research. This is further known as: *
a. Effector variable
b. Criterion variable
c. Extraneous variable
d. Moderator variable

98. Which of the following is the antecedent variable for Jason’s study? *
a. Type of hospital
b. Metro Manila
c. Skill performance
d. ER nurses

99. On the other hand, the resultant variable in the study is: *
a. Metro Manila
b. Skill performance
c. Type of hospital
d. ER nurses

100. Suppose Julius had rejected the null hypothesis in his study when it is actually true, he committed? *
a. Type II error
b. Sampling bias
c. Systematic error
d. Type I error