G

NUR 200 SAS COMPILATION
SAS 1 b. Asthma
c. Chronic obstructive bronchitis
1. The term “pink puffer” refers to the client with which d. Emphysema.
of the following symptoms? 8. Clients with chronic obstructive bronchitis are given
a. ARDS diuretic therapy. Which of the following reasons
b. Asthma explains why?
c. Chronic obstructive bronchitis a. reducing fluid volume reduces oxygen demand
d. Emphysema. b. reducing fluid volume improves clients’ morbidity
2. The underlying pathophysiology of COPD is: c. restricting fluid volume reduces sputum production
d. reducing fluid volume improves respiratory function
a. inflamed airways that obstruct airflow.
b. mucus secretions that block airways 9. Teaching for a client with chronic obstructive
c. overinflated alveoli that impair gas exchange. pulmonary disease (COPD) should include which of the
d. characterized by variations of all of the above. following topics?
3. The abnormal inflammatory response in the lungs a. How to have his wife learn to listen to his lungs with a
occurs primarily in the: stethoscope
b. How to increase his oxygen therapy
a. airways. c. How to treat respiratory infections without going to
b. parenchyma. the physician
c. pulmonary vasculature. d. How to recognize the signs of impending respiratory
d. areas identified in all of the above. infection.
4. Two diseases common to the etiology of COPD are: 10. A nurse plans care for a client with chronic
obstructive pulmonary disease, knowing that the client
a. asthma and atelectasis.
is most likely to experience what type of acid- base
b. chronic bronchitis and emphysema.
imbalance.
c. pneumonia and pleurisy.
d. tuberculosis and pleural effusions. a. respiratory acidosis
b. respiratory alkalosis
5. The term “blue bloater” refers to which of the
c. metabolic acidosis
following conditions?
d. metabolic alkalosis
a. adult respiratory distress syndrome
b. asthma SAS 2
c. chronic obstructive bronchitis
d. emphysema
1. A nurse is caring for several clients. Which of the
6. The most important environmental risk factor for following clients are at risk for having a pulmonary
emphysema is: embolism? (Select all that apply.)
a. air pollution. A. A client who has a BMI of 30
b. allergens. B. A female client who is postmenopausal
c. infectious agents. C. A client who has a fractured femur
d. cigarette smoking. D. A client who is a marathon runner
7. A 66-year-old client has marked dyspnea at rest, is E. A client who has chronic atrial fibrillation
thin and uses accessory muscles to breathe. He is 2. A nurse is reviewing prescriptions for a client who has
tachypneic, with a prolonged expiration phase. He has acute dyspnea and diaphoresis. The client states that
no cough. He leans forward with his arms braced on his she is anxious because she feels that she cannot get
knees to support his chest and shoulder for breathing. enough air. Vital signs are: heart rate 117/min,
This client has symptoms of which of the following respiratory rate 38/min, temperature 38.4° C (101.2° F),
respiratory disorder? and blood pressure 100/54 mm Hg. Which of the
a. ARDS following actions is the priority
SAS 1 b. Asthma
c. Chronic obstructive bronchitis
1. The term “pink puffer” refers to the client with which d. Emphysema.
of the following symptoms? 8. Clients with chronic obstructive bronchitis are given
a. ARDS diuretic therapy. Which of the following reasons
b. Asthma explains why?
c. Chronic obstructive bronchitis a. reducing fluid volume reduces oxygen demand
d. Emphysema. b. reducing fluid volume improves clients’ morbidity
2. The underlying pathophysiology of COPD is: c. restricting fluid volume reduces sputum production
d. reducing fluid volume improves respiratory function
a. inflamed airways that obstruct airflow.
b. mucus secretions that block airways 9. Teaching for a client with chronic obstructive
c. overinflated alveoli that impair gas exchange. pulmonary disease (COPD) should include which of the
d. characterized by variations of all of the above. following topics?
3. The abnormal inflammatory response in the lungs a. How to have his wife learn to listen to his lungs with a
occurs primarily in the: stethoscope
b. How to increase his oxygen therapy
a. airways. c. How to treat respiratory infections without going to
b. parenchyma. the physician
c. pulmonary vasculature. d. How to recognize the signs of impending respiratory
d. areas identified in all of the above. infection.
4. Two diseases common to the etiology of COPD are: 10. A nurse plans care for a client with chronic
obstructive pulmonary disease, knowing that the client
a. asthma and atelectasis.
is most likely to experience what type of acid- base
b. chronic bronchitis and emphysema.
imbalance.
c. pneumonia and pleurisy.
d. tuberculosis and pleural effusions. a. respiratory acidosis
b. respiratory alkalosis
5. The term “blue bloater” refers to which of the
c. metabolic acidosis
following conditions?
d. metabolic alkalosis
a. adult respiratory distress syndrome
b. asthma SAS 2
c. chronic obstructive bronchitis
d. emphysema
1. A nurse is caring for several clients. Which of the
6. The most important environmental risk factor for following clients are at risk for having a pulmonary
emphysema is: embolism? (Select all that apply.)
a. air pollution. A. A client who has a BMI of 30
b. allergens. B. A female client who is postmenopausal
c. infectious agents. C. A client who has a fractured femur
d. cigarette smoking. D. A client who is a marathon runner
7. A 66-year-old client has marked dyspnea at rest, is E. A client who has chronic atrial fibrillation
thin and uses accessory muscles to breathe. He is 2. A nurse is reviewing prescriptions for a client who has
tachypneic, with a prolonged expiration phase. He has acute dyspnea and diaphoresis. The client states that
no cough. He leans forward with his arms braced on his she is anxious because she feels that she cannot get
knees to support his chest and shoulder for breathing. enough air. Vital signs are: heart rate 117/min,
This client has symptoms of which of the following respiratory rate 38/min, temperature 38.4° C (101.2° F),
respiratory disorder? and blood pressure 100/54 mm Hg. Which of the
a. ARDS following actions is the priority
action at this time? 8. A client is suspected of having pulmonary embolism.
A nurse assesses the client, knowing that which of the
A. Notify the provider.
following is a common clinical manifestation of
B. Administer heparin via IV infusion. pulmonary embolism?
C. Administer oxygen therapy.
D. Obtain a spiral CT scan. A. Dyspnea
B. Bradypnea
3. A male patient’s X-ray result reveals bilateral white- C. Bradycardia
outs indicating adult respiratory distress syndrome D. Decrease respiration
(ARDS). This syndrome results from;
9. A patient has been hospitalized in the ICU for a near
A. Cardiogenic pulmonary edema drowning event. The patient’s respiratory function has
B. Respiratory alkalosis been deteriorating over the last 24 hours. The physician
C. Increased pulmonary capillary permeability. suspects acute respiratory distress syndrome. A STAT
D. Renal failure chest x-ray is ordered. What finding on the chest x-ray
4. A nurse is caring for a male client with acute is indicative of ARDS?
respiratory distress syndrome. Which of the following A. infiltrates only on the upper lobes
would the nurse expect to note in the client? B. enlargement of the heart with bilateral lower lobe
A. Pallor infiltrates
B. Low arterial PaO2 C. white-out infiltrates bilaterally
C. Elevated arterial PaO2 D. normal chest x-ray
D. Decreased respiratory rate.
10. Which patient below is at MOST risk for developing
5. A nurse is assessing a client who has a pulmonary ARDS and has the worst prognosis?
embolism. Which of the clinical manifestations should A. A 52-year-old male patient with a pneumothorax.
the nurse expect to find? (Select all that apply.) B. A 48-year-old male being treated for diabetic
A. Bradypnea ketoacidosis.
B. Pleural friction rub C. A 69-year-old female with sepsis caused by a gram-
C. Hypertension negative bacterial infection.
D. Petechiae D. A 30-year-old female with cystic fibrosis.
E. Tachycardia 11. The nurse assesses a patient for possible pulmonary
6. You’re providing care to a patient who is being embolism. The nurse looks for the most frequent sign
treated for aspiration pneumonia. The patient is on a of:
100% nonrebreather mask. Which finding below is a A. Cough
HALLMARK sign and symptom that the patient is B. Hemoptysis
developing acute respiratory distress syndrome C. Syncope
(ARDS)? D. Tachypnea
A. The patient is experiencing bradypnea. 12. The following are nursing intervention to assist in
B. The patient is tired and confused. the prevention of pulmonary embolism in a hospitalized
C. The patient’s PaO2 remains at 45 mmHg.
patient include all except:
D. The patient’s blood pressure is 180/96.
A. A liberal fluid intake
7. A male adult patient hospitalized for treatment of a B. Assisting the patient to do leg elevation above the
pulmonary embolism develops respiratory alkalosis. level of the heart.
Which clinical findings commonly accompany C. Encouraging the patient to dangle his or her legs over
respiratory alkalosis?
the side of the bed for 30 minutes, four times a day.
A. Nausea and vomiting D. The use of elastic stocking, especially when
B. Abdominal pain or diarrhea decreased mobility would promote venous stasis.
C. Hallucination or tinnitus 13. You are caring for a patient with acute respiratory
D. Lightheadedness and paresthesia distress syndrome. As the nurse you know that prone
positioning can be beneficial for some patients with 3. The initial characteristics symptoms of a simple
this condition. Which findings below indicate this type pneumothorax is.
of positioning was beneficial for your patient with
ARDS? A. ARDS
B. Severe respiratory distress
A. Improvement in lung sounds C. Sudden chest pain
B. Development of a V/Q mismatch D. Tachypnea and chest discomfort
C. PaO2 increased from 59 mmHg to 82 mmHg
D. PEEP needs to be titrated to 15 mmHg of water 4. Clinical manifestation of related to pneumothorax
includes the following except for:
14. A patient is experiencing respiratory failure due to
pulmonary edema. The physician suspects ARDS but A. Pleuritic pain
wants to rule out a cardiac cause. A pulmonary artery B. Respiratory distress
wedge pressure is obtained. As the nurse you know that C. Acrocyanosis
what measurement reading obtained indicates that this D. Tachypnea
type of respiratory failure is NOT cardiac related? 5. Which of the following should the nurse assess in
A. >25 mmHg patient with pneumothorax?
B. <10 mmHg A. Tracheal alignment
C. >50 mmHg B. Expansion of the chest
D. <18 mmHg C. Breath sounds
15. Which of the following is a type of embolism? D. All of the above
A. Travelling emboli 6. The pressure required in the pleural space to keep

B. Fat emboli the lungs inflated is:
C. Burn emboli A. Positive
D. Diabetic emboli B. Negative
C. Atmospheric
D. All of the above
SAS 3
7. The following are types of pneumothorax except:
1. The nurse is presenting a class on chest tubes. Which A. Trauma
statement describes a tension pneumothorax? B. Simple
C. Tension
A. A tension pneumothorax develops when an air-filled
D. Direct.
bleb on the surface of the lung ruptures.
B. When a tension pneumothorax occursasth, the air 8. On auscultation, which of the following suggest a
moves freely between the pleural space and the right pneumothorax/
atmosphere.
C. The injury allows air into the pleural space but A. Bilateral inspiratory and expiratory crackles.
prevents it from escaping from the pleural space. B. Absence of breath sounds in the right thorax.
D. A tension pneumothorax results from a puncture of C. Inspiratory wheezes in the right thorax.
the pleura during a central line placement. D. Bilateral pleural friction rub.
2. The nurse is caring for a client with a right-sided chest

tube secondary to a pneumothorax. Which 9. Nurse Lei is caring for a client with pneumothorax
interventions should the nurse implement when caring and who has had a chest tube inserted notes continues
for this client? Select all that apply. gentle bubbling in the suction control chamber. Which
A. Place the client in a low-Fowler's position. action is appropriate?
B. Assess chest tube drainage system frequently. A. Do nothing, because this is an expected finding.
C. Maintain strict bed rest for the client. B. Immediately clamp the chest tube and notify the
D. Secure a loop of drainage tubing to the sheet. physician.
E. Observe the site for subcutaneous emphysema.
C. Check for an air leak because the bubbling should be 3. Hypertension is known as the silent killer. This phrase
intermittent. is associated with the fact that hypertension often goes
D. Increase the suction pressure so that the bubbling undetected until symptoms of other system failures
becomes vigorous. occur. This may occur in the form of:
10. An emergency room nurse is assessing a male client A. Cerebrovascular accident
who has sustained a blunt injury to the chest wall. B. Liver disease
Which of the signs would indicate the presence of C. Myocardial infarction
pneumothorax in this client? D. Pulmonary disease
A. A low respiratory rate 4. A client is receiving spironolactone to treat
B. Diminished breath sounds hypertension. Which of the following instructions
C. The presence of barrel chest should the nurse provide?
D. A sucking sound at the site of injury
A. Eat foods high in potassium
B. Take daily potassium supplements
C. Discontinue sodium restriction
SAS 4 D. Avoid salt substitute
1. The physician diagnosed the patient with Class III 5. The most important long-term goal for a client with
Primary Pulmonary Hypertension. The nurse is aware hypertension would be to:
that the characteristic of this condition is:
A. Learn how to avoid stress
A. No manifestation at rest and mild to moderate B. Explore a job change or early retirement
physical activity induces dyspnea, fatigue, chest pain, or C. Make a commitment to long term therapy
lightheadedness. D. Control high blood pressure
B. No or slight manifestation at rest and mild (less than 6. A nurse in the emergency department is assessing a
ordinary) activity induces dyspnea, fatigue, chest pain or client who was in a motor vehicle crash. Findings
lightheadedness. include absent breath sounds in the left lower lobe
with dyspnea, blood pressure 118/68 mm Hg, heart rate
C. Dyspnea and fatigue is present at rest, unable to 124/min, respiratory rate 38/min, temperature 38.6° C
carry out any level of physical activity without (101.4° F), and SaO2 92% on room air. Which of the
manifestations, and following actions should the nurse take first?
manifestations of right sided heart failure apparent A. Obtain a chest x-ray.
(engorged neck veins, dependent edema and enlarged B. Prepare for chest tube insertion.
liver). C. Administer oxygen via a high-flow mask.
D. Pulmonary hypertension diagnosed by pulmonary D. Initiate IV access.
function test and right sided cardiac catheterization, no 7. Which of the following regarding pulmonary
limitation of physical activity, and moderate physical hypertension is false:
activity does not include dyspnea, fatigue, chest pain or
light headedness. A. PH has many underlying etiologies
B. The disease affects the left side of the heart
2. The morning weight for a client with emphysema C. The hemodynamic definition of PH is a mean
indicates that the client has gained 5 pounds in less pulmonary arterial pressure (PAP) greater than 25
than a week, even though his oral intake has been mmHg.
modest. The client's weight gain may reflect which D. Pulmonary arterial hypertension is a subset of
associated complication of COPD? pulmonary hypertension.
A. Polycythemia 8. Which of the following statement is not correct
B. Cor Pulmonale regarding pulmonary hypertension.
C. Left Ventricular failure
D. Compensated acidosis A. The disease affects men more than women.
B. Non- specific symptom such as fatigue and edema are C. Atmospheric
present clinically. D. All of the above
C. Catheterization is required when PH is suspected.
D. Underlying causes are evaluated. 5. The following are types of pneumothorax except:
9. Which of the following statement about pulmonary A. Trauma

arterial hypertension is incorrect. B. Simple
C. Tension
A. Vasoconstriction is an issue D. Direct
B. Vascular wall re-modelling is an issue
C. There is a cure for pulmonary arterial hypertension. 6. The healthcare provider is assisting during the
D. The balance of vasoconstriction and vasodilatation insertion of a pulmonary artery catheter. Which of
may indicate PAH. these, if assessed in the patient, would indicate the
patient is experiencing a complication from the catheter
10. All of the following are true regarding calcium insertion?
channel blockers in pulmonary arterial hypertension.
A. Inspiration phase is greater than expiration
A. Calcium channel blockers have a selective effect on B. Diaphragmatic excursion of 3 cm
vascular smooth muscles. C. Tracheal deviation from normal
B. Normal physiologic doses are sufficient for treatment D. Vesicular breath sounds noted on auscultation
purposes.
C. Adverse effect must be considered. 7. During the assessment of a 60-year-old female
D. Long -term clinical response is less than 10%. patient, you note the following signs: dyspnea,
hypotension, reduced chest expansion on the left side,
hyper resonant percussion note and tactile fremitus on
the left side, absent breath sounds on the left side, and
SAS 5 a tracheal shift to the right. These findings suggest
which of the following?
1. An initial characteristic symptom of a simple
pneumothorax is: A. A pleural effusion on the left side
B. A pneumothorax on the left side
A. ARDS C. Atelectasis on the left side
B. Severe onset of chest pain D. Consolidation on the left side
C. Severe respiratory distress
D. Tachypnea and chest discomfort. 8. A 50-year-old male patient is intubated with a size 8
endotracheal tube and is receiving volume-controlled
2. Clinical manifestations related to pneumothorax A/C ventilation. Upon assessment, you note that the
include the following except for: patient’s cuff pressure is measured at 38 cm H2O.
A. Pleuritic pain Which of the following would you recommend?
B. Respiratory distress A. Withdraw the tube 1-2 cm and reassess the patient’s
C. Acrocyanosis breath sounds
D. Tachypnea B. Recommend reintubation with a smaller
3. Which of the following the nurse assesses in patient endotracheal tube
with pneumothorax? C. Lower the cuff pressure to < 30 cm H2O
D. Recommend ventilation via a tracheostomy instead
A. Tracheal alignment
9. An adult patient who is receiving mechanical
B. Expansion of the chest
ventilation suddenly started showing signs of
C. Breath sounds
tachypnea. Upon assessment, you note tracheal
D. All of the above
deviation to the right and decreased breath sounds and
4. The pressure required in the pleural space to keep hyperresonance on the left. Which of the following
the lungs inflated is: would you recommend?
A. Positive A. The patient needs suctioning
B. Negative B. The patient needs a bronchoscopy
C. The insertion of a chest tube 4. A nurse is conducting a health history with a client
D. The patient needs a thoracentesis with a primary diagnosis of heart failure. Which of the
following disorders reported by the client is unlikely to
10. During the assessment of a 52-year-old female play a role in exacerbating the heart failure?
patient that is receiving oxygen via nasal cannula at 4
L/min, you hear the bubble humidifier making a A. Recent URI
whistling noise. Which of the following is the most likely B. Nutritional anemia
cause of this finding? C. Peptic ulcer disease
D. A-fib
A. There is an obstruction in the delivery tube
B. The patient’s ventilation has increased 5. A client is wearing a continuous cardiac monitor,
C. There is a clogged system diffuser which begins to sound its alarm. A nurse sees no
D. The flowmeter pressure is set too high electrocardiogram complexes on the screen. The first
action of the nurse is to:
SAS 6 A. Check the client status and lead placement.
B. Press the recorder button on the electrocardiogram
1. A 60-year-old male client comes into the emergency console.
department with complaints of crushing chest pain that C. Call the physician.
radiates to his shoulder and left arm. The admitting D. Call a code blue
diagnosis is acute myocardial infarction. Immediate
admission orders include oxygen by NC at 4L/minute, 6. Which of the following recurring conditions most
blood work, chest xray, an ECG, and 2 mg of morphine commonly occurs in clients with cardiomyopathy?
given intravenously. The nurse should first:
A. Heart failure
A. Administer morphine B. Diabetes
B. Obtain 12 leads ECG C. MI
C. Obtain laboratory work D. Pericardial effusion
D. Order chest X-ray
7. When interpreting an ECG, the nurse would keep in
2. Sublingual nitroglycerin tablets begin to work within 1 mind which of the following about the P wave? Select
to 2 minutes. How should the nurse instruct the client all that apply.
to use the drug when chest pain occurs?
A. Reflects electrical impulse beginning at the SA node
A. Take one tablet every 2-5 minutes until pain stops. B. Indicated electrical impulse beginning at the AV node.
B. Take one tablet and rest for 10 minutes. Call the C. Reflects atrial muscle depolarization
physician if pain persist after 10 minutes. D. Identifies ventricular muscle depolarization
C. Take one tablet, then an additional tablet every 5 E. Has duration normally of 0.11 seconds or less.
minutes for a total of 3 tablets. Call the physician if pain
8. Which of the following arteries primarily feeds the
persist after 3 tablets.
anterior wall of the heart?
D. Take one tablet. If pain persist, after 5 minutes, take
two tablets. If pain still persist 5 minutes later, call the A. Circumflex artery
physician. B. Internal mammary artery
C. Left anterior descending artery
3. A nurse is preparing for the admission of a client with
D. Right coronary artery
heart failure who is being sent directly to the hospital
from the physician’s office. The nurse would plan on 9. With which of the following disorders is jugular vein
having which of the following medications readily distention most prominent?
available for use?
A. Abdominal aortic aneurysm
A. Diltiazem ( Cardizem B. Heart failure
B. Digoxin ( Lanoxin) C. MI
C. Propranolol ( Inderal) D. Pneumothorax
D. Metoprolol ( Lopressor)
10. Dyspnea, cough, expectoration, weakness, and SAS 7
edema are classic signs and symptoms of which of the
following conditions? 1. A patient is being treated for cardiogenic shock.
A. Pericarditis Which statement below best describes this condition?
B. Hypertension Select all that apply:
C. MI A. “The patient will experience an increase in cardiac
D. Heart Failure output due to an increase in preload and afterload.”
11. Which of the following factors can cause blood B. “A patient with this condition will experience
pressure to drop to normal levels? decreased cardiac output and decreased tissue
perfusion.”
A. Kidney’s excretion of sodium only C. “This condition occurs because the heart has an
B. Kidney’s retention of sodium and water inadequate blood volume to pump.”
C. Kidney’s excretion of sodium and water D. “Cardiogenic shock leads to pulmonary edema.”
D. Kidney’s retention of sodium and excretion of water.
2. Cardiac output is very important for determining if a
12. The physician refers the client with unstable angina patient is in cardiogenic shock. What is a normal cardiac
for a cardiac catheterization. The nurse explains to the output in an adult?
client that this procedure is being used in this specific
case to: A. 2-5 liters/minute
B. 1-3 liters/minute
A. Open and dilate the blocked coronary arteries. C. 4-8 liters/minute
B. Assess the extent of arterial blockage D. 8-10 liters/minute
C. Bypass obstructed vessels
D. Assess the functional adequacy of the valves and
heart muscles. 3. Which patient below is at MOST risk for developing
cardiogenic shock?
13. As an initial step in treating a client with angina, the
physician prescribes nitroglycerin tablets, 0.3mg given A. A 52-year-old male who is experiencing a severe
sublingually. This drug’s principal effects are produced allergic reaction from shellfish.
by: B. A 25-year-old female who has experienced an upper
thoracic spinal cord injury.
A. Antispasmodic effect on the pericardium C. A 72-year-old male who is post-op from a liver
B. Causing an increased myocardial oxygen demand transplant.
C. Vasodilation of peripheral vasculature D. A 49-year-old female who is experiencing an acute
D. Improved conducting in the myocardium. myocardial infarction.
14. Furosemide is administered intravenously to a client
with HF. How soon after administration should the 4. You’re caring for a patient with cardiogenic shock.
nurse begin to see evidence of the drugs desired Which finding below suggests the patient’s condition is
effect? worsening? Select all that apply:
A. 5 to 10 minutes A. Blood pressure 95/68
B. 30 to 60 minutes B. Urinary output 20 mL/hr
C. 2-4 hours C. Cardiac Index 3.2 L/min/m2
D. 6-8 hours D. Pulmonary artery wedge pressure 30 mmHg
15. Which of the following symptoms is most commonly
5. You’re precepting a new nurse. You ask the new
associated with left-sided heart failure?
nurse to list the purpose of why a patient with
A. Crackles cardiogenic shock may benefit from an intra-aortic
B. Arrhythmias balloon pump. What responses below indicate the new
C. Hepatic engorgement nurse understands the purpose of an intra-aortic
D. Hypotension balloon pump? Select all that apply:
A. “This device increases the cardiac afterload, which A. systole, diastole
will increase cardiac output.” B. diastole, systole
B. “This device will help increase blood flow to the C. inspiration, expiration
coronary arteries.” D. expiration, inspiration
C. “The balloon pump will help remove extra fluid from
the heart and lungs.”
D. “The balloon pump will help increase cardiac SAS 8
output.”
1. The client is admitted to the hospital with a
6. A patient is receiving treatment for an acute hypertensive crisis. Diazoxide (Hyperstat) is ordered.
myocardial infarction. The nurse is closely monitoring During administration the nurse should:
the patient for signs and symptoms associated with
cardiogenic shock. Which value below is associated with A. Utilize an infusion pump
cardiogenic shock? B. Check the blood glucose level
C. Place the patient in Trendelenburg position
A. Cardiac index 1.5 L/min/m2 D. Cover the solution with foil
B. Pulmonary capillary wedge pressure (PCWP) 10
mmHg 2. A 52-year-old patient who has no previous history of
C. Central venous pressure (CVP) 4 mmHg hypertension or other health problems suddenly
D. Troponin <0.01 ng/mL develops a BP of 188/106 mm Hg. After reconfirming
the BP, it is appropriate for the nurse to tell the patient
7. A patient who has cardiogenic shock is experiencing that
labored breathing and low oxygen levels. A STAT chest
x-ray is ordered. The x-ray results show pulmonary A. a BP recheck should be scheduled in a few weeks.
edema. The physician orders Furosemide IV. What B. the dietary sodium and fat content should be
finding would require immediate nursing action? decreased.
C. there is an immediate danger of a stroke and
A. Blood pressure 98/54 hospitalization will be required.
B. Urinary output 45 mL/hr D. more diagnostic testing may be needed to determine
C. Potassium 1.8 mEq/L the cause of the hypertension.
D. Heart rate 110 bpm
3. Which action will be included in the plan of care
8. They physician orders a Dobutamine IV drip on a when the nurse is caring for a patient who is receiving
patient in cardiogenic shock. After starting the IV drip, sodium nitroprusside (Nipride) to treat a hypertensive
the nurse would make it priority to monitor for? emergency?
A. Rebound hypertension A. Organize nursing activities so that the patient has
B. Ringing in the ears undisturbed sleep for 6 to 8 hours at night.
C. Worsening hypotension B. Assist the patient up in the chair for meals to avoid
D. severe headache complications associated with immobility.
9. Which medications below are used in cardiogenic C. Use an automated noninvasive blood pressure
shock that provide a positive inotropic effect on the machine to obtain frequent BP measurements.
heart? Select all that apply: D. Place the patient on NPO status to prevent aspiration
caused by nausea and the associated vomiting.
A. Nitroglycerin
B. Sodium Nitroprussidde 4. The nurse has just finished teaching a hypertensive
C. Dobutamine patient about the newly prescribed quinapril (Accupril).
D. Norepinephrine Which patient statement indicates that more teaching is
E. Dopamine needed?
A. "The medication may not work as well if I take any
10. A patient with cardiogenic shock has an intra-aortic aspirin."
balloon pump. As the nurse you know that during B. "The doctor may order a blood potassium level
________ the balloon deflates and during _____ the occasionally."
balloon inflates in a section of the aorta.
C. "I will call the doctor if I notice that I have a frequent C. Because at no point in the disease progression does
cough." symptoms ever present
D. "I won't worry if I have a little swelling around my lips D. Because it never progresses slowly, it occurs
and face." suddenly and immediately
5. During change-of-shift report, the nurse obtains this 10. You are taking care of a patient in the hospital and
information about a hypertensive patient who received the CNA reports to you that their blood pressure is
the first dose of propranolol (Inderal) during the 198/101. They have been running 140's/80's
previous shift. Which information indicates that the throughout their stay. What will you do first?
patient needs immediate intervention?
A. Check the cuff size to make sure it’s appropriate and
A. The patient's most recent BP reading is 156/94 mm recheck blood pressure
Hg. B. STAT page the physician
B. The patient's pulse has dropped from 64 to 58 C. Ensure the recording has been appropriately
beats/minute. documented and continue to monitor them with their
C. The patient has developed wheezes throughout the next BP reading in 4 hours
lung fields. D. Check the chart, obtain any PRN antihypertensives
D. The patient complains that the fingers and toes feel and immediately administer them
quite cold.
6. Which action will the nurse in the hypertension clinic SAS 9
take in order to obtain an accurate baseline blood
pressure (BP) for a new patient? 1 Which of the following heart muscle diseases is
unrelated to other cardiovascular diseases?
A. Obtain a BP reading in each arm and average the
results. A. Cardiomyopathy
B. Deflate the BP cuff at a rate of 5 to 10 mm Hg per B. Coronary artery disease
second. C. Myocardial infarction
C. Have the patient sit in a chair with the feet flat on the D. Pericardial effusion
floor. 2. Which of the following types of cardiomyopathy can
D. Assist the patient to the supine position for BP be associated with childbirth?
measurements.
A. Dilated
7. The nurse obtains this information from a patient B. Hypertrophic
with prehypertension. Which finding is most important C. Myocarditis
to address with the patient? D. Restrictive
A. Low dietary fiber intake 3. Septal involvement occurs in which type of
B. No regular aerobic exercise cardiomyopathy?
C. Weight 5 pounds above ideal weight
D. Drinks wine with dinner once a week A. Congestive
B. Dilated
8. Your patient's blood pressure is 172/98. Is this a C. Hypertrophic
hypertensive emergency? D. Restrictive
A. Yes -it this 4 Which of the following recurring conditions most
B. No - it would be considered Stage 2 Hypertension commonly occurs in clients with cardiomyopathy?
C. No - this is considered pre-hypertension
D. No - it would be considered Stage 1 Hypertension A. Heart failure
B. DM
9. Why is HTN considered a silent killer? C. MI
A. Because symptoms don't usually present until end D. Pericardial effusion
organ damage occurs
B. It is not; myocardial infarctions are considered the
silent killer
5 What is the term used to describe an enlargement of A. Vagus nerve to slow the heart rate
the heart muscle? B. Vagus nerve to increase the heart rate; overdriving
the rhythm
A. Cardiomegaly C. Diaphragmatic nerve to slow the heart rate
B. Cardiomyopathy D. Diaphragmatic nerve to overdrive the rhythm
C. Myocarditis
D. Pericarditis 2. A nurse is watching the cardiac monitor and notices
that the rhythm suddenly changes. There are no P
6. Dyspnea, cough, expectoration, weakness, and waves, the QRS complexes are wide, and the ventricular
edema are classic signs and symptoms of which of the rate is regular but over 100. The nurse determines that
following conditions? the client is experiencing:
A. Pericarditis A. Premature ventricular contractions
B. Hypertension B. Ventricular tachycardia
C. Obliterative C. Ventricular fibrillation
D. Restricted D. Sinus tachycardia
7. Which of the following types of cardiomyopathy does 3. A nurse notices frequent artifact on the ECG monitor
not affect cardiac output? for a client whose leads are connected by cable to a
A. Dilated console at the bedside. The nurse examines the client to
B. Hypertrophic determine the cause. Which of the following items is
C. Restrictive unlikely to be responsible for the artifact?
D. Obliterative
A. Frequent movement of the client
8. Which of the following cardiac conditions does a B. Tightly secured cable connections
fourth heart sound (S4) indicate? C. Leads applied over hairy areas
D. Leads applied to the limbs
A. Dilated aorta
B. Normally functioning heart 4 A nurse is caring for a client with unstable ventricular
C. Decreased myocardial contractility tachycardia. The nurse instructs the client to do which
D. Failure of the ventricle to eject all the blood during of the following, if prescribed, during an episode of
systole ventricular tachycardia?
9. Which of the following classes of drugs is most widely A. Breathe deeply, regularly, and easily
used in the treatment of cardiomyopathy? B. Inhale deeply and cough forcefully every 1 to 3
seconds
A. Antihypertensive C. Lie down flat in bed
B. Beta-adrenergic blockers D. Remove any metal jewelry
C. Calcium channel blockers
D. Nitrates 5 When ventricular fibrillation occurs in a CCU, the first
person reaching the client should:
10. Which of the following blood tests is most indicative
of cardiac damage? A. Administer oxygen
B. Defibrillate the client
A. Lactic dehydrogenase C. Initiate CPR
B. Complete blood count D. Administer sodium bicarbonate intravenously
C. Troponin I
D. Creatine kinase 6. A nurse is watching the cardiac monitor, and a client’s
rhythm suddenly changes. There are no P waves;
SAS 10 instead there are wavy lines. The QRS complexes
measure 0.08 second, but they are irregular, with a rate
1 A client with rapid rate atrial fibrillation asks a nurse of 120 beats a minute. The nurse interprets this rhythm
why the physician is going to perform carotid massage. as:
The nurse responds that this procedure may stimulate
A. Sinus tachycardia
the:
B. Atrial fibrillation
C. Ventricular tachycardia B. He has fresh, active upper GI bleeding
D. Ventricular fibrillation C. He needs transfusion of packed RBC
D. He needs immediate saline gastric lavage
7. A nurse notes that a client with sinus rhythm has a
premature ventricular contraction that falls on the T 3. Which diagnostic tests would be used first to evaluate
wave of the preceding beat. The client’s rhythm a client with upper GI bleeding?
suddenly changes to one with no P waves or definable
QRS complexes. Instead there are coarse wavy lines of A. Upper GI series
varying amplitude. The nurse assesses this rhythm to be B. Arteriography
C. Endoscopy
A. Ventricular tachycardia D. Hemoglobin level and hematocrit
B. Ventricular fibrillation
C. Atrial fibrillation 4. A male client with extreme weakness, pallor, weak
D. Asystole peripheral pulses, and disorientation is admitted to the
emergency department. His wife reports that he has
8. When auscultating the apical pulse of a client who been “spitting up blood.” A Mallory-Weiss tear is
has atrial fibrillation, the nurse would expect to hear a suspected, and the nurse begins taking a client history
rhythm that is characterized by: from the client’s wife. The question by the nurse that
demonstrates her understanding of MalloryWeiss
A. The presence of occasional coupled beats tearing is:
B. Long pauses in otherwise regular rhythm
C. A continuous and totally unpredictable irregularity A. “Tell me about your husband’s alcohol usage”
D. Slow but strong and regular beats B. Has your husband recently fallen or injured his
chest?”
9. A client is having frequent premature ventricular C. “Is your husband being treated with tuberculosis?”
contractions. A nurse would place priority on D. “Describe spices and condiments your husband uses
assessment of which of the following items? on food.”
A. Blood pressure and peripheral perfusion 5. A client is admitted to the hospital after vomiting
B. Sensation of palpitation bright red blood and is diagnosed with a bleeding
C. Causative factor such as caffeine duodenal ulcer. The client develops a sudden, sharp
D. Precipitating factors such as infections pain in the mid epigastric area along with a rigid,
10. A client with a bundle branch block is on a cardiac boardlike abdomen. These clinical manifestations most
monitor. The nurse should expect to observe: likely indicate which of the following?
A. Sagging ST segment A. The esophagus has become inflamed

B. Absence of P wave configurations B. Additional ulcers have developed
C. Inverted T waves following each QRS complex C. An intestinal obstruction has developed
D. Widening of QRS complexes to 0.12 seconds or D. The ulcers have perforated
greater 6. Patient admitted to ER has profuse bright-red
hematemesis. During initial care of the patient, the
SAS 11 nurse's first priority is to:
1. The nurse is caring for a female client with active A. perform a nursing assessment of patient's status
upper GI bleeding. What is the appropriate diet for this B. establish 2 IV sites
client during the first 24 hours after admission? C. obtain a thorough health history
D. perform a gastric lavage with cool tap water in prep
A. Nothing by mouth
for endoscopic exam
B. Regular diet
C. Clear liquids 7. You promote hemodynamic stability in a patient with
D. Skim milk upper GI bleeding by:
2. Kevin has a history of peptic ulcer disease and vomits A. Encouraging oral fluid intake.
coffee-ground emesis. What does this indicate? B. Monitoring central venous pressure
A. His gastric bleeding occurred 2 hours earlier
C. Monitoring laboratory test results and vital signs presence of a fluid thrill and shifting dullness on
D. Giving blood, electrolyte and fluid replacement percussion. After administering diuretic therapy, which
nursing action would be most effective in ensuring safe
8. Your patient has a GI tract that is functioning, but has care?
the inability to swallow foods. Which is the preferred
method of feeding for your patient? A. Measuring serum potassium for hyperkalemia
B. Assessing the client for hypovolemia
A. TPN C. Measuring the client’s weight daily
B. PPN D. Documenting precise intake and output.
C. NG feeding
D. Oral liquid supplement 13. A client with suspected gastric cancer undergoes an
endoscopy of the stomach. Which of the following
9. A 24-year-old man undergoes a laparotomy after a assessments made after the procedure would indicate
gunshot wound to the abdomen. The patient has the development of a potential complication?
multiple injuries including significant liver laceration,
colon injuries, multiple small bowels and an injury to A. The client displays signs of sedation
the intrahepatic vena cava. The patient receives 34 units B. The client demonstrates lack of appetite
of packed red blood cells, 15 liters of crystalloid, 11 C. The client complaints of a sore throat
units of FFP, and 12 pack of platelets. The patient’s D. The client experiences a sudden increase in
abdomen is packed close and he is taken to the temperature.
intensive care unit for further resuscitation. Which of
the following is sequela of abdominal compartment 14. Thrombus formation is a danger for all
syndrome? postoperative clients. The nurse should act
independently to prevent this complication by:
A. Decreased systemic vascular resistance
B. Increased intracranial pressure A. Encouraging adequate fluids
C. Decreased plasma renin and aldosterone B. Performing active -assistive leg exercise
D. Decreased peak airway pressure C. Massaging gently the legs with lotion
D. Applying elastic stocking
10. The patient is at risk for developing intra-abdominal
hypertension (IAH) after surgery to correct abdominal 15. Oxygen 3L/min by nasal cannula is prescribed for
trauma. Inwhich way will the nurse measure the Joey who is admitted to the hospital for chest pain. The
progress of this complication? nurse institutes safety precautions in the room because
oxygen:
A. Monitoring the amount of respiratory distress
exhibited by the patient A. Supports combustion
B. Monitoring the amount of gastrointestinal tube B. Converts to an alternate form of matter
drainage C. Has unstable properties
C. Measurement of abdominal distention D. Is inflammable
D. Monitoring transurethral bladder pressure
11. A patient has severe abdominal compartment SAS 12
syndrome and will undergo surgical decompression. The
nurse will expect to administer which drugs before this 1. A male client with a history of cirrhosis and
surgery to help reduce unstable cardiac dysrhythmias? alcoholism is admitted with severe dyspnea resulted to
Select all that apply ascites. The nurse should be aware that the ascites is
most likely the result of increased.
A. Furosemide
B. Vasopressin A. Pressure in the portal vein
C. Sodium Bicarbonate B. Production of serum albumin
D. Epinephrine C. Secretion of bile salt
E. Mannitol D. Interstitial osmotic pressure
12. A 52-year-old man was referred to the clinic due to 2. Which diagnostic test is best to evaluate liver
increased abdominal girth. He is diagnosed with ascites enlargement and ascites?
by the
A. Ultrasound A. Meats and beans
B. X-ray B. Butter and gravies
C. CT Scan C. Potatoes and pasta
D. Nuclear medicine D. Cakes and pastries
3. Mr. Gonzales was admitted to the hospital with 9. When teaching a client about pancreatic function, the
ascites and jaundice. To rule out cirrhosis of the liver: nurse understands that pancreatic lipase performs
Which laboratory test indicates liver cirrhosis? which function?
A. Decreased red blood cell count A. Transport fatty acids into the brush border
B. Decreased serum acid phosphatase B. Breaks down fat into fatty acids and glycerol
C. Elevated white blood cell count C. Triggers cholecystokinin to contract the gallbladder
D. Elevated serum aminotransferase D. Breaks down protein into dipeptides and amino acid
4. A patient with chronic alcohol abuse is admitted with 10. For Rico who has chronic pancreatitis, which nursing
liver failure. You closely monitor the patient’s blood intervention would be most helpful?
pressure because of which change that is associated
with the liver failure? A. Allowing liberalized fluid intake
B. Counseling to stop alcohol consumption
A. Hypoalbuminemia C. Encouraging daily exercise
B. Increased capillary permeability D. Modifying dietary protein
C. Abnormal peripheral vasodilation
D. Excess renin release of the kidney 11. A clinical manifestation of acute pancreatitis is
epigastric pain. Your nursing intervention to facilitate
5. You’re caring for Lewis, a 67 y.o. patient with liver relief of pain would place the patient in a:
cirrhosis who developed ascites and requires
paracentesis. Relief of which symptom indicated that A. Knee chest position
the paracentesis was effective? B. Semi-Fowler’s position
C. Recumbent position
A. Pruritus D. Low -Fowlers position
B. Dyspnea
C. Jaundice 12. What assessment finding of a patient with acute
D. Peripheral neuropathy pancreatitis would indicate a bluish discoloration
around the umbilicus?
6. You’re caring for Betty with liver cirrhosis. Which of
the following assessment findings leads you to suspect A. Grey-Turner’s sign
B. Homan’s sign
hepatic encephalopathy in her?
C. Rovsing’s sign
A. Asterixis D. Cullen’s sign
B. Chvostek sign
C. Trousseau’s sign 13. Pancreatitis is commonly characterized by:
D. Hepatojugular reflex A. Edema and inflammation
7. Develop a teaching care plan for Angie who is about B. Pleural effusion
to undergo a liver biopsy. Which of the following points C. Sepsis
do you include? D. Disseminated intravascular coagulation
A. “You’ll need to lie on your stomach during the test” 14. A major symptom of pancreatitis that brings the
B. “you’ll need to lie on your right side after the test.” patient to medical care is:
C. “During the biopsy you’ll be asked to exhale deeply A. Severe abdominal pain
and hold it.” B. Fever
D. “The biopsy is performed under general anesthesia.” C. Jaundice
8. The student nurse is teaching the family of a patient D. Mental agitation
with liver failure. You instruct them to limit which foods
in the patient’s diet?
15. The nurse should assess for an important early D. Apply an electrocardiogram monitor.
indicator of acute pancreatitis, which is a prolonged and
6. During the admission of a client with diabetic
elevated level of:
ketoacidosis, Nurse Kendra will anticipate the physician
A. Serum calcium ordering which of the following types of intravenous
B. Serum lipase solution if the client cannot take fluids orally?
C. Serum bilirubin
D. Serum amylase A. Lactated Ringer’s solution
B. 0.9 normal saline solution
C. 5% dextrose in water (D5W)
SAS 13 D. 0.45% normal saline solution
1. A client is in DKA, secondary to infection. As the 7. Which adaptations should the nurse caring for a
condition progresses, which of the following symptoms client with diabetic ketoacidosis expect the client to
might the nurse see? exhibit? Select all that apply:
A. Kussmaul’s respirations and a fruity odor on the A. Sweating

breath B. Low PCO2
B. Shallow respirations and severe abdominal pain C. Retinopathy
C. Decreased respirations and increased urine output. D. Acetone breath
D. Cheyne-stokes respirations and foul-smelling urine E. Elevated serum bicarbonate
2. When a client is in diabetic ketoacidosis, the insulin 8. Which of the following chronic complications is
that would be administered is: associated with diabetes?
A. Human NPH insulin A. Dizziness, dyspnea on exertion, and coronary artery

B. Human regular insulin disease.
C. Insulin lispro injection B. Retinopathy, neuropathy, and coronary artery
D. Insulin glargine injection disease
C. Leg ulcers, cerebral ischemic events, and pulmonary
3. A client with a diagnosis of diabetic ketoacidosis infarcts
(DKA) is being treated in the ER. Which finding would a D. Fatigue, nausea, vomiting, muscle weakness, and
nurse expect to note as confirming this diagnosis? cardiac arrhythmia’s
A. Elevated blood glucose level and a low plasma 9. Which of the following if stated by the nurse is
bicarbonate correct about Hyperglycemic Hyperosmolar Nonketotic
B. Decreased urine output Syndrome (HHNS)?
C. Increased respirations and an increase in Ph
D. Comatose state A. This syndrome occurs mainly in people with Type I
Diabetes
4. Which of the following methods of insulin B. It has a higher mortality rate than Diabetic
administration would be used in the initial treatment of Ketoacidosis
hyperglycemia in a client with diabetic ketoacidosis? C. The client with HHNS is in a state of over hydration
D. This condition develops very rapidly
A. Subcutaneous
B. Intramuscular 10. Blood sugar is well controlled when Hemoglobin
C. IV bolus only A1C is:
D. IV bolus, followed by continuous infusion.
A. Below 5.7%
5. A nurse is caring for a client admitted to the ER with B. Between 12%-15%
DKA. In the acute phase the priority nursing action is to C. Less than 180 mg/dL
prepare to: D. Between 90 and 130 mg/dL
A. Administer regular insulin intravenously 11. The client’s blood gases reflect diabetic acidosis. The
B. Administer 5% dextrose intravenously nurse should expect:
C. Correct the acidosis
A. Increased pH
B. Decreased PO2
C. Increased PCO2 2. The most common early sign of kidney disease is:
D. Decreased HCO3
A. Sodium retention
12. Dr. Hugo has prescribed sulfonylureas for Rebecca in B. Elevated BUN level
the management of diabetes mellitus type 2. As a nurse, C. Development of metabolic acidosis
you know that the primary purpose of sulfonylureas, D. Inability to dilute or concentrate urine
such as long-acting glyburide (Micronase), is to:
3. Your patient is complaining of muscle cramps while
A. Induce hypoglycemia by decreasing insulin sensitivity. undergoing hemodialysis. Which intervention is
B. Improve insulin sensitivity and decrease effective in relieving muscle cramps?
hyperglycemia.
C. Stimulate the beta cells of the pancreas to secrete A. Increase the rate of dialysis
insulin. B. Infuse normal saline solution
D. Decrease insulin sensitivity by enhancing glucose C. Administer a 5% dextrose solution
uptake. D. Encourage active ROM exercises
13. When a client is first admitted with hyperglycemic 4. Polystyrene sulfonate (Kayexalate) is used in renal
hyperosmolar nonketotic syndrome (HHNS), the nurse’s failure to:
priority is to provide: A. Correct acidosis
A. Oxygen B. Reduce serum phosphate levels
B. Carbohydrates C. Exchange potassium for sodium
D. Prevent constipation from sorbitol use
C. Fluid replacement
D. Dietary instruction 5. What change indicates recovery in a patient with
14. A nurse performs a physical assessment on a client nephrotic syndrome?
with type 2 DM. Findings include a fasting blood glucose A. Disappearance of protein from the urine
of 120mg/dl, temperature of 101, pulse of 88, B. Decrease in blood pressure to normal
respirations of 22, and a bp of 140/84. Which finding C. Increase in serum lipid levels
would be of most concern of the nurse? D. Gain in body weight
A. Pulse 6. Which sign indicated the second phase of acute renal
B. BP failure?
C. Respiration
D. Temperature A. Daily doubling of urine output (4 to 5 L/day)
B. Urine output less than 400 ml/day
15. The principal goals of therapy for older patients who C. Urine output less than 100 ml/day
have poor glycemic control are: D. Stabilization of renal function
A. Enhancing quality of life. 7. Which cause of hypertension is the most common in
B. Decreasing the chance of complications. acute renal failure?
C. Improving self-care through education.
D. All of the above. A. Pulmonary edema
B. Hypervolemia
C. Hypovolemia
SAS 14
D. Anemia
1. Which sign indicated the second phase of acute renal
8. You have a patient that is receiving peritoneal
failure?
dialysis. What should you do when you notice the
A. Daily doubling of urine output (4 to 5 L/day) return fluid is slowly draining?
B. Urine output less than 400 ml/day
A. Check for kinks in the outflow tubing
C. Urine output less than 100 ml/day
B. Raise the drainage bag above the level of the
D. Stabilization of renal function
abdomen
C. Place the patient in a reverse Trendelenburg position
D. Ask the patient to cough 5. Decreased levels of erythropoietin, a substance
normally secreted by the kidneys, leads to which serious
9. Dietary intervention for renal deterioration includes
complication of chronic renal failure?
limiting the intake of:
A. Anemia.
A. Fluid B. Acidosis.
B. Protein C. Hyperkalemia.
C. Sodium and potassium D. Pericarditis.
D. All of the above
6. In chronic renal faiure (end-stage renal disease),
10. Significant nursing assessment data relevant to renal decreased glomerular filtration leads to:
function should include information about:
A. Increased pH.
A. Any voiding disorders. B. Decreased creatinine clearance.
B. The patient’s occupation. C. Increased BUN.
C. The presence of hypertension or diabetes.
D. All of the above.
D. All of the above
7. What is the most important nursing diagnosis for a
patient in end-stage renal disease?
SAS 15 A. Risk for injury

B. Fluid volume excess
1. In chronic renal failure (end-stage renal disease), C. Altered nutrition: less than body requirements
decreased glomerular filtration leads to: D. Activity intolerance
A. Increased pH. 8. Frequent PVCs are noted on the cardiac monitor of a
B. Decreased creatinine clearance. patient with end-stage renal disease. The priority
C. Increased BUN. intervention is:
D. All of the above.
A. Call the doctor immediately
2. A patient with diabetes has had many renal calculi B. Give the patient IV lidocaine (Xylocaine)
over the past 20 years and now has chronic renal C. Prepare to defibrillate the patient
failure. Which substance must be reduced in this D. Check the patient’s latest potassium level
patient’s diet?
9. What is the most important nursing diagnosis for a
A. Carbohydrates patient in end-stage renal disease?
B. Fats
C. Protein A. Risk for injury
D. Vitamin C B. Fluid volume excess
C. Altered nutrition: less than body requirements
3. Your patient with chronic renal failure reports D. Activity intolerance
pruritus. Which instruction should you include in this
patient’s teaching plan? 10. What is the appropriate infusion time for the
dialysate in your 38 y.o. patient with chronic renal
A. Rub the skin vigorously with a towel failure?
B. Take frequent baths
C. Apply alcohol-based emollients to the skin A. 15 minutes
D. Keep fingernails short and clean B. 30 minutes
C. 1 hour
4. A major sensitive indicator of kidney disease is: D. 2 to 3 hours
A. BUN level.
B. Creatinine clearance level. SAS 16
C. Serum potassium level.
1. A client arrives in the emergency department with an
D. Uric acid level.
ischemic stroke and receives tissue plasminogen
activator (t-PA) administration. Which is the priority
nursing assessment?
A. Complete physical and history. C. Discuss the precipitating factors that caused the
B. Upcoming surgical procedures. symptoms.
C. Time of onset of current stroke. D. Schedule for A STAT computer tomography (CT) scan
D. Current medications. of the head.
2. During the first 24 hours after thrombolytic therapy 8. What is a priority nursing assessment in the first 24
for ischemic stroke, the primary goal is to control the hours after admission of the client with a thrombotic
client’s: stroke?
A. Respirations A. Echocardiogram
B. Temperature B. Cholesterol level
C. Pulse C. Pupil size and papillary response
D. Blood pressure D. Vowel sounds
3. The most common cause of cerebrovascular accident 9. Which action should take the highest priority when
is: caring for a client with hemiparesis caused by a
cerebrovascular accident (CVA)?
A. Arteriosclerosis
B. Embolism A. Apply antiembolism stockings
C. Hypertensive changes B. Place the client on the affected side.
D. Vasospasm C. Use hand rolls or pillows for support.
D. Perform passive range-of-motion (ROM) exercises.
4. The degree of neurologic damage that occurs with an
ischemic stroke depends on the: 10. A 70 yr-old client with a diagnosis of leftsided
cerebrovascular accident is admitted to the facility. To
A. Location of the lesion. prevent the development of diffuse osteoporosis, which
B. Size of the area of inadequate perfusion of the following objectives is most appropriate?
C. Amount of collateral blood flow.
D. Combination of the above factors. A. Maintaining vitamin levels.
B. Promoting weight-bearing exercises
5. The majority of strokes have what type of origin? C. Promoting range-of-motion (ROM) exercises
A. Cardiogenic emboli. D. Maintaining protein levels
B. Cryptogenic.
C. Large artery thrombotic.
D. Small artery thrombotic. SAS 17
6. Mr. Mendoza who has suffered a cerebrovascular
accident (CVA) is too weak to move on his own. To help
the client avoid pressure ulcers, Nurse Celia should: 1. A patient with a spinal cord injury (SCI) complains
about a severe throbbing headache that suddenly
A. Reduce the client's fluid intake.
started a short time ago. Assessment of the patient
B. Encourage the client to use a footboard.
reveals increased blood pressure (168/94) and
C. Perform passive range-of-motion (ROM) exercises.
decreased heart rate (48/minute), diaphoresis, and
D. Turn him frequently.
flushing of the face and neck. What action should you
7. A 78-year old client is admitted to the emergency take first?
department with numbness and weakness of the left
A. Administer the ordered acetaminophen (Tylenol).
arm and slurred speech. Which nursing intervention is
B. Check the Foley tubing for kinks or obstruction.
priority?
C. Adjust the temperature in the patient’s room.
A. Notify the speech pathologist for an emergency D. Notify the physician about the change in status.
consult.
2. A patient with a spinal cord injury at level C3-4 is
B. Prepare to administer recombinant tissue
being cared for in the ED. What is the priority
plasminogen activator (rt-PA).
assessment?
A. Determine the level at which the patient has intact B. By inserting a nasopharyngeal airway
sensation. C. By inserting a oropharyngeal airway
B. Assess the level at which the patient has retained D. By performing the head-tilt, chin-lift maneuver
mobility.
C. Check blood pressure and pulse for signs of spinal 8. The nurse is planning care for the client in spinal
shock. shock. Which of the following actions would be least
D. Monitor respiratory effort and oxygen saturation helpful in minimizing the effects of
level. A. Using vasopressor medications as prescribed
3. You are pulled from the ED to the neurologic floor. B. Applying Teds or compression stockings.
Which action should you delegate to the nursing C. Moving the client quickly as one unit
assistant when providing nursing care for a patient with D. Monitoring vital signs before and during position
SCI? changes
A. Assess patient’s respiratory status every 4 hours. 9. The nurse is caring for a client admitted with spinal
B. Take patient’s vital signs and record every 4 hours. cord injury. The nurse minimizes the risk of
C. Monitor nutritional status including calorie counts. compounding the injury most effectively by:
D. Have patient turn, cough, and deep breathe every 3 A. Logrolling the client on a soft mattress
hours. B. Keeping the client on a stretcher
4. You are helping the patient with an SCI to establish a C. Logrolling the client on a firm mattress
bladder-retraining program. What strategies may D. Placing the client on a Stryker frame
stimulate the patient to void? (Choose all that apply). 10. After falling 20’, a 36-year-old man sustains a C6
A. Stroke the patient’s inner thigh. fracture with spinal cord transaction. Which other
B. Pull on the patient’s pubic hair. findings should the nurse expect?
C. Initiate intermittent straight catheterization. A. Quadriplegia and loss of respiratory function
D. Pour warm water over the perineum. B. Loss of bowel and bladder control
E. Tap the bladder to stimulate detrusor muscle. C. Paraplegia with intercostal muscle loss
5. You are preparing a nursing care plan for the patient D. Quadriplegia with gross arm movement and
with SCI including the nursing diagnosis Impaired diaphragmic breathing
Physical Mobility and Self-Care Deficit. The patient tells
you, ―I don’t know why we’re doing all this. My life’s
over.‖ What additional nursing diagnosis takes priority
SAS 18
based on this statement?
A. Risk for Injury related to altered mobility
B. Imbalanced Nutrition, Less Than Body Requirements 1. A patient who is in hypovolemic shock has the
C. Impaired Adjustment to Spinal Cord Injury following clinical signs: Heart rate 120 beats/minute,
D. Poor Body Image related to immobilization blood pressure 80/55 mmHg and urine output 20ml/hr.
6. A client with a C6 spinal injury would most likely have After administering an IV fluid bolus, which of these
which of the following symptoms? signs if noted by the healthcare provider is the best
indication of improved perfusion?
A. Aphasia
B. Hemiparesis A. Heart rate drops to 100 beats/minute.
C. Paraplegia B. Right atrial pressure increases.
D. Tetraplegia C. Urine output increases to 30mL/hour.
D. Systolic blood pressure increases to 85 mmHg.
7. A 20-year-old client who fell approximately 30’ is
unresponsive and breathless. A cervical spine injury is 2. An anxious female client complains of chest tightness,
suspected. How should the first-responder open the tingling sensations, and palpitations. Deep, rapid
client’s airway for rescue breathing? breathing, and
A. By performing a jaw-thrust maneuver

carpal spasms are noted. Which of the following priority Which of the following observations by the nurse
action should the nurse do first? indicates that neurogenic shock persists?
A. Provide oxygen therapy. A. Positive reflexes.
B. Notify the physician immediately. B. Hyperreflexia.
C. Administer anxiolytic medication as ordered. C. Inability to elicit a Babinski’s reflex.
D. Have the client breathe into a brown paper bag. D. Reflex emptying of the bladder.
3. Nurse Kelly, a triage nurse encountered a client who 8. The nurse is planning care for the client in neurogenic
complaints of mid-sternal chest pain, dizziness, and shock. Which of the following actions would be least
diaphoresis. Which of the following nursing action helpful in minimizing the effects of vasodilation below
should take priority? the level of the injury?
A. Complete history taking. A. Monitoring vital signs before and during position
B. Put the client on ECG monitoring. changes
C. Notify the physician. B. Using vasopressor medications as prescribed
D. Administer oxygen therapy via nasal cannula. C. Moving the client quickly as one unit
D. Applying Teds or compression stockings.
4. A 65-year-old patient arrived at the triage area with
complaints of diaphoresis, dizziness, and left-sided 9. A client with a T1 spinal cord injury arrives at the
chest pain. This patient should be prioritized into which emergency department with a BP of 82/40, pulse 34,
category? dry skin, and flaccid paralysis of the lower extremities.
Which of the following conditions would most likely be
A. Non-urgent.
suspected?
B. Urgent.
C. Emergent. A. Autonomic dysreflexia.
D. High urgent. B. Hypervolemia.
C. Neurogenic shock.
5. A client arrived at the emergency department after D. Sepsis.
suffering multiple physical injuries including a fractured
pelvis from avehicular accident. Upon assessment, the 10. A client comes into the ER after hitting his head in
client is incoherent, pale, and diaphoretic. With vital an MVA. He’s alert and oriented. Which of the following
signs as follows: temperature of 97°F (36.11° C), blood nursing interventions should be done first?
pressure of 60/40 mm Hg, heart rate of 143
beats/minute, and a respiratory rate of 30 A. Assess full ROM to determine extent of injuries
breaths/minute. The client is mostly suffering from B. Immobilize the client’s head and neck
which of the following shock? C. Call for an immediate chest x-ray
D. Open the airway with the head-tilt chin-lift maneuver
A. Cardiogenic.
B. Distributive. 11. Emergency treatment for a client with impending
C. Hypovolemic. anaphylaxis secondary to hypersensitivity to a drug
D. Obstructive. should include which of the following actions first?
6. A patient with a spinal cord injury is recovering from A. Administering oxygen

B. Inserting an I.V. catheter
neurogenic shock. The nurse realizes that the patient
should not develop a full bladder because what C. Obtaining a complete blood count (CBC)
emergency condition can occur if it is not corrected D. Taking vital signs
quickly? 12. Anaphylactic shock is associated with which type of
A. Autonomic dysreflexia. hypersensitivity?
B. Autonomic crisis. A. Type I hypersensitivity.
C. Autonomic shutdown. B. Type II hypersensitivity.
D. Autonomic failure. C. Type III hypersensitivity.
7. The nurse is evaluating neurological signs of the male D. Type IV hypersensitivity.
client in neurogenic shock following spinal cord injury.
13. Following the initial care of a client with asthma and B. Changes in mental status.
impending anaphylaxis from hypersensitivity to a drug, C. Vital sign stability.
the nurse should take which of the following steps next? D. All of the above.
A. Administer beta-adrenergic blockers. 4. Physiologic responses to all types of shock include the
B. Administer bronchodilators. following except:
C. Obtain serum electrolyte levels.
D. Have the client lie flat in the bed. A. Activation of the inflammatory system.
B. Activation of the coagulation system.
14. Nurse Ejay is assigned to a telephone triage. A client C. Hypoperfusion of tissues.
called who was stung by a honeybee and is asking for D. Vasoconstriction.
help. The client reports of pain and localized swelling
but has no respiratory distress or other symptoms of 5. What age group is the most susceptible to sepsis?
anaphylactic shock. What is the appropriate initial A. Infants.
action that the nurse should direct the client to B. Adolescents.
perform? C. Elderly.
A. Removing the stinger by scraping it. D. Young adults.
B. Applying a cold compress. 6. Following emergency endotracheal intubation, you
C. Taking an oral antihistamine. must verify tube placement and secure the tube. List in
D. Calling the 911. order the steps that are required to perform this
15. An anxious 24-year-old college student complains of function?
tingling sensations, palpitations, and chest tightness. I. Obtain an order for a chest x-ray to document tube
Deep, rapid breathing and carpal spasms are noted. placement.
What priority nursing action should you take? II. Secure the tube in place.
A. Have the student breathe into a paper bag. III. Auscultate the chest during assisted ventilation.
B. Notify the physician immediately. IV. Confirm that the breath sounds are equal and
C. Obtain an order for an anxiolytic medication. bilateral.
D. Administer supplemental oxygen A. IV, I, III, II
B. III, IV, II, I
SAS 19 C. III, II, IV, I
D. IV, III, I, II
7. The emergency medical service (EMS) has
1.The main goal of treating septic shock is: transported a patient with severe chest pain. As the
A. Preserving the myocardium. patient is being transferred to the emergency stretcher,
B. Restoring adequate fluid status. you note unresponsiveness, cessation of breathing, and
C. Identification and elimination of the cause of no palpable pulse. Which task is appropriate to delegate
infection. to the nursing assistant?
D. Identification and elimination of the cause of allergy. A. Placing the defibrillator pads
2. Medical management of septic shock includes all of B. Chest compressions
the following except: C. Bag-valve mask ventilation
D. Assisting with oral intubation
A. Administration of colloids.
B. Administration of Drotrecogin alfa. 8. Which client factors should alert the nurse to
C. Aggressive fluid resuscitation. potential increased complications with a burn injury?
D. Aggressive nutritional supplementation.
A. The client is a 26-year-old male.
3. Patients receiving fluid replacement therapy should B. The client has had a burn injury in the past.
be frequently monitored for: C. The burned areas include the hands and perineum.
D. The burn took place in an open field and ignited the
A. Adequate urinary output.
client’s clothing.
9. The burned client’s family ask at what point the client of breath sounds in the right upper lobe of the lung. The
will no longer be at increased risk for infection. What is nurse immediately assesses for other signs of which
the nurse’s best response? condition?
A. “When fluid remobilization has started.” A. Right pneumothorax
B. “When the burn wounds are closed.” B. Pulmonary embolism
C. “When IV fluids are discontinued.” C. Displaced endotracheal tube
D. “When body weight is normal.” D. Acute respiratory distress syndrome
10. In reviewing the burned client’s laboratory report of 4. The nurse is assessing a client with multiple trauma
white blood cell count with differential, all the following who is at risk for developing acute respiratory distress
results are listed. Which laboratory finding indicates the syndrome. The nurse should assess for which earliest
possibility of sepsis? sign of acute respiratory distress syndrome?
The total white blood cell count is 9000/mm3. A. Bilateral wheezing
The lymphocytes outnumber the basophils. B. Inspiratory crackles
The “bands” outnumber the “segs.” C. Intercostal retractions
The monocyte count is 1,800/mm3. D. Increased respiratory rate
5. A client with myocardial infarction is developing
cardiogenic shock. Because of the risk of myocardial
SAS 20 ischemia, what condition should the nurse carefully
assess the client for?
A. Bradycardia
1. The nurse assesses the client who has chronic renal
B. Ventricular dysrhythmias
failure and notes the following: crackles in the lung
C. Rising diastolic blood pressure
bases, elevated blood pressure, and weight gain of 2
D. Falling central venous pressure
pounds in one day. Based on these data, which of the
following nursing diagnoses is appropriate? 6. What is the priority nursing diagnosis with your
patient diagnosed with end-stage renal disease?
A. Excess fluid volume related to the kidney’s inability to
maintain fluid balance. A. Activity intolerance
B. Ineffective tissue perfusion related to interrupted B. Fluid volume excess
arterial blood flow. C. Knowledge deficit
C. Ineffective therapeutic Regimen Management related D. Pain
to lack of knowledge about therapy.
D. Increased cardiac output related to fluid overload. 7. Frequent PVCs are noted on the cardiac monitor of a
patient with end-stage renal disease. The priority
2. Crackles in the lungs, weight gain, and elevated blood intervention is:
pressure are indicators of excess fluid volume, a
common complication in chronic renal failure. The A. Call the doctor immediately
client’s fluid status should be monitored carefully for B. Give the patient IV lidocaine (Xylocaine)
imbalances on an ongoing basis. C. Prepare to defibrillate the patient
D. Check the patient’s latest potassium level
A. Accumulation of waste products
B. Oliguria 8. A patient with diabetes mellitus and renal failure
C. Gastric ulcers begins hemodialysis. Which diet is best on days
D. Electrolyte imbalances between dialysis treatments?
3. A client has been admitted with chest trauma after a A. Low-protein diet with unlimited amounts of water
motor vehicle crash and has undergone subsequent B. Low-protein diet with a prescribed amount of water
intubation. The nurse checks the client when the high- C. No protein in the diet and use of a salt substitute
pressure alarm on the ventilator sounds, and notes that D. No restrictions
the client has absence 9. After the first hemodialysis treatment, your patient
develops a headache, hypertension, restlessness,
mental confusion, nausea, and vomiting. Which (40.6º C to 46.1° C).
condition is indicated? 2. Remove the victim from the cold environment.
3. Monitor for signs of compartment syndrome.
A. Disequilibrium syndrome 4. Apply a loose, sterile, bulky dressing.
B. Respiratory distress 5. Administer a pain medication.
C. Hypervolemia
D. Peritonitis A. 5, 2, 1, 3, 4
B. 2, 5, 1, 4, 3
10. Your 60 y.o. patient with pyelonephritis and possible C. 2, 1, 5, 3, 4
septicemia has had five UTIs over the past two years. D. 3, 2, 1, 4, 5
She is fatigued from lack of sleep, has lost weight, and
urinates frequently even in the night. Her labs show: 3. You are caring for a patient who was brought into the
sodium, 154 mEq/L; osmolarity 340 mOsm/L; glucose, emergency department unresponsive, hypotensive and
127 mg/dl; and potassium, 3.9 mEq/L. Which nursing tachypneic. Upon further assessment, you realize that
diagnosis is priority? the patient’s temperature is 106 degrees Fahrenheit.
You suspect heat stroke. What would your priority
A. Fluid volume deficit related to osmotic diuresis nursing intervention be?
induced by hyponatremia
B. Fluid volume deficit related to inability to conserve A. Obtain a history from the patient.
water B. Take oral temperature to monitor effectiveness of
C. Altered nutrition: Less than body requirements treatment.
related to hypermetabolic state C. Call the family for consent to treat.
D. Altered nutrition: Less than body requirements D. Take off the patient’s clothing, wrap him or her in
related to catabolic effects of insulin deficiency wet towels and place a fan on the patient.
4. An elementary school nurse is teaching children how
to prevent injuries from cold exposure in the winter.
SAS 21 Which student statement demonstrates that the
teaching has been effective?
A. "Dressing in layers is important."
1. The following clients are presented with signs and
B. "I will drink lots of water when I exercise."
symptoms of heat-related illness. Which of them needs
C. "Taking frequent breaks will help me rest."
to be attended first?
D. "Wearing three pairs of cotton socks is very
A. A relatively healthy homemaker who reports that the important.''
air conditioner has been broken for days and who
5. Which client is at greatest risk for heat exhaustion?
manifest fatigue, hypotension, tachypnea, and profuse
sweating. A. 24-year-old construction worker
B. An elderly person who complains of dizziness and B. 34-year-old policeman
syncope after standing in the sun for several hours to C. 42-year-old swimming instructor
view a parade. D. 78-year-old gardener
C. A homeless person who is a poor historian; has
altered mental status, poor muscle coordination, and 6. A 16-year-old high school athlete recently suffered
hot, dry ashen skin; and whose duration of heat heat exhaustion. The school nurse is instructing the
exposure is unknown. student on how to prevent a recurrence of this
D. A marathon runner who complains of severe leg situation. Which student statement demonstrates that
cramps and nausea, and manifests weakness, pallor, the teaching is effective?
diaphoresis, and tachycardia. A. "I should try to exercise between noon and 3 PM."
2. You are caring for a client with a frostbite on the feet. B. "I will limit my fluids to drinking 'sports' drinks after I
Place the following interventions in the correct order. exercise."
C. "Taking frequent rests is important when working in a
hot environment."
1. Immerse the feet in warm water 100° F to 105° F
D. "Wearing dark-colored clothing to deflect the sun A. Risk for Impaired Mobility related to potential tendon
away from me will help me stay cooler." damage.
B. Risk for Infection related to organisms specific to cat
7. On a hot summer day, an older adult is found by a bites.
neighbor lying on the apartment floor, agitated and C. Ineffective Health Maintenance related to
confused. After calling 911, the neighbor places ice bags immunization status.
to the client's groin area and armpits. Upon arrival at D. Impaired Skin Integrity related to puncture wounds.
the hospital, which action does the emergency
department (ED) nurse perform first? 2. You are assigned to telephone triage. A patient who
was stung by a common honey bee calls for advice,
A. Administers 2 acetylsalicylic acid tablets (aspirin) reports pain and localized swelling, but denies any
orally respiratory distress or other systemic signs of
B. Checks the client's airway, continuing oxygen by mask anaphylaxis. What is the action that you should direct
C. Monitors the client's vital signs the caller to perform?
D. Places a cooling blanket on the client
A. Remove the stinger by scraping.
8. While at a soccer match, a player drops to the ground B. Take an oral antihistamine
with heat exhaustion and a diminished level of
C. Call 911.
consciousness (LOC). What does the team nurse do D. Apply a cool compress.
first?
3. A client calls the office of his primary care health care
A. Gives salt tablets provider and tells the nurse that he was just stung by a
B. Moves the player to the shade bumblebee while gardening. The client is afraid of a
C. Places ice packs under the arms severe reaction, because the client's neighbor
D. Provides a cool electrolyte fluid drink experienced such a reaction just 1 week ago. The
9. Which of the following nursing interventions is appropriate nursing action is to:experienced such a
appropriate for a client who is suffering from a fever? reaction just 1 week ago. The appropriate nursing action
is to:
A. Avoid giving the client food
B. Increase the client's fluid volume A. Advise the client to soak the site in hydrogen
C. Provide oxygen peroxide.
D. All of the above B. Ask the client if he ever sustained a bee sting in the
E. Both B and C past.
C. Tell the client to call an ambulance for transport to
10. A client has started sweating profusely due to the emergency room.
intense heat. His overall fluid volume is low and he has D. Tell the client not to worry about the sting unless
developed electrolyte imbalance. This client is most difficulty with breathing occurs
likely suffering from:
4. The camp nurse prepares to instruct a group of
A. Malignant hyperthermia children about Lyme disease. Which of the following
B. Heat exhaustion information would The nurse include in the
C. Heat stroke instructions?
D. Heat cramps
A. Lyme disease is caused by a tick carried by deer.
SAS 22 B. Lyme disease is caused by contamination from cat
feces.
C. Lyme disease can be contagious by skin contact with
an infected individual.
1. You are assessing a patient who has sustained a cat D. Lyme disease can be caused by the inhalation of
bite to the left hand. The cat is up-to-date spores from bird droppings.
immunizations. The date of the patient’s last tetanus
shot is unknown. Which of the following is the priority
nursing diagnosis?
5. The client is diagnosed with stage I of Lyme disease. working in his yard. Although initially alert and oriented,
The nurse assesses the client for which characteristic of he begins to develop wheezing and an itchy throat. He
this stage? complains of nausea and severe anxiety. The ED nurse
should prepare to administer all of the following for
A. Arthralgias initial treatment EXCEPT:
B. Flu-like symptoms
C. Enlarged and inflamed joints A. Adrenaline
D. Signs of neurological disorders B. Antibiotic
C. Oxygen
6. A camp nurse is providing snakebite prevention tips. D. Antihistamines
Which statement by a client camper indicates a need for
additional education?
SAS 23
a. "A dead snake is a safe snake."
b. "Snakes are most active on warm nights."
c. "Snakes should be transported in sealed glass 1. Nurse Kelly is teaching the parents of a young child
containers." how to handle poisoning. If the child ingests poison,
d. "Venomous snakes are not good pets." what should the parents do first?
7. A 12-year-old client comes to the emergency A. Call an ambulance immediately.

department (ED) after being bitten by a scorpion at a B. Call the poison control center.
local petting zoo. Which action does the nurse perform C. Punish the child for being bad.
first? D. Administer ipecac syrup.
A. Administers a tetanus shot 2. A client arrives in the emergency unit and reports
B. Applies an ice pack to the sting site that a concentrated household cleaner was splashed in
C. Assesses the client's vital signs both eyes. Which of the following nursing actions is a
D. Calls the poison control center priority?
8. A nurse is teaching a class of park rangers-in-training A. Use Restasis (Allergan) drops in the eye.
about prioritizing care for clients who have received B. Flush the eye repeatedly using sterile normal saline.
snakebites. Which ranger's statement demonstrates a C. Examine the client's visual acuity.
need for further clarification? D. Patch the eye.
A. ''Do not allow the client to ingest any alcohol or 3. In relation to submersion injuries, which task is most
caffeine.'' appropriate to delegate to an LPN/LVN?
B. ''The extremity should be kept below the level of the A. Monitor an asymptomatic near-drowning victim.
heart.'' B. Remove wet clothing and cover the victim with a
C. ''The first priority is to move the client to a safe area warm blanket.
away from the snake.'' C. Talk to a community group about water safety issues.
D. ''You should first place a tourniquet above the bite.'' D. Stabilize the cervical spine for an unconscious
9. While on the playground, a school child is stung by a drowning victim.
bee, resulting in redness and swelling. The school nurse 4. The nurse employed in an emergency department is
is nearby when it happens. What does the nurse do assigned to triage clients coming to the emergency
first? department for treatment on the evening shift. The
A. Applies an ice pack to the stinger nurse should assign priority to which client?
B. Gently scrapes out the stinger with a credit card A. A client complaining of muscle aches, a headache,
C. Injects the child with an epinephrine pen (Epi-Pen and history of seizures
auto-injector) B. A client who twisted her ankle when rollerblading
D. Removes the bee and saves it for evidence of the and is requesting medication for pain
sting C. A client with a minor laceration on the index finger
10. A young man is brought to the Emergency sustained while cutting an eggplant
Department after receiving multiple fire ant bites while
D. A client with chest pain who states that he just ate
pizza that was made with a very spicy sauce
5. Which of these toxic substances is more likely to
cause sickness in infants and elderly adults?
A. Lead
B. Carbon monoxide
C. Bee venom
D. Bleach
E. Turpentine
6. How can you reduce the risk that a child will be
accidentally poisoned by medicine?
A. Never say that medicine is “candy”
B. Keep medicines in their original containers and in
locked cabinets
C. Make sure you put medicines away after using them
D. All of the above
7. How can you reduce your risk for accidental
poisoning with medicine?
A. Always turn on the light when taking medicine
B. Clean out your medicine cabinet regularly
C. Carefully read the labels on your medicine
D. All of the above
8. If your child eats or drinks a toxic substance, what
should you do?
A. Call the poison control center right away
B. Try to get your child to throw up (vomit)
C. Call your child's healthcare provider
D. None of the above
9. What information should you have ready when you

call a poison control center?
A. Time the poisoning occurred
B. Age of your child
C. Name of the product taken
D. All of the above
10. How can you help prevent accidental poisoning by
household products?
A. Never mix household chemical products together
B. Open a window or turn on a fan when using a
chemical product
C. Never sniff containers to find out what's inside
D. All of the above

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NUR 200 SAS COMPILATION

A. Travelling emboli 6. The pressure required in the pleural space to keep

2. The nurse is caring for a client with a right-sided chest

9. Which of the following statement about pulmonary A. Trauma

A. Sagging ST segment A. The esophagus has become inflamed

A. Kussmaul’s respirations and a fruity odor on the A. Sweating

A. Human NPH insulin A. Dizziness, dyspnea on exertion, and coronary artery

SAS 15 A. Risk for injury

A. By performing a jaw-thrust maneuver

6. A patient with a spinal cord injury is recovering from A. Administering oxygen

7. A 12-year-old client comes to the emergency A. Call an ambulance immediately.

9. What information should you have ready when you

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