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Test Bank 2
2. The client with cellulitis of the lower leg has had cultures done on the affected area. The
nurse reviewing the results of the culture report interprets that which of the following
organisms is not part of the normal flora of the skin?
1. Escherichia coli
2. Candida albicans
3. Staphylococcus aureus
4. Staphylococcus epidermidis
ANS: 1
Rationale: E. coli is normally found in the intestines and is a common source of

infection of wounds and the urinary system. C. albicans, S. aureus, and S. epidermis are
part of the normal flora of the skin.
Test-Taking Strategy: To answer this question correctly, you must be familiar with the
normal microorganisms that inhabit the skin. Note that the question asks for the
organism that is not part of normal flora. Remember that E. coli is normally found in the
intestines. Review basic skin structures if you had difficulty with this question.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: Ignatavicius, D., & Workman, M. (2010). Medical-surgical nursing: patient-
centered collaborative care (6th ed.). St. Louis: Saunders.
OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Adult Health/Integumentary
MSC: Integrated Process: Nursing Process—Assessment
3. The client complains of chronic pruritus. Which of the following diagnoses would the
nurse expect to support this client’s complaint?
1. Anemia
2. Renal failure
3. Hypothyroidism
4. Diabetes mellitus
ANS: 2
Rationale: Clients with renal failure often have pruritus, or itchy skin. This is because of
impaired clearance of waste products by the kidneys. The client who is markedly anemic
is likely to have pale skin. Hypothyroidism may lead to complaints of dry skin. Clients
with diabetes mellitus are at risk for skin infections and skin breakdown.
Test-Taking Strategy: Focus on the subject, chronic pruritus. Remember that clients
with renal failure often experience this problem. If this question was difficult, review the
common causes of pruritus.
PTS: 1
Elsevier items and derived items © 2011, 2008, 2005, 2002 by Saunders, an imprint of Elsevier Inc.
Test Bank 3

4. A client being seen in an ambulatory clinic for an unrelated complaint has a butterfly
rash noted across the nose. The nurse interprets that this finding is consistent with early
manifestations of which of the following disorders?
1. Hyperthyroidism
2. Pernicious anemia
3. Cardiopulmonary disorders
4. Systemic lupus erythematosus (SLE)
ANS: 4
Rationale: An early sign of SLE is the appearance of a butterfly rash across the nose.
Hyperthyroidism often leads to moist skin and increased perspiration. Pernicious anemia
is exhibited by pale skin. Severe cardiopulmonary disorders may lead to clubbing of the
fingers.
Test-Taking Strategy: To answer this question accurately, you must be familiar with the
impact of systemic conditions on the skin. Remember that SLE causes a characteristic
butterfly rash. If this question was difficult, review the disorders identified in the options
and the associated skin conditions that occur in each disorder.
PTS: 1
5. The nurse notes that the older adult client has a number of bright, ruby-colored, round
lesions scattered on the trunk and thighs. The nurse correctly interprets the finding as
alterations in blood vessels of the skin and defines them as:
1. Purpura
2. Venous star
3. Cherry angioma
4. Spider angioma
ANS: 3
Rationale: A cherry angioma occurs with increasing age and has no clinical
significance. It is noted by the appearance of small, bright, ruby-colored round lesions
on the trunk and/or extremities. Purpura results from hemorrhage into the skin. A venous
star results from increased pressure in veins, usually in the lower legs, and has an
irregularly shaped bluish center with radiating branches. Spider angiomas have a bright
Test Bank 4
red center, with legs that radiate outward. These are commonly seen in those with liver
disease or vitamin B deficiency, although they can occur occasionally without
underlying pathology.
various alterations in vascularity that can occur in the skin. Note the relationship of the
words “ruby” in the question and “cherry” in the correct option. If you had difficulty
with this question, review the various skin alterations identified in each of the options.
PTS: 1
6. The client has been diagnosed with paronychia. The nurse understands that this is a
disorder of the:
1. Nails
2. Hair follicles
3. Pilosebaceous glands
4. Epithelial layer of skin
ANS: 1
Rationale: Paronychia is a fungal infection that is most often caused by Candida

albicans. This results in inflammation of the nail fold, with separation of the fold from
the nail plate. The area is generally tender to touch, with purulent drainage. Disorders of
the hair follicles include folliculitis, furuncles, and carbuncles. Disorders of the
pilosebaceous glands include acne vulgaris and seborrheic dermatitis. There are a variety
of disorders involving the epithelial skin.
Test-Taking Strategy: To answer this question accurately, you must be familiar with a
variety of skin disorders and their causes. Remember that paronychia is a nail disorder.
If this question was difficult, review the characteristics of paronychia.
PTS: 1
7. The client is diagnosed with a full-thickness burn. The nurse understands that which of
the following structural areas of the skin is involved?
1. Epidermis only
Test Bank 5
2. Epidermis and deeper dermis

3. Epidermis and upper layer of dermis
4. Epidermis, entire dermis, and epithelial portion of subcutaneous fat
ANS: 4
Rationale: A full-thickness burn involves the epidermis, entire dermis, and epithelial
portion of subcutaneous fat layer. “Epidermis only” describes a superficial burn.
“Epidermis and deeper dermis” describes a partial-thickness burn, and “epidermis, entire
dermis, and epithelial portion of subcutaneous fat” describes a deep partial-thickness
burn.
classification of burn depth and the associated skin structures affected. Noting the words
“full-thickness” will direct you to “epidermis, entire dermis, and epithelial portion of
subcutaneous fat.” If this question was difficult, review the types of burn injuries.
PTS: 1
8. A client who suffered carbon monoxide poisoning from working on an automobile in a

closed garage has a carbon monoxide level of 15%. The nurse would anticipate
observing which sign or symptom?
1. Coma
2. Flushing
3. Dizziness
4. Tachycardia
ANS: 2
Rationale: The signs and symptoms worsen as the carbon monoxide level rises in the
bloodstream. Impaired visual acuity occurs at 5% to 10%, whereas flushing and
headache are seen at 11% to 20%. Nausea and impaired dexterity appear at levels of
21% to 30%, and a 31% to 40% level is accompanied by vomiting, dizziness, and
syncope. Levels of 41% to 50% cause tachypnea and tachycardia, and those higher than
50% result in coma and death.
Test-Taking Strategy: Knowledge of the various manifestations of carbon monoxide

poisoning is needed to answer this question. Remember that flushing is noted at levels of
11% to 20%. If you had difficulty with this question, review the manifestations
associated with carbon monoxide poisoning.
PTS: 1
Test Bank 6
DIF: Level of Cognitive Ability: Analyzing

REF: Black, J., & Hawks, J. (2009). Medical-surgical nursing: clinical management for
positive outcomes (8th ed.). St. Louis: Saunders.
9. A client is admitted to the hospital with cellulitis of the lower leg. The nurse would
anticipate which of the following therapies to be prescribed?
1. Intermittent heat lamp treatments
2. Alternating hot and cold compresses
3. Warm compresses to the affected area
4. Cold compresses to the affected area
ANS: 3
Rationale: Warm compresses may be used to decrease the discomfort, erythema, and
edema that accompany cellulitis. Definitive treatment includes antibiotic therapy after
appropriate cultures have been done. Other supportive measures are also used to manage
such symptoms as fatigue, fever, chills, headache, or myalgia. Heat lamps are not used
because of the risk of burns, and moist heat is most useful in treating this disorder.
Test-Taking Strategy: Use knowledge of the disease process and concepts related to
heat and cold therapy to answer this question. Eliminate “alternating hot and cold
compresses” and “cold compresses to the affected area” first, because cold therapy
would cause vasoconstriction rather than vasodilation. Choose correctly between
“intermittent heat lamp treatments” and “warm compresses to the affected area,”
knowing that moist heat decreases the discomfort, erythema, and edema that
accompanies cellulitis. If you had difficulty with this question, review the treatment
associated with cellulitis.
PTS: 1
REF: Monahan, F., Sands, J., Marek, J., Neighbors, M., & Green, C. (2007). Phipps'
medical-surgical nursing: health and illness perspectives (8th ed.). St. Louis: Mosby.
MSC: Integrated Process: Nursing Process—Planning
10. The nurse has instructed the client in the correct technique for breast self-examination
(BSE). For a portion of the examination, the client will lie down. If the client were to
examine the right breast, the nurse would tell the client to place a pillow:
1. Under the left scapula
2. Under the left shoulder
3. Under the right shoulder
4. Under the small of the back
ANS: 3
Test Bank 7
Rationale: The nurse would instruct the client to lie down and place a towel or pillow
under the shoulder on the side of the breast to be examined. If the right breast is to be
examined, the pillow would be placed under the right shoulder, and vice versa.
Therefore “under the left scapula,” “under the left shoulder,” and “under the small of the
back” are incorrect.
Test-Taking Strategy: Use the process of elimination, and visualize this procedure. This
will direct you to “under the right shoulder.” If you are unfamiliar with the procedure for
performing BSE, review this important self-examination.
PTS: 1
DIF: Level of Cognitive Ability: Applying
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Content Area: Adult Health/Oncology
MSC: Integrated Process: Teaching and Learning
11. The nurse would identify that which of the following foods should be increased in the
diet to help decrease the risk of cancer development?
1. Bacon
2. Broccoli
3. Bologna
4. Broiled beef
ANS: 2
Rationale: Broccoli is a cruciferous vegetable, which is helpful in reducing the risk of

cancer. Other cruciferous vegetables are cauliflower, Brussels sprouts, and cabbage. Red
meat (“bacon”) and meats with nitrites (“bologna” and “broiled beef”) can increase the
risk of developing cancer.
Test-Taking Strategy: Remember that options that are comparable or alike are not likely
to be correct. With this in mind, note that each incorrect option lists a meat, whereas the
correct choice is a cruciferous vegetable. Review dietary risk factors for cancer if you
had difficulty with this question.
PTS: 1
REF: Nix, S. (2009). Williams’ basic nutrition and diet therapy (13th ed.). St. Louis:
Mosby.
MSC: Integrated Process: Nursing Process—Implementation
12. The nurse would include which of the following in a list of the most helpful foods for
the vegan client wishing to increase foods high in vitamin A?
Test Bank 8
1. Peas
2. Carrots
3. Potatoes
4. Green beans
ANS: 2
Rationale: Foods that are high in vitamin A include carrots, green leafy vegetables, and
yellow vegetables. The other vegetables are high in vitamins but do not necessarily have
the highest amount of vitamin A.
Test-Taking Strategy: Note the strategic words “most helpful.” To answer this question
accurately, you must be aware of the type of foods that are naturally high in vitamin A.
Remember that carrots are high in vitamin A. If you had difficulty with this question,
review foods that are in this vitamin group.
PTS: 1
REF: Peckenpaugh, N. (2010). Nutrition essentials and diet therapy (11th ed.). St.
Louis: Saunders.
13. According to the American Cancer Society, fecal occult blood testing should be done
annually after the age of _____ years.
1. 30
2. 40
3. 50
4. 60
ANS: 3
Rationale: Fecal occult blood testing for colorectal cancer should be done annually for
both men and women after the age of 50 years. The other options are incorrect.
recommendations for cancer screening published by the American Cancer Society. This
would allow you to eliminate each of the incorrect options easily. Review these cancer
prevention guidelines.
PTS: 1
Test Bank 9
14. A 27-year-old female client is undergoing evaluation of lumps in her breasts. In

determining whether the client could have fibrocystic breast disorder, the nurse should
ask the client whether the breast lumps seem to become more prominent or troublesome
at which of the following times?
1. After menses
2. Before menses
3. During menses
4. At any time, regardless of the menstrual cycle
ANS: 2
Rationale: The nurse assesses the client with fibrocystic breast disorder for worsening
of symptoms (breast lumps, painful breasts, and possible nipple discharge) before the
onset of menses. This is associated with cyclical hormone changes. Therefore “after
menses,” “during menses,” and “at any time, regardless of the menstrual cycle” are
incorrect.
Test-Taking Strategy: Note the strategic words “more prominent or troublesome.” This
implies that there is a predictable variation in symptoms. Use knowledge of the effects
of hormonal variations to select the correct option. Review fibrocystic breast disorder if
you had difficulty with this question.
PTS: 1
15. The nurse is assigned to the care of a client scheduled for surgery for a right colon
tumor. Which of the following is the most characteristic manifestation of cancer at this
site?
1. Frequent diarrhea
2. Crampy gas pains
3. Flat, ribbon-like stools
4. Dull abdominal pain exacerbated by walking
ANS: 4
Rationale: Characteristic symptoms of right colon tumors include vague, dull,

abdominal pain exacerbated by walking, and dark red- or mahogany-colored blood
mixed in the stool. The symptoms described in the other options are associated with left
colon tumors.
Test-Taking Strategy: Knowledge regarding the signs of right and left colon tumors is
required to answer this question. Note, however, that “crampy gas pains” and “dull
Test Bank 10
abdominal pain exacerbated by walking” describe different patterns of pain. This may
suggest to you that one of the two is correct. If you are not familiar with the differences
between right and left colon tumors, review this content.
PTS: 1
16. A client has undergone abdominal perineal resection for a bowel tumor. The nurse
interprets that the client’s colostomy is beginning to function if which of the following
signs is noted?
1. Absent bowel sounds
2. The passage of flatus
3. Blood drainage from the colostomy
4. The client’s ability to tolerate food
ANS: 2
Rationale: Following abdominal perineal resection, a colostomy should begin to

function within 72 hours after surgery, although it may take up to 5 days. The nurse
should monitor for a return of peristalsis by listening for bowel sounds and checking for
the passage of flatus. Absent bowel sounds indicate that peristalsis has not returned. The
client would remain NPO until bowel sounds return and the colostomy is functioning.
Bloody drainage is not expected from a colostomy.
Test-Taking Strategy: Note the strategic words “beginning to function.” These strategic
words should assist in eliminating “absent bowel sounds.” Knowledge of general
postoperative measures will assist in eliminating “the client’s ability to tolerate food.”
Focus on the subject of the question to make your final selection. Review postoperative
care of a client following abdominal perineal resection if you had difficulty with this
question.
PTS: 1
17. A nurse assessing a postoperative ureterostomy client will interpret that the stoma has
normal characteristics if the stoma is:
1. Dry
2. Pale
Test Bank 11
3. Dark-colored
4. Red and moist
ANS: 4
Rationale: Following ureterostomy, the stoma should be red and moist. A dry stoma
may indicate fluid volume deficit. A pale stoma may indicate an inadequate vascular
supply. Any darkness or duskiness of the stoma may mean loss of vascular supply and
must be corrected immediately to prevent necrosis.
Test-Taking Strategy: Knowledge of normal stoma characteristics is needed to answer

this question. Remember that a red and moist stoma is an expected finding. If you had
difficulty with this question, review expected and unexpected findings following
ureterostomy.
PTS: 1
TOP: Content Area: Adult Health/Renal
18. The nurse monitoring the oncological client for early signs of vena cava syndrome
would include assessment for which of the following?
1. Cyanosis
2. Arm edema
3. Periorbital edema
4. Mental status changes
ANS: 3
Rationale: Vena cava syndrome occurs when the superior vena cava is compressed or
obstructed by tumor growth. Early signs and symptoms generally occur in the morning
and include edema of the face, especially around the eyes, and client complaints of
tightness of a shirt or blouse collar. As the compression worsens, the client experiences
edema of the hands and arms. Mental status changes and cyanosis are late signs.
Test-Taking Strategy: To answer this question accurately, you must be familiar with
vena cava syndrome and its manifestations. Note the strategic word “early” in the
question. This will assist in directing you to the correct option. If you are unfamiliar
with vena cava syndrome, review the signs of this oncological emergency.
PTS: 1
Test Bank 12

19. The nurse understands that which of the following hormones is directly responsible for
maintaining the free or unbound portion of serum calcium within normal limits?
1. Thyroid hormone
2. Parathyroid hormone
3. Follicle-stimulating hormone
4. Adrenocorticotropic hormone
ANS: 2
Rationale: Parathyroid hormone is responsible for maintaining serum calcium and

phosphorous levels within normal range. Thyroid hormone is responsible for
maintaining a normal metabolic rate in the body. Follicle-stimulating hormone and
adrenocorticotropic hormone are produced by the anterior pituitary gland. They are
responsible for growth and maturation of the ovarian follicle and stimulation of the
adrenal glands, respectively.
Test-Taking Strategy: Basic knowledge of physiology associated with the parathyroid

gland is needed to answer this question. This gland is responsible for maintaining the
important balance of calcium and phosphorus in the body. Review the function of the
parathyroid gland if you had difficulty with this question.
PTS: 1
TOP: Content Area: Adult Health/Endocrine
20. The client with an endocrine disorder complains of weight loss and diarrhea, and says
that he can “feel his heart beating in his chest.” The nurse interprets that which of the
following glands is most likely responsible for these symptoms?
1. Thyroid
2. Pituitary
3. Parathyroid
4. Adrenal cortex
ANS: 1
Rationale: The thyroid gland is responsible for a number of metabolic functions in the
body, including metabolism of nutrients (such as fats and carbohydrates). Increased
metabolic function places a demand on the cardiovascular system for a higher cardiac
output. Thus, a client with increased activity of the thyroid gland exhibits weight loss
from higher metabolic rate and increased pulse rate.
Test Bank 13
Test-Taking Strategy: Use knowledge of the function of the thyroid gland to answer this
question. Remember that the thyroid gland is responsible for metabolic function. This
will assist in directing you to “thyroid.” If you had difficulty answering this question,
review the function of the thyroid gland.
PTS: 1
21. The client is experiencing an episode of hypoglycemia. The nurse understands that the
physiological mechanism that should take place to combat this decrease in the blood
glucose level is:
1. Decreased cortisol release
2. Increased insulin secretion
3. Decreased epinephrine release
4. Increased glucagon secretion
ANS: 4
Rationale: Glucagon is secreted from the alpha cells in the pancreas in response to
declining blood glucose levels. At the same time, hypoglycemia triggers increased
cortisol release, increased epinephrine release, and decreased secretion of insulin.
“Decreased cortisol release,” “increased insulin secretion,” and “decreased epinephrine
release” are not physiological mechanisms that take place to combat the decrease in the
blood glucose level.
Test-Taking Strategy: To answer this question accurately, you must be familiar with
how each of the hormones listed is affected by blood glucose levels. Thinking about the
pathophysiology of hypoglycemia will direct you to “increased glucagon secretion.” If
this question was difficult, review this physiological mechanism.
PTS: 1
22. The client with diabetes experiences breakdown of fats for conversion to glucose. The
nurse determines that this response is occurring if the client has elevated levels of which
of the following substances?
1. Glucose
2. Ketones
Test Bank 14
3. Glucagon
4. Lactic dehydrogenase
ANS: 2
Rationale: Ketones are a byproduct of fat metabolism. When this process occurs to the
extreme, it is termed ketoacidosis. “Glucose,” “glucagon,” and “lactic dehydrogenase”
are incorrect.
Test-Taking Strategy: Knowledge of the pathophysiology of glucose metabolism is

needed to answer this question. Remember that ketones are a byproduct of fat
metabolism. If this question was difficult, review the physiological process of fat
breakdown.
PTS: 1
23. The client with diabetes mellitus is being tested to determine long-term diabetic control.
Which of the following results would the nurse expect to see if the client’s long-term
control is within acceptable limits?
1. Glycosylated hemoglobin of 6%
2. Fasting blood glucose level of 150 mg/dL
3. Presence of ketones in the urine
4. Presence of albumin in the urine
ANS: 1
Rationale: This measurement of glycosylated hemoglobin (Hb A1c) detects glucose

binding on the red blood cell (RBC) membrane and is expressed as a percentage. It
measures glucose for the life of the RBC, which is 120 days. The fasting blood glucose
level should be lower than 130 mg/dL. The urine should be free of both ketones and
urine.
Test-Taking Strategy: Specific knowledge of the effects of an increased blood glucose

level in the body is necessary to answer this question. Noting the words “long-term” will
direct you to “glycosylated hemoglobin of 6%.” Review the alterations in normal
physiology that occur with diabetes mellitus if you had difficulty with this question.
PTS: 1
Test Bank 15

24. The nurse is caring for a client with a dysfunctional thyroid gland and is concerned that
the client will exhibit signs of thyroid storm. Which of the following is an early indicator
of this complication?
1. Hyperreflexia
2. Constipation
3. Bradycardia
4. Low-grade temperature
ANS: 1
Rationale: Clinical manifestations of thyroid storm include a fever as high as 106° F,

hyperreflexia, abdominal pain, diarrhea, dehydration rapidly progressing to coma, severe
tachycardia, extreme vasodilation, hypotension, atrial fibrillation, and cardiovascular
collapse.
clinical manifestations of thyroid storm. This condition is a rare but potentially fatal
hypermetabolic state. Remembering the description of thyroid storm will direct you to
the correct option. If you are unfamiliar with thyroid storm, review this content.
PTS: 1
25. The client is undergoing an oral glucose tolerance test. The nurse interprets that the
client’s results are not compatible with diabetes mellitus if the glucose level is lower
than which of the following cutoff values after 120 minutes (2 hours)?
1. 80 mg/dL
2. 110 mg/dL
3. 140 mg/dL
4. 160 mg/dL
ANS: 3
Rationale: The normal reference values for oral glucose tolerance tests are lower than
140 mg/dL at 120 minutes; lower than 200 mg/dL at 30, 60, and 90 minutes; and lower
than 115 mg/dL in the fasting state. The other values are not part of the reference ranges.
normal values for this screening test for diabetes. Think about the physiology associated
with diabetes mellitus and the procedure for this test to answer correctly. Noting the
Test Bank 16
words “not compatible with diabetes mellitus” will assist in answering correctly. Review
this test if you had difficulty with this question.
PTS: 1
REF: Pagana, K., & Pagana, T. (2009). Mosby’s diagnostic and laboratory test
reference (9th ed.). St. Louis: Mosby.OBJ: Client Needs: Physiological Integrity
26. A client who visits the physician’s office for a routine physical reports new onset of
intolerance to cold. Knowing that this is a frequent complaint associated with
hypothyroidism, the nurse continues to assess for which of the following?
1. Weight loss and thinning skin
2. Complaints of weakness and lethargy
3. Increased heart rate and respiratory rate
4. Diaphoresis and increased hair growth
ANS: 2
Rationale: Weakness and lethargy are common complaints associated with

hypothyroidism. Other common symptoms include weight gain, bradycardia, decreased
respiratory rate, dry skin, and hair loss.
Test-Taking Strategy: Focus on the client’s diagnosis. Recalling the pathophysiology

associated with hypothyroidism will direct you to “complaints of weakness and
lethargy.” Review this disorder if you had difficulty with this question.
PTS: 1
27. The nurse is caring for a client diagnosed with suspected acute pancreatitis. When
reviewing the client’s laboratory results, the nurse determines that which of these
findings will support the diagnosis?
1. Elevated serum lipase level
2. Elevated serum bilirubin level
3. Decreased serum trypsin level
4. Decreased serum amylase level
ANS: 1
Rationale: The serum lipase level is elevated in the presence of pancreatic cell injury.
Serum trypsin and amylase levels are also elevated in pancreatic injury. Although
Test Bank 17
bilirubin can be elevated in the client with pancreatitis, it is secondary to the

hepatobiliary obstructive process.
Test-Taking Strategy: Focusing on the client’s diagnosis and its pathophysiology will
direct you to “elevated serum lipase level.” If this question was difficult, review tests for
diagnosing acute pancreatitis.
PTS: 1
TOP: Content Area: Adult Health/Gastrointestinal
28. A nurse is caring for a client postoperatively following creation of a colostomy. Which
of the following nursing diagnoses should the nurse include in the plan of care?
1. Sexual dysfunction
2. Disturbed body image
3. Fear
4. Imbalanced nutrition: more than body requirements
ANS: 2
Rationale: Disturbed body image relates to loss of bowel control, the presence of a
stoma, the release of fecal material onto the abdomen, the passage of flatus, odor, and
the need for an appliance (external pouch). There are no data in the question to support
“sexual dysfunction” and “fear.” A risk for “imbalanced nutrition: less than body
requirements” is the more likely nursing diagnosis.
Test-Taking Strategy: Use the process of elimination. Use the data presented in the
question to assist in selecting the correct option. There are no data in the question to
support sexual dysfunction” and “fear.” Reading “imbalanced nutrition: less than body
requirements” carefully will assist in eliminating this option. Review care to the client
following a colostomy creation if you had difficulty with this question.
PTS: 1
OBJ: Client Needs: Psychosocial Integrity
MSC: Integrated Process: Nursing Process—Planning
29. The client is experiencing blockage of the common bile duct. Which of the following
food selections made by the client indicates the need to plan for further diet teaching?
1. Rice
2. Whole milk
Test Bank 18
3. Broiled fish
4. Baked chicken
ANS: 2
Rationale: Bile acids or bile salts are produced by the liver to emulsify or break down
fats. Blockage of the common bile duct impedes the flow of bile from the gallbladder to
the duodenum, thus preventing breakdown of fatty intake. Knowledge of this should
direct you to “whole milk.” Dairy products, such as whole milk, ice cream, butter, and
cheese, are high in cholesterol and fat and should be avoided.
Test-Taking Strategy: Note the strategic words “need to plan for further diet teaching.”
These words indicate a negative event query and ask you to select an option that is an
incorrect food item. Knowledge of carbohydrate and protein contents of various foods
will also assist you with eliminating options “rice,” “broiled fish,” and “baked chicken.”
If you had difficulty with this question, review the physiology of digestion.
PTS: 1
DIF: Level of Cognitive Ability: Evaluating
30. The nurse is reviewing laboratory test results for the client with liver disease and notes
that the client’s albumin level is low. Which of the following nursing actions is focused
on the consequence of low albumin levels?
1. Evaluating for asterixis
2. Inspecting for petechiae
3. Palpating for peripheral edema
4. Evaluating for decreased level of consciousness
ANS: 3
Rationale: Albumin is responsible for maintaining the osmolality of the blood. When
there is a low albumin level, there is decreased osmotic pressure, which in turn can lead
to peripheral edema. “Evaluating for asterixis,” “inspecting for petechiae,” and
“evaluating for decreased level of consciousness” are incorrect and are not associated
with a low albumin level.
function of various substances produced by the liver. “Evaluating for asterixis” and
“evaluating for decreased level of consciousness” can be eliminated because
neuromuscular disturbances (such as asterixis and altered levels of consciousness) are
the consequence of reabsorbed toxic substances. Eliminate “inspecting for petechiae”
because petechiae are the result of hematological dysfunction secondary to liver disease.
If needed, review the physiology of the liver and the function of albumin.
Test Bank 19
PTS: 1
31. Discharge teaching for a client recovering from an attack of chronic pancreatitis should
include which of the following instructions?
1. Alcohol should be consumed in moderation.
2. Avoid caffeine, because it may aggravate symptoms.
3. Diet should be high in carbohydrates, fats, and proteins.
4. Frothy fatty stools indicate that enzyme replacement is working.
ANS: 2
Rationale: Knowing that caffeinated beverages, such as coffee, tea, and soda, will
worsen symptoms, such as pain, will direct you to select “Avoid caffeine, because it
may aggravate symptoms.” Alcohol can precipitate an attack of chronic pancreatitis and
needs to be avoided. The recommended diet is moderate carbohydrates, low fat, and
high protein. Frothy fatty stools indicate that the replacement enzyme dose needs to be
increased.
Test-Taking Strategy: “Alcohol should be consumed in moderation” can be

immediately eliminated because alcohol can precipitate another attack and needs to be
avoided. “Diet should be high in carbohydrates, fats, and proteins” can be eliminated
because the recommended diet is moderate carbohydrates, low fat, and high protein.
Finally, frothy fatty stools indicate that the enzyme dose needs to be increased, so
“frothy fatty stools indicate that enzyme replacement is working” can be eliminated.
Review home care instructions for the client with chronic pancreatitis if you had
difficulty answering this question.
PTS: 1
32. A client returns to the nursing unit after undergoing an esophagogastroduodenoscopy

(EGD). Which of the following reflects appropriate intervention by the nurse?
1. Allow the client unassisted bathroom privileges.
2. Keep the client lying flat in bed in the supine position.
3. Withhold oral fluids until the client’s gag reflex has returned.
Test Bank 20
4. Tell the client to report a sore throat immediately, because it is a serious

complication.
ANS: 3
Rationale: In preparation for the passage of the endoscope, an anesthetic is sprayed to

inactivate the gag reflex and thus facilitate passage of the tube. It may take 1 to 2 hours
for the anesthetic spray to wear off and for the gag reflex to return. “Allow the client
unassisted bathroom privileges,” “keep the client lying flat in bed in the supine
position,” and “tell the client to report a sore throat immediately, because it is a serious
complication” are incorrect.
Test-Taking Strategy: Apply knowledge of endoscopic procedures of the upper

gastrointestinal tract to assist you with selecting the correct option. Because the client
will receive conscious sedation for the procedure and anesthetic spray to the throat,
postprocedure safety precautions must be maintained. This includes assistance to the
bathroom and head of the bed elevation to prevent aspiration of oral secretions. A sore
throat is common postprocedure and may persist for a few days but is not a cause for
alarm. Review these postprocedural instructions if you had difficulty with this question.
PTS: 1
REF: Pagana, K., & Pagana, T. (2009). Mosby’s diagnostic and laboratory test
reference (9th ed.). St. Louis: Mosby.
OBJ: Client Needs: Safe and Effective Care Environment
33. The nurse is assisting the physician during a colonoscopy procedure. The nurse helps the
client to assume which of the following positions for the procedure?
1. Left Sims
2. Lithotomy
3. Knee chest
4. Right Sims
ANS: 1
Rationale: The client is placed in the left Sims position for the procedure. This position
uses the client’s anatomy to the best advantage for introducing the colonoscope. The left
Sims position would also be used for giving the client an enema while lying down.
Therefore “lithotomy,” “knee chest,” and “right Sims” are incorrect.
Test-Taking Strategy: Using concepts related to gastrointestinal (GI) anatomy to answer

this question will help you eliminate “right Sims.” When answering such factual
questions as these, remember the guiding principles and attempt to visualize the
procedure to help you select the correct option. Knowledge and visualization of
“lithotomy” and “knee chest” positions will help you eliminate these options. Review
this procedure if you had difficulty with this question.
Test Bank 21
PTS: 1
34. The client is scheduled for oral cholecystography. For the evening meal prior to the test,
the nurse provides a list of foods from which diet type?
1. Liquid
2. Fat-free
3. Low-protein
4. High-carbohydrate
ANS: 2
Rationale: Normal dietary intake of fat should be maintained during the days preceding
the test to empty bile from the gallbladder. A low-fat or fat-free diet is prescribed on the
evening before the test. This prevents contraction of the gallbladder and allows for
accumulation of the contrast substance needed for x-ray visualization during the testing
procedure. Therefore “liquid,” “low-protein,” and “high-carbohydrate” are incorrect.
Test-Taking Strategy: Knowledge that an oral cholecystogram is an x-ray of the

gallbladder will assist in directing you to the correct option. Think about the function of
the gallbladder and its interaction with fat intake to assist in selecting “fat-free.” Review
preprocedural care for oral cholecystography if you had difficulty with this question.
PTS: 1
REF: Monahan, F., Sands, J., Marek, J., Neighbors, M., & Green, C. (2007). Phipps'
medical-surgical nursing: health and illness perspectives (8th ed.). St. Louis: Mosby.
35. In which of the following optimal positions should the nurse plan to place the client after
bolus feeding using a nasogastric tube?
1. Head of bed (HOB) flat, with client supine for at least 60 minutes
2. HOB elevated 45 to 60 degrees, with client supine for 15 minutes
3. HOB elevated 10 degrees, with client in the left lateral position for 60 minutes
4. HOB elevated 30 to 45 degrees, with client in the right lateral position for
60 minutes
ANS: 4
Another Random Scribd Document
with Unrelated Content
CHAPTER XXIII
Greyhound
“Watch the broncs!” Silent yelled. “The feller that threw that is close!”
Teddy leaped to his feet, his revolver in his hand. The ponies were tied a
little distance from the campfire, and he stumbled toward them through
heavy underbrush.
“Take the left, Nick!” Roy exclaimed. “I’ll follow Teddy. He’s likely to
get a bullet through him, rushing around like that! Get away from the light
of that fire!”
Nick rolled, pulled out his gun, and found himself against a tree. He got
quickly to his feet.
“Don’t shoot, no matter what you see,” Silent yelled hoarsely. “Teddy
an’ Roy are out there—you might hit them.”
But Teddy had reached the horses, and Roy was at his side.
“Didn’t get ’em,” the boy panted. “What do you say we—”
“For the love of Pete, Teddy, we haven’t got a chance in this darkness!
There may be half a dozen men around here, waiting for us to separate so
they can pot us off. Let’s stick together, anyhow.”
“Where are the others?” Teddy had one hand on Flash’s neck. “We’ll
never get this chance again, Roy! Shall we let that scoundrel get away?
Snakes, we could track him! Easy!”
“Not so easily! Now listen. Let’s see where Nick and Silent are. Then
we’ll have a look at the paper—tied to the stone.”
There was a crashing in the brush near them and both boys faced quickly
about, their guns leveled.
“Speak up!” Roy shouted sternly. “Who’s there?”
“Nick,” came the answer. “Silent with you?”
“No, I thought—” Roy, raising his voice, called: “Hey, Silent! Over this
way!”
They waited. There was no reply.
“He’s around some place,” Teddy said anxiously. “If any one is waiting
to knock us off, they know where we are, so a little more noise won’t hurt.
Hey, Silent!”
Still no answer. They listened carefully to hear if any one was walking
near them, but no footsteps disturbed the stillness.
“Maybe he stumbled and fell,” Roy suggested. “We’ll have to go back.
Leave the broncs—no, we’d better tie ’em close to the fire where we can
watch ’em.”
They untied the horses and led them slowly toward the campfire. They
fastened the animals about ten yards from it.
“Silent,” Teddy called again. “Hey, Silent!”
“If he hit his head and knocked himself cold, he’s lyin’ around here,”
Nick said. “He yelled to me an’ I saw him go for the bushes, an’ that’s the
last. You don’t think—” he paused suggestively.
“Well, they didn’t shoot him, that’s sure,” Roy declared. “We’d have
heard the shot. And I don’t think they knifed him, because something tells
me Silent could take care of himself in a game of that sort.”
“But what in thunder happened?” Teddy exclaimed impatiently. “He’s
gone, hasn’t he?”
“He’ll come back,” Roy declared with a confidence he did not feel. “In
the meantime—” he stopped and picked up the stone. Breaking the string
that held the paper to it, he glanced down. Teddy heard him give a grunt.
“What is it?”
“Here—bring it to the fire, so you can see. What do they think we are?
Kids, to be scared by a thing like that?”
Holding the paper so the firelight flickered upon it, Teddy and Nick, who
leaned over his shoulder, read two words, printed:
LAY OFF
Below was a rude picture of a dog, evidently meant to be a greyhound.
“Lay off!” Nick repeated. “Yea, we’ll lay off all right! By golly, I’d like
to have my hands on the feller who wrote that!”
“So that’s Greyhound’s signature,” Roy mused. “Well, I must say he
picked a good one. A dog! Let’s have the paper, Teddy.” With a sudden
motion he tossed it into the fire. “And now, we’ll have a look for Silent.”
“Wish we had a few electric flashlights,” Teddy muttered. “Silent may
be lying near us and we’d never know it.”
“We’ll have to take a chance,” Roy said firmly. “Keep your guns ready.
Come on now. Don’t spread. Stick together, and we’ll cover what ground
we can. Move in a circle.”
For two hours the three searched in the vicinity of their camp, walking in
ever widening circles. At the end of that time they returned, to find the fire
nearly out. Teddy wearily replenished it, and threw himself on the ground.
“No good, I reckon,” he said hopelessly. “He’s not around here. What’s
the plan now, Roy?”
“Nothing, Teddy,” Roy replied in a tired voice. “We’ll have to wait,
that’s all. Try to get some sleep.”
“What are you going to do?”
“Well, I’ll sit up for a while. Then I’ll wake you or Nick and you can
watch. There ought to be some one to keep a lookout.”
“All right.”
Teddy drew his blanket around him, and Nick did the same. Roy sat
upright, his back against a tree, his revolver in his lap. The rifles were still
in their cases by the pile of saddles. A revolver was the only effective
weapon in this situation.
Roy found it difficult to keep his eyes open. Several times he caught
himself nodding and jerked his head upright again. How long it was before
he heard that noise in the bushes he never knew. It may have been an hour
or more, it may have been only a few minutes. But, as he sat there, there
came to his ears the crackle of twigs, as if a man were treading on them.
“Teddy! Nick!” he whispered. “Snap to it! Here’s—”
The two sleepers awoke and went quickly to where Roy was sitting. The
fire at that moment flared up and the light showed them a man standing
perfectly still not ten feet away.
“Silent!” Nick yelled. “It’s you!”
“It’s me,” came the answer. “Don’t let no bullets ride.” He stepped
forward. They saw that his face was drawn, his eyes haggard.
“Where have you been?” Teddy asked quickly. “What happened?”
Silent waved his hand.
“Nick, will you put on some coffee?”
“Sure, sure!” Nick hastened to comply. Silent seated himself by the fire,
his head in his hands.
“Anything wrong?” Roy demanded. “You hurt?”
The head shook a denial.
“Not hurt—just tired.” He took a deep breath. “Roy, I found it.”
“Found what?”
“Greyhound’s camp. It’s about seven miles from here. I tracked the guy
who threw that note—I tracked him miles. He had a pony a little way out
from here. I had to run then. Run behind the bronc, for seven miles!
Snakes!”
“Here,” Nick said. “Drink this!” He held out a tin cup filled with hot
coffee. “That’ll fix you up.”
Silent buried his nose in the cup without a word. Hot as the liquid was,
he finished it without raising his head.
“Baby, that’s good,” he declared, and his voice was stronger now. “A
little more, Nick, if you have any left.” Suddenly he flung his chin up. “Say,
did you guys hear what I said? I found Greyhound’s camp!”
“I reckon you know the answer to that?” Roy said quietly.
“Well, I was hopin’, boys—I was hopin’. You’ll go with me now?”
“We will, Silent.”
He thrust out his hand and gripped Roy’s.
“Fellers, what I’m wantin’ to say I can’t, ’cause I’m not built that-a-way.
But I guess you understand.” He stopped and turned aside. “One more swig
of coffee an’ I’ll be with you.”
“Let’s get the saddles on,” Teddy said swiftly. “Nick, you see what you
can do for Silent an’ we’ll saddle your bronc. Give him something to eat if
he’ll take it.”
“Nothin’ to eat,” Silent declared. “One more cup of coffee, that’s all.”
Then, when the horses had been saddled, they set out in the darkness.
Silent, veteran plainsman that he was, knew the way was clear to him.
He had gone over the route on foot, and could not mistake it, even in that
blackness with only a hint of moon shining through clouds to relieve it.
Their path, with Silent leading, was up hill.
“Before we get there, we’d better have a plan of action,” Roy declared.
Unconsciously his voice was lowered, as though there were those about
who might hear. “How many men are in the camp Silent?”
“Four. But I think there’s another that I didn’t see. They have a tent with
the broncs tied near it. A cliff of some sort rises at the back.”
“They can’t get through that way?”
“Don’t see how.”
Roy thought for a moment before he spoke again.
“Silent,” he said, “there’s one thing I’ve got to say. We’re not riding
these men down to shoot them like dogs, even though that’s what they are.
We’re going to round ’em up and take ’em back to camp.”
“I see, Roy.” Silent’s voice was a monotone. “Reckon you’re right. But
when I see the skunk who shot my dad an’ brother in cold blood—”
“I know, Silent,” Roy broke in. “But we’re not like that, see? We can’t
do it!”
“Nope, we can’t.” Silent swallowed audibly. “You got my word, Roy.”
“That’s the fight! It’s best, Silent—you know that.”
“Yea, I know that, Roy. All right. That’s over. Now here’s what I think
we ought to do. It’ll be morning soon, and the best time to get those rascals
would be at dawn when there’s light enough to see, but not too much.”
“That seems good to me,” Roy agreed. All thought of fatigue had fled
from him and from his companions. Their blood was racing fast.
“O. K. Then that’s settled. We’ve got an hour yet—maybe two. When we
come close to their camp I want you to get off your bronc an’ take a look at
it. That’s so you’ll know the lay of the land. We won’t have to go so close,
but there’s not much danger—they’re all asleep now. Greyhound thinks he’s
hot stuff—doesn’t even need a guard.” A thin smile curved Silent’s lips.
They rode for some time longer, then Silent called a halt. They were near
the camp of the outlaws.
“Come on, Roy,” Silent whispered. “You fellows wait here. We’ll be
back in ten minutes.”
“And if you’re not?” Teddy asked in a low voice.
“We will be. Let’s go!”
Silent and Roy dismounted and were off. Nick and Teddy awaited them
impatiently, every minute seeming like an hour. But finally they returned,
and again mounted their ponies. The first faint blush of the false dawn
tinged the east.
“Well, boys—” Roy turned and faced the others—“reckon it’s about the
zero hour. I saw enough of the camp to think we can get the rascals without
getting hurt. Silent will be on one end of the line and I’ll be on the other.
Teddy, you and Nick can ride in the center. Keep about ten feet apart. Just
beyond here there’s a clearing, and we’ll ride through to that. The tent is
right in the middle. Go easy at first, and keep together! Soon as we reach
the clearing, Silent is going to fire a shot. Use your revolvers—rifles will be
no good. But don’t shoot any one—unless in self-defense. We want to
capture these fellows, not kill ’em. All set?”
“We’ll keep as much as possible to the protection of the trees,” Teddy
said. “It would be pretty easy for those men to pot us from inside their tent.”
“We’ll have to chance that,” Roy replied. “Well?”
“Let’s go!”
Quietly, silently they rode through the woods. In the east the sky was
becoming grey. Birds were awakening. Nature stretched, and yawned.
Suddenly the clearing was before them. The tent stood like a white,
sluggish animal that had fallen asleep there. A few feet behind the tent was
the cliff. Five horses were tied to trees near by. Roy was thankful for the
light which made all this visible.
In another moment the signal would be given. A gun was raised.
Crack!
Silent’s revolver had spoken.
“Come out of there, you guys!”
“Come a-runnin’!”
“Greyhound, we want you!”
A head poked from the tent flap and was as quickly withdrawn. A rifle
came next, with a man behind it.
Teddy took aim and fired. The rifle dropped from the man’s hand. His
right arm hung useless.
“Getting to be expert at that!” Teddy yelled. “The next one who pulls a
gun goes down! Found out we mean business, hey?”
“Greyhound!” Silent roared the name. “Greyhound, come out o’ that!”
“I’m comin’!”
The wounded man who stood holding to the flap of the tent was thrust
aside. A figure, one arm in a sling, burst into the open. In his uninjured
hand he held not a revolver, but a rifle!
“Somebody want me?”
The rifle was raised—with one hand Greyhound raised and aimed it. His
finger touched the trigger and Silent’s hat sailed off.
Silent, head up, face grim as death, leveled his gun.
“Greyhound,” he shouted, “you’re finished!”
The gun was aimed straight at the outlaw’s breast. He stood not ten feet
from Silent, a perfect target. But he did not move. Then, slowly, Silent’s
gun was lowered.
“You can’t reload,” Silent said simply. “I’m a different breed from you,
Greyhound. I give you back your life.”
Teddy and Roy stared at the man called Greyhound. He stood not less
than six feet four, with huge shoulders and arms. Alone in that clearing he
stood, defying them all. At least, Greyhound was not a coward.
“Drop that rifle,” Roy called sternly. “Drop it, and tell your men to come
out here with their hands in the air!”
For a moment rage came over the face of the man. Then he shrugged his
shoulders.
“What’s the use?” he muttered. “It’s over. Come out, boys—we’re done
for. Leave the guns behind.”
He tossed the rifle carelessly to the ground. His eyes were fixed on
Silent’s face.
“You ain’t goin’ to shoot?”
“No, Greyhound, I ain’t goin’ to shoot,” Silent replied slowly. “There’s
others that you have to settle with. Roy, he’s your prisoner.”
One by one the bandits filed from the tent, their hands held high. Teddy
counted five, including Greyhound. All were accounted for. The man who
had been shot stood by the tent, groaning.
“Nick, search ’em,” Roy said. “Then let that baby who’s making all that
noise sit down.”
Nick obeyed. Two of the outlaws had guns, and he tossed them away.
“How about their broncs, Roy?”
“They’ll ride those back to Nugget Camp.”
“Here!” Teddy dismounted, and went toward the tent. “Nick, let’s use a
bit of this rope. They won’t need it any more.”
Together he and Nick stripped the tent of its ropes, and bound the hands
of the prisoners, all but the injured man. Greyhound’s well arm was tied
behind his back. Then they were ordered to mount their ponies.
From his horse Greyhound glanced carelessly at Silent.
“Reckon we swing—hey?” he asked, sneeringly.
“You’ll get a fair trial,” Silent said harshly. “If you’re guilty you’ll
swing.”
“If we’re guilty!” Greyhound laughed loudly. “Well, boys, it was fun
while it lasted! I told you hard luck followed me, but you thought I was
kiddin’. I wasn’t. Now, you guys—” he turned toward Teddy—“there’s one
you missed. He’s hidin’ under a blanket. It won’t be hangin’ for him, so he
might as well come out. His bronco is tied down the trail a piece. Allen!”
From the tent came a pitiful figure, white-faced in the lightening dawn.
It was the swindler from Nugget Camp.
Nick eyed him frowningly.
“Allen,” Greyhound said, “here’s some friends of yours. Want to take a
little ride with ’em?”
“Don’t kill me!” Allen moaned, trembling violently. “Don’t shoot me!
I’ll tell you everything! There’s fifty thousand dollars’ worth of gold in this
tent! You can have it all, but don’t shoot!”
“That, boys, is our bootblack!” Greyhound exclaimed, laughing loudly.
“What he says is true. You might as well have the gold. I’ll leave it to you
in my will.” He laughed again. “If that fellow Decker we shot a month ago
is still livin’, some of it belongs to him. He sure worked for it.”
“Jerry Decker!” Teddy cried. “Then he will get his nuggets back!”
“There’s some of it comin’ to you, too,” Greyhound went on, nodding
toward Silent. A puzzled frown came to his face. “I can’t understand it,” he
muttered. “I can’t understand it a-tall! There you stand with a gun an’ me in
front of you, me the feller who killed your folks, an’ you don’t shoot!”
“We’re not like you, Greyhound,” Roy said shortly. “We’re not
murderers.”
“Murderers?” The man repeated the word, as though he did not
understand. “Oh, that’s what I am, hey? Well, maybe you’re right. Well,
that’s all.” His voice dropped. He turned wearily to Roy. “If you’re ready,
we may as well start.”
Head down, shoulders bent forward, he started down the long trail just as
the sun tossed the first beams over the hills.
CHAPTER XXIV
Ready to Quit
Men crowded to the flaps of their tents, chewing in haste the last of their
breakfast. Others slammed open the doors of rude slab-sided shacks, some
holding in their hands coffee pots which they had been about to set on the
stove. Many of the miners of Nugget Camp, who had already eaten their
morning meal and were on the way to work their claims, stopped and stared
at the cavalcade on its way down the one main street.
“What is it, boys?”
“Some kind of a pee-rade, I’ll gamble!”
“But what for?”
“Must be the start of a circus!”
Thus the comments that greeted Roy, Teddy and their friends as they
rode along, closely guarding Greyhound and his gang.
“Hey, what’s the parade for?” some one sang out.
“Robbery and murder!” answered Roy, with a grim face.
“Robbery?”
“Murder?”
The words were enough to set the whole camp astir had it not already
been galvanized into life by the sight of the armed men guarding the others
on horses.
“Watch out, fellows!” warned Teddy in a low voice. “Some of their
friends may try a rescue!” He nodded toward the prisoners.
“Friends!” ejaculated Roy. “They won’t have any friends when we tell
what happened—and when they hear Silent’s story.”
So it proved. Feeling ran high against the outlaws and there were a few
reckless spirits in Nugget Camp who would have taken the prisoners from
the X Bar X boys and strung the criminals to the nearest trees. But wiser
counsel prevailed.
Luckily there had come to camp that morning a deputy sheriff on some
other mission. But when he saw the prisoners and heard the story, he
quickly swore in other deputies to aid him and, taking charge of the
prisoners, soon had them as safely housed as was possible in that rough
country.
“And to think you fellers caught them!” murmured more than one rough
old miner, as what Roy and Teddy Manley had done became broadcast
about camp. “Sufferin’ hoptoads! Some nerve!”
“Not much nerve needed when we knew what had happened to Silent,”
remarked Teddy.
The excitement did not last long—excitement was too readily made to
order in Nugget Camp—and when the prisoners had been taken away with
the promise of justice being meted out to them, the new prospectors went
back to working their claims.
But they did not forget the boast Allen had made about the quantity of
gold concealed in the lair of the outlaws, and when they had time to
investigate, Roy, Teddy, and their friends went back to recover it.
Allen had not been wrong. A large quantity of gold dust, some almost
pure nuggets, and a large quantity of ore as thickly studded with lumps of
gold as is a Christmas pudding with plums, was collected. Most of it had
been stolen at different times from miners who had made lucky strikes and
who had foolishly talked too freely of their good fortune, or else who, as
foolishly, “hit the red-eye trail” and became so helpless that they fell easy
prey to the thugs in Greyhound’s gang.
Among the pile of nuggets were some marked in a peculiar way, and
these, it developed later, were the property of Jerry Decker. Though the
amount was not quite as much as he claimed (due, perhaps, to toll taken by
the bandits) it was a goodly sum, and when news of the recovery of it was
sent to the injured man it did more to restore him to health and strength than
all the doctor’s medicine.
“Well, fellows, we’ve got to work harder than we’ve been doing,” Roy
announced one night as the prospectors gathered about the campfire. They
had been gradually sinking their shaft deeper and deeper, and had cut
several lateral tunnels, timbered with much labor and no little risk, but, so
far, all the gold they had taken out had not paid them for their work—not
even counting the first big nugget found.
“Work harder?” groaned Teddy. “My back’s ’most broken now, and as
for my hands—I’ll be lucky if I can ever hold the reins again,” and he held
up his blistered palms.
“Don’t give up!” begged Gus. “Lots of times, when everything seems
like to be peterin’ out, a man may make a lucky strike.”
“Well, it’s got to come pretty soon for me, or I’ll pull up stakes and go
back to riding fence,” announced Teddy.
“Are you really serious about that?” asked his brother.
“I sure am. This gold rush doesn’t mean as much as it did at first.”
Truth to tell, Nugget Camp did appear to be “petering out.” It had been
famous in its day, and might be again, many days hence. But just now, aside
from a few sensational finds of rich nuggets here and there, most of the
miners, including the X Bar X boys, were not making a living at it. About
the only ones who were really taking in anything were the proprietors of the
gambling joints and the various “hotels.”
“Oh, don’t give up yet,” begged Roy, as he and Teddy prepared to turn in
that night. “They don’t really need us back at the ranch, and we might as
well give the wheel of fortune another turn or two.”
“Oh, I’m not quitting—completely,” said Teddy. “As for them not
needing us—”
“I get your drift, as the hill said to the snowbank!” broke in Roy, with a
chuckle. “You mean—”
“If you say ‘girls’ I’ll attack you with this!” and Teddy held up a slippery
cake of soap he had just been using at the wash basin.
“Let it go at that!” wisely rejoined the other.
“I’ll stay one more week,” was Teddy’s final decision.
That last week the prospectors worked as they had never worked before.
They dug until far into the night, taking advantage of the bright moon, and
excavated by means of lanterns lowered into the shaft. They built new
sluice-boxes with closer cleats and panned their clean-up every other day
with great care.
Yet the little pile of yellow grains remaining after all the gravel and dirt
had been washed away, was pitifully small compared with the terrible
exertions that went into that shaft and the tunnels.
“Well, this is the end of the week,” remarked Teddy one evening after
the routine clean-up, and he looked at the small quantity of gold that
resulted. “I’m through!”
“Yes, I guess we might as well call it a finished job and quit,” agreed his
brother grimly. “Old One Eleven didn’t pan out as expected. Oh, well,
we’re not out much—only our time and trouble.”
“That’s all,” agreed Teddy. “And we cleaned up that gang and got back a
lot of gold for others, if we couldn’t wash out any for ourselves. Well, we’ll
pack up in the morning and hit the trail for home.”
CHAPTER XXV
One Eleven Comes Through

“All set!” called Teddy early next morning.
“Let ’em ride!” echoed Roy.
Breakfast was finished and the prospectors were ready to break camp.
Nat Raymond and Jim Casey had come over to help their former cow-
punching comrades take down the tents and pack the duffle for the trip
home. Nat and Jim were just as disappointed in their claims as were the X
Bar X boys, and were also ready to quit.
“This here place is a fake!” Nat grumbled. “Good thing your dad
promised us back our jobs,” he said to Roy and Teddy. “But the worst of it
will be sittin’ on the fence listenin’ to Pop say: ‘I told you so!’ Snakes!”
Bug Eye, who was rolling up blankets, snickered.
“Boy! Me? I’m not kickin’! I got seven hundred bucks out o’ this here
little ole camp, lemme tell you!”
“Well, we sure had an exciting time,” Teddy commented. “Nick, hand
me those ponchos, will you? Hey, who’s this coming?”
Toward them came running a figure, waving his hands wildly.
“Now what’s eatin’ that guy?” Silent asked wonderingly. “Looks like a
windmill on wheels!”
“It’s Maryland!” Roy declared. “Remember him, Teddy? Yes, it’s
Maryland, all right!”
“Thought he was on the wagon,” Gus said. “Boy, he’s sure kickin’ up the
dust!”
Maryland, his face red from his exertions, stumbled toward them.
“Hey,” he yelled. “Hey! Hey!”
“Charleston!” Nick roared. “Hey-hey yourself!”
“Listen, fellers! Listen!” he panted fiercely, trying to get enough breath
to talk with. “Listen! Don’t pull up stakes! I got somethin’ to tell you!”
“Well, for Pete’s sake, spit it out without all that ‘hey-hey’ business!”
Bug Eye exclaimed. “Let’s have it!”
“Well, I been workin’ on my mine—it’s near yours! I dug on a slant,
instead of straight down, an’ the first thing I knew I came out in the shaft
you fellers sunk. But not in any of your tunnels—a different one.”
“That’s O. K.,” Roy said easily. “You’re forgiven. Take the shaft and
build yourself a house with it.”
“No, but listen, you fellers! That ain’t all! I struck gold! Plenty of it!
Reams of it! An’ most of it is on your claim! An’ that’s why I ran down
here, bustin’ my windpipe, to tell you!”
“Gold!”
Teddy and Roy started forward.
“Well, may I be pinned by the seat of my pants to a clothesline for the
rest of my natural life!” Nick blurted out. “Our last day here, an’ gold is
found on our claim!”
“And then some more!” Maryland went on excitedly. “There’s enough to
make us all rich! By golly, she’s lying around in bucketfuls!”
“I see you-all read romances,” Silent said calmly. But even he was
thrilled at the news. “Bucketfuls, hey? I reckon that means about fourteen
carat alloy. Well, Maryland, you done us a favor!”
How much of a favor Maryland had actually done was not known until
the boys reached their claim. And, strangely enough, Maryland had not
exaggerated. He had struck a pocket exceptionally rich in gold, and the soil
about it promised further deposits. Silent declared the yellow stuff already
unearthed would total nearly forty thousand dollars.
“And that’s the beginning,” he said. “Now, how about stakin’ a few
claims for the boys at home before the rush starts? I want to get one for
Jack Conroy, my partner. An’ I suppose you want one for your dad?”
“Sure do,” Teddy replied. “Say, we’ll give Pop one! Then let’s see what
he has to offer! Baby, if that doesn’t quiet him, nothing will!”
The claims, adjoining One Hundred Eleven, were staked, Gus, Nat, and
Jim Casey abandoning their old diggings and locating near the new ones.
Gus’s prophecy had come true—they had struck gold.
And what a reception Teddy and Roy received when they reached home!
Before leaving Nugget Camp they sold some gold, receiving a certified
check. This check Roy, followed by Teddy, bore to his father.
“Remember the grub stake you gave us?” Roy asked, as Mr. Manley
looked at him quizzically. “What did we say then?”
“Well, you mentioned somethin’ about me gettin’ it back four times
over,” Mr. Manley replied. “Of course, I know you didn’t mean that, so—”
“Take a look!” chuckled his son.
He thrust out the check. In red perforated figures were the numerals
$25,000.
“For the love of Pete!” Mr. Manley gasped. “Four times! And then
some! Boys, you sure hit it! Wait till I show this to your mother! Twenty-
five thou—well, you bloated bankers, you! Do the boys know about this?”
Teddy winked.
“Tell you, Dad,” he said, grinning, “I want to wait until Pop gets in front
of something soft, then I’ll flash it on him. He’ll keel over like a split
flagpole!”
And, it might be added in passing, Pop did.
“Did you bring me that gold bracelet?” asked Belle Ada as she greeted
her brothers in the flush of their success.
“Bracelet?” cried Teddy. “I—now—”
“We’ll get you one made of platinum first chance we get,” broke in Roy.
“I reckon you-all can leave that to me!” chuckled Jerry Decker, who had
been brought over to X Bar X ranch to enjoy the celebration. “Guess it’s
customary fer a patient to give his nurse a leetle somethin’, ain’t it?” he
appealed to Mr. Manley.
“Of course!” agreed the rancher.
Later, when Jerry had gone back East and bought with his nuggets a little
farm, a registered package came for Belle Ada. It contained a wonderful
bracelet with two diamonds in it.
“They’re bright like your eyes,” Jerry wrote in the note that
accompanied the gift.
Belle Ada smiled happily.
“And here’s a registered package for you too, Pop,” said Roy.
“For me! Quit your joshin’!”
“No, really! Guess your cousin sent it.”
It was a watch and chain from Mr. Decker. Pop strung it across his
cowhide vest proudly and wore it continually after that, on a horse or off.
“Read this, Roy!” called Teddy to his brother one day when the mail had
come in, bringing several papers. He tossed the sheet to his brother.
On the front page was an account of the trial and conviction of
Greyhound and most of his gang. They were wanted for many other crimes
than the robbing of Jerry Decker and the killing of the father and brother of
Silent Neville, so there was no need for the ranch boys to give any
testimony.
“Twenty years for Allen,” mused Roy. “He’ll sit in his cell a long time.”
“Whew! I wouldn’t want to be Allen!”
“Me, either! Come on, I’m crazy for a ride! Beat you around the corral!”
A little later a cloud of dust hid the X Bar X boys and their ponies.
THE END
This Isn’t All!

Would you like to know what became of the good friends you have made in
this book?
Would you like to read other stories continuing their adventures and
experiences, or other books quite as entertaining by the same author?
On the reverse side of the wrapper which comes with this book, you will
find a wonderful list of stories which you can buy at the same store where
you got this book.
Don’t throw away the Wrapper
Use it as a handy catalog of the books you want some day to have. But in
case you do mislay it, write to the Publishers for a complete catalog.
WESTERN STORIES FOR BOYS

By JAMES CODY FERRIS
Individual Colored Wrappers and Illustrations by
WALTER S. ROGERS
Each Volume Complete in Itself.
Thrilling tales of the great west, told primarily for boys but which will
be read by all who love mystery, rapid action, and adventures in the great
open spaces.
The Manley Boys, Roy and Teddy, are the sons of an old ranchman, the
owner of many thousands of heads of cattle. The lads know how to ride,
how to shoot, and how to take care of themselves under any and all
circumstances.
The cowboys of the X Bar X Ranch are real cowboys, on the job when
required but full of fun and daring—a bunch any reader will be delighted to
know.
THE X BAR X BOYS ON THE RANCH
THE X BAR X BOYS IN THUNDER CANYON
THE X BAR X BOYS ON WHIRLPOOL RIVER
THE X BAR X BOYS ON BIG BISON TRAIL
THE X BAR X BOYS AT THE ROUND-UP
THE X BAR X BOYS AT NUGGET CAMP
THE X BAR X BOYS AT RUSTLER’S GAP
GROSSET & DUNLAP, Publishers, NEW YORK
FAMOUS ROVER BOYS SERIES

BY ARTHUR M. WINFIELD
(Edward Stratemeyer)
OVER THREE MILLION COPIES SOLD OF THIS SERIES.
Uniform Style of Binding. Colored Wrappers.

Every Volume Complete in Itself.
THE ROVER BOYS AT SCHOOL
THE ROVER BOYS ON THE OCEAN
THE ROVER BOYS IN THE JUNGLE
THE ROVER BOYS OUT WEST
THE ROVER BOYS ON THE GREAT LAKES
THE ROVER BOYS IN THE MOUNTAINS
THE ROVER BOYS ON LAND AND SEA
THE ROVER BOYS IN CAMP
THE ROVER BOYS ON THE RIVER
THE ROVER BOYS ON THE PLAINS
THE ROVER BOYS IN SOUTHERN WATERS
THE ROVER BOYS ON THE FARM
THE ROVER BOYS ON TREASURE ISLE
THE ROVER BOYS AT COLLEGE
THE ROVER BOYS DOWN EAST
THE ROVER BOYS IN THE AIR
THE ROVER BOYS IN NEW YORK
THE ROVER BOYS IN ALASKA
THE ROVER BOYS IN BUSINESS
THE ROVER BOYS ON A TOUR
THE ROVER BOYS AT COLBY HALL
THE ROVER BOYS ON SNOWSHOE ISLAND
THE ROVER BOYS UNDER CANVAS
THE ROVER BOYS ON A HUNT
THE ROVER BOYS IN THE LAND OF LUCK
THE ROVER BOYS AT BIG HORN RANCH
THE ROVER BOYS AT BIG BEAR LAKE
THE ROVER BOYS SHIPWRECKED
THE ROVER BOYS ON SUNSET TRAIL
THE ROVER BOYS WINNING A FORTUNE
Grosset & Dunlap, Publishers, New York
THE HARDY BOYS SERIES

By FRANKLIN W. DIXON
Individual Colored Wrappers and Text Illustrations by
WALTER S. ROGERS
Every Volume Complete in Itself
THE HARDY BOYS are sons of a celebrated American detective, and

during vacations and their off time from school they help their father by
hunting down clues themselves.
THE TOWER TREASURE
A dying criminal confessed that his loot had been secreted “in the
tower.” It remained for the Hardy Boys to make an astonishing discovery
that cleared up the mystery.
THE HOUSE ON THE CLIFF
The house had been vacant and was supposed to be haunted. Mr. Hardy
started to investigate—and disappeared! An odd tale, with plenty of
excitement.
THE SECRET OF THE OLD MILL
Counterfeit money was in circulation, and the limit was reached when
Mrs. Hardy took some from a stranger. A tale full of thrills.
THE MISSING CHUMS
Two of the Hardy Boys’ chums take a motor trip down the coast. They
disappear and are almost rescued by their friends when all are captured. A
thrilling story of adventure.
HUNTING FOR HIDDEN GOLD
Mr. Hardy is injured in tracing some stolen gold. A hunt by the boys
leads to an abandoned mine, and there things start to happen. A western
story all boys will enjoy.
GROSSET & DUNLAP, Publishers, NEW YORK

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One Eleven Comes Through

This Isn’t All!

WESTERN STORIES FOR BOYS

GROSSET & DUNLAP, Publishers, NEW YORK

FAMOUS ROVER BOYS SERIES

OVER THREE MILLION COPIES SOLD OF THIS SERIES.

Uniform Style of Binding. Colored Wrappers.

Grosset & Dunlap, Publishers, New York

THE HARDY BOYS SERIES

THE HARDY BOYS are sons of a celebrated American detective, and

GROSSET & DUNLAP, Publishers, NEW YORK

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