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Nursing Comprehensive Exam 5

50 Questions
Nursing Quizzes & Trivia
Questions and Answers
  • 1. 
    A client with newly diagnosed polycystic kidney disease has just finished speaking with the physician about the disorder.  The client asks the nurse to explain again what the most serious complication of the disorder might be.  In formulating a response, the nurse incorporates the understanding that the most serious complication is:
    • A. 

      Diabetes insipidus

    • B. 

      Syndrome of inappropriate antidi-uretic hormone (ADH) secretion

    • C. 

      End stage renal disease (ESRD)

    • D. 

      Chronic urinary tract infection (UTI)

  • 2. 
    • A. 

      Tolerance for sips of clear liquids

    • B. 

      Temperature

    • C. 

      Hourly urine output

    • D. 

      Ability to turn side to side

  • 3. 
    • A. 

      Impaired Physical Mobility

    • B. 

      Activity Intolerance

    • C. 

      Ineffective Breathing Pattern

    • D. 

      Ineffective Airway Clearance

  • 4. 
    A client with gastric tumor is scheduled for subtotal gastrectomy (Billroth II procedure).  The nurse explains the procedure to the client and tells the client that the:
    • A. 

      Proximal end of the distal stomach is anastomosed to the duodenum

    • B. 

      Antrum of the stomach is removed with the remaining portion anastomosed to the duodenum

    • C. 

      Entire stomach is removed and the esophagus is anastomosed to the duodenum

    • D. 

      Lower portion of the stomach is removed and the remainder is anastomosed to the jejunum

  • 5. 
    A nurse prepares a postoperative plan of care for a client scheduled for hypophysectomy.  The nurse avoids including which of the following in the plan?
    • A. 

      Mouth care

    • B. 

      Coughing and deep breathing

    • C. 

      Monitoring intake and output

    • D. 

      Daily weights

  • 6. 
    A client undergoes a thyroidectomy.  The nurse monitors the client for signs of damage to the parathyroid glands postoperatively.  Which of the following findings would indicate damage to the parathyroid glands?
    • A. 

      Hoarseness

    • B. 

      Tingling around the mouth

    • C. 

      Respiratory distress

    • D. 

      Neck pain

  • 7. 
    A nurse is caring for a client who is comatose.  The nurse notes in the chart that the client is exhibiting decerebrate posturing.  Based on this documented finding, the nurse expects to note which of the following?
    • A. 

      Extension of the extremities after a stimulus

    • B. 

      Flexion of the extremities after a stimulus

    • C. 

      Upper extremity flexion with lower extremity extension

    • D. 

      Upper extremity extension with lower extremity flexion

  • 8. 
    A nurse is caring for a client who had a total knee replacement.  Postoperatively, which of the following nursing assessments is the highest priority?
    • A. 

      Bladder distention

    • B. 

      Homans’ sign

    • C. 

      Extremity shortening

    • D. 

      Heel breakdown

  • 9. 
    A nurse is assessing a client’s smoking habit. The client admits smoking ¾ pack per day for the last 10 years. The nurse calculates that the client has a smoking history of how many pack-years?
    • A. 

      0.75 pack-years

    • B. 

      7.5 pack-years

    • C. 

      15 pack-years

    • D. 

      30 pack-years

  • 10. 
    A nurse is conducting a health history of a client with hyperparathyroidsm. Which of the following questions made to the client would elicit information about this condition?
    • A. 

      "Have you had problems with diarrhea lately?"

    • B. 

      "Do you have tremors in your hands?"

    • C. 

      "Are you experiencing pain in your joints?"

    • D. 

      "Do you notice swelling in your legs at night?"

  • 11. 
    An 18 year-old client seeks medical attention for intermittent episodes in which the fingers of both hands become cold, pale, and numb, followed by redness and swelling and throbbing, achy pain. Raynaud’s disease is suspected. The nurse further assesses the client to see if these episodes occur with:
    • A. 

      Exposure to heat

    • B. 

      Being in a relaxed environment

    • C. 

      Prolonged episodes of inactivity

    • D. 

      Ingestion of coffee or chocolate

  • 12. 
    A client is admitted to the hospital with a diagnosis of pericarditis. A nurse assesses the client for which manifestation that differentiates pericarditis from other cardiopulmonary problems?
    • A. 

      Chest pain that worsens on inspiration

    • B. 

      Pericardial friction rub

    • C. 

      Anterior chest pain

    • D. 

      Weakness and irritability

  • 13. 
    An ambulatory care nurse is assessing client with chronic sinusitis. The nurse interprets that which of the following client manifestations is unrelated to this problem?
    • A. 

      Purulent nasal discharge

    • B. 

      Chronic cough

    • C. 

      Headache more pronounced in the evening

    • D. 

      Anosmia

  • 14. 
    A client has Impaired Verbal Communication as a result of a temporary tracheostomy following a laryngectomy.   In planning for communication with this client, a nurse would avoid which of the following methods because it would be the least helpful for this particular client?
    • A. 

      Use of hand or finger signals

    • B. 

      Nodding and shaking the head for yes and no

    • C. 

      Use of a picture board

    • D. 

      Use of a pencil and paper

  • 15. 
    A client seeks treatment in an ambulatory clinic for a complaint of hoarseness that has lasted for 6 weeks.   Based on the symptom, the nurse interprets that the client is at risk of having:
    • A. 

      Laryngeal cancer

    • B. 

      Acute Laryngitis

    • C. 

      Bronchogenic cancer

    • D. 

      Thyroid cancer

  • 16. 
    A nurse in an ambulatory clinic administers a Mantoux skin test to a client on a Monday. The nurse plans to have the client return to the clinic to have results read on:
    • A. 

      Tuesday or Wednesday

    • B. 

      Wednesday or Thursday

    • C. 

      Thursday or Friday

    • D. 

      The following Monday

  • 17. 
    A nurse is caring for a client who has just experienced a pulmonary embolism. The client is restless and very anxious. The nurse uses which approach in communicating with this client?
    • A. 

      Explaining each treatment in great detail

    • B. 

      Having the family reinforce the nurse’s directions

    • C. 

      Giving simple clear directions and explanations

    • D. 

      Speaking very little to the client until the crisis is over

  • 18. 
    • A. 

      Encouraging the client to cough and deep breathe

    • B. 

      Staying with the client

    • C. 

      Interpreting the arterial blood gas report

    • D. 

      Distracting the client with television

  • 19. 
    A nurse is conducting a health screening clinic.  The nurse interprets that which of the following clients participating in the screening has the greatest need for instruction to lower the risk of developing respiratory disease?
    • A. 

      A 50-year-old smoker with cracked asbestos lining on basement pipes in the home

    • B. 

      A 40-year-old smoker who works in a hospital

    • C. 

      A 36-year-old who works with pesticides

    • D. 

      A 25-year-old whose hobby is woodworking

  • 20. 
    A nurse is interviewing a client with chronic obstructive pulmonary disease (COPD), who has a respiratory rate of 35 breaths/min and is experiencing extreme dyspnea. Which if the following nursing diagnoses would be most appropriate for this client?      
    • A. 

      Impaired Verbal Communication related to a physical barrier

    • B. 

      Ineffective individual coping related to the client’s inability to handle a situational crisis

    • C. 

      Altered Body Image related to neurological deficit

    • D. 

      Knowledge deficit related to COPD

  • 21. 
    A nurse has received a client assignment for the day and is organizing the required tasks. Which of the following will not be a component of the plan for time management?      
    • A. 

      Prioritizing client needs and daily tasks

    • B. 

      Providing time for unexpected tasks

    • C. 

      Gathering supplies before beginning a task

    • D. 

      Documenting task completion at the end of the day

  • 22. 
    A registered nurse (RN) is a preceptor for a new nursing graduate and is describing critical paths and variance analysis to the new graduate. The RN instructs the new nursing graduate that a variance analysis is performed on all clients:        
    • A. 

      Daily during hospitalization

    • B. 

      Every other day of hospitalization

    • C. 

      Every third day of hospitalization

    • D. 

      Continuously

  • 23. 
    • A. 

      Autocratic

    • B. 

      Situational

    • C. 

      Democratic

    • D. 

      Laissez-faire

  • 24. 
    • A. 

      Functional nursing

    • B. 

      Team nursing

    • C. 

      Exemplary model of nursing

    • D. 

      Primary nursing

  • 25. 
    A nurse is receiving a client in transfer from the postanesthesia care unit following a left above-the-knee amputation. The nurse should take which of the following most important actions when positioning the client at this time?  
    • A. 

      Put the bed in reverse Trendelenburg position

    • B. 

      Keep the stump flat with the client lying on the operative side

    • C. 

      Position the stump flat on the bed

    • D. 

      Elevate the foot of the bed

  • 26. 
    A nurse manager is planning to implement a change in the method of documentation system in the nursing unit. Many problems have occurred as a result of the present documentation system and the nurse manager determines that a change is required. The initial step in the process of change for the nurse manager is which of the following?     
    • A. 

      Plan strategies to implement the change

    • B. 

      Identify potential solutions and strategies for the change process

    • C. 

      Set goals and priorities regarding the change process

    • D. 

      Identify the inefficiency that needs improvement or correction

  • 27. 
    A client who had a spinal fusion with insertion of hardware is extremely concerned with the perceived lengthy rehabilitation period. The client expresses concerns about finances and the ability to return to prior employment. The nurse understands that the client’s needs could best be addressed by referral to the
    • A. 

      Surgeon

    • B. 

      Clinical nurse specialist

    • C. 

      Social worker

    • D. 

      Physical therapist

  • 28. 
    • A. 

      He states that he will not allow his wife to come home to die

    • B. 

      He immediately arranges for their three teen-aged children to live with relatives in another state

    • C. 

      He express his anger at God and the physicians for allowing this to happen

    • D. 

      He refuses to visit wife in the hospital or to discuss her illness

  • 29. 
    A camp nurse provides instructions regarding skin protection from the sun to the parents who are preparing their children for a camping adventure.  The nurse avoid telling the parents:
    • A. 

      To obtain a sunscreen product with an SPF of 15 or more

    • B. 

      That sunscreen will not be required on cloudy days

    • C. 

      To pack a hat, long-sleeved shirt, and long pants for the child

    • D. 

      To select tightly woven materials for greater protection from sun rays

  • 30. 
    • A. 

      This will be a totally painless experience. It is nothing to worry about

    • B. 

      I’m sure it will be a relief for you just as soon as I discontinue this IV for good. Just relax and take a deep breath

    • C. 

      This procedure will not take long and will be over soon. I can see that you’re anxious.

    • D. 

      Removal of the IV shouldn’t be painful ; however, the IV will need to be restarted in another location.

  • 31. 
    A client goes into respiratory distress, and an arterial blood gas (ABG) specimen is drawn from the radial artery. The nurse performs the Allen's test prior to the ABG to determine the adequacy of the:           
    • A. 

      Femoral circulation

    • B. 

      Brachial circulation

    • C. 

      Carotid circulation

    • D. 

      Ulnar circulation

  • 32. 
    A client has died, and a nurse asks a family member about the funeral arrangements. The family member refuses to discuss the issue.  The nurse’s most appropriate action is to:
    • A. 

      Provide information needed for decision making

    • B. 

      Assess the risk of self-harm and refer the family member to a Psychiatric Nursing professional

    • C. 

      Demonstrate acceptance of the family member’s feelings

    • D. 

      Remain with the family member without discussing funeral arrangements

  • 33. 
    • A. 

      Gently massage the area around the site daily

    • B. 

      Cleanse the site daily with alcohol

    • C. 

      Keep the cannula stabilized or anchored properly with tape

    • D. 

      Immobilize the extremity until the IV is discontinued

  • 34. 
    A client is diagnosed with hyperphosphatemia.  The nurse encourages the client to limit intake of which of the following items that exacerbates the condition?
    • A. 

      Bananas

    • B. 

      Grapes

    • C. 

      Coffee

    • D. 

      Carbonated beverages

  • 35. 
    A client is diagnosed with thrombophlebitis of the left leg.  A nurse documents in the nursing care plan that the client should be placed on bed test with:
    • A. 

      The left leg kept flat

    • B. 

      Elevation of the left leg

    • C. 

      The left leg in a dependent position

    • D. 

      Bathroom privileges

  • 36. 
    A client is ready to be discharged to home health care for continued intravenous (IV) therapy at home.  Home care instructions regarding care of the IV have been given to the client.  The best way to evaluate the client ability to care for the IV site is to:    
    • A. 

      Ask the client to verbalize IV site care

    • B. 

      Ask the client to change the IV dressing

    • C. 

      Review the entire discharge plan with the client again

    • D. 

      Demonstrate the dressing change again for the client one last time before discharge

  • 37. 
    A client is scheduled for an arteriogram using a radiopaque dye.  A nurse assesses which most critical item before the procedure?            
    • A. 

      Intake and output

    • B. 

      Vital signs

    • C. 

      Height and weight

    • D. 

      Allergy to iodine or shellfish

  • 38. 
    A client receives intralipids intravenously at home. The client’s spouse manages the infusion.  The community health nurse discusses potential adverse reactions and side effects of the therapy with the client and the spouse.  Following the discussion, the nurse expects the spouse to verbalize, that in case of a suspected adverse reaction, the priority action is to:
    • A. 

      Take a blood pressure

    • B. 

      Stop the infusion

    • C. 

      Contact the nurse

    • D. 

      Contact the local area emergency response team

  • 39. 
    A client scheduled for the insertion of an implanted port for intermittent chemotherapy treatment says, “I’m not sure if I can handle having a tube coming out of me all the time. What will my friends think?” Based on the client’s statements, the nurse plans to do which of the following first
    • A. 

      Show the client various central line tubes and catheters

    • B. 

      Explain that an implanted port is placed under the skin and is not visible

    • C. 

      Notify the physician of the client’s concerns

    • D. 

      Explain that the client friends probably will not see the tube under the clothing

  • 40. 
    A client who has a history of gout is also diagnosed with urolithiasis.  The stones are determined to be of the uric acid type.  The nurse gives the client instructions in foods to limit, which include
    • A. 

      Liver

    • B. 

      Apples

    • C. 

      Carrots

    • D. 

      Milk

  • 41. 
    A client who has been receiving long-term diuretic therapy is admitted to the hospital with a diagnosis of dehydration.  A nurse would assess for which sign or symptom that correlates with this fluid imbalance?         
    • A. 

      Increased blood pressure

    • B. 

      Decreased pulse

    • C. 

      Decreased central venous pressure (CVP)

    • D. 

      Bibasilar crackles

  • 42. 
    A client who had drainage of a pleural effusion is in pain. The nurse avoids which of the following interventions in providing support to this client?
    • A. 

      Offering verbal support and reassurance

    • B. 

      Assisting the client to find positions of comfort

    • C. 

      Leaving the client alone for an extended rest period

    • D. 

      Providing pain medication for the client

  • 43. 
    A client with a history of self-managed peptic ulcer disease has frequently used excessive amount of oral antacids.  A nurse interprets that this client is at most risk for which acid-base disturbance?    
    • A. 

      Metabolic acidosis

    • B. 

      Metabolic acidosis

    • C. 

      Respiratory alkalosis

    • D. 

      Respiratory acidosis

  • 44. 
    • A. 

      Infiltration

    • B. 

      Phlebitis

    • C. 

      Thrombosis

    • D. 

      Infection

  • 45. 
    A client with Chlamydia infection has received instructions on self-care and prevention of further infection.  The nurse evaluates that the client needs further reinforcement if the client states to:   
    • A. 

      Reduce the chance of reinfection by limiting the number of sexual partners

    • B. 

      Use latex condoms to prevent disease transmission

    • C. 

      Return to the clinic as requested for follow-up culture in 1 week

    • D. 

      Antibiotics prophylactically to prevent symptoms of Chlamydia

  • 46. 
    A client with diabetes mellitus is told that amputation of the leg is necessary to sustain life. The client is very upset and says to a nurse. “This is all the doctor’s fault!  I have done everything that the doctor has asked me to do!” The nurse interprets the client’s statement as:         
    • A. 

      An expected coping mechanism

    • B. 

      A need to notify the hospital lawyer

    • C. 

      An expression of guilt on the part of the client

    • D. 

      An ineffective coping mechanism

  • 47. 
    A clinic nurse provides information to a married couple regarding measures to prevent infertility.  Which statement made by the husband indicates a need for providing further information?
    • A. 

      We need to avoid excessive intake of alcohol

    • B. 

      We need to decrease exposure to environmental hazards.

    • C. 

      We need to eat a nutritious diet

    • D. 

      I need to maintain warmth to the scrotum

  • 48. 
    A community health nurse is working with food services in a rural school setting.  A goal for the school dietary program is to avoid nutritional deficiencies and enhance children’s nutritional status through healthy dietary practices.  In implementing interventions by levels of prevention, which of the following would be a primary prevention intervention that the nurse could use?         
    • A. 

      Case finding in the school to identify dietary practices

    • B. 

      School screening programs for early detection of children with poor eating habits

    • C. 

      Providing educational programs, literature, and posters to promote awareness of healthy eating

    • D. 

      Conducting a community-wide dietary screening activity to detect community dietary trends

  • 49. 
    A community health nurse visits a client who is receiving total parental nutrition (TPN) in the home. The client states, “I really miss eating with my family at dinner.” Which is the best response by the nurse? 
    • A. 

      It is normal to miss something as basic as eating.

    • B. 

      I think in a few weeks you will probably be allowed to eat a little

    • C. 

      Tell me more about how you feel about dinner time

    • D. 

      You could sit with your family at dinner time anyway even if do not eat.

  • 50. 
    A European-American client maintains eye contact with a nurse during conversation regarding a preoperative teaching plan.  The nurse interprets this nonverbal communication as: 
    • A. 

      Rudeness

    • B. 

      Arrogance

    • C. 

      Indicating uneasiness

    • D. 

      Indicating trustworthiness