Pre-board Exam For November 2009 NLE (Practice Mode)
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- 1.A pregnant woman who is at term is admitted to the birthing unit in active labor. The client has only progressed from 2cm to 3 cm in 8 hours. She is diagnosed with hypotonic dystocia and the physician ordered Oxytocin (Pitocin) to augment her contractions. Which of the following is the most important aspect of nursing intervention at this time?
- A.
Timing and recording length of contractions.
- B.
Monitoring.
- C.
Preparing for an emergency cesarean birth.
- D.
Checking the perineum for bulging.
- 2.A client who hallucinates is not in touch with reality. It is important for the nurse to:
- A.
Isolate the client from other patients.
- B.
Maintain a safe environment.
- C.
Orient the client to time, place, and person
- D.
Establish a trusting relationship.
- 3.The nurse is caring to a child client who has had a tonsillectomy. The child complains of having dryness of the throat. Which of the following would the nurse give to the child?
- A.
Cola with ice
- B.
Yellow noncitrus Jello
- C.
Cool cherry Kool-Aid
- D.
A glass of milk
- 4.The physician ordered Phenylephrine (Neo-Synephrine) nasal spray to a 13-year-old client. The nurse caring to the client provides instructions that the nasal spray must be used exactly as directed to prevent the development of:
- A.
Increased nasal congestion.
- B.
Nasal polyps
- C.
Bleeding tendencies.
- D.
Tinnitus and diplopia.
- 5.A client with tuberculosis is to be admitted in the hospital. The nurse who will be assigned to care for the client must institute appropriate precautions. The nurse should:
- A.
Place the client in a private room.
- B.
Wear an N 95 respirator when caring for the client.
- C.
Put on a gown every time when entering the room.
- D.
Don a surgical mask with a face shield when entering the room.
- 6.Which of the following is the most frequent cause of noncompliance to the medical treatment of open-angle glaucoma?
- A.
The frequent nausea and vomiting accompanying use of miotic drug.
- B.
Loss of mobility due to severe driving restrictions.
- C.
Decreased light and near-vision accommodation due to miotic effects of pilocarpine.
- D.
The painful and insidious progression of this type of glaucoma.
- 7.In the morning shift, the nurse is making rounds in the nursing care units. The nurse enters in a client’s room and notes that the client’s tube has become disconnected from the Pleurovac. What would be the initial nursing action?
- A.
Apply pressure directly over the incision site.
- B.
Clamp the chest tube near the incision site.
- C.
Clamp the chest tube closer to the drainage system.
- D.
Reconnect the chest tube to the Pleurovac.
- 8.Which of the following complications during a breech birth the nurse needs to be alarmed?
- A.
Abruption placenta.
- B.
Caput succedaneum.
- C.
Pathological hyperbilirubinemia.
- D.
Umbilical cord prolapse
- 9.The nurse is caring to a client diagnosed with severe depression. Which of the following nursing approach is important in depression?
- A.
Protect the client against harm to others.
- B.
Provide the client with motor outlets for aggressive, hostile feelings.
- C.
Reduce interpersonal contacts.
- D.
Deemphasizing preoccupation with elimination, nourishment, and sleep.
- 10.A 3-month-old client is in the pediatric unit. During assessment, the nurse is suspecting that the baby may have hypothyroidism when mother states that her baby does not:
- A.
Sit up.
- B.
Pick up and hold a rattle.
- C.
Roll over.
- D.
Hold the head up.
- 11.The physician calls the nursing unit to leave an order. The senior nurse had conversation with the other staff. The newly hired nurse answers the phone so that the senior nurses may continue their conversation. The new nurse does not know the physician or the client to whom the order pertains. The nurse should:
- A.
Ask the physician to call back after the nurse has read the hospital policy manual.
- B.
Take the telephone order.
- C.
Refuse to take the telephone order.
- D.
Ask the charge nurse or one of the other senior staff nurses to take the telephone order.
- 12.The staff nurse on the labor and delivery unit is assigned to care to a primigravida in transition complicated by hypertension. A new pregnant woman in active labor is admitted in the same unit. The nurse manager assigned the same nurse to the second client. The nurse feels that the client with hypertension requires one-to-one care. What would be the initial action of the nurse?
- A.
Accept the new assignment and complete an incident report describing a shortage of nursing staff.
- B.
Report the incident to the nursing supervisor and request to be floated.
- C.
Report the nursing assessment of the client in transitional labor to the nurse manager and discuss misgivings about the new assignment.
- D.
Accept the new assignment and provide the best care.
- 13.A newborn infant with Down syndrome is to be discharged today. The nurse is preparing to give the discharge teaching regarding the proper care at home. The nurse would anticipate that the mother is probably at the:
- A.
40 years of age
- B.
20 years of age.
- C.
35 years of age.
- D.
20 years of age.
- 14.The emergency department has shortage of staff. The nurse manager informs the staff nurse in the critical care unit that she has to float to the emergency department. What should the staff nurse expect under these conditions?
- A.
The float staff nurse will be informed of the situation before the shift begins.
- B.
The staff nurse will be able to negotiate the assignments in the emergency department.
- C.
Cross training will be available for the staff nurse.
- D.
Client assignments will be equally divided among the nurses.
- 15.The nurse is assigned to care for a child client admitted in the pediatrics unit. The client is receiving digoxin. Which of the following questions will be asked by the nurse to the parents of the child in order to assess the client’s risk for digoxin toxicity?
- A.
“Has he been exposed to any childhood communicable diseases in the past 2-3 weeks?”
- B.
“Has he been taking diuretics at home?”
- C.
“Do any of his brothers and sisters have history of cardiac problems?”
- D.
“Has he been going to school regularly?”
- 16.The nurse noticed that the signed consent form has an error. The form states, “Amputation of the right leg” instead of the left leg that is to be amputated. The nurse has administered already the preoperative medications. What should the nurse do?
- A.
Call the physician to reschedule the surgery.
- B.
Call the nearest relative to come in to sign a new form.
- C.
Cross out the error and initial the form.
- D.
Have the client sign another form.
- 17.The nurse in the nursing care unit checks the fluctuation in the water-seal compartment of a closed chest drainage system. The fluctuation has stopped, the nurse would:
- A.
Vigorously strip the tube to dislodge a clot.
- B.
Raise the apparatus above the chest to move fluid.
- C.
Increase wall suction above 20 cm H2O pressure.
- D.
Ask the client to cough and take a deep breath.
- 18.The pediatric nurse in the neonatal unit was informed that the baby that is brought to the mother in the hospital room is wrong. The nurse determines that two babies were placed in the wrong cribs. The most appropriate nursing action would be to:
- A.
Determine who is responsible for the mistake and terminate his or her employment.
- B.
Record the event in an incident/variance report and notify the nursing supervisor.
- C.
Reassure both mothers, report to the charge nurse, and do not record.
- D.
Record detailed notes of the event on the mother’s medical record.
- 19.Before the administration of digoxin, the nurse completes an assessment to a toddler client for signs and symptoms of digoxin toxicity. Which of the following is the earliest and most significant sign of digoxin toxicity?
- A.
Tinnitus
- B.
Nausea and vomiting
- C.
Vision problem
- D.
Slowing in the heart rate
- 20.Which of the following treatment modality is appropriate for a client with paranoid tendency?
- A.
Activity therapy.
- B.
Individual therapy.
- C.
Group therapy.
- D.
Family therapy.
- 21.The client with rheumatoid arthritis is for discharge. In preparing the client for discharge on prednisone therapy, the nurse should advise the client to:
- A.
Wear sunglasses if exposed to bright light for an extended period of time.
- B.
Take oral preparations of prednisone before meals.
- C.
Have periodic complete blood counts while on the medication.
- D.
Never stop or change the amount of the medication without medical advice.
- 22.A pregnant client tells the nurse that she is worried about having urinary frequency. What will be the most appropriate nursing response?
- A.
“Try using Kegel (perineal) exercises and limiting fluids before bedtime. If you have frequency associated with fever, pain on voiding, or blood in the urine, call your doctor/nurse-midwife.
- B.
“Placental progesterone causes irritability of the bladder sphincter. Your symptoms will go away after the baby comes.”
- C.
“Pregnant women urinate frequently to get rid of fetal wastes. Limit fluids to 1L/daily.”
- D.
“Frequency is due to bladder irritation from concentrate urine and is normal in pregnancy. Increase your daily fluid intake to 3L.”
- 23.Which of the following will help the nurse determine that the expression of hostility is useful?
- A.
Expression of anger dissipates the energy.
- B.
Energy from anger is used to accomplish what needs to be done.
- C.
Expression intimidates others.
- D.
Degree of hostility is less than the provocation.
- 24.The nurse is providing an orientation regarding case management to the nursing students. Which characteristics should the nurse include in the discussion in understanding case management?
- A.
Main objective is a written plan that combines discipline-specific processes used to measure outcomes of care.
- B.
Main purpose is to identify expected client, family and staff performance against the timeline for clients with the same diagnosis.
- C.
Main focus is comprehensive coordination of client care, avoid unnecessary duplication of services, improve resource utilization and decrease cost.
- D.
Primary goal is to understand why predicted outcomes have not been met and the correction of identified problems.
- 25.The physician orders a dose of IV phenytoin to a child client. In preparing in the administration of the drug, which nursing action is not correct?
- A.
Infuse the phenytoin into a smaller vein to prevent purple glove syndrome.
- B.
Check the phenytoin solution to be sure it is clear or light yellow in color, never cloudy.
- C.
Plan to give phenytoin over 30-60 minutes, using an in-line filter.
- D.
Flush the IV tubing with normal saline before starting phenytoin.
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