Adult Health Clinical Nurse Specialist Exam Prep Test
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Welcome to the Adult Health Clinical Nurse Specialist Exam Prep Test. This questionnaire has more than twenty-five questions about some of the fundamental duties and technical work a nurse must carry out. So, if you are aspiring to become an adult health clinical nurse, this quiz might help you clear your exam.
- 1.The nurse is monitoring the client’s laboratory values. Which laboratory report is diagnostic for a urinary tract infection (UTI)?
- A.
Hemogram
- B.
Urinalysis
- C.
Urine Culture
- D.
Metanephrines
- 2.The nurse is caring for a client diagnosed with chronic renal failure (CRF). Which antecedents would the nurse assess? Select all that apply.
- A.
Current diet.
- B.
Diabetes.
- C.
Hypertension.
- D.
Fluid restitions.
- E.
Race
- 3.The client is in the intensive care department (ICD) after a motor-vehicle accident in which the client lost an estimated three (3) units of blood. Which action by the nurse could prevent the client from developing acute renal failure?
- A.
Take and document the client’s vital signs every hour.
- B.
Assess the client’s dressings every two (2) hours.
- C.
Check the client’s urinary output every shift.
- D.
Maintain the client’s blood pressure greater than 100/60.
- 4.The nurse has identified the concept of urinary elimination for a client. Which information is most important for the nurse to provide to the health-care provider the next day? Day One (Shift Time) Oral (in mL) Intravenous (in mL) Urine (in mL) Nasogastric Tube (in mL) Other (Specific) (in mL) 0701-1500 2100 1000 435 Emesis 40 1501-2300 1500 1000 375 2301-0700 200 1000 500 Total 3800 3000 1310 40
- A.
The client vomited 40 mL on the day shift.
- B.
The client has an adequate oral intake, and IV fluids are not needed.
- C.
The client has had 6,800 mL intake and 1,350 mL output in the last 24 hours.
- D.
The client does not like to have to keep the urine for measurement.
- 5.The client diagnosed with chronic renal failure (CRF) is prescribed hemodialysis on Monday, Wednesday, and Friday. Which interventions should the dialysis nurse implement? Select all that apply.
- A.
Weigh the client before and after each treatment.
- B.
Discuss the recommended fluid restriction.
- C.
Provide potato chips or pretzels as a snack.
- D.
Monitor the hemodialysis access site continuously.
- E.
Keep up a lively conversation during the treatments.
- 6.The nurse is administering morning medications. Which medication should the nurse question administering? Client Name: ACC Admitting Diagnosis: Acute Renal Failure Account Number: 678905 Med Rec #: 01 01 02 Allergies Penicillin Date | Medication | 2301–0700 | 0701–1500 | 1501–2300 Yesterday | Furosemide (Lasix) 80 mg PO daily | - | 0900 K1 4.3 | - | Yesterday | Erythropoietin (Epogen) Sub Q daily times 3 days | - | 0900 | - | Yesterday | Multivitamin with iron PO daily | - | 0900 | - | Yesterday | Levothyroxine (Synthroid) 0.75 mcg PO daily | - | 0900 | - | Signature of Nurse: Day Nurse RN (DN)
- A.
Furosemide.
- B.
Erythropoietin.
- C.
Multivitamin with iron.
- D.
Levothyroxine.
- 7.The nurse identifies the concepts of elimination and immunity for a female client diagnosed with a urinary tract infection. Which discharge instructions should the nurse provide the client? Select all that apply.
- A.
Teach the client to wipe from front to back after voiding.
- B.
Encourage the client to drink cranberry juice each morning.
- C.
Inform the client that frequent episodes of incontinence are expected.
- D.
Discuss the signs and symptoms of a recurrent infection.
- E.
Have the client fill a container of water to sip until at least 2,000 mL is consumed.
- F.
Request that the client sit in a tub of warm water twice a day for 25 minutes.
- 8.The client diagnosed with chronic renal failure (CRF) is prescribed a 60-gm protein, 2,000-mg sodium diet. Which food choices indicate the client understands the dietary restrictions?
- A.
A 4-ounce grilled chicken breast, broccoli, and small glass of unsweet tea.
- B.
Baked potato with chopped ham and sour cream, 12-ounce steak, and beer.
- C.
Double patty cheeseburger, french fries, and saccharin sweet Kool Aid.
- D.
Roast beef sandwich, potato chips, and soft drink.
- 9.The elderly client presents to the emergency department complaining of burning on urination with an urgency to void, and a temperature of 99.8°F. Which intervention should the nurse implement first?
- A.
Ask the client to provide a clean voided midstream urine for culture.
- B.
Insert an 18-gauge peripheral IV catheter and start normal saline fluids.
- C.
Arrange for the client to be admitted to the medical unit.
- D.
Initiate the ordered intravenous antibiotic medication.
- 10.The client diagnosed with a urinary tract infection has a blood pressure of 83/56 mm Hg and a pulse of 122 bpm. Which should the nurse implement first?
- A.
Notify the health-care provider (HCP).
- B.
Hang the IVPB antibiotic at the prescribed rate.
- C.
Check the laboratory work to determine if the urine culture has been completed.
- D.
Increase the normal saline IV fluids from keep open to 150 mL/hour on the IV pump.
- 11.The nurse enters the client’s room and notes an unconscious client with an absence of respirations and no pulse or blood pressure. The concept of perfusion is identified by the nurse. Which should the nurse implement first?
- A.
Notify the health care provider.
- B.
Call a rapid response team (RRT).
- C.
Determine the telemetry monitor reading.
- D.
Push the Code Blue button.
- 12.The 45-year-old male client diagnosed with essential hypertension has decided not to take his medications. The client’s BP is 178/94, indicating a perfusion issue. Which question should the nurse ask the client first?
- A.
“Do you have the money to buy your medication?”
- B.
“Does the medication give unwanted side effects?”
- C.
“Did you quit taking the medications because you don’t feel bad?”
- D.
“Can you tell me why you stopped taking the medication?”
- 13.The nurse identifies the concept of altered tissue perfusion related to a client admitted with atrial fibrillation. Which interventions should the nurse implement? Select all that apply.
- A.
Monitor the client’s blood pressure and apical rate every four (4) hours.
- B.
Place the client on intake and output every shift.
- C.
Require the client to sleep with the head of the bed elevated.
- D.
Teach the patient to perform Buerger Allen exercises daily.
- E.
Determine if the client is on an antiplatelet or anticoagulant medication.
- F.
Assess the client’s neurological status every shift and prn.
- 14.The nurse identifies the concept of perfusion for a client diagnosed with congestive heart failure. Which assessment data support this concept?
- A.
The client has a large abdomen and a positive tympanic wave.
- B.
The client has paroxysmal nocturnal dyspnea.
- C.
The client has 2+ glucose in the urine.
- D.
The client has a comorbid condition of myocardial infarction.
- 15.The nurse is caring for a client diagnosed with coronary artery disease (CAD). Which should the nurse teach the client prior to discharge?
- A.
Carry your nitroglycerin tablets in a brown bottle.
- B.
Swallow a nitroglycerin tablet at the first signof angina.
- C.
If one nitroglycerin tablet does not work in 10 minutes, take another.
- D.
Nitroglycerin tablets have a fruity odor if they are potent.
- 16.The nurse is caring for a client who suddenly complains of crushing substernal chest pain while ambulating in the hall. Which nursing action should the nurse implement first?
- A.
Call a Code Blue.
- B.
Assess the telemetry reading.
- C.
Take the client’s apical pulse.
- D.
Have the client sit down.
- 17.
The client’s telemetry reading is below. Which should the nurse implement?- A.
Take the client’s apical pulse and blood pressure.
- B.
Prepare to administer amiodarone IVPB.
- C.
Continue to monitor.
- D.
Place oxygen on the client via a nasal cannula.
- 18.The nurse is functioning in the role of medication nurse during a code. Which should the nurse implement when administering amiodarone for ventricular tachycardia?
- A.
Mix the medication in 100 mL of fluid and administer rapidly.
- B.
Push the amiodarone directly into the nearest IV port and raise the arm.
- C.
Question the physician’s order because it is not ACLS recommended.
- D.
Administer via an IV pump based on mg/kg/min.
- 19.The client diagnosed with an ST elevation myocardial infarction (STEMI) has developed 2+ edema bilaterally of the lower extremities and has crackles in all lung fields. Which should the nurse implement first?
- A.
Notify the health care provider (HCP).
- B.
Assess what the client ate at the last meal.
- C.
Request a STAT 12 lead electrocardiogram.
- D.
Administer furosemide IVP.
- 20.The nurse is administering morning medications to clients on a telemetry unit. Which medication would the nurse question?
- A.
Furosemide IVP to a client with a potassiumlevel of 3.6 mEq/L.
- B.
Digoxin orally to a client diagnosed withrapid atrial fibrillation.
- C.
Enalapril orally to a client whose BP is 86/64and apical pulse is 65.
- D.
Morphine IVP to a client complaining ofchest pain and who is diaphoretic.
- 21.The nurse is admitting a client diagnosed with coronary artery disease (CAD) and angina. Which concept is priority?
- A.
Sleep, rest, activity.
- B.
Comfort.
- C.
Oxygenation.
- D.
Perfusion.
- 22.The home health nurse is assigned a client diagnosed with heart failure. Which should the nurse implement? Select all that apply.
- A.
Request a dietary consult for a sodium-restricted diet.
- B.
Instruct the client to elevate the feet duringthe day.
- C.
Teach the client to weigh every morningwearing the same type of clothing.
- D.
Assess for edema in dependent areas of thebody.
- E.
Encourage the client to drink at least3,000 mL of fluid per day.
- F.
Have the client repeat back instructions to thenurse.
- 23.
The telemetry monitor tech notifies the nurse of the strip shown below. Which should the nurse implement first?
- A.
Instruct the unlicensed assistive personnel (UAP) to check the client.
- B.
Go to the client’s room and assess the client personally.
- C.
Have the monitor tech check the client using a different lead.
- D.
Call for the Code Blue team and perform cardiopulmonary resuscitation.
- 24.The nurse is working with a group of new graduates on a medical-surgical unit. Which should the nurse explain about completing first morning rounds on clients?
- A.
Perform a “down and dirty” assessment on each client soon after receiving report.
- B.
Determine which client should have a bath and inform the unlicensed assistive personnel.
- C.
Give all the clients a wet wash to wash the face and a toothbrush and toothpaste.
- D.
Pick up any paper on the floor and get the room ready for morning physician rounds.
- 25.The nurse has received shift report. Which client should the nurse assess first?
- A.
The client diagnosed with coronary artery disease complaining of severe indigestion.
- B.
The client diagnosed with congestive heart failure who has 3+ pitting edema.
- C.
The client diagnosed with atrial fibrillation whose apical rate is 110 and irregular.
- D.
The client diagnosed with sinus bradycardia who is complaining of being constipated.
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