Pre-board Exam For June 2009 NLE- Www.Rnpedia.Com

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  • 1/100 Questions

    When documenting information in a client's medical record, the nurse should:  

    • Erase any errors.
    • Use a #2 pencil.
    • Leave one line blank before each new entry.
    • End each entry with the nurse's signature and title.
Please wait...
About This Quiz

Mark the letter of the letter of choice then click on the next button. Score will be posted as soon as the you are done with the quiz. You got 120 minutes to finish the exam. Good luck!

Pre-board Exam For June 2009 NLE- Www.Rnpedia.Com - Quiz

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  • 2. 

    To decrease the symptoms of gastroesophageal reflux disease (GERD), the physician orders dietary and medication management. Nurse Helen should teach the client that the meal alteration that would be most appropriate would be:

    • Ingest foods while they are hot

    • Divide food into four to six meals a day

    • Eat the last of three meals daily by 8pm

    • Suck a peppermint candy after each meal

    Correct Answer
    A. Divide food into four to six meals a day
    Explanation
    The volume of food in the stomach should be kept small to limit pressure on the cardiac sphincter.

    Rate this question:

  • 3. 

    A paranoid male client with schizophrenia is losing weight, reluctant to eat, and voicing concerns about being poisoned. The best intervention by nurse Dina would be to:

    • Allow the client to open canned or pre-packaged food

    • Restrict the client to his room until 2 lbs are gained

    • Have a staff member personally taste all of the client’s food

    • Tell the client the food has been x-rayed by the staff and is safe

    Correct Answer
    A. Allow the client to open canned or pre-packaged food
    Explanation
    The client’s comfort, safety, and nutritional status are the priorities; the client may feel comfortable to eat if the food has been sealed before reaching the mental health facility.

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  • 4. 

    After a laryngectomy, the most important equipment to place at the client’s bedside would be:

    • Suction equipment

    • Humidified oxygen

    • A nonelectric call bell

    • A cold-stream vaporizer

    Correct Answer
    A. Suction equipment
    Explanation
    Respiratory complications can occur because of edema of the glottis or injury to the recurrent laryngeal nerve.

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  • 5. 

    After a mastectomy or hysterectomy, clients may feel incomplete as women. The statement that should alert nurse Gina to this feeling would be:

    • “I can’t wait to see all my friends again”

    • “I feel washed out; there isn’t much left”

    • “I can’t wait to get home to see my grandchild”

    • “My husband plans for me to recuperate at our daughter’s home”

    Correct Answer
    A. “I feel washed out; there isn’t much left”
    Explanation
    The client’s statement infers an emptiness with an associated loss.

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  • 6. 

    A client’s sputum smears for acid fast bacilli (AFB) are positive, and transmission-based airborne precautions are ordered. Nurse Kyle should instruct visitors to:

    • Limit contact with non-exposed family members

    • Avoid contact with any objects present in the client’s room

    • Wear an Ultra-Filter mask when they are in the client’s room

    • Put on a gown and gloves before going into the client’s room

    Correct Answer
    A. Wear an Ultra-Filter mask when they are in the client’s room
    Explanation
    Tubercle bacilli are transmitted through air currents; therefore personal protective equipment such as an Ultra-Filter mask is necessary.

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  • 7. 

    Before an amniocentesis, nurse Alexandra should:

    • Initiate the intravenous therapy as ordered by the physician

    • Inform the client that the procedure could precipitate an infection

    • Assure that informed consent has been obtained from the client

    • Perform a vaginal examination on the client to assess cervical dilation

    Correct Answer
    A. Assure that informed consent has been obtained from the client
    Explanation
    An invasive procedure such as amniocentesis requires informed consent.

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  • 8. 

    Which of the following is the best guarantee that the patient’s priority needs are met?  

    • Checking with the relative of the patient

    • Preparing a nursing care plan in collaboration with the patient

    • Consulting with the physician

    • Coordinating with other members of the team

    Correct Answer
    A. Preparing a nursing care plan in collaboration with the patient
    Explanation
    The best source of information about the priority needs of the patient is the patient himself. Hence using a nursing care plan based on his expressed priority needs would ensure meeting his needs effectively.

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  • 9. 

    Nurse Bea plans of assigning competent people to fill the roles designed in the hierarchy. Which process refers to this?

    • Staffing

    • Scheduling

    • Recruitment

    • Induction

    Correct Answer
    A. Staffing
    Explanation
    Staffing is a management function involving putting the best people to accomplish tasks and activities to attain the goals of the organization.

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  • 10. 

    When caring for a dying client who is in the denial stage of grief, the best nursing approach would be to:

    • Agree and encourage the client’s denial

    • Allow the denial but be available to discuss death

    • Reassure the client that everything will be OK

    • Leave the client alone to confront the feelings of impending loss

    Correct Answer
    A. Allow the denial but be available to discuss death
    Explanation
    This does not remove client’s only way of coping, and it permits future movement through the grieving process when the client is ready.

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  • 11. 

    A breastfeeding mother asks the nurse what she can do to ease the discomfort caused by a cracked nipple. Nurse Tina should instruct the client to:

    • Manually express milk and feed it to the baby in a bottle

    • Stop breastfeeding for two days to allow the nipple to heal

    • Use a breast shield to keep the baby from direct contact with the nipple

    • Feed the baby on the unaffected breast first until the affected breast heals

    Correct Answer
    A. Feed the baby on the unaffected breast first until the affected breast heals
    Explanation
    The most vigorous sucking will occur during the first few minutes of breastfeeding when the infant would be on the unaffected breast; later suckling is less traumatic.

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  • 12. 

    To check for wound hemorrhage after a client has had a surgery for the removal of a tumor in the neck, nurse grace should:

    • Loosen an edge of the dressing and lift it to see the wound

    • Observe the dressing at the back of the neck for the presence of blood

    • Outline the blood as it appears on the dressing to observe any progression

    • Press gently around the incision to express accumulated blood from the wound

    Correct Answer
    A. Observe the dressing at the back of the neck for the presence of blood
    Explanation
    Drainage flows by gravity.

    Rate this question:

  • 13. 

    When planning discharge teaching for a young female client who has had a pneumothorax, it is important that the nurse include the signs and symptoms of a pneumothorax and teach the client to seek medical assistance if she experiences:

    • Substernal chest pain

    • Episodes of palpitation

    • Severe shortness of breath

    • Dizziness when standing up

    Correct Answer
    A. Severe shortness of breath
    Explanation
    This could indicate a recurrence of the pneumothorax as one side of the lung is inadequate to meet the oxygen demands of the body.

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  • 14. 

    Nurse Wilma recognizes that failure of a newborn to make the appropriate adaptation to extrauterine life would be indicated by:

    • Flexed extremities

    • Cyanotic lips and face

    • A heart rate of 130 beats per minute

    • A respiratory rate of 40 breath per minute

    Correct Answer
    A. Cyanotic lips and face
    Explanation
    Cenral cyanosis (blue lips and face) indicates lowered oxygenation of the blood, caused by either decreased lung expansion or right to left shunting of blood.

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  • 15. 

    Nurse Tony stresses the need for all the employees to follow orders and instructions from him and not from anyone else. Which of the following principles does he refer to?

    • Scalar chain

    • Discipline

    • Unity of command

    • Order

    Correct Answer
    A. Unity of command
    Explanation
    The principle of unity of command means that employees should receive orders coming from only one manager and not from two managers. This averts the possibility of sowing confusion among the members of the organization.

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  • 16. 

    A 10 year old who has sustained a head injury is brought to the emergency department by his mother. A diagnosis of a mild concussion is made. At the time of discharge, nurse Ron should instruct the mother to:

    • Withhold food and fluids for 24 hours.

    • Allow him to play outdoors with his friends.

    • Arrange for a follow up visit with the child’s primary care provider in one week.

    • Check for any change in responsiveness every two hours until the follow-up visit.

    Correct Answer
    A. Check for any change in responsiveness every two hours until the follow-up visit.
    Explanation
    Signs of an epidural hematoma in children usually do not appear for 24 hours or more hours; a follow-up visit usually is arranged for one to two days after the injury.

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  • 17. 

    Realizing that the hypokalemia is a side effect of steroid therapy, nurse Monette should monitor a client taking steroid medication for:

    • Hyperactive reflexes

    • An increased pulse rate

    • Nausea, vomiting, and diarrhea

    • Leg weakness with muscle cramps

    Correct Answer
    A. Leg weakness with muscle cramps
    Explanation
    Impulse conduction of skeletal muscle is impaired with decreased potassium levels, muscular weakness and cramps may occur with hypokalemia.

    Rate this question:

  • 18. 

    When assessing a newborn suspected of having Down syndrome, nurse Rey would expect to observe:

    • Long thin fingers

    • Large, protruding ears

    • Hypertonic neck muscles

    • Simian lines on the hands

    Correct Answer
    A. Simian lines on the hands
    Explanation
    This is characteristic finding in newborns with Down syndrome.

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  • 19. 

    A client has sustained a fractured right femur in a fall on stairs. Nurse Troy with the emergency response team assess for signs of circulatory impairment by:

    • Turning the client to side lying position

    • Asking the client to cough and deep breathe

    • Taking the client’s pedal pulse in the affected limb

    • Instructing the client to wiggle the toes of the right foot

    Correct Answer
    A. Taking the client’s pedal pulse in the affected limb
    Explanation
    Monitoring a pedal pulse will assess circulation to the foot.

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  • 20. 

    The central problem the nurse might face with a disturbed schizophrenic client is the client’s:

    • Suspicious feelings

    • Continuous pacing

    • Relationship with the family

    • Concern about working with others

    Correct Answer
    A. Suspicious feelings
    Explanation
    The nurse must deal with these feelings and establish basic trust to promote a therapeutic milieu.

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  • 21. 

    At 11:00 pm the count of hydrocodone (Vicodin) is incorrect. After several minutes of searching the medication cart and medication administration records, no explanation can be found. The primary nurse should notify the:

    • Nursing unit manager

    • Hospital administrator

    • Quality control manager

    • Physician ordering the medication

    Correct Answer
    A. Nursing unit manager
    Explanation
    Controlled substance issues for a particular nursing unit are the responsibility of that unit’s nurse manager.

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  • 22. 

    The pHN bag is an important tool in providing nursing care during a home visit. The most important principle of bag technique states that it:

    • Should save time and effort.

    • Should minimize if not totally prevent the spread of infection.

    • Should not overshadow concern for the patient and his family.

    • May be done in a variety of ways depending on the home situation, etc.

    Correct Answer
    A. Should minimize if not totally prevent the spread of infection.
    Explanation
    Bag technique is performed before and after handling a client in the home to prevent transmission of infection to and from the client.

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  • 23. 

    Nurse Mae tells one of the staff, “I don’t have time to discuss the matter with you now. See me in my office later” when the latter asks if they can talk about an issue. Which of the following conflict resolution strategies did she use?

    • Smoothing

    • Compromise

    • Avoidance

    • Restriction

    Correct Answer
    A. Avoidance
    Explanation
    This strategy shuns discussing the issue head-on and prefers to postpone it to a later time. In effect the problem remains unsolved and both parties are in a lose-lose situation.

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  • 24. 

    A mother brought her daughter, 4 years old, to the RHU because of cough and colds. Following the IMCI assessment guide, which of the following is a danger sign that indicates the need for urgent referral to a hospital?

    • Inability to drink

    • High grade fever

    • Signs of severe dehydration

    • Cough for more than 30 days

    Correct Answer
    A. Inability to drink
    Explanation
    A sick child aged 2 months to 5 years must be referred urgently to a hospital if he/she has one or more of the following signs: not able to feed or drink, vomits everything, convulsions, abnormally sleepy or difficult to awaken.

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  • 25. 

    Nurse Leslie recognizes that a pacemaker is indicated when a client is experiencing:

    • Angina

    • Chest pain

    • Heart block

    • Tachycardia

    Correct Answer
    A. Heart block
    Explanation
    This is the primary indication for a pacemaker because there is an interfere with the electrical conduction system of the heart.

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  • 26. 

     A preschooler is admitted to the hospital with a diagnosis of acute glomerulonephritis. The child’s history reveals a 5-pound weight gain in one week and peritoneal edema. For the most accurate information on the status of the child’s edema, nursing intervention should include:

    • Obtaining the child’s daily weight

    • Doing a visual inspection of the child

    • Measuring the child’s intake and output

    • Monitoring the child’s electrolyte values

    Correct Answer
    A. Obtaining the child’s daily weight
    Explanation
    Weight monitoring is the most useful means of assessing fluid balance and changes in the edematous state; 1 liter of fluid weighs about 2.2 pounds.

    Rate this question:

  • 27. 

    A client is experiencing stomatitis as a result of chemotherapy. An appropriate nursing intervention related to this condition would be to:

    • Provide frequent saline mouthwashes

    • Use karaya powder to decrease irritation

    • Increase fluid intake to compensate for the diarrhea

    • Provide meticulous skin care of the abdomen with Betadine

    Correct Answer
    A. Provide frequent saline mouthwashes
    Explanation
    This is soothing to the oral mucosa and helps prevent infection

    Rate this question:

  • 28. 

    To enhance a neonate’s behavioral development, therapeutic nursing measures should include:

    • Keeping the baby awake for longer periods of time before each feeding

    • Assisting the parents to stimulate their baby through touch, sound, and sight.

    • Encouraging parental contact for at least one 15-minute period every four hours.

    • Touching and talking to the baby at least hourly, beginning within two to four hours after birth

    Correct Answer
    A. Assisting the parents to stimulate their baby through touch, sound, and sight.
    Explanation
    Stimuli are provided via all the senses; since the infant’s behavioral development is enhanced through parent-infant interactions, these interactions should be encouraged.

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  • 29. 

    One day the mother of a young adult confides to nurse Frida that she is very troubled by he child’s emotional illness. The nurse’s most therapeutic initial response would be:

    • “You may be able to lessen your feelings of guilt by seeking counseling”

    • “It would be helpful if you become involved in volunteer work at this time”

    • “I recognize it’s hard to deal with this, but try to remember that this too shall pass”

    • “Joining a support group of parents who are coping with this problem can be quite helpful.

    Correct Answer
    A. “Joining a support group of parents who are coping with this problem can be quite helpful.
    Explanation
    Taking with others in similar circumstances provides support and allows for sharing of experiences.

    Rate this question:

  • 30. 

    A 2 ½ year old child undergoes a ventriculoperitoneal shunt revision. Before discharge, nurse John, knowing the expected developmental behaviors for this age group, should tell the parents to call the physician if the child:

    • Tries to copy all the father’s mannerisms

    • Talks incessantly regardless of the presence of others

    • Becomes fussy when frustrated and displays a shortened attention span

    • Frequently starts arguments with playmates by claiming all toys are “mine”

    Correct Answer
    A. Becomes fussy when frustrated and displays a shortened attention span
    Explanation
    Shortened attention span and fussy behavior may indicate a change in intracranial pressure and/or shunt malfunction.

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  • 31. 

    When a client on labor experiences the urge to push a 9cm dilation, the breathing pattern that nurse Rhea should instruct the client to use is the:

    • Expulsion pattern

    • Slow paced pattern

    • Shallow chest pattern

    • Blowing pattern

    Correct Answer
    A. Blowing pattern
    Explanation
    Clients should use a blowing pattern to overcome the premature urge to push.

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  • 32. 

    Nurse Katrina prepares an older-adult client for sleep, actions are taken to help reduce the likelihood of a fall during the night. Targeting the most frequent cause of falls, the nurse should:

    • Offer the client assistance to the bathroom

    • Move the bedside table closer to the client’s bed

    • Encourage the client to take an available sedative

    • Assist the client to telephone the spouse to say “goodnight”

    Correct Answer
    A. Offer the client assistance to the bathroom
    Explanation
    Statistics indicate that the most frequent cause of falls by hospitalized clients is getting up or attempting to get up to the bathroom unassisted.

    Rate this question:

  • 33. 

    Which of the following factors are major components of a client's general background drug history?

    • Allergies and socioeconomic status

    • Urine output and allergies

    • Gastric reflex and age

    • Bowel habits and allergies

    Correct Answer
    A. Allergies and socioeconomic status
    Explanation
    General background data consist of such components as allergies, medical history, habits, socioeconomic status, lifestyle, beliefs, and sensory deficits. Urine output, gastric reflex, and bowel habits are significant only if a disease affecting these functions is present.

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  • 34. 

    Nurse Oliver interviews a young female client with anorexia nervosa to obtain information for the nursing history. The client’s history is likely to reveal a:

    • Strong desire to improve her body image

    • Close, supportive mother-daughter relationship

    • Satisfaction with and desire to maintain her present weight

    • Low level of achievement in school, with little concerns for grades

    Correct Answer
    A. Strong desire to improve her body image
    Explanation
    Clients with anorexia nervosa have a disturbed self image and always see themselves as fat and needing further reducing.

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  • 35. 

    A client with obstruction of the common bile duct may show a prolonged bleeding and clotting time because:

    • Vitamin K is not absorbed

    • The ionized calcium levels falls

    • The extrinsic factor is not absorbed

    • Bilirubin accumulates in the plasma

    Correct Answer
    A. Vitamin K is not absorbed
    Explanation
    Vitamin K, a fat soluble vitamin, is not absorbed from the GI tract in the absence of bile; bile enters the duodenum via the common bile duct.

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  • 36. 

    On admission, a client has the following arterial blood gas (ABG) values: PaO2, 50 mm Hg; PaCO2, 70 mm Hg; pH, 7.20; HCO3–, 28 mEq/L. Based on these values, the nurse should formulate which nursing diagnosis for this client?  

    • Risk for deficient fluid volume

    • Deficient fluid volume

    • Impaired gas exchange

    • Metabolic acidosis

    Correct Answer
    A. Impaired gas exchange
    Explanation
    The client has a below-normal value for the partial pressure of arterial oxygen (PaO2) and an above-normal value for the partial pressure of arterial carbon dioxide (PaCO2), supporting the nursing diagnosis of Impaired gas exchange. ABG values can't indicate a diagnosis of Fluid volume deficit (or excess) or Risk for deficient fluid volume. Metabolic acidosis is a medical, not nursing, diagnosis; in any event, these ABG values indicate respiratory, not metabolic, acidosis.

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  • 37. 

     Which of the following is the most prominent feature of public health nursing?  

    • It involves providing home care to sick people who are not confined in the hospital

    • Services are provided free of charge to people within the catchment area.

    • The public health nurse functions as part of a team providing a public health nursing services.

    • Public health nursing focuses on preventive, not curative, services.

    Correct Answer
    A. Public health nursing focuses on preventive, not curative, services.
    Explanation
    The catchment area in PHN consists of a residential community, many of whom are well individuals who have greater need for preventive rather than curative services.

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  • 38. 

    Nurse Mickey is administering dexamethasome (Decadron) for the early management of a client’s cerebral edema. This treatment is effective because:

    • Acts as hyperosmotic diuretic

    • Increases tissue resistance to infection

    • Reduces the inflammatory response of tissues

    • Decreases the information of cerebrospinal fluid

    Correct Answer
    A. Reduces the inflammatory response of tissues
    Explanation
    Corticosteroids act to decrease inflammation which decreases edema.

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  • 39. 

    Nurse Pauline determines whether resources were maximized in implementing Ligtas Tigdas, she is evaluating:

    • Effectiveness

    • Efficiency

    • Adequacy

    • Appropriateness

    Correct Answer
    A. Efficiency
    Explanation
    Efficiency is determining whether the goals were attained at the least possible cost.

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  • 40. 

    What other statistic may be used to determine attainment of longevity?

    • Age-specific mortality rate

    • Proportionate mortality rate

    • Swaroop’s index

    • Case fatality rate

    Correct Answer
    A. Swaroop’s index
    Explanation
    Swaroop’s index is the percentage of the deaths aged 50 years or older. Its inverse represents the percentage of untimely deaths (those who died younger than 50 years).

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  • 41. 

    Lissa is a B.S.N. graduate. She want to become a Public Health Nurse. Where will she apply?

    • Department of Health

    • Provincial Health Office

    • Regional Health Office

    • Rural Health Unit

    Correct Answer
    A. Rural Health Unit
    Explanation
    R.A. 7160 devolved basic health services to local government units (LGU’s ). The public health nurse is an employee of the LGU.

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  • 42. 

    Nurse Willy reads about Path Goal theory. Which of the following behaviors is manifested by the leader who uses this theory?

    • Recognizes staff for going beyond expectations by giving them citations

    • Challenges the staff to take individual accountability for their own practice

    • Admonishes staff for being laggards

    • Reminds staff about the sanctions for non performance

    Correct Answer
    A. Recognizes staff for going beyond expectations by giving them citations
    Explanation
    Path Goal theory according to House and associates rewards good performance so that others would do the same.

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  • 43. 

    During a group therapy session, one of the clients ask a male client with the diagnosis of antisocial personality disorder why he is in the hospital. Considering this client’s type of personality disorder, the nurse might expect him to respond:

    • “I need a lot of help with my troubles”

    • “Society makes people react in old ways”

    • “I decided that it’s time I own up to my problems”

    • “My life needs straightening out and this might help”

    Correct Answer
    A. “Society makes people react in old ways”
    Explanation
    The client is incapable of accepting responsibility for self-created problems and blames society for the behavior.

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  • 44. 

    A patient has partial-thickness burns to both legs and portions of his trunk.  Which of the following I.V. fluids is given first?

    • Albumin

    • D5W

    • Lactated Ringer’s solution

    • 0.9% sodium chloride solution with 2 mEq of potassium per 100 ml

    Correct Answer
    A. Lactated Ringer’s solution
    Explanation
    Lactated Ringer’s solution replaces lost sodium and corrects metabolic acidosis, both of which commonly occur following a burn. Albumin is used as adjunct therapy, not primary fluid replacement. Dextrose isn’t given to burn patients during the first 24 hours because it can cause pseudodiabetes. The patient is hyperkalemic from the potassium shift from the intracellular space to the plasma, so potassium would be detrimental.

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  • 45. 

    Nurse Vicky is aware that teaching about colostomy care is understood when the client states, “I will contact my physician and report ____":

    • If I notice a loss of sensation to touch in the stoma tissue”

    • When mucus is passed from the stoma between irrigations”

    • The expulsion of flatus while the irrigating fluid is running out”

    • If I have difficulty in inserting the irrigating tube into the stoma”

    Correct Answer
    A. If I have difficulty in inserting the irrigating tube into the stoma”
    Explanation
    This occurs with stenosis of the stoma; forcing insertion of the tube could cause injury.

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  • 46. 

    Nurse Zen applies a fetal monitor to the abdomen of a client in active labor. When the client has contractions, the nurse notes a 15 beat per minute deceleration of the fetal heart rate below the baseline lasting 15 seconds. Nurse Cathy should:

    • Change the maternal position

    • Prepare for an immediate birth

    • Call the physician immediately

    • Obtain the client’s blood pressure

    Correct Answer
    A. Change the maternal position
    Explanation
    Stimulation of the sympathetic nervous system is an initial response to mild hypoxia that accompanies partial cord compression (umbilical vein) during contractions; changing the maternal position can alleviate the compression.

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  • 47. 

    When caring for the a client with a pneumothorax, who has a chest tube in place, nurse Kate should plan to:  

    • Administer cough suppressants at appropriate intervals as ordered

    • Empty and measure the drainage in the collection chamber each shift

    • Apply clamps below the insertion site when ever getting the client out of bed

    • Encourage coughing, deep breathing, and range of motion to the arm on the affected side

    Correct Answer
    A. Encourage coughing, deep breathing, and range of motion to the arm on the affected side
    Explanation
    All these interventions promote aeration of the re-expanding lung and maintenance of function in the arm and shoulder on the affected side.

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  • 48. 

    The nurse is performing wound care using surgical asepsis. Which of the following practices violates surgical asepsis?

    • Holding sterile objects above the waist

    • Pouring solution onto a sterile field cloth

    • Considering a 1″ (2.5-cm) edge around the sterile field contaminated

    • Opening the outermost flap of a sterile package away from the body

    Correct Answer
    A. Pouring solution onto a sterile field cloth
    Explanation
    Pouring solution onto a sterile field cloth violates surgical asepsis because moisture penetrating the cloth can carry microorganisms to the sterile field via capillary action. The other options are practices that help ensure surgical asepsis.

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  • 49. 

    When administering pancrelipase (Pancreases capsules) to child with cystic fibrosis, nurse Faith knows they should be given:

    • With meals and snacks

    • Every three hours while awake

    • On awakening, following meals, and at bedtime

    • After each bowel movement and after postural draianage

    Correct Answer
    A. With meals and snacks
    Explanation
    Pancreases capsules must be taken with food and snacks because it acts on the nutrients and readies them for absorption.

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  • Aug 21, 2023
    Quiz Edited by
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  • Feb 22, 2010
    Quiz Created by
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