Evaluation Exam
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1. Which of the following would be priority assessment data to gather from a client who has been diagnosed with pneumonia? Select all that apply. *
1 point
Required
2. The nurse is teaching a client who has been diagnosed with TB how to avoid spreading the disease to family members. Which statement(s) by the client indicate(s) that he has understood the nurse’s instructions? Select all that apply. *
1 point
Required
3. The nurse is learning how to use the hospital’s new electronic medication administration record. The nurse knows this tool has the potential to do which of the following? Select all that apply. *
1 point
Required
4. The nurse is admitting a client with hypoglycemia. Identify the signs and symptoms the nurse should expect. Select all that apply. *
1 point
Required
5. An older adult male client with a history of myasthenia gravis is admitted to the medical/surgical unit. Which of the following tests should the nurse expect to see ordered? Select all that apply. *
1 point
Required
6. When planning care for a client with ulcerative colitis who is experiencing symptoms, which client care activities can the nurse appropriately delegate to an unlicensed assistant? Select all that apply. *
1 point
Required
7. Standard precautions were designed for the care of all clients in hospitals, regardless of their diagnosis or infection status. Guidelines for standard precautions include: *
1 point
8. A client is receiving a blood transfusion. The nurse observes that the client is experiencing diarrhea, abdominal pain, and chills. Which of the following actions should the nurse take FIRST? *
1 point
9. Randy has undergone a kidney transplant, what assessment would prompt Nurse Katrina to suspect organ rejection? *
1 point
10. Which action will you take to most effectively reduce the incidence of hospital-associated urinary tract infections? *
1 point
11. The physician orders an MRI of the brain for an adult male client. Which of the following findings in the client’s history should the nurse report to the physician? *
1 point
12. A client who has recently traveled to China comes to the emergency department (ED) with increasing shortness of breath and is strongly suspected of having a severe acute respiratory syndrome (SARS). Which of these prescribed actions will you take first? *
1 point
13. A 26-year-old client is diagnosed with scarlet fever. Which of the following is the most appropriate type of isolation for this client? *
1 point
14. A 7-year-old girl with type 1 insulin-dependent diabetes mellitus (IDDM) has been home sick for several days and is brought to the Emergency Department by her parents. If the child is experiencing ketoacidosis, the nurse would expect to see which of the following lab results? *
1 point
15. You are preparing to care for a 6-year-old who has just undergone allogeneic stem cell transplantation and will need protective environment isolation. Which nursing tasks will you delegate to a nursing assistant? Select all that apply. *
1 point
Required
16. Among the following signs and symptoms, which would most likely be present in a client with mitral regurgitation? *
1 point
17. A client with acne has been using isotretinoin (Accutane). She tells the nurse that she recently learned she is pregnant. She asks, “Will my pregnancy interfere with the medication’s effectiveness?” Which of the following is the appropriate response by the nurse? *
1 point
18. A local high school is having a health fair. Which of the following main courses should the nurse recommend as most healthful for a teenager whose cholesterol level is 300 mg/ dL? *
1 point
19. Kris with a history of chronic infection of the urinary system complains of urinary frequency and burning sensation. To figure out whether the current problem is of renal origin, the nurse should assess whether the client has discomfort or pain in the: *
1 point
20. The nurse is caring for a male client. The client has exhibited some signs of anxiety and hostility. The nurse is aware that the client is a recently returned combat veteran. The nurse should assess the client for which of the following conditions? *
1 point
21. The nurse is instructing a client with iron-deficiency anemia. Which of the following meal plans would the nurse expect the client to select? *
1 point
22. Nurse Perry is evaluating the renal function of a male client. After documenting urine volume and characteristics, Nurse Perry assesses which signs as the best indicator of renal function. *
1 point
23. Smoking cessation is a critical strategy for the client with Buerger’s disease, Nurse Jasmin anticipates that the male client will go home with a prescription for which medication? *
1 point
24. Nurse Zeny is caring for a client in an acute Addisonian crisis. Which laboratory data would the nurse expect to find? *
1 point
25. The nurse has been working with a 45-yearold African American who bicycles to work. Lab tests show low serum lipids. The nurse knows that the client’s risk factors for primary (essential) hypertension include which of the following? *
1 point
26. Nurse Lilly has been assigned to a client with Raynaud’s disease. Nurse Lilly realizes that the etiology of the disease is unknown, but it is characterized by: *
1 point
27. Clients with sickle cell anemia are taught to avoid activities that cause hypoxia and hypoxemia. Which of the following activities would the nurse recommend? *
1 point
28. Myrna, a 52-year-old client with a fractured left tibia, has a long leg cast and she is using crutches to ambulate. Nurse Joy assesses for which sign and symptom that indicates complication associated with crutch walking? *
1 point
29. The nurse is educating a mother-to-be about possible danger signs during the last three months of pregnancy. Which of the following would NOT cause the nurse concern about danger signs? *
1 point
30. Which of the following statements should the nurse teach the neutropenic client and his family to avoid? *
1 point
31. George, who has undergone thoracic surgery has a chest tube connected to a water-seal drainage system attached to suction. Presence of excessive bubbling is identified in the water-seal chamber, the nurse should: *
1 point
32. A newly admitted client diagnosed with Hodgkin’s disease undergoes an excisional cervical lymph node biopsy under local anesthesia. What does the nurse assess first after the procedure? *
1 point
33. Paul is admitted to the hospital due to metabolic acidosis caused by Diabetic ketoacidosis (DKA). The nurse prepares which of the following medications as an initial treatment for this problem? *
1 point
34. A client has Gastroesophageal Reflux Disease (GERD). The nurse should teach the client that after every meal, the client should: *
1 point
35. Which of the following antituberculosis drugs can damage the 8th cranial nerve? *
1 point
36. Which of the following symptoms during the icteric phase of viral hepatitis should the nurse expect the client to inhibit? *
1 point
37. Marco, who was diagnosed with a brain tumor, was scheduled for craniotomy. In preventing the development of cerebral edema after surgery, the nurse should expect the use of: *
1 point
38. Kenneth, who was diagnosed with liver cirrhosis has the potential to develop complications. Which among the following complications should the nurse anticipates? *
1 point
39. Nurse Hazel teaches the client with angina about common expected side effects of nitroglycerin including: *
1 point
40. Karen has been diagnosed with aplastic anemia. The nurse monitors for changes in which of the following physiologic functions? *
1 point
41. The first thing that a nurse must ensure when the baby’s head comes out is *
1 point
42. Which of the following signs and symptoms would Nurse Maureen include in her teaching plan as an early manifestation of laryngeal cancer? *
1 point
43. Karina, a client with myasthenia gravis, is to receive immunosuppressive therapy. The nurse understands that this therapy is effective because it: *
1 point
44. Nurse Judith obtains a specimen of clear nasal drainage from a client with a head injury. Which of the following tests differentiates mucus from cerebrospinal fluid (CSF)? *
1 point
45. Which of the following characteristics or situations is indicated when a client with borderline personality disorder has a crisis? *
1 point
46. A 65-year-old female is experiencing a flare-up of pruritus. Which of the client’s actions could aggravate the cause of flare-ups? *
1 point
47. The nurse takes report on a client returning from left-sided cardiac catheterization. The client also underwent a percutaneous transluminal coronary angioplasty (PTCA), with drug-eluding stents placed in the right coronary artery and left coronary artery, and the site was closed with a collagen plug. The nurse would expect to assess the entry site on the client at which of the following locations? *
1 point
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48. You are preparing to leave the room after performing oral suctioning on a client who is on contact and airborne precautions. In which order will you perform the following actions? *
1 point
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49. Nurse Isabelle enters the room of a client with a cognitive impairment disorder and asks what day of the week it is; what the date, month, and year are; and where the client is. The nurse is attempting to assess: *
1 point
50. A 10-year-old client contracted COVID-19 when traveling abroad with her parents. The nurse knows she must put on personal protective equipment to protect herself while providing care. Based on the mode of transmission, which personal protective should not be worn by the nurse? Select all that apply. *
1 point
Required
51. The school nurse is asked which action will take to have the most impact on the incidence of infectious diseases in school. The correct response is: *
1 point
52. A client is admitted to the emergency room with renal calculi and is complaining of moderate to severe flank pain and nausea. The client’s temperature is 100.8 degrees Fahrenheit. The priority nursing goal for this client is: *
1 point
53. Which of the following nursing interventions is applicable for a hospitalized client with mania who is exhibiting manipulative behavior? Select all that apply. *
1 point
Required
54. What are the appropriate interventions for caring for the client in alcohol withdrawal? Select all that apply. *
1 point
Required
55. A 25-year-old male client has been newly diagnosed with hypothyroidism and will take levothyroxine (Synthroid) 50 mcg/day by mouth. As part of the teaching plan, the nurse emphasizes that this medication: *
1 point
56. The patient’s heparin drip is infusing at 11 ml/hr on an infusion pump. The bag of fluid is mixed 25,000 units of Heparin in 250 ml D5W. Calculate how many units of heparin the patient is receiving hourly. Fill in the blank and round to the nearest whole number for your final answer. (In units/hour) *
1 point
57. A health care provider orders cefoxitin (Mefoxin) 0.5 g in 275 mL of D5W to infuse IVPB over 2 hours; Drop Factor: 60 gtt/mL. How many gtts/min will you regulate the IV? Fill in the blank and round to the nearest whole number for your final answer. *
1 point
58. A nurse is assessing a newborn infant following circumcision and notes that the circumcised area is red with a small amount of bloody drainage. Which of the following nursing actions would be most appropriate? *
1 point
59. A nursing instructor asks a nursing student to describe the procedure for administering erythromycin ointment into the eyes of a neonate. The instructor determines that the student needs to research this procedure further if the student states: *
1 point
60. The nurse is providing discharge teaching for the client with leukemia. The client should be told to avoid: *
1 point
61. The nurse is monitoring a client following a lung resection. The hourly output from the chest tube was 300mL. The nurse should give priority to: *
1 point
62. The infant is admitted to the unit with tetralogy of fallot. The nurse would anticipate an order for which medication? *
1 point
63. The nurse is educating the lady’s club in a self-breast exam. The nurse is aware that most malignant breast masses occur in the Tail of Spence. On the diagram below, select where the Tail of Spence is. *
1 point
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64. The nurse is conducting a physical assessment on a client with anemia. Which of the following clinical manifestations would be most indicative of the anemia? *
1 point
65. An African American female comes to the outpatient clinic. The physician suspects vitamin B12 deficiency anemia. Because jaundice is often a clinical manifestation of this type of anemia, what body part would be the best indicator? *
1 point
66. The physician has ordered a histoplasmosis test for the elderly client. The nurse is aware that histoplasmosis is transmitted to humans by: *
1 point
67. A pregnant woman arrives at the emergency department (ED) with abruptio placentae at 34 weeks’ gestation. She’s at risk for which of the following blood dyscrasias? *
1 point
68. Corticosteroids are potent suppressors of the body’s inflammatory response. Which of the following conditions or actions do they suppress? *
1 point
69. A patient infected with human immunodeficiency virus (HIV) begins zidovudine therapy. Which of the following statements best describes this drug’s action? *
1 point
70. A 20-year-old patient is being treated for pneumonia. He has a persistent cough and complains of severe pain on coughing. What could you tell him to help him reduce his discomfort? *
1 point
71. A firefighter who was involved in extinguishing a house fire is being treated for smoke inhalation. He developed severe hypoxia 48 hours after the incident, requiring intubation and mechanical ventilation. Which of the following conditions has he most likely developed? *
1 point
72. Which of the following measures best determines that a patient who had a pneumothorax no longer needs a chest tube? *
1 point
73. A client receiving haloperidol (Haldol) complains of a stiff jaw and difficulty swallowing. The nurse’s first action is to: *
1 point
74. Which of the following signs of increased intracranial pressure (ICP) would appear first after head trauma? *
1 point
75. A client admitted with chronic heart failure is taking furosemide. Which of the following statements, if made by the client, BEST demonstrates to the nurse that the client understands the side effects associated with this drug? *
1 point
76. When giving intravenous (I.V.) phenytoin, which of the following methods should you use? *
1 point
77. After a liver biopsy, place the patient in which of the following positions? *
1 point
78. Following myocardial infarction, a hospitalized patient is encouraged to practice frequent leg exercises and ambulate in the hallway as directed by his physician. Which of the following choices reflects the purpose of exercise for this patient? *
1 point
79. A clinic patient has recently been prescribed nitroglycerin for treatment of angina. He calls the nurse complaining of frequent headaches. Which of the following responses to the patient is correct? *
1 point
80. A clinic patient has a hemoglobin concentration of 10.8 g/dL and reports sticking to a strict vegetarian diet. Which of the following nutritional advice is appropriate? *
1 point
81. A hospitalized patient is receiving packed red blood cells (PRBCs) for treatment of severe anemia. Which of the following is the most accurate statement? *
1 point
82. Marco approached Nurse Trisha asking for advice on how to deal with his alcohol addiction. Nurse Trisha should tell the client that the only effective treatment for alcoholism is: *
1 point
83. An individual with depression has a deficiency in which neurotransmitters, based on the biogenic amine theory? *
1 point
84. In a day treatment program, a manic client is creating considerable chaos, behaving in a dominating and manipulative way. Which nursing intervention is most appropriate? *
1 point
85. A nurse is caring for a patient with a platelet count of 20,000/microliter. Which of the following is an important intervention? *
1 point
86. A nurse is caring for patients in the oncology unit. Which of the following is the most important nursing action when caring for a neutropenic patient? *
1 point
87. A patient is undergoing the induction stage of treatment for leukemia. The nurse teaches family members about infectious precautions. Which of the following statements by family members indicates that the family needs more education? *
1 point
88. The Hodgkin’s disease patient described in the question above undergoes a lymph node biopsy for definitive diagnosis. If the diagnosis of Hodgkin’s disease were correct, which of the following cells would the pathologist expect to find? *
1 point
89. A newly admitted client has a sickle cell crisis. The nurse is planning care based on the assessment of the client. The client is complaining of severe pain in his feet and hands. The pulse oximetry is 92. Which of the following interventions would be implemented first? Assume that there are orders for each intervention. *
1 point
90. Which of the following assignments by the RN would be appropriate for an LPN/LVN? *
1 point
91. After receiving a report from the night nurse, which of the following clients should the nurse see FIRST? *
1 point
92. The nurse is working on a surgical unit. Which of the following tasks would be appropriate for the nurse to delegate to nursing assistive personnel (NAP)? *
1 point
93. The nurse is designing a diet plan for a 70-year-old with poorly fitting dentures who has been recently diagnosed with type 2 diabetes. The nurse knows that which of the following is the LEAST likely risk to the client? *
1 point
94. The nurse is providing education at a senior center. Which of the following measures will the nurse say is MOST effective in attaining normal blood sugar levels in a client with type 2 diabetes? *
1 point
95. The nurse is conducting an admission assessment of a client with vitamin B12 deficiency. Which of the following would the nurse include in the physical assessment? *
1 point
96. Heberden’s nodes are a common sign of osteoarthritis. Which of the following statements is correct about this deformity? *
1 point
97. A 50-year-old male client comes to the nurses’ station and asks the nurse if he can go to the cafeteria to get something to eat. When told that his privileges do not include visiting the cafeteria, the client becomes verbally abusive. Which of the following approaches by the nurse would be MOST effective? *
1 point
98. Which of the following statements explains the main difference between rheumatoid arthritis and osteoarthritis? *
1 point
99. Nurse Len should expect to administer which medication to a client with gout? *
1 point
100. The nurse cares for an elderly client who appears fully alert and oriented. As it gets later in the day, the nurse notices the client becoming increasingly confused and agitated. It would be MOST appropriate for the nurse to take which of the following actions? *
1 point
101. A client is scheduled to have surgery the following day. The client tells the nurse, “I’m very scared. I have never had surgery before and am afraid that I might not make it through.” Which of the following responses by the nurse is the MOST appropriate? *
1 point
102. A client with post-traumatic stress disorder (PTSD) appears to be having a flashback. It would be MOST appropriate for the nurse to perform which of the following interventions? *
1 point
103. The nurse is working in an outpatient clinic. The nurse has a client who appears intoxicated and who drove to the appointment. The nurse is concerned about the client’s ability to drive home. Which of the following should the nurse do FIRST? *
1 point
104. Mr. Domingo with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client’s hypertension is caused by excessive hormone secretion from which of the following glands? *
1 point
105. A female client tells nurse Nikki that she has been working hard for the last 3 months to control her type 2 diabetes mellitus with diet and exercise. To determine the effectiveness of the client’s efforts, the nurse should check: *
1 point
106. The client says to the nurse “Pray for me” and entrusts her wedding ring to the nurse. The nurse knows that this may signal which of the following: *
1 point
107. A patient is admitted to the same-day surgery unit for liver biopsy. Which of the following laboratory tests assesses coagulation? Select all that apply. *
1 point
Required
108. While working in a pediatric clinic, you receive a telephone call from the parent of a 10-year-old who is receiving chemotherapy for leukemia. The client’s sibling has chickenpox. Which of these actions will you anticipate taking next? *
1 point
109. The client has a medical history of alcohol abuse and had a drink yesterday. The nurse notes tremors, diaphoresis, and an elevated heart rate. The nurse should perform which of the following actions FIRST? *
1 point
110. A client with bipolar disorder makes a sexually inappropriate comment to the nurse. The nurse should take which of the following actions? *
1 point
111. A cast is applied to a 9-month-old girl for the treatment of talipes equinovarus. Which of the following instructions is MOST essential for the nurse to give to the child’s mother regarding her care? *
1 point
112. On the third day after a partial thyroidectomy, Proserfina exhibits muscle twitching and hyperirritability of the nervous system. When questioned, the client reports numbness and tingling of the mouth and fingertips. Suspecting a life-threatening electrolyte disturbance, the nurse notifies the surgeon immediately. Which electrolyte disturbance most commonly follows thyroid surgery? *
1 point
113. When preparing Judy with acquired immunodeficiency syndrome (AIDS) for discharge to the home, the nurse should be sure to include which instruction? *
1 point
114. The nurse is taking care of a young child a few hours after a tonsillectomy. Which of the following nursing interventions would be appropriate to promote adequate nutrition and oral hydration for this child? *
1 point
115. The nurse is taking care of a quadriplegic young man who suffers from a C2-C3 fracture after an auto accident 3 months prior. He has a tracheotomy, is ventilator-dependent, and has been discharged to home with skilled home nursing care. The nurse knows that this client is at risk for autonomic dysreflexia. Which of the following measures should this nurse take to keep the client comfortable, manage his elimination needs, and prevent common causes of autonomic dysreflexia? *
1 point
116. The nurse in an outpatient clinic has received an order from the physician to remove the client’s sutures. The nurse should do which of the following? *
1 point
117. After receiving a dose of penicillin, a client develops dyspnea and hypotension. Nurse Celestina suspects the client is experiencing anaphylactic shock. What should the nurse do first? *
1 point
118. A client who has chronic pain asks the nurse about alternative therapy in conjunction with traditional treatment. Which of the following forms of alternative therapy could the nurse provide for this client? *
1 point
119. The nurse working in an outpatient clinic has the opportunity to teach an insulin-dependent client. Which of the following topics would be MOST appropriate for the nurse to include when teaching personal hygiene? *
1 point
120. A 70-year-old male presented to the Emergency Department with shortness of breath, crackles in the bases and middle of the lung fields bilaterally, +2 pitting edema bilaterally of the lower extremities, and a weight increase of 6 lb. in one week. His heart rate is 82 and his blood pressure is 162/90. Per physician’s order, the nurse administers 40 mg of furosemide intravenously. The nurse knows that which of the following indicates effectiveness of the medication? *
1 point
121. A nurse discourages a patient from straining excessively when attempting to have a bowel movement. What physiological response primarily may be prevented by avoiding straining on defecation? *
1 point
122. Mr. Marquez with rheumatoid arthritis is about to begin aspirin therapy to reduce inflammation. When teaching the client about aspirin, the nurse discusses adverse reactions to prolonged aspirin therapy. These include: *
1 point
123. In an individual with Sjögren’s syndrome, nursing care should focus on: *
1 point
124. When taking a dietary history from a newly admitted female client, Nurse Len should remember which of the following foods is a common allergen? *
1 point
125. Nurse John is caring for clients in the outpatient clinic. Which of the following phone calls should the nurse return first? *
1 point
126. The nurse is conducting a home visit with a client who has a history of angina. Which of the following BEST demonstrates that further teaching about nitroglycerin therapy is required? *
1 point
127. The nurse is assessing a young-adult pregnant client with no allergies who has tested positive for gonorrhea. Which of the following medications should the nurse expect to be part of the treatment plan? *
1 point
128. Nurse Eve is caring for a client who had a thyroidectomy 12 hours ago for treatment of Grave’s disease. The nurse would be most concerned if which of the following was observed? *
1 point
129. Nurse Tina prepares a client for peritoneal dialysis. Which of the following actions should the nurse take first? *
1 point
130. A client is having a tonic-clonic seizure. Which of the following should the nurse do FIRST? *
1 point
131. Which of the following interventions should be prioritized in the care of the suicidal client? *
1 point
132. The nursing diagnosis that would be most appropriate for a 22-year-old client who uses ritualistic behavior would be: *
1 point
133. The nurse knows which of the following body systems is responsible for the production of erythropoietin? *
1 point
134. A 39-year-old client has been diagnosed with end-stage renal disease and is on the transplant waiting list. The client has been receiving dialysis through a subclavian central vein catheter while an arteriovenous fistula is maturing. Besides dialysis access, the surgical floor nurse can utilize this subclavian central vein catheter for which of the following? *
1 point
135. A patient with liver cirrhosis is undergoing blood transfusion of whole blood in D5LR solution. The nurse will do which of the following actions? *
1 point
136. Nurse Rica is teaching a client and her family about the causes of depression. Which of the following causative factors should the nurse emphasize as the most significant? *
1 point
137. A 56-year-old is admitted to the burn unit with partial and full thickness burns of both legs, which occurred when a charcoal grill tipped over on her. The burn area is edematous. blister formation and a large amount of fluid exudate is noted. Urine output is 30 ml/hour, BP 90/60 and pulse 110. A primary nursing diagnosis during the initial 48-72 hours following the burn is: *
1 point
138. The nurse has been assigned to a client with Buerger’s disease (thromboangiitis obliterans). Which of the following anatomic areas are most often affected by this vascular condition? *
1 point
139. The nurse describes a client as anxious. Which of the following statements about anxiety is true? *
1 point
140. A client is admitted to the birthing suite in early active labor. The priority nursing intervention on the admission of this client would be: *
1 point
141. Nurse Clarisse is teaching a patient about a newly prescribed drug. What could cause a geriatric patient to have difficulty retaining knowledge about prescribed medications? *
1 point
142. Which nursing diagnosis is/are most applicable to a client with fecal incontinence? Select all that apply. *
1 point
Required
143. The physician prescribes 250 mg of a drug. The drug vial reads 500 mg/ml. How much of the drug should the nurse give? *
1 point
144. The assigned LPN of the unit reports to you that a client’s blood pressure and heart rate have decreased, and when her face is assessed, one side twitches. What is the most appropriate thing to do as a nurse? *
1 point
145. An 85-year-old male has been losing mobility and gaining weight over the last two (2) months. The patient also has the heater running in his house 24 hours a day, even on warm days. Which of the following tests is most likely to be performed? *
1 point
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