RPN Integrated Practice Test I:

Case Study
Ms. Patricia Hines, 23 year old, has been admitted with a diagnosis of anorexia nervosa. She has
participated in the development of her care plans.
Questions 1 to 6 refer to this case

1. Ms. Hines states, Everyone is over reacting to my condition and I would do much better with
treatment at home. This statement by Ms. Hines reflects which one of following?
a. Acceptance of her condition
b. Fear of her condition
c. Denial of her condition
d. Understanding of her condition
Answer: B the patient is aware that theres something wrong, however, has shown anxiety about her
consideration.

2. Which one of the following examples from Ms. Hines chart uses appropriate abbreviations?
a.
b.
c.
d.

Symt. of anorexia presented

Enc. client to discuss feelings
Stated goal is wt. gain of 4 kg
Discussed wt loss
Answer: C - weight is acceptable abbreviation for weight.

3. What aspect of Ms. Hines care should take priority for the practical nurse?
a.
b.
c.
d.

Building a trusting relationship with her.

Reviewing the care plan with her
Discussing her nutrition with the dietitian.
Assisting her to identify coping skills.
Answer: A trusting relationship is essential at the beginning of the patient-nurse relationship. Trust helps
the nurse to provide a meaningful and effective nursing care for the patient.

4. Ms. Hines has lost 1 kg in the past week. Which one of the following responses by the
practical nurse would best help Ms. Hines meet her nutritional needs?
Eating may speed up your discharge
Lets review your goals from your care plan
Would you like to see the dietitian?
Shall we take it one day at a time
Answer: B - Reviewing goals refocuses the patient.

a.
b.
c.
d.

5. The practical nurse notices Ms. Hines hiding food under her dinner tray and comments on
it. Ms. Hines says, Quit telling me to eat! Which one of the following responses should
the practical nurse make?
a. Ms. Saunders, you need to review your nutritional goals
b. You should try to eat all the food on your tray
c. You have an eating disorder and we want to help you with it
d. I want you to tell me why you are here
Answer: C This is the truth and it will bring awareness to the patient; the nurse also offer help to the
patient.

6. The practical nurse finds Ms. Hines crying and pacing in her room. Which one of the
following entries is acceptable for the practical nurse to record in Ms. Bakers chart?
a. Found Ms. Baker crying and pacing
b. Observed crying and pacing in her room
c. Entered her room, Ms. Baker is upset
d. Crying and agitated
Answer: A nursing notes should be carried in an unbiased manner factual and objective.
Case Study
Mrs. Mary Angelin, 45 year old, is admitted to the palliative care unit with pancreatic cancer. Her husband
and two teenage children accompany her. She states that she has abdominal pain. She is jaundiced and has
ascites. The physician has told them that Mrs. Angelin will live only for a few more weeks.
Questions 7 to 9 refer to this case

7. Mrs. Angelin is on a vegetarian diet. The physician has ordered a regular diet with
supplements. How should the practical nurse proceed?
a. Advise Mrs. Angelin to discuss his dietary request with the physician
b. Suggest that Mrs. Angelin bring vegetarian meal from home
c. Inform Mrs. Angelin that protein is required for his disease process
d. Notify the dietitian of Mrs. Angelins need for a change in meal plan
Answer: D the patients diet must be regarded

8. Mrs. Angelin asks how she and her children will know that her husbands death is getting
close. How should the practical nurse respond?
a. You will hear the death rattle right before he dies
b. His breathing may slow with longer periods between breaths
c. There is really no way of knowing when it will happen
d. The nursing staff will give you enough time to call the family.
Answer: B this is called agonal breathing a sign that death is imminent.

9. Mrs. Angelin calls the practical nurse to the bedside because her husband is taking his last
breaths. Mrs. Angelin starts to cry and tremble. How should the practical nurse respond?
Reassure Mrs. Angelin that her husband is no longer suffering.
Inform Mrs. Angelin that pastoral care will be contacted to comfort her family.
Stand quietly at the bedside with Mrs. Angelin and her children
Ask if there is anyone else that she would like the nursing staff to call
Answer: C the nurses presence is enough emotional support to the grieving family.

a.
b.
c.
d.

Independent Questions

10. The Practical Nurse enters Mrs. Stems room to administer the 0800 H insulin dose. Mrs.
Stem states, That is not my usual dose of insulin. How should the practical nurse
respond to Mrs. Stem?
a. Let me check the medication order again and Ill be back in few minutes.
b. Ill check with my colleague, who is right here to see if this the right dose.
c. I saw your insulin order about 1 hour ago and this is what the physician ordered.
d. Mrs. Stem, I know what I am doing and you should trust me, this is the correct does.
Answer: A checking the order will prevent medication error

11. Nora C., 75 year old, has recently had surgery resulting in a colostomy. She is withdrawn
and angry about the colostomy. Which one of the following actions would be effective in
helping Nora?
a. Suggest that she meet others who have had colostomy
b. Respect to remain in her room and be angry
c. Provide her with pamphlets
d. Demonstrate the ease of her appliance change
Answer: B anger is a normal response in a grieving patient. The nurse needs to show acceptance and
understanding of the patients feeling.

12. Which one of the following best describes the concept of Standard Precautions?
a. It is a method of infection control used only when the client test positive for a communicable
disease
b. It is a method of sterilization that follows is in emergency and high-risk clinical situations
c. It is a process where soiled articles are separated from clean hospital supplies
d. It is a system of generic infection control practices for all clients
Answer: D universal means generic which is applicable to everyone

13. What action is best when the practical nurse observes that a clients drug dosage for an
antihypertensive medication is twice the recommended dose for that medication?
Take the clients vital signs before proceeding with administration.
Take the clients blood pressure every 1 to 2 hours.
Check with the client to determine how long she has been taking medication.
Re-check the dosage on the physicians order sheet.
Answer: D the doctors order states the correct dosage for the patient.

a.
b.
c.
d.

14. Mr. Ford, 29 years old, is experiencing anxiety following a diagnosis of testicular cancer.
What should the practical nurse do?
Ask him if he is concerned about not having children
Encourage him to verbalize his feelings
Suggest that he talk to his significant other
Refer him to a testicular cancer support group
Answer: B being able to express feeling is the best way of decreasing anxiety.

a.
b.
c.
d.

15. Birol is frail, 18-year-old client who is in end stages of AIDS. He has open areas on his
upper and lower extremities. He is having severe, persistent pain and is due to receive
morphine sulfate (Morphine) 10 mg subcutaneously. Which of the following nursing
intervention best apply when the practical nurse prepares to administer morphine to
Benny?
a. Inject the morphine in the upper abdomen using a - inch - needle at 45.
b. Inject the morphine in the upper arm using a 1-inch needle at 45.
c. Contact the pharmacist and ask if morphine can be absorbed subcutaneously.
d. Call the physician and request an alternative route for morphine.
Answer: A - Morphine can be given subcutaneously

16. The practical nurse is asked by a colleague to witness the wastage of two narcotic tablets

a.

that have fallen on the floor. After co-signing the narcotic sheet, the practical nurse sees
the colleague put the two tables in a uniform pocket. Which actions must the practical
nurse take?
Report and document the incident.

b. Encourage the colleague to attend a self-help group for professionals.

c. Ignore the incident and observe for further occurrences.
d. Telephone the discipline committee of the regulatory body.
Answer: A the nurse in charge or the nursing supervisor must be informed and will determine if the nurse
needs help like drug rehabilitation.

17. An elderly male client with alcoholism states that he is thinking of committing suicide
and asks that this information be kept confidential. Which of the following responses is
most appropriate for the PN to make?
a. For your own safety, I have to report this immediately.
b. You are not really serious about this?
c. Have you spoken to your physician about this
d. Are you drinking more now?
Answer: A there should be no secrets in the hospital to promote the welfare of the patient.

18. The PN is asked to set up an IV infusion of 1,000 ml normal saline for a client. Which
one of the following actions is the first responsibility of the practical nurse?
Explaining the procedure to the client
Teaching the client about IV infusion therapy
Verifying the physicians order for the client
Assembling the equipment at the clients bedside
Answer: C ensure that the order is correct prior to its implementation

a.
b.
c.
d.

19. Mrs. Graf, 65 years old, reports that her toenails are thick, yellow, and difficult to trim.
Which one of the following measures by the PN would best promote wellness on the
patient?
a. Suggest that she visit a foot care specialist for nail trimming.
b. Demonstrate how to trim her toenails short rounded at the corners.
c. Trim her toenails after they soaked in hot water for 10 minutes.
d. Suggest that she use a small sharp scissors for trimming her toenails.
Answer: A thick, yellow toenails are abnormal. A specialist must be sought to prevent any undesired
effect from nail trimming.

20. The PN witnesses Mrs. Silver, 72 years old, being handled roughly by another staff
member. What should the PN do first?
Report the staff member to nurse in charge
Ensure the physician is informed and document the incident
Reassign Mrs. Fraser to another staff member
Discuss the incident with the staff member and document
Answer: D this is the appropriate initial action; the RPN will report the incident to the charge nurse if the
staff continues to mistreat the patient.

a.
b.
c.
d.

21. Mr. Hart, 48 year old, with type II diabetes mellitus has been started on insulin. He asks
the PN if he now has type l diabetes. What is the PNs best response?
a. No, insulin can be prescribed for people with type II diabetes.
b. You can have type 1 and type II diabetes at the same time.
c. Would you like to speak with the diabetes educator?
d. Taking insulin will prevent you from developing type 1diabetes.
Answer: A - type II DM can be temporarily switched to insulin in any stress-related event.

22. Mr. Arrais, 78 years old, has dementia and is in a long-term care unit. As the PN leads
him to the shower, he starts to scream and pulls away. What should the PN do?
a. Check if he has an order for a sedative
b. Remove him from the area and try the shower later
c. Show him others being showered so he knows its is safe
d. Ask his wife if she come and help with his shower
Answer: B the shower should be done when the patient calms down

23. Ena, 14 years old, has returned to the unit following application of a right wrist cast. The
PN observes that Enas fingers are cold and edematous. What should the PNs immediate
action?
a. Lower the affected limb
b. Report the observation
c. Obtain a cast cutter
d. Assess right radial pulse
Answer: B the patients symptoms are indicative of poor circulation from the cast. The physician must be
informed.

24. Tamer, a 22-year-old client with an unstable cardiac defect, is admitted to a medical unit
for telemetry monitoring. The PN was assigned as the primary care provider for this
client. What should the PN do in this situation?
a. Continue to care for Andy, monitoring his condition closely
b. Discuss the assignment with the nurse-in-change
c. Ask for assistance from the other practical nurse on the unit
d. Discuss concerns regarding this client assignment with the physician
Answer: B this assignment is beyond the PN scope of practice

25. Mr. M. Simpson, 85 year old, was recently admitted to hospital with dementia. Which
one of the following actions should the PN take in determining the amount of assistance
Mr. Simpson requires at mealtime?
a. Ask Mr. Simpson to describe his eating habits
b. Consult the physicians about Mr. Simpson food preferences
c. Ask the nurse-in-change
d. Check the nursing care plan
Answer: A this helps the RPN assess the type of assistance the patient requires

26. Mr. Frances, 65 year old, has end-stage cancer and requires narcotics for pain
management. When should the PN administer this medication to Mr. Frances?
a. When he states that he is experiencing pain
b. On a regular schedule, as ordered, before his pain recurs
c. Upon non-verbal signs of pain
d. When there is a change in his vital signs
Answer: B this result to well-controlled pain management

27. Mrs. Smikle, 54 year old, has Multiple Sclerosis and a self-care deficit due to decreased
a.
b.

mobility. Which one of the following actions should be the PNs first priority when
providing Mrs. Smikle early morning care?
Help her with mouth care
Offer toileting

c. Assist with bed bath

d. Perform special skin care
Answer: B toileting is usually the utmost need upon waking up, i.e. emptying bladder

28. Mrs. Sikora, 73 year old, has been recently prescribed an oral antihypertensive
medication. What
should the PN do when administering this drug?
a. Measure her blood pressure just before giving her the drug.
b. Withhold the medication just before giving her diastolic BP is less than 80mmHg.
c. Assess the effectiveness of the drug 15 after administration.
d. Ensure her medication is administrated with meals.
Answer: A anti hypertensive drugs promotes hypotension

29. Mrs. Kitching, 79 year-old native women from Northern Province, speaks limited
English. She has been diagnosed with type 1 diabetes mellitus was transferred to a
metropolitan hospital for development of a treatment regimen and teaching. How can the
PN best assist in teaching Mrs. Kitching about her diabetic diet?
a. Encourage Mrs. Kitching to attend a group session on diabetic diets
b. Use illustrated teaching materials to help Mrs. Kitchings understanding
c. Repeat key terms and directions to reinforce Mrs. Kitchings learning
d. Provide a copy of a standard diabetic diet for Mrs. Kitching to take home
Answer: A this helps the patient learn about her diabetic diet

30. A patient with a history of IV drug abuse is currently on Tylenol #3, 2 tabs q 3-4hrs. One
hour following receiving a dose, the patient complains of pain. What appropriate action
should betaken by the PN?
a. Inform Doctor to ease patients pain
b. Do nothing because the is experiencing tolerance
c. Give another 2 tab of Tylenol #3
d. Tell the patient to wait for another 2 hrs
Answer: A a doctors order is necessary before the pain medication can be given to the patient

31. The PN is serving the lunch tray to the anorexic patient. When accounting for the
a.
b.
c.
d.

patients intake, which of the following methods implemented by the PN is appropriate?

Stay with the patient while she eats patients with anorexia nervosa sometimes hide or
throw their food because they refuse to eat.
Monitor input and output by collecting her tray after lunch
Leave patient and attend to other patient and come back later to see what she has eaten
Instruct the patient to give you a list of what she has eaten

32. A patient comes to the hospital for complain of itchiness and pain. Upon assessing him
a.
b.
c.
d.

you notice that he has scabies. The best action taken by the PN would be:
Report to physician
Report charge nurse scabies is bacterial infection which requires treatment. The RN will
report the finding to the physician
Report to Public Health
Instruct him to wash his skin with soap and water

33. When giving IM injection using the deltoid muscle in a male adult would be:
a. 1 inch

b. 2
c. 0.5
d. 1.5 a male adult is more muscular which requires a 1.5 inch needle
34. An optic medication is given in the ear. What appropriate action should the PN take?
a. Irrigate the ear
b. Report to the physician and document incident report wrong medication must be reported
c.
d.

to the physician
Clean the ear with sterile gauze
Observe the patient for any adverse reaction

35. The patient with fracture on the right femur complains of dyspnea. On physical
assessment the PN
discovers that the patient has high BP. Which of the following position is best for the patient?
a. Semi fowler
b. Prone
c. Supine
d. Sims
Answer: A this promotes oxygenation through lung expansion

36. Following application of plaster cast on the L wrist, the PN should:

a.
b.
c.
d.

Check for wet cast

Know when to sling
Check the blanching of right fingers
Check the blanching of left fingers good circulation on the L arm with cast must be
ensured

37. The patient with a diagnosis of MI complains of pain, became diaphoretic, dyspneic and
a.
b.
c.
d.

cyanotic. Which of the following actions would a priority for this patient?
Administer nitroglycerin paste
Administer oxygen MONA (morphine, oxygen, NTG and ASA) is the acronym in treating
MI.
Call the doctor
Document the observation

38. An Alzheimers patient fell on the floor and appears to have no injury. When the PN tries
a.
b.
c.
d.

to assess him he became so aggressive and violent. He shouted at the PN to leave him
alone. What would be the action of the PN?
Ask the charge nurse to call his wife
Stay with the patient and ask the charge nurse to call the physician
Wait till he calm down and continue the assessment safety of the patient and the nurse
must be ensured.
Force him to stand and sit him on the chair

39. The patient with hip fracture femur went to surgery, a skeletal traction and pins were
applied. Which action indicates that the patient needs further teaching?

a. A t-shirt is used to cover the pins from his friends pins should be left open to air
b. He said that he cant raised his bed more than 45
c. He told the nurse the traction touches the bed

d. Some weights were removed

40. A psychiatric patient is ready for discharge. The PN heard him telling everyone that he is
going to kill his girlfriend. What appropriate action should the PN take?

a. Inform the physician about the threat it is the responsibility of the physician to ensure the
safety of the patient a 24-hour watch may be required for this patient

b. Tell the girlfriend

c. Keep quiet
d. Inform the cops
41. The homeless patient who was hospitalized because of thigh cellulitis states, Its been a
a.
b.
c.
d.

long time I do not had a good meal. What will be the right strategy to improve his
nutritional needs?
Tell him about the importance of food and wound healing protein and Vit. C rich diet
will promote tissue healing on the patient
Give him the menu to choose his food
Encourage to let him eat 6 small meals and provide with drink supplement
Encourage him to eat his favourite food

42. A diabetic patient type 1 and his wife are having lunch. The wife gets a slice of cake for
a.
b.
c.
d.

him. Which action taken by the PN is appropriate?

Let the diabetic have it
I have to check your diet plan the patient is made aware that cake may not be allowed
You cannot have a slice
Let the patient choose

43. The 16 year old was so upset that her mother is dying. What is the appropriate action of
a.
b.
c.
d.

the PN?
Let her express what she feels
Refer her to the grieving counselling group upset (anger) is the first stage of grieving;
support is needed
Leave her alone with her private grieving
Give her privacy

44. Nurses role when a family is waiting for a loved one to die include:
a.
b.
c.
d.

Tell the family to spend as much time with their mother.

Give them something to drink
Monitor them with their needs
Always visit
Answer: A family members should be allowed to spend quality time to a departing loved one part f
grieving process

45. It was already 3:00 AM when a terminally-ill patient called the PN and he requested to
see the chaplain. He said, I think I will die soon. What would be the response of the
PN?
a. Offer to read the passage for him
b. Leave a message to the chaplains phone
c. Call the right person who is on call for the night of chaplaincy
d. Tell the patient that the message will be pass on to the morning staff
Answer: C the patients request must be provided

46. Prior to the arrival of the family, the most appropriate care on the body of the patient who
a.
b.
c.
d.

died few minutes ago would be:

Put the tag on her feet
Elevated the head at 45
Place both hands on his abdomen
Do bed bath and change the linen the body must be prepared for viewing

47. An old woman became so weak while ambulating and about to fall. The PN would
a.
b.
c.
d.

Let her slide slowly on the floor and ask for help
Transfer her in her wheelchair
Transfer her to her bed
Catch her so that she will not touch the ground
Answer: A this prevents further injury to the patient

48. The patient requested the PN to fill up his will for he is so weak to write. The most
appropriate response made of the PN would be:

a. Let you children do it for you

b. Ask your lawyer to help you the lawyer is responsible to look after legal issues including
patients will

c. The PN will assist the patient with his will

d. Refer the patient to the RN
49. Your patient from the operating room has returned to the unit. The most appropriate
a.
b.
c.
d.

initial action taken by the PN would be:

Take the vital signs this will rule out post-op complications
Check the patients wound for bleeding
Make the patient comfortable in bed
Assess the patient for pain

50. A type I diabetic patient has no response. What is the action of the PN?
a.
b.
c.
d.

Elevate her head

Give insulin
Take her blood sugar
Call for code blue help is top priority if someone was found unresponsive

51. Kelly is a new arrival in the community. She went to the community health center and
a.
b.
c.
d.

asked the PN where she can find an abortion clinic. This is Kellys 4th abortion. The PN
response include:
Give her some information of clinics location
Ask her if she wants to talk to social worker and find some alternative the social
worker is the best person to provide help to the patient
Suggest that adoption is another alternative
Tell her that her abortion is now habitual

52. Following a successful delivery at the discharge teaching session, a single mom states, I
do not know if I can handle the responsibility What would be the most appropriate
action taken by the PN?
a. The PN will refer her to the social worker b. The PN will assure her that everything will be fine
c. Teach her to do the breastfeeding
d. The PN will suggest adoption
Answer: A the social worker can provide assistance just in case the mother opts adoption

53. The PN has finished assisting the physician performed a lumbar puncture. The purpose of
a.
b.
c.
d.

the puncture was to help confirm the diagnosis of meningitis in a newly admitted patient.
The equipment used will be sterilized by which method?
An autoclave this completely destroy organisms
An antiseptic
A disinfectant
A short burst of steam

54. Following 3 days of bed rest, the patient will ambulate for the first time. Which of the
a.
b.
c.
d.

following observation by the PN suggests that the patient tolerated the activity without
distress?
The patient took small steps at the rate of 40 50 per minute this is an accomplishment
The patient reported feeling dizzy and weak and perspired profusely.
The patients head was down, gaze was cast down, and toes were pointed outward.
The patients pulse and respiratory rates are moderately increased during ambulation

55. A patient tells the PN, I brought my own enema and I want you to use it Which is an
appropriate
respond?
a. I cannot give this enema
b. Notify physician for an order
c. Give patient enema
d. Allow the patient to use his own enema kit the patient should be allowed to use her own kit if
enema is ordered

56. The homeless patient will be discharged. The PN was so sorry for him because he had no
address to go home to. What would be the best help for this person?

a. Find the nearest shelter from the hospital so that it will be convenient for the patient for his follow
up visits shelter is for homeless

b. Refer him to the social worker and non-profit organization for some assistance
c. Advise the patient to come for his medical follow up
d. Provide some money for the patient
57. The mother with a history of Chlamydia would like to breastfeed her newborn. What
would be the best advised that can be given to the mother?

a. Let her breastfeed the baby the mother is allowed to breastfeed; chlamydia can be
b.
c.
d.

transferred during vaginal, anal or oral sex, anyone who is sexually active is at risk of
contracting this infection.
Tell her to bottle-feed the infant
She should not breastfeed her baby
She can breastfeed and bottle feed if breast milk is not sufficient

58. Youre inspecting a childs pupils as part of the routine examination. You shine a light
into his right
eye. Whats the normal response?
a. Both eyes dilate.
b. Both eyes constrict.
c. The child closed his eyes.
d. One pupil is non-reactive.
Answer: B shining a light in the right eye should cause the right pupil to constrict as well as the left eye
(consensual).

59. Twenty-four hours following burn accident, Johnny was given Morphine Sulfate to
control his pain.
Which of the following parameters should the PN utilize to accurately measure the clients response to
drug therapy?
a. How the client feels
b. Use the pain scale systemScale of 1 of 10.
c. Pay attention to non-verbal cues.
d. Monitor the clients vital signs

60. Health record indicates that there has been a significant decline in the number of immunization
administered over the last 15 yrs in a community of 10,000 people. What is the most efficient first
step to identify the reason for this decline in immunization?
a. Analyze the age characteristics and the community using the most recent census data.
b. Review hospital admission data at the community hospital.
c. Conduct a series of home visit in the community asking about immunization practices.
d. Review disease specific mortality and morbidity data from Statistics Canada.
Answer: A the community was not growing perhaps there were no deliveries

61. Which of the following statements made by the patient should the PN include in her
documentation at the end of the shift?
a. That green pill is not given to me anymore.
b. Ive never seen my attending physician since after surgery.
c. I did not have any bowel movement for the last 3 days.
d. It seems that I will never get over with the death of my husband.
Answer: D this is a depressed patient possible suicide

62. How can the PN assist the patient to die without having her license revoked?
a. Give lethal injection.
b. Remove the non-rebreather mask this can be legally done to DNR patients
c. Place the patient in the palliative care
d. Do not allow the patient to drink
63. What is the purpose of eligibility?
a. To collect taxes
b. To protect the public from harm this is the purpose of licensing
c. To gauge the knowledge of the examinee
d. To revoke your license
64. The PN is teaching the pregnant mother about the use of seat belt as safety measure. This is an

example of:

a.
b.
c.
d.

Health promotion
Prevention of illness and injury
Treating the symptoms
Restoration of wellness
Answer: A - process of enabling people to exercise control over those factors and conditions that influence
their health

65. A patient was visited by a friend. His friend was carrying clear plastic bag with white powder
inside. The PN has acted appropriately when she
a. Confiscates the bag and document her intervention
b. Calls security and inform the nursing supervisor illegal drugs are strictly prohibited
c. Prevents the friend from visiting the patient
d. Ignore the visiting friend and pretend not to see the plastic bag

66. Larissa is a new post op patient. The physician ordered Demerol 2 to 5 mg IM Q 4 hours PRN for
pain. Forty minutes after she received 2 mg of Demerol for pain, she was asking for another pain
medication for her severe pain. Which of the following actions taken by the RPN is appropriate?
a. Give another 2 mg of Demerol still allowed based on order
b. Inform the charge nurse
c. Inform the physician
d. The patient must be given pain medication Q 4 hours

67. The PN received a phone call from a patient who is unable to do his dressing. Which action taken
by the PN is most appropriate?

a. The patient was given sterile dressing pack and disposable forceps
b. The patient was instructed to use sterile dressing and sterile forceps
c. Instruct the patient to go to the community health center the nurse at the center should be
able to help the patient with dressing changes

d. Give a telephone instruction and teach the patient how to do his dressing changes at home
68. Rosy is a 45-year-old female patient who sustained renal failure from a severe blood transfusion
a.
b.
c.
d.

reaction. She was ordered several medications including aluminum hydroxide. The well-informed
PN is aware that Aluminum hydroxide was ordered in an attempt to
Increase the phosphate level.
Increase the calcium level.- aluminum is a phosphate binder decreases phosphate and thus
calcium level increases (phosphate is inversely related to calcium)
Treat the patients peptic ulcer.
Neutralize the HCL in the stomach.

69. PN Evelia was confronted by PN Corrie because she didnt check the NGT placement prior to
administering the NG feeds. PN Evelia says, The CXR was already done and the tube placement
was confirmed and therefore theres no need to check the tube. PN Corrie will do which of the
following:
a. Document what had happened in the progress notes
b. Inform the nursing supervisor
c. Confront PN Marie
d. Fill out an incident report
Answer: B since the patients safety is in danger, the supervisor must be informed

70. A young patient with Leukemia decides to stop his chemotherapy. Which appropriate question
should the PN ask the client?
a. Ask him if he realizes the benefits of the therapy.usually lack of education is causing
the
problem
b. Ask him if he is aware of the consequences of quitting the therapy.
c. Ask him if he is aware of the side effects of the therapy.
d. Ask him if he has discussed his plans with his physician.

71. Mr. Harris father died suddenly. Shortly after the funeral, the PN visits Mr. Harris. He tells her

a.
b.
c.
d.

that he doesnt want to see anybody, feels no enjoyment in anything and feels hopeless and
useless. Which of the following questions asked by the PN is most relevant to the patients
condition?
Is it your fathers death that is affecting you?
Do you feel alright in spite of your problems?
Have you thought of harming yourself?- direct question is asked among suicidal patients
May I know whats bothering you?

72. Health teachings on foods rich in folic acid on a pregnant mother to prevent complications on a
growing fetus is under:
a. Health promotion
b. Primary
c. Secondary
d. Tertiary
Answer: A - process of enabling people to exercise control over those factors and conditions that influence
their health

73. Screening for high blood cholesterol in the community is under:

a. Health promotion
b. Primary
c. Secondary - treatment is secondary
d. Tertiary
Answer: C- Secondary prevention includes early detection and treatments of adverse conditions; cure of
illness , prevention of complications and disability, and confinement of the spread of communicable
diseases, screening, examination of asymptomatic people for disorders such tuberculosis, diabetes, and
hypertension

74. Health on the effects of smoking and lecture on how to stop smoking is under:
a. Health promotion
b. Primary
c. Secondary
d. Tertiary
Answer: A - process of enabling people to exercise control over those factors and conditions that influence
their health

75. When taking the BP of a patient who has AIDS the PN must:
a. Wear clean gloves.
b. Use barrier techniques.
c. Wear a mask and gown.

d. Wash the hands thoroughly.

Answer: D blood and body fluid precautions require that hands be washed before and after patient care to
minimize the risk of transmission.
76. The PN understands that the patient with esophageal varices should not be given foods such as:
a. Crackers
b. Purred food
c. Liquid
d. Soft
Answer: A hard food may lead to bleeding esophageal varices.

77. To prevent toxoplamosis, the PN should instruct to avoid:

a. Contact with cat feces
b. Working with heavy metals
c. Ingestion of fresh water fish
d. Excessive radiation exposure
Answer: A - Toxoplasma gondii, a protozoan, can be transmitted by exposure to infected cat feces or
ingestion of undercooked contaminated meat.

78. After the resuscitation, Mabels condition stabilizes but now with a much poorer prognosis. When
the family of a terminally ill child asks the nurse to help them end the suffering of their loved
ones, the following would be the most appropriate response by the nurse:
a. Euthanasia is under the criminal code
b. This is against the code of nursing ethics
c. You should not lose hope as long as your loved ones lives
d. This is against the standard of nursing practice
Answer: A this is the law in Canada and USA.

79. Martha, 62 yrs old, with history of CVA sustains L hemiparesis. She was admitted in your unit
with a diagnosis of pneumonia. To promote optimal ventilation, Martha is required to be up bed
during the day. Safe and appropriate transfer of the patient from bed to chair with two person
include:
a. Place the wheelchair parallel to the bed, facing the foot of the bed, each PN to place her hand
under the patients axilla and lift patient to the wheelchair.
b. Place the wheelchair to the foot part of the bed at R angle, 2 PNs to lift the patient
simultaneously.
c. Place the wheelchair near and parallel to the bed and the PN to help patient pivot herself in
the chair.
d. Place patient in sitting position, place the w/c close to the bed and locked, instruct patient to
stand while you support the affected hand and pivot herself in the wheelchair.
Answer: D this is the safest way of transferring the patient with weakness from bed to wheelchair.

80. A client is admitted with severe dehydration and is in critical condition. The doctor has ordered IV
bolus. On the basis of the nursing scope of practice, the PN is not aware if she can carry out verbal
order, will do which of the following?
a. Refuses to carry out the order and informs the nursing supervisor
b. Checks the hospital policy manual on verbal orders and emergency cases
c. Asks help from a more senior nurse on duty
d. Carry out the order in emergency situation
Answer: B the hospital policy provides clear directives on issues affecting patients care

81. The PN was asked to help out in performing range of motion (ROM) exercise on a patient as part
a.
b.
c.
d.

of rehabilitation and appropriately responds

It is a basic nursing care.
It is the physiotherapists responsibility.
I need to check the policy and procedure manual and see if I am allowed to help out.
Prevention of contraction is also our roles and not just the physiotherapist. this is also an
PN role

82. The PN was about to administer Edwards antibiotics and after which he is being reposition when
the nurses aide came and reported that the other patients IV pump alarm went off. The PN has
appropriately prioritize her nursing activities as:
a. Administer the antibiotics, reposition the patient, and attend to the other patients IV pump.
b. Administer the antibiotics, reposition the patient, ask the nursing aide to the patient.
c. Turn off the other patients IV alarm, administer the antibiotics, reposition the patient.
this sequence of nursing interventions will prevent losing the IV access (as a priority)
d. Reposition the patient, turn off the other patients IV alarm, administer the antibiotics.

83. Which of the following positions is appropriate post hip arthroplasty?

a. Abduction and internal rotation of the affected leg
b. Abduction and neutral position of the affected leg the newly replaced hip must be extended
and abducted as much as possible

c. Adduction and internal rotation of the affected leg

d. Adduction and neutral position of the affected leg
84. Which of the following symptoms are characteristics of impending diabetic coma?
a. Hyperreflexia, babinski reflex, numbness
b. Hot, dry, flushed skin, excessive thirst, rapid pulsedue to dehydration
c. Hot flashes, severe hunger, restlessness, bradycardia.
d. Profuse diaphoresis, headache, bradycardia.
85. Coma associated with diabetic ketoacidosis is usually a result of
a. Excessive circulating insulin
b. Collapse due to dehydration
c. Depressed cerebral function due to ketones
d. Decreased cerebral tissue perfusion due to decreased circulating insulin
Answer: D insulin helps in providing glucose (energy) to the brain tissues

86. A blood sugar of 2.5 mmOs/L would indicate which of the following conditions?
a. Ketoacidosis
b. Normal serum blood glucose.
c. Insulin reactions hypoglycaemia is usually caused by low blood sugar from insulin
d. Glycosuria
87. The treatment of choice for severe ketoacidosis in a conscious person is:
a. Orange juice
b. Candy
c. Insulin ketoacidosis is abnormally high blood sugar and insulin is the treatment of
choice (faster effect)

d. Exercise

88. A type I diabetic client asks the PN why she cant take a pill for her diabetes. Which of the
following best describes the action of oral hypoglycemic agents?
a. They stimulate beta cells in the pancreas to release endogenous insulin.
b. They supply exogenous insulin, which enhances the transfer of glucose into cells.
c. They supply exogenous insulin, which restores efficient sugar utilization.
d. They stimulate adipose tissue to release endogenous insulin,
Answer: A birth control pills are steroids and the increase the blood sugar level

89. When teaching insulin self-administration, it is most important that the client learn to:
a. Rotate injection sites.
b. Wipe the needle with alcohol.
c. Hold the hub of the needle.
d. Cool the insulin before injecting.
Answer: A rotating injection sites prevent atrophy or dystrophy of muscles which can lead to poor
absorption of insulin

90. The PN should instruct a woman with diabetes that symptoms of hypoglycemia includes:
a. Cool skin, sweating, headache.
b. Constipation, increase in weight, hunger.
c. Hot, dry skin, rapid pulse, thirst.
d. Nausea, fruity breath odor, diarrhea.
Answer: A these are signs of hypoglycemia

91. In preparation for patients discharge, the PN reviews the diabetic exchange list with a diabetic
client. A sandwich made of 2 slices of whole wheat bread, one slice of bologna, 1 tsp of
mayonnaise and 2 lettuce leaves is the equivalent of:
a. 1 bread exchange, 2 meat exchanges, fat exchange, and 1 vegetable exchange.
b. 2 bread exchanges, 1 meat exchange, 1 fat exchange, and 1 vegetable exchange.
c. 1 bread exchange, 2 meat exchanges, and 2 fat exchanges.
d. 2 bread exchanges, 1 meat exchange, 1 fat exchange, 2 vegetable exchanges.

92. On the day of discharge, a newly diagnosed diabetic says, Tell me again what I should do if I
develop a fever. The best response for the PN to make is to instruct the patient to:
a. Increase her caloric intake and decrease her insulin dosage.
b. Discontinue taking insulin until after her febrile state has passed.
c. Continue taking insulin as prescribed.
d. See her physician to have her insulin dosage adjusted.
Answer: D fever, infection, or any stress-related event in a diabetic would require increase dosage of
insulin

93. A client is admitted to the hospital with severe abdominal pain and vomiting. He is put on a clear
liquid diet. Which of the following fluids is not acceptable food to include in the diet?
a. Prune juice.- this is not clear liquid; this is fiber food
b. Apple juice.
c. Cranberry juice.
d. Lemon juice.

94. A patient is described as obese in the hospital chart. Which of the following is a correct definition
of obese?

a.
b.
c.
d.

10 20% over ideal weight.

20 50% over ideal weight.
0 100% over ideal weight.
>100% over ideal weight.

95. Which of the following food combinations would be permitted on a bland low-fat diet?
a. Pistachio ice cream with chocolate sauce.
b. Vanilla yogurt with canned peaches.
c. Tea with milk and toast.
d. Pea soup with garlic croutons.
96. A patient has an atherosclerotic heart condition, which has developed over a number of years.
Which of the following diets is known to be a risk factor in the incidence of atherosclerotic heart
disease?
a. High fat, high cholesterol. cholesterol sticks to the wall and opening of arteries
(atherosclerosis)
b. High protein, high salt.
c. High protein, high fat.
d. High salt, high fat.

97. At discharge, a client is advised to follow a caloric restricted diet. Which of the following would
be an ideal rate of weight loss?
a. 0.5 lb per day.
b. 0.5 lb per week.
c. 1 lb per week.
d. 1 lb per day.

98. The PN is devising a care plan to optimize capacity for oral feedings in a client undergoing
treatment for cervical cancer. Which of the following measures would be most likely to increase
her total intake?
a. Provide high fat snacks.
b. Provide small, frequent feedings.
c. Provide additional fluids at meals.
d. Provide food only at her request.

99. Which of the following foods is allowed on a renal failure client?

a. Pineapple icedecreased protein is required for patient with renal failure
b. Pork chops.
c. Cheese sandwich.
d. Yogurt.
100.
Which of the following effects describes the goal of a renal diet?
a. Lowered intake of protein to decrease BUN.- urea is waste product that must be
b.
c.
d.

excreted during urination; in renal failure, urine output is decreased and thus urea
accumulates in the blood
Lowered intake of sugars to decrease blood glucose.
Lowered intake of fats to decrease blood triglycerides.
Lowered intake of amino acids to decrease triglycerides and serum albumin.

101.

A patients husband asks why vitamin B12 cant be given on a pill form. The best response
by the registered PN is:
a. Your wifes symptoms of deficiency are quite severe and large doses can only be given by
injection.
b. Your wifes stomach doesnt secrete the necessary substance for B12 to be absorbed
orally.due to lack of intrinsic factor in the stomach and small intestine to absorbed
Vit. B12.
c. Is your wife afraid of needles?
d. The intramuscular route is the fastest way for the B12 to be absorbed.

102.

A woman asks the PN how long she will need injections of Vitamin B12. The most
appropriate response to the PN is:
a. For the rest of your life.since intrinsic factors are no longer available, Vit. B 12 are
taken lifetime
b. Ask your doctor.
c. Six months to a year.
d. That will be determined by your blood count.

103.

A 9-day-old infant is diagnosed with phenylketonuria (PKU). Which of the following

must be eliminated from the PKU diet?
a. Phenylalanine this is low in protein
b. Potassium
c. Sodium
d. Glucose.

104.

A type 1 diabetic is placed on 1800 calorie/day diet. Which of the following foods is a
suitable exchange for a fat of butter?
a. cup of milk.
b. 2 cups of yogurt.
c. cup of cabbage.
d. 1 tablespoon of mayonnaise.

105.

A 7 yr old child has cystic fibrosis. His parents have been instructed to make certain
dietary modifications. Which of the following adjustments is likely to be made in a normal diet
a. Increased protein.
b. Increased fat.
c. Increased carbohydrates.
d. Increased potassium.

106.
a.
b.
c.
d.

Which of the following meals would have the least residue?

Bouillon, grilled cheese sandwich, and grapes.
Corned beef, buttered peas, and custard.
Roast lamb, buttered rice and sponge cake.
Strained cream of asparagus

107.
Which of the following types of insulin is the slowest acting form:
a. Regular
b. Ultralente- this take more than 36 hours to peak
c. NPH

d. Humulin N
108.
a.
b.
c.
d.

Which of the following appetizers would be permitted in a low-fat diet?

Shrimp cocktail
Liver pate
Oysters
Raw vegetables and cheese dip has the lowest fat

109.

What is the primary reason patient with cystic fibrosis have difficulty absorbing
nutrients?
a. Liver failure
b. Pancreatic insufficiency - the pancreatic ducts are obstructed with thick, tenacious
secretions in cystic fibrosis preventing the pancreatic enzymes to reach the intestines and
stomach
c. Heart overload
d. Vitamin deficiency

110.

Which of the following principles should serve as the basis for managing childhood
weight problems?
a. Allow for linear growth without weight gain.
b. Allow for slow weight loss, approximately one pound per week.
c. Allow for weight loss by exercise only.
d. Allow for weight loss only under physician supervision.

111.

A 3-year-old girl is brought to the emergency room. She has a history of vomiting and
diarrhea for the past 3 days. Which of the following signs and symptoms would most likely be
seen?
a. Shortness of breath.
b. Slow heart rate.
c. Sunken eyeballs. this is a sign of dehydration
d. Tremors.

112.

The best way to maintain an adequate fluid intake for a toddler with nausea, vomiting,
and diarrhea would be to:
a. Keep her NPO and give hypotonic solutions intravenously.- hypotonic fluid (NS)
replenishes the fluids in the intravascular space
b. Force fluids and give hypertonic solutions intravenously.
c. Provide jello and Popsicles to increase fluid intake.
d. Keep her NPO and feed her via nasogastric tube.

113.

Which of the following laboratory findings should the nurse expect to be consistent with
fluid volume depletion?
a. Specific gravity of 1.020.
b. Specific gravity of 1.034.- indicates highly diluted urine, a sign of dehydration
c. Potassium of 5.8 mEq/L.
d. Potassium of 4.8 mEq/L.

114.

An 80-year-old man is admitted to the hospital to undergo abdominal surgery. His

admitting orders include activity as desired, standard bowel prep and an intravenous infusion of

5% Dextrose in water to infuse at 75 cc/hr starting at 6:00 PM on the evening before surgery. The
primary purpose of administering intravenous fluids to a patient before surgery is to:
a. Have a route for administering medications rapidly.
b. Avoid the need for inserting it on the morning of surgery.
c. Decrease the patients desire to take fluids by mouth.
d. Assure that the patient remains adequately hydrated.- IV fluids prior to surgery is
essential to hydration and BP support

115.

Which of the following changes in the condition of a patient with hyperkalemia is

most significant in terms of indicating a serious complication?
a. A weight gain of 4 lb in a day.
b. An increase in nausea.
c. An increase in muscle irritability.
d. An episode of fibrillation.- high potassium level causes cardiac arrest (Ventricular
fibrillation)

116.

Which of the following sets of vital signs is most indicative of fluid overload due to blood
transfusion?
a. Decreased PR, increased BP, decreased RR.
b. Increased PR, increased BP, increased RR. these are signs of hypervolemia
c. Increased PR, increased BP, decreased RR.
d. Decreased PR, decreased BP, increased RR.

117.

In order to administer 1000 cc, 40 mEq of KCl at 100 cc/hour using an administration set
which delivers 60 gtt/cc, the PN should adjust the flow rate to:
a. 5 gtt/min.
b. 60 gtt/min.
c. 100 gtt/min.
d. 125 gtt/min.

118.

Which of the following signs and symptoms is an early indication of fluid volume
imbalance?
a. Cyanosisnot related
b. Diarrhea
c. Edema--symptom
d. Shockcause

119.

Which of the following statements regarding the administration of blood transfusion is

NOT true?
a. Blood should run for no more than a period of 4 hours.
b. Blood should be run with normal saline.
c. Blood should be used promptly or be returned to the refrigerator.
d. Blood should be run quickly at first and then regulated to rate ordered.- blood should be
ran slowly on the first few minutes to minimize the effect of blood transfusion reaction
(should it occur)

120.

In evaluating clients fluid balance, which of the following things would most likely
require intervention?
a. Output is 300 cc less than intake.

b. Output is 800 cc less than intake.output is usually more than intake to prevent fluid
c.
d.

overload
Intake is 1,800 cc in 24 hours.
Intake and output are equal.

121.

A child with AIDS is living in a foster home. Which of the following instructions would
be important to give to the foster parents:
a. Weight the child daily
b. Feed the child on demand
c. Wash hands before and after handling the child
d. Always wear gloves when handling the child
Answer: C Handwashing is the most effective technique in preventing the spread of infection.

122.
a.
b.
c.
d.

Children who are abused often:

Hate their parents
Protect their parents
Tell everybody what their parents are doing
Run away from home
Answer: B Abused children often love their parents and are fearful of separation and will protect the
parents when possible.

123.
a.
b.
c.
d.

The presence of gonorrhea in a 4-year-old girl is likely due to:

Immunosuppression
Physical abuse
Accidental transmission
Sexual Abuse
Answer: D Gonorrhea is a sexually transmitted disease. The child must have come in contact with an
infected person to contract it.

124.

Femoral and spiral fractures in children are particularly suspicious in which of these
groups:
a. Adolescents
b. School age children
c. Preschoolers
d. Infants
Answer: D - These types of fractures are unlikely to occur in children who are not yet walking.

125.

A child who presents with an accidental scalding would have which of the following burn
patterns:
a. Socklike
b. Glovelike
c. On the front of the body only
d. No particular pattern
Answer: D Accidental burns do not demonstrate any particular pattern.

126.
A child with Cerebral Palsy has difficulty chewing and swallowing. This is likely due to:
a. Motor damage
b. Cognitive damage
c. Muscle weakness

d. Sensory damage
Answer; A The motor function of the brain may be damaged in CP and will interfere with oral motor
function in the child, making chewing and swallowing difficult.
127.
a.
b.
c.
d.

The most accurate way to assess mental status in children is to assess:

Behavior
Orientation to person, place and time
Alertness
Response to tactile stimuli
Answer: A Children who are ill will demonstrate a change in the level of activity and interest in their
environment.

128.

When teaching the mother of an infant about introducing solid foods the nurse would
instruct the mother to start with:
a. Rice cereals
b. Yogurt
c. Applesauce
d. Peas
Answer: A Early food introduction should be started with easily digestible single grain cereals, such as
rice cereal.

129.

A mother of a 6-month-old wants to begin supplementing breastfeeding. Which of the

following would the PN instruct her to use
a. Low iron formula
b. Formula with iron
c. Soy milk
d. Cows milk
Answer: B By 6 months neonatal iron stores have depleted and must be replaced through diet.

130.

A 2-year-old is in the supermarket with his mother and begins to have a tantrum because
she wont give him a lollipop. A nurse standing behind them on line might suggest the following to
the mother.
a.
Give him the lollipop now and explain to him after that next time he wants something
he
should ask for it nicely
b. Scold the child and refuse his request
c. Ignore the childs behavior
d. Pick the child up and comfort him but do not give him the lollipop
Answer: C Ignoring the behavior decreases the importance of the event. The child is not motivated by the
parental response when having a tantrum in early toddlerhood.

131.
a.
b.
c.
d.

A child with PKU (Phenylketonuria) would have the following finding:

Musty smelling urine
Shiny, foal smelling stool
Multiple care-au-lait spots
Extra gluteal folds
Answer: A The urine of a child with PKU will have a musty smell from the inability to breakdown
protein.

132.

What is the most common long-term effect of myelomeningocele:

a.
b.
c.
d.

Renal disease
Heart disease
Hydrocephalus
Bowel dysfunction
Answer: D Long term effects of Myelomeningocele involve motor and sensory function to the lower
extremities and the bowel and bladder.

133.
a.
b.
c.
d.

A preoperative intervention for an infant with a myelomeningocele the PN would:

Place the child in a side lying position
Place the child in a prone position
Place the child in semi fowlers position
Place the child under a heat lamp to facilitate drying of the sac
Answer: B Prone positioning prevents the sac from injury.

134.
a.
b.
c.
d.

The child with myelomeningocele is prone to urinary tract infection because:

Pericare is difficult to perform
Poor innervation of motor nerves to the bladder
Difficulty with oral intake
Poor immune response
Answer: B UTI is common in children with myelomeningocele because they develop neurogenic bladder
and urinary stasis.

135.

Due to the fact that children with AIDS often suffer from neurological infections it would
be important to teach the mother:
a. To take the babys temperature daily
b. To assess developmental milestones and report any regression
c. Give the baby supplemental feedings with a high calorie formula
d. Aggressively work with the child to maintain all developmental milestones achieved
Answer: B Neurological involvement may cause developmental delay and regression. This must be
anticipated and assessed.

136.

A 6-year-old with Pneumonocytis Carnii Pneumonia secondary to AIDS is admitted on

the unit. The most appropriate room assignment for this child would be a:
a. 4-bedded-room that is empty
b. 2-bedded-room with an infant with pyloric stenosis
c. 2-bedded-room with a 7-year-old who has leukemia
d. 2-bedded-room with another child who has AIDS
Answer A: This child has an infectious opportunistic infection, preventing exposure to other patients is a
priority.

137.
b.
c.
d.

A patient has Parkinsons disease. How would you encourage him to walk to the
bathroom to bathe?
a. Come with me. Its your bath time.
Your bath time is now. Do you want it now or later?
If you dont feel like walking to the bathroom, I will give you a sponge bath in bed.
Lets go to the bathroom for your bath.

138.
A patient who has a heart disease wants to eat fried foods. How would you respond?
a. You cant eat fried foods because you have heart disease.

b. Lets review your dietary nutrition plan.

c. Fried foods are very unhealthy and youre not supposed to eat any.
d. Youre not allowed to eat any fried foods.
139.
a.
b.
c.
d.

How do you change a colostomy with a new bag or pouch?

Remove used pouch directly.
Ensure that the clamp is applied before removing pouch.
Remove the bag and change it with the new one.
Empty the bag then carefully untape the pouch.

140.

A pregnant teenager tells you not to tell her parents that she is pregnant. How would you
respond?
a. Ask how she feels about her pregnancy.
b. Refer the teenager to a social worker.
c. Tell the patient that you will keep her information confidential.
d. Ask the patient what are some possible reactions would her parents have if they knew she was
pregnant.

141.
a.
b.
c.
d.

Which among the following indicates dehydration in a child?

Slow respiration
Slow, thready pulse
Hypertension
Increased BUN urea is excreted during urination; in dehydration, urine output is
abnormally low which causes urea to stay in the blood

142.
a.
b.
c.
d.

How do you position a chair in readiness to transfer a patient from a bed to the chair?
Angle the chair slightly facing the head of the bed.
Angle the chair slightly facing the foot of the bed.
Place the chair perpendicular to the head of the bed.
Place the chair perpendicular to the foot of the bed.

143.
a.
b.
c.
d.

Which among the following is a common side effect of antihypertensive drugs?

Hypotension anti hypertensive drugs lower BP
Hyperactivity
Dehydration
Hypoglycemia

144.
How do you give a calcium tablet to a patient who has difficulty swallowing?
a. Crush the medication and mix with jam or jelly.
b. Assess the gag reflex. = giving po medication may cause aspiration to the patient with
swallowing difficulty

c. Request for an alternative route of medication.

d. Administer the medication in the sitting position.
145.
A client is refusing calcium as it upsets his stomach. How would you give the calcium?
a. Give the calcium with yogurt.
b. Give the calcium with green leafy vegetables such as spinach.

c. Give the calcium between meals or at bedtime. food in the stomach will decrease the
d.

side effect of calcium

Give the calcium with bran cereals.

146.

Tim who is an 18-year-old football player, scheduled for arthroscopic surgery. What
should the PN do just before sending him to the operating room?
a. Collect all valuables and put them in the bedside table.
b. Perform a surgical scrub on the operating side.
c. Ensure that the operative checklist is completed. the pre op checklist must be
completed prior to surgery
d. Teach deep breathing and coughing exercise.

147.

The PN is performing a postural drainage on a patient who has pneumonia. Which among
the following is a positive outcome of the procedure?
a. Patient is able to cough with expelled sputum. postural drainage dislodges secretions
sticking on the bronchial tree, thus promoting easy expectoration
b. Patient has a dry cough.
c. No wheezing on auscultation.
d. Improvement in the spirometer.

148.

A patient with DM is admitted in the hospital. For unknown reason, the patient became
upset and angry and was overheard shouting at his mother during the visit. In regards to this
observation, the PN has appropriately taken which of the following actions?
a. Close the patients door.
b. Inform the patient that his behavior is inappropriate.
c. Leave them alone as this is their private affair.
d. Approach the patient during the visit and say, You look upset. Is there something
bothering you. I heard how you talked to your mom in a higher tone. this a
therapeutic response = very objective and focuses on the findings

149.

The hospital ward was very busy. The nurse-in-charge came and asked the practical nurse
to help
her out with vital signs and medications. Which appropriate action should the PN take?
a. Take the vital signs and refuse to administer the medications
b. Refuse to take vital signs; refuse to administer medications
c. Take the vital signs and administer medications the PN should be able to help out with
patient care as requested
d. Report the situation to the supervisor so this can be avoided in the future.

150.
What is the correct way of opening a sterile dressing change equipment box?
a. Open with a pair of scissors
b. Open the box by grasping the upper flap of the outer wrap, pulling towards your body
c. Open the box by grasping the upper flap of the outer wrap, pulling away from your
body this prevents possible contamination of the sterile field

d. Open the box by grasping the upper flap of the outer wrap to any direction desired.