CHILD BEARING AND NEONATAL

1. Which of the following obstetric clients should the nurse see first?
A. The client who is 40 weeks gestation having contractions every 5 minute lasting
50 seconds
B. The client who is 32 weeks gestation with terbutaline (brethinc) intravenously
C. The one-day postpartum client who has changed two peri-pads in the last six
hours
D. The diabetic obstetric client with a glucose level of 90mg/dL

2. The client visits the prenatal clinic stating she believes she is pregnant. A pregnancy
test is done to detect elevated levels of:
A. Prolactin
B. Human chorionic gonadotropin
C. Lecithin-sphingomyelin
D. Estriol

3. Which intructionshould be given to the client being discharged after evacaution of a

hydatidyform mole?
A. Return to the clinic in six weeks for a urinalysis
B. Avoid exercise for at least six weeks
C. Do not become pregarent for at least twelve months
D. Return to the clinic in six months for liver enzyme studies

4. The pregnant client with AIDS is diagnosed with cytomegalovirus. The nurse is aware
that the client probably contracted cytomegalovirus from:
A. Blood or body fluid exposure to the virus
B. Emptying her cat’s litter box
C. Contaminated food or water
D. Pigeon feces
5. Which test is most diagnostic for syphilis?

A. Culture
B. VDRL
C.RPR
D. FTA-ABS

6. The client is diagnosed with genital herpes. Which medication is used to treat genital
herpes?

A. Acyclovir (zovirax)
B. Podophyllin
C. AZT (retrovir)
D. Isoniazid (lanzid

Answers to Exam Questions

1. Answer B is correct. The client who is 32 weeks gestation receiving brethrine is

unstable and requires further nursing assesment. Answer A is incorrect because the client
who is 40 weeks gestation having contractions every 5 minute lasting 50 seconds is
normal. Answer C is incorrect because changing two peripads in the last six hours is
normal; therefore, it is not highestnpriority. Answer D is incorrect because a bloods
glucose of 90mg/dL is within normal limits.

2. Answer B is correct. HCG levels elevate rapidly and can be detected as early two days
after the missed period. Answer A is incorrect because prolactin is elevated with a
prolactinoma, a type of pituitary tumor. Answer C is incorrect because
lecithin/sphingomyelin (L/S ratio) is indicative of lung maturity. Answer D is incorrect
because estriol levels indicate fetal well-being.
3. Answer C is correct. The client that has experienced a hydatidiform mole should avoid
becoming pregarent again for one year because chorionic carcinoma is associated with
hydatidiform mole. If the client does become pregnat and there are cells for chorionic
carcinoma, the hormonal stimulation can cause rapid cell proliferation and growth of the
cancer. Answer A is incorrect because a urinalysis in six weeks is not necessary. Answer
B is incorrect because exercise is not contraindicated after a hydatidiform mole. Answer
D is incorrect because checking liver enzymes in six months is not necessary after a
hydatidiform mole.

4. Answer C is correct. Cytomegalovirus virus is transmitted predominantly by blood or

body fluid exposure to the virus. Answer B is incorrect toxoplasmosis is transmitted
through contaminated cat feces. Answer C is incorrect because contaminated food or
water can cause many illnesses; for example, E. Coli, listeria, colostridium difficile, and
many others. Anwere D is incorrect because histoplasmosis is transmitted by bird feces.

5. Answer D is correct. The fluorescent treponemal antibody test (FTA-ABS) is most

diagnostic for syphilis. Answer A is incorrect because a culture of the discharge is used to
diagnose gonorrhea, not syphilis. Answer B and C are incorrect becausethey are
screening tests and are not as diagnostic as the FTA-ABS is.

6. Answer A is correct. Acyclovir is used to treat genital herpes. Answer B is incorrect

because podophyllin is used to treat condyloma acuminata (veneral warts). Answer C is
incorrect because AZT (retrovir) is used prevent HIV transmission from mother to baby.
Answer D is incorrect because isoniazid is used to treat tuberculosis, not herpes.

PEDIATRIC CARE
1. The nurse is caring for a child with neutropenia. Which beverage is unsuitable for the

client with a low neutrophil count?

A. 2% milk
 B. Fresh squeezed lemonade

C. Kool-Aid

D. Ginger ale

Answer B is correct.

Rational:

Clients with a low neutrophil count should adhere to a low bacteria diet. Fresh squeezed

lemonade can be contaminated from bacteria on the lemon rind. Answers A,C, and D are

suitable for the client with neutropenia therefore they are incorrect.

2. The physician has ordered a sweat test a child suspected of having cystic fibrosis. A

positive sweat test is based on:

A. Chloride level

B. Potassium transport

C. Serum sodium

D. Calcium level

Answer A is correct.

Rational:

A positive sweat testis reflected by elevations in the chloride level. Answers B, C and D

are not measured by the sweat test; therefore they are incorrect.

3. The nurse is conducting a scoliosis screening clinic at the local school. The nurse knows

that she is most likely to find scoliosis in:

A. Adolescent males

B. Preteen males

C. Preteen females
 D. Adolescent females

Answer D is correct.

Rational:

The most likely group to have scoliosis is adolescent girls. The groups in answers A, B,

and C are not as likely to have scoliosis; therefore, those answers are incorrect.

4. During a routine well-child check-up, the mother of a toddler asks when she should

schedule her child’s first dental visit. The nurse’s response is based on the knowledge

that most children have all their permanent teeth by age:

A. 12 months

B. 18 months

C. 24 months

D. 30 months

Answer D is correct.

Rational:

Most children have all their primary teeth by age 30 months. Answers A, B, and C are

incorrect because tooth eruption is not complete.

5. A 15 month old is admitted with diagnosis of bronchiolitis. Wich medication

recognized as the only effective treatment for bronchiolitis.

a. Ribavirin

b. Respigam

c. Sandimmune

d. Synagis

Rasional.
 Answer A is correct. The only effective treatment of bronchiolitis
(respiratori synctial virus) is ribavirin. Answers B dan D are incorrect
because they are used prophylactically, not as a treatment for
bronchiolitis. Sandimmune, an immunosupperssive drug, is not used for
treating bronchiolitis; therefore, Answer C is incorrect.
PHSYCIATRIC
When assessing the risk of suicide for a depressed client, the nurse knows that :

A. People who talk about suicide are not likely to harm themselves.
B. The availability of means is essential to even the simplest suicide plan.
C. Clients who survive unsuccessful suicide attempts are not likely to try
again.
D. An overdose of pills is never as lethal as injury by firearms.

2. The diagnoses of conduct disorder and antisocial personality are both caracterized by :

a. A lack of guilt or remorse for wrongdoing

b. A lower than average level of intelligence

c. Consistent parenting

d. Close friendships among age-related peers

Answer A is correct. The child with conduct disorder and the adult with antisocial personality
disorder are characterized by lack of guilt or remorse for wrongdoings. Answer B is incorrect
because both can have a higher than average IQ. Answer C is incorrect because both have a
history of parental neglect or inconsistent parenting. Answer D is incorrect because both lack
close friendships.

3. The physician has ordered a sweat test for a child suspected of having cysticfibrosis. A positive
sweat test is based on :

a. Chloride level

b. Potassium transport

c. serum sodium

d. calcium level
Answer A is correct. A positive sweat test is reflected by elevations in the chloride level. Answers
B,C, and D are not measured by the sweat test; therefore, they are incorrect.

4. A client with dystyhmia has a nursing diagnosis of self-esteem disturbance related to

feelings of worthlessness. Which goal reflects an increase in the client’s self-esteem?
a. The client identifies two personal behaviors that alienate others.
b. The client attends and participates in morning goal-setting activities.
c. The client eats in the cafeteria with other clients from the unit.
d. The client identifies one or two positive self-attributes.
Answer D is correct. An increase in the client’s self-esteem is evidenced by
the fact that he/she can recognize positive self attributes. Answer A, B,
and C are incorrect because they do not reflect an increase in self-
esteem.

5. A client with depression and suicidal ideation is admitted to the behavioral healthunit
for observation. Which of the followinginterventions provides best for the client’s safety?

a. Day hall supervision

b. Constant supervision
c. Checks every 15 minutes
d. One- on- one night supervision
Answer B is correct. The client admitted with suicidal thoughts or suicidal gestures is
best cared for by constant supervision. Answer A,C and D do not provide for continual
observations to ensure the client’s safety; therefore, they are incorrect

6. Which of the following findings is a factor in the development of lithium toxicity?

a. Hyponatremia

b. Hypercalcemia

c. Hypocalcemia

d. Hypernatremia
 Answer A is correct. The client who is taking lithium needs an adequate intake of sodium
and fluid to prevent the development of lithium toxicity. Answer B, C, and D are
incorrect.
7. a client schedule for electroconvulsive theraphy asks the nurse how the theraphy helps relieve
her depresiion. The nurse’s response is based on an understanding that ECT:

A. eliminates the neurotransmitter acetylcholine

B. Increases the perception of external stimuli

C. Decreases levels of cortisol from the adrenal cortex

D. Produces a seizures that temporarily alters brain chemicals

Answer:

4. answer D is correct. Electroconvulsive theraphy produces a tonic – clonic seizure that

temporarily increases brain chemicals,serotonin,dopamine and norepinephine. Answer A,B,C are
not true statements therefore,they are incorrect.
Emergency Care

1. The nurse is triaging four clients injured in a train derailment. Which client
should receive priority treatment?

a. A 42-year-old with dyspnea and chest asymmetry

b. A 17-year-old with a fractured arm

c. A 14-year-old with facial lacerations

d. A 30-year-old with blunt abdominal trauma

Answer :A

Rationale :

Answer A is correct. Following the ABCDs of basic emergency care, the client
with dyspnea and asymmetrical chest should be cared for first because these
symptoms are assosiated with flail chest. Answer D is incorrect because he should
cared for second because of the likehood of organ damage and bleeding. Answer
B is incorrect because he should be cared for after the client with abdominal
trauma. Answer C is incorrect because he should receive care last because his
injuries are less severe.

2. Direct pressure to adeep laceration on the client’s lower leg has failed to stop
the bleeding. The nurse’s next action should be able to:

A. Place a tourniquet proximal to the laceration

B. Elevate the leg above the level of the heart

C. Cover the laceration and apply an ice compress

D. Apply pressure to the femoral artery

Answer :B

Rationale :

Answer B is correct. If bleeding does not subside with direct pressure, the nurse
should elevate the extremity above the level of the heart. Answer A and D are
done only if other measures are ineffective, so they are incorrect. Answer C would
slow the bleeding, but will not stop it, so it’s incorrect.

3. The nurse is preparing to administer Ringer’s lactate to a client with

hypovolemic shock. Which intervension is important in helping to stabilize
the client’s condition?

A. Warning the intravenous fluids

B. Determining whether the client can take oral fluids

C. Checking for the strength of pedal pulses

D. Obtaining the spesific gravity of the urine

Answer :A

Rationale :
Naswer A is correct. Warming the intarvenous fluid helps to prevent further stress
on the vascular system. Thirst is a sign of hypovolemia; homever, oral fluids alone
will not meet the fluid needs of the client in hypovolemic shock, so anwer B is
incorrect. Answer C and D are wrong because they can be used for baseline
information but will not help stabilize the client.

4. A client with a history of severe depression has been brought to the emergency
room with an overdose of barbiturates. The nurse should pay careful attention
to the client’s:

A. Urinary output

B. Respirations

C. Temperature

D. Verbal responsiveness

Answer :B

Rationale :

Answer B is correct. Barbiturate overdose result in central nervous system

depresion, which leads to respiratory failure. Answers A and C are important to
the client’s overall condition but are not spesific to the specific to the question, so
they are incorrect. The use of barbiturates result in slow, slurred speech, so answer
D is expected, and therefore incorrect.

5. A pediatric client is admitted after ingesting a bottle of vitamins with iron.

Emergency care would include treatment with:

A. Acetylcystein

B. Deferoxamine

C. Calcium disodium acetate

D. British anti-lewisite
 Answer :B

Rationale :

Answer B is correct. Deferoxamine is the antidote for iron poisoning. Answer A is

the antidote for acetaminophen overdose, making it wrong. Answer C and D are
antidote for lead poisoning, so they we wrong.

6. A client is to receive antivenin following a snake bite. Before administering

the antivenin, the nurse should give priority to:

A. Administering a loval anesthetic

B. Checking for an allergic response

C. Withholding fluids for 6-8 hours

Answer :B

Rationale :

Answer B is correct. The nurse should perform the skin or eye test before
administering antivenin. Answer A and D ar unnecessary and therefore incorrect.
Answer C would help calm the client but is not a priority before giving the
antivenin, making it incorrect.
LEGAL ISSUES
1. Wich information should be reported to the state board of nursing?

a. The facility fails to provide literature in both Spanish and English.

b. The narcotic count has been incorrect on the unit for the fast three days.

c. The client fails to receive an intemized account of his bills and services received
during his hospital stay.

d. The nursin assistan assigned to the client hepatitis fails to feed the client and
give him a bath.
Answer B is correct. The Joint Commission on Accreditation of Hospital will probably be
interested in the problems in answer A and C, so they are incorrect. The failure of the nursing
assistan to assist the client with hepatitis should be reported to the charge nurse. If the behavior
continues, termination can result, but it doesn’t need to be reported to the board. So answer D
is incorrect.

2. The charge nurse witnesses the nursing assistant being abusive to a client in the nursing
home facility. The nursing assistant can be charged with which of the following ?

a. Negligence

b. Tort

c. Assault

d. Malpractice

Rational

Answer C is correct. Assault is defined as striking or touching the client inappropriately.

Negligence is failing to perform care for the client, so answer A is incorrect. A tort is
wrongful act committed on the client or his belongings, so anwers B is incorrect.
Malpractice is failing to perform an act that the nurse knows should be done or doing
something wrong that causes harm to the client, so answer D is incorrect.

3. which nurse should be assigned to care for the client with preeclampsia?
a. The RN with 2 weeks experience on postpartum
b. The RN with 3 years experience in labor and delivery
c. The RN with 10 years experience in surgery
d. The RN with 1 year experience in the neonatal intensive care unit
Answer:
Answer B is correct. The nurse in answer B has the most experience in knowing
the possible complications involved with preeclampsia. The nurse in answer A is a new
nurse to this unit, so the answer is incorrect. The nurse in experience with postpartal
client, so the answer is incorrect. The nurse in answer D also has no experience with
postpartal clients, so the answer is incorrect.
4. Which assigment is outside the realm of nusing practice for the licensed practical
nurse?
A. Inserting a foley catheter
B. Discontinuing a nasogastric tube
C. Obtaining a sputum specimen
D. Starting a blood transfusion
The Answer is:
D
Rational:
The LPN can be assigned to insert Foley and French urinary catheters, discontinue Levin
and gavage gastric tubes, and obtain all types of specimens.

5. The client returns to the unit from surgery with a blood pressure of 100/50,
pulse 122, and respiration 30. Which action by the nurse should receive
priority?
• A. Continue to monitor the vital signs
• B. Contact the physician
• C. ask the client how he feels
• D. Ask the LPN to continue the post op care
Answer B is correct.
• RATIONAL: The vital signs are abnormal and should be reported’
immediately. Continuing to monitor the vital signs can result in
deterioration of the client’s condition, so answer A is incorrect. Asking
the client how he feels would supply only subjective data, so answer C is
incorrect. The LPN is not the best answer to be assigned to this client
because he is unstable, so answer D is incorrect
•
( CULTURAL PRACTICES INFLUENCING NURSING CARE )

1. a japanese client refuse ton eat the ice cream or drink the milk on his tray. which
action by the nurse would indicate an undestanding of the client's needs ?

a. she obtains yogurt for the client instead

 b. she obtains an order for lactaid dietary supplement

c. she removes the milk from the tray and says nothing to the client

d. she asks the client why he will not drink the milk

answer : B is correct . many of Japanese descent are lactose intolerant- it is not that milk
not allowed in their culture. Yogurt also causes gas and bloating, so answer A is
incorrect. Removing the items from the tray does not provide the needed calcium in the
diet, so answer C is incorrect. It is inappropriate to ask “why” in most cultures, so answer
D is incorrect

2. Which medication will most likely be refused by a Muslim client ?

a. Insulin

b. Cough syrup

c. NSAIDs

d. Antacida

Answer : B is correct . most cough syrup contain alcohol, which is forbidden in the
Islamic religion. Attempts should be made to obtain cough suppressant that does
not contain alcohol. The client will most will most likely take insulin, nonsteroidal
anti imflamatory drugs, and antacids, so answer A,C, and D is incorrect

3. The client is practicing Hindu. Which food should be removed from the clients tray

a. Bread

b. Cabbage

c. Steak

d. Apple

Answer : C is correct. In the Hindu religion , beef prohibited. All breads, vegetables,
and fruits are allowed, so answer A,B and D are incorrect

4. The condition of an Arab client who is terminally ill deteriorates and death seems
imminent. If the client is hospitalized in the mainland Inited States, the nurse should
position the bed facing which direction ?

a. Northeast

b. Southeast

c. West
 d. South

Answer : answer B is correct . at the time of death, the Muslim client will wish to be
positioned facing Mecca, which is to the southeast of the United States. Answer A,C,
and D are therefore incorrect .

30. An 88-year-old female jewish client is admitted to the hospital and

diagnosed with diabetes. Which type of insulin is refused by this client ?

A. Beef

B. Pork

C. Synthetic

D. Fish

Rational :

Answer B is correct. Pork is not allowed in the diet or medications of jewish

client. Both synthetic and beef insulins are allowed, so answer A and C are
incorrect. There is no such thing as fish insulin, so answer D is incorrect

COMMUNITY HEALTH CARE

1. The nurse observes that a hispanic client and his family have been late for their appointment
the last three times. Which of the following is the best explaination for this behavior :

a. a lack of concern for the health of the client

b. an attempt to avoid talking to the nurse

c. the client probably forgot the appointment time

d. the client and family view time differently than does the nurse

Answer D is correct. If the client misses and appointment or is late for the appointment, it is not
necessarily true that the client is disinterested or forgot. Mny in the hispanic culture see time as
a relative thing and live in the present.

2. According to Winslow which of the following is the goal of public health ?

A. For people to attain their birthrights and longevity
B. For promotion of health and prevention and disease
C. For people to have access to basic health services
 D. For people to be organized in their health efforts

Answer : A. For people to attain their birthrights and longevity

RATIONAL:
• According to Winslow , all public health efforts are people to realize their
health efforts

3. What is true of primary facilities?

A. They are usually government – run

B. Their services are provied on an out-patient basis

C. They are training facilities for health profeasionals

D. A community hospital is an example of this level of health facilities

Answer B

Primata facilities government and non government facilities that provisi basis out-patient service

4. Population- focused nursing practice requires which of the following processes?

A. Community organizing .

B. Nursing, process

C. Community diagnosis

D. Epidemiologic process

Answer: (C) Community diagnosis

Population-focused nursing care means providing care based on the greater need of the
majority of the population. The greater need is identified through community diagnosis.

5. Which of the following is the most prominent feature of public health nursing?
• A. It involves providing home care to sick people who are not confined in
the hospital.
• B. Services are provided free of charge to people within the catchment area.
• C. The public health nurse functions as part of a team providing a public
health nursing services.
• D. Public health nursing focuses on preventive, not curative, services
•
• (D) Public health nursing focuses on preventive, not curative, services.
•
• Rational : the catchment area in public health nursing consists of a
residential community, many of whom are well individuals who have
greater need for preventive rather than curative services.