Community, questions ,

1. The nurse manager learns of a train derailment and several casualties will be transported to the emergency department. What action should the nurse take first?

a) Reassign an increased number of staff to the triage area

b) Activate the hospital emergency response plan

c) Ensure all client treatment areas are well stocked with supplies

d) Begin calling off-duty staff to see if they will come in to work

2. The home health nurse is visiting an older adult client with diabetes mellitus. The nurse becomes concerned and implements safety education when which of the following occurs?

a. Neighbors bring a warm lunch to client

b. Client stores diabetic testing supplies on kitchen table

c. Children adjusted air conditioners in kitchen and bedrooms

d. Grandchildren place baskets of folded laundry by bedroom door

3. The nurse determines that a new mother is in greatest need of more education about infant care and safety when the mother makes which statement?

a) “Solid foods are unnecessary during the baby’s first 4–6 months.”

b) At bedtime, I should put my baby on her tummy to prevent choking

c) “I should wake my baby up every 3–4 hours for feeding.”

d) “I am pretty sure that I am going to breastfeed my baby.”

4. An adolescent client with paranoid schizophrenia is involuntarily admitted for 48 hours by the courts and psychiatrist after threatening the parents with a knife. What should the nurse explain to the parents about the determination that the courts and psychiatrist will make after the 48 hours has expired?

a) If the client is willing to take medication

b) If the client is a danger to self and others

c) If the client is a danger to self

d) If the client is willing to receive outpatient treatment

5. The nurse is assessing the parents of a child who has been admitted for suspected physical abuse. Which statement made by the father would indicate risk for abuse?

a) “We wanted to have this child so much.”

b) “My parents never beat me.”

c) “He gets Cs in school but that’s the best he can do.”

d) “He only behaves when I am tough on him.”

6. A major portion of a construction project has collapsed. The Emergency Department (ED) has been notified that numerous victims are being transported to the ED. What should be the first action of the ED nurses?

a) Implement personnel recall system

b) Set up a temporary morgue

c) Assess department for resources—staff, beds, equipment

d) Discharge stable clients

7. A Code Red (fire) has been announced on the hospital unit. What is the nurse’s first response?

a) Contain the fire

b) Report fire to other staff

c) Extinguish the fire

d) Remove clients in danger from the fire

8. The nurse finds a client lying on the floor near the foot of the bed. After assessing the client and notifying the health care provider, what client information should the nurse document on the incident report?

a) Found lying on floor at foot of bed

b) States nursing staff did not respond to call light

c) Fell while walking to the bathroom

d) Tripped while rushing to the bathroom to avoid incontinence

9. A nurse is contacted by a neighbor who is upset, saying that she discovered her child eating half a bottle of flavored vitamins. What should the nurse recommend that the neighbor do immediately?

a. Take the child to the Emergency Department

b. Contact the Poison Control Center

c. Check whether the vitamins were fat-soluble or water-soluble

d. Take no action since they are only vitamins

10. The nurse is aware that a confused older adult client is at risk for falls. Which intervention would the nurse avoid using with this client?

a. Orient the client to the call light system.

b. Assist with appropriate toileting every 2 hours.

c. Keep the hospital bed in low position.

d. Keep the full bed rails up at all times.

11. When teaching clients in the community about relevant theories of family violence, the nurse should emphasize what area of commonality between children and adult victims?

a) Predisposition to careless behaviors

b) Vulnerability to acts of power and dominance

c) Inability to control their emotions

d) Annoyances within the family unit

12. An adolescent client is admitted to an inpatient unit following a report of suicidal ideations. The client’s parents report that until three months ago, the client was “totally normal, a great student and a pleasure to be around.” They also state that the client has begun to have failing grades in school and to “act like a tramp with anyone and everyone.” Based on this data, the nurse’s priority is to assess the client for indications of which problem?

a) School-related stress

b) Antisocial personality traits

c) Sexual violence

d) Usual coping skills

13. A young man is brought to the Emergency Department as a victim of a multi-vehicle accident that caused multiple casualties. The man is awake and alert. He has a fracture of his right tibia and several small lacerations on his face. How will the triage nurse categorize this client?

a) Priority 1 (red tag)

b) Priority 2 (yellow tag)

c) Priority 4 (black tag)

d) Priority 3 (green tag)

14. The result of a toddler’s lead screening is 12 mg/dL. What would the nurse say to the mother at this time?

a) “Tell me about where you live.”

b) “Have you noticed any blood in his stools?”

c) “His lab values are just fine.”

d) “When were his last immunizations?”

15. The nurse would ask a client scheduled for a venogram about allergy to which substance before the procedure?

a) Meat tenderizer

b) Peanuts

c) Eggs

d) Iodine

16. Which information would the nurse omit from written documentation when a reportable incident has occurred?

a) Names of witnesses on incident report

b) Nursing interventions in medical record

c) That an incident report was submitted in medical record

d) Time healthcare provider was called about incident report

17. The nurse is assessing a school-age child. Which finding by the nurse may indicate physical neglect?

a) Boisterous activity

b) Sudden onset of enuresis

c) Stealing or hoarding food

d) Not following instructions well

18. The nurse admits a female client to the Emergency Department who arrives with a black eye and reports of headache, chronic pain, GI problems, menstrual irregularities, and anxiety. A previous physical workup was negative. The nurse should assess the client for which priority problems?

Select all that apply.

a) Irritable bowel syndrome

b) Migraine headache

c) Physical or sexual abuse

d) Premenstrual syndrome

e) Self-Directed Violence

19. A school nurse is planning a health class on accidents and injuries for high school students. Which topic is most important to include?

a) Motor vehicle–related injuries

b) Injury due to residential fires

c) Occupational-related injuries at work

d) Fall-related injuries

20. The nurse has applied elbow splints on a confused client to prevent the client from removing the intravenous (IV) line. Which of the following interventions is required?

a) Ask for renewal of prescription for restraint every 72 hours

b) Remove elbow splints every 8 hours

c) Document appearance of client’s IV site every hour

d) Assess and document client’s condition at least every hour

21. Public health nurses have been activated to open a shelter due to an approaching hurricane. What most important items should families be encouraged to take to the emergency shelter?

a. Cats and small dogs

b. Medication and vital records

c. Radios and small personal electronics

d. Food and extra clothing

22. The school nurse plans safety education for high school students and their parents. Which safety threat that is a developmental risk factor for adolescents should the nurse address?

a) Feelings of being invulnerable to risks that affect others

b) Sports-related injuries that often result from not obeying rules and/or intense competition

c) Substance abuse as a means of dealing with stress

d) Polypharmacy, which results in mixing of multiple medications

23. The nurse calculates a dose of a medication for subcutaneous injection to be 4.5 mL. Rechecking the calculation yields the same result. What is the next best action that the nurse should take?

a. Call the prescriber.

b. Verify the written prescription.

c. Ask another nurse to check the dosage calculation.

d. Call the pharmacist.

24. A client who attempts to pull out a central venous access device has been prescribed to have a wrist restraint applied for safety reasons. Which action should the nurse take to apply the restraint correctly?

a) Ensure that three fingers can slide between the skin and the restraint

b) Secure safety restraint straps so they do not tighten if client pulls on them

c) Secure the straps of the safety restraint to the bed frame

d) Use a full knot to secure the safety restraint

25. Which snack would the nurse appropriately offer the hospitalized toddler?

a. Peanuts

b. Grapes

c. Crackers

d. Cereal bar

26. A client receives a dose of intravesical chemotherapy as treatment for bladder cancer. Which statement should the nurse make to unlicensed assistive personnel (UAP) about caring for this client?

a) “Ask the client to wipe the toilet seat with a tissue after each bathroom use.”

b) “Assist the client to the bathroom and wear sterile gloves for perineal care.”

c) “Be sure the client uses a bedpan for voiding for the next 24 hours.”

d) “Double-flush the toilet after each time the client voids.”

27. The nurse is caring for a parent suspected of physically abusing a child. In the first nurse–client interaction, what should the nurse first attempt to accomplish?

a) Explain that the abuse will be reported.

b) Teach effective parenting skills.

c) Approach the client in a nonjudgmental manner.

d) Determine if the client was personally abused as a child.

28. What is the best method for the nurse to use to encourage the use of bicycle helmets by school-aged children?

a) Advocate for legislation on helmet laws

b) Recommend the parents purchase stylish helmets to increase compliance

c) Teach parents to role-model helmet use while riding bicycles

d) Verbally reprimand children who report not wearing helmets while riding

29. What is the best method for the nurse to use to encourage the use of bicycle helmets by school-aged children?

a) Advocate for legislation on helmet laws

b) Recommend the parents purchase stylish helmets to increase compliance

c) Teach parents to role-model helmet use while riding bicycles

d) Verbally reprimand children who report not wearing helmets while riding

30. The nurse is caring for a young child with mitt restraints. Which action should the nurse take regularly to ensure that the child’s needs are met?

a) Ensure that the straps are tied to non-movable parts of the crib

b) Check that the call bell is pinned to the child’s gown

c) Check adequacy of circulation and skin condition

d) Check that the tongue blades in pockets are intact and ends are covered or padded

31. A newborn is scheduled for discharge from the birthing center tomorrow. When teaching the new parents about car seats, which characteristics of infant restraint systems would the nurse include as essential for the newborn? (Select all that apply)

a) In the back seat

b) Rear-facing

c) In the front seat

d) Forward-facing

e) Of a solid and neutral color

32. The nurse is caring for a client who has fallen 20 feet from a roof. While performing the primary assessment, what is the most important nursing intervention?

a. Remove clothing

b. Assess for facial lacerations

c. Maintain cervical spine precautions

d. Assess mental status

33. The nurse should explain to the mother of a 10-month-old infant that a rear-facing car safety seat should continue to be used until the child exceeds the weight limit or is what number of months of age. Record your answer, rounding to the nearest whole number.

34. The nurse assesses the temperature and blood pressure of a client on contact precautions every shift because of wound infection. What action should the nurse take to minimize the spread of microorganisms?

a) No special action is required with the equipment

b) Cleanse the equipment after each use

c) Keep the equipment in the client’s room

d) Store the equipment in the soiled utility room between uses

35. The nurse provides care in the labor and delivery department. During which procedure should the nurse wear protective goggles in addition to gloves?

a) Changing a wet disposable bed pad

b) Sterilizing used instruments

c) Inserting an intravenous line

d) Assisting during an amniotomy

36. The nurse identifies a client as being at high risk for infection. Which action should the nurse take to reduce the spread of microorganisms when caring for this client?

a) Perform hand hygiene before and after client care

b) Use clean gloves when providing client care

c) Transfer the client to a private room

d) Institute transmission-based precautions

37. The mother of a 2-month-old receiving immunizations for the first time is also a college student. When the mother asks how immunizations relate to what she learned in microbiology class, at which link should the nurse explain that immunizations interrupt the chain of infection?

a) Portal of entry

b) Mode of transmission

c) Susceptible host

d) Portal of exit

38. The nurse needs to rearrange client room assignments to accommodate new admissions to the division. Which clients could the nurse safely cohort together in a two bedroom? Select all that apply

a) 10-year-old with a white blood cell count of 2800/mm3

b) 12-year-old recovering from an appendectomy for a ruptured appendix

c) 9-year-old with pneumonia.

d) 11-year-old with scarlet fever

e) 8-year-old with encephalitis

39. A client with pneumonia caused by penicillin-resistant Streptococcus pneumoniae (PRSP) has a tracheostomy that needs suctioned. In which order should the nurse perform or apply personal protective equipment? All options must be used.

a) Mask

b) Goggles/eye protection

c) Hand washing

d) Gloves

e) Gown

40. The nurse provides teaching to a client with tuberculosis. Which client statement indicates that teaching about infection control measures has been effective?

a) “I will need to use paper plates and cups to eat.”

b) “I need to wear a mask when I go to x-ray.”

c) “I will flush the toilet twice after urinating.”

d) “Nurse, can you give me some gloves so I can blow my nose?”

41. The nurse reviews care required by a group of assigned clients. For which client health problem should the nurse implement contact precautions?

a) Scarlet fever

b) Wound infection

c) Rubella

d) Measles

42. After preparing a sterile field for a dressing change the nurse is called out of the client’s room. Which action should the nurse take?

a) Continue quickly with the procedure, then address the issue outside of the client’s room.

b) Ensure the client safety, cover the field with a sterile towel and respond to the issue out of the room.

c) Ensure client safety, discard the sterile supplies and respond to the reason being called out of the room

d) Explain the situation to the client needing the wound dressing change, leave the sterile supplies in place and attend to the other issue.

43. After preparing a sterile field for a dressing change the nurse is called out of the client’s room. Which action should the nurse take?

a) Continue quickly with the procedure, then address the issue outside of the client’s room.

b) Ensure the client safety, cover the field with a sterile towel and respond to the issue out of the room.

c) Ensure client safety, discard the sterile supplies and respond to the reason being called out of the room

d) Explain the situation to the client needing the wound dressing change, leave the sterile supplies in place and attend to the other issue.

44. A client with acquired immunodeficiency syndrome (AIDS) and Pneumocystis jiroveci pneumonia is being admitted to the nursing unit. Which type of precautions should the nurse instruct unlicensed assistive personnel to use?

a) Droplet

b) Airborne

c) Standard

d) Contact

45. A client with diabetes mellitus requires irrigation of a leg ulcer and insulin injections. Which action should the nurse take to maintain medical asepsis when caring for this client? Select all that apply.

a) Wipe the rubber stopper on the insulin vial with alcohol before withdrawing dose.

b) Use sterile gloves to change the dressing for the leg ulcer

c) Wash hands before and after performing client care

d) Wear personal protective equipment during the dressing change

e) Recap the needle after administering insulin injection

46. The nurse teaches a new group of adolescent hospital volunteers about the chain of infection. Which item should the nurse include as an example of how an infection would spread through droplets?

a) Nonsterile surgical instruments

b) Contaminated dressings

c) Soiled linens

d) Sneezing and coughing

47. The nurse needs to collect a specimen from the client. For which type of specimen should the nurse use medical aseptic technique?

a) Urine specimen from straight catheterization

b) Culture of an abdominal wound

c) Stool specimen for ova and parasites

d) Sputum specimen via tracheostomy

48. The nurse determines that a client who has an infection requires transmission-based droplet precautions. For which antibiotic-resistant microorganism is this client receiving treatment?

a) Vancomycin-intermediate-resistant Staphylococcus

b) Penicillin-resistant Streptococcus pneumonia

c) Vancomycin-resistant Enterococcus

d) Methicillin-resistant Staphylococcus aureus

49. A client is placed on contact precautions. What action should the nurse take regarding the client’s meal trays?

a) Tell the client that the dishes used for meals will be kept in the client’s room and washed between meals

b) Inform the dietary department that disposable meal trays will be needed

c) Ask UAP to wash the meal tray items with chlorhexidine before returning tray to the meal cart in the hall

d) Tell unlicensed assistive personnel (UAPs) to place used meal trays in the soiled utility room

50. The clinic nurse anticipates that genetic screening and follow-up counseling will most likely be provided for clients who have which of the following? Select all that apply.

a) Breast cancer

b) Routine pregnancy

c) Hypertension

d) Hemophilia

e) Melanoma

51. The nurse should instruct a 75-year-old female client to seek follow-up evaluation from a primary care provider for which observed or reported finding(s)? Select all that apply.

a) Dark pigments noted on forearms

b) Feelings of loneliness after death of a spouse

c) Bone or joint pain and weakness

d) Slight increase in fatigue at the end of the day

e) Nodes palpable under the axilla

52. A postmenopausal client is just learning to do breast self-examination (BSE). Which time should the nurse recommend that the client perform BSE?

a) Weekly just before grocery shopping

b) Just prior to each 6-month check-up for another identified health problem

c) Once a month on a standard day that the client can remember

d) On a random day once each month according to convenience

53. When the nurse assesses the health and dietary patterns of a vegetarian client. , Which finding does the nurse conclude is most likely to negatively affect the clients health status?

a) Use of vitamin B12 supplements

b) Genetic tendency toward lactose intolerance

c) Intake of milk and dairy products

d) Reports of problems with vision

54. The client with chronic renal failure stated on admission to the hospital, “I am a vegan type of vegetarian.” What foods would the nurse consider most appropriate when filling out the client’s dietary menu?

a) Milk and tomato soup

b) Green salad with walnuts

c) Steamed cabbage and sausage

d) Canned vegetables and noodles

55. During a routine annual exam for a 6-year-old, the pediatric nurse explains to the mother that blood is drawn on the child to screen for which of the following?

a) Any underlying infection

b) All types of hepatitis

c) Normal formation of blood cells

d) Onset of diabetes mellitus

56. When giving postoperative care to a 30-year-old male client, the nurse discusses cancer risks. The client states, “I have never heard of testicular exams.” The nurse should include which priority intervention in the plan of care?

a. Allow the client to verbalize fears related to cancer risk

b. Assist the client to set up a calendar of dates to perform self-testicular exams

c. Encourage a high-fiber diet to decrease the risk of testicular cancer

d. Teach the client to see a healthcare provider for a yearly testicular examination

57. The nurse is participating in a health promotion fair. When discussing aerobic exercise, the nurse should include which point?

a. Each exercise session should last for at least 45 minutes, and preferably 60

b. Fast walking is a good form of aerobic exercise

c. Exercise should be done 7 days per week

d. If one cannot talk when exercising, then the appropriate level of energy is being used

58. When teaching a group of adults about health promotion practices, the nurse would include which of the following? Select all that apply.

a) Colonoscopy is recommended after age 35.

b) Genetic screening is helpful in identification of cancer risks.

c) Men need to perform breast and testicle exams monthly.

d) Annual mammograms are recommended after a total mastectomy.

e) Annual medical exams are important to detect changes.

59. When teaching a 30-year-old male about testicular self-examination (TSE), the nurse recognizes more education is needed when the client makes which statement?

a) “If I do not feel one testicle, I will check it again next month.”

b) “The testicle and spermatic cords can be easily felt.”

c) “In the morning after a shower is the best time for TSE.”

d) “I will perform TSE monthly and see my healthcare provider yearly.”

60. During a health fair at a public recreational park, the nurse providing cancer health risk information answers several questions for clients who use ultraviolet light tanning salons. Which information is most important to include?

a) Tanning using ultraviolet light is safer than sun light.

b) Using tanning beds without clothing contaminates skin and leads to infections.

c) Using sunscreen will prevent skin cancers, even when using tanning beds.

d) Skin damage is more likely to occur from ultraviolet light than from indirect sunlight.

61. The client with chronic renal failure states, “I don’t eat red meat.” After further discussion with the client about what foods are acceptable, the nurse would recommend which meal choice to the client?

a) Milk and chicken soup with crackers

b) Noodle casserole and canned peas

c) Steamed cabbage with rice

d) Baked white fish and fresh carrots

62. The nurse is most concerned with providing further teaching for the client with diabetes who has which dietary habit?

a) Buys canned fruit instead of fresh because it is cheaper

b) Eats six meals per day

c) Drinks orange juice each morning

d) Eats an apple and cheese before going to bed

63. A 4-year-old client is coming to the healthcare provider’s office for a well-child visit. Which routine screenings does the nurse plan? Select all that apply.

a) Lead screening

b) Hearing

c) Vision

d) Blood pressure

e) Urinalysis

64. The nurse makes which dietary menu selection for a client with iron-deficiency anemia?

a) Salad with lettuce, fruit, and nuts

b) Mixed greens salad topped with tuna fish

c) Lasagna with tomato sauce and steamed carrots

d) Roast beef and broccoli

65. The nurse is preparing a presentation on health promotion and maintenance based on Health People 2020 plan. The nurse wants to arrange the material from individual to more global concepts. In what order should the topics be presented? Reorder here:

1. Environmental quality

2. Physical activity and exercise

3. Tobacco use

a) 1,2,3

b) 2,3,1

c) 3.1.2

d) 2.1.3

66. A 20-year-old female sees a healthcare provider for her first adult physical examination. The nurse anticipates that which screening measure will be done at this visit as a baseline for further reference? Select all that apply.

a) Blood glucose level

b) Serum cholesterol level

c) Body mass index (BMI) measurement

d) Mammography

e) Clinical breast exam (CBE)

67. When teaching a male client about testicular cancer, which manifestations would the nurse include? Select all that apply.

a) Dragging sensation in scrotum

b) Nodules in between testes and cord

c) Painless swelling of scrotum

d) Reddened rash over affected testicle

e) Dull pain in scrotum

68. A school nurse has finished conducting a teaching session with high school students about breast self-examination (BSE). The nurse concludes that the teaching was effective when a student states to do a BSE at which time?

a) Once per month when the client thinks she is ovulating

b) Seven days after menstruation begins

c) On the first day of the menstrual cycle

d) On the first day of each month

69. The ambulatory care nurse working with adolescent male clients determines that which client is most at risk for testicular cancer?

a. Teenager who swims daily on a swim team

b. Baseball catcher who wears supportive gear during sports activities

c. Client whose father had colon cancer

d. Twenty-year-old with one undescended testicle

70. Which of the following should the nurse review in a discharge teaching plan for a client with Type 1 diabetes mellitus who was admitted with a blood glucose level of 562 mg/dL? Select all that apply.

a) Probable need for weight loss

b) Exercise requirements

c) Nutrient intake and diet planning

d) Importance of keeping medical appointments

e) Need for oral antidiabetic medications

71. When a client comes into the emergency department (ED) reporting constipation and abdominal pain, what would be the most common risk factors the nurse would assess for?

a. History of diverticulitis or diverticulosis

b. Dietary and exercise patterns

c. Level of nutrition understanding and laxative abuse

d. Nutritional intake of proteins and fatty acids

72. The ambulatory pediatric nurse explains to the mother of a 4-year-old that a routine health screening would include which items? Select all that apply.

a) Standing on one foot

b) Measuring height and weight

c) Urinalysis

d) Reading an eye chart

e) Testing of all cranial nerves

73. The nurse would teach a male client, over age 50, that which health screenings should be done annually? Select all that apply.

a) Prostate exam

b) Testicular self-examination

c) Skin examination

d) Bone density test

e) Colonoscopy

74. During a health fair, the nurse provides cancer health risk information to a group of individuals who indicate that they frequent ultraviolet sun tanning salons. Which statement by one of the attendees would lead the nurse to provide additional information?

a) “Using tanning beds without clothing contaminates skin and leads to infections.”

b) “Skin damage is more likely to occur from ultraviolet light than from direct sunlight.”

c) “Using sunscreen will prevent skin cancers, even from tanning beds.”

d) “Tanning from ultraviolet light using new equipment is safer than tanning from sun rays.”

75. The nurse working in a prenatal clinic concludes that genetic counseling would be most important for the client who has a family history of which disorder?

a) Sickle cell anemia

b) Hypertension

c) Type 2 diabetes mellitus

d) Coronary heart disease

76. The nurse would place highest priority on teaching healthy behaviors to the adolescent who makes which of the following statements? Select all that apply.

a) “I am learning to drive my father’s truck.”

b) “If I want to smoke pot, I will try it.”

c) “I think sex is gross.”

d) “There is no way I would use a condom.”

e) “It scares me that I have so many friends that drink alcohol.”

77. A client with a strong family history of hypertension states actions to prevent the disease including diet changes, exercise, and weight management. What action should the nurse take with this client?

a. Recommend prophylactic antihypertensive medication because of the family history

b. Emphasize the hypertension will occur because of the family history

c. Praise and reassure client that these actions will prevent the development of hypertension

d. Recognize healthy lifestyle habits and emphasize importance of early detection to prevent complications

78. When discharging a client on oral anticoagulant therapy, the nurse would include further teaching for the client who has a lifestyle that includes which of the following?

a) Walking one mile a day

b) Spending most of the time alone

c) Growing green vegetables

d) Living in a rural setting

79. The nurse is most concerned with providing further teaching for the client with diabetes who reports which of the following?

a) Eating an apple and cheese before going to bed

b) Buying canned fruit instead of fresh fruit because it is cheaper

c) Eating six meals per day to prevent hypoglycemia

d) Drinking orange juice every morning

80. The nurse explains to a client who has had all molars removed that he will likely be allowed to have which foods added to the diet by the third postoperative day

a) Cereal flakes and milk

b) Gelatin and applesauce

c) Pancakes and eggs

d) Bacon and eggs

81. What statement made by a client indicates to the nurse an understanding of genetic testing?

Select all that apply.

a) “I need to keep a diary of my activities during the week of the screening.”

b) “Counseling will be provided at a follow-up appointment.”

c) “Medicine will be prescribed for me.”

d) “Blood may be drawn from me and my spouse, as well as our children.”

e) “My nutritional intake will be recorded.”

82. A 55-year-old African-American female client presents with a heart rate of 124 bmp and blood pressure of 130/80 mm Hg. The client reports palpitations and shortness of breath. During the health history, the nurse notes that the client takes multivitamins and fish oil. What should the nurse explore during the assessment?

a. Use of other herbs and over-the-counter medicines

b. Venous blood for oxygenation saturation

c. Peripheral edema

d. Family history of sickle cell and lung disease

83. An older adult female client has osteoporosis. In counseling the client about the best form of exercise, what exercise would the nurse recommend?

a) Walking

b) Swimming

c) Cycling on a stationary bicycle

d) Jogging

84. The nurse is establishing a health promotion program for healthy young adults. What should the nurse include to promote healthy lifestyle choices?

a) Chest x-ray for lung cancer

b) Accident prevention

c) Bone density test for osteoporosis

d) Screening for breast, cervical, uterine, and prostate cancer

85. The nurse is teaching a group of adults about health screenings for cancer. What should the nurse include in this discussion? Select all that apply.

a) Annual medical exams uncover most tumors

b) Men should perform breast and testicular self-exams (BSE, TSE) monthly

c) Annual mammograms are recommended after a total mastectomy

d) Inspection of the skin for cancer becomes less important as one ages

e) Genetic screening is helpful in identification of cancer risks

86. The nurse should interpret that which client is most at risk for developing skin cancer?

a) A baby underneath a large beach umbrella

b) A teenager who wears a ski outfit when skiing

c) An 80-year-old farmer who wears a cap when working

d) A 20-year-old lifeguard at the lake who wears sunscreen

87. The nurse should interpret that which client is most at risk for developing skin cancer?

a. A baby underneath a large beach umbrella

b. A teenager who wears a ski outfit when skiing

c. An 80-year-old farmer who wears a cap when working

d. A 20-year-old lifeguard at the lake who wears sunscreen

88. The nurse should interpret that which client is most at risk for developing skin cancer?

a) A baby underneath a large beach umbrella

b) A teenager who wears a ski outfit when skiing

c) An 80-year-old farmer who wears a cap when working

d) A 20-year-old lifeguard at the lake who wears sunscreen

89. A postpartum client adheres to the hot/cold theory of disease causation. Which of the following interventions would be appropriate for the postpartum client? Select all that apply.

a) Warming blankets

b) Heat packs

c) Sits baths

d) Cool cloths

e) Perineal ice packs

90. A Chinese client with cancer is likely to prefer consuming which of the following food items? Select all that apply

a) Cold foods

b) Fried foods

c) Hot Foods

d) Bland foods

91. A client has been late for office appointments on several occasions. In fact, the client has arrived more than 2 hours late for a scheduled appointment. Which strategy might be most effective in scheduling future appointments?

a) Call client on the day before the appointment.

b) Allow client to select a block of time in which to arrive for the appointment, such as between 12p.m. and 5 p.m.

c) Collaborate with client and family to reinforce the importance of keeping the scheduled appointment.

d) Provide client with a notification card that includes the date and time of the next appointment, as well as the cancellation policy.

92. A dark-skinned client is noted to have patches of white, unpigmented skin. The nurse concludes that which of the following variations in skin is likely present?

a) Mongolian spots

b) Pallor

c) Vitiligo

d) Petechiae

93. A client with anemia of chronic disease (ACD) is referred for nutritional counseling regarding dietary intake. Which method would be most helpful for the nurse to implement to meet nutritional goals?

a) Instruct the client on adequate sources of iron in the diet.

b) Evaluate client’s dietary pattern for nutritional adequacy.

c) Have the client consume more calories in order to meet increased nutritional demands.

d) Have the client continue to take Epogen/Procrit as prescribed because that will help to maintain adequate nutritional stores.

94. The nurse has instructed a vegetarian client regarding the use of complementary proteins in the diet. Which client statement indicates that teaching has been effective?

a. “I will increase my intake of fruits and eat a wide variety of them.”

b. “I will eat gelatin for dessert.”

c. “I will eat different plant food products together to provide complementary proteins.”

d. “I will eat more complete protein food sources.”

95. A client who is given a clear-liquid diet tray prior to diagnostic testing states, “I’m not eating this and want some real food.” What would be the best response by the nurse?

a) “I understand this is not your usual diet, but it is needed to help the test establish a diagnosis.”

b) “This is the diet that has been ordered for you. It is the only diet you can have right now.”

c) “Would like me to get you some other type of broth or juice?”

d) “I am sure that you will have a regular diet after the test, so please just try some of this for now.”

96. Which foods will the nurse include in the diet plan for a client with hypoparathyroidism?

a) Bran cereal, lima beans, corn

b) Bananas, spinach, sweet potatoes

c) Cheese, yogurt, legumes

d) Bacon, rice, canned tuna

97. A client has been involved in a nutritional research study that has been performed three times and the same findings have been obtained. The nurse concludes this study has a good measure of which study attribute?

a) Statistical value

b) Reliability

c) Worth

d) Validity

98. A client receiving large amounts of antibiotics has been started on PROBIOTIC. When the client asks what this is for, the nurse explains that this will have which effect?

a) Prevent the antibiotic from causing diarrhea.

b) Help to restore normal bacterial in the body.

c) Destroy bacteria that are not killed by the antibiotic.

d) Help to boost the immune system.

99. A 40-year-old female client with a family history of coronary heart disease (CHD) expresses interest in modifying her diet to include foods to reduce associated risk factors. The nurse suggests she increase intake of which foods that are high in carotenoids? Select all that apply.

a) Cauliflower and cabbage

b) Strawberries and oranges

c) Soy products

d) Black and green tea

e) Green peppers and squash

100. The nurse instructs the underweight client to consume what extra number of kilocalories per day for a 1-pound weight gain per week. Provide a numerical answer.

a) 250

b) 500

c) 750

d) 1000

101. When caring for a client with a history of alcoholism, the nurse checks laboratory values, anticipating deficiencies of which micronutrients that are particularly affected?

a. Magnesium and phosphorus

b. Sodium and potassium

c. Magnesium and chloride

d. Calcium and potassium

102. Which information should the nurse provide to a client who is planning to begin a low-carbohydrate (CHO) diet to lose weight?

a) A minimum level (50–100 grams/day) of CHOs is needed in the body in order to prevent protein breakdown.

b) A decrease of CHOs in the diet will not affect other nutrient proportions in the body.

c) Lowering of CHOs is the only way to effect sustained weight loss.

d) The client should increase dietary fiber level to compensate for decreased CHOs.

103. A client has just been diagnosed with night blindness. The nurse should place the highest priority on reinforcing with the client with which item of information?

a) This condition will be permanent, so a referral is needed for occupational therapy to assist you with living with this type of deficit.”

b) “Long-term hospitalization may be needed for this condition.”

c) “This is only a temporary condition that can be reversed with effective medical treatment of vitamin A.”

d) “This condition usually resolves spontaneously and is often a result of an allergic reaction.”

104. The nurse has just admitted a client who has bulimia and has been abusing laxatives and diet pills. The nurse places highest priority on which goal of care?

a) Promote the development of insight into the behaviors.

b) Promote the acceptance of self and body.

c) Promote adequate nutrition and retention of food.

d) Promote the development of realistic dieting expectations.

105. The nurse reviewing the dietary assessment of an HIV-positive female notes the client has been skipping meals and progressively losing weight. What dietary interventions would be best for the nurse to suggest promoting weight gain?

a) Have the client keep a food diary recording food preferences and usual dietary pattern.

b) Tell the client that additional salt in the diet will help to increase weight.

c) Tell the client that the use of nutrient-dense food and fortified protein shakes will help promote weight gain.

d) Tell the client that her weight may fluctuate in response to her menstrual cycle so there is no need to worry for now.

106. The nurse would encourage which of the following foods to the client with a deficiency in thiamine? Select all that apply.

a) Lean pork, beef, and liver

b) Citrus fruits

c) Strawberries

d) Sunflower and sesame seeds

e) Peanuts

107. While obtaining a stool specimen for a guaiac test, the nurse discovers that the client has been taking large doses of vitamin C for the past several days. The nurse considers which of the following information when deciding what action to take?

a. The test may show in a false positive result.

b. There will be no effect on the test results.

c. The test may show in a false negative result.

d. The test results will be open to interpretation.

108. A 53-year-old male comes to the clinic for a routine physical examination. During the intake screening, the nurse notes the client’s weight is 216 pounds and height is 66 inches. The body mass index (BMI) is calculated at 35. What interpretation should the nurse make about the client’s weight?

a. It is within normal limits, so a weight reduction diet is unnecessary.

b. It is lower than normal, so education about nutrient-dense foods is needed.

c. It indicates obesity, so weight reduction and exercise are needed.

d. It indicates an overweight status, so dietary modification and exercise is needed.

109. The nurse interprets that a premature infant is at greatest risk for inadequate intake of which vitamins because of alterations in fat absorption?

a) Vitamin C

b) B complex

c) Folic acid

d) Vitamin E

110. A client has been taking nutrition bars containing Korean ginseng for the past 2 weeks to increase concentration and stamina. Based on knowledge of the herb, the nurse instructs the client to do which of the following?

a) Continue use of the nutrition bar daily as desired.

b) Avoid use of the nutrition bar with coffee, tea, or cola.

c) Avoid operating machinery or driving a car while taking the nutrition bar.

d) Avoid this form of the herb, which is known to increase adverse effects.

111. A client taking Saint John’s wort in capsule form to treat mild depression for the past week complains of its ineffectiveness. Which statement made by the nurse is most appropriate?

a) “You may need to switch to another form of the herb.”

b) “It may take several weeks for the therapy to be effective.”

c) “Saint John’s wort may not be effective for your type of depression.”

d) “You should take the herb at night.”

112. The nurse is providing information about reducing exposure to antigens in a client who is allergic to dust. When the nurse visits the home, she evaluates the learning of the family. Which finding in the client’s home indicates a need for additional teaching?

a) The family reports they take turns vacuuming the entire house each day

b) Hardwood floors with attractive throw rugs decorate the family room

c) The adult family members have switched to the nicotine patch as they attempt to stop smoking

d) The room is decorated with hanging live plants and arrangements of silk flowers

113. The nurse is providing health teaching to a group of high school students about infectious mononucleosis. When discussing timing of disease transmission, the nurse explains that the incubation period for this infection is up to:

a) Two weeks

b) Two to Four Weeks

c) Four to Six Weeks

d) Six to Eight Weeks

114. The public health nurse at a health fair explains that which virus is most likely to be acquired through casual contact with an infected individual?

a) Human immunodeficiency virus (HIV)

b) Influenza virus

c) Cytomegalovirus (CMV)

d) Herpes virus

115. Which of the following publication promotes the goals of disease prevention and health promotion for all citizens in the US?

a. Notes on Nursing

b. Healthy People 2020

c. Silent Spring

d. Sustainable Development and Healthy Environments

116. Where do many uninsured patients receive care?

a) Emergency Rooms

b) Specialist and therapeutic locations

c) Family Doctors Clinics

d) Community Occupational Therapist Locations

117. A major barrier to healthcare access includes:

a) High insurance costs

b) Cost containment

c) Nonunion jobs

d) Inability to pay for services

118. What is one important way for community health nurses to support patients in the current economic environment of health practice

a) Gaining 3rd party reimbursement for advanced practice nurses

b) Following a market justice approach and limiting government controls

c) Promoting government initiatives to provide universal health care

d) Helping patients become informed as consumers in consumer driven healthcare

119. Primary prevention in health promotion for the elderly includes all of the following except

a) Environmental safety

b) Adequate nutrition

c) Class on low impact exercise

d) Completing a health appraisal for hypertension

120. Which of the following are nursing interventions useful for health promotion

a) Exercise, games, sports

b) Nutrition, rest, stress management

c) Assessing, planning, evaluating

d) Teaching, screening, counseling