Pre-Board Exam Drill

SITUATION 1: A patient just arrived in the Oncology unit from the Post Anesthesia Care Unit (PACU) following a Left Modified Radical Mastectomy because of Inflammatory Breast Cancer (IBC). She has a pressure dressing over the surgical site and two drains. Assessment shows her vital signs are stable, fully awake and claims that pain is under control. Fortune is the nurse assigned to the patient.
1. From the following data obtained from the chart by Fortune, which is NOT a risk factor which could have predisposed the patient to breast cancer:
a. Age – 55
b. Height 5’2”, weight 160 lbs.
c. Menarche at age 13
d. Mother died of colon cancer
2. Fortune read a literature which says that by the time Inflammatory Breast Cancer (IBC) is diagnosed, 50% - 75% have palpable auxiliary nodes; as many as 30% have gross distant metastasis; and as few as 30% of patients have an underlying breast mass. Which of the following is the APPROPRIATE interpretation of this research findings.
a. Auxiliary nodes were palpated on 20 out of 30 women positive for IBC3
b. Out of the 20 women who were positive for IBC, only 5 have metastasis
c. If there were 10 women diagnosed with IBC, 3 have positive lymph nodes
d. Breast mass was identified on 8 out of 30 women positive for IBC
3. Fortune recognizes that adjuvant chemotherapy for breast cancer may include any of the following EXCEPT:
a. Monoclonal antibody
b. Antibiotics
c. Proton inhibitors – this is a drug for ulcer
d. Antiestrogen – tamoxifen

4. Fortune understands that when the antineoplastic  agent leaks through the peripheral vascular access during chemotherapy procedure, which of the following is expected to be done FIRST?
a. Refer to the physician
b. Stop the chemotherapy infusion
c. Cleanse site with saline solution
d. Call another nurse to check the intravenous site

5. A clinical trial is currently being undertaken to test treatments for Inflammatory Breast Cancer (IBC). The research team leader wishes to include the patient as a participant in the study. As a patient advocate, which of the following will Fortune do FIRST?
a. Obtain informed consent from the patient
b. Explain to the patient the scope of the clinical trial
c. Inquire from the team leader benefits for the patient
d. Read more related literatures
SITUATION 2: During a staff meeting in the Intensive Care Unit, the nurse manager reported a list of procedures that need to be reviewed and updated. One of these procedures is the precautionary measures related to ventilator associated pneumonia.- on mechanical ventilation through an endotracheal or tracheostomy tube for at least 48 hours
6. While brainstorming, the group mentioned the use of evidence-based techniques. Which of the following statements given by the members of the group reflect evidence-based methods?
a. “Let us ask opinions of experts”
b. “The experiences of the nurses must be obtained”
c. “Review of related literature will be very helpful”
d. “We must agree on a common procedure”
7. The nurse manager assigned a group to develop a project intended to improve the existing procedure related to the prevention of ventilator associated pneumonia among ICU patients. A first team leader was selected by the group. Which of the following will the team leader do FIRST?
a. Tell the group to state their objectives
b. Formulate a list of desired outcomes
c. Set a target
d. State actions to be done by each member of the group
8. Which of the following definitions best describes pneumonia?
 A. Inflammation of the large airways
B. Severe infection of the bronchioles
C. Inflammation of the pulmonary parenchyma
D. accumulation of fluids in the lungs
9. The nurse is preparing her plan of care for her patient diagnosed with pneumonia. Which is the most appropriate nursing diagnosis for this patient?
        A. Fluid volume deficit
        B. Decreased tissue perfusion.
        C. Impaired gas exchange.
        D. Risk for infection

10. What action should the nurse take in assisting Mr. Ramos in doing deep breathing and coughing exercise?
A. Recognize that the patient is too sick to cough at this time
B. Splint the patient’s chest while he coughs
C. Turn Mr. Ramos to the unaffected side and ask him to cough
D. Encourage her to cough and then give her pain medication as ordered
11. Ms. Sy undergoes surgery and the abdominal aortic aneurysm is resected and  replaced with a graft. When she arrives in the RR she is still in shock. The nurse's priority should be
         A. placing her in a trendeleburg position
         B. putting several warm blankets on her
         C. monitoring her hourly urine output
         D. assessing her VS especially her RR

12. Ana's postoperative vital signs are a blood pressure of 80/50 mm Hg, a pulse of 140, and respirations of 32. Suspecting shock, which of the following orders would the nurse question?
         A. Put the client in modified Trendelenberg's position.
         B. Administer oxygen at 100
         C. Monitor urine output every hour.
         D. Administer Demerol 50mg IM q4h

13. When assessing Luther for hypovolemic shock, which of the following data indicates that he is in IRREVERSIBLE stage of shock?
a. Restless, anxious and confused
b. Anuria
c. Skin, cool, pale and moist- compensatory stage
d. Pulse rapid and weak – reversible stage
14. The physician ordered colloid solution such as Dextran 40. During the infusion, Luther complained of dyspnea. Upon auscultation, you noted wheezes. Which of the following will you do FIRST?
a. Discontinue the infusion
b. Place Luther on a Fowler’s position..
c. Decrease infusion rate
d. Call the attending physician

15. Luther’s central venous pressure is monitored every hour. When you measure the CVP using a water manometer, you are expected to observe which of the following to ensure accuracy of CVP measurement?
a. Maintain the client on a Fowler’s position
b. Use a one way stopcock to regulate flow of IV fluids to the water manometer
c. Immobilize client’s right arm
d. Keep the zero point of the manometer in level with the client’s right atrium
SITUATION 4: You are caring for Warren, 58 years old, who is diagnosed with Laryngeal cancer
16. Warren, who is scheduled for a total laryngectomy and radical neck dissection for cancer of the larynx, asks you, “How will I talk after the surgery?” as his nurse your BEST response will be:
a. “You will breathe through a permanent opening in your neck, but you will not be able to communicate orally”
b. “You won’t be able to talk right after surgery, but you will be able to speak again once the tracheostomy tube is removed”
c. “You will have a permanent opening in your neck, and you will need to have rehabilitation for some type of voice restoration”
d. “You won’t be able to speak as you used to but there are artificial voice devices that will give you the ability to speak normally”
17. Warren returns from surgery with a tracheostomy tube after a total laryngectomy and radical neck dissection. In caring for Warren during the first 24 hours after surgery, your PRIORITY nursing action is to:
a. Avoid changing tracheostomy ties
b. Monitor for bleeding around stoma
c. Assess the airway patency and breath sounds
d. Clean the inner cannula every 8 hours
18. After doing assessment, one of the nursing diagnosis you identified is “Body image disturbance related to loss of control of personal care.” To evaluate effectiveness of your interventions, the expected outcome for the problem that Warren should demonstrate is that he:
a. Lets his wife provide hygiene and stoma care
b. Wears clothing that minimizes the disfigurement caused by surgery
c. Asks that only family members be allowed to visit
d. Learns to remove and clean the laryngectomy tube independently
19. Warren is scheduled to start radiation therapy. You have just taught Warren all about radiation therapy. Which of the following statements by Warren would indicate that your teaching has been EFFECTIVE?
a. “I can use lotions to moisturize the skin on my throat”
b. “I will need to buy a water bottle to carry with me”
c. “I need to use alcohol-based mouthwashes to help clean oral ulcers”
d. “I may experience diarrhea, I may have diarrhea until radiation is complete”
20. After completing the discharge instructions for Warren, you  determine that ADDITIONAL instruction is needed when he says:
a. “I can participate in most of my prior fitness activities except swimming”
b. “I should wear a Medic Alert Bracelet that identifies me as a neck breather”
c. “I must keep the stoma covered with a loose sterile dressing at all times”
d. “I need to eat nutritious meals even though I can’t smell or taste very well”

Pre-Board Exam Drill: Maternal Child and Community Health Nursing C

This is a 30 point Pre-Board Exam Drill on Maternal and Child Nursing and Community Health Nursing SET C.

Test your knowledge on nursing concepts, test your test-taking skills and develop your attitude in attacking board exam questions. Answer these questions on a piece of paper. Check your answers and don't forget to review the rationale behind the correct answer. Good luck with your exam!

1.When assessing a newborn diagnosed with ductus arteriosus, Nurse Melissa should expect that the child most likely would have an:

a. Loud, machinery-like murmur.
b. Bluish color to the lips.
c. Decreased BP reading in the upper extremities
d. Increased BP reading in the upper extremities.


2.The reason nurse May keeps the neonate in a neutral thermal environment is that when a newborn becomes too cool, the neonate requires:

a. Less oxygen, and the newborn’s metabolic rate increases.
b. More oxygen, and the newborn’s metabolic rate decreases.
c. More oxygen, and the newborn’s metabolic rate increases.
d. Less oxygen, and the newborn’s metabolic rate decreases.


3.Before adding potassium to an infant’s I.V. line, Nurse Ron must be sure to assess whether this infant has:

a. Stable blood pressure
b. Patant fontanelles
c. Moro’s reflex
d. Voided


4.Nurse Fe should know that the most common causative factor of dermatitis in infants and younger children is:

a. Baby oil
b. Baby lotion
c. Laundry detergent
d. Powder with cornstarch


5.During tube feeding, how far above an infant’s stomach should the nurse hold the syringe with formula?

a. 6 inches
b. 12 inches
c. 18 inches
d. 24 inches


6. In a mothers’ class, Nurse Lhynnete discussed childhood diseases such as chicken pox. Which of the following statements about chicken pox is correct?

a. The older one gets, the more susceptible he becomes to the complications of chicken pox.
b. A single attack of chicken pox will prevent future episodes, including conditions such as shingles.
c. To prevent an outbreak in the community, quarantine may be imposed by health authorities.
d. Chicken pox vaccine is best given when there is an impending outbreak in the community.


7.Barangay Wakwak had an outbreak of German measles. To prevent congenital rubella, what is the BEST advice that you can give to women in the first trimester of pregnancy in the barangay Wakwak?

a. Advice them on the signs of German measles.
b. Avoid crowded places, such as markets and movie houses.
c. Consult at the health center where rubella vaccine may be given.
d. Consult a physician who may give them rubella immunoglobulin.


8. May Anne a public health nurse knows that to determine possible sources of sexually transmitted infections, the BEST method that may be undertaken is:

a. Contact tracing
b. Community survey
c. Mass screening tests
d. Interview of suspects


9. Claudine, a 33-year old female client came for consultation at the health center with the chief complaint of fever for a week. Accompanying symptoms were muscle pains and body malaise. A week after the start of fever, the client noted yellowish discoloration of his sclera. History showed that he waded in flood waters about 2 weeks before the onset of symptoms. Based on her history, which disease condition will you suspect?

a. Hepatitis A
b. Hepatitis B
c. Tetanus
d. Leptospirosis


10. Ronie a 3-year old client was brought to the health center with the chief complaint of severe diarrhea and the passage of “rice water” stools. The client is most probably suffering from which condition?

a. Giardiasis
b. Cholera
c. Amebiasis
d. Dysentery


11.The most prevalent form of meningitis among children aged 2 months to 3 years is caused by which microorganism?

a. Hemophilus influenzae
b. Morbillivirus
c. Steptococcus pneumoniae
d. Neisseria meningitidis


12.The student nurse is aware that the pathognomonic sign of measles is Koplik’s spot and you may see Koplik’s spot by inspecting the:

a. Nasal mucosa
b. Buccal mucosa
c. Skin on the abdomen
d. Skin on neck


13.Angel was diagnosed as having Dengue fever. You will say that there is slow capillary refill when the color of the nailbed that you pressed does not return within how many seconds?

a. 3 seconds
b. 6 seconds
c. 9 seconds
d. 10 seconds


14.In Integrated Management of Childhood Illness, the nurse is aware that the severe conditions generally require urgent referral to a hospital. Which of the following severe conditions DOES NOT always require urgent referral to a hospital?

a. Mastoiditis
b. Severe dehydration
c. Severe pneumonia
d. Severe febrile disease


15.Myrna a public health nurse will conduct outreach immunization in a barangay Masay with a population of about 1500. The estimated number of infants in the barangay would be:

a. 45 infants
b. 50 infants
c. 55 infants
d. 65 infants


16.The community nurse is aware that the biological used in Expanded Program on Immunization (EPI) should NOT be stored in the freezer?

a. DPT
b. Oral polio vaccine
c. Measles vaccine
d. MMR


17.It is the most effective way of controlling schistosomiasis in an endemic area?

a. Use of molluscicides
b. Building of foot bridges
c. Proper use of sanitary toilets
d. Use of protective footwear, such as rubber boots


18.Several clients is newly admitted and diagnosed with leprosy. Which of the following clients should be classified as a case of multibacillary leprosy?

a. 3 skin lesions, negative slit skin smear
b. 3 skin lesions, positive slit skin smear
c. 5 skin lesions, negative slit skin smear
d. 5 skin lesions, positive slit skin smear


19.Nurses are aware that diagnosis of leprosy is highly dependent on recognition of symptoms. Which of the following is an early sign of
leprosy?

a. Macular lesions
b. Inability to close eyelids
c. Thickened painful nerves
d. Sinking of the nosebridge


20. Perlita brought her 10 month old infant for consultation because of fever, started 4 days prior to consultation. In determining malaria risk, what will you do?

a. Perform a tourniquet test.
b. Ask where the family resides.
c. Get a specimen for blood smear.
d. Ask if the fever is present everyday.

"Try not to become a man of success, but rather try to become a man of value."

Pre-Board Exam Drill: Fundamentals of Nursing D

This is a 30 point Pre-Board Exam Drill on Fundamentals of Nursing SET D.

Test your knowledge on nursing concepts, test your test-taking skills and develop your attitude in attacking board exam questions. Answer these questions on a piece of paper. Check your answers and don't forget to review the rationale behind the correct answer. Good luck with your exam!

1. Before administering a nasogastric feeding, the nurse aspirate the stomach contents and obtain 50 cc of residual. the next action is to:
a. discard aspirate and begin tube feeding
b. replace aspirate and begin tube feeding
c. discard aspirate and hold the tube feeding
d. replace aspirate and hold the tube feeding

2. You are assigned to a client with a central vein IV infusing hyperalimentation solution. The most important nursing intervention is:
a. preparing the next bottle of solution prior to use
b. maintaining the exact amount of solution administered hourly by adjusting the flow rate
c. checking urine specific gravity, sugar, and acetone every for hours
d. changing the IV filter and tubing with each bottle change

3. You have been assigned to a female patient who needs to have a sterile urine specimen sent to the laboratory for a culture and sensitivity. After inserting the catheter, you find that urine is not flowing. Your next action is to:
a. remove the catheter, check the meatus, and reinsert the catheter
b. obtain a new, larger sized catheter and insert it
c. reassess if the catheter is in the vagina; if so, remove it and reinsert into meatus
d. insert the catheter a little farther, wait a few seconds, and if urine does not flow, reassess placement


4. When the urine begins to flow through catheter, your next action is to:
a. inflate the catheter balloon with sterile water
b. place the catheter tip into the specimen container
c. connect the catheter into the drainage tubing
d. place the catheter tip into the urine collection receptacle


5. Following application of a leg cast, you will first check the toes for:
a. increase in temperature
b. change in color
c. edema
d. movement


96. The client is unable to feel you apply pressure on his toes and complains of tingling. These signs indicate:
a. pressure on a nerve
b. phantom pain syndrome
 c. overmedication of an analgesic
d. improper alignment of the fracture


7. From your knowledge of the casting procedure, you understand that a wet cat should be:
a. placed on a firm surface for the first few hours
b. handled only with the palms of the hands
c. left alone to set for at least three hours
d. pelated to lessen chance of irritation to the client

8. During a retention catheter insertion or bladder irrigation, the nurse must use:
a. sterile equipment and wear sterile gloves
b. clean equipment and maintain surgical asepsis
c. sterile equipment and maintain medical asepsis
d. clean equipment and technique


9. Care for a client following a bronchoscopy will include:
a. withholding food and liquids until the gag reflex returns
b. providing throat irrigations every four hours
c. having the client refrain from talking for several days
d. suctioning frequently, as ordered


10. Reviewing the lab tests of a client scheduled for surgery, you find that the white blood cell count is 9800/mm3. The most appropriate intervention is to:
a. call the operating room and cancel the surgery
b. notify the surgeon immediately
c. take on action as your recognize that it is a normal value
d. call the lab and have the test repeated

11. If the client with psoriasis complains about pruritus, the nurse should suggest using:
a. drying soaps or agents
b. hot water when bathing
c. emollient lubricants
d. a towel to provide vigorous drying after bathing


12. You are supervising a student nurse giving an IM injection to a client with right hip arthroplasty. You will know the SN requires further instruction if she:
a. administers the injection in the left deltoid muscle
b. turns the client on her right hip to administer the injection
c. keeps the abduction pillow in place and turns the client 10 degrees to administer the injection on the unaffected side
d. administers the injection after turning the client to her left thigh, keeping the abduction pillow in place


13. You are assisting a client to choose a meal that follows his dietary orders of high calorie, high protein, decreased sodium, and low potassium. You will know the understands his dietary guidelines when he chooses:
a. crab, beets and spinach, baked potato, and milk
b. halibut, salad, rice, and instant coffee
c. sirloin steak, salad, baked potato with butter, and chocolate ice cream
d. salmon, rice, green beans, sourdough bread, coffee, and ice cream


14. The best rationale for introducing your-self to a blind client and telling him exactly what you are doing is that these actions:
a. illustrate the principle of open communication
b. decrease the client’s anxiety and fear of the unknown
c. are the accepted procedure for beginning a nurse-client relationship
d. encourage and utilize clear communication

15. Sitting down at the client’s bedside to talk with the client with convey a sense of:
a. sympathy 
b. communication
c. empathy
d. encouragement

16. While assessing a client who has orders for a hot-water bottle, heating pad, or hot compress, the first sign of possible thermal injury is:
a. tingling sensation in the extremities c. edema
b. redness in the are d. pain


17. When charting the procedure for applying restraints to a client, you will include:
a. what the client says about the restraint
b. procedure for applying the restraint
c. physician’s orders regarding the restraint
d. condition of the extremity following application


18. To perform the skill “turning to the side-lying position,” you would lower the head of the bed, elevate bed to working height, move client to your side of the bed, and flex client’s knees. The next intervention, would be to:
a. roll the client on his side
b. reposition client
c. place one hand on client’s hip and other on shoulder
d. reposition client’s arms so they are not under his body

19. Your client insists on being discharged from the hospital against medical advice. From a legal standpoint, the most important nursing action is to:
a. notify the supervisor and hospital administration
b. determine exactly why the client wants to leave
c. put all appropriate forms in the client’s chart before he leaves the hospital
d. request that the client sign the against medical advice (AMA) form


20. You are moving the client from the bed to a chair. The first appropriate intervention is to:
a. dangle the client at his bedside
b. put nonslip shoes or slippers on client’s feet
c. rock the client and pivot
d. position client so that he is comfortable.

21. The nurse answers the phone in the emergency room, a woman states that she has a nosebleed that has not stopped for the past two hours. The nurse tells her that she should come to the ER immediately but do which of the following first?
a. put pressure on the bridge of the nose for 5 to 30 minutes, applying an icepack and sit with the head forward
b. apply heat to the bridge of the nose and do not eat
c. sit with the head back and use a towel to blot blood drainage
d. when blood is felt in the nose, lightly blow the nose into a tissue
 

22. A male client has been diagnosed with chronic obstructive pulmonary disease (COPD) for the last 10 years. He continues to smoke 2 packs of cigarettes a day. He requires oxygen to perform his daily activities. Which of the following therapeutic management modalities is necessary?
a. low flow of oxygen is usually ordered
b. oxygen flow is adjusted to a higher level if shortness of breath occurs
c. petroleum jelly should be applied around the nares to prevent irritation
d. oxygen flow rate is not a concern since he will feel better if the rate is high


23. Mrs. X has been diagnosed with acute asthma. she has been admitted to the hospital and all of the following instructions to the nurse are correct, except:
a. the head of the bed should be in the high position to facilitate drainage and breathing
b. a cool and dry environment should be maintained
c. air conditioner filter should be changed often
d. oxygen should never be used as it could restrict airways more


24. A female patient has had a partial gastrectomy with a vagotomy and pyloroplasty today. She has a nasogastric tube in her nares connected to low intermittent suction. The nurse should take which of the following precautions?
a. do not irrigate or reposition the NG tube because the stomach sutures can be ruptured
b. always use wrist restraints to assure placement of NGT
c. the NG tube should not be taped to the nose
d. expect copious amount of bright red blood from the NG tube postoperatively


25. A man complains of cramping abdominal pain. He has been diagnosed with acute diverticulitis. What nursing interventions are likely to be ordered?
a. increase activity and regular diet as tolerated
b. advise bed rest, clear liquids and meperidine (Demerol), 50 mg IM every 3-4 hours as needed 
c. use ice packs on the abdomen and place the client in the trendelenburg position
d. use a K-pad (a temperature controlled heating pad) on the abdomen and allow regular diet as tolerated


26. has been diagnosed with esophageal varices. The physician notes there is active bleeding and orders the nurse to insert NG tube. The nurse should do which of the following?
a. insert the NG tube immediately
b. question the order because a varix might be perforated during insertion
c. use copious amount of K-Y jelly to insert the NG tube
d. refuse the order because a varix might be perforated during insertion


27. A 30-year-old patient has been diagnosed with folic acid deficiency. The client asks the nurse which foods are high in folic acid, and the nurse correctly responds:
a. green leafy vegetables, organ meats, nuts and eggs
b. fresh shrimp and oysters
c. dried fruits and oatmeal
d. tofu and tuna


28. Which of the following is an example of pica?
a. a craving for sweets
b. a craving for laundry starch and ice
 c. a craving for shellfish
d. craving for pickles


29. An 82-year-old woman living in a long-term care facility develops urinary incontinence. After ruling out the presence of urinary retention or a urinary tract infection (UTI), the nurse should:
a. establish a 3-hour prompted voiding schedule
b. insert a foley catheter or teach the client to self-catheterize
c. restrict her fluid intake to 1500 ml/day
d. use adult diapers and change them frequently


30. Client education for the individual with gout includes:
a. dietary instructions to limit meat, poultry, organ meats and alcohol
b. dietary instructions to limit complex carbohydrates such as flat bread, rice and pasta
c. instructions for proper cast care
d. signs and symptoms of compartment syndrome, a major complication

“If A is a success in life, then A equals x plus y plus z. Work is x; y is play; and z is keeping your mouth shut” - A. Eistein

Pre-Board Exam Dill: Fundamentals of Nursing C

This is a 30 point Pre-Board Exam Drill on Fundamentals of Nursing SET C.

Test your knowledge on nursing concepts, test your test-taking skills and develop your attitude in attacking board exam questions. Answer these questions on a piece of paper. Check your answers and don't forget to review the rationale behind the correct answer. Good luck with your exam!

1. When a client responds to a crisis situation or an acute injury, the sympathetic nervous system will respond in which of the following ways?
a. it will increase blood flow to the abdominal organs
b. it will decrease blood flow to the vital organs
c. it will stimulate the adrenals to release epinephrine


2. During the clonic phase of a generalized seizure, you may expect to see:
a. pupil dilatation, tachycardia and muscle spasms
b. bladder incontinence, elevated blood pressure and diaphoresis
c. loss of consciousness, cessation of breathing and cyanosis
d. contracted throat muscles, hyperventilation and salivation


3. The physician orders ice for the scrotum of a client diagnosed with epididymitis. The nurse correctly assumes that:
a. ice slows circulation and decreases peripheral edema
b. ice should be applied in intervals, not continuously
c. ice is placed on the scrotum continuously until the physician orders otherwise
d. ice will not stop the pain, and it has a placebo effect

4. The best time for menstruating women to perform a breast self-examination is:
a. right before the menstrual period
b. during the menstrual period
c. a few days after the menstrual period
d. 14 days after the menstrual period


5. Which of the following procedures is most effective for preventing hemolytic blood transfusion reactions?
a. administer the blood through 5% dextrose in water (D5W)
b. administration of a steroid prior to the transfusion
c. careful identification of the client and the blood product
d. using a leukocyte-poor filter during the transfusion


6. A superficial partial-thickness burn should heal in:
a. one week c. six weeks
b. three weeks d. two months
Answer A: Healing of superficial partial-thickness burns usually occurs within a week.

7. The setting that is most suitable for the treatment of a client with a full thickness burn is:
a. admission to a burn unit
b. admission to a medical unit
c. treatment in an emergency room or ambulatory care setting
d. home health care
Answer A: Full-thickness burns usually require hospitalization in a burn unit with comprehensive care by a burn team. The age of a client and the body area involved determine the need for emergency attention.

8. A full thickness burn would appear:
a. red, as if client were sunburned
b. bright red and weeping fluid
c. mottled without weeping fluid
d. brown and leather-like


9. In a patient with full thickness burn of the face, the nurse must immediately address:
a. airway management and hypovolemic shock
b. moderate discomfort and minor fluid loss
c. pain management with intravenous morphine
d. wound care


10. A full thickness burn of the face should heal in:
a. one week c. six weeks
b. three weeks d. months


11. If the client with psoriasis complains about pruritus, the nurse should suggest using:
a. drying soaps or agents
b. hot water when bathing
c. emollient lubricants
d. a towel to provide vigorous drying after bathing


12. You are supervising a student nurse giving an IM injection to a client with right hip arthroplasty. You will know the SN requires further instruction if she:
a. administers the injection in the left deltoid muscle
b. turns the client on her right hip to administer the injection
c. keeps the abduction pillow in place and turns the client 10 degrees to administer the injection on the unaffected side
d. administers the injection after turning the client to her left thigh, keeping the abduction pillow in place


13. You are assisting a client to choose a meal that follows his dietary orders of high calorie, high protein, decreased sodium, and low potassium. You will know the understands his dietary guidelines when he chooses:
a. crab, beets and spinach, baked potato, and milk
b. halibut, salad, rice, and instant coffee
c. sirloin steak, salad, baked potato with butter, and chocolate ice cream
d. salmon, rice, green beans, sourdough bread, coffee, and ice cream


14. The best rationale for introducing your-self to a blind client and telling him exactly what you are doing is that these actions:
a. illustrate the principle of open communication
b. decrease the client’s anxiety and fear of the unknown
c. are the accepted procedure for beginning a nurse-client relationship
d. encourage and utilize clear communication

15. Sitting down at the client’s bedside to talk with the client with convey a sense of:
a. sympathy 
b. communication
c. empathy
d. encouragement

16. While assessing a client who has orders for a hot-water bottle, heating pad, or hot compress, the first sign of possible thermal injury is:
a. tingling sensation in the extremities c. edema
b. redness in the are d. pain


17. When charting the procedure for applying restraints to a client, you will include:
a. what the client says about the restraint
b. procedure for applying the restraint
c. physician’s orders regarding the restraint
d. condition of the extremity following application


18. To perform the skill “turning to the side-lying position,” you would lower the head of the bed, elevate bed to working height, move client to your side of the bed, and flex client’s knees. The next intervention, would be to:
a. roll the client on his side
b. reposition client
c. place one hand on client’s hip and other on shoulder
d. reposition client’s arms so they are not under his body

19. Your client insists on being discharged from the hospital against medical advice. From a legal standpoint, the most important nursing action is to:
a. notify the supervisor and hospital administration
b. determine exactly why the client wants to leave
c. put all appropriate forms in the client’s chart before he leaves the hospital
d. request that the client sign the against medical advice (AMA) form


20. You are moving the client from the bed to a chair. The first appropriate intervention is to:
a. dangle the client at his bedside
b. put nonslip shoes or slippers on client’s feet
c. rock the client and pivot
d. position client so that he is comfortable.

21. The primary purpose of client education is to:
a. collect client data
b. determine readiness to learn
c. assess degree of compliance
d. increase client’s knowledge that will affect health status

22. Your initial instruction to a client on the use of crutches to move upstairs should be to:
a. start with crutches and the unaffected leg on the same level
b. start with crutches and the affected leg on the same level
c. place crutches on the step after the affected leg is moved up the stair
d. place crutches on the stair and then move the affected leg to the stair


23. When a client experiences a severe anaphylactic reaction to a medication, your initial action is to:
a. start an IV 
b. assess vital signs
c. place the client in a supine position
d. prepare equipment for intubation


24. If a blood transfusion reaction occurs, the first intervention is to:
a. place the client in high-fowler’s position
b. call the physician
c. slow the rate of transfusion to “keep open” rate
d. shut off the transfusion


25. The correct action for instilling eye drops is to instill the drops:
a. at the outer canthus of the eye
b. over the conjunctiva
c. directly on the cornea
d. into the center of conjunctival sac


26. Assessing a client for hypovolemic shock, the sign that you would expect to note if this complication occurs is:
a. hypertension 
b. cyanosis
c. oliguria
d. tachypnea


27. When evaluating the client’s understanding of a low potassium diet, you will know he understands if he tells you that he will avoid:
a. pasta 
b. raw apples
c. dry cereal
d. french bread


28. Irrigating a nasogastric tube should be carried out using which one of the following protocols?
a. gently instill 20 cc normal saline and then withdraw solution
b. instill 30 cc sterile water and then withdraw solution
c. instill 30 cc sterile saline, forcefully if necessary, and allow fluid to flow into basin for return
d. gently instill 20 cc sterile water and then allow fluid to flow into basin for return


29. The morning of the second postoperative day, a female patient is to be ambulated. Your first intervention is to:
a. get her up in a chair
b. use a walker when getting her up
c. have her put minimal weight on the affected side
d. practice getting her out of bed by slightly flexing her lips


30. You are assigned a client who has just had a nasogastric tube inserted postoperatively. During your evaluation of his status, you will check for:
a. electrolyte imbalance
b. gastric distention
c. ulcerative colitis
d. infection

Gastrointestinal-Hepatobillary NCLEX-RN DRILL

This is a 30 point drill on concepts regarding Management of Clients with Gastrointestinal-Hepatobillary Disorders. Use this to serve as your pretest and post test on the subject Mattter

Test your knowledge on nursing concepts, test your test-taking skills and develop your attitude in attacking board exam questions. Answer these questions on a piece of paper. Check your answers and don't forget to review the rationale behind the correct answer. Good luck with your exam!

1. During preparation for bowel surgery, a male client receives an antibiotic to reduce intestinal bacteria. Antibiotic therapy may interfere with synthesis of which vitamin and may lead to hypoprothrombinemia?

a. vitamin A

b. vitamin D

c. vitamin E

d. vitamin K

2. When evaluating a male client for complications of acute pancreatitis, the nurse would observe for:

a. increased intracranial pressure.

b. decreased urine output.

c. bradycardia.

d. hypertension.

3. A male client with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse position the client for this test initially?

a. Lying on the right side with legs straight

b. Lying on the left side with knees bent

c. Prone with the torso elevated

d. Bent over with hands touching the floor

4. A male client with extreme weakness, pallor, weak peripheral pulses, and disorientation is admitted to the emergency department. His wife reports that he has been “spitting up blood.” A Mallory-Weiss tear is suspected, and the nurse begins taking a client history from the client’s wife. The question by the nurse that demonstrates her understanding of Mallory-Weiss tearing is:

a. “Tell me about your husband’s alcohol usage.”

b. “Is your husband being treated for tuberculosis?”

c. “Has your husband recently fallen or injured his chest?”

d. “Describe spices and condiments your husband uses on food.”

5. Which of the following nursing interventions should the nurse perform for a female client receiving enteral feedings through a gastrostomy tube?

a. Change the tube feeding solutions and tubing at least every 24 hours.

b. Maintain the head of the bed at a 15-degree elevation continuously.

c. Check the gastrostomy tube for position every 2 days.

d. Maintain the client on bed rest during the feedings.

6. A male client is recovering from a small-bowel resection. To relieve pain, the physician prescribes meperidine (Demerol), 75 mg I.M. every 4 hours. How soon after administration should meperidine’s onset of action occur?

a. 5 to 10 minutes

b. 15 to 30 minutes

c. 30 to 60 minutes

d. 2 to 4 hours

7. The nurse is caring for a male client with cirrhosis. Which assessment findings indicate that the client has deficient vitamin K absorption caused by this hepatic disease?

a. Dyspnea and fatigue

b. Ascites and orthopnea

c. Purpura and petechiae

d. Gynecomastia and testicular atrophy

8. Which condition is most likely to have a nursing diagnosis of fluid volume deficit?

a. Appendicitis

b. Pancreatitis

c. Cholecystitis

d. Gastric ulcer

9. While a female client is being prepared for discharge, the nasogastric (NG) feeding tube becomes clogged. To remedy this problem and teach the client’s family how to deal with it at home, what should the nurse do?

a. Irrigate the tube with cola.

b. Advance the tube into the intestine.

c. Apply intermittent suction to the tube.

d. Withdraw the obstruction with a 30-ml syringe.

10. A male client with pancreatitis complains of pain. The nurse expects the physician to prescribe meperidine (Demerol) instead of morphine to relieve pain because:

a. meperidine provides a better, more prolonged analgesic effect.

b. morphine may cause spasms of Oddi’s sphincter.

c. meperidine is less addictive than morphine.

d. morphine may cause hepatic dysfunction.

11. Mandy, an adolescent girl is admitted to an acute care facility with severe malnutrition. After a thorough examination, the physician diagnoses anorexia nervosa. When developing the plan of care for this client, the nurse is most likely to include which nursing diagnosis?

a. Hopelessness

b. Powerlessness

c. Chronic low self esteem

d. Deficient knowledge

12. Which diagnostic test would be used first to evaluate a client with upper GI bleeding?

a. Endoscopy

b. Upper GI series

c. Hemoglobin (Hb) levels and hematocrit (HCT)

d. Arteriography

13. A female client who has just been diagnosed with hepatitis A asks, “How could I have gotten this disease?” What is the nurse’s best response?

a. “You may have eaten contaminated restaurant food.”

b. “You could have gotten it by using I.V. drugs.”

c. “You must have received an infected blood transfusion.”

d. “You probably got it by engaging in unprotected sex.”

14. When preparing a male client, age 51, for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis?

a. Obstruction of the appendix may increase venous drainage and cause the appendix to rupture.

b. Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.

c. The appendix may develop gangrene and rupture, especially in a middle-aged client.

d. Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage.

15. A female client with hepatitis C develops liver failure and GI hemorrhage. The blood products that would most likely bring about hemostasis in the client are:

a. whole blood and albumin.

b. platelets and packed red blood cells.

c. fresh frozen plasma and whole blood.

d. cryoprecipitate and fresh frozen plasma.

16. To prevent gastroesophageal reflux in a male client with hiatal hernia, the nurse should provide which discharge instruction?

a. “Lie down after meals to promote digestion.”

b. “Avoid coffee and alcoholic beverages.”

c. “Take antacids with meals.”

d. “Limit fluid intake with meals.”

17. The nurse caring for a client with small-bowel obstruction would plan to implement which nursing intervention first?

a. Administering pain medication

b. Obtaining a blood sample for laboratory studies

c. Preparing to insert a nasogastric (NG) tube

d. Administering I.V. fluids

18. A female client with dysphagia is being prepared for discharge. Which outcome indicates that the client is ready for discharge?

a. The client doesn’t exhibit rectal tenesmus.

b. The client is free from esophagitis and achalasia.

c. The client reports diminished duodenal inflammation.

d. The client has normal gastric structures.

19. A male client undergoes total gastrectomy. Several hours after surgery, the nurse notes that the client’s nasogastric (NG) tube has stopped draining. How should the nurse respond?

a. Notify the physician

b. Reposition the tube

c. Irrigate the tube

d. Increase the suction level

20. What laboratory finding is the primary diagnostic indicator for pancreatitis?

a. Elevated blood urea nitrogen (BUN)

b. Elevated serum lipase

c. Elevated aspartate aminotransferase (AST)

d. Increased lactate dehydrogenase (LD)

21. A male client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note:

a. yellow sclerae.

b. light amber urine.

c. circumoral pallor.

d. black, tarry stools.

22. Nurse Hannah is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention:

a. a sedentary lifestyle and smoking.

b. a history of hemorrhoids and smoking.

c. alcohol abuse and a history of acute renal failure.

d. alcohol abuse and smoking.

23. While palpating a female client’s right upper quadrant (RUQ), the nurse would expect to find which of the following structures?

a. Sigmoid colon

b. Appendix

c. Spleen

d. Liver

24. A male client has undergone a colon resection. While turning him, wound dehiscence with evisceration occurs. The nurse’s first response is to:

a. call the physician.

b. place saline-soaked sterile dressings on the wound.

c. take a blood pressure and pulse.

d. pull the dehiscence closed.

25. The nurse is monitoring a female client receiving paregoric to treat diarrhea for drug interactions. Which drugs can produce additive constipation when given with an opium preparation?

a. Antiarrhythmic drugs

b. Anticholinergic drugs

c. Anticoagulant drugs

d. Antihypertensive drugs

26. A male client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, the nurse should stress the importance of:

a. increasing fluid intake to prevent dehydration.

b. wearing an appliance pouch only at bedtime.

c. consuming a low-protein, high-fiber diet.

d. taking only enteric-coated medications.

27. The nurse is caring for a female client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission?

a. Regular diet

b. Skim milk

c. Nothing by mouth

d. Clear liquids

28. A male client has just been diagnosed with hepatitis A. On assessment, the nurse expects to note:

a. severe abdominal pain radiating to the shoulder.

b. anorexia, nausea, and vomiting.

c. eructation and constipation.

d. abdominal ascites.

29. A female client with viral hepatitis A is being treated in an acute care facility. Because the client requires enteric precautions, the nurse should:

a. place the client in a private room.

b. wear a mask when handling the client’s bedpan.

c. wash the hands after touching the client.

d. wear a gown when providing personal care for the client.

30. Which of the following factors can cause hepatitis A?

a. Contact with infected blood

b. Blood transfusions with infected blood

c. Eating contaminated shellfish

d. Sexual contact with an infected person

"In order to succeed, your desire for success should be greater than your fear of failure."

NCLEX-RN DRILL 1

Test your knowledge in nursing concepts. Improve our test taking skills. Develop your attitude in attacking board type questions. Answer this NCLEX-RN DRILL and review the rationale behind the correct answer.

Tip!: Practice doesn't make your perfect but practice makes you better

1 A client is being discharged and needs instructions on wound care.When planning to teach the client, the nurse should:
a. identify the client’s learning needs and learning ability.
b. identify the client’s learning needs and advise him what to do.
c. identify the client’s problems and make the appropriate referral.
d. provide pamphlets or videotapes for ongoing learning.

2 A client is requesting a second opinion. The nurse who supports and promotes the client’s rights is acting as the client’s:
a. teacher.
b. adviser.
c. supporter.
d. advocate.

3 The client tells the nurse she has been smoking one pack of cigarettes a day for the past 20 years. The nurse recognizes this is what part of the nursing process?
a. assessment
b. planning
c. implementation
d. evaluation

4 During the assessment step of the nursing process, the nurse collects subjective and objective data. The nurse uses the information to identify:
a. medical diagnoses.
b. actual or potential problems.
c. client’s response to illness.
d. need for community support groups.

5 The nurse performs daily, routine equipment checks to detect possible malfunction. This is part of the nurse’s role in the:
a. nursing process.
b. quality assurance plan.
c. care management.
d. assessment plan.

6 The nurse is developing a nursing diagnosis for a client who has pneumonia. The nurse recognizes
the diagnosis describes an actual or potential problem that:
a. the nurse can treat independently
b. the nurse can treat with a physician’s order.
c. requires physician’s intervention.
d. relates to the clients’ primary diagnosis.

7 After administering pain medication, the nurse returns to check the client’s level of comfort. This stage
of the nursing process is known as:
a. assessment.
b. planning.
c. implementation.
d. evaluation.

8 A client has lost 10 pounds related to nausea and vomiting. The nurse identifies an appropriate expected
outcome: The client will:
a. gain weight.
b. gain 2 pounds within 1 week.
c. not lose weight.
d. gain 10 pounds in 2 days.

9 A problem-solving process that requires empathy, knowledge, divergent thinking, discipline, and creativity is known as:
a. critical thinking.
b. nursing process.
c. framework for nurses.
d. care management.

10 At the end of the shift, the nurse is ready to leave but has not been relieved by the oncoming shift nurse. The nurse’s responsibility to provide care for clients is part of the nurse’s:
a. Code of Ethics.
b. nursing process.
c. critical thinking.
d. quality assurance.

“A thinker sees his own actions as experiments and questions--as attempts to find out something. Success and failure are for him answers above all.” - Nietzche

Pre-Board Exam Drill: Fundamentals of Nursing B

This is a 30 point Pre-Board Exam Drill on Fundamentals of Nursing SET B.

Test your knowledge on nursing concepts, test your test-taking skills and develop your attitude in attacking board exam questions. Answer these questions on a piece of paper. Check your answers and don't forget to review the rationale behind the correct answer. Good luck with your exam!

1. The nurse is inserting an indwelling urinary catheter. Which action is essential to decrease the complications associated with catheter insertion?
a. cleanse the female client using betadine-soaked 4x4’s, cleaning from the rectal area to the clitoris
b. utilizing a catheter that is slightly larger than the external urinary meatus
c. utilize clean technique
d. test the retention balloon prior to insertion

2. The nurse is caring for an adult client who is scheduled for an intravenous pyelogram (IVP). Which nursing intervention is essential?
a. encourage large amounts of fluids prior to the test
b. assess for any indications of allergies
c. administer a laxative
d. restrict fluids only in clients with marginal renal reserve or uncontrolled diabetes


3. The nurse is caring for a client who has a nasogastric tube attached to low wall suction. The suction is not working. Which is the nurse least likely to note when assessing the client?
a. client vomits
b. client has a distended abdomen
c. there is no nasogastric output in the last two hours
d. large amounts of nasogastric output


4. A client who has ascites is admitted to the hospital and will be undergoing a paracentesis. What should be included in the nursing care plan?
a. monitor client closely for evidence of vascular collapse
b. place client in Trendelenburg position for the procedure
c. encourage client to drink plenty of fluids to distend the bladder prior to the procedure
d. have client remain on bed rest for 24 hours following the procedure


5. A patient underwent an exploratory laparotomy two days ago. The physician has just written an order for a soft diet. The nurse assessed the client and did not hear bowel sounds in any quadrant. What is the best nursing action?
a. follow the physician’s order and feed the client
b. cancel the physician’s order and make the client NPO
c. order clear liquids for the client
d. notify the physician that the client does not have bowel sounds at this time


6. Your patient is receiving O2 at 2 liters per nasal cannula. His roommate lights a cigarette and tosses the match catching the curtain on fire. What is the priority action for the nurse?
a. turn off the oxygen 
b. sound the fire alarm
c. try to extinguish the fire
d. remove the clients from the room


7. An 84-year-old male patient has been bedridden for two weeks. Which of the following complaints by the patient indicates to the nurse that he is developing a complication of immobility?
a. stiffness of the right ankle joint 
b. soreness of the gums
c. short term memory loss
d. decreased appetite

8. Which of the following nursing interventions indicate an understanding on the part of the nurse concerning proper care of pressure ulcers?
a. rub reddened skin to increase circulation
b. use a heat lamp 4 times a day to dry the wound surface
c. cleanse a non-infected pressure ulcer with isotonic saline
d. cleanse a non-infected pressure ulcer with povidone-iodine
ANSWER C: A noninfected pressure ulcer should be cleansed gently with a non-ionic cleanser such as isotonic saline to prevent disruption of healing.

9. A client has been placed in blood and body fluid isolation. The nurse is instructing auxiliary personnel in the correct procedures. Which statement by the nursing assistant indicates the best understanding of the correct protocol for blood and body fluid isolation?
a. masks should be worn with all client contact
b. gloves should be worn for contact with non-intact skin, mucous membranes or soiled items
c. isolation gowns are not needed
d. a private room is always indicated


10. A female client will have to change the dressing on her injured right leg twice a day. The dressing will be a sterile dressing, using 4x4’s, normal saline irrigant, and abdominal pads. Which statement best indicates that the patient understands the importance of maintaining asepsis?
a. “If I drop the 4x4’s on the floor, I can use them as long as they are not soiled.”
b. “If I drop the 4x4's on the floor, I can use them if I rinse them with sterile normal saline.”
c. “If I question the sterility of any dressing material, I should not use it.”
d. “I should put on my sterile gloves, then open the bottle of saline to soak the 4x4’s.”


11. Which of the following nursing interventions would the nurse perform prior to administering a tube feeding?
a. check for placement by aspirating for gastric contents with a syringe and test pH with Testape
b. advance the tube 3-5 inches prior to the feeding
c. instruct the client to swallow
d. instill 30 ml of sterile water into the tube


12. An adult client is being treated in the burn unit for partial and full-thickness burns of the left foot, ankle, and leg. Skin autographs are taken from the right thigh and a skin graft is performed. The nurse planning care for the client on return from the operating room includes which of the following nursing interventions?
a. change dressing on graft sites every shift
b. cover donor site with fine mesh gauze and expose to air
c. lubricate donor site with skin cream every shift
d. hydrotherapy to graft sites daily


13. The nurse is caring for a client who is being transfused for severe gastrointestinal bleeding. The nurse can decrease the danger of hypothermia by:
a. administering blood with normal saline
b. administering blood products through a central line
c. giving only packed cells
d. warming blood to body temperature before administering


14. The mother of a three-year-old child calls the clinic and states that her child has just swallowed an unknown amount of baby aspirin. What is the best initial action for the nurse to take?
a. call the physician
b. instruct the mother to bring the child to the emergency room as soon as possible
c. discuss with the mother observable changes for which she should watch the child
d. tell the mother to give ipecac to the child and then come to the emergency room


15. A 56-year-old is admitted to the burn unit with partial and full-thickness burns of both legs, which occurred when a charcoal grill tipped over on her. The burn area is edematous. Blister formation and a large amount of fluid exudate is noted. Urine output is 30 ml per hour, BP 90/60, and pulses 110. A primary nursing diagnosis during the initial 48-72 hours following the burn is:
a. body image disturbance related to disfiguring burns of both legs
b. high risk for infection related to skin breakdown
c. potential for ineffective airway clearance related to smoke inhalation
d. fluid volume deficit related to increased capillary permeability


16. While assessing the client with burns on the back and trunk, the nurse notes areas that are not painful, grayish–white in color, and leathery in appearance. The nurse documents that these burns are:
a. superficial burns 
b. superficial partial thickness burns
c. deep partial thickness burns
d. full thickness burns


17. An adult is scheduled for IVP. Before sending her to have the test the nurse should:
a. ask if she is allergic to barium
b. ask is she is allergic to shellfish
c. give her a full glass of water
d. instruct her not to urinate until after the test


18. An adult has received one unit of packed red blood cells after sustaining severe trauma to his legs with profuse bleeding. To evaluate whether the transfusion has been effective the nurse should:
a. take his blood pressure
b. auscultate lung sounds
c. check hemoglobin and hematocrit results
d. take his temperature


19. The nurse is administering tracheostomy care to an adult. Which of the following should be included in the procedure?
a. soaking the outer cannula with saline solution
b. performing the procedure utilizing medical asepsis
c. soaking the inner cannula in half-strength hydrogen peroxide solution
d. cutting a sterile gauze pad to place between the neck and the tracheostomy tube


20. Which of the following teaching should the nurse include when establishing a bowel-training regimen for a 62-year-old with chronic constipation?
a. avoid laxative
b. decrease exercise
c. increase the fiber content of your diet
d. increase fluid intake 4500-5000 ml


21. The nurse answers the phone in the emergency room, a woman states that she has a nosebleed that has not stopped for the past two hours. The nurse tells her that she should come to the ER immediately but do which of the following first?
a. put pressure on the bridge of the nose for 5 to 30 minutes, applying an icepack and sit with the head forward
b. apply heat to the bridge of the nose and do not eat
c. sit with the head back and use a towel to blot blood drainage
d. when blood is felt in the nose, lightly blow the nose into a tissue
 

22. A male client has been diagnosed with chronic obstructive pulmonary disease (COPD) for the last 10 years. He continues to smoke 2 packs of cigarettes a day. He requires oxygen to perform his daily activities. Which of the following therapeutic management modalities is necessary?
a. low flow of oxygen is usually ordered
b. oxygen flow is adjusted to a higher level if shortness of breath occurs
c. petroleum jelly should be applied around the nares to prevent irritation
d. oxygen flow rate is not a concern since he will feel better if the rate is high


23. Mrs. X has been diagnosed with acute asthma. she has been admitted to the hospital and all of the following instructions to the nurse are correct, except:
a. the head of the bed should be in the high position to facilitate drainage and breathing
b. a cool and dry environment should be maintained
c. air conditioner filter should be changed often
d. oxygen should never be used as it could restrict airways more


24. A female patient has had a partial gastrectomy with a vagotomy and pyloroplasty today. She has a nasogastric tube in her nares connected to low intermittent suction. The nurse should take which of the following precautions?
a. do not irrigate or reposition the NG tube because the stomach sutures can be ruptured
b. always use wrist restraints to assure placement of NGT
c. the NG tube should not be taped to the nose
d. expect copious amount of bright red blood from the NG tube postoperatively


25. A man complains of cramping abdominal pain. He has been diagnosed with acute diverticulitis. What nursing interventions are likely to be ordered?
a. increase activity and regular diet as tolerated
b. advise bed rest, clear liquids and meperidine (Demerol), 50 mg IM every 3-4 hours as needed 
c. use ice packs on the abdomen and place the client in the trendelenburg position
d. use a K-pad (a temperature controlled heating pad) on the abdomen and allow regular diet as tolerated


26. has been diagnosed with esophageal varices. The physician notes there is active bleeding and orders the nurse to insert NG tube. The nurse should do which of the following?
a. insert the NG tube immediately
b. question the order because a varix might be perforated during insertion
c. use copious amount of K-Y jelly to insert the NG tube
d. refuse the order because a varix might be perforated during insertion


27. A 30-year-old patient has been diagnosed with folic acid deficiency. The client asks the nurse which foods are high in folic acid, and the nurse correctly responds:
a. green leafy vegetables, organ meats, nuts and eggs
b. fresh shrimp and oysters
c. dried fruits and oatmeal
d. tofu and tuna


28. Which of the following is an example of pica?
a. a craving for sweets
b. a craving for laundry starch and ice
 c. a craving for shellfish
d. craving for pickles


29. An 82-year-old woman living in a long-term care facility develops urinary incontinence. After ruling out the presence of urinary retention or a urinary tract infection (UTI), the nurse should:
a. establish a 3-hour prompted voiding schedule
b. insert a foley catheter or teach the client to self-catheterize
c. restrict her fluid intake to 1500 ml/day
d. use adult diapers and change them frequently


30. Client education for the individual with gout includes:
a. dietary instructions to limit meat, poultry, organ meats and alcohol
b. dietary instructions to limit complex carbohydrates such as flat bread, rice and pasta
c. instructions for proper cast care
d. signs and symptoms of compartment syndrome, a major complication