PRACTICE TEST 3: High Risk Adult
RESPIRATORY
1. A home health care nurse is instructing a
client with chronic obstructive pulmonary
disease (COPD) how to perform breathing
techniques that will assist in exhaling carbon
dioxide and open the airways. The nurse
teaches the client which technique?
A. Pursed-lip breathing C. Abdominal
breathing
B. Intercostal chest expansion D. Chest
physical therapy
2. A nurse is teaching a client with chronic
obstructive pulmonary disease (COPD) how
to purse lip breathe. The nurse tells the
client:
A. That inhalation should be twice as long as
exhalation.
B. To loosen the abdominal muscles while
breathing out.
C. That exhalation should be twice as long
as inhalation
D. To inhale with pursed lips and exhale with
mouth open wide.
3. A client with emphysema should receive
only 1-3 L/min of oxygen, if needed, or he
may lose his hypoxic drive. Which of the
following statements is correct about hypoxic
drive?
A. The client doesn’t notice he needs to
breathe.
B. The client breathes only when his oxygen
levels climb above a certain point.
C. The client breathes only when his oxygen
levels dip below a certain point
D. The client breathes only when his carbon
dioxide level dips below a certain point.
4. A client with a chest tube has
accidentally removed it. What should be
done first?
A. Lie the client down on his left side
B. Lie the client down on his right side
C. Apply an occlusive dressing over the site
D. Reinsert the chest tube that fell out
5. A client’s arterial blood gas (ABG)
analysis reveals a pH of 7.18, PaCO2 of
73mm Hg, PaO2 of 77mm Hg, and HCO3- of
24mEq/L. What do these values indicate?
A. Metabolic acidosis C.
Metabolic alkalosis
B. Respiratory alkalosis D menu. The nurse advises the client to avoid
Respiratory acidosis
ENDOCRINE METABOLIC
6. A client is admitted to the hospital in
metabolic acidosis caused by diabetic
ketoacidosis (DKA). The nurse prepares to
administer which of the following
medications as a primary initial treatment for
this problem?
A. Sodium bicarbonate C.
Potassium
B. Calcium gluconate D. Insulin
7. A clinic nurse instructs a client with
diabetes mellitus about how to prevent
diabetic ketoacidosis (DKA) on days when
the client is feeling ill. Which statement if
made by the client, indicates a need for
further education?
9. A nurse undergoes a thyroidectomy. The
nurse monitors the client for signs of
damage to the parathyroid glands
postoperatively. Which of the following
findings would indicate damage to the
parathyroid glands?
A. Hoarseness C.
Respiratory distress
B. Tingling around the mouth D. Neck pain
10. Which of the following forms of severe
hyperthyroidism is life threatening and
produces high fever, extreme tachycardia,
and altered mental status?
A. Hepatic coma
B. Myxedema coma
C. Thyroid storm
D. Hyperosmolar hyperglycemic nonketotic
syndrome
11. Laboratory findings indicating
decreased levels of glucose and sodium and
increased levels of potassium and white
blood cells (WBCs) would correlate with
which disease?
A. Addison’s disease C. Diabetes
mellitus
B. Cushing’s syndrome D.
Hypothyroidism
12. A client has thin extremities but an
obese truncal area and a “buffalo hump” at
the shoulder area. The client also complains
of weakness and disturbed sleep. Which of
the following disorders is the most likely
diagnosis?
A. Addison’s disease C. Grave’s
disease
B. Cushing’s syndrome D.
Hyperparathyroidism
13. When a client who has a liver disorder is
having an invasive procedure, the nurse
helps assure safety by assessing the results
of which of the following tests?
A. Coagulation studies C. Serum
chemistries
B Liver enzyme levels D. White
blood cell count
14. A nurse is assisting the client with
hepatic encephalopathy to fill out the dietary
which of the following entrée items that
could aggravate the client’s condition?
A. Fresh fruit plate C. Vegetable
lasagna
B. Tomato soup D. Ground
beef patty
15. A nurse has assisted the physician with
a liver biopsy that was done at the bedside.
On completion of the procedure, the nurse
assists the client into which of the following
positions?
A. Left-side lying with a small pillow or towel
under the puncture site
B. Right side lying with a small pillow or
towel under the puncture site
C. Left side lying with the right arm elevated
above the head
D. Right side lying with the left arm elevated
18. A nurse is admitting a client with
chronic renal failure (CRF) to the nursing
unit. The nurse assesses for which of the
following most frequent cardiovascular signs
that occurs in the client with CRF?
A. Hypertension
C.Tachycardia
B. Hypotension D.
Bradycardia
19. A client receiving hemodialysis
suddenly becomes short of breath and
complains of chest pain. The client is
tachycardic, pale and anxious. The nurse,
suspecting an air embolism, should:
A. Continue dialysis at a slower rate after
checking the lines for air
B. Discontinue dialysis and notify the
physician.
C. Monitor vital signs every 15 minutes for
the next hour
D. Administer a 500-ml bolus of normal
saline to break up the air embolus
20. A nurse is assessing a client who has
begun using peritoneal dialysis. The nurse
would determine that which of the following
manifestations noted in the client would
most likely indicate the onset of peritonitis?
A. Temperature of 37.5 degrees C
B. History of GI upset 1 week ago
C. Cloudy dialysate output
D. Presence of crystals in dialysate output
CARDIOVASCULAR
21. Which of the following blood tests is
most indicative of cardiac damage?
A. Lactic dehydrogenase C. Creatinine
phosphokinase
B. Complete blood count D. Blood
chemistry
22. Which of the following diagnostic tools
is most commonly used to determine the
location of myocardial damage?
A. Cardiac catheterization C.
Echocardiogram
B. Cardiac enzymes D.
Electrocardiogram
23. Cardiac monitoring leads are placed on
a client who is at risk for premature
ventricular contractions (PVCs). The nurse
assesses the client’s rhythm to detect PVCs
by looking for
A. Premature beats followed by a
compensatory pause
B. QRS complexes are short and narrow
C. Inverted P waves before the QRS
complexes
D. A P wave preceding every QRS complex
24. A nurse in the emergency room is
assessing a client with chest pain. Which of
the following observations by the nurse helps
to determine that this pain is due to
myocardial infarction?
A. The pain, unrelieved by nitroglycerin, was
relieved with morphine sulfate
B. The pain was described as substernal and
27. A client is experiencing pulmonary
edema as an exacerbation of chronic left-
sided heart failure. The nurse assesses this
client for which of the following
manifestations?
A. Distended neck veins C. Weight loss
B. Peripheral pitting edema D. Bilateral
crackles
28. Thrombophlebitis has been diagnosed
in a hospitalized client. A nurse should avoid
doing which of the following during the care
of this client?
A. Maintaining the client on bed rest
B. Applying moist heat to the leg
C. Elevating the feet above heart level
D. Placing a pillow under the client’s knees
BURNS
29. A client has been admitted to the burn
unit with extensive full-thickness burns.
Which of the following considerations has
priority?
A. Fluid status C. Level of
pain
B. Body image D. Risk of
infection
30. An adult client arrives in the emergency
department with burns to both legs and
perineal areas. Using the Rule of Nines, the
nurse would determine that approximately
what percentage of the client’s body surface
has been burned?
A. 19% C. 37%
B. 46% D. 65%
31. A client with a burn injury is transferred
to the nursing unit, and a regular diet has
been prescribed. Which dietary items should
the nurse encourage the client to eat in
order to promote wound healing?
A. Beef, potatoes, gelatine, orange juice
B. Peanut butter and jelly, cantaloupe, tea
C. Chicken breast, broccoli, strawberries,
milk
D. Spaghetti with tomato sauce, garlic
bread, ginger ale
32. Skin closure with heterograft is
performed on the burn client. The client
asks the nurse about the meaning of a
heterograft. The nurse tells the client that a
heterograft is skin from
A. Another species C. The
burned client
B. A cadaver D. A skin
bank
33. A client suffers a second-degree burn
on the entire surface of the upper left arm.
Which nursing action is most important when
assessing circulation?
A. Monitoring blood pressure in the left arm
B. Evaluating the strength of the left hand
C. Assessing capillary refill in the left hand
D. Measuring circumference of the left arm
34. A client involved in a house fire is
experiencing respiratory distress and an
radiating to the left arm inhalation injury is suspected. The nurse
C. The client experienced no nausea or monitors which of the following for the
vomiting presence of carbon monoxide poisoning?
D. The client reports that the pain began A. Pulse oximetry C. Sputum carbon
while the client was going up the stairs levels
B. Urine myoglobin D. Serum
25. A nurse suspects that cardiogenic shock carboxyhemoglobin levels
is developing in a client who had a
myocardial infarction. The nurse assesses
for which of the following peripheral vascular
manifestations of this complication?
A. Flushed, dry skin with bounding pedal
pulses
B. Warm, moist skin with irregular pedal
pulses
C. Cool, dry skin with alternating weak and
strong pedal pulses
D. Cool, clammy skin with weak or thready
pedal pulses

26. Toxicity from which of the following

medications may cause a client to see a
green halo around lights?
A. Digoxin C. Furosemide
B. Metoprolol D. Enalapril