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Like us on Facebook www.facebook.com/haadprometricsreviewer 6. Which of the ff c
onditions would a nurse recognize as contributing to development of respiratory
acidosis? A. B. C. D. Emphysema Hyperventilation Diarrhea Achalasia
7. A woman who is 24 hrs postpartum and who has an episiotomy would be instructe
d to report which of the ff findings immediately? A. B. C. D. Decrtease in urine
output Absence of a daily bowel movement Presence of lochia rubra Increase in p
erineal pain sensation
8. A nurse is counseling a parent of a 6 mos old infant about beginning solid fo
ods in the infants diet. Which of the ff should the nurse recommend be introduced
initially? A. B. C. D. Poached egg Strained peaches Pureed peas Rice cereal
9. A nurse observes a nurses aide taking all of the ff measures when caring for a
patient in the postoperative period ff a pneumonectomy. Which measures would re
quire immediate intervention by the nurse? A. B. C. D. Assisting the patient to
ambulate in the hall Positioning the patient on the unoperated side Placing elas
tic stockings on the patients legs Splinting the patients chest during coughing
10. Which of the ff pulmonary findings would a nurse expect to assess in a patie
nt who has lower lobe pneumonia? A. B. C. D. Paradoxical chest movement Eupnea B
ronchial breath sounds Kussmaul respirations
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ld assess a patient who has peripheral vascular disease of which of the ff venou
s insufficiencies?
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16. Which of the ff behaviors would indicated the greatest improvement in a pat
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ient who was admitted to the hospital with a diagnosis of hyperactivity. A. B. C
. D. The The The The patient patient patient patient completes an assigned task
frequently apologizes for his behavior takes naps during the day is on the unit
17. When admitting a 4 day old Hispanic infant to the pediatric unit, the nurse
notes irregular bluish discoloration over the infants sacrum and buttocks. The nu
rse should recognize that this is a? A. B. C. D. Sign of child abuse and is repo
rtable Manifestation of a rare bleeding disorder Normal variation in the skin as
sessment of a newborn Result of a traumatic birth injury
18. The nurse assessing a toddler who has an acute upper respiratory infection n
otes that the child has been vomiting. The nurse correctly interprets the vomiti
ng as. A. B. C. D. An indication that the child also has a gastrointestinal infe
ction A sign that the child is unable to mobilize secretions in the lungs A comm
on manifestation of respiratory illness in young children A common manifestation
of respiratory illness in young children
19. A patient in the recovery room complains of incisional pain. Which of the ff
nursing interventions would be most appropriate? A. B. C. D. Give meperidine (D
emerol) 50 mg, IM, as ordered Encourage deep breathing exercises Place the patie
nt in a prone position Give acetaminophen (Tylenol), 2 tablets as ordered
20. Which of the ff nursing measures would be most appropriate in the care of a
patient who has acute epistaxis? A. B. C. D. Tilt the patients head back Place th
e patients head between his legs Pinch the nose and have the patient lean forward
Place warm compresses on the patients nasal bridge
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ers) Like us on Facebook www.facebook.com/haadprometricsreviewer 21. Which of th
e ff questions is most important for a nurse to ask when taking a history from a
patient who presents with symptoms of peripheral arterial occlusive disease?
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B. Blurred vision C. Hair loss D. Cloudy urine 27. A nurse would recognize that
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adolescents perceive which of the ff issues as being a priority? A. B. C. D. Nu
trition Safety Education Privacy
28. A 7 yrs old girl is to begin her first immunization schedule. According to r
ecommended guidelines, which of the ff vaccines is not needed? A. B. C. D. Polio
Measles Pertussis Mumps
29. AN elderly widow who has dementia of the Alzheimer type says to the nurse wh
o offers her breakfast, Oh no, honey. I have to wait until my husband gets here. T
he nurse should say to the woman. A. Your husband died 6 yrs ago. Let me put milk
on your cereal for you. B. Ive told you several times that your husband is dead. I
ts time to eat now. C. Youre going to have to wait a long time. Your food will get c
old. D. Why do you think hes alive? Why cant you just eat your breakfast? 30. Which o
f the ff findings would a nurse identify as indicative of septic shock in a pati
ent? A. B. C. D. Bradycardia Flushed appearance Cool, clammy skin S3 gallop
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ers) Like us on Facebook www.facebook.com/haadprometricsreviewer 31. The nurse s
hould instruct a patient who is to receive Digoxin (Lanoxin) to report developme
nt of which of the ff side effects? A. B. C. D. Ringing in the ears Loss of appe
tite Signs of bruising Sensitivity to sunlight
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36. A 4 mos old infant who has acquired immune deficiency syndrome (AIDS) and i
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s living with the biological mother would receive the injectable form of polio v
accine for which of the ff reasons? A. B. C. D. Improve absorption Improve immun
ity Decreased viral shedding Decreased risk of anaphylaxis
37. Which of the ff parameters should be given priority when caring for a patien
t with hypoadrenalism (Addisons disease)? A. B. C. D. Evaluating pulmonary functi
on Monitoring blood sugar Measuring blood pressure Assessing neurological status
38. Which of the ff comments, if made by the spouse of a patient who has been ne
wly diagnosed with schizophrenia, would indicate that the spouse has a correct u
nderstanding of the disorder? A. I cant wait for this illness-related problems to
disappear. B. My spouse and I will need ongoing psychiatric support in the communi
ty. C. Ill be glad when my spouse becomes the person I married again. D. My spouse wi
ll no longer live with me because permanent hospitalization is necessary. 39. A p
hysician has written all of the ff orders for a patient who has a diagnosis of s
eptic shock. Which order should the nurse carry out first? A. B. C. D. Obtain cu
lture specimens Initiate antibiotic therapy Insert indwelling urinary (Foley) ca
theter Apply antiembolism stocking
40. A child present with periorbital edema, dark-colored urine and decreased uri
ne output. A priority question for the nurse to ask when obtaining the history f
rom the parent is. A. B. C. D. Has your children diagnosed recently with strep th
roat? Does your child get short of breath when playing? Is there any history of live
r disease in the family? Does your child seem to be more tired than usual?
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Email haadprometricsreviewer@yahoo.com (international Orders) Like us on Faceboo
k www.facebook.com/haadprometricsreviewer 46. Which of the ff concepts should a
nurse emphasize when conducting a community education program on reducing the ri
sk of rape? A. B. C. D. Rape rarely occurs in rural areas The very young and the
very old are usually safe from rape People who walk in groups are less likely t
o be raped Rape is a response to sexual needs
47. A child who has sickle cell disease should eat foods rich in folic acid. Whi
ch of the ff foods would a nurse encourage the child to eat? A. B. C. D. Peas Sp
inach Squash Carrots
48. Which of the ff instructions regarding skin care should a nurse give to a pa
tient who is receiving radiation therapy? A. B. C. D. Cover the irradiated area w
ith a light gauze dressing. Rinse the irradiated area with normal saline solution. A
pply petroleum-based ointment to the treatment area. Use a mild soap to cleanse th
e affected area.
49. The family you are caring for had difficult labor and an unexpected cesarean
delivery. They voice their displeasure with the way the situation was handled a
nd are threatening to sue. As the nurse caring for this family, you will. A. B.
C. D. Carefully document your care on the patients chart Delegate routine care to
other personnel Go into the room only when called, to allow for privacy Contact
the hospital legal advisor prior to giving care
50. An infant is born at 34 weeks gestation is at risk for respiratory synctial
virus (RSV). When teaching the family about health care promotion, what primary
recommendation should the nurse make to the parents? A. B. C. D. Avoid group sett
ings of other children if at all possible. Limit visitation of the infant by anyon
e who has cold. Use good hand washing techniques. Keep the baby out of drafts.
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52. A patient who has a diagnosis of metastatic cancer of the kidney is told by
the physician that the kidney needs to be removed. The patient asks the nurse. Wh
at should I do? Which of the ff responses by the nurse would be most therapeutic?
A. B. C. D. Lets talk about your options. You need to follow the doctors advice. What
does your family want you to do? I wouldnt have the surgery done without a second o
pinion.
53. An adolescent who has sickle cell disease is planning to go camping. A nurse
would advise the child that a crisis might be precipitated by A. B. C. D. Walki
ng in the woods Fishing in a cold water stream Canoeing on a lake Cycling up mou
ntain trails
54. A patient who has peptic ulcer disease is receiving sucralfate (Cerafate). T
he nurse should instruct the patient to take the medication A. B. C. D. 1 hr aft
er meals Only at bedtime With meals Up to one hour before meals
55. A patient diagnosed with post-traumatic stress disorder is troubled by frequ
ent nightmares. The patient asks the nurse, Whats wrong with me? Which of the ff re
sponses by the nurse would be most therapeutic? A. B. C. D. Many people experienc
e intense reactions ff a frightening experience. Nightmares are a means of working
off psychic energy. Nothing is wrong with you. Why do you think theres something wro
ng with you?
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56. Which of the ff statements, if made by a patient who is being discharged wi
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th a posterior nasal pack, indicates that the patient needs further instruction?
A. B. C. D. I I I I will will will will irrigate the packing daily. change the packi
ng every 2 days. cough and deep breathe 4x a day. take antibiotics until the packi
ng is removed.
57. A nurse observes a colleague taking all of the ff actions when caring for a
patient who has a leakage of cerebrospinal fluid from the nose. Which action wou
ld require further discussion? A. B. C. D. Placing the patient in low-Fowlers pos
ition Assisting the patient to void on a bedpan Inserting gauze packing into the
patients nose Shining a penlight into the patients eye
58. To which of the ff nursing diagnosis would a nurse give priority for a patie
nt whose blood test reveals a white blood cell count of 3000mm? A. B. C. D. Risk
for activity intolerance Impaired gas exchange Impaired tissue integrity Risks
for infection
59. A patient is to receive an intramuscular injection of iron dextran (INFeD).
Which of the ff steps should a nurse take before giving the injection? A. Rotate
the medication vial for one minute prior to drawing the medication into the syr
inge B. Pull the skin to one side prior to inserting the needle C. Apply ice to
the site prior to plunging the needle D. Change to a 25-gauge needle prior to ad
ministering the medication 60. A nurse would expect a typical preschool-age chil
d to display which of the ff behaviors? A. B. C. D. Responding to requests by fr
equently using the term no Making change for a quarter Imitating behavior of signi
ficant adults during play Readily accepting a substitute babysitter
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86-29-29 (Philippines) Email haadprometricsreviewer@yahoo.com (international Ord
ers) Like us on Facebook www.facebook.com/haadprometricsreviewer 61. Test result
s indicate that your patient is HIV positive. The patient has stated that her ch
oice of infant feeding is breast milk. Your postpartum plan of care should be ba
sed on the knowledge that
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B. Limiting green, leafy vegetables C. Using automatic blood pressure cuffs D.
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Providing meticulous oral care
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86-29-29 (Philippines) Email haadprometricsreviewer@yahoo.com (international Ord
ers) Like us on Facebook www.facebook.com/haadprometricsreviewer 66. A patient d
oes not swallow medication, but hold the tablet in her mouth until she is able t
o expectorate. The nurse should A. Discuss with the physician the use of aversio
n therapy to promote patient compliance. B. Ask the physician for an order to ch
ange to an intramuscular form of the medication. C. Discuss with the physician t
he use of a liquid instead of a tablet. D. Ask the physician for an order to dis
continue the medication. 67. A child has just undergone a shunting procedure for
hydrocephalus. A nurse should question the placement of which of the ff patient
s in the childs room? A. B. C. D. A A A A child child child child who who who who
has has has has acute glomerulonephritis viral pneumonia infantile eczema under
gone an appendectomy
68. A nurse should include which of the ff strategies in the care plan of a chil
d who is receiving cyclophosphamide (CYTOXAN) for treatment of Hodgkins disease?
A. B. C. D. Monitor the childs intake and output Assess the childs apical heart ra
te Place a footboard at the end of the childs bed Evaluate the childs hemoglobin l
evel
69. A nurse teaches self-care management to a teenaged patient who is being trea
ted for scoliosis using a Milwaukee brace. Which of the ff statements, if made b
y the patient, indicates a correct understanding of the instructions? A. B. C. D
. I I I I can swim for 1 hr without brace. must wear the brace over my jacket. can rem
ove the brace for sleeping. must give up driving my car.
70. A Patient who has disseminated intravascular coagulation (DIC) is administer
ed heparin sodium. Which of the ff responses, of identified in the patient, woul
d indicate that the heparin is effective? A. Breath sounds clear to auscultation
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D. How would you feel about sitting down?
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ers) Like us on Facebook www.facebook.com/haadprometricsreviewer 76. At 33 weeks
of pregnancy, a woman who has been treated pregnancy induced hypertension is ad
mitted to the hospital because condition has not improved. She is placed on bed
rest and started magnesium sulfate therapy. Which of the ff assessment is essent
ial for nurse to make? A. B. C. D. Obtaining the womans weight daily Assessing th
e womans abdominal circumference Observing the woman for jaundice Checking the eq
uality of the womans femoral pulses for her on the
77. An infant has a temperature of 104 F (40.0 C) which of the ff interventions
would be most effective in reducing the infants fever? A. B. C. D. Placing the in
fant in a cooling blanket Putting the infant in a tub of tepid water Administeri
ng the prescribed antipyretic to the infant sponging the infant with alcohol
78. Which of the ff comments by the spouse of a patient who abuses alcohol indic
ates a correct understanding of the term Blockouts as applied to alcoholism? A. B.
C. D. My My My My spouse only drinks after work. spouse drinking causes him to forge
t some event. spouse becomes angry when hes drinking. spouses employer doesnt know he
drinks.
79. A nurse should assess a patient who has had a recent myocardial infarction f
or which of the ff symptoms of pericarditis? A. B. C. D. Dull pain while sitting
Burning pain in the chest Throbbing pain radiating to the jaw Sharp pain on ins
piration
80. Which expected outcome should be given priority in the nursing care plan for
a patient with adult respiratory distress syndrome (ARDS)? A. B. C. D. Systolic
blood pressure greater than 90 mm Hg Oxygen saturation greater than 95% Respira
tion rate less than 20/min Heart rate less than 100/min
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prometricsreviewer@yahoo.com (international Orders) Like us on Facebook www.face
book.com/haadprometricsreviewer 86. A nurse is planning a community education pr
esentation on domestic violence. Which of the ff factors should the nurse includ
e? A. B. C. D. Instructions on harmonious living with a spouse The telephone num
ber of the local safe house Ways to include the extended family Assertiveness tr
aining
87. A nurse is caring for a patient who has just had an endotracheal tube insert
ed. Which of the ff actions would the nurse take first? A. B. C. D. Inflate the
cuff with appropriate volume Auscultate for bilateral breath sounds Tape the tub
e securely in place Suction for pulmonary secretions
88. When caring for a patient who is on a mechanical ventilator, the nurse shoul
d monitor the patient for which of the ff complications? A. B. C. D. Flail chest
Pleural effusion Pneumothorax Pulmonary embolus
89. Which of the ff nursing interventions would be most effective in helping a p
arent who is grieving the loss of a young child? A. B. C. D. Schedule times to d
iscuss family pictures with the parent Encourage the parent to have another chil
d as soon as possible Recommend frequent periods of sleep during the day Distrac
t the parent from thinking about the child
90. Which of the ff nursing actions should be carried out first when an patient
requires tracheostomy care? A. B. C. D. Cleansing around the tracheostomy tube s
toma Deflating the tracheostomy tube cuff Removing the inner cannula from the tr
acheostomy Suctioning the tracheostomy tube
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ers) Like us on Facebook www.facebook.com/haadprometricsreviewer 91. A nurse car
ing for a patient from a different culture notices that the patient did not eat
the food on the meal tray. Which of the ff comments by the nurse demonstrate an
understanding of cultural diversity?
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Email haadprometricsreviewer@yahoo.com (international Orders) Like us on Faceboo
k www.facebook.com/haadprometricsreviewer 96. A 2 yrs old is being discharged fr
om the ambulatory surgery center 10 hrs after undergoing a tonsillectomy. Which
of the ff findings would prompt the nurse to delay discharge? A. B. C. D. Compla
ints of pain Frequent swallowing Refusing to speak Continual mouth breathing
97. To which of the ff nursing diagnosis should a nurse give priority when plann
ing care for a patient who is in cardiogenic shock? A. B. C. D. Risk for infecti
on Altered nutrition: less than body requirements Altered tissue perfusion: peri
pheral Fluid volume deficit
98. A nurse observes a colleague performing an assessment of a child who has a h
ead injury by using the Glasgow coma scale. Which of the ff assessments, if perf
ormed by the colleague, indicates the colleague needs instruction regarding the
use of this scale? A. B. C. D. Motor response Deep tendon reflexes Verbal abilit
y Eye opening
99. Which of the ff statements, if made by a patient who has had a basal cell ca
rcinoma removed, would indicate to the nurse the need for further instruction? A
. B. C. D. I I I I will will will will use sunscreen with at least a sun protection
factor (SPF) of 15. use tanning booths rather than sunbathing from now on. stay ou
t of the sun between 10:00 am and 2:00 pm. wear a broad-brimmed hat when I am in
the sun.
100. To which of the ff nursing diagnosis would a nurse give priority in the car
e of a patient whose blood test reveals a red blood cell count of 3.0 million/mm
? A. B. C. D. Risk Risk Risk Risk for for for for activity intolerance fluid vol
ume deficit impaired skin integrity infection
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106. A nurse would assess a patient who has adrenal insufficiency for signs of A
ddisons disease, which include A. B. C. D. Striae on the abdomen Acne lesions on
the face Bronzed appearance of the skin Buffalo bump or the shoulders 7 yrs old
child has a varicella zoster. A community health nurse the childs parent about ov
er the counter medications that can be comfort the child. Which of the ff medica
tions, if selected by the would require further instruction?
107. A teaches used to parents, A. B. C. D.
Grape-flavored diphenhydramine (Benadryl) elixir to reduce itching Acetylsalicyl
ic acid (Aspirin) tablets to reduce fever Orange-flavored Ibuprofen (Pediaprofen
) elixir to minimize discomfort A topical paste of baking soda and water to reli
eve itching
108. A postpartum patient delivered 2 hrs ago. During round the nurse finds that
the patient has soaked a number of pads and is lying in a pool of blood. The nu
rses first action should be to. A. B. C. D. Go to the door and call for help Plac
e the patient in reverse trendelenberg position Increase the patients intravenous
fluid rate Massage the patients fundus
109. Which of the laboratory results is important for the nurse to monitor in a
patient who has multiple mycloma? A. B. C. D. Urinary 17-kelosteroids Serum Pota
ssium Serum Calcium Urine osmolarity
110. A child who is diagnosed with pharyngitis has a negative throat culture. Th
e childs parent asks the nurse, Why didnt the doctor give my child a prescription f
or antibiotics? The nurses response should be based on the understanding that A. A
ntibiotics are not effective against viral illnesses B. Viral throat infections
can be painful therefore, they may seem serious to children and their families C
. Bacterial infection, rather than viral infection, causes an elevation in tempe
rature D. Antibiotics are prescribed only if the infection last for more than on
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1. Key : C C. The pain medication should be administered before the pain begins
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to increase rather than when it becomes severe. When administered in this manne
r, the patient usually requires far less pain medication. The patients order perm
its the morphine after 8 hrs. The nurse should begin a schedule of every 10 hrs
rather than every 12 hrs. A. The p.r.n. injection is for severe pain. There is b
reakthrough pain occurring but there is no indication that it is severe. B. The
patients is having breakthrough pain after 1 hr. The oral medication needs to be
administered more frequently than every 12 hrs. D. There is no need to notify t
he physician since the orders already written cover this situation. The nurse sh
ould chart the change in medication administration as well as the outcome of the
new medication schedule. Withholding the analgesic will make the pain more seve
re and should not be done. 2. Key : B B. The return of cloudy dialysate fluid us
ually indicates the presence of infection. The nurse should take the patients vit
al signs to determine if the patient has temperature and notify the physician. A
. Clear yellow output is a normal finding and would not need to be reported to t
he physician immediately. C. The patient may experience some slight cramping due
to the pressure of the dialysis solution. D. Output does not always equal input
on every dialysis exchange. The overall pattern of instillation and output shou
ld be assessed. A drainage output of 50 ccs less than installed is not unusual. 3
. Key : B B. Respiratory alkalosis is due to hyperventilation, which causes exce
ssive blowing off of carbon dioxide and, hence, a decrease in plasma carbonic acid
concentration. A. Chronic obstructive pulmonary disease is associated with resp
iratory acidosis since the patient retains carbon dioxide. C. Frequent loose sto
ols (diarrhea) can cause normal anion gap acidosis (metabolic acidosis) D. Hiata
l hernia is not associated with a blood gas abnormality. However, excessive inge
stion of antacids containing bicarbonate can cause metabolic alkalosis. 4. Key :
A A. Wilms tumor, or neuroblastoma, is the most frequent intra-abdominal tumor
of childhood and the most common type of cancer. Preoperatively it is important
that the tumor is not palpated unless absolutely necessary, since manipulation o
f the tumor may case dissemination of cancer cell so to adjacent and distal site
s. B and D. Preoperative care includes temperature monitoring and intake and out
put measurement. C. The childs blood pressure is assessed frequently since hypert
ension from excess rennin production in the kidney is a possibility. 5. Key : A
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A, C and D. All of these are appropriate actions by the aide and do not require
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intervention by the nurse. 10. Key : C C. Bronchial and bronchovesicular sounds
that are audible in the lungs signify pathology. Usually they indicate consolid
ated areas in the lungs (e.g. pneumonia, heart failure) and necessitate further
evaluation. A. Paradoxical chest movement is not identified as a symptom of pneu
monia. It indicates flail chest. B. Eupnea is normal, quiet breathing D. Kussmau
l breathing is deep, rapid breathing, a dyspnea occurring in paroxysms and often
preceding diabetic coma.
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D D. There is moderate to severe edema in venous insufficiency. The patient wou
ld exhibit edema of the ankles. A. There is an aching, cramping type of pain in
venous insufficiency. Paresthesias are present in arterial insufficiency. B. Bou
nding pedal pulses are not identified as an manifestation of venous insufficienc
y. They indicate good arterial blood flow. C. Intermittent claudication is a man
ifestation of arterial insufficiency 12. Key : C C. This response encourages the
teenager to elaborate about his body image. A. Hair loss is a side effect of ch
emotherapy and not an indicator of the effectiveness of treatment. B. This respo
nse may help the teenage to identify with someone else who does not have hair, b
ut it should not be the nurses initial response. D. The nurse can tell other sugg
estions for how to handle the hair loss, but the nurses initial response should b
e directed toward getting the patient to talk about his feelings. 13. Key : B B.
The patient detoxifying from alcohol and other drugs experiences anxiety becaus
e the patients usual coping mechanism is removed. Consequently, the patient will
often use any method to obtain a drug, including feigning illness. When the pati
ent complains, he/she should be assesses for the presence of a physical illness.
In the absence of illness, the patients behavior can be seen as an attempt to co
ntrol the anxiety. A. The patient is usually more concerned with his/her own nee
ds rather than the feelings of staff C. The patients physical examination was neg
ative D. The patient is using the same coping strategy as before, i.e. reliance
on a drug to control the anxiety. The patient needs to learn alternate methods o
f coping 14. Key : D
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19. Key : A A. Intramuscular pain medication should be administered as ordered
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in the immediate postoperative period so that the pain does not become severe an
d interfere with recovery. B. Deep breathing encourages lung expansion but does
not relieve incisional pain. C. The prone position would not be comfortable for
the patient if there is an abdominal or chest incision. D. Tylenol usually is no
t strong enough to relieve incisional pain in the immediate postoperative period
. Medication is administered intramuscularly or intravenously until the patients
is fully reactive and no longer NPO. 20. Key : C C. Initial treatment of epista
xis includes applying direct pressure by pinching the soft, outer portion of the
nose against the midline septum. A and B. The patient should sit with the head
tilted forward to prevent aspiration. D. Ice or cool compresses can be applied t
o the nose. If bleeding is from the anterior nasal cavity, then anterior packing
is used in treatment.
HAAD/PROMETRICS ANSWERS AND RATIONALES For HAAD/PROMETRICS REVIEWER orders text
0919-286-29-29 (Philippines) Email haadprometricsreviewer@yahoo.com (internation
al Orders) Like us on Facebook www.facebook.com/haadprometricsreviewer 21. Key :
A A. Pain while walking is a sign of intermittent claudication and arterial ins
ufficiency. B. There is a minimal swelling associated with peripheral arterial o
cclusive. Swelling occurs with venous insufficiency. C. Complaints of pain in th
e calf on dorsiflexion of the foot is a positive Homans sign, and is diagnostic o
f thrombophlebitis. D. The client with peripheral arterial insufficiency has ski
n with a cool to cold temperature. 22. Key : B B. Lochia serosa (pink or brown)
begins three to four days after childbirth and continues to about 10 days, when
it changes to lochia alba, a yellow to white discharge. A. Clots are described o
nly with lochia rubra (dark red) which occurs up to three to four days after del
ivery. C. Clots are not described with lochia serosa (pink). D. Lochia alba occu
rs 10 days after delivery. 23. Key : A A. The treatment for varicosities of the
vulva is to place a pillow under the buttocks several times a day to elevate the
pelvis or to assume an elevated Sims position. B. A pregnant woman will be unabl
e to lie prone due to her gravid uterus. C. No pressure should be applied to the
perineum. Varicosities can be relieved by lying down as often as possible and m
inimizing standing.
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A. The nurse should orient thee patient to reality by reminding the patient tha
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t her husband died six years ago. The nurse should then move on to the activity
at hand. B. This response is harsh. The patient should be told when events occur
red, not just that they happened. C. This response does not present an accurate
picture of reality and is not appropriate. D. The patient should not be asked fo
r an explanation but should be reminded that her spouse died six years ago.
HAAD/PROMETRICS ANSWERS AND RATIONALES For HAAD/PROMETRICS REVIEWER orders text
0919-286-29-29 (Philippines) Email haadprometricsreviewer@yahoo.com (internation
al Orders) Like us on Facebook www.facebook.com/haadprometricsreviewer 30. Key :
B B. Warm, flushed skin is an integumentary finding of septic shock. A. Tachyca
rdia, rather than bradycardia, is a cardiovascular finding of septic shock. C. C
ool, clammy skin is found in hypovolemic shock D. No murmur or gallop is auscult
ated during septic shock. 31. Key : B B. The dose of digoxin should be withheld
and the doctor notified if the patients pulse if <60 or> 110, or if the patient e
xperiences anorexia, nausea, vomiting, sudden weight gain or edema. Blurred visi
on and seeing green or yellow halos around objects should be reported. A. Ringin
g in the ears is a side effect of Aspirin therapy. C and D. Bruising and sensiti
vity to sunlight are not side effects of digoxin. 32. Key : C C. Women with cyst
ic fibrosis may have lessened fertility from the inability of sperm to migrate t
hrough viscid cervical mucus. Other reasons for possible infertility are malnutr
ition and chronic infection. A. Cystic fibrosis affects fertility but does not n
ecessarily cause sterility in females. B. Cystic fibrosis does not necessarily l
ead to higher incidence of spontaneous abortion. D. Cystic fibrosis does affect
the reproductive system, often causing decreased fertility in female patients. 3
3. Key : C C. Instruct the patient and the family to observe the skin daily for
changes and to maintain good foot care. A. The patient legs should be elevated t
o promote venous return. B. The patient should avoid direct heat application to
the extremities. D. The patient should avoid standing or sitting in one position
for lengthy periods of time. 34. Key : C
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38. Key : B B. Information on community resources should be made available to pa
tients and families alike. Family education and family therapy are known to dimi
nish the negative effects of family life on schizophrenics. A and C. Patients an
d families should be made aware that schizophrenia is a relapsing disorder. D. W
hen schizophrenic patient return to a family environment consisting of warmth, c
oncern and support, a relapse is less likely to occur. 39. Key : A A. Septic sho
ck can be caused by any microorganism. Obtaining specimens for culture should be
done prior to the administration of antibiotic therapy. B. After obtaining a cu
lture, antibiotic therapy is usually instituted. C and D. A Foley catheter and a
nti-embolism stocking are not indicated in the treatment of septic shock. 40. Ke
y : A A. Manifestation such as periorbital edema, dark-colored urine and decreas
ed urinary output indicate glomerulonephritis, which occurs after a streptococca
l infection. B and D. Shortness of breath and fatigue are not generally related
to glomerulonephritis C. Glomerulonephritis is not related to a history of liver
disease in the family. HAAD/PROMETRICS ANSWERS AND RATIONALES For HAAD/PROMETRI
CS REVIEWER orders text 0919-286-29-29 (Philippines) Email haadprometricsreviewe
r@yahoo.com (international Orders) Like us on Facebook www.facebook.com/haadprom
etricsreviewer 41. Key : D D. Some women experience a localized lower abdominal
pain called mittelschmerz that coincides with ovulation. A, B and C. Nausea, vom
iting, heavy menstrual flow, low grade fever and malaise are not indicative of m
ittelschmerz. 42. Key : A A. Contractions are timed from the beginning of one co
ntraction to the beginning of the next contraction. B, C and D. These are incorr
ect ways of timing contractions and would require additional teaching by the nur
se. 43. Key : C C. Exposure of nipple to air help to toughen the tissue and decr
ease the risk of sore nipples. A. Nipple shield are not used routinely by breast
feeding mothers. B. Soap should be avoided. Water only is needed to keep the nip
ple clean. D. No antiseptic creams should be used on the nipples. 44. Key : B
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B. Delegating routine care to other personnel is not an appropriate response by
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the nurse. The nurse should continue to care for the family unless requested no
t to do so. C. Going into the room only when called indicates avoidance of the s
ituation and may be misconstrued by the family. D. The hospital legal advisor sh
ould be made aware of the situation but does not need to be contracted prior to
care. 50. Key : C C. Respiratory synctial virus is the causative organism in bro
nchiolitis. Good handwashing techniques are essential to prevent the spread of t
he virus. A, B and D. Rest, oxygen and hydration are the essential aspects of ca
re for the infant with respiratory synctial virus. A cool must humidifier is rec
ommended if the room air is dry. Visitors do not have to be limited, but the fam
ily should be aware that the infant probably will be fatigued, irritable, anxiou
s and unable to eat or sleep.
HAAD/PROMETRICS ANSWERS AND RATIONALES For HAAD/PROMETRICS REVIEWER orders text
0919-286-29-29 (Philippines) Email haadprometricsreviewer@yahoo.com (internation
al Orders) Like us on Facebook www.facebook.com/haadprometricsreviewer 51. Key :
B B. The WBC count is usually quite high in leukemia. A normal level is 450010,
000 mm. A. The platelet count is decreased in leukemia. This is normal count. C.
In leukemia the hematocrit would be decreased, and this is a normal value D. In
leukemia the hemoglobin would be decreased, and not increased. 52. Key : A A. Th
e nurse should provide an opportunity for the patient to ventilate and to discus
s her concern. This response lets the patient know that there are care options a
nd allows for discussion of treatment. B. This response minimizes the patients pa
rticipation in her own treatment plan. C. The most important issue in this situa
tion is what the patient wants to do. D. A second opinion might be encouraged bu
t the best response by the nurse is to encourage the patient to talk about her c
oncerns. 53. Key : D D. In sickle cell anemia, the goal is to minimize tissue de
oxygenation. The adolescent should be instructed to include frequent rest period
s during physical activities, avoid contact sports if the spleen is enlarged, av
oid environments for low oxygen concentration, such as high altitudes or nonpres
surized airplanes, and avoid known sources of infection. A, B and C. None of the
se activities are particularly strenuous. The adolescent should be advised to in
clude frequent rest periods when active. The most likely activity to precipitate
sickle cell crisis during this vacation is cycling up mountain trails because o
f the elevation of the mountains.
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B. Impaired gas exchange is seen in respiratory disorders such as pneumonia. C.
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Impaired tissue integrity is seen in decreased perfusion of tissues. 59. Key :
B B. The Z-track method of injection is used to administer iron dextran. The ski
n should be pulled sideways away from the muscle. A. The medication vial does no
t need to be rotated for one minute prior to injection. C. Ice should not be app
lied to the site prior to administration and may cause delay in absorption of th
e medication. D. The needle should be changed to a 22-gauge needle, two to three
inches long. 60. Key : C C. The preschooler characteristically is initiative, e
specially in faithfully reproducing the behavior of significant adults. A. Toddl
er hood is the period of the terrible twos. A time of exploration of the environme
nt as the child learns how things work, what the word no means and the power of te
mper tantrums. B. School-age children have the mental ability to make change out
of a quarter by seven years of age. D. During the preschool period the individu
ation- separation process is complete. Preschoolers relate to unfamiliar people
easily and tolerate brief separations from patents.
HAAD/PROMETRICS ANSWERS AND RATIONALES For HAAD/PROMETRICS REVIEWER orders text
0919-286-29-29 (Philippines) Email haadprometricsreviewer@yahoo.com (internation
al Orders) Like us on Facebook www.facebook.com/haadprometricsreviewer 61. Key :
D D. Transmission of HIV to the fetus or neonate can occur transplacentally and
less often by blood and vaginal secretions during delivery and/or via breast mi
lk. A. Breastfeeding would be contraindicated because of the possibility of tran
smitting the virus through the milk. B. Formula-feeding would be encouraged to p
revent transmission of HIV, not because the mother may die. C. The mother should
consider her HIV status when deciding whether or not breastfeed her infant. 62.
Key : C C. Bringing both parties together is the most effective strategy for di
scussing the issues and developing a plan to resolve them. Both parties have an
opportunity to express themselves, have the same information from the charge nur
se, and can be involved in, and have responsibility for, the resolution. A. This
option does not provide resolution of the conflict and may be perceived as taki
ng sides. B. This option puts responsibility for resolving the conflict on the c
harge nurse, rather than those involved in the situation.
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B. Developing infection is the greatest hazard following a shunting procedure.
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The nurse should be on the alert for potential sources of infection. The patient
with a shunt should not be place with a patient who has viral pneumonia. A, C a
nd D. Patients with acute glomerulonephritis and infantile eczema and patients w
ho have undergone an appendectomy do not pose a threat to the patient with a shu
nt. 68. Key : A A. Intake and output should be monitored. To prevent the develop
ment of hemorrhagic cystitis, fluid intake should be 1000-2000 ml/day. B. There
is no indication for the necessity of monitoring apical pulse rate. C. Foot drop
is a complication of treatment with vincristine (Oncovine). D. Administration o
f cyclophosphamide rarely causes anemia. 69. Key : A A. Swimming strengthens mus
cles. The brace can be removed for one hour each day for swimming. B. The brace
can be worn over a t-shirt only. C. The brace must be worn for 23 hours a day, s
even days a week. D. There is no indication that driving a car is contraindicate
d when wearing the brace. 70. Key : B B. Indications of effective treatment with
heparin are a return of clotting test to normal and decrease in hemorrhagic man
ifestations. Stools negative for occult blood is an indication of effectiveness
of treatment. A, C and D. Clear breath sounds, pupils equal and reactive to ligh
t and pink, moist mucous membranes are not indicators of the effectiveness of he
parin therapy.
HAAD/PROMETRICS ANSWERS AND RATIONALES For HAAD/PROMETRICS REVIEWER orders text
0919-286-29-29 (Philippines) Email haadprometricsreviewer@yahoo.com (internation
al Orders) Like us on Facebook www.facebook.com/haadprometricsreviewer 71. Key :
C C. Atrial fibrillation is characterized by an irregular atrial and ventricula
r rhythm. A and B. A pounding headache and visual disturbances are not manifesta
tions of atrial fibrillation. D. Low, rather than high, blood pressure would be
observed in atrial fibrillation. 72. Key : D D. Hydrochlorothiazide can cause hy
pokalemia. Oranges are a good source of potassium replacement and should not be
restricted in the diet. A. Green, leafy vegetables are a source of postpartum an
d should not be limited. B. Tomato juice is not recommended because it has a hig
h sodium content.
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cool moist compresses to the skin, re-effective if employed about one hour afte
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r the antipyretic is given so that the set point is lowered. D. Isopropyl alcoho
l should never be used for sponging. Neurotoxic effect such as stupor, coma and
even death have been reported. 78. Key : B B. Blockouts are an early symptom of
alcoholism. They are defined as amnesia for short-term memories while remote mem
ory stays intact. For example, after a night of drinking with friends, and indiv
idual cannot remember how he/she got home the night before. A, C and D. None of
these responses is a description of blockouts. 79. Key : D D. Pain associated wi
th pericarditis is classically pleuritic and is aggravated by breathing, especia
lly on inspiration. A. A dull pain while sitting may be indicative of angina. B.
A burning pain in the chest may be indicative of esophageal reflux or angina. C
. Throbbing pain radiating to the jaw may indicate a myocardial infarction. 80.
Key : B B. The goal of nursing care for the patient with adult respiratory distr
ess syndrome (ARDS) is to monitor the patients response to the ventilator. This i
s achieved by monitoring non-invasive respiratory parameters, such as pulse oxim
etry, for oxygen saturation levels. A, C and D. Monitoring the identified vital
signs is important, but does not take priority over monitoring the oxygen satura
tion level.
HAAD/PROMETRICS ANSWERS AND RATIONALES For HAAD/PROMETRICS REVIEWER orders text
0919-286-29-29 (Philippines) Email haadprometricsreviewer@yahoo.com (internation
al Orders) Like us on Facebook www.facebook.com/haadprometricsreviewer 81. Key :
C C. A patient may be bradycardic and asymptomatic, but treatment is necessary
if the patient has symptoms such as hypotension. The patient should be assessed
before any treatment modalities are instituted. A, B and D. The patient should b
e assessed for signs of intolerance to the bradycardia, such as dizziness, chest
pain or hypotension. Prior to initiating any action. 82. Key : C C. Offering to
stay with the spouse is a way of providing support through a difficult event th
at can be traumatic. A. The spouse does not need to speak with the physician bef
ore he sees his wifes body. B. This response takes away the spouses choice and imp
lies that the spouse may not be strong enough for the task. D. This response pos
tpones the action and does not address the spouses needs.
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B. Immediately after an endotracheal tube is inserted, its placement must be ve
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rified. This is done by assessing for bilateral, equal breath sounds. A, C and D
. Assessment of endotracheal tube placement must be done immediately following i
nsertion of the tube. All other actions would be done once placement is confirme
d. 88. Key : C C. Patients receiving mechanical ventilation can experience barot
raumas, or damage to the lungs by positive pressure. Barotraumas includes pneumo
thorax, subcutaneous emphysema and pneumomediastinum. A. Mechanical ventilation
is a treatment for flail chest rather than a complication. B and D. Pleural effu
sion and pulmonary embolus are not complications of mechanical ventilation. 89.
Key : A A. Using memories is positive. This process goes on with great sadness,
but is part of the resolution of grief. Using family pictures encourages the ber
eaved to think and talk about numerous memories. B. This response is not helpful
and negates the importance of the deceased child and of the need for grieving.
C. This response promotes avoidance in the patient. D. The patient needs to talk
about the deceased child. This response may indicate to the patient that the nu
rse is uncomfortable talking about the child. 90. Key : D D. Tracheostomy care i
s initiated with suctioning of the tracheostomy tube, as needed. A and C. Cleans
ing around the stoma is done after suctioning and cleansing of the inner cannula
. B. The tracheostomy tube cuff should not deflated in order to prevent expulsio
n of the tube.
HAAD/PROMETRICS ANSWERS AND RATIONALES For HAAD/PROMETRICS REVIEWER orders text
0919-286-29-29 (Philippines) Email haadprometricsreviewer@yahoo.com (internation
al Orders) Like us on Facebook www.facebook.com/haadprometricsreviewer 91. Key :
A A. Inquiring as to the types of food eaten at home shows the nurses awareness
of the patients cultural and dietary norms. B. This is patronizing response that
does not allow for discussion of the problem. C. This response does not provide
an opportunity for discussion of eating patterns and food likes and dislikes. D.
With this response the nurse assumes that the patient dislikes the food when th
at may not be the reason that he/she not eating. 92. Key : B B. Hypercyanotic sp
ells, also called blue or tet spells are seen in infants with tetralogy of fallot pr
ior to surgical repair. The infant becomes acutely
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C. Since the throat is sore, many children refuse to speak. This would not dela
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y discharge. D. Mouth-breathing is expected following a tonsillectomy. Preoperat
ively, inflamed tonsils may partially obstruct the passage of food and air. If a
denoids are also swollen, it may be difficult for air to pass from the nose to t
he throat. Postoperatively, some swelling may persist; therefore, mouthbreathing
may continue. A cool vaporizer keeps mucous membranes moist during mouth-breath
ing. 97. Key : C C. Cardiogenic shock occurs when the contractility of the cardi
ac muscle is directly impaired. Vasodilatation results in a declining blood pres
sure and altered tissue perfusion. The priority nursing diagnosis is altered tis
sue perfusion: peripheral. A, B and D. The priority for nursing care of the pati
ent in cardiogenic shock is maintaining organ perfusion and not preventing infec
tion, administering nutrients or administering additional fluids. 98. Key : B B.
The Glascow coma scale consist of the three-part assessment including best verb
al response, best motor response and eye-opening ability. Deep tendon reflexes a
re not part of this assessment. The nurse should instruct the colleague in prope
r use of the scale. A, C and D. Assessment of motor response, verbal ability and
eye-opening ability indicates correct use of the scale. 99. Key : B B. The use
of sun lamps or commercial tanning booths should be avoided. A, C and D. These m
easures indicate a correct understanding of the precautions to be taken by patie
nts with basal cell carcinoma. 100. Key : A A. Decreased RBC production can indi
cate anemia or hemorrhage. In either case the patient experiences fatigue due to
decreased oxygen-carrying capacity. Priority should focus on risk for activity
intolerance. B, C and D. Risk for fluid volume deficit, impaired skin integrity
and infection are not priority nursing diagnosis of the patient with a decreased
red cell count. Risk for activity intolerance should be the priority.
HAAD/PROMETRICS ANSWERS AND RATIONALES For HAAD/PROMETRICS REVIEWER orders text
0919-286-29-29 (Philippines) Email haadprometricsreviewer@yahoo.com (internation
al Orders) Like us on Facebook www.facebook.com/haadprometricsreviewer 101. Key
: A A. Working with the patient provides support and allows for modeling of beha
vior. B. This response by the nurse allows the patient to decline the invitation
to participate in activities. C. Suicidal patients are usually depressed and sh
ow diminished interest in activities. This approach does not encourage participa
tion.
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C. Patient with primary adrenal hypofunction (Addisons disease) have elevated le
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vels of plasma adrenal corticotropic hormone (ACTH) and melanocyte-stimulating h
ormone which can result in areas of increase pigmentation. A, B and D. Abdominal
striae, acne lesions and buffalo hump are manifestations of hyperfunction of th
e adrenal glands rather than hypofunction. 107. Key : B B. The parent be instruc
ted to avoid the use of Aspirin because of its association with Reyes syndrome. A
. Diphenhydramine hydrochloride (Benadryl) may be used to relieve itching. C. Pe
diaprofen may be used to relieve discomfort. D. A tropical paste of baking soda
and water may be used on lesions to relieve itching. 108. Key : C C. In an emerg
ency such as post-birth hemorrhage, the initial nursing role includes the monito
ring for, and detecting of, developing problems. The nurse should support blood
volume by increasing the flow rate of infusing fluids or by beginning an infusio
n with a large-bore intracatheter. Oxytoxic agents are administered as ordered.
A. The nurse should obtain assistance since hemorrhage may be rapid and team app
roach is essential. However, the nurse should institute corrective measure befor
e securing assistance. B. The woman should be placed in a position that allows e
levation of the knees and lower legs to 45 degrees. Reverse trendelenburg positi
on involves elevation of the head and lowering of the legs. D. Massaging the fun
dus is appropriate to prevent hemorrhage when the uterus is boggy. It may also b
e used to control bleeding post-delivery. However, since this patient has soaked
pads and considerable blood loss, the priority would be fluid replacement. 109.
Key : C C. Hypercalcemia is usually present in patients with multiple myeloma.
Multiple myeloma is characterized by an abnormal proliferation of plasma cells a
nd bone destruction. The nurse should check laboratory studies for the presence
of calcium in the urine. A, B and D. Laboratory date found in multiple myeloma i
nclude an increased bilirubin level and sedimentation rate, decreased sodium and
chloride levels, folate deficiency, hypercalcemia, uremia, renal stones and the
presence of Bence-jones protein in the urine. 110. Key : A A. Viral illness are
symptomatically managed and do not respond to antibiotics. B. Viral throat infe
ctions can be painful; therefore, they may appear to be serious to children and
their families. However, unless there is a secondary bacterial infection, they d
o not require antibiotic treatment. C. Both viral and bacterial agents may cause
fevers. However, antibiotics are not effective against viruses.