UNIVERSITY OF THE CORDILLERAS

COLLEGE OF NURSING
NCM 103-Concept
1st Semester Academic Year 2012-2013
FINAL EXAMINATION
GENERAL INSTRUCTIONS: SELECT THE BEST ANSWER THAT CORRESPONDS TO THE SITUATION / STATEMENT GIVEN.
SHADE THE LETTER OF YOUR CHOICE USING BLUE INK ON THE ANSWER SHEET THAT IS PROVIDED TO YOU. NO ERASURES
OR SUPERIMPOSITION ALLOWED FOR THE ENTIRE TEST. FAILURE TO COMPLY WILL INVALIDATE YOUR ANSWERS.

MULTIPLE CHOICE 100 POINTS (1 POINT EACH QUESTION).

1. The nurse should teach the client to prevent corneal irritation from mild exophthalmos by:
a. Massaging the eye at regular intervals
b. Instilling an ophthalmic anesthetic as ordered
c. Wearing dark-colored glasses
d. Covering both eyes with moistened gauze pads
2. A client with a large goiter is scheduled for subtotal thyroidectomy to treat thyrotoxicosis. Saturated solution of
potassium iodide (SSKI) is prescribed preoperatively for the client .The primary reason for using this drug is that it
helps.
a. Slow progression of exophthalmos
b. Reduce the vascularity of thyroid gland
c. Decrease the body’s ability to store thyroxine
d. Increase the body’s ability to excrete thyroxine
3. The nurse ask the client to state her name as soon as she regains consciousness post operatively after a subtotal
thyroidectomy and at each assessment.the nurse does this primarily to monitor for signs of which of the
following.

a. Internal hemorrhage c. Laryngeal nerve damage

b. Decrease level of consciousness d. Upper airway obstruction

4. A client who has undergone a subtotal thyroidectomy is subject to complications in the first 48 hours after
surgery ,the nurse should obtain and keep at the bedside equipment to

a. Begin TPN c. Administer tube feeding

b. Start a cut down infusion d. Perform tracheostomy

5. Appropriate nursing diagnosis for a client with hypothyroidism would probably include which of the following?
a. Risk for injury (corneal abrasion)related to incomplete closure of eyelids
b. Imbalance nutrition less than body requirements to hypermetabolism
c. Deficient fluid volume related to diarrhea
d. Activity intolerance related to fatigue associated with disorder
6. A client with DM asks the nurse to recommend something to remove corns from his toes .the nurse should
advise him to
a. Apply a high-quality corn plaster to the area
b. Consult the physician or podiatrist to about removing the corn
c. Apply iodine on the corn before peeling them off.
d. Soak his feet to borax solution to peel off the corn
7. The diabetic client who is taking insulin Lispro (Humalog) injections would be advise to eat
a. Within 10-15 minutes after injection
b. 1 hour after injection
c. At any time because timing of meals with Humalog injections is unnecessary
d. 2 hours before the injection
8. A female client with type 1 DM is experiencing minor illness with the flu. The nurse should instruct the client
a. To increase the frequency of blood monitoring
b. That she should try to reduce food intake to diminish nausea
c. That she does not need to take the insulin if she cannot eat
d. To take half of the normal dose of insulin
9. Which of the following monitoring activities would be a major focus when planning a nursing care for a client
who has undergone Transphenoidal Hypophysectomy?

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 a. Monitoring for cerebrospinal fluid leak c. Monitoring for Cushing’s syndrome
b. Monitoring for blood glucose levels d. Monitoring for cardiac arrest

10. Which of the following findings would be typical for Addison's disease?

a. Hypokalemia c. Hypoglycemia
b. Hypernatremia d. Decreased blood urea nitrogen level.

11. Which statement should the nurse make when teaching the client about taking oral corticoids?
a. “Take your medication with a full glass of water”
b. “take your medication on empty stomach”
c. “Take your medication at bedtime to increase absorption”
d. “Take your medication with meals or with an antacid”
12. A client with Cushing’s disease needs to modify dietary intake to control symptoms. In addition to increase
protein which strategy would be most appropriate?

a. Increase calories c. Restrict potassium

b. Restrict sodium d. Reduce fat by 10%

13. After a bilateral adreanlectomy for Cushing’s diseases, the client is told by the physician that she needs periodic
testosterone injections. She asks the nurse,” what is that for? Did he forget I am a woman? What would be the
nurse response?
a. “Testosterone is needed to balance the reproductive cycle”
b. Testosterone is needed to restore the body’s sodium and potassium balance
c. “Testosterone is given to stimulate protein anabolism”
d. Testosterone is given to stabilize mood swings
14. The primary feature of pheochromocytoma’s effect on blood pressure is?
a. Systolic hypertension
b. Diastolic hypertension
c. Hypertension that is resistant to treatment with drugs
d. Widening pulse pressure
15. The client with pheochromocytoma should be instructed to avoid activities that precipitates hypertensive crisis
or paroxysms,such as:

a. Jogging c. Anxiety
b. Valsava maneuver d. Hypoglycemia

16. A client is diagnosed with type 1 DM. The nurse understands that which of the following factors is not believed
to be a cause of the beta cell destruction that accompanies this disorder?

a. Genetic factors c. Primary failure of glucagon secretion

b. Autoimmune factors d. Viruses

17. A client with diabetes mellitus is prone to breaking down fats for conversion to glucose. The nurse determines
that this response currently is occurring if the client has elevated levels of which of the following substances?

a. Glucose c. Glucagon
b. Ketones d. Lactic dehydrogenase

18. A client is diagnosed with Cushing’s syndrome. The nurse understands that this client has excesses of which of
the following substances?

a. Calcium c. Epinephrine
b. Cortisol d. Norepinephrine

19. A client has overactivity of the thyroid gland. The nurse anticipates that the client will experience which of the
following effects from this hormonal excess?

a. Low blood glucose levels c. Weight gain

b. Nutritional deficiencies d. Increased body fat stores

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20. A client with hypovolemia experiences activation of the rennin angiotensin system to maintain blood pressure.
a.
The Aldosterone c. will
nurse kows that as part of this response, the endocrine system Cortisol
have increased production and secretion
b. Adrenocorticotropic hormone
of which mineralocorticoid? d. Glucagon

21. A client with medullary carcinoma of the thyroid gland has an excess function of the C cells of the thyroid gland.
The nurse interprets that this client is primarily at risk of having abnormalities of which of the following
electrolytes?

a. Sodium c. Calcium
b. Potassium d. Magnesium

22. A client has abnormal amounts of circulating thyronine and thyroxine. The nurse understands that the client
may have a deficiency of which of the following dietary elements?

a. Calcium c. Phosphorus
b. Magnesium d. Iodine

23. A client with endocrine disorder has weight loss and tachycardia. The nurse determines that which of the
following glands is most likely responsible for these symptoms?

a. Thyroid c. Adrenal cortex

b. Parathyroid d. Pituitary

24. A nurse overhears a discussion about a client who has an altered production of cortisol. The nurse plans care
knowing that the client is experiencing difficulty with synthesis of which of the following types of substances?

a. Androgens c. Glucocorticoids
b. Catecholamines d. Mineralocorticoids

25. A client’s serum calcium level is high. The nurse plans care knowing that which of the following hormones is
directly responsible for maintaining the free or unbound portion of the serum calcium within normal limits?

a. Thyroid hormone c. Follicle stimulating hormone

b. Parathyroid hormone d. Adrenocorticotropic hormone

26. A client has a tumor that is interfering with the function of the hypothalamus. The nurse would expect that the
client would exhibit which of the following clinical problems?

a. Glucocorticoid excess or deficit c. Antidiuretic hormone excess or deficit

b. Mineralocorticoid excess or deficit d. Melatonin excess or deficit

27. A client is diagnosed with dysfunction of the adrenal medulla. The nurse monitors for changes in client status
related to altered production and secretion of which of the following substances?

a. Cortisol c. Aldosterone
b. Epinephrine d. Androgens

28. A client has impaired function of the posterior pituitary gland. The nurse plans care knowing that the client may
exhibit altered secretion of which of the following hormones?

a. Antidiuretic hormone c. Follicle stimulating hormone

b. Growth hormone d. Luteinizing hormone

29. A client has an endocrine system dysfunction of the pancreas. The nurse plans care knowing that the client will
exhibit impaired secretion of which of the following substances?

a. Amylase c. Trypsin
b. Lipase d. Insulin

30. The student nurse is discussing hormones secreted by the posterior hypothalamus to his patient who has
problems with the gland. The student nurse is correct when he states which of the ff hormone is secreted by the
posterior pituitary gland?

a. Anti-diuretic hormone (ADH) b. Adreno-Cortico Tropic Hormone (ACTH)

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 c. Prolactin d. Adreno-Cortico Tropic Hormone (ACTH)

31. The nurse is performing an assessment on a client with a diagnosis of myxedema (hypothyroidism). Which of the
following assessment findings would the nurse expect to note in this client?

a. Thin, silky hair c. Fine muscle tremors

b. Dry skin d. Bulging eyeballs

32. The nurse is performing an assessment on a client with a diagnosis of hyperthyroidism. Which finding would the
nurse expect to note in this client?

a. Periorbital edema c. Dry skin

b. Coarse facial features d. Bulging eyeballs

33. The nurse is reviewing the laboratory results of a client with a diagnosis of Cushing’s syndrome. Which laboratory
finding would the nurse most likely expect to note in this client?

a. A blood glucose level of 110 mg/dl c. A WBC count of 6000 cells/microL

b. A potassium level of 5.5 mEq/L d. A platelet count of 200,000/microL

34. The unconscious client arrives in the emergency room. The spouse informs the client has DM. a blood glucose
level reads 40 mg/dl. Which of the ff medications is expected to be given?

a. Regular insulin c. Diabeta

b. Glucagon d. NPH insulin

35. The nurse is providing instructions to a client with a diagnosis of Addison’s disease regarding the administration
of prescribed glucocorticoids the nurse instruct the client
a. To avoid taking the medication if nausea occurs
b. To stop the medication if side effect occurs
c. That minimal side effects will occur from the use of this medication
d. That an increase dose of medication may be needed during times of stress
36. The client with DM reports to the health care clinic for glycosylated hemoglobin A1C level. Which of the ff
laboratory results indicate client compliance with the prescribed diabetic regimen?

a. 5% c. 10%
b. 8% d. 15%

37. A nurse is providing instructions to a client newly diagnosed with DM regarding insulin administration. The
physician prescribed a mixture of NPH and regular insulin. The nurse would instruct the client that the first step
is to
a. Inject air to the amount of NPH insulin prescribed into the vial of NPH insulin
b. Inject air equal to the amount of regular insulin prescribed into the vial of regular insulin
c. Draw up the correct dosage of regular insulin into the syringe
d. Draw up the correct dosage of NPH insulin into the syringe
38. A nurse is caring for a client ff an adrenalectomy and is monitoring for signs of adrenal insufficiency. Which of the
ff if noted in the client would indicate signs and symptoms related to insufficiency?
a. Subnormal temperature
b. Hypotension and fever
c. Mental status change and hypertension
d. Complaints of weakness and hypertension
39. A nurse is monitoring a client ff thyroidectomy for signs of hypocalcemia. Which of the ff signs if noted in the
client, most likely would indicate the presence of hypocalcemia

a. Tingling aroud the mouth c. Negative Chvostek’s sign

b. Flaccid paralysis d. Bradycardia

40. A nurse is monitoring a client with Grave’s disease for signs of thyrotoxic crisis (thyroid storm). Which of the ff
signs and symptoms, if noted will alert the nurse to the presence of this crisis?

a. Pallor and tachycardia c. Restlessness and bradycardia

b. Fever and tachycardia d. Agitation and bradycardia
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 41. A nurse is reviewing the assessment finding and laboratory data of a client with syndrome of inappropriate anti
diuretic hormone (SIADH). The nurse understands that which of the ff is not a characteristic of this disorder?

a. Signs of water intoxication c. High urine osmolality

b. Hypernatremia d. Low serum osmolality

42. A nurse is reviewing the assessment findings on a client with a diagnosis of diabetes insipidus (DI). The nurse
understands that which of the ff is unassociated with this disorder?

a. Complaints of excessive thirst c. Polyuria

b. Polydipsia d. Concentrated urine

43. A test to measure long term control of DM has been prescribed for a client. The nurse tells the client that long
term control can be measured because chronic high blood sugar level lead to irreversible glucose binding onto
which of the following items?

a. Muscle tissue c. Red blood cells

b. Adipose tissue d. Platelets

44. A client is admitted with a diagnosis of Addison’s disease. The nurse would assess for which of the ff associated
problems with this disorder?

a. Hypotension c. Obesity
b. Hirsutism d. Edema

45. A client has begun medication therapy with propylthiouracil (PTU). The nurse would assess the client for signs
and symptoms of which of the ff adverse effects of this medication?

a. Joint pain c. Renal toxicity

b. hypothyroidism d. hyperglycemia

Gastrointestinal Disorders

46. A client is admitted to hospital after vomiting bright red blood and is diagnosed with bleeding duodenal ulcer.
The client develops a sudden sharp pain in the midepigastric region along with rigid board like abdomen .the
clinical manifestations most likely indicate which of the following
a. An intestinal obstruction has developed
b. Additional ulcers have developed
c. The esophagus have inflamed
d. The ulcer has perforated
47. The nurse is preparing to teach a client with peptic ulcer disease about the diet that should be followed after
discharge. The nurse should explain that the diet will most likely consist the following:

a. Bland foods c. Any food that is tolerated

b. High protein foods d. Large amount of milk

48. A client is taking an antacid for treatment of peptic ulcer disease. Which of the following statements best
indicates that the client understands how to correctly take the antacid?
a. “I should take my antacid before I take my other medications”
b. “I need to decrease mi intake of fluids so that I don’t dilute the effect of my antacids”
c. “my antacid will be most effective if I take it whenever I experience stomach pains”
d. “it is best for me to take my antacids 1-3 hours after meals”
49. A client has been diagnosed with adenocarcinoma of the stomach and is scheduled to undergo a subtotal
gastrectomy (Billroth II procedure).During preop teaching; the nurse is reinforcing information about the surgical
procedure. Which of the following explanations is most appropriate
a. The procedure will result in enlargement of pyloric sphincter
b. The result will result in anastomosis of the gastric stump to the jejunum
c. The procedure will result in removal of duodenum
d. The procedure will result in repositioning of the vagus nerve
50. After subtotal gastrectomy, care of the patients NGT and drainage system should include the following

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 a. Irrigate the tube with 30 ml of sterile water every hour as needed
b. Reposition the tube if it is not draining well
c. Monitor the client for nausea, vomiting and abdominal distention
d. Turn the machine to high suction if the drainage is sluggish on low suction
51. As a result of gastric resection, the client is at risk for development of dumping syndrome. The nurse would
prepare a plan of care for this client based on knowledge that this problem stems primarily from which
gastrointestinal changes?
a. Excess secretion of digestive enzyme in the intestines
b. Rapid emptying of stomach content into the small intestines
c. Excess glycogen production by the liver
d. Loss of gastric enzymes
52. The client is scheduled to have an upper gastrointestinal tract series. Which of the following treatments should
the nurse anticipate after the examination?

a. Administering laxative c. Giving the client a tap water enema

b. Placing the client on a clear liquid diet d. Starting an intravenous infusion

53. The client with colon cancer has an abdomino-perineal resection with colostomy, Which of the following nursing
intervention is most appropriate for this client in the post op period:
a. Maintain the client in semi- Folwer’s position
b. Assist the client with warm sitz bath
c. Administer 30ml of milk of magnesia to stimulate colostomy activity
d. Remove the ostomy pouch as needed so the stoma can be assessed.
54. The nurse evaluates stoma during initial postoperative period. Which of the following observations should be
reported immediately to the physician

a. Stoma is slightly edematous c. The stoma oozes a small amount of blood

b. Stoma is dark red purple d. The stoma doesn’t expel stool

55. While changing the client’s colostomy bag and dressing, the nurse assesses that the client is ready to participate
on her care by noting which of the following?
a. The client asks what time the doctor will visit that day
b. The client asks on the supplies used during the dressing change
c. The client talks about something she reads in the morning newspaper
d. The client complains about the way the night nurse change the dressing
56. A client with Crohns disease experiences rectal bleeding along with 15-20 watery stools per day. Which of the
following signs would be indicative of dehydration?

a. Sunken eyeball c. Moist skin

b. Decrease pulse rate d. Petting edema

57. Which of the following would be a priority focus of care of the client experiencing an exacerbation of Crohns
disease?

a. Encouraging regular ambulation c. Maintaining current weight

b. Promoting bowel rest d. Decreasing episode of rectal bleeding

58. A client who had an appendectomy for perforated appendix returns from surgery with a drain inserted in the
incisional site. The nurse understands that the purpose of the drain is to accomplish which of the following?

a. Provide access for wound irrigation c. Minimize development of scar tissues

b. Promote drainage for wound exudate d. Decrease post-operative discomforts

59. In a client with acute appendicitis, the nurse should anticipate which of the following treatments?
a. Administration of enemas, to cleanse the bowel
b. Insertion of a NGT
c. Placement of a client on NPO
d. Administration of het to the abdomen
60. An obese woman complains of intense heartburn and asks the nurse to explain the reason for her problem. The
nurse’s explanation should be based on which of the following statements?
A. Cardiac sphincter tone is decreased. B. Cardiac sphincter tone is increased.

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 C. Gastric emptying time is increased. D. Dietary protein is inadequately digested.
61. The home care nurse is visiting a client with a diagnosis of pernicious anemia that developed as a result of gastric
surgery. The nurse instructs the client that because the stomach lining produces a decreased amount of intrinsic
factor in this disorder, the client with need
a. Vitamin B 6 injections c. An antacid
b. An antibiotic d. Vitamin B 12 injections
62. The nurse is preparing to perform an abdominal examination on a client. The nurse would place he client in
which of the following positions for this examination?
a. Supine with the head raised slightly and the knees slightly flexed
b. Semi-fowler with the head raised 45 degrees and the knees flat
c. Sims’ position
d. Supine with the head and feet flat
63. A nurse is providing instructions to a client who will collect a stool specimen for occult blood. The nurse instructs
the client to avoid which of the following for 3 days before the collection of the stool specimen?
a. Milk products c. Red meat
b. Hard cheese d. Cottage cheese
64. An ambulatory care nurse is preparing to assist the physician in performing a liver biopsy on a client. The client is
receiving a local anesthetic for the procedure. The nurse would assist the client to which position for this test to
be performed?
a. Right lateral side-lying
b. Left lateral side-lying
c. Prone with the hands crossed under the head
d. Supine with the right hand under the head
65. A nurse is developing a plan of care for the client who is scheduled to return to the nursing unit following a liver
biopsy. The nurse plans to position the client
a. On the left side c. Supine
b. On the right side d. Prone
66. A client has been diagnosed with gastroesophageal reflux disease. The nurse interprets that the client has
dysfunction of which of the following parts of the digestive system?
a. Chief cells of the stomach c. Lower esophageal sphincter
b. Parietal cells of the stomach d. Upper esophageal sphincter
67. A client has experienced delayed gastric emptying. The nurse determines that which of the following structures
is responsible for the client’s symptoms?
a. Pyloric sphincter c. Jejunum
b. Cardiac sphincter d. Ileum
68. A client with gastric hyperacidity asks the nurse why there are not also ulcers in the small intestine from the
excess gastric acid being produced. The nurse responds that the pH of intestinal contents is raised by
bicarbonate that is present in the
a. Liver enzymes c. Parietal cells
b. Bile d. Pancreatic juice
69. A nurse is caring for a group of clients on the surgical nursing unit. The nurse anticipates that the client who
underwent which of the following procedures is most likely to have some long-term residual difficulty with
absorption of nutrients?
a. Appendectomy c. Ascending colostomy
b. Colectomy d. Small-bowel resection
70. A client is experiencing blockage of the common bile duct. The nurse alters the client’s diet, knowing that the
client will experience difficulty digesting
a. Fats c. Proteins
b. Carbohydrates d. Water-soluble vitamins
71. A nurse is teaching a client about an upcoming colonoscopy procedure. The nurse would include in the
instructions that the client will be place in which of the following positions for the procedure?
a. Left sims c. Knee-chest
b. Right sims d. Lithotomy
72. The nurse is teaching the postgastrectomy client about measures to prevent dumping syndrome. Which
statement by the client indicates a need for further teaching?
a. “I need to lie down after eating.” b. “I need to drink liquids with meals.”

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 c. “I need to eat small meals six times daily.” d. “I need to avoid concentrated sweets.”
73. A nurse understands that excessive use of oral antacids like calcium carbonate because of gastric ulcers can
result in which acid-base disturbance?
a. Respiratory acidosis c. Metabolic alkalosis
b. Respiratory alkalosis d. Metabolic acidosis
74. In assessing the abdomen of your client the proper sequence should be which of the following?
a. Inspection, auscultation, percussion, palpation
b. Inspection, percussion, palpation, auscultation
c. Inspection, percussion, auscultation, palpation
d. Inspection, palpation, percussion, auscultation
75. Which of the following acid base imbalances would the nurse anticipate developing in a client with a nasogastric
tube inserted connected to a drainage bottle for decompression?
a. Respiratory acidosis c. Metabolic acidosis
b. Respiratory alkalosis d. Metabolic alkalosis
76. The nurse is performing an assessment on a client with acute pancreatitis who was admitted to the hospital.
Which of the following assessment questions most specifically would elicit information regarding the pain that is
associated with acute pancreatitis?
a. Does the pain in your lower abdomen radiate to your groin?
b. Does the pain in your stomach radiate to your back?
c. Does the pain in your stomach radiate to your lower middle abdomen?
d. Does the pain in your abdomen radiate to the hip?
77. A nurse is assigned to care for a client with a Sengstaken-Blakemore tube. The nurse would suspect that the
client has diagnosis of?
a. Gastritis c. Gastroesopheal reflux disorder
b. Esophageal varices d. Bowel obstruction
78. A nurse has been caring for a client with Sengstaken-Blakemore tube. The physician arrives and deflates the
tube. The nurse would monitor the client closely for which of the ff?
a. Swelling of the abdomen c. Hematemesis
b. Bloody diarrhea d. An elevated temperature
79. A client has a large, deep duodenal ulcer diagnosed by endoscopy. The nurse assesses this client most carefully
for which of the ff signs and symptoms?
a. Nausea and vomiting
b. Sudden severe pain in the midepigastric region
c. Bradycardia
d. Numbness in the legs
80. A nurse is assisting a client with Crohn’s disease to ambulate in the bathroom when the client has finished having
a bowel movement, the nurse assesses the stool for which of the ff expected characteristics?
a. Dry, hard stool c. Loose watery stool
b. Chalky gray stool d. Blood in the stool
81. A nurse is assessing a client with a duodenal ulcer. The nurse interprets that which of the ff symptoms displayed
by a client is most consistent with the typical presentation of duodenal ulcer?
a. Nausea and vomiting c. Pain relieved by food intake
b. Weight loss d. Food that intensifies by food intake
82. A nurse is preparing to care for a client with Sengstaken-Blakemore tube inserted. The nurse gathers supplies,
knowing that which of the ff items must be kept at the bedside at all times?
a. An irrigation set c. Kelly clamp
b. Scissors d. Obturator
83. A nurse is caring for a client with a diagnosis of chronic gastritis. The nurse monitors the client, knowing that this
client is at risk for which of the ff vitamin deficiency?
a. Vit B2 c. Vit B 6
b. Vit B12 d. Vit B1
84. The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the
client, indicate the best understanding of the medication therapy?
a. The cimitidine will coat my stomach
b. Omeprazole will change the fluid in my stomach
c. Antacids will cause me to produce less acids
d. Sucralfate will coat the ulcer and help it heal
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85. The client with peptic ulcer disease is scheduled for pyloroplasty. The client asks the nurse about the procedure.
The nurse plans to respond knowing that pyloroplasty involves?
a. Cutting the vagus nerve
b. Removing the distal portion of the stomach
c. Removing the ulcer and a large portion of the cells that produce hydrochloric acid
d. An incision and resuturing of the pylorus to relax the muscle.
86. A client is scheduled for vagotomy. The client asks the nurse about the purpose of this procedure. The nurse tells
that
a. Decrease food absorption in the stomach c. Halts stress reactions
b. Heals the gastric mucosa d. Reduces the stimulus for acid secretion
87. The client with hiatal hernia experiences heartburn ff meals. The nurse would plan to teach the client to avoid
which of the ff, which is contraindicated with hiatal hernia?
a. Taking in small, frequent meals c. Raising the head of bed on 6-inch block
b. Lying recumbent following meals d. Taking anti H2 receptor medication
88. The nurse s doing preoperative teaching with a client who is about to undergo a creation of Kock pouch. The
nurse interprets that the client has the best understanding of the nature of the surgery if the client makes which
of the ff statement?
a. I will need to drain the pouch regularly with a catheter
b. I will need to wear a drainage bag for the rest of my life
c. The drainage from this type of ostomy is formed
d. I will be able to pass stool by the rectum eventually
89. The nurse would assess the client experiencing an acute episode of cholecystitis for pain is located in the
a. Right upper quadrant and radiates to the left scapula and shoulder
b. Right upper quadrant and radiates to the right scapula and shoulder
c. Left upper quadrant and radiates to the left scapula and shoulder
d. Left upper quadrant and radiates to the right scapula and shoulder
90. A client with celiac disease asks the nurse on what foods are allowed in his diet. The nurse is correct when he
states

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 a. Barley c. Rice
b. Oats d. Wheat

Prelim and Midterm Concept

91. A nurse is sending and ABG specimen to the laboratory for analysis. Which information is not indicated on the
laboratory requisition?
a. The date and time the specimen was drawn
b. A list of allergies
c. Any supplemental oxygen that the client is receiving
d. Ventilator setting
92. A client with no history of cardiovascular disease comes to ambulatory clinic with flu like symptoms. The
client suddenly complains of chest pain. Which of the following questions would best help the nurse to
discriminate pain caused by a non cardiac problem?
a. Have you ever had this pain before?
b. Can you describe the pain to me?
c. Does the pain get worse when you breathe in?
d. Can you rate the pain to me from 1-10?
93. It is part of the conduction system of the heart. It initiates each heart beat.

a. Left ventricle c. Bundle of his

b. Sinoatrial node d. Atrioventricular node

94. A nurse is caring for a client with a diagnosis of a deep vein thrombosis who is receiving a continuous
intravenous infusion of heparin sodium. Which of the ff lab results will the nurse specifically review to
determine if an effective and appropriate dose of the heparin is being delivered?
a. Prothrombin time
b. International normalized ratio
c. Activated partial thromboplastin time
d. Platelet count
95. A nursing student is preparing to perform cardiovascular assessment on a client. A nursing instructor asks the
student about the procedure to elicit Homan’s sign. Which response of the nursing student would indicate an
understanding of this assessment technique?
a. “I will ask the woman to raise the legs up to the waist and then lower the legs slowly.”
b. “I will ask the woman to extend her legs flat on the bed, and I will grasp the foot and gently dorsiflex it.”
c. “I will ask the woman to extend the legs flat on the bed, and I will grasp the foot and sharply extend it.”
d. “I will ask the woman to raise the legs and to try to lower them against pressure from my hand.”
96. A nurse is preparing for the admission of heart failure client who is being sent directly to the hospital from
the physician’s clinic. The nurse would plan on having which of the ff medications readily available for use?

a. Diltiazem (cardizem) c. Propanolol (inderal)

b. Digoxin (lanoxin) d. Metoprolol (lopressor)

97. The nurse is providing instructions to a client with diagnosis of hypertension regarding items to avoid that are
high in sodium. The nurse instructs the client to avoid…

a. Cantaloupe c. Mineral water

b. Broccoli d. Bananas

98. The nurse in the medical unit is reviewing the lab results of a client who has been transferred to the intensive
care unit. The nurse notes that a cardiac troponin T level was drawn on the client while in the intensive care
unit. The nurse determines that this test was performed to assist in diagnosing which of the ff conditions?

a. Myocardial infarction c. Ventricular tachycardia

b. Congestive heart failure d. Atrial fibrillation

99. The clinic nurse is reviewing the assessment findings of a client who has been taking spironolactone
(aldactone) as a treatment for hypertension. Which of the ff if noted in the clients record would indicate that
the client is experiencing side effect related to the medication?

a. A potassium level of 3.2 mEq/L b. A potassium level of 5.8 mEq/L

 c. Client complains of constipation d. Client complains of dry skin

100. A client is admitted to the hospital with a suspected diagnosis of MI. the nurse is reviewing the lab
results performed on the client. Which of the ff lab results would indicate the presence of MI?

a. Increased creatinine kinase MB c. Increased blood urea nitrogen

b. Increased creatinine kinase MM d. Decreased white blood cell count

101. A nurse is caring for a client with a diagnosis of MI. The client calls the nurse because the client is,
experiencing chest pain. The nurse administers nitroglycerin tablet as prescribed. The chest pain is unrelieved
by nitroglycerin. The next nursing action is which of the ff?
a. Administer another nitroglycerin tablet.
b. Increase the flow rate of the oxygen
c. Contact the doctor
d. Call the client’s family
102. A nurse is caring for a client with a diagnosis of MI and is assisting the client in completing the diet
menu. Which of the ff beverages would the nurse instruct the client to select from the menu?

a. Coffee c. Lemonade
b. Tea d. Cola

103. The following are nursing diagnoses for the client with left sided heart failure except:
a. Impaired gas exchange c. Decreased tissue perfusion
b. Decreased cardiac output d. Fluid volume deficit
104. Which of the following is not a characteristics of chest pain in MI
a. it is describe as crushing c. the pain is relieved by rest
b. the pain radiates to one or both arms d. the pain is prolonged
105. A client is schedules for cardiac catheterization using a dye which of the following assessments is the
most critical before the procedure?
a. Intake and output c. Height and weight
b. Baseline peripheral pulses d. Allergy to iodine or shellfish
106. A patient with diabetes mellitus has a blood glucose level of 640 mg/dl. The nurse interprets that this
patient is most at risk of developing which type of acid-base imbalance?
a. Respiratory Acidosis c. Metabolic Acidosis
b. Respiratory Alkalosis d. Metabolic Alkalosis
107. A nurse caring for a patient with late stage of salicylate poisoning who is experiencing metabolic
acidosis, reviews the result of the patient’s blood chemistry profile. The nurse anticipates that which
laboratory value is related to the patient acid-base disturbance?

a. Sodium: 145 meg/L c. Potassium: 5.2 meg/L

b. Magnesium: 2.0 meg/L d. Phosphorus : 2.3 meg/L

108. A 1000 ml intravenous (IV) solution of normal saline 0.9% is prescribed for the patient. The nurse
understands that this type of IV solution.
a. Is isotonic with the plasma and other body fluids
b. Is hypertonic with the plasma and other body fluids
c. Affects the plasma osmolarity.
d. Is the same solution as sodium chloride 0.45%
109. A patient who has fallen from a ladder fractured three ribs has arterial blood gas (ABG) results of ph
7.38, PCO2 38 mmHg PO2 86 mmHg. The nurse interprets that the patients ABG’s indicate which of the
following?

a. Normal results c. Metabolic Acidosis

b. Metabolic Alkalosis d. Respiratory Acidosis

110. A patient with late – stage of Chronic Obstructive Pulmonary Disease (COPD) is admitted to the
hospital with acute exacerbation. Which of the following blood gas results would the nurse most likely expect
to note?

a. PO2 of 68 and PCO2 0f 40 c. PO2 of 70 and PCO2 Of 50

b. PO2 of 55 and PCO2 of 40 d. PO2 of 60 and PCO2 of 50
111. A nurse provides dietary instructions to the patient receiving aldactone. Which food item would the
nurse instruct the client to avoid while taking this medication?

a. Crackers c. Bananas
b. Shrimp d. Popcorn

112. A nurse is conducting dietary teaching with a patient who is hypocalcemic. The nurse encourages the
patient to increase intake of which of the ff foods?

a. Apples c. Cheese
b. Chiken Breast d. Cooked Pasta

113. A patient is diagnosed with hyperphosphatemia. The nurse encourages the client to limit intake of
which item that will aggravate the condition?

a. Bananas c. Coffee
b. Grapes d. Carbonated Beverages

114. A nurse is reviewing the client’s arterial blood gas ( ABG ) results Which finding would indicate that
the client has respiratory acidosis ?
a. Ph 7.5, PCO2 30 c. Ph 7.3,PC02 19
b. Ph7.3, PCO2 50 d. Ph 7.5,PCO2 30

115. A nurse evaluates the arterial blood gas ( ABG ) results of a client who is receiving supplemental
oxygen. Which finding would indicate that the O2 level was adequate?

a. PO2 of 80 mmHg c. Po2 of 50 mmHg

b. PO2 of 60 mmHg d. PO2 of 45 mmHg

116. A nurse is assigned to care for a group of clients. On review of the clients medical records, the nurse
determines that which patient is at risk for fluid volume excess?
a. The client with renal failure
b. The client with ileostomy
c. The client taking diuretics
d. The client who requires gastrointestinal suctioning

117. When monitoring a client who has respiratory alkalosis, a nurse would expect which of the following
arterial blood gas labels?
a. pH 7.50; pCO2 30 mmHg; pO2 80 mm Hg
b. pH 7.30; pCO2 56 mmHg, pO2 68 mm Hg
c. pH 7.38; pCO2 42 mmHg, pO2 88 mm Hg
d. pH 7.26, pCO2 37 mmHg, pO2 75 mm Hg
118. An Allen’s test should be performed before extracting blood from:
A. carotid artery C. femoral artery
B. radial artery D. brachial artery
119. A clinic nurse has ordered a Mantoux skin test to a client. The nurse tells the client to return to the
clinic for reading the results in…
a. 24 to 36 hrs c. 36 to 48 hrs
b. 24 to 48 hrs d. 48 to 72 hrs

120. A nursing instructor asks a nursing student to describe the route of transmission of TB. The nursing
instructor concludes that the student understands this route of transmission if the student states that TB is
transmitted by…

a. The airborne route c. The fecal-oral route

b. Blood and body fluids d. Hand to mouth