1.

When planning care for a male client with burns on the upper torso, which nursing
diagnosis should take the highest priority?
A. Ineffective airway clearance related to edema of the respiratory passages
B. Impaired physical mobility related to the disease process
C. Disturbed sleep pattern related to facility environment
D. Risk for infection related to breaks in the skin

2. In a female client with burns on the legs, which nursing intervention helps prevent
contractures?
A. Applying knee splints
B. Elevating the foot of the bed
C. Hyperextending the client’s palms
D. Performing shoulder range-of-motion exercises

3. A male client comes to the physician’s office for treatment of severe sunburn. The nurse
takes this opportunity to discuss the importance of protecting the skin from the sun’s
damaging rays. Which instruction would best prevent skin damage?
A. “Minimize sun exposure from 1 to 4 p.m. when the sun is strongest.”
B. “Use a sunscreen with a sun protection factor of 6 or higher.”
C. “Apply sunscreen even on overcast days.”
D. “When at the beach, sit in the shade to prevent sunburn.”

4. A female client is brought to the emergency department with second- and third-degree
burns on the left arm, left anterior leg, and anterior trunk. Using the Rule of Nines, what is
the total body surface area that has been burned?
A. 18%
B. 27%
C. 30%
D. 36%

5. Which nursing intervention can help a client maintain healthy skin?

A. Keep the client well hydrated.
B. Avoid bathing the client with mild soap.
C. Remove adhesive tape quickly from the skin.
D. Recommend wearing tight-fitting clothes in hot weather.

6. A male client with psoriasis visits the dermatology clinic. When inspecting the affected
areas, the nurse expects to see which type of secondary lesion?
A. Scale
B. Crust
C. Ulcer
D. Scar
7. A female adult client with atopic dermatitis is prescribed a potent topical corticosteroid,
to be covered with an occlusive dressing. To address a potential client problem associated
with this treatment, the nurse formulates the nursing diagnosis of Risk for injury. To
complete the nursing diagnosis statement, the nurse should add which “related-to”
phrase?
A. Related to potential interactions between the topical corticosteroid and other prescribed
drugs
B. Related to vasodilatory effects of the topical corticosteroid
C. Related to percutaneous absorption of the topical corticosteroid
D. Related to topical corticosteroid application to the face, neck, and intertriginous sites

8. A male client is diagnosed with herpes simplex. Which statement about herpes simplex
infection is true?
A. During early pregnancy, herpes simplex infection may cause spontaneous abortion or
premature delivery.
B. Genital herpes simplex lesions are painless, fluid-filled vesicles that ulcerate and heal in 3 to 7
days
C. Herpetic keratoconjunctivitis usually is bilateral and causes systemic symptoms.
D. A client with genital herpes lesions can have sexual contact but must use a condom.

9. A female client with a severe staphylococcal infection is receiving the aminoglycoside

gentamicin sulfate (Garamycin) by the I.V. route. The nurse should assess the client for
which adverse reaction to this drug?
A. Aplastic anemia
B. Ototoxicity
C. Cardiac arrhythmias
D. Seizures

10. A male client is diagnosed with primary herpes genitalis. Which instruction should the
nurse provide?
A. “Apply one applicator of terconazole intravaginally at bedtime for 7 days.”
B. “Apply one applicator of tioconazole intravaginally at bedtime for 7 days.”
C. “Apply acyclovir ointment to the lesions every 3 hours, six times a day for 7 days.”
D. “Apply sulconazole nitrate twice daily by massaging it gently into the lesions.”

11. Nurse Bea plans to administer dexamethasone cream to a client who has dermatitis
over the anterior chest How should the nurse apply this topical agent?
A. With a circular motion, to enhance absorption
B. With an upward motion, to increase blood supply to the affected area
C. In long, even, outward, and downward strokes in the direction of hair growth
D. In long, even, outward, and upward strokes in the direction opposite hair growth

12. Nurse Mary is caring for a wheelchair-bound client. Which piece of equipment
impedes circulation to the area it’s meant to protect?
A. Polyurethane foam mattress
B. Ring or donut
C. Gel flotation pad
D. Water bed

13. Nurse Harry documents the presence of a scab on a client’s deep wound. The nurse
identifies this as which phase of wound healing?
A. Inflammatory
B. Migratory
C. Proliferative
D. Maturation

14. In an industrial accident, a male client that weighs 155 lb (70 kg) sustained full-
thickness burns over 40% of his body. He’s in the burn unit receiving fluid resuscitation.
Which observation shows that the fluid resuscitation is benefiting the client?
A. A urine output consistently above 100 ml/hour
B. A weight gain of 4 lb (2 kg) in 24 hours
C. Body temperature readings all within normal limits
D. An electrocardiogram (ECG) showing no arrhythmias

15. A female client with herpes zoster is prescribed acyclovir (Zovirax), 200 mg P.O. every
4 hours while awake. The nurse should inform the client that this drug may cause:
A. palpitations.
B. dizziness.
C. diarrhea.
D. metallic taste.

16. A female client sees a dermatologist for a skin problem. Later, the nurse reviews the
client’s chart and notes that the chief complaint was intertrigo. This term refers to which
condition?
A. Spontaneously occurring wheals
B. A fungus that enters the skin’s surface, causing infection
C. Inflammation of a hair follicle
D. Irritation of opposing skin surfaces caused by friction

17. A male client who has suffered a cerebrovascular accident (CVA) is too weak to move
on his own. To help the client avoid pressure ulcers, the nurse should:
A. turn him frequently.
B. perform passive range-of-motion (ROM) exercises.
C. reduce the client’s fluid intake.
D. encourage the client to use a footboard.

18. A male client visits the physician’s office for treatment of a skin disorder. As a primary
treatment, the nurse expects the physician to prescribe:
A. an I.V. corticosteroid.
B. an I.V. antibiotic.
C. an oral antibiotic.
D. a topical agent.

19. While in a skilled nursing facility, a male client contracted scabies, which is diagnosed
the day after discharge. The client is living at her daughter’s home, where six other
persons are living. During her visit to the clinic, she asks a staff nurse, “What should my
family do?” The most accurate response from the nurse is:
A. “All family members will need to be treated.”
B. “If someone develops symptoms, tell him to see a physician right away.”
C. “Just be careful not to share linens and towels with family members.”
D. “After you’re treated, family members won’t be at risk for contracting scabies.”

20. When caring for a male client with severe impetigo, the nurse should include which
intervention in the plan of care?
A. Placing mitts on the client’s hands
B. Administering systemic antibiotics as prescribed
C. Applying topical antibiotics as prescribed
D. Continuing to administer antibiotics for 21 days as prescribed

21. A female client with second- and third-degree burns on the arms receives autografts.
Two days later, the nurse finds the client doing arm exercises. The nurse knows that this
client should avoid exercise because it may:
A. dislodge the autografts.
B. increase edema in the arms.
C. increase the amount of scarring.
D. decrease circulation to the fingers.

22. Nurse Tamara discovers scabies when assessing a client who has just been transferred
to the medical-surgical unit from the day surgery unit. To prevent scabies infection in
other clients, the nurse should:
A. wash hands, apply a pediculicide to the client’s scalp, and remove any observable mites.
B. isolate the client’s bed linens until the client is no longer infectious.
C. notify the nurse in the day surgery unit of a potential scabies outbreak.
D. place the client on enteric precautions.

23. Dr. Martinez prescribes an emollient for a client with pruritus of recent onset. The
client asks why the emollient should be applied immediately after a bath or shower. How
should the nurse respond?
A. “This makes the skin feel soft.”
B. “This prevents evaporation of water from the hydrated epidermis.”
C. “This minimizes cracking of the dermis.”
D. “This prevents inflammation of the skin.”
24. Following a full-thickness (third-degree) burn of his left arm, a male client is treated
with artificial skin. The client understands postoperative care of artificial skin when he
states that during the first 7 days after the procedure, he will restrict:
A. range of motion.
B. protein intake.
C. going outdoors.
D. fluid ingestion.

25. A male client with a solar burn of the chest, back, face, and arms is seen in urgent care.
The nurse’s primary concern should be:
A. fluid resuscitation.
B. infection.
C. body image.
D. pain management.

26. The nurse is providing home care instructions to a client who has recently had a skin
graft. It’s most important that the client remember to:
A. use cosmetic camouflage techniques.
B. protect the graft from direct sunlight.
C. continue physical therapy.
D. apply lubricating lotion to the graft site.

27. A male client is diagnosed with gonorrhea. When teaching the client about this
disease, the nurse should include which instruction?
A. “Avoid sexual intercourse until you’ve completed treatment, which takes 14 to 21 days.”
B. “Wash your hands thoroughly to avoid transferring the infection to your eyes.”
C. “If you have intercourse before treatment ends, tell sexual partners of your status and have
them wash well after intercourse.”
D. “If you don’t get treatment, you may develop meningitis and suffer widespread
central nervous system (CNS) damage.”

28. A female client with atopic dermatitis is prescribed medication for

photochemotherapy. The nurse teaches the client about the importance of protecting the
skin from ultraviolet light before drug administration and for 8 hours afterward and
stresses the need to protect the eyes. After administering medication for
photochemotherapy, the client must protect the eyes for:
A. 4 hours.
B. 8 hours.
C. 24 hours.
D. 48 hours.

29. A female client with genital herpes simplex is being treated in the outpatient
department. The nurse teaches her about measures that may prevent herpes recurrences
and emphasizes the need for prompt treatment if complications arise. Genital herpes
simplex increases the risk of:
A. cancer of the ovaries.
B. cancer of the uterus.
C. cancer of the cervix.
D. cancer of the vagina.

30. Which of the following is the initial intervention for a male client with
external bleeding?
A. Elevation of the extremity
B. Pressure point control
C. Direct pressure
D. Application of a tourniquet

31. Nurse JV is performing wound care. Which of the following practices violates surgical
asepsis?
A. Holding sterile objects above the waist
B. Considering a 1″ edge around the sterile field as being contaminated
C. Pouring solution onto a sterile field cloth
D. Opening the outermost flap of a sterile package away from the body

32. During the acute phase of a burn, the nurse in-charge should assess which of the
following?
A. Client’s lifestyle
B. Alcohol use
C. Tobacco use
D. Circulatory status

33. Nurse Catherine is changing a dressing and providing wound care. Which activity
should she perform first?
A. Assess the drainage in the dressing.
B. Slowly remove the soiled dressing
C. Wash hands thoroughly.
D. Put on latex gloves.

34. Nurse Melinda is caring for an elderly bedridden adult. To prevent pressure ulcers,
which intervention should the nurse include in the plan of care?
A. Turn and reposition the client at least once every 8 hours.
B. Vigorously massage lotion into bony prominences.
C. Post a turning schedule at the client’s bedside.
D. Slide the client, rather than lifting, when turning.
35. Nurse Jody formulates a nursing diagnosis of Impaired physical mobility for a client
with third-degree burns on the lower portions of both legs. To complete the nursing
diagnosis statement, the nurse should add which “related-to” phrase?
A. Related to fat emboli
B. Related to infection
C. Related to femoral artery occlusion
D. Related to circumferential eschar

36. The nurse is assessing for the presence of cyanosis in a male dark-skinned client. The
nurse understands that which body area would provide the best assessment?
A. Lips
B. Sacrum
C. Earlobes
D. Back of the hands

37. Which of the following individuals is least likely to be at risk of developing psoriasis?
A. A 32 year-old-African American
B. A woman experiencing menopause
C. A client with a family history of the disorder
D. An individual who has experienced a significant amount of emotional distress

38. Which of the following clients would least likely be at risk of developing skin
breakdown?
A. A client incontinent of urine feces
B. A client with chronic nutritional deficiencies
C. A client with decreased sensory perception
D. A client who is unable to move about and is confined to bed

39. The nurse prepares to care for a male client with acute cellulites of the lower leg. The
nurse anticipates that which of the following will be prescribed for the client?
A. Cold compress to the affected area
B. Warm compress to the affected area
C. Intermittent heat lamp treatments four times daily
D. Alternating hot and cold compresses continuously

40. The clinic nurse is assessing the skin of a white client who is diagnosed with psoriasis.
Which of the following characteristic is associated with this skin disorder?
A. Clear, thin nail beds
B. Red-purplish scaly lesions
C. Oily skin and no episodes of pruritus
D. Silvery-white scaly patches on the scalp, elbow, knees, and sacral regions

41. The clinic nurse notes that the physician has documented a diagnosis of herpes zoster
(shingles) in the male client’s chart. Based on an understanding of the cause of this
disorder, the nurse determines that this definitive diagnosis was made following
which diagnostic test?
A. Patch test
B. Skin biopsy
C. Culture of the lesion
D. Woo’s light examination

42. The nurse is assigned to care for a female client with herpes zoster (Shingles). Which
of the following characteristics would the nurse expect to note when assessing the lesions
of this infection?
A. Clustered skin vesicles
B. A generalized body rash
C. Small blue-white spots with a red base
D. A fiery red, edematous rash on the cheeks

43. When assessing a lesion diagnosed as malignant melanoma, the nurse in-charge most
likely expects to note which of the following?
A. An irregular shaped lesion
B. A small papule with a dry, rough scale
C. A firm, nodular lesion topped with crust
D. A pearly papule with a central crater and a waxy border

44. The nurse prepares discharge instructions for a male client following cryosurgery for
the treatment of a malignant skin lesion. Which of the following should the nurse include
in the instruction?
A. Avoid showering for 7 to 10 days
B. Apply ice to the site to prevent discomfort
C. Apply alcohol-soaked dressing twice a day
D. Clean the site with hydrogen peroxide to prevent infection

45. Nurse Kevin reviews the client’s chart and notes that the physician has documented a
diagnosis of paronychia. Based on this diagnosis, which of the following would the nurse
expect to note during the assessment?
A. Red shiny skin around the nail bed
B. White taut skin in the popliteal area
C. White silvery patches on the elbows
D. Swelling of the skin near the parotid gland

46. A male client arrives at the emergency room and has experienced frostbites to the
right hand. Which of the following would the nurse note on assessment of the client’s
hand?
A. A pink, edematous hand
B. A fiery red skin with edema in the nail beds
C. Black fingertips surrounded by an erythematous rash
D. A white color to the skin, which is insensitive to touch

47. The evening nurse reviews the nursing documentation in the male client’s chart and
notes that the day nurse has documented that the client has a stage II pressure ulcer in the
sacral area. Which of the following would the nurse expect to note on assessment of the
client’s sacral area?
A. Intact skin
B. Full-thickness skin loss
C. Exposed bone, tendon, or muscle
D. Partial-thickness skin loss of the dermis

48. Nurse Imee is implementing a teaching plan to a group of adolescents regarding the
causes of acne. Which of the following is an appropriate nursing statement regarding the
cause of this disorder?
A. “Acne is caused by oily skin”
B. “The actual cause is not known”
C. “Acne is caused by eating chocolate”
D. “Acne is caused as a result of exposure to heat and humidity”

49. The nurse is reviewing the healthcare record of a male clients scheduled to be seen at
the health care clinic. The nurse determines that which of the following individuals is at
the greatest risk for development of an integumentary disorder?
A. An adolescent
B. An older female
C. A physical education teacher
D. An outdoor construction worker

50. A male client schedule for a skin biopsy is concerned and asks the nurse how painful
the procedure is. The appropriate response by the nurse is:
A. “There is no pain associated with this procedure”
B. “The local anesthetic may cause a burning or stinging sensation”
C. A preoperative medication will be given so you will be sleeping and will not feel any pain”
D. “There is some pain, but the physician will prescribe an opioid analgesic following the
procedure”

51. The nurse is teaching a female client with a leg ulcer about tissue repair and wound
healing. Which of the following statements by the client indicates effective teaching?
A. “I’ll limit my intake of protein.”
B. “I’ll make sure that the bandage is wrapped tightly.”
C. “My foot should feel cold.”
D. “I’ll eat plenty of fruits and vegetables.”
52. Following a full-thickness (third-degree) burn of his left arm, a male client is treated
with artificial skin. The client understands postoperative care of artificial skin when he
states that during the first 7 days after the procedure, he will restrict:
A. range of motion.
B. protein intake.
C. going outdoors.
D. fluid ingestion.

53. Following a small-bowel resection, a male client develops fever and anemia. The
surface surrounding the surgical wound is warm to the touch and necrotizing fasciitis is
suspected. Another manifestation that would most suggest necrotizing fasciitis is:
A. erythema.
B. leukocytosis.
C. pressure-like pain.
D. swelling.

54. While in a skilled nursing facility, a female client contracted scabies, which is
diagnosed the day after discharge. The client is living at her daughter’s home, where six
other persons are living. During her visit to the clinic, she asks a staff nurse, “What should
my family do?” The most accurate response from the nurse is:
A. “All family members will need to be treated.”
B. “If someone develops symptoms, tell him to see a physician right away.”
C. “Just be careful not to share linens and towels with family members.”
D. “After you’re treated, family members won’t be at risk for contracting scabies.”

55. The nurse is assessing a male client admitted with second- and third-degree burns on
the face, arms, and chest. Which finding indicates a potential problem?
A. Partial pressure of arterial oxygen (PaO2) value of 80 mm Hg
B. Urine output of 20 ml/hour
C. White pulmonary secretions
D. Rectal temperature of 100.6° F (38° C)

56. A female client exhibits s purplish bruise to the skin after a fall. The nurse would
document this finding most accurately using which of the following terms?
A. Purpura
B. Petechiae
C. Ecchymosis
D. Erythema

57. An older client’s physical examination reveals the presence of a number of bright red-
colored lesions scattered on the trunk and tights. The nurse interprets that this indicates
which of the following lesions due to alterations in blood vessels of the skin?
A. Cherry angioma
B. Spider angioma
C. Venous star
D. Purpura

58. A nurse is reviewing the medical record of a male client to be admitted to the nursing
unit and notes documentation of reticular skin lesions. The nurse expects that these
lesions will appear to be:
A. Ring-shaped
B. Linear
C. Shaped like an arc
D. Net-like appearance

59. A male client seen in an ambulatory clinic has a butterfly rash across the nose. The
nurse interprets that this finding is consistent with early manifestations of which of the
following disorders?
A. Hyperthyroidism
B. Pernicious anemia
C. Cardiopulmonary disorders
D. Systemic lupus erythematosus (SLE)

60. A female client with cellulites of the lower leg has had cultures done on the affected
area. The nurse reading the culture report understands that which of the following
organisms is not part of the normal flora of the skin?
A. Staphylococcus epidermidis
B. Staphylococcus aureus
C. Escherichia coli (E. coli)
D. Candida albicans

1. JT being the charge nurse for today is providing orientation to Nurse Brad, a newly
hired employee. Which of the following action by Nurse Brad requires the most
immediate action?
A. Educating a newly admitted burn client regarding the use of pressure garments.
B. Obtaining an anaerobic culture specimen from a superficial burn wound.
C. Administering tetracycline with a glass of milk to a client with cellulitis.
D. Discussing the use of herpes zoster vaccine with a 20-year-old client.

2. Nurse Sierra is assessing the skin of a client suffering from psoriasis. She understands
that which characteristic is associated with this skin disorder?
A. Red-purplish scaly lesions.
B. Silvery-white scaly patches on the scalp, elbows, knees, and sacral regions.
C. Clear, thin nail beds.
D. Oily skin and absence of pruritus.
3. The client arrives at the emergency department and has experienced frostbite to the
right hand. Which of the following would the nurse note on assessment of the client’s
hand?
A. A white color to the skin, which is insensitive to touch.
B. A pink, edematous hand.
C. A fiery red skin with edema in the nail beds.
D. Black fingertips surrounded by an erythematous rash.

4. Which assessment finding calls for the most immediate further assessment or
interventions?
A. Bilateral erythema of the face and neck.
B. Bluish color around the earlobes and lips.
C. Dark brown spotting on the back and chest.
D. Yellow color of the skin and sclera.

5. Nurse Keith is conducting a session about the principles of first aid and is discussing the
interventions for a snakebite to an extremity. He should inform those attending the
session that the first priority intervention in the event of this occurrence is which of the
following?
A. Remove jewelry and constricting clothing from the victim.
B. Move the victim to a safe area away from the snake and encourage the victim to rest.
C. Immobilize the affected extremity.
D. Place the extremity in a position so that it is below the level of the heart.

6. The clinic nurse notes that the physician has documented a diagnosis of herpes zoster
(shingles) in the client’s chart. Based on an understanding of the cause of this disorder,
the nurse determines that this definitive diagnosis was made following which diagnostic
test?
A. Wood’s light examination.
B. Patch test.
C. Skin biopsy.
D. Culture of the lesion.

7. Nurse Luis is caring for a client who has just had a squamous cell carcinoma removed
from the face. Which activities can you delegate to an experienced nursing LPN/LVN?
A. Monitoring the surgical site for swelling, bleeding or pain.
B. Teaching the client about risk factors for squamous cell carcinoma.
C. Discussing the reasons for avoiding aspirin use for a week after surgery.
D. Showing the client how to take care for the surgical site at home.

8. When assessing a lesion diagnosed as malignant melanoma, the nurse most likely
expects to note which of the following?
A. A firm, nodular lesion topped with crust.
B. A pearly papule with a central crater and a waxy border.
C. An irregularly shaped lesion.
D. A small papule with a dry, rough scale.

9. Nurse Chael is performing a skin assessment on a new resident in a long-term care

facility. Which finding is of most concern?
A. All the toenails are thickened and yellow.
B. Silver scaling is present on the elbows and knees.
C. An irregular border is seen on a black mole on the scalp.
D. Numerous striae are noted across the abdomen and buttocks.

10. A client calls the emergency department and tells the nurse that he had been cleaning
a wooden area in the backyard and came directly into contact with poison ivy shrubs. The
client tells the nurse that he cannot see anything on the skin and ask the nurse what to do.
Which of the following is the appropriate nursing response?
A. “Apply calamine lotion immediately to the exposed skin areas.”
B. “It is not necessary to do anything if you cannot see anything on your skin.”
C. “Come to the emergency department.”
D. “Take a shower immediately, lathering, and rinsing several times.”

11. A client returns to the clinic for follow-up treatment following a skin biopsy of a
suspicious lesion performed one (1) week ago. The biopsy report indicates that the lesion
is a melanoma. The nurse understands that which of the following describes a
characteristic of this type of a lesion?
A. Melanoma is characterized by local invasion.
B. Melanoma is highly metastatic.
C. Metastasis is rare.
D. Melanoma is encapsulated.

12. A 30-year old woman who has been taking isotretinoin (Accutane) to treat severe
cystic acne make all these statements while being seen for a follow-up examination.
Which statement is of most concern?
A. “Sometimes I get nauseated after taking the medication.”
B. “My husband and I are thinking of starting a family soon.”
C. “I have been having problems driving when it gets dark.”
D. “I don’t think there has been much improvement in my skin.”

13. A client has been taking prednisone (Deltasone) 20 mg once a day to treat severe
seborrheic dermatitis. Which of the following assessment findings is of most concern?
A. Complaints of epigastric pain.
B. Blood pressure 145/90 mm Hg.
C. Blood glucose level 129 mg/dL.
D. Complaints of increase appetite.
14. A client is being admitted for the treatment of acute cellulitis of the thigh. The client
asks the admitting nurse to explain what cellulitis means. The nurse bases the response on
the understanding that the characteristics of cellulitis include:
A. An epidermal and lymphatic infection caused by Staphylococcus.
B. An inflammation of the epidermis only.
C. A skin infection into the subcutaneous tissue and dermis.
D. An acute superficial infection of the lymphatics and dermis.

15. The nurse manager is planning the clinical assignments for the day. Which staff
members can be assigned to care for a client with herpes zoster? Select all that apply
A. The nurse who never had German Measles.
B. The nurse who never received the varicella zoster vaccine.
C. The nurse who never had mumps.
D. The nurse who never had roseola.
E. The nurse who never had chicken pox.

16. A female client went to the emergency department states that she is having burning
and intense itching on the skin. A further assessment made by the nurse notes that the
client is having red and white patches in the mouth. Based on this, the nurse understand
that the client is most likely is suffering from?
A. Shingles.
B. Erysipelas.
C. Eczema.
D. Candida Albicans.

17. A nurse is developing a care plan for a client suffering from shingles. Which of the
following cranial nerve should the nurse assess as part of the client’s care?
A. Cranial nerve number I
B. Cranial nerve number IV
C. Cranial nerve number VII
D. Cranial nerve number XI

18. Nurse Jeff is performing skin assessment on a client with a facial lesion. It appears as a
well-defined, red, scaling, thickened bump. This type of skin lesion refers to?
A. Kaposi’s Sarcoma.
B. Melanoma.
C. Squamous cell.
D. Basal cell.

19. The nurse is teaching a female client with a leg ulcer about tissue repair and wound
healing. Which of the following statements by the client indicates effective teaching?
A. “To make the bandage tightly wrapped .”
B. “My foot should feel cold.”
C. “I’ll include fruits and vegetables in my meal plan.”
D. “I’ll restrict my intake of protein.”

20. A client with a severe cellulitis on the left hand was ordered to have cultures done on
the affected area. After few days, the culture report was released. The nurse understands
that which of the following organisms is not part of the normal flora of the skin?
A. Staphylococcus aureus.
B. Candida albicans.
C. Campylobacter jejuni.

1. Which of the following arteries primarily feeds the anterior wall of the heart?
A. Circumflex artery
B. Internal mammary artery
C. Left anterior descending artery
D. Right coronary artery

2. When do coronary arteries primarily receive blood flow?

A. During inspiration
B. During diastole
C. During expiration
D. During systole

3. Which of the following illnesses is the leading cause of death in the US?
A. Cancer
B. Coronary artery disease
C. Liver failure
D. Renal failure

4. Which of the following conditions most commonly results in CAD?

A. Atherosclerosis
B. DM
C. MI
D. Renal failure

5. Atherosclerosis impedes coronary blood flow by which of the following mechanisms?

A. Plaques obstruct the vein
B. Plaques obstruct the artery
C. Blood clots form outside the vessel wall
D. Hardened vessels dilate to allow the blood to flow through

6. Which of the following risk factors for coronary artery disease cannot be corrected?
A. Cigarette smoking
B. DM
C. Heredity
D. HPN

7. Exceeding which of the following serum cholesterol levels significantly increases the
risk of coronary artery disease?
A. 100 mg/dl
B. 150 mg/dl
C. 175 mg/dl
D. 200 mg/dl

8. Which of the following actions is the first priority care for a client exhibiting signs and
symptoms of coronary artery disease?
A. Decrease anxiety
B. Enhance myocardial oxygenation
C. Administer sublingual nitroglycerin
D. Educate the client about his symptoms

9. Medical treatment of coronary artery disease includes which of the following

procedures?
A. Cardiac catheterization
B. Coronary artery bypass surgery
C. Oral medication administration
D. Percutaneous transluminal coronary angioplasty

10. Prolonged occlusion of the right coronary artery produces an infarction in which of
the following areas of the heart?
A. Anterior
B. Apical
C. Inferior
D. Lateral

11. Which of the following is the most common symptom of myocardial infarction?
A. Chest pain
B. Dyspnea
C. Edema
D. Palpitations

12. Which of the following landmarks is the correct one for obtaining an apical pulse?
A. Left intercostal space, midaxillary line
B. Left fifth intercostal space, midclavicular line
C. Left second intercostal space, midclavicular line
D. Left seventh intercostal space, midclavicular line
13. Which of the following systems is the most likely origin of pain the client describes as
knifelike chest pain that increases in intensity with inspiration?
A. Cardiac
B. Gastrointestinal
C. Musculoskeletal
D. Pulmonary

14. A murmur is heard at the second left intercostal space along the left sternal border.
Which valve area is this?
A. Aortic
B. Mitral
C. Pulmonic
D. Tricuspid

15. Which of the following blood tests is most indicative of cardiac damage?
A. Lactate dehydrogenase
B. Complete blood count
C. Troponin I
D. Creatine kinase

16. What is the primary reason for administering morphine to a client with myocardial
infarction?
A. To sedate the client
B. To decrease the client’s pain
C. To decrease the client’s anxiety
D. To decrease oxygen demand on the client’s heart

17. Which of the following conditions is most commonly responsible for myocardial
infarction?
A. Aneurysm
B. Heart failure
C. Coronary artery thrombosis
D. Renal failure

18. What supplemental medication is most frequently ordered in conjuction with

furosemide (Lasix)?
A. Chloride
B. Digoxin
C. Potassium
D. Sodium

19. After myocardial infarction, serum glucose levels and free fatty acids are both
increased. What type of physiologic changes are these?
A. Electrophysiologic
B. Hematologic
C. Mechanical
D. Metabolic

20. Which of the following complications is indicated by a third heart sound (S3)?
A. Ventricular dilation
B. Systemic hypertension
C. Aortic valve malfunction
D. Increased atrial contractions

21. After an anterior wall myocardial infarction, which of the following problems is
indicated by auscultation of crackles in the lungs?
A. Left-sided heart failure
B. Pulmonic valve malfunction
C. Right-sided heart failure
D. Tricuspid valve malfunction

22. Which of the following diagnostic tools is most commonly used to determine the
location of myocardial damage?
A. Cardiac catheterization
B. Cardiac enzymes
C. Echocardiogram
D. Electrocardiogram

23. What is the first intervention for a client experiencing myocardial infarction?
A. Administer morphine
B. Administer oxygen
C. Administer sublingual nitroglycerin
D. Obtain an electrocardiogram

24. What is the most appropriate nursing response to a myocardial infarction client who is
fearful of dying?
A. “Tell me about your feeling right now.”
B. “When the doctor arrives, everything will be fine.”
C. “This is a bad situation, but you’ll feel better soon.”
D. “Please be assured we’re doing everything we can to make you feel better.”

25. Which of the following classes of medications protects the ischemic myocardium by
blocking catecholamines and sympathetic nerve stimulation?
A. Beta-adrenergic blockers
B. Calcium channel blockers
C. Narcotics
D. Nitrates
26. What is the most common complication of a myocardial infarction?
A. Cardiogenic shock
B. Heart failure
C. Arrhythmias
D. Pericarditis

27. With which of the following disorders is jugular vein distention most prominent?
A. Abdominal aortic aneurysm
B. Heart failure
C. Myocardial infarction
D. Pneumothorax

28. What position should the nurse place the head of the bed in to obtain the most
accurate reading of jugular vein distention?
A. High-Fowler’s
B. Raised 10 degrees
C. Raised 30 degrees
D. Supine position

29. Which of the following parameters should be checked before administering digoxin?
A. Apical pulse
B. Blood pressure
C. Radial pulse
D. Respiratory rate

30. Toxicity from which of the following medications may cause a client to see a green
halo around lights?
A. Digoxin
B. Furosemide
C. Metoprolol
D. Enalapril

31. Which of the following symptoms is most commonly associated with left-sided heart
failure?
A. Crackles
B. Arrhythmias
C. Hepatic engorgement
D. Hypotension

32. In which of the following disorders would the nurse expect to assess sacral edema in
bedridden client?
A. DM
B. Pulmonary emboli
C. Renal failure
D. Right-sided heart failure

33. Which of the following symptoms might a client with right-sided heart failure exhibit?
A. Adequate urine output
B. Polyuria
C. Oliguria
D. Polydipsia

34. Which of the following classes of medications maximizes cardiac performance in

clients with heart failure by increasing ventricular contractility?
A. Beta-adrenergic blockers
B. Calcium channel blockers
C. Diuretics
D. Inotropic agents

35. Stimulation of the sympathetic nervous system produces which of the following
responses?
A. Bradycardia
B. Tachycardia
C. Hypotension
D. Decreased myocardial contractility

36. Which of the following conditions is most closely associated with weight gain, nausea,
and a decrease in urine output?
A. Angina pectoris
B. Cardiomyopathy
C. Left-sided heart failure
D. Right-sided heart failure

37. What is the most common cause of abdominal aortic aneurysm?

A. Atherosclerosis
B. DM
C. HPN
D. Syphilis

38. In which of the following areas is an abdominal aortic aneurysm most commonly
located?
A. Distal to the iliac arteries
B. Distal to the renal arteries
C. Adjacent to the aortic branch
D. Proximal to the renal arteries
39. A pulsating abdominal mass usually indicates which of the following conditions?
A. Abdominal aortic aneurysm
B. Enlarged spleen
C. Gastric distention
D. Gastritis

40. What is the most common symptom in a client with abdominal aortic aneurysm?
A. Abdominal pain
B. Diaphoresis
C. Headache
D. Upper back pain

41. Which of the following symptoms usually signifies rapid expansion and impending
rupture of an abdominal aortic aneurysm?
A. Abdominal pain
B. Absent pedal pulses
C. Angina
D. Lower back pain

42. What is the definitive test used to diagnose an abdominal aortic aneurysm?
A. Abdominal X-ray
B. Arteriogram
C. CT scan
D. Ultrasound

43. Which of the following complications is of greatest concern when caring for a
preoperative abdominal aneurysm client?
A. HPN
B. Aneurysm rupture
C. Cardiac arrhythmias
D. Diminished pedal pulses

44. Which of the following blood vessel layers may be damaged in a client with an
aneurysm?
A. Externa
B. Interna
C. Media
D. Interna and Media

45. When assessing a client for an abdominal aortic aneurysm, which area of the abdomen
is most commonly palpated?
A. Right upper quadrant
B. Directly over the umbilicus
C. Middle lower abdomen to the left of the midline
D. Midline lower abdomen to the right of the midline

46. Which of the following conditions is linked to more than 50% of clients with
abdominal aortic aneurysms?
A. DM
B. HPN
C. PVD
D. Syphilis

47. Which of the following sounds is distinctly heard on auscultation over the abdominal
region of an abdominal aortic aneurysm client?
A. Bruit
B. Crackles
C. Dullness
D. Friction rubs

48. Which of the following groups of symptoms indicated a ruptured abdominal

aneurysm?
A. Lower back pain, increased BP, decreased RBC, increased WBC
B. Severe lower back pain, decreased BP, decreased RBC, increased WBC
C. Severe lower back pain, decreased BP, decreased RBC, decreased WBC
D. Intermittent lower back pain, decreased BP, decreased RBC, increased WBC

49. Which of the following complications of an abdominal aortic repair is indicated by

detection of a hematoma in the perineal area?
A. Hernia
B. Stage 1 pressure ulcer
C. Retroperitoneal rupture at the repair site
D. Rapid expansion of the aneurysm

50. Which hereditary disease is most closely linked to aneurysm?

A. Cystic fibrosis
B. Lupus erythematosus
C. Marfan’s syndrome
D. Myocardial infarction

51. Which of the following treatments is the definitive one for a ruptured aneurysm?
A. Antihypertensive medication administration
B. Aortogram
C. Beta-adrenergic blocker administration
D. Surgical intervention
52. Which of the following heart muscle diseases is unrelated to other cardiovascular
diseases?
A. Cardiomyopathy
B. Coronary artery disease
C. Myocardial infarction
D. Pericardial Effusion

53. Which of the following types of cardiomyopathy can be associated with childbirth?
A. Dilated
B. Hypertrophic
C. Myocarditis
D. Restrictive

54. Septal involvement occurs in which type of cardiomyopathy?

A. Congestive
B. Dilated
C. Hypertrophic
D. Restrictive

55. Which of the following recurring conditions most commonly occurs in clients with
cardiomyopathy?
A. Heart failure
B. DM
C. MI
D. Pericardial effusion

56. What is the term used to describe an enlargement of the heart muscle?
A. Cardiomegaly
B. Cardiomyopathy
C. Myocarditis
D. Pericarditis

57. Dyspnea, cough, expectoration, weakness, and edema are classic signs and symptoms
of which of the following conditions?
A. Pericarditis
B. Hypertension
C. Obliterative
D. Restrictive

58. Which of the following types of cardiomyopathy does not affect cardiac output?
A. Dilated
B. Hypertrophic
C. Restrictive
D. Obliterative
59. Which of the following cardiac conditions does a fourth heart sound (S4) indicate?
A. Dilated aorta
B. Normally functioning heart
C. Decreased myocardial contractility
D. Failure of the ventricle to eject all the blood during systole

60. Which of the following classes of drugs is most widely used in the treatment of
cardiomyopathy?
A. Antihypertensive
B. Beta-adrenergic blockers
C. Calcium channel blockers
D. Nitrates