1. Nurse Brenda is teaching a patient about a newly
Before administering the evening dose of a prescribed
prescribed drug. What could cause a geriatric patient to
have difficulty retaining knowledge about prescribed
medications?
A. Decreased plasma drug levels
B. Sensory deficits
C. Lack of family support
D. History of Tourette syndrome
2. When examining a patient with abdominal pain the
nurse in charge should assess:
A. Any quadrant first
B. The symptomatic quadrant first
C. The symptomatic quadrant last
D. The symptomatic quadrant either second or third
3. The nurse is assessing a postoperative adult patient.
Which of the following should the nurse document as
subjective data?
A. Vital signs
B. Laboratory test result
C. Patient’s description of pain
D. Electrocardiographic (ECG) waveforms
4. A male patient has a soft wrist-safety device. Which
assessment finding should the nurse consider abnormal?
A. A palpable radial pulse
B. A palpable ulnar pulse
C. Cool, pale fingers
D. Pink nail beds
5. Which of the following planes divides the body
longitudinally into anterior and posterior regions?
A. Frontal plane
B. Sagittal plane
C. Midsagittal plane
D. Transverse plane
6. A female patient with a terminal illness is in denial.
Indicators of denial include:
A. Shock dismay
B. Numbness
C. Stoicism
D. Preparatory grief
7. The nurse in charge is transferring a patient from the
bed to a chair. Which action does the nurse take during
this patient transfer?
A. Position the head of the bed flat
B. Helps the patient dangle the legs
C. Stands behind the patient
D. Places the chair facing away from the bed
8. A female patient who speaks a little English has
emergency gallbladder surgery, during discharge
preparation, which nursing action would best help this
patient understand wound care instruction?
A. Asking frequently if the patient understands the
instruction
B. Asking an interpreter to replay the instructions
to the patient.
C. Writing out the instructions and having a family
member read them to the patient
D. Demonstrating the procedure and having the
patient return the demonstration
9.
medication, the nurse on the evening shift finds an
unlabeled, filled syringe in the patient’s medication
drawer. What should the nurse in charge do?
A. Discard the syringe to avoid a medication error
B. Obtain a label for the syringe from the pharmacy
C. Use the syringe because it looks like it contains
the same medication the nurse was prepared to
give
D. Call the day nurse to verify the contents of the
syringe
10. When administering drug therapy to a male geriatric
patient, the nurse must stay especially alert for adverse
effects. Which factor makes geriatric patients to adverse
drug effects?
A. Faster drug clearance
B. Aging-related physiological changes
C. Increased amount of neurons
D. Enhanced blood flow to the GI tract
11. A female patient is being discharged after cataract
surgery. After providing medication teaching, the nurse
asks the patient to repeat the instructions. The nurse is
performing which professional role?
A. Manager
B. Educator
C. Caregiver
D. Patient advocate
12. A female patient exhibits signs of heightened
anxiety. Which response by the nurse is most likely to
reduce the patient’s anxiety?
A. “Everything will be fine. Don’t worry.”
B. “Read this manual and then ask me any
questions you may have.”
C. “Why don’t you listen to the radio?”
D. “Let’s talk about what’s bothering you.”
13. A scrub nurse in the operating room has which
responsibility?
A. Positioning the patient
B. Assisting with gowning and gloving
C. Handling surgical instruments to the surgeon
D. Applying surgical drapes
14. A patient is in the bathroom when the nurse enters to
give a prescribed medication. What should the nurse in
charge do?
A. Leave the medication at the patient’s bedside
B. Tell the patient to be sure to take the medication.
And then leave it at the bedside
C. Return shortly to the patient’s room and remain
there until the patient takes the medication
D. Wait for the patient to return to bed, and then
leave the medication at the bedside
15. The physician orders heparin, 7,500 units, to be
administered subcutaneously every 6 hours. The vial
reads 10,000 units per milliliter. The nurse should
anticipate giving how much heparin for each dose?
A. ¼ ml
B. ½ ml
C. ¾ ml
D. 1 ¼ ml
16. The nurse in charge measures a patient’s temperature
at 102 degrees F. what is the equivalent Centigrade
temperature?
A. 39 degrees C
B. 47 degrees C
C. 38.9 degrees C
D. 40.1 degrees C
17. To evaluate a patient for hypoxia, the physician is
most likely to order which laboratory test?
A. Red blood cell count
B. Sputum culture
C. Total hemoglobin
D. Arterial blood gas (ABG) analysis
18. The nurse uses a stethoscope to auscultate a male
patient’s chest. Which statement about a stethoscope
with a bell and diaphragm is true?
A. The bell detects high-pitched sounds best
B. The diaphragm detects high-pitched sounds best
C. The bell detects thrills best
D. The diaphragm detects low-pitched sounds best
19. A male patient is to be discharged with a prescription
for an analgesic that is a controlled substance. During
discharge teaching, the nurse should explain that the
patient must fill this prescription how soon after the date
on which it was written?
A. Within 1 month
B. Within 3 months
C. Within 6 months
D. Within 12 months
20. Which human element considered by the nurse in
charge during assessment can affect drug
administration?
A. The patient’s ability to recover
B. The patient’s occupational hazards
C. The patient’s socioeconomic status
D. The patient’s cognitive abilities
21. An employer establishes a physical exercise area in
the workplace and encourages all employees to use it.
This is an example of which level of health promotion?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Passive prevention
22. What does the nurse in charge do when making a
surgical bed?
A. Leaves the bed in the high position when
finished
B. Places the pillow at the head of the bed
C. Rolls the patient to the far side of the bed
D. Tucks the top sheet and blanket under the
bottom of the bed
23. The physician prescribes 250 mg of a drug. The drug
vial reads 500 mg/ml. how much of the drug should the
nurse give?
A. 2 ml
B. 1 ml
C. ½ ml
D. ¼ ml
24. Nurse Mackey is monitoring a patient for adverse
reactions during barbiturate therapy. What is the major
disadvantage of barbiturate use?
A. Prolonged half-life
B. Poor absorption
C. Potential for drug dependence
D. Potential for hepatotoxicity
25. Which nursing action is essential when providing
continuous enteral feeding?
A. Elevating the head of the bed
B. Positioning the patient on the left side
C. Warming the formula before administering it
D. Hanging a full day’s worth of formula at one
time
26. When teaching a female patient how to take a
sublingual tablet, the nurse should instruct the patient to
place the table on the:
A. Top of the tongue
B. Roof of the mouth
C. Floor of the mouth
D. Inside of the cheek
27. Which action by the nurse in charge is essential
when cleaning the area around a Jackson-Pratt wound
drain?
A. Cleaning from the center outward in a circular
motion
B. Removing the drain before cleaning the skin
C. Cleaning briskly around the site with alcohol
D. Wearing sterile gloves and a mask
28. The doctor orders dextrose 5% in water, 1,000 ml to
be infused over 8 hours. The I.V. tubing delivers 15
drops per milliliter. The nurse in charge should run the
I.V. infusion at a rate of:
A. 15 drop per minute
B. 21 drop per minute
C. 32 drop per minute
D. 125 drops per minute
29. A male patient undergoes a total abdominal
hysterectomy. When assessing the patient 10 hours later,
the nurse identifies which finding as an early sign of
shock?
A. Restlessness
B. Pale, warm, dry skin
C. Heart rate of 110 beats/minute
D. Urine output of 30 ml/hour
30. Which pulse should the nurse palpate during rapid
assessment of an unconscious male adult?
A. Radial
B. Brachial
C. Femoral
D. Carotid
Answers and Rationales
1. Answer B. Sensory deficits could cause a
geriatric patient to have difficulty retaining
knowledge about prescribed medications.
Decreased plasma drug levels do not alter the
patient’s knowledge about the drug. A lack of
family support may affect compliance, not
knowledge retention. Toilette syndrome is
unrelated to knowledge retention.
2. Answer C. The nurse should systematically
assess all areas of the abdomen, if time and the
patient’s condition permit, concluding with the
symptomatic area. Otherwise, the nurse may
elicit pain in the symptomatic area, causing the
muscles in other areas to tighten. This would
interfere with further assessment.
3. Answer C. Subjective data come directly from
the patient and usually are recorded as direct
quotations that reflect the patient’s opinions or
feelings about a situation. Vital signs, laboratory
test result, and ECG waveforms are examples of
objective data.
4. Answer C. A safety device on the wrist may
impair circulation and restrict blood supply to
body tissues. Therefore, the nurse should assess
the patient for signs of impaired circulation,
such as cool, pale fingers. A palpable radial or
lunar pulse and pink nail beds are normal
findings.
5. Answer A. Frontal or coronal plane runs
longitudinally at a right angle to a sagittal plane
dividing the body in anterior and posterior
regions. A sagittal plane runs longitudinally
dividing the body into right and left regions; if
exactly midline, it is called a midsagittal plane.
A transverse plane runs horizontally at a right
angle to the vertical axis, dividing the structure
into superior and inferior regions.
6. Answer A. Shock and dismay are early signs of
denial-the first stage of grief. The other options
are associated with depression—a later stage of
grief.
7. Answer B. After placing the patient in high
Fowler’s position and moving the patient to the
side of the bed, the nurse helps the patient sit on
the edge of the bed and dangle the legs; the
nurse then faces the patient and places the chair
next to and facing the head of the bed.
8. Answer D. Demonstrating by the nurse with a
return demonstration by the patient ensures that
the patient can perform wound care correctly.
Patients may claim to understand discharge
instruction when they do not. An interpreter of
family member may communicate verbal or
written instructions inaccurately.
9. Answer A.  As a safety precaution, the nurse
should discard an unlabeled syringe that
contains medication. The other options are
considered unsafe because they promote error.
10. Answer B. Aging-related physiological changes
account for the increased frequency of adverse
drug reactions in geriatric patients. Renal and
hepatic changes cause drugs to clear more
slowly in these patients. With increasing age,
neurons are lost and blood flow to the GI tract
decreases.
11. Answer B. When teaching a patient about
medications before discharge, the nurse is acting
as an educator. The nurse acts as a manager
when performing such activities as scheduling
and making patient care assignments. The nurse
performs the care giving role when providing
direct care, including bathing patients and
administering medications and prescribed
treatments. The nurse acts as a patient advocate
when making the patient’s wishes known to the
doctor.
12. Answer D. Anxiety may result from feeling of
helplessness, isolation, or insecurity. This
response helps reduce anxiety by encouraging
the patient to express feelings. The nurse should
be supportive and develop goals together with
the patient to give the patient some control over
an anxiety-inducing situation. Because the other
options ignore the patient’s feeling and block
communication, they would not reduce anxiety.
13. Answer C. The scrub nurse assist the surgeon by
providing appropriate surgical instruments and
supplies, maintaining strict surgical asepsis and,
with the circulating nurse, accounting for all
gauze, sponges, needles, and instruments. The
circulating nurse assists the surgeon and scrub
nurse, positions the patient, applies appropriate
equipment and surgical drapes, assists with
gowning and gloving, and provides the surgeon
and scrub nurse with supplies.
14. Answer C. The nurse should return shortly to the
patient’s room and remain there until the patient
takes the medication to verify that it was taken
as directed. The nurse should never leave
medication at the patient’s bedside unless
specifically requested to do so.
15. Answer C. The nurse solves the problem as
follows:
 10,000 units/7,500 units = 1 ml/X
 10,000 X = 7,500
 X= 7,500/10,000 or ¾ ml
16. Answer C. To convert Fahrenheit degrees to
centigrade, use this formula:
 C degrees = (F degrees – 32) x 5/9
 C degrees = (102 – 32) 5/9
 70 x 5/9 = 38.9 degrees C
17. Answer D. All of these test help evaluate a
patient with respiratory problems. However,
ABG analysis is the only test evaluates gas
exchange in the lungs, providing information
about patient’s oxygenation status.
18. Answer B. The diaphragm of a stethoscope
detects high-pitched sound best; the bell detects
low pitched sounds best. Palpation detects thrills
best.
19. Answer C. In most cases, an outpatient must fill
a prescription for a controlled substance within 6
months of the date on which the prescription
was written.
20. Answer D. The nurse must consider the patient’s
cognitive abilities to understand drug
instructions. If not, the nurse must find a family
member or significant other to take on the
responsibility of administering medications in
the home setting. The patient’s ability to
recover, occupational hazards, and
socioeconomic status do not affect drug
administration.
21. Answer A. Primary prevention precedes disease
and applies to health patients. Secondary
prevention focuses on patients who have health
problems and are at risk for developing
complications. Tertiary prevention enables
patients to gain health from others’ activities
without doing anything themselves.
22. Answer A. When making a surgical bed, the
nurse leaves the bed in the high position when
finished. After placing the top linens on the bed
without pouching them, the nurse fanfolds these
linens to the side opposite from where the
patient will enter and places the pillow on the
bedside chair. All these actions promote transfer
of the postoperative patient from the stretcher to
the bed. When making an occupied bed or
unoccupied bed, the nurse places the pillow at
the head of the bed and tucks the top sheet and
blanket under the bottom of the bed. When
making an occupied bed, the nurse rolls the
patient to the far side of the bed.
23. Answer C. The nurse should give ½ ml of the
drug. The dosage is calculated as follows:
 250 mg/X=500 mg/1 ml
 500x=250
 X=1/2 ml
24. Answer C. Patients can become dependent on
barbiturates, especially with prolonged use.
Because of the rapid distribution of some
barbiturates, no correlation exists between
duration of action and half-life. Barbiturates are
absorbed well and do not cause hepatotoxicity,
although existing hepatic damage does require
cautions use of the drug because barbiturates are
metabolized in the liver.
25. Answer A. Elevating the head of the bed during
enteral feeding minimizes the risk of aspiration
and allows the formula to flow in the patient’s
intestines. When such elevation is
contraindicated, the patient should be positioned
on the right side. The nurse should give enteral
feeding at room temperature to minimize GI
distress. To limit microbial growth, the nurse
should hang only the amount of formula that can
be infused in 3 hours.
26. Answer C. The nurse should instruct the patient
to touch the tip of the tongue to the roof of the
mouth and then place the sublingual tablet on
the floor of the mouth. Sublingual medications
are absorbed directly into the bloodstream form
the oral mucosa, bypassing the GI and hepatic
systems. No drug is administered on top of the
tongue or on the roof of the mouth. With the
buccal route, the tablet is placed between the
gum and the cheek.
27. Answer A. The nurse always should clean
around a wound drain, moving from center
outward in ever-larger circles, because the skin
near the drain site is more contaminated than the
site itself. The nurse should never remove the
drain before cleaning the skin. Alcohol should
never be used to clean around a drain; it may
irritate the skin and has no lasting effect on
bacteria because it evaporates. The nurse should
wear sterile gloves to prevent contamination, but
a mask is not necessary.
28. Answer C. Giving 1,000 ml over 8 hours is the
same as giving 125 ml over 1 hour (60 minutes)
to find the number of milliliters per minute:
 125/60 min = X/1 minute
 60X = 125X = 2.1 ml/minute
 To find the number of drops/minute:
 2.1 ml/X gtts = 1 ml/15 gtts
 X = 32 gtts/minute, or 32
drops/minute
29. Answer A. Early in shock, hyperactivity of the
sympathetic nervous system causes increased
epinephrine secretion, which typically makes the
patient restless, anxious, nervous, and irritable.
It also decreases tissue perfusion to the skin,
causing pale, cool clammy skin. An above-
normal heart rate is a late sign of shock. A urine
output of 30 ml/hour is within normal limits.
30. Answer D. During a rapid assessment, the
nurse’s first priority is to check the patient’s
vital functions by assessing his airway,
breathing, and circulation. To check a patient’s
circulation, the nurse must assess his heart and
vascular network function. This is done by
checking his skin color, temperature, mental
status and, most importantly, his pulse. The
nurse should use the carotid artery to check a
patient’s circulation. In a patient with a
circulatory problems or a history of
compromised circulation, the radial pulse may
not be palpable. The brachial pulse is palpated
during rapid assessment of an infant.