Nursing Practice I Set B
by Admin · April 14, 2009
Topics on this nursing practice tests are:
- Foundation of Nursing
- Nursing Research
- Professional Adjustment
- Leadership and Management
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Nursing Practice I - Set B
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Question 1 |
Josephine has suffered from an extensive brain injury and can’t make her own treatment choices. Which written document is recognized by law and provides direction for provision of care at a time when the client can’t make her own choice?
A | Advance directive |
B | Living will |
C | Durable power of attorney |
D | Patient self-determination |
Question 1 Explanation:
An advance directive is a document written or completed by the client and used by a facility to provide care at a time when the client can’t make her own choices. The living will and durable power of attorney are both examples of advance directives.
Question 2 |
Patricia is aware of the importance of controlling threats to internal validity for experimental research, which include the following examples EXCEPT:
A | History |
B | Maturation |
C | Attrition |
D | Design |
Question 2 Explanation:
Design is not a threat to internal validity of the instrument just like the other options.
Question 3 |
Julius, who’s a member of the Jehovah’s Witnesses refuses a blood transfusion based on his religious beliefs and practices. His decision must be followed based on which ethical principle?
A | The right to die |
B | Advance directive |
C | The right to refuse treatment |
D | Substituted judgment |
Question 3 Explanation:
The right to refuse treatment is an ethical principle of respect for the autonomy of the individual. The client can refuse treatment if he’s competent and aware of the risks and complications associated with that refusal.
Question 4 |
A nurse-manager appropriately behaves as an autocrat in which situation?
A | Planning vacation time for staff. |
B | Directing staff activities if a client has a cardiac arrest. |
C | Evaluating a new medication administration process. |
D | Identifying the strengths and weaknesses of a client education video. |
Question 4 Explanation:
In a crisis situation, the nurse-manager should take command for the benefits of the client. Planning vacation time and evaluating procedure and client resources require staff input characteristics of a democratic or participative manager.
Question 5 |
Dr. Rodriguez orders an intravenous (IV) dose of 400,000 units of penicillin G benzathine (Bicillin). The label on the 10ml ampule sent from the pharmacy reads penicillin G benzathine (Bacillin) 300,000 units per milliliter. Nurse Myrna prepares how much medication to administer the correct dose?
A | 1.3 ml |
B | 1.5 ml |
C | 10 ml |
D | 13 ml |
Question 5 Explanation:
400,000 units × 1 ml/300,000 units = Milliliters per dose
400,000 units/300,000 units = 1.3 ml
Question 6 |
When should the nurse Oliver check a client for rebound tenderness?
A | Near the beginning of the examination |
B | Before doing anything else |
C | Anytime during the examination |
D | At the end of the examination |
Question 6 Explanation:
If a client complains of abdominal pain, the nurse should check for rebound tenderness. Because this maneuver can be painful, the nurse should perform it at the end of the abdominal assessment.
Question 7 |
Marjorie, a staff nurse on a busy pediatric unit is an excellent role model for her colleagues. She encourages them to participate in the unit’s decision-making process and helps them improve their clinical skills. This nurse is functioning effectively in which role?
A | Manager |
B | Autocrat |
C | Leader |
D | Authority |
Question 7 Explanation:
A leader doesn’t have formal power and authority but influences the success of a unit by being an excellent role model and by guiding, encouraging, and facilitating professional growth and development.
Question 8 |
Why should an infant be quiet and seated upright when the nurse Len assesses his fontanels?
A | The mother will have less trouble holding a quiet, upright infant. |
B | Lying down can cause the fontanels to recede, making assessment more difficult. |
C | The infant can breathe more easily when sitting up. |
D | Lying down and crying can cause the fontanels to bulge. |
Question 8 Explanation:
Lying down and crying can cause the fontanels to bulge, giving the nurse an inaccurate assessment. The nurse should sit the child upright and try to keep him calm and quiet. The fontanels should look almost flush with the scalp and surface, and slight pulsation should be visible. The fontanels should feel soft and either flat or slightly indented.
Question 9 |
The selection of a nursing care delivery system (NCDS) is critical to the success of a nursing area. Which factor is essential to the evaluation of a NCDS?
A | Determining how planned absences, such as vacation time, will be scheduled so that all staff are treated fairly. |
B | Identifying who will be responsible for making client care decisions. |
C | Deciding what type of dress code will be implemented. |
D | Identifying salary ranges for various types of staff. |
Question 9 Explanation:
Determining who has responsibility for making decisions regarding client care is an essential element of all client care delivery systems. Dress codes, salary, and scheduling planned staff absences are important to any organizations but aren’t actually determined by the NCDS.
Question 10 |
Nurse Ronald is preparing to administer medication through a nasogastric tube that is connected to suction. To administer the medication accurately, the nurse would:
A | Aspirate the nasogastric tune after medication administration to maintain patency. |
B | Position the client supine to assist in medication absorption. |
C | Clamp the nasogastric tube for 30 minutes following the administration of the medication. |
D | Change the suction setting to low intermittent suction for 30 minutes after medication administration. |
Question 10 Explanation:
If a client has a nasogastric tube connected to suction, the nurse should wait up to 30 minutes before reconnecting the tube to the suction apparatus to allow adequate time for medication absorption.
Question 11 |
Dr. Garcia orders Morphine Sulfate, 1/8 gr IM stat. The medication ampule reads morphine sulfate, 10 mg per mL. Nurse Deric prepares how many milliliters to administer the correct dose?
A | 0.5 mL |
B | 0.75 mL |
C | 0.85 mL |
D | 1.5 mL |
Question 11 Explanation:
You must convert 1/8 gr to milligrams. After converting grains to milligrams, use the formula to calculate the correct dose.
Conversion:
60 mg: 1 gr:: x mg: 1/8 gr
1x = 1/8 × 60/1
X = 60/8 = 7.5 mg
Formula:
Desired_ × X ml = Milliliters per dose
Available
7.5 mg × 1 mL/10mg = 0.75 mL
Question 12 |
In which circumstance may the nurse legally and ethically disclose confidential information about a client?
A | The human immunodeficiency virus (HIV)-status of a single male client to his family members. |
B | The diagnosis of pancreatic cancer to the client’s significant other. |
C | The diagnosis of an uncontrolled seizure disorder of a taxi driver to a state agency. |
D | The client is 32 weeks pregnant with twins and is legally separated. |
Question 12 Explanation:
The nurse maybe lawfully disclose confidential information about a client when the welfare of the person is at stake.
Question 13 |
Beatrice, a nurse-manager must include which item as part of the personnel budget?
A | Anticipated overtime payments for staff |
B | Computers for staff use |
C | Office supplies for secretarial use |
D | Videos for staff education |
Question 13 Explanation:
Personnel budgets include salaries, benefits, Anticipated overtime costs, and potential salary increases. Office supplies and videos are part of the day-to-day operating budget. Any expense or single item of equipment costing more that 25,000 is part of the capital budget.
Question 14 |
Nurse Catherine is caring for a client immediately after removal of the endotracheal tube following radical neck dissection. The nurse reports which of the following signs immediately if experienced by the client?
A | Stridor |
B | Occasional pink-tinged sputum |
C | Respiratory rate of 24 breaths per minute |
D | A few basilar crackles on the right |
Question 14 Explanation:
The nurse reports stridor to the physician immediately. This is a pitched, coarse sound that is heard with the stethoscope over the trachea. Stridor indicates airway edema and places the client at risk for airway obstruction.
Question 15 |
Nurse Rose is helping to plan a teaching session for a client who will be discharged with a colostomy. When describing a healthy stoma, which statement should the nurse be sure to include?
A | "The stoma should appear dark and have a bluish hue." |
B | "At first, the stoma may bleed slightly when touched." |
C | "The stoma should remain swollen distal to the abdomen." |
D | "A burning sensation under the stoma faceplate is normal." |
Question 15 Explanation:
For the first few days to a week after a client receives a colostomy, slight bleeding normally occurs when the stoma is touched because the surgical site is still fresh. However, profuse bleeding should be reported immediately. A dark stoma with a bluish hue indicates impaired circulation; a normal stoma should appear red, similar to the buccal mucosa. Swelling should decrease in 6 weeks, leaving a stoma that protrudes slightly from the abdomen; continued swelling suggests a blockage. A burning sensation under the faceplate is abnormal and indicates skin breakdown.
Question 16 |
Which statement is true concerning informed consent?
A | Minors are permitted to give informed consent. |
B | The profession nurse and physician may both obtain informed consent. |
C | The client must be fully informed regarding treatment, test, surgery, and the risks and benefits prior to giving informed consent. |
D | Mentally competent and incompetent clients can legally give informed consent. |
Question 16 Explanation:
When the professional nurse is involved in the informed consent process, the nurse is only witnessing the consent process and doesn’t actually obtain the consent. Only a minor who is married or emancipated can give informed consent. Obtaining consent is the responsibility of the physician. Legally, the client must be mentally competent to give consent procedure.
Question 17 |
Nurse Mandy can auscultate for heart sounds more easily if the male client is:
A | Supine. |
B | On his right side. |
C | Holding his breath. |
D | Leaning forward. |
Question 17 Explanation:
The nurse can best auscultate for heart sounds by asking the client to lean forward and exhale forcefully. This enables the nurse to listen after exhalation without the sound of expiration interfering. The supine position is used to visually inspect the precordium, allowing the nurse to watch the chest wall for movement, pulsations, and exaggerated lifts or strong outward thrusts over the chest during systole. A left lateral decubitus position may make it easier for the nurse to hear low-pitched sounds related to atrioventricular valve problems.
Question 18 |
One of the related studies that she reads is a phenomenological research. Which of the following questions is answered by this type of qualitative research?
A | ”What is the way of life of this cultural group?” |
B | “What is the effect of the intervention to the dependent variable?” |
C | “What the essence of the phenomenon is as experienced by these people?” |
D | “What is the core category that is central in explaining what is going on in that social scene?” |
Question 18 Explanation:
Phenomenological research deals with the meaning of experiences as those who experienced the phenomenon understand it.
Question 19 |
Nurse Olivia assisting a physician with the removal of a chest tube. The nurse most appropriately instructs the client to:
A | Stay very still |
B | Inhale and exhale quickly |
C | Exhale slowly |
D | Perform Valsalva’s maneuver |
Question 19 Explanation:
When the chest tube is removed, the client is to ask to perform Valsalva’s maneuver (take a deep breath, exhale, and bear down). The tube is quickly withdrawn, and an air tight dressing is taped in place. An alternative instruction is to ask the client to take a deep breath and hold the breath while the tube is removed.
Question 20 |
The nurse is auscultating a client's chest. How can the nurse differentiate a pleural friction rub from other abnormal breath sounds?
A | A rub occurs during expiration only and produces a light, popping, musical noise. |
B | A rub occurs during inspiration only and may be heard anywhere. |
C | A rub occurs during both inspiration and expiration and produces a squeaking or grating sound. |
D | A rub occurs during inspiration only and clears with coughing. |
Question 20 Explanation:
A pleural friction rub, heard in the lateral portion of the lungs during both inspiration and expiration, produces a squeaking or grating sound. Other abnormal sounds may clear with coughing, but pleural friction rubs don't.
Question 21 |
Dr. De Leon orders 1000 mL D5W to infuse at a rate of 125 mL per hour. Nurse Michelle determines that it will take how many hours for 1 L to infuse?
A | 8 hours |
B | 10 hours |
C | 12 hours |
D | 15 hours |
Question 21 Explanation:
You must determine that 1 L equals 1000 mL. Next, use the formula in determining infusion time in hours.
Total volume to infuse____ = Infusion time
Milliliters per hour being infused
1000 mL/125 mL = 8 hours
Question 22 |
Delegation is the process of transferring work to subordinates. A nurse-manager can appropriately delegate which task?
A | Scheduling staff assignments for the next month. |
B | Terminating a nursing assistant for insubordination. |
C | Deciding on salary increases for licensed practical nurses after they complete orientation. |
D | Telling a staff nurse to initiate disciplinary action against one of her peers. |
Question 22 Explanation:
Scheduling may be safely and appropriately delegated. Terminations, disciplinary action, and salary increases shouldn’t be delegated to staff, which doesn’t have the power and authority to take such actions.
Question 23 |
Dr. Alarcon orders levothyroxine (Synthroid), 150 mcg PO daily. The medication label reads Synthroid, 0.1 mg per tablet. Nurse Leng administers how many tablet (s) to the client?
A | 1 tablet |
B | 1.5 tablet |
C | 2 tablets |
D | 2.5 tablets |
Question 23 Explanation:
You must convert 150 mcg to milligrams. In the metric system, to convert smaller to larger, divide by 1000 or move the decimal three places to the left. Therefore, 150 mcg equals 0.15 mg. Use the formula to calculate the correct dose.
Desired × Tablet = Tablets per dose
Available
0.15 mg × 1 tablet = 1.5 tablets
0.1 mg
Question 24 |
Nurse Ron who works in a hospital is governed by a contract. Which of the following statements is true?
A | He can terminate his employment anytime he likes. |
B | He cannot just be assigned to the night shift because it is not explicit in his contract. |
C | He is liable for damages if he violates his contract. |
D | All of the above. |
Question 24 Explanation:
An employee can leave his institution anytime only if he is being treated inhumanely or he is subjected to serious insult by the employer or his representative or a crime is committed against his person. A nurse who seeks employment in a hospital knows (and should accept that).
Question 25 |
Dr. Cruz orders 1000 ml of ½ normal saline (NSS) to infuse over 8 hours. The drop factor is 15 drops per 1 ml. Nurse Ron sets the flow rate at how many drops per minute?
A | 20 drops per minute |
B | 22 drops per minute |
C | 28 drops per minute |
D | 31 drops per minute |
Question 25 Explanation:
Use the IV flow formula
Total volume × Drop factor/Time in minutes = Drops per minute
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