Nursing Practice Test III – Set B

by Daisy Jane Antipuesto RN MN · May 24, 2009

The scope of this Nursing Practice Test III: Medical Surgical Nursing.

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Nursing Practice Test III - Set B

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Question 1

Audrey complains of severe, throbbing headache following a lumbar puncture. The priority nursing intervention for this patient is to:

A	restrict fluid intake
B	increase fluid intake
C	raise the head of the bed
D	assess vital signs

Question 1 Explanation:

The nurse should encourage the patient to increase her fluid intake to approximately 3 qt (3L/day) for 24 to 48 hours. The headache is most likely due to decreased cerebrospinal fluid (CSF) circulating around the cranium.

Question 2

Treatment for Reynaud's disease includes:

A	avoiding cold and stress
B	vasodilator drug therapy
C	amputating the affected hand
D	removing the blood clot

Question 2 Explanation:

Initial treatment consist of avoiding cold, avoiding mechanical or chemical injury and quitting smoking.

Question 3

Mr. Morales, age 76 is admitted to the medical-surgical floor with weakness and left-sided chest pain. The symptoms have been present for several weeks after a viral illness. Which assessment finding is most symptomatic or pericarditis?

A	Pericardial friction rub
B	Bilateral crackles auscultated at the lung bases
C	Pain unrelieved by a change in position
D	Third heart sound (S3)

Question 3 Explanation:

A pericardial friction rub may be present with the pericardial effusion of pericardidits. The lungs are typically clear when auscultated. Siitng up and leaning forward often relieves pericarditis pain. An S3 indicates left-sided heart failure and isn't usually presetn with pericarditis.

Question 4

Following a total gastrectomy, the patient should receive which supplement to prevent pernicious anemia?

A	Calcium
B	Phosphorus
C	Vitamin D
D	Vitamin B12

Question 4 Explanation:

Patients who have had a total gastrectomy are at risk for developing pernicious anemia because the parietal cells in the stomach that secrete the intrinsic factor required for Vitamin B12 absorption are no longer present.

Question 5

When nurse Margaret attempts to ventilate a patient during cardiopulmonary resuscitation, she notices an airway obstruction. In an unresponsive adult, the most common cause of airway obstruction is:

A	the patient's dentures
B	a foreign body
C	the tongue
D	the epiglottis

Question 5 Explanation:

In an unresponsive adult, the most common cause of airway obstruction is the tongue.

Question 6

A patient with tuberculosis is taking isoniazid (Laniazid) and rifampi (Rifadin). What additional medication typically is given to minimize the adverse effects of isoniazid?

A	Pyridoxine (Vitamin B6)
B	Ethambutol hydrochloride (Myambutol)
C	Magnesium sulfate
D	Cyanocobalamin (Vitamin b12)

Question 6 Explanation:

Pyridoxine commonly is administered to minimize peripheral neuropathy associated with isoniazid.

Question 7

A patient with a bowel obstruction located high in the intestinal tract will have:

A	pain relief with defacation
B	a fecal breath odor
C	respiratory difficulty
D	pain relief with vomiting

Question 7 Explanation:

When the obstruction is located high in the intestinal tract, little room exists for fluids of food. Vomiting of the gastric contents will relieve pressure and pain.

Question 8

Mr. Vullanueva experiences orthostatic hypotension while receiving furosemide (Lasix). Nurse Gio should:

A	administer IV fluids as ordered
B	administer a vasodilator as prescribed
C	instruct her to sit up for several minutes before standing
D	insert an indwelling urinary catheter to track output

Question 8 Explanation:

The nurse should instruct the patient to rise slowly to a standing position to combat orthostatic hypotention.

Question 9

In a comatose patient, hearing is the last sense to be lost. Therefore, the nurse should always:

A	talk loudly in case the patient can hear
B	speak softly before gently touching the patient
C	tall others in the room not to talk to the patient
D	tell family members that the patient probably can't hear

Question 9 Explanation:

Many patients have reported being able to hear when being in a comatose state. Therefore, the nurse should converse as if the patient was alert and oriented. talking loudly is only appropriate if the patient is hard of hearing, and family should be encourage to talk with the patient unless contraindicated.

Question 10

A patient complains to the nurse that his sputum is thick and he has difficulty expectorating. Nurse Jillian should:

A	offer him milk
B	offer him water
C	start IV fluids immediately
D	tell him to avoid drinking apple juice

Question 10 Explanation:

Inadequate hydration can cause sputum to become thick and difficult to expectorate.

Question 11

Which signs and symptoms are associated with an acoustic neuroma?

A	Amenorrhea and obesity
B	Acromegaly
C	Ataxia and intention tremor
D	Unilateral hearing loss and tinnitus

Question 11 Explanation:

Unilateral hearing loss that occurs over an extended time and tinnitus care are classic signs and symptoms of an acoustic neuroma.

Question 12

Which of the following dosage forms can be crushed, dissolved in water, and administered thorugh a nasogastric (NG) tube?

A	Simple compressed tablets
B	Enteric-coated tablets
C	Time-release capsules
D	Controlled-delivery capsules

Question 12 Explanation:

Liquid forms and simple compressed tablets are the only drug forms that can be administered through an NG tube.

Question 13

Neomycin (Neo-Tabs) is administered before bowel surgery to:

A	decrease the risk of wound infection
B	increase the body's immunologic response to surgery
C	decrease the incidence of postoperative atelectasis
D	prevent postoperative bladder atony.

Question 13 Explanation:

Neomycin, and antibiotic, is used to decrease the bacteria in the bowel before surgery to reduce the risk of wound contamination.

Question 14

Capillary refill time is normally:

A	1 to 2 seconds
B	3 to 5 seconds
C	6 to 8 seconds
D	9 to 10 seconds

Question 14 Explanation:

Capillary refill time that's longer than 2 seconds is considered delayed and indicates decreased perfusion.

Question 15

Nurse Trina has just finished teaching a group of new patient care aides about the spread of tuberculosis (TB). She knows her teaching has been effective when one of the aides states:

A	"I could get TB by coming in contact with the patient's stool"
B	"I could get TB if I become contaminated with the patient's blood"
C	"I could get TB if I inhale infected droplets when the patient coughs"
D	"I could get TB if I handle the patient's urine without wearing gloves"

Question 15 Explanation:

Tb transmission occurs when an infected person coughs or sneezes, spreading infected droplets.

Question 16

When the nurse performs a neurologic assessment on Antoinette, her pupils are dilated and don't respond to light. the patient most likely has:

A	glaucoma
B	damage to the third cranial nerve
C	damage to the lumbar spine
D	Bell's palsy

Question 16 Explanation:

The third cranial nerve (oculomotor) is responsible for pupil constriction. When there is damage to the nerve, the pupils remain dilated and don't respond to light.

Question 17

Drainage on a craniotomy dressing must be measured and marked. Which of the following should be reported immediately to the doctor?

A	Bloody drainage
B	Yellowish drainage
C	Greenish drainage
D	Foul-smelling drainage

Question 17 Explanation:

Bloody drainage on a craniotomy dressing could indicate hemorrhage and should be reported immediately to the doctor.

Question 18

Vagal stimulating on the heart primarily causes:

A	increased parasympathetic tone
B	increased sympathetic tone
C	decreased parasympathetic tone
D	decreased sympathetic tone

Question 18 Explanation:

Vagal stimulation increases parasympathetic tone, which decreases the heart rate and may slow atrioventricular conduction.

Question 19

The doctor writes an order for the nurse to discontinue a patient's nasogastric (NG) tube. Before removing the tube, the nurse should:

A	make sure the patient is able to chew food
B	assess the patient for bowel sounds
C	determine if the patient is hungry and wants to eat
D	aspirate gastric contents to make sure that the residual volume is less than 100 ml.

Question 19 Explanation:

Before removing the client's NG tube, the nurse should assess the patient for bowel sounds. If bowel sounds aren't present, the patient may still have a bowel obstruction or paralytic ileus, so the tube should not be removed.

Question 20

The patient with neuropathy affecting the legs and feet should be instructed to:

A	avoid walking barefoot
B	keep his feet warm high heating pads or heavy wool socks.
C	take vasoconstricting drugs on schedule
D	include foods high in vitamin K in his diet

Question 20 Explanation:

Patients with neuropathy affecting the legs and feet will have decreased sensation and may be unaware of temperature extremes and injury. The patient should be advised to wear shoes and socks and stop smoking if possible (smoking causes vasoconstriciton). Vasoconstriction will exacerbate problem.

Question 21

Diet planning for a patient with an ilesostomy should include:

A	telling the patient to restrict his fluid intake
B	instructing the patient to limit potassium-rich foods
C	explaining that he should limit his calorie intake
D	telling the patient to avoid high-fiber foods

Question 21 Explanation:

The dietary teaching plan should include telling the patient to avoid high-fiber foods that could cause blockage. The patient should consume plenty of fluids and be encouraged to maintain a high-calorie diet that is rich in potassium.

Question 22

Which nursing diagnosis takes priority for the patient with Bell's palsy?

A	Risk for dysfunctional grieving
B	Risk for injury related to corneal laceration
C	Risk for chronic low self-esteem
D	Risk for impaired physical mobility

Question 22 Explanation:

The patient with Bell's Palsy will be unable to close his eyelid on the affected side; therefore, he'll be at risk for injury to the cornea.

Question 23

When assessing breath sounds, nurse Gina would anticipate hearing bronchoalveolar sounds:

A	over the trachea only
B	over the central airways
C	throughout the entire lung fields
D	throughout the peripheral lung fields only

Question 23 Explanation:

Bronchoalveolar beath sounds, which are loud and coarse are normally auscultated over the central airways.

Question 24

The most common cause of cardiac arrest in an adult is:

A	electrolyte disturbance
B	respiratory arrest
C	ventricular fibrillation
D	drug toxicity

Question 24 Explanation:

Although electrolyte disturbances, respiratory arrest and drug toxicity can cause cardiac arrest, ventricular fibrillation is the most common cause of cardiac arrest in adults.

Question 25

A patient with appendicitis is at risk for developing:

A	peritonitis
B	hemorrhage
C	bowel obstruction
D	renal failure

Question 25 Explanation:

Increased intraluminal pressure, transmural swelling and inflammation can rupture appendix and cause peritonitis.

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Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

Nursing Practice Test III – Set B

Nursing Practice Test III - Set B

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