PRACTICE TEST QUESTIONS

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Question Number 1 of 40 A nurse arranges for a interpreter to
facilitate communication between the health care team and a non-
English speaking client. To promote therapeutic communication, the
appropriate action for the nurse to remember when working with an
interpreter is to
The correct response is "A".
Promote verbal and nonverbal communication with both the
A)
client and the interpreter
Speak only a few sentences at a time and then pause for a few
B)
moments
Plan that the encounter will take more time than if the client
C)
spoke English
Ask the client to speak slowly and to look at the person spoken
D)
to
Your response was "A". The correct answer is A: Promote verbal and
nonverbal communication with both the client and the interpreter

The nurse should communicate with the client and the family, not with
the interpreter. Culturally appropriate eye contact, gestures, and body
language toward the client and family are important factors to enhance
rapport and understanding. Maintain eye contact with both the client
and interpreter to elicit feedback and read nonverbal cues.

2. client refuses to take the medication prescribed because the client

prefers to take
The correct response is "B".
A) Report the behavior to the charge nurse
Talk with the client to find out about the preferred herbal
B)
preparation
C) Contact the client's health care provider
D) Explain the importance of the medication to the client
Your response was "D". The correct answer is B: Talk with the client to
find out about the preferred herbal preparation Respect for differences
is demonstrated by incorporating traditional cultural practices for
staying healthy into professional prescriptions and interventions. The
challenge for the health-care provider is to understand the client''s
perspective. "Culture care preservation or maintenance refers to those
assistive, supporting, facilitative or enabling professional actions and
decisions that help people of a particular culture to retain and/or
preserve relevant care values to that they can maintain their well-
being, recover from illness or face handicaps and/or death
Question Number 3 of 40A nurse aide is taking care of a 2 year-old
child with Wilm's tumor. The nurse aide asks the nurse why there is a
sign above the bed that says DO NOT PALPATE THE ABDOMEN? The
best response by the nurse would be which of these
statements?
The correct response is "A".
A) "Touching the abdomen could cause cancer cells to spread."
B) "Examining the area would cause difficulty to the child."
C) "Pushing on the stomach might lead to the spread of infection."
"Placing any pressure on the abdomen may cause an abnormal
D)
experience."
Your response was "B". The correct answer is A: "Touching the
abdomen could cause cancer cells to spread." Manipulation of the
abdomen can lead to dissemination of cancer cells to nearby and
distant areas. Bathing and turning the child should be done carefully.
The other options are similar but not the most specific.
Question Number 4 of 40
A nurse is caring for a client with peripheral arterial insufficiency of the
lower extremities. Which intervention should be included in the plan of
care to reduce leg pain? The correct response is "D".
A) Elevate the legs above the heart
B) Increase ingestion of caffeine products
C) Apply cold compresses
D) Lower the legs to a dependent position
Your response was "A". The correct answer is D: Lower the legs to a
dependent position Ischemic pain is relieved by placing feet in a
dependent position. This position improves peripheral perfusion.
Question Number 5 of 40
A mother calls the clinic, concerned that her 5 week-old infant is
"sleeping more than her brother did." What is the best initial response?
The correct response is "C".
A) "Do you remember his sleep patterns?"
B) "How old is your other child?"
C) "Why do you think this a concern?"
D) "Does the baby sleep after feeding?"
Your response was "D". The correct answer is C: "Why do you think
this a concern?" Open ended questions encourage further discussion
and conversation, thereby eliciting further information
Question Number 6 of 40
The nurse is teaching diet restrictions for a client with Addison's
disease. The client would indicate an understanding of the diet by
stating
correct response is "A".
 A) "I will increase sodium and fluids and restrict potassium."
B) "I will increase potassium and sodium and restrict fluids."
C) "I will increase sodium, potassium and fluids."
D) "I will increase fluids and restrict sodium and potassium."
Your response was "B". The correct answer is A: "I will increase
sodium and fluids and restrict potassium." The manifestation of
Addison''s disease due to mineralocorticoid deficiency resulting from
renal sodium wasting and potassium retention include dehydration,
hypotension, hyponatremia, hyperkalemia and acidosis.
Question Number 7 of 40 A client with considerable pain asks:
“What is your opinion regarding acupuncture as a drug-free method for
alleviating pain?” The nurse responds, "I'd forget about it as those
weird non-Western treatments can be scary." The nurse's response is
an example of
The correct response is "C".
A) Prejudice
B) Discrimination
C) Ethnocentrism
D) Cultural insensitivity
Your response was "B". The correct answer is C: Ethnocentrism
Ethnocentrism, the universal tendency of human beings to think that
their ways of thinking, acting, and believing are the only right, proper,
and natural ways, can be a major barrier to providing culturally
conscious care. Ethnocentrism perpetuates an attitude that beliefs that
differ greatly from one''s own are strange, bizarre, or unenlightened,
and therefore wrong. Ethnocentrism refers to the unconscious
tendency to look at others through the lens of one''s own cultural
norms and customs and to take for granted that one''s own values are
the only objective reality. At a more complex level, the ethnocentrist
regards others as inferior or immoral and believes his or her own ideas
are intrinsically good, right, necessary, and desirable, while remaining
unaware of his or her own value judgments
Question Number 8 of 40
The nurse is caring for a client with COPD who becomes dyspneic. The
nurse should The correct response is "C".
A) Instruct the client to breathe into a paper bag
B) Place the client in a high Fowler's position
C) Assist the client with pursed lip breathing
D) Administer oxygen at 6L/minute via nasal cannula
Your response was "B". The correct answer is C: Assist the client with
pursed lip breathing Use pursed-lip breathing during periods of
dyspnea to control rate and depth of respiration and improve
respiratory muscle coordination
Question Number 9 of 40 The nurse is speaking to a group of
parents and school teachers of children about care for children with
rheumatic fever. It is a priority to emphasize that
The correct response is "D".
A) Home schooling is preferred to classroom instruction
B) Children may remain strep carriers for years
C) Most play activities will be restricted indefinitely
D) Clumsiness and behavior changes should be reported
Your response was "D". The correct answer is D: Clumsiness and
behavior changes should be reported A major manifestation of
rheumatic fever that reflects central nervous system involvement is
chorea. Early symptoms of chorea include behavior changes and
clumsiness. Chorea is characterized by sudden, aimless, irregular
movements of the extremities, involuntary facial grimaces, speech
disturbances, emotional lability, and muscle weakness. Chorea is
transitory and all manifestations eventually disappear.
Question Number 10 of 40
To obtain data for the nursing assessment, the nurse should:
The correct response is "D".
A) Observe carefully the client’s nonverbal behaviors
B) Adhere to pre-planned interview goals and structure
C) Allow clients to talk about whatever they want
Elicit clients' description of their experiences, thoughts and
D)
behaviors
Your response was "D". The correct answer is D: Elicit clients''
description of their experiences, thoughts and behaviors The nurse’s
understanding of the client rests the comprehensiveness of
assessment data obtained by listening to the client’s self revelation.
Question Number 11 of 40 A nurse manager considers changing
staff assignments from 8 hour shifts to 12 hour shifts. A staff-selected
planning committee has approved the change, yet the staff are
complaining. As a change agent, the nurse manager should first
The correct response is "B".
A) Support the planning committee and post the new schedule
Explore how the planning committee evaluated barriers to the
B)
plan
C) Design a different approach to deliver care with fewer staff
D) Retain the previous staffing pattern for another 6 months
Your response was "A". The correct answer is B: Explore how the
planning committee evaluated barriers to the plan The manager is
ultimately responsible for delivery of care and yet has given a
committee chosen by staff the right to approve or disapprove the
change. Planned change involves exploring barriers and restraining
forces before implementing change. To smooth acceptance of the
change, restraining factors need to be evaluated. The manager wants
to build the staff''s skills at implementing change. Helping the
committee evaluate its decision-making is a useful step before
rejecting or implementing the change. When possible all affected by
the change should be involved in the planning. The question is
whether staff input has been thoroughly taken into consideration
Question Number 12 of 40 The nurse detects blood-tinged fluid
leaking from the nose and ears of a head trauma client. What is the
appropriate nursing action?
The correct response is "C".
A) Pack the nose and ears with sterile gauze
B) Apply pressure to the injury site
C) Apply bulky, loose dressing to nose and ears
D) Apply an ice pack to the back of the neck
Your response was "B". The correct answer is C: Apply bulky, loose
dressing to nose and ears Applying a bulky, loose dressing to the nose
and ears permits the fluid to drain and provides a visual reference for
the amount of drainage.

Question Number 13 of 40 A 6 year-old child diagnosed with acute

glomerulonephritis (AGN) is experiencing anorexia, moderate edema
and elevated blood urea nitrogen (BUN) levels. The child requests a
peanut butter sandwich for lunch. What would the nurse's best
response to this request?
The correct response is "C".
"That's a good choice, and I know it is your favorite. You can
A)
have it today."
B) "I'm sorry, that is not a good choice, but you could have pasta."
"I know that is your favorite, but let me help you pick another
C)
lunch."
"You cannot have the peanut butter until you are feeling
D)
better."
Your response was "B". The correct answer is C: "I know that is your
favorite, but let me help you pick another lunch." Children with AGN
who have edema, hypertension oliguria and azotemia may have
dietary restrictions limiting sodium, fluids, protein and potassium.
Giving the child a short explanation and offering to talk about an
alternative is appropriate for this age.
Question Number 14 of 40 The nurse is planning care for a 2 year-
old hospitalized child. Which of the following will produces the most
stress at this age?
The correct response is "A".
A) Separation anxiety
B) Fear of pain
C) Loss of control
D) Bodily injury
Your response was "B". The correct answer is A: Separation anxiety
While a toddler will experience all of the stresses, separation from
parents is the major stressor.
Question Number 15 of 40 A client admits to benzodiazepine
dependence for several years. She is now in an outpatient
detoxification program. The nurse must understand that a priority
during withdrawal is
The correct response is "A".
A) Avoid alcohol use during this time
B) Observe the client for hypotension
C) Abrupt discontinuation of the drug
D) Assess for mild physical symptoms
Your response was "A". The correct answer is A: Avoid alcohol use
during this time Central nervous system depressants interact with
alcohol. The client will gradually reduce the dosage, under the health
care provider''s direction. During this time, alcohol must be avoided.
Question Number 16 of 40
The nurse will administer liquid medicine to a 9 month-old child. Which
of the following methods is appropriate?
The correct response is "B".
A) Allow the infant to drink the liquid from a medicine cup
B) Administer the medication with a syringe next to the tongue
C) Mix the medication with the infant's formula in the bottle
D) Hold the child upright and administer the medicine by spoon
Your response was "A". The correct answer is B: Administer the
medication with a syringe next to the tongue Using a needle-less
syringe to give liquid medicine to an infant is often the safest method.
If the nurse directs the medicine toward the side or the back of the
mouth, gagging will be reduced.
Question Number 17 of 40
The nurse is caring for a client with a deep vein thrombosis. Which
finding would require the nurse's immediate attention?
The correct response is "C".
 A) Temperature of 102 degrees Fahrenheit
B) Pulse rate of 98 beats per minute
C) Respiratory rate of 32
D) Blood pressure of 90/50
Your response was "A". The correct answer is C: Respiratory rate of 32
Clients with deep vein thrombosis are at risk for the development of
pulmonary embolism. The most common symptoms are tachypnea,
dyspnea, and chest pain.
Question Number 18 of 40 A mother telephones the clinic and says
“I am worried because my breast-fed 1 month-old infant has soft,
yellow stools after each feeding.” The nurse's best response would be
which of these?
The correct response is "A".
This type of stool is normal for breast fed infants. Keep doing as
A)
you have.
The stool should have turned to light brown by now. We need to
B)
test the stool
Formula supplements might need to be added to increase the
C)
bulk of the stools.
Water should be offered several times each day in addition to
D)
the breast feeding.
Your response was "A". The correct answer is A: This type of stool is
normal for breast fed infants. Keep doing as you have. In breast-fed
infants, stools are frequent and yellow to golden and vary from soft to
in feedings is indicated
Question Number 19 of 40
A client with a history of heart disease takes prophylactic aspirin daily.
The nurse should monitor which of the following to prevent aspirin
toxicity?
The correct response is "D".
A) Serum potassium
B) Protein intake
C) Lactose tolerance
D) Serum albumin
Your response was "C". The correct answer is D: Serum albumin When
highly protein-bound drugs are administered to patients with low
serum albumin (protein) levels, excess free (unbound) drug can cause
exaggerated and dangerous effects.
Question Number 20 of 40 A client calls the nurse with a complaint
of sudden deep throbbing leg pain. What is the appropriate first action
by the nurse?
The correct response is "B".
A) Suggest isometric exercises
 B) Maintain the client on bed rest
C) Ambulate for several minutes
D) Apply ice to the extremity
Your response was "D". The correct answer is B: Maintain the client on
bed rest The finding suggests deep vein thrombosis. The client must
be maintained on bed rest and the provider notified immediately.
Question Number 21 of 40
Hospital staff requests that the parents with a Greek heritage of a
hospitalized infant remove the amulet from around the child's neck.
The parents refuse. The nurse understands that the parents may be
concerned about
The correct response is "B".
A) Mental development delays
B) Evil eye or envy of others
C) Fright from spiritual beings
D) Balance in body systems
Your response was "A". The correct answer is B: Evil eye or envy of
others Matiasma, "BAD eye or evil eye " results from the envy or
admiration of others. While the eye is able to harm a wide variety of
things including inanimate objects, children are particularly susceptible
to attack. Persons of Greek heritage employ a variety of preventive
mechanisms to thwart the effects of envy, including protective charms
in the form of amulets consisting of blessed wood or incense.
Question Number 22 of 40 Which type of traction can the nurse
expect to be used on a 7 year-old with a fractured femur and
extensive skin damage?
The correct response is "A".
A) Ninety-ninety
B) Buck's
C) Bryant
D) Russell
Your response was "B". The correct answer is A: Ninety-ninety Ninety
degree-ninety degree traction is used for fractures of the femur or
tibia. A skeletal pin or wire is surgically placed through the distal part
of the femur, while the lower part of the extremity is in a boot cast.
Traction ropes and pulleys are applied.
Question Number 23 of 40 The nurse is caring for several 70 to 80
year-old clients on bed rest. What is the most important measure to
prevent skin breakdown?
The correct response is "B".
A) Massage legs frequently
B) Frequent turning
 C) Moisten skin with lotions
D) Apply moist heat to reddened areas
Your response was "B". The correct answer is B: Frequent turning
Frequent turning will prevent skin breakdown.
Question Number 24 of 40 A 24 year-old male is admitted with a
diagnosis of testicular cancer. The nurse would expect the client to
have
The correct response is "D".
A) Scrotal discoloration
B) Sustained painful erection
C) Inability to achieve erection
D) Heaviness in the affected testicle
Your response was "A". The correct answer is D: Heaviness in the
affected testicle The feeling of heaviness in the scrotum is related to
testicular cancer and not epididymitis. Sexual performance and related
issues are not affected at this time.
Question Number 25 of 40 A nurse has asked a second staff nurse
to sign for a wasted narcotic, which was not witnessed by another
person. This seems to be a recent pattern of behavior. What is the
appropriate initial action?
The correct response is "A".
A) Report this immediately to the nurse manager
B) Confront the nurse about the suspected drug use
Sign the narcotic sheet and document the event in an incident
C)
report
D) Counsel the colleague about the risky behaviors
Your response was "B". The correct answer is A: Report this
immediately to the nurse manager The incident must be reported to
the appropriate supervisor, for both ethical and legal reasons. This is
not an incident that a co-worker can resolve without referral to a
manager.
Question Number 26 of 40 Which statement describes strategies
that help build personal power in an organization?
The correct response is "B".
Longevity in an organization, social ties to people in power, and
A) a history as someone who does not back down in conflict ends
with success
Goals are met with the use of networking, mentoring, and
B)
coalition building
High visibility and formal power are maintained with a
C)
confrontational style
Credibility to one's position is enhanced when professional dress
D)
and demeanor are employed
Your response was "A". The correct answer is B: Goals are meet with
the use of networking, mentoring, and coalition building Networking,
mentoring, and coalition building are positive uses of personal power
to meet goals.
Question Number 27 of 40 Which of the following should the nurse
obtain from a client prior to having electroconvulsive therapy?
The correct response is "D".
A) Permission to videotape
B) Salivary pH
C) Mini-mental status exam
D) Pre-anesthesia work-up
Your response was "C". The correct answer is D: Pre-anesthesia work-
up ECT is delivered under general anesthesia and the client should be
prepared as for any procedure involve anesthesia
Question Number 28 of 40 A 9 year-old is taken to the emergency
room with right lower quadrant pain and vomiting. When preparing the
child for an emergency appendectomy, what must the nurse expect to
be the child's greatest fear?
The correct response is "C".
A) Change in body image
B) An unfamiliar environment
C) Perceived loss of control
D) Guilt over being hospitalized
Your response was "A". The correct answer is C: Perceived loss of
control For school age children, major fears are loss of control and
separation from friends/peers.

Question Number 29 of 40 After successful alcohol detoxification, a

client remarked to a friend, "I’ve tried to stop drinking but I just can’t,
I can’t even work without having a drink." The client’s belief that he
needs alcohol indicates his dependence is primarily
The correct response is "A".
A) Psychological
B) Physical
C) Biological
D) Social-cultural
Your response was "B". The correct answer is A: Psychological With
psychological dependence, it is the client ‘s thoughts and attitude
toward alcohol that produces craving and compulsive use
Question Number 30 of 40 The nurse is assigned to care for a client
newly diagnosed with angina. As part of discharge teaching, it is
important to remind the client to remove the nitroglycerine patch after
12 hours in order to prevent what condition?
The correct response is "B".
A) Skin irritation
B) Drug tolerance
C) Severe headaches
D) Postural hypotension
Your response was "B". The correct answer is B: Drug tolerance
Removing a nitroglycerine patch for a period of 10-12 hours daily
prevents tolerance to the drug, which can occur with continuous patch
use

Question Number 31 of 40
Which statement describes the use of a decision grid for decision
making?
The correct response is "A".
A) It is both a visual and a quantitative method of decision making
B) It is the fastest way for group decision making
C) It allows the data to be graphed for easy interpretation
D) It is the only truly objective way to make a decision in a group
Your response was "B". The correct answer is A: It is both a visual and
a quantitative method of decision making A decision grid allows the
group to visually examine alternatives and evaluate them
quantitatively with weighting
Question Number 32 of 40 The most common reason for an Apgar
score of 8 and 9 in a newborn is an abnormality of what parameter?
The correct response is "D".
A) Heart rate
B) Muscle tone
C) Cry
D) Color
Your response was "B". The correct answer is D: Color Acrocyanosis
(blue hands and feet) is the most common Apgar score deduction, and
is a normal adaptation in the newborn
Question Number 33 of 40
During the two-month well-baby visit, the mother complains that
formula seems to stick to her baby's mouth and tongue. Which of the
following would provide the most valuable nursing assessment?
The correct response is "D".
A) Inspect the baby's mouth and throat
B) Obtain cultures of the mucous membranes
C) Flush both sides of the mouth with normal saline
D) Use a soft cloth to attempt to remove the patches
Your response was "A". The correct answer is D: Use a soft cloth to
attempt to remove the patches Candidiasis can be distinguished from
coagulated milk when attempts to remove the patches with a soft cloth
are unsuccessful
Question Number 34 of 40
In preparing medications for a client with a gastrostomy tube, the
nurse should contact the health care provider before administering
which of the following drugs through the tube?
The correct response is "A".
A) Cardizem SR tablet (diltiazem)
B) Lanoxin liquid
C) Os-cal tablet (calcium carbonate)
D) Tylenol liquid (acetaminophen
Your response was "A". The correct answer is A: Cardizem SR tablet
(diltiazem) Cardizem SR is a "sustained-release" drug form. Sustained
release (controlled-release; long-acting) drug formulations are
designed to release the drug over an extended period of time. If
crushed, as would be required for gastrostomy tube administration,
sustained-release properties and blood levels of the drug will be
altered. The health care provider must substitute another medication.
Question Number 35 of 40 What is the major developmental task
that the mother must accomplish during the first trimester of
pregnancy?
The correct response is "A".
A) Acceptance of the pregnancy
B) Acceptance of the termination of the pregnancy
C) Acceptance of the fetus as a separate and unique being
D) Satisfactory resolution of fears related to giving birth
Your response was "C". The correct answer is A: Acceptance of the
pregnancy During the first trimester the maternal focus is directed
toward acceptance of the pregnancy and adjustment to the minor
discomforts.

Question Number 36 of 40 The nurse is caring for several

hospitalized children with the following diagnoses. Which disorder is
likely to result in metabolic acidosis?
The correct response is "A".
A) Severe diarrhea for 24 hours
B) Nausea with anorexia
C) Alternating constipation and diarrhea
D) Vomiting for over 48 hours
Your response was "A". The correct answer is A: Severe diarrhea
Severe diarrhea is the only problem listed that can lead to metabolic
acidosis if untreated.
Question Number 37 of 40
Dual diagnosis indicates that there is a substance abuse problem as
well as a
A) Cross addiction
B) Mental disorder
C) Disorder of any type
D) Medical problem
Your response was "A". The correct answer is B: Mental disorder Dual
diagnosis is the concurrent presence of a major psychiatric disorder
and chemical dependence.
Question Number 38 of 40
During the initial physical assessment on a client who is a Vietnamese
immigrant, the nurse notices small, circular, ecchymotic areas on the
client's knees. The best action for the nurse to take is to
The correct response is "A".
Ask the client for more information about the nature of the
A)
bruises
B) Ask the client and then the family about the findings
C) Report the bruising to social services to follow-up
D) Document the findings on the admission sheet
Your response was "A". The correct answer is A: Ask the client for
more information about the nature of the bruises "Cupping" is
practiced by Vietnamese. The principle is to create a vacuum inside a
special cup by igniting alcohol-soaked cotton inside the cup. When the
flame extinguishes, the cup is immediately applied to the skin of the
painful site. The belief: the suction exudes the noxious element. The
greater the bruise, the greater the seriousness of the illness. There is
no need to ask the family members.
Question Number 39 of 40
A diabetic client asks the nurse why the health care provider ordered a
glycolsylated hemoglobin (HbA) measurement, since a blood glucose
reading was just performed. You will explain to the client that the HbA
test:
The correct response is "D".
Provides a more precise blood glucose value than self-
A)
monitoring
B) Is performed to detect complications of diabetes
C) Measures circulating levels of insulin
D) Reflects an average blood sugar for several months
Your response was "A". The correct answer is D: Reflects an average
blood sugar for several months Glycosolated hemoglobin values reflect
the average blood glucose (hemoglobin-bound) for the previous 3-4
months and is used to monitor client adherence to the therapeutic
regimen
Question Number 40 of 40
The nurse is caring for a depressed client with a new prescription for
an SSRI antidepressant. In reviewing the admission history and
physical, which of the following should prompt questions about the
safety of this medication? correct response is "B".
A) History of obesity
B) Prescribed use of an MAO inhibitor
C) Diagnosis of vascular disease
D) Takes antacids frequently
Your response was "A". The correct answer is B: Prescribed use of an
MAO inhibitor SSRIs should not be taken concurrently with MAO
inhibitors because serious, life-threatening reactions may occur with
this combination of drugs