Evoke-ATTI Nurse Review Center a.

Ride a bicycle
CGFNS Boot Camp b. Walk to school
Neuromuscular/Respiratory Disorders c. Do frequent isometric exercises
d. Watch TV for prolonged periods
1. Which of the following medications may be prescribed to
prevent a thromboembolic cerebrovascular accident 7. A child is diagnosed to have Reye’s syndrome. What
(CVA)? health teaching should the nurse give to the mother?
a. acetaminophen a. Avoid crowded places
b. streptokinase b. Immediately report to the doctor the slightest sign of
c. ticlopidine infection
d. methylprednisolone c. Avoid giving salicylates to the child
d. Make sure her immunizations are up to date
2. Hydrocephalus, if untreated, can cause mental retardation
because 8. How will a nurse determine the presence of scoliosis in a
a. CSF dilutes blood supply, causing cells to atrophy patient?
b. Hypertonic CSF disturbs normal plasma a. Has waddling gait
concentration depriving nerve cells of vital nutrients. b. Uneven gluteal folds
c. Increasing head size necessitates more oxygen and c. One side of the dress appears longer than the other
nutrients than normal blood flow can supply d. Pain on hopping
d. Gradually increasing size of the ventricles presses the
brain against the bony cranium; anoxia and decreased 9. The most frequently occurring type of brain tumor is a
blood supply result. a. Glioma
b. Meningioma
3. Developmental dysplasia of the hip is often discovered by c. Neurofibroma
the nurse in the newborn nursery when the infant’s d. Pituitary adenoma
assessment reveals:
a. A depressed dance reflex 10. Of the following combinations of symptoms the most
b. Asymmetry of the gluteal folds indicative of increased intracranial pressure is:
c. Limitation in adduction of the leg a. Weak rapid pulse, normal blood pressure, intermittent
d. Shortening of the leg on the unaffected side fever, lethargy
b. Rapid weak pulse, fall in blood pressure, low
4. Three days after admission, a 2 year old with the temperature, restlessness.
diagnosis of meningitis appears clinically improved. A c. Slow bounding pulse, rising blood pressure, elevated
spinal tap is done to assess the child’s response to therapy. temperature, stupor
The nurse correctly interprets that the child’s condition is d. Can usually be stopped after a year’s absence of
improving when the report of the spinal fluid indicates seizures
a. Decreased protein
b. Decreased glucose 11. The primary responsibility of a nurse during a client’s
c. Increased cell count generalized motor seizure is
d. Increased specific gravity a. determining if an aura was explained
b. inserting a plastic airway between the teeth
5. A 9 year old has a fractured tibia and a full leg-cast has c. Clearing the immediate environment for safety
been applied. The nurse should immediately notify the d. Administering the prescribed prn anticonvulsant
physician if assessment demonstrates:
a. A pedal pulse of 90 12. Following a CVA, a client is confined to bed rest. Forty-
b. An increased urinary output eight hours following the CVA, the nurse should institute
c. An inability to move the toes a. Active exercise of all extremities
d. A plaster cast that is still damp after 4 hours b. Passive range of motion exercises
c. Light weight lifting exercises of the right side
d. Exercises that would actively capitalize on returning
muscle function.

13. Clients with myasthenia gravis , Guillain-Barre

6. To prevent loss of joint function in a child with juvenile Syndrome, or amyotrophic lateral sclerosis are likely to
rheumatoid arthritis, the nurse should teach the parents to experience:
avoid letting the child: a. Progressive deterioration until death
 b. Increased risk of respiratory complications a. A stressful week at work
c. Deficiencies of essential neurotransmitters b. Ingestion of more fruits and vegetables
d. Involuntary twitching of small muscle groups c. A recent bout of the flu
d. Inability to sleep well
14. The client is admitted to the hospital with a diagnosis of
Guillain-Barre or syndrome (polyradiculitis). The nurse 20. Following a spinal cord injury the physician indicates that
inquires during the nursing admission interview if the a client is a paraplegic. The family asks the nurse what
client has a history of this means. The nurse explains that
a. Back injury or trauma to the spinal cord a. Upper extremities are paralyzed
b. Seizures or trauma to the brain b. Lower extremities are paralyzed
c. Respiratory or gastrointestinal infection during the c. One side of the body is paralyzed
previous months d. Both lower and upper extremities are paralyzed
d. Meningitis during the past 5 years
21. A client with a spinal cord injury has paraplegia. The
15. A client with head trauma develops a urine output of 300 nurse recognizes that one major early problem will be:
ml/hr, dry skin, and dry mucous membranes. Which of a. Bladder control
the following nursing interventions is the most b. Client education
appropriate to perform immediately? c. Quadricep setting
a. evaluate urine specific gravity d. Use of aids in ambulation
b. anticipate treatment for renal failure
c. provide emollients to the skin to prevent breakdown 22. In some clients with multiple sclerosis, plasmapheresis
d. slow the IV fluids and notify the physician diminishes symptoms. Plasmapheresis achieves this
effect by removing which of the following blood
16. A client with myasthenia gravis asks the nurse why the components?
disease has occurred. The nurse bases the reply on the a. catecholamines
knowledge that there is a: b. antibodies
a. A genetic defect in the production of acetylcholine c. plasma proteins
b. A reduced amount of neurotransmitter acetylcholine d. lymphocytes
c. A decreased number of functioning acetylcholine
receptor sites 23. While cooking, your client couldn’t feel the temperature
d. An inhibition of the enzymes AchE leaving the end of a hot oven. Which lobe could be dysfunctional?
plates folded a. frontal
b. occipital
17. Myasthenia gravis most frequently affects: c. parietal
a. Males ages 15-35 d. temporal
b. Children ages 5-15
c. Females ages 10-30 24. The nurse is conducting health screening for osteoporosis.
d. Both sexes 20-40 The nurse interprets that which of the following clients is
at greatest risk for developing this disorder?
18. The nurse should expect a client with an exacerbation of a. A 36 year old male who has asthma
multiple sclerosis to experience: b. A 25 year old female who jogs
a. Double vision c. A sedentary 65 year old female who smokes
b. Resting tremors cigarettes
c. Flaccid paralysis d. A 70 year old male who consume excess alcohol
d. Mental retardation

25. The home health nurse is planning to teach the client with
19. The client is admitted with an exacerbation of multiple osteoporosis about home medications to reduce the risk of
sclerosis (MS). The nurse is assessing the client for falls. Which of the following recommendations are
possible precipitating risk factors. Which of the following unnecessary to include in the teaching plan?
factors, if stated by the client, does the nurse assess as a. Use of staircase railings
being unrelated to the exacerbation? b. Use of nightlights
 c. Removing wall to wall carpeting d. To engage in moderate low-impact exercise when not
d. Placing handrails in the bathroom fatigued.

26. Which of the following would the nurse assess in a client 33. The client with a fractured tibia has not been taking
with an extracapsular hip fracture? methocarbamol (Robaxin). When teaching the client
a. Internal rotation about this drug, which of the following would the nurse
b. Muscle flaccidity include as the drug’s primary effect?
c. Shortening of the affected leg
d. Absence of pain in the fractured area a. Killing of microorganisms
b. Reduction in itching
27. While performing a physical assessment of a client with c. Relief of muscle spasms
gout of the great toe, the nurse should assess for d. Decrease in nervousness.
additional tophi (urate deposits) on the
a. Chin 34. A nurse caring for several clients with fractures. Which
b. Ears client is most at risk for fat emboli?
c. Buttocks a. A 4 y/o with a wrist fracture
d. Abdomen b. A 20 y/o with a femur fracture
c. A 35 y/o with an ulnar fracture
28. When teaching about dietary control of gout, the nurse is d. A 75 y/o with rib fractures
aware that the dietary teaching was understood when the
client states, “I will avoid eating” 35. On a visit to the clinic, a client reports the onset of early
a. Eggs symptoms of rheumatoid arthritis. Which of the
b. Shellfish following would the nurse most likely assess?
c. Fried poultry a. limited motion of joints
d. Cottage cheese b. deformed joints of the hands
c. early morning stiffness
29. When completing the history and physical examination of d. rheumatoid nodules
a client diagnosed with osteoarthristis, which of the
following would the nurse assess? 36. When completing the history and physical examination of
a. Anemia a client diagnosed with osteoarthritis, which of the
b. Osteoposrosis following would the nurse assess?
c. Weight loss a. anemia
d. Local joint pain b. osteoporosis
c. weight loss
30. At which of the following times would the nurse instruct d. local joint pain
the client to take ibuprofen (Motrin) prescribed for left
hip pain secondary to osteoarthritis, to minimize gastric 37. When admitting a client with a fractured extremity, the
mucosal irritation? nurse would focus the assessment on which of the
a. At bedtime following?
b. On arising a. the area proximal to the fracture
c. Immediately after a meal b. the actual fracture site
d. On an empty stomach c. the area distal to the fracture
d. the opposite extremity for baseline comparison
31. A client is suspected of having SLE. Which of the
following is a characteristic sign of SLE? 38. Before the nurse assists the client to crutch walk, a critical
a. Rash on the face across the bridge of the nose and on assessment is to:
the cheeks a. evaluate the desire to be independent
b. Fatigue b. assess the lower extremity muscle tone
c. Fever c. determine the ability to ambulate alone
d. Elevated RBC count d. evaluate the need for other assistive devices
32. The home care nurse visits a client with SLE. Which of 39. What does the nurse include in the teaching plan for a
the following is not a component of the teaching plan for client with seizures who is going home with a prescription
the client to manage fatigue? for Gabapentin (Neurontin)?
a. To avoid long periods of rest a. take all the medication until it is gone
b. To sit whenever possible b. notify the physician if vision changes occur
c. To take a hot bath in the evening c. store Gabapentin in the refrigerator
 d. take Gabapentin with an antacid to protect against 46. Which of the following nursing interventions is
ulcers appropriate for a client with an ICP of 20 mm Hg?
a. give the client a warming blanket
40. The nurse determines that Baclofen (Lioresal) is b. administer low-dose barbiturates
accomplishing its intended purpose for a client with MS c. encourage the client to hyperventilate
when it achieves which of the following? d. restrict fluids
a. induces sleep
b. stimulates the clients appetite 47. A client has signs of increased ICP. Which of the
c. relieves muscular spasticity following is an early indicator of deterioration in the
d. reduces the urine bacterial count client’s condition?
a. widening pulse pressure
41. A client with Parkinson’s disease asks the nurse to explain b. decrease in the pulse rate
to his nephew “what the doctor said the pallidotomy c. dilated, fixed pupil
would do?” What is the nurse’s best response? The main d. decrease in level of consciousness
goal for the client after pallidotomy is improved?
a. functional ability 48. A client taking Carbamazepine (Tegretol) should be
b. emotional stress monitored for which of the following potential
c. alertness complications?
d. appetite a. Adult respiratory distress syndrome
b. diplopia
42. When a client arrives in the emergency department c. elevated levels of phenytoin
with an ischemic CVA, what is the priority for the nurse d. leukocytosis
to assess in relation to the treatment of tissue plasminogen
activator (t-PA) administration? 49. The client has a sustained ICP of 20 mm Hg. The nurse
a. current medications should position the client.
b. complete physical and history a. with the head of the bed elevated 30 to 45 degrees
c. time of onset of current CVA b. in Trendelenburg’s position
d. upcoming surgical procedures c. in left Simm’s position
d. with the head elevated on two pillows
43. When an unconscious client with multiple injuries arrives
in the emergency room, which nursing intervention 50. When teaching the client with Meniere’s disease, which of
receives the highest priority? the following instructions would a nurse give abut
a. establishing an airway vertigo?
b. replacing blood loss a. report dizziness at once
c. stopping bleeding from open wounds b. drive in daylight hours only
d. checking for a neck fracture c. get up slowly, turning the entire body
d. change position using the logroll
44. The nurse monitors the client who is at risk for increased
intracranial pressure (ICP) for 51. Nursing care of a client with damage to the thalamus,
a. unequal pupil size hypothalamus, and pineal gland would be based on
b. decreasing systolic blood pressure knowing the client has problems in which of the
c. tachycardia following areas?
d. decreasing body temperature a. seizure control
b. identifying foreign agents
c. difficulty regulating emotions
d. initiating movements and maintaining temperature
control and the sleep-awake cycle

45. Which of the following respiratory patterns indicate 52. For a client having an episode of acute narrow-angle
increasing ICP in the brain stem? glaucoma, a nurse expects to give which of the following
a. slow, irregular respirations medications?
b. rapid, shallow respirations a. acetazolamide (Diamox)
c. asymmetric chest excursion b. Atropine sulfate
d. nasal flaring c. Furosemide (Lasix)
d. Streptokinase (Kabikinase)
53. When giving IV phenytoin, which of the following underlying cause of epidural hematoma is usually related
methods should be used? to which of the following conditions?
a. use an in-line filter a. laceration of the middle meningeal artery
b. withhold other anticonvulsants b. rupture of the carotid artery
c. mix the drug with saline solution only c. thromboembolism from a carotid artery
d. flush the IV catheter with dextrose solution d. venous bleeding from the arachnoid space

54. Which of the following instruments is used to record 61. An 86 year old client with a stroke in evolution and a
intraocular pressure? history of CAD is brought to the medical-surgical floor.
a. goniometer His medications include heparin, isosorbide, and
b. ophthalmoscope verapamil. Which of the following conditions should be
c. slit lamp avoided in a client with CVA?
d. tonometer a. dehydration
b. hypocarbia
55. After the nurse instills atropine drops into both eyes for a c. hypotension
client undergoing an ophthalmic examination, which of d. tube feeding
the following instructions would be given to the client?
a. be careful because the blink reflex is paralyzed 62. Which of the following symptoms of increased ICP after
b. Avoid wearing your regular glasses when driving head trauma would appear first?
c. Be aware that the pupils may be unusually small a. bradycardia
d. Wear dark glasses in bright light because the pupils b. large amounts of very dilute urine
are dilated c. restlessness and confusion
56. When assessing a client with herniated nucleus pulposus d. widened pulse pressure
(HNP) of L4-5, the nurse would expect to find which of
the following symptoms of spinal cord compression? 63. A client in status epilepticus arrives at the emergency
a. low back pain department. The family is interviewed to determine the
b. pain radiating across the buttocks cause of this problem. Which of the following events
c. positive Kernig’s sign may have predisposed the client to this condition?
d. urinary incontinence a. abruptly stopping anticonvulsant therapy
b. airplane travel
57. A nurse assesses a client who has episodes of autonomic c. exposure to sunlight
dysreflexia. Which of the following conditions can cause d. recent upper respiratory infection
autonomic dysreflexia?
a. headache 64. Clients taking phenytoin should avoid using alcohol for
b. lumbar spinal cord injury which of the following reasons?
c. neurogenic shock a. alcohol raises the phenytoin level
d. noxious stimuli b. alcohol raises the seizure threshold
c. alcohol impairs judgment and coordination
58. A client recovering from a spinal cord injury has a great d. alcohol decreases the effectiveness of phenytoin
deal of spasticity. Which of the following medications
may be used to control spasticity? 65. Which of the following adverse effects may occur during
a. Hydralazine hydrochloride (Apresoline) Phenytoin (Dilantin) therapy?
b. Baclofen (Lioresal) a. dry mouth
c. Lidocaine hydrochloride (Xylocaine) b. furry tongue
d. Methyprednisolone (Medrol) c. somnolence
d. tachycardia
59. A client with C7 quadriplegia is flushed and anxious and
complains of a pounding headache. Which of the 66. A client with suspected multiple sclerosis (MS) undergoes
following symptoms would also be anticipated? a lumbar puncture. Which of the following abnormalities
a. decreased urine output or oliguria is typically found in the CSF of clients with MS?
b. hypertension and bradycardia a. blood or increased RBC
c. respiratory depression b. elevated WBC or pus
d. symptoms of shock c. increased glucose concentrations
d. increased protein levels
60. A client admitted o the emergency department for head
trauma is diagnosed with an epidural hematoma. The
67. Which of the following symptoms occurs initially in
Parkinson’s disease? 74. During the assessment of a client, signs of osteroarthritis
a. akinesia are noted. Which of the following assessment findings
b. aspiration of food would indicate osteoarthritis?
c. dementia a. elevated ESR
d. pill rolling movements of the hand b. multiple subcutaneous nodules
c. asymmetrical joint involvement
68. One hour after receiving pyridostigmine bromide d. signs of inflammation, such as heat, fever, and
(Mestinon), a client reports difficulty swallowing and malaise
excessive respiratory secretions. The nurse notifies the
physician and prepares to administer which of the 75. A client is diagnosed with a herniated nucleus pulposus, or
following medications/ herniated disk. Which of the following statements about a
a. Additional pyridostigmine herniated disk?
b. Atropine sulfate a. the disk slips out of alignment
c. Edrophonium chloride (Tensilon) b. the disk shatters and fragments place pressure on
d. Neostigmine methylsulfate (Prostigmin) nerve roots
c. the nucleus tissue itself remains centralized, and the
69. When prioritizing care, which of the following clients surrounding tissue is displaced
should the nurse assess first? d. the nucleus of the disk puts pressure on the annulus,
a. A 17 year old client 24 hours postappendectomy causing pressure on the nerve roots
b. A 33 year old client with a recent diagnosis of
Guillain-Barre 76. Which of the following symptoms would occur with a
c. A 50 year old client 3 days postmyocardial infarction herniated nucleus pulposus?
d. A 50 year old client with diverticulitis a. pain, numbness, weakness, leg or foot pain
b. shortness of breath, weakness, leg or foot pain
70. Which of the following values is considered normal for c. inability to walk, shortness of breath, weakness, leg
intracranial pressure? or foot pain
a. 0 to 15 mmHg d. unstable gait, disorientation, numbness, weakness,
b. 25 mmHg leg or foot pain.
c. 35 to 45 mmHg
d. 120/80 mmHg 77. Conservative treatment of a herniated nucleus pulposus
would include which of the following measures?
71. Which of the following conditions is the primary a. surgery
complication of osteoporosis? b. bone fusion
a. pain c. bed rest, pain medication, physiotherapy
b. fractures d. strenuous exercise, pain medication
c. hardening of the bones
d. increased bone matrix and remineralization 78. Which of the following symptoms is an early sign of
compartment syndrome?
72. A client has been prescribed a diet that limits purine-rich a. pain
foods. Which of the following foods would the nurse b. paresthesia
teach her to avoid eating? c. skin pallor
a. bananas and dried fruits d. swelling
b. milk, ice cream, and yogurt
c. wine, cheese, preserved fruits, meats, and vegetables
d. anchovies, sardines, kidneys, sweet breads, and
lentils 79. Which of the following symptoms are considered signs of
a fracture?
73. Heberden’s nodes are a common sign of osteoarthritis. a. tingling, coolness, loss of pulses
Which one of the following statements is correct about b. loss of sensation, redness, warmth
this deformity? c. coolness, redness, new site of pain
a. it appears only in men d. redness, warmth, pain at the site of injury
b. it appears on the distal interphalangeal joint
c. it appears on the proximal interphalangeal joint 80. Which of the following signs and symptoms can occur
d. it appears on the dorsolateral aspect of the with fat emboli?
interphalangeal joint
 a. tachypnea, tachycardia, shortness of breath, 86. A 2 year old child with bronchopulmonary dysplasia is
paresthesias placed on Furosemide (Lasix) once per day. The parents
b. paresthesia, bradypnea, bradycardia, petechial rash are being educated on foods that are rich in potassium.
on chest and neck Which of the following foods should the nurse
c. bradypnea, bradycardia, shortness of breath, petechial recommend?
rash on chest and neck a. apples
d. tachypnea, tachycardia, shortness of breath, petechial b. oranges
rash on chest and neck c. peaches
d. raisin
81. Treatment of a fat embolus may include which of the
following therapies? 87. While examining a child with acute epiglottitis, the nurse
a. albuterol, oxygen, I.V. fluids, steroids should have which of the following items available?
b. oxygen, I.V. fluids, steroids, antibiotics a. cool mist tent
c. morphine, oxygen, I.V. fluids, antibiotics b. intubation equipment
d. theophylline, morphine, oxygen, I.V. fluids c. tongue depressor
d. viral culture medium
82. When preparing a teaching plan for the client with
osteoarthritis who is taking celcoxib (Celebrex), the nurse 88. A 2 year old child is brought to the emergency department
expects to explain that the major advantage of celecoxib in respiratory distress. The child refuses to lie down and
over diclofenac (Voltaren) is that celecoxib is less likely prefers to sit upright and lean forward with chin thrust
to produce which of the following? out, mouth open, and tongue protruding (tripod position).
a. hepatotoxicity This is a classic sign of which of the following illnesses?
b. renal toxicity a. Acute epiglottitis
c. GI bleeding b. Croup
d. Nausea and vomiting c. Pertussis
d. Pharyngitis
83. A client with a hip fracture has undergone surgery for
insertion of a femoral head prosthesis. Which of the 89. Which of the following chloride levels is a diagnostic
following activities would the nurse instruct the client to criteria for cystic fibrosis?
avoid? a. below 20 mEq/L
a. crossing the legs while sitting down b. below 40 mEq/L
b. sitting on a raised commode seat c. 40 to 60 mEq/L
c. using an abductor splint while lying on the side d. above 60 meq/L
d. rising straight from a chair to a standing position
90. A 10 month old infant is found in respiratory arrest and
84. To make a definitive diagnosis of TB, the nurse understand cardiopulmonary resuscitation is started. Which of the
that the physician must order a following sites is best to check for a pulse?
a. chest x-ray a. brachial
b. tuberculin skin test b. carotid
c. pulmonary function test c. femoral
d. sputum for acid-fast testing d. radial

91. Which of the following findings would you expect on a

85. A 10 year old client with asthma has recently started typical X-ray of a child with asthma?
receiving I.V. aminophylline. He begins to vomit and a. atelectasis
complains of his stomach hurting. Which of the b. hemothorax
following nursing interventions is appropriate? c. infiltrates
a. check the theophylline level d. pneumothoraces
b. increase the infusion rate of the aminophylline
c. take no action; aminophylline can cause nausea 92. What is the therapeutic range of aminophylline?
d. stop the aminophylline infusion and call the a. 2 to 4 ug/ml
physician b. 5 to 15 ug/ml
c. 10 to 20 ug/ml
 d. 20 to 30 ug/ml a. acetylsalicylic acid (Aspirin)
b. milk of magnesia
93. A 2 month old infant is brought to the emergency c. pepcid (Famotidine)
department and a preliminary diagnosis of bronchiolitis is d. benadryl (Diphenhydramine)
given. Which of the following symptoms would the nurse
expect to find on assessment? 100. The nurse is aware that a client understands the
a. bradycardia instructions about an appropriate breathing technique for
b. increased appetite chronic obstructive pulmonary disease when the client?
c. wheezing on auscultation a. inhales through the mouth
d. no signs of an upper respiratory infection b. increases the RR
c. holds each breath for a second at the end of
94. A client is placed on a ventilator. Because inspiration
hyperventilation can occur when mechanical ventilation is d. progressively increases the length of the inspiratory
used, the nurse should monitor the client for signs of phase
a. hypoxia
b. hypercapnia
c. metabolic acidosis
d. respiratory alkalosis

95. The description that should be used for the soft swishing
sounds of normal breathing heard when the nurse
auscultates a client’s chest would be
a. fine crackles
b. adventitious sounds
c. vesicular breath sounds
d. diminished breath sounds

96. Which of the following pulmonary findings would a nurse

expect to assess in a patient who has lower lobe
pneumonia?
a. paradoxical chest movement
b. eupnea
c. bronchial breath sounds
d. Kussmul’s respiration

97. A 2 year old is admitted to the pediatric unit with a

diagnosis of acute asthma. A blood sample is obtained to
measure the child’s arterial blood gases. The nurse should
expect:
a. an elevated pH
b. a raised oxygen level
c. a decreased bicarbonate level
d. an increased carbon dioxide level

98. When preparing for the admission of a child with acute

laryngitis (croup), the nurse on the pediatric unit should
first:
a. arrange for a quiet, cool room
b. pad the side rails of the croup tent
c. obtain a tracheostomy set at the bedside
d. set up a cot so that the parent can stay

99. The nurse admits a client with asthma who reports taking
all the following medications. Which medication would
the nurse suspect as the possible cause of asthma attack?