Question 1

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Epinephrine is often used in combination with local infiltration anesthetic because it:

a.

Prolongs the local action of the anesthetic agent

b.

Causes vasoconstriction

c.

All of the above

d.

Prevents rapid absorption of the anesthetic drug

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The correct answer is: All of the above

Question 2
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The most dangerous complication of epidural anesthesia is:

a.

Headache

b.

Respiratory depression

c.

Hypotension

d.

Cardiac dysrythmias
Feedback
The correct answer is: Respiratory depression

Question 3
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Only the scrub nurse can extend an arm over the sterile area to deliver sterile supplies.

a.

True

b.

False

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The correct answer is: True

Question 4
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Which of the following nursing actions should be given highest priority when admitting the patient into
the operating room?

a.

Positioning and skin preparation

b.

Level of consciousness

c.

Vital signs

d.

Patient identification and correct operative consent

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The correct answer is: Patient identification and correct operative consent
Question 5
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Kayecee is 6 days post abdominal surgery. Which sign alerts the nurse to wound evisceration?

a.

Severe pain

b.

Acute bleeding

c.

Pink serous drainage

d.

Purple drainage

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The correct answer is: Severe pain

Question 6
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A patient becomes anxious the day before her scheduled surgery. Which of the following sets of
manifestations suggest that the patient is having anxiety?

a.

Papillary dilatation, diaphoresis, hypotension, bradycardia

b.

Hypertension, tachycardia, pupil dilatation, cold clammy skin

c.

Warm flushed skin, tachycardia, urinary frequency, bradypnea

d.

Bradypnea, tachycardia, cold clammy skin, pupil constriction

Feedback
The correct answer is: Hypertension, tachycardia, pupil dilatation, cold clammy skin

Question 7
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Which of the following characterizes excitement stage of anesthesia?

a.

Extends from the loss of consciousness to the loss of lid reflex

b.

Occurs from the administration of anesthesia to the loss of consciousness

c.

From the loss of lid reflex to the loss of most reflexes

d.

From the loss of most reflexes to respiratory and circulatory failure

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The correct answer is: Extends from the loss of consciousness to the loss of lid reflex

Question 8
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The patient informs the operating nurse that his grandmother spiked a 104F temperature in the
operating room and nearly died 15 years ago. What relevance is this information regarding the patient?

a.

Grandmother's surgery has no relevance to the patient's surgery.

b.

Patient may be nervous.

c.

Patient may be at risk for developing malignant hyperthermia.

d.

Patient may be at risk for hypothermia.

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The correct answer is: Patient may be at risk for developing malignant hyperthermia.

Question 9
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Majority of surgical procedures performed today require overnight hospitalization, because "high tech"
interventions require intense postoperative monitoring.

a.

True

b.

False

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The correct answer is: False

Question 10
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A postoperative client asks a nurse why it is so important to deep breathe and cough after surgery. In
formulating a response the nurse incorporates the understanding that retained pulmonary secretions in
a postoperative client can lead to

a.

Fluid imbalance

b.

Pulmonary edema

c.

Pneumonia

d.
Carbon dioxide retention

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The correct answer is: Pneumonia

Question 11
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In obtaining a history of a client with COPD, which of the following would not be related to potentially
causing/triggering the disease process?

a.

Cigarette smoking

b.

Occupational and air pollution

c.

Smokeless tobacco

d.

Genetic tendencies

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The correct answer is: Cigarette smoking

Question 12
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To prevent headache after spinal anesthesia the patient should be positioned:

a.

Semi-fowler’s

b.

Modified Trendelenburg

c.
Flat on bed for 6 to 8 hours

d.

Prone position

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The correct answer is: Flat on bed for 6 to 8 hours

Question 13
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The nurse screens the preoperative client for conditions that may increase the risk for complications
during the preoperative period. Which of the following conditions are possible risk factors?

a.

The planned surgical procedure is tonsillectomy

b.

The surgery is planned as an ambulatory/same day surgery procedure

c.

The client is 70 years old and obese

d.

The client is 5 feet tall and weighs 100 lbs.

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The correct answer is: The client is 70 years old and obese

Question 14
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In collecting a sputum specimen for acid-fast bacteria and culture, the nurse would be sure to

a.

Provide an early-morning specimen

b.
Collect the specimen after any meal

c.

Instruct the client to spit the specimen into a clean container

d.

Collect the specimen after antibiotic therapy is initiated

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The correct answer is: Provide an early-morning specimen

Question 15
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The arterial blood gas measurement that best reflects the adequacy of alveolar ventilation is the:

a.

PaO2

b.

PaCO2

c.

pH

d.

SaO2

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The correct answer is: PaCO2

Question 16
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A patient comes to the emergency room reporting a knifelike pain when taking a deep breath. What
does this type of pain likely indicate to the nurse?

a.
Lung infarction

b.

Bronchogenic cancer

c.

Bacterial pneumonia

d.

Pleurisy

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The correct answer is: Pleurisy

Question 17
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A patient is having repair of vaginal prolapse. What position does the nurse place the patient in?

a.

Left lateral sims

b.

Prone position

c.

Lithotomy position

d.

Trendelenburg

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The correct answer is: Lithotomy position

Question 18
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The term used to describe thoracic surgery in which an entire lung is removed is:
a.

Wedge resection

b.

Pneumonectomy

c.

Lobectomy

d.

Segmentectomy

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The correct answer is: Pneumonectomy

Question 19
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What finding by the nurse may indicate the patient has chronic hypoxia?

a.

Pale skin

b.

Cyanosis

c.

Crackles

d.

Peripheral edema

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The correct answer is: Cyanosis

Question 20
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Question text
The nurse maintains a recommended position for a patient post op tonsillectomy:

a.

Semi fowlers with neck flexed

b.

Supine with neck hyperextended

c.

Reverse Trendelenburg with neck extended

d.

Prone with head on a pillow & turned to the side

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The correct answer is: Prone with head on a pillow & turned to the side

Question 21
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A client with a perforated gastric ulcer is scheduled for emergency surgery. The client cannot sign the
operative consent form because of sedation from narcotic analgesics that have been administered. The
nurse should take which of the following most appropriate actions in the care of this client?

a.

Obtain a telephone consent from a family member and have the consent witnessed by two persons.

b.

Have the hospital Chaplain sign the informed consent immediately

c.

Obtain a court order for the surgery

d.

Send the client to surgery without the consent form being signed

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The correct answer is: Obtain a court order for the surgery

Question 22
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Vitamin K is an essential vitamin requirement for surgery, because it is needed for collagen synthesis.

a.

False

b.

True

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The correct answer is: False

Question 23
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A surgical procedure which is necessary for the well-being of the client, but may be done later is
categorized as:

a.

Planned required surgery

b.

Elective surgery

c.

Imperative surgery

d.

Optional surgery

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The correct answer is: Elective surgery

Question 24
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Question text
A patient is having postoperative vomiting. What is the priority nursing action?

a.

Offer water & juices to preplace fluid & electrolytes

b.

Turn the patient's head completely to one side to prevent aspiration of vomitus into the lungs

c.

Support the wound area to prevent wound disruption

d.

Measure the amount of vomitus to estimate fluid loss, in order to accurately monitor fluid balance

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The correct answer is: Turn the patient's head completely to one side to prevent aspiration of vomitus
into the lungs

Question 25
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A significant mortality rate exists for those alcoholics who experience "delirium tremens"
postoperatively. When caring for an alcoholic, the nurse should assess for symptoms of alcohol
withdrawal:

a.

About 24 hours postoperatively

b.

Within the 1st 12 hours

c.

On the 2nd or 3rd day

d.

4 days after surgery

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The correct answer is: On the 2nd or 3rd day

Question 26
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What is the primary purpose of a PACU?

a.

Arousal of client following the use of conscious sedation

b.

Follow-through on the surgeon’s postoperative orders

c.

Ongoing critical evaluation and stabilization of the client

d.

Prevention of lengthened hospital stay

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The correct answer is: Arousal of client following the use of conscious sedation

Question 27
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A client says to the nurse, “It’s hard for me to breathe; I feel winded all the time.” The nurse would
record this subjective feeling on the chart as

a.

Respiratory fatigue

b.

Apnea

c.

Tachypnea

d.

Dyspnea
Feedback
The correct answer is: Dyspnea

Question 28
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Which of the following is experienced by the patient who is under spinal anesthesia?

a.

The patient is unconscious

b.

The patient experiences amnesia

c.

The patient experiences total loss of sensation

d.

The patient is awake

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The correct answer is: The patient is awake

Question 29
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A client has chronic obstructive pulmonary disease (COPD) caused by an enzyme deficiency. The nurse
would explains that the enzyme most likely to be responsible for COPD is

a.

Trypsin

b.

Alpha1-antitrypsin (ATT)

c.

Pepsin
d.

Glutamic-oxaloacetic transaminase (GOT)

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The correct answer is: Alpha1-antitrypsin (ATT)

Question 30
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Coordinates, oversees, and participates in the client’s nursing care while the client is in the operating
room.

a.

Nurse anesthetist

b.

Circulating nurse

c.

Scrub nurse

d.

Holding area nurse

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The correct answer is: Circulating nurse

Question 31
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The nurse is instructing the patient on collection of sputum specimen. What should not be included in
the instructions?

a.

Submit an early morning specimen

b.

Spit mucus into the sterile specimen container

c.

Take a few deep breaths before coughing

d.

Rinse with mouthwash prior to providing the specimen

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The correct answer is: Rinse with mouthwash prior to providing the specimen

Question 32
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It is recommended that those who smoke cigarettes should stop smoking atleast ____ before surgery.

a.

3 months

b.

3 weeks

c.

2 months

d.

2 weeks

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The correct answer is: 2 months

Question 33
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The nurse is performing an assessment of a patient who arrived in the emergency room with barbiturate
overdose. The respiration are normal for 3-4 breathes followed by 60 seconds of apnea. How does the
nurse document the rspiration?

a.

Tachypnea
b.

Eupnea

c.

Biot's respiration

d.

Cheyne-Stokes respiration

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The correct answer is: Biot's respiration

Question 34
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The following ensure validity of informed written consent EXCEPT:

a.

The patient is of legal age with proper mental disposition

b.

The consent is secured before administration of any medication that alter the level of consciousness

c.

If the patient is unable to write, secure the consent from a companion

d.

The consent has been secured within 24 hours before the surgery

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The correct answer is: If the patient is unable to write, secure the consent from a companion

Question 35
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Your patient is having a mastectomy. What dietary supplement will the patient need?

a.
Sodium

b.

Calcium

c.

Protein

d.

Vitamin B12

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The correct answer is: Protein

Question 36
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When preparing a diabetic client for surgery, the nurse should be aware of which of the following
potential surgical risks associated with the disorder?

a.

Altered metabolism and excretion of drugs.

b.

Respiratory depression from anesthesia

c.

Slow wound healing

d.

Fluid and electrolyte imbalances

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The correct answer is: Slow wound healing

Question 37
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A nurse in the post anesthesia unit receives a postoperative client from the operating room. After the
initial assessment of the client, the nurse plans to continue with postoperative assessment activities:

a.

Every hour for 2 hours, and then every 4 hours as needed

b.

Every 5mins for the first half hour, every 15mins for 2 hours, every 30mins for 4 hours, and then every
hour as needed.

c.

Every 30mins for the first hour, every hour for 2 hours, and then every 4 hours as needed.

d.

Every 15mins for the first hour, every 30 minutes for 2 hours, every hour for 4 hours and then every 4
hours as needed.

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The correct answer is: Every 15mins for the first hour, every 30 minutes for 2 hours, every hour for 4
hours and then every 4 hours as needed.

Question 38
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The pathophysiology of emphysema is directly related to airway obstruction. The end result of
deterioration is:

a.

Hypoxemia secondary to impaired oxygen diffusion

b.

Respiratory acidosis d/t airway obstruction

c.

Hypercapnia resulting to decreased carbon dioxide elimination

d.

Diminished alveolar surface area

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The correct answer is: Diminished alveolar surface area
Question 39
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During assessment, the nurse notes the presence of a “barrel chest”, which the nurse knows is caused
by:

a.

A compensatory expansion of the bronchial airway

b.

A progressive increase in the vital capacity

c.

A decrease in the intrapleural pressure

d.

Air trapping in the lungs

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The correct answer is: Air trapping in the lungs

Question 40
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Older patients need more anesthetic agent to produce anesthesia, because they eliminate the
anesthetic agents quickly.

a.

False

b.

True

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The correct answer is: False

Question 41
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The potential effects of medication therapy must be evaluated before surgery. A drug classification that
can cause electrolyte imbalance is:

a.

Corticosteroid

b.

Phenothiazines

c.

Insulin

d.

Diuretics

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The correct answer is: Diuretics

Question 42
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A nurse is monitoring a postoperative client after abdominal surgery for signs of complications. The
nurse assesses the client for the presence of Homan’s sign and determines that this sign is positive if
which of the following is noted?

a.

Crackles on auscultation

b.

Pain with dorsiflexion of the foot

c.

Absent bowel sounds

d.

Incisional pain
Feedback
The correct answer is: Pain with dorsiflexion of the foot

Question 43
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Choose the initial part of the respiratory tract that is not considered part of gas- exchange airways.

a.

Alveolar sacs

b.

Bronchioles

c.

Respiratory bronchioles

d.

Alveolar ducts

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The correct answer is: Bronchioles

Question 44
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The patient is being discharged home from day surgery after a endoscopy. What instruction should the
patient be given prior to leaving the hospital?

a.

Eat a large meal at home.

b.

The patient is not to drive a vehicle.

c.

Do not sign important papers for the first 12 hours after surgery.
d.

The patient should have a glass of brandy the first night home to help him or her sleep.

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The correct answer is: The patient is not to drive a vehicle.

Question 45
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An informed consent is required for:

a.

Irrigation of the external ear

b.

urethral catheterization

c.

Insertion of an intravenous cathether

d.

A closed reduction of a fracture

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The correct answer is: A closed reduction of a fracture

Question 46
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The nurse would explain to a client with complaints of wheezing and chest tightness that wheezing
occurs when

a.

Air is passing through a narrowed airway

b.

Air is trapped in the alveoli

c.

Sputum production is increased

d.

An allergic reaction is taking place

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The correct answer is: Air is passing through a narrowed airway

Question 47
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A client tells the nurse that he read something about “dead space” in an article about emphysema and
asks the nurse to explain it to him. The nurse’s most accurate answer would be

a.

“Dead space is a small area of necrotic tissue that can cause infection.”

b.

“Dead space consists of parts of the lower airway that serve as a conduit for fresh air.”

c.

“Dead space is an area of your lung that does not participate in air exchange.”

d.

“Any part of your lungs that contains mucous secretions is called dead space.”

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The correct answer is: “Dead space is an area of your lung that does not participate in air exchange.”

Question 48
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In assessing a client for emphysema, the nurse would know that the physical finding most often
associated with this condition is

a.

Bulbous nose
b.

Varicose veins

c.

Barrel chest

d.

Spider angiomas

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The correct answer is: Barrel chest

Question 49
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The goal for a diabetic patient undergoing surgery is to maintain a blood glucose level of:

a.

140-200 mg/dl

b.

300- 350 mg/dl

c.

200- 240 mg/dl

d.

250- 300 mg/dl

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The correct answer is: 140-200 mg/dl

Question 50
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Appendectomy is classified as

a.
Reconstructive

b.

Ablative

c.

Palliative

d.

Constructive

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The correct answer is: Ablative

Question 51
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An example of a surgical procedure classified as urgent is:

a.

An appendectomy

b.

A repair of multiple stab wounds

c.

An exploratory laparotomy

d.

A face lift

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The correct answer is: An exploratory laparotomy

Question 52
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Question text
Which type of surgery is most likely to predispose a patient to postoperative atelectasis, pneumonia or
respiratory failure?

a.

Upper abdominal surgery on a patient with normal pulmonary function

b.

Surgery on the extremities of a nonsmoking football player

c.

Upper abdominal surgery on an obese patient with a long history of smoking

d.

Lower abdominal surgery on a young patient with diabetes mellitus

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The correct answer is: Upper abdominal surgery on an obese patient with a long history of smoking

Question 53
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The primary goal of witholding food & water before surgery is to prevent:

a.

Aspiration

b.

Distention

c.

Obstruction

d.

Infection

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The correct answer is: Aspiration

Question 54
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An oxygen is prescribed to a patient with COPD. The nurse knows that the most effective delivery system
is:

a.

An oxygen mask at 8LPM

b.

A rebreathing bag that delivers O2 greater than 60%

c.

A venturi mask at 55 %

d.

A nasal cannula at 3LPM

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The correct answer is: A nasal cannula at 3LPM

Question 55
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Nursing suggestions for a patient with acute or chronic sinusitis include:

a.

Local heat application to promote drainage

b.

Increased humidity

c.

Adequate fluid intake

d.

All of the above

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The correct answer is: All of the above
Question 56
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What are the circulating nurse's responsibilities, in contrast to the scrbs nurse's reponsibilities?

a.

Setting up sterile table

b.

Assisting the surgeon

c.

Passing instruments

d.

Coordinating the surgical team

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The correct answer is: Coordinating the surgical team

Question 57
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A surgery that is performed to determine the origin or cause of a disorder is categorized as:

a.

Restorative

b.

Diagnostic

c.

Palliative

d.

Curative
Feedback
The correct answer is: Restorative

Question 58
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The intraoperative phase of perioperative nursing ends when the surgery is completed.

a.

True

b.

False

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The correct answer is: False

Question 59
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The nurse who is assessing several clients with respiratory problems would expect that increased tactile
fremitus will most likely be demonstrated by the client with

a.

Pneumonia

b.

Pneumothorax

c.

Pulmonary emboli

d.

Pleural effusion

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The correct answer is: Pneumonia
Question 60
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The patient wears dentures and is reluctant to remove them for the surgery. What is the nurse's best
response?

a.

“You may keep your dentures; I will just notify the operating nurse.”

b.

“Your dentures need to be removed as a safety precaution: they could potentially interfere with your
airway during surgery.”

c.

“Everyone needs to remove their dentures prior to surgery.”

d.

“You can have your teeth back right after your surgery.”

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The correct answer is: “Your dentures need to be removed as a safety precaution: they could potentially
interfere with your airway during surgery.”

Question 61
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A nurse is assessing a 2-day postoperative patient following chest surgery. The patient is reluctant to
ambulate, has a nonproductive cough, and has crackles at the base of the lung. The nurse determines
that the patient is most likely exhibiting symptoms of static pulmonary secretions. What should the
nurse's primary interventions for this entail?

a.

Encourage leg exercises every 2 hours.

b.

Decrease the patient's intake of fluids

c.
Turn the patient and encourage deep breathing every 2 hours.

d.

Send a sputum sample for culture and sensitivity testing.

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The correct answer is: Turn the patient and encourage deep breathing every 2 hours.

Question 62
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When performing a surgical dressing change of a client’s abdominal dressing, a nurse notes an increase
in the amount of drainage and separation of the incision line. The underlying tissue is visible to the
nurse. The nurse would do which of the following in the initial care of this wound?

a.

Irrigate the wound and apply a sterile dry dressing

b.

Apply a sterile dressing soaked in normal saline

c.

Apply a sterile dressing soaked in povidone iodine

d.

Leave the incision open to the air to dry the area.

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The correct answer is: Apply a sterile dressing soaked in normal saline

Question 63
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Which of the following is a basic guideline for maintaining surgical asepsis?

a.

Sterile supplies can be used on another patient if the packages are intact.

b.
The outer lip of a sterile solution is considered sterile.

c.

The scrub nurse may pour a sterile solution from a non-sterile bottle.

d.

Sterile surfaces or articles may touch other sterile surfaces.

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The correct answer is: Sterile surfaces or articles may touch other sterile surfaces.

Question 64
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Which of the following statements best describes the preoperative period?

a.

It begins when the client makes the appointment with the surgeon to discuss the need for surgery.

b.

It is a time during which the client’s need for surgery is established

c.

It is the time during which the client receives education and testing related to the impending surgery

d.

Begins when the client is scheduled for surgery and ends at the time of transfer to the OR bed.

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The correct answer is: It begins when the client makes the appointment with the surgeon to discuss the
need for surgery.

Question 65
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Nursing management for patient with acute pharyngitis includes:

a.
Suggesting a DAT diet

b.

Applying warm compress to relieve sore throat

c.

Encourage used of ice collar

d.

Encourage deep breathing

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The correct answer is: Encourage used of ice collar

Question 66
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Nursing responsibilities before a thoracentesis should include:

a.

Informing the patient about NPO before the procedure

b.

Informing the patient about induction of general anesthesia

c.

Informing the patient about pressure sensation that will be experienced before the procedure

d.

Informing the patient that the position during the procedure is prone

Feedback
The correct answer is: Informing the patient about pressure sensation that will be experienced before
the procedure

Question 67
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Question text
Based on your knowledge on tonsillitis, you know that the patient must have experienced symptoms
that required surgical intervention. Clinical manifestations may have included:

a.

Hypertrophy of the tonsils and repeated attacks of tonsillitis

b.

Sore throat

c.

Frequent fever

d.

Possibility of superinfection

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The correct answer is: Hypertrophy of the tonsils and repeated attacks of tonsillitis

Question 68
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Question text
What should be worn at all times in the restricted zone of the operating room?

a.

Goggles

b.

Clean gloves

c.

Masks covering the nose and mouth

d.

Re-usable shoe covers

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The correct answer is: Masks covering the nose and mouth

Question 69
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A nurse has instructed a preoperative patient about deep breathing and coughing exercises during the
postoperative period. How might the nurse determine that the patient has understood the instructions?

a.

“My deep breathing will help to prevent nausea.”

b.

“If I cough and deep breathe, I will be less likely to develop pneumonia.”

c.

“My coughing and deep breathing exercises will be most effective if I lie on my stomach.”

d.

“Taking deep breaths will help to decrease my incisional pain.”

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The correct answer is: “If I cough and deep breathe, I will be less likely to develop pneumonia.”

Question 70
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Question text
A 55-year-old man is scheduled for colon resection due to presence of mass obstructing the lumen of
the large intestine. This type of surgery is

a.

Emergent

b.

Urgent

c.

Required

d.

Elective
Feedback
The correct answer is: Emergent

Question 71
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In the postprocedure care of a client who had a right thoracentesis, the nurse would

a.

Administer oxygen at 2 L/min per nasal cannula

b.

Assist to ambulate and deep-breathe

c.

Record the amount of fluid withdrawn

d.

Turn the client to the right side

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The correct answer is: Turn the client to the right side

Question 72
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Acute pharyngitis of a bacterial nature is most commonly caused by:

a.

Klebsiella

b.

Pseudomonas

c.

GABHS

d.
Staphylococcus

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The correct answer is: GABHS

Question 73
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Question text
The nurse is taking a respiratory history for a patient who has come into the clinic with chronic cough.
What information should the nurse obtain from this patient?

a.

Previous history of cardiovascular disease

b.

Social support

c.

Occupational & environmental exposure

d.

Financial ability to pay

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The correct answer is: Occupational & environmental exposure

Question 74
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A patient has a wound that has hemorrhaged. What does the nurse understand about the primary cause
of patient's high risk of infection?

a.

Retrograde bacterial contamination

b.

Dead space & deap cells provide culture medium

c.
The tissue become less resilient

d.

Reduced amount of oxygen & nutrients are available

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The correct answer is: Reduced amount of oxygen & nutrients are available

Question 75
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If a client experiences a wound dehiscence, which of the following describes what is happening with the
wound?

a.

Extreme pain at incision site

b.

Purulent drainage

c.

A partial or complete separation of outer layers at incision site

d.

The inner and outer layers of the incision are separated

Feedback
The correct answer is: A partial or complete separation of outer layers at incision site

Question 76
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Which of the following nursing actions would help the patient decrease anxiety during the preoperative
period?

a.

Spending time listening to the patient and answering questions

b.
Reassuring the patient that the surgical staff are competent professional

c.

Encouraging sleep and limiting interruptions

d.

Explaining all procedures thoroughly in chronological order

Feedback
The correct answer is: Spending time listening to the patient and answering questions

Question 77
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A nurse has conducted preoperative teaching for a client scheduled for surgery in 1 week. The client has
history of arthritis and has been taking acetylcylic acid (Aspirin). The nurse determines that the client
needs additional teaching if the client states:

a.

“Aspirin can cause bleeding after surgery.”

b.

“Aspirin can cause my ability to clot blood to be abnormal.”

c.

“I need to discontinue the aspirin 48 hours before the scheduled surgery.”

d.

“I need to continue to take aspirin as prescribed until the day of surgery.”

Feedback
The correct answer is: “I need to continue to take aspirin as prescribed until the day of surgery.”

Question 78
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The nurse measures the postoperative urinary output for a patient. What results should the nurse
report to the surgeon for a 2 hour period?
a.

Between 100-200ml

b.

More tha 200ml

c.

Between 75-100ml

d.

Less than 30ml

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The correct answer is: Less than 30ml

Question 79
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For a patient with chronic bronchitis, the nurse expects to see the major clinical symptoms of:

a.

Chest pain during respiration

b.

Tachypnea & tachycardia

c.

Fever, chills & diaphoresis

d.

Dyspnea & productive cough

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The correct answer is: Dyspnea & productive cough

Question 80
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Question text
A patient has just arrived on the general surgery unit from the PACU. Which of the following needs to be
the initial intervention the nurse takes?

a.

Assess the surgical site, noting the amount and character of drainage

b.

Allow the family to visit the patient to decrease his anxiety

c.

Provide comfort for the patient by draping with blanket

d.

Take vital signs, assessing first for a patent airway and quality of respiration

Feedback
The correct answer is: Take vital signs, assessing first for a patent airway and quality of respiration

Started on Monday, 9 November 2020, 8:01 AM

State Finished
Completed on Monday, 9 November 2020, 9:58 AM
Time taken 1 hour 57 mins
Grade 46.00 out of 81.00 (57%)
Question 1
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Thoracentesis was performed to a chest injured client and drained blood from the chest. What most
likely be the condition of the patient:

a.

Ruptured diaphragm

b.

Spontaneous pneumothorax

c.

Tamponade
d.

Hemothorax

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The correct answer is: Hemothorax

Question 2
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A 60-year-old male client comes into the emergency department with complaints of crushing substernal
chest pain that radiates to his shoulder and left arm. The admitting diagnosis is acute myocardial
infraction (MI). Immediate admission orders include oxygen by nasal cannula at 4 L/minute, blood work,
a chest radiograph, a 12-lead electrocardiogram (ECG), and 2 mg of morphine sulfate given
intravenously. The nurse should first:

a.

Order the chest radiograph

b.

Administer the morphine

c.

Obtain a 12-lead ECG

d.

Obtain the blood work

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The correct answer is: Administer the morphine

Question 3
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The pain in angina is produced primarily by:

a.

Myocardial ischemia
b.

Thromboemboli

c.

Presence of atheroma

d.

Vasoconstriction

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The correct answer is: Myocardial ischemia

Question 4
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The nurse is providing teaching to a patient about reducing modifiable risk factors to peripheral vascular
disease. Which of the following would be an appropriate statement by the nurse?

a.

“Aspirin significantly increases the viscosity of blood”

b.

“Vigorous exercise increases blood viscosity”

c.

“Weight loss yields negligible peripheral vascular improvement”

d.

“Cigarette smoking produces peripheral vasoconstriction”

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The correct answer is: “Cigarette smoking produces peripheral vasoconstriction”

Question 5
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An emergency room nurse is assessing a female client who has sustained a blunt injury in the chest wall.
Which of these signs would indicate presence of a pneumothorax?
a.

Low respiratory rate

b.

Diminished breath sounds

c.

A sucking sound at the site of injury

d.

The presence of barrel chest

Question 6
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When caring for a client immediately after an MI, the nurse’s first priority would be:

a.

Monitoring for presence of dysrhythmias.

b.

Relieving client’s apprehension.

c.

Prevention of embolism.

d.

Relief of pain.

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The correct answer is: Relief of pain.

Question 7
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When teaching the client with MI, the nurse explains that the pain associated with MI is caused by:
a.

Left ventricular overload

b.

Insufficient oxygen reaching the heart muscle

c.

Extracellular electrolyte imbalances

d.

Impending circulatory collapse

Feedback
The correct answer is: Insufficient oxygen reaching the heart muscle

Question 8
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The nurse is teaching the patient with iron deficiency anemia about taking supplemental iron at home.
Which of the following instructions should the nurse be sure to include?

a.

Take medication with vitamin C

b.

Caution of constipation

c.

Supplemental iron may cause diarrhea

d.

Crush the pills & mix with water

Feedback
The correct answer is: Take medication with vitamin C

Question 9
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Question text
The recommended parenteral route for administering iron preparations to treat anemia is:

a.

Intermittent infusion

b.

Deep gluteal IM injection using Z-track method

c.

IM injection at the deltoid muscle

d.

Subcutaneous injection with weekly site rotation

Feedback
The correct answer is: Deep gluteal IM injection using Z-track method

Question 10
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A nurse immediately inspects the patient’s skin. She observes a bluish tinge around the patient’s lips.
She knows that this is an indication of:

a.

Pallor

b.

Xanthelasma

c.

Peripheral cyanosis

d.

Central cyanosis

Feedback
The correct answer is: Central cyanosis

Question 11
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Which of the following terms is used to describe the amout of stretch on the myocardium at the end of
diastole?

a.

Cardiac index

b.

Afterload

c.

Preload

d.

Cardiac output

Feedback
The correct answer is: Preload

Question 12
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The physician inserts a chest tube into a female client to treat pneumothorax. The tube is connected to
water seal drainage. The nurse in charge can prevent chest tube air leaks by:

a.

Checking the patency of the chest tube

b.

Checking & taping all connections

c.

Keeping the chest drainage below the level of the chest

d.

Keeping the head of the bed slightly elevated

Feedback
The correct answer is: Checking & taping all connections

Question 13
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The nurse explaining aspects of pernicious anemia to the client would include information regarding:

a.

Frequent bouts of dyspnea.

b.

Lack of any effective treatment for this disorder.

c.

The risks relative to dehydration.

d.

Deficiency of intrinsic factor.

Feedback
The correct answer is: Deficiency of intrinsic factor.

Question 14
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The nurse should be most concerned about which of the following findings associated with chest pain?

a.

Pain is relieved with 1 nitroglycerin

b.

Pain increases with inspiration

c.

Pain lasts longer than 20 minutes

d.
Pain is relieved with rest

Feedback
The correct answer is: Pain lasts longer than 20 minutes

Question 15
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The statement about dietary iron made by a client with iron deficiency anemia that indicates
understanding of the dietary concepts is

a.

“I know that lean red meat are one of the best source of iron.”

b.

“I will not be able to obtain enough iron by just increasing my dietary intake.”

c.

“I should be able to change my diet so that I can get sufficient iron.”

d.

“I know that iron from animal sources is not absorbed well.”

Feedback
The correct answer is: “I know that lean red meat are one of the best source of iron.”

Question 16
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A medical record of a patient states a probable diagnosis of chronic stable angina. The nurse knows that
patients’ pain is:

a.

Is incapacitating

b.

Is relieved by rest & is predictable

c.
Has increased progressively in frequency & duration

d.

Usually occurs at night & relieved when sitting

Feedback
The correct answer is: Is relieved by rest & is predictable

Question 17
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Question text
The most important long term goal for a client with hypertension would be:

a.

Learn how to avoid stress

b.

Explore job change

c.

Control high blood pressure

d.

Make commitment to long term therapy

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The correct answer is: Control high blood pressure

Question 18
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The nurse would explain that angina pain usually differs from the pain of a myocardial infarction (MI) in
that angina pain:

a.

Is seldom relieved by rest

b.
Lasts less than 15 minutes

c.

Is accompanied by palpitations

d.

Radiates to the arm, jaw, or throat

Feedback
The correct answer is: Lasts less than 15 minutes

Question 19
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Question text
Myocardial cell damage can be reflected by high levels of cardiac enzymes. The most specific index of all
the cardiac enzymes is:

a.

Troponin

b.

Creatinine Kinase

c.

Myoglobin

d.

Alkaline phosphatase

Feedback
The correct answer is: Troponin

Question 20
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In order to prevent tolerance to nitrogycerin patch. The nurse should instruct the patient to:

a.
Use NTG for episodes of angina only

b.

Switch to sublingual NTG when the BP increases

c.

Apply the NTG patch during the day & remove at night

d.

Apply the NTG patch every other day

Feedback
The correct answer is: Apply the NTG patch during the day & remove at night

Question 21
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The nurse would instruct the client with iron deficiency anemia increase intake of the following except?

a.

Poultry.

b.

Citrus fruits.

c.

Leafy green vegetables.

d.

Tea.

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The correct answer is: Tea.

Question 22
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A nurse should know that a diagnosis of hemolytic anemia is associated with all of the following except:
a.

Defective erythrocyte

b.

Elevated bilirubin

c.

Abnormality in the plasma

d.

Decreased reticulocyte count

Feedback
The correct answer is: Abnormality in the plasma

Question 23
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A strong risk factors of heart disease is:

a.

Cholesterol, 300 mg/dl

b.

LDL, 160 mg/dl

c.

HDL, 60 mg/dl

d.

A ration of LDL to HDL, 4.5:1.0

Feedback
The correct answer is: Cholesterol, 300 mg/dl

Question 24
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Question text
Which of the following symptoms should the nurse teach the client with unstable angina to report
immediately to her physician?

a.

Pain during an argument

b.

Pain during sex

c.

A change & worsening pattern of pain

d.

Pain after an activity

Feedback
The correct answer is: A change & worsening pattern of pain

Question 25
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Which diagnostic test will help the physician make the most conclusive diagnosis of aplastic anemia?

a.

Differential blood count

b.

Bone marrow aspiration

c.

Schilling test

d.

Hemogram

Feedback
The correct answer is: Bone marrow aspiration

Question 26
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Question text
The nurse would explain to a client that the isoenzyme specific for damage to the myocardial muscle is:

a.

CK-MM

b.

CK-BB

c.

CK-MB

d.

LDH-5

Feedback
The correct answer is: CK-MB

Question 27
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Question text
Choose an incorrect statement about myocardial infarction pain. It is:

a.

Relieved by rest & inactivity

b.

Sudden in onset and prolonged duration

c.

Substernal in location

d.

Viselike & radiates to the shoulders & arms

Feedback
The correct answer is: Relieved by rest & inactivity
Question 28
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A client with hemolytic blood disorder is jaundiced. The nurse explains to the client that the jaundice is
caused by increased bilirubin in the plasma as a result of:

a.

Increased production of unconjugated bilirubin

b.

Failure of the liver to conjugate indirect bilirubin

c.

Obstruction of bile

d.

Increased hemoglobin in the plasma

Feedback
The correct answer is: Increased production of unconjugated bilirubin

Question 29
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A patient who has been diagnosed with variant (Pritzmetal’s) angina asks the nurse how this type of
angina differs from stable angina. The nurse’s reply should include?

a.

“Variant angina is normally triggered by exertion”

b.

“Variant angina may be associated with changes in the ECG.”

c.

“The chest discomfort of variant angina is worse.”

d.
“The pain of variant angina is less than that of stable angina.”

Feedback
The correct answer is: “Variant angina may be associated with changes in the ECG.”

Question 30
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Question text
The most common symptom of acute myocardial infarction is which of the following?

a.

Shortness of breath

b.

Pain relieved by nitroglycerin

c.

Pain in the shoulder & left arm

d.

Substernal chest pain unrelieved by rest

Feedback
The correct answer is: Substernal chest pain unrelieved by rest

Question 31
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A patient is being seen at the clinic on a monthly basis for assessment of blood pressure. The patient has
been checking BP at home with a consistent reading of 180/100 mmHg. What does the nurse suspect
this patient is experiencing?

a.

Isolated hypertension

b.

Primary hypertension

c.
Hypertensive urgency

d.

Secondary hypertension

Feedback
The correct answer is: Hypertensive urgency

Question 32
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Question text
Lumen narrowing with atherosclerosis is caused by:

a.

Scarred endothelium

b.

All of the above

c.

Thrombus formation

d.

Atheroma formation in the intima

Feedback
The correct answer is: All of the above

Question 33
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Question text
A client diagnosed with a spontaneous pneumothorax necessiting the insertion of a chest tube. What is
the best explanation for the nurse to provide this client:

a.

"The tube will drain fluid from your chest."

b.
"The tube will seal the hole in your lungs."

c.

"The tube controls the amout of air that enters your chest."

d.

"The tube will remove excess air from your chest."

Feedback
The correct answer is: "The tube will remove excess air from your chest."

Question 34
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A healthy serum cholesterol level would be a reading of:

a.

160-200 mg/dl

b.

250- 275 mg/dl

c.

210-240 mg/dl

d.

280-300 mg/dl

Feedback
The correct answer is: 160-200 mg/dl

Question 35
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An intravenous analgesic frequently administered to relieve chest pain associated with myocardial
infarction is:

a.
Hydromorphone hydrochloride

b.

Codeine sulfate

c.

Meperidine hydrochloride

d.

Morphine sulfate

Feedback
The correct answer is: Morphine sulfate

Question 36
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A hypertensive male client, age 55, is slightly obese, has a sedentary lifestyle, and smokes half a pack of
cigarettes daily. For the behavioral change with the most immediate and positive impact on his blood
pressure, the nurse would focus on:

a.

Caffeine restriction

b.

Weight reduction measures

c.

Smoking cessation

d.

Regular exercise

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The correct answer is: Smoking cessation

Question 37
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Question text
A patient with chronic renal failure is being examined by the nurse practitioner for anemia. The nurse
knows to review the laboratory data for a decreased hemoglobin level, RBC and:

a.

Decreased in the iron binding capacity

b.

Increased reticulocyte count

c.

Increased in corpuscular value

d.

Decreased erythropoietin level

Feedback
The correct answer is: Decreased erythropoietin level

Question 38
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Heart rate is stimulated by all of the following except:

a.

The vagus nerve

b.

Increased thyroid hormone

c.

Increased levels of catecholamines

d.

The sympathetic nervous system

Feedback
The correct answer is: Increased thyroid hormone

Question 39
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Question text
A non modifiable risk factors for atherosclerosis is:

a.

Obesity

b.

Family history

c.

Hyperlipidemia

d.

Stress

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The correct answer is: Family history

Question 40
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Because a client is receiving hydrochlorothiazide, a diuretic, for treatment of hypertension, the nurse
would frequently review the client’s level of:

a.

Sodium

b.

Calcium

c.

Hemoglobin

d.

Potassium

Feedback
The correct answer is: Hemoglobin
Question 41
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The nurse is assessing a patient with severe hypertension. When performing a focused assessment of
the eyes, what may be observed related to hypertension?

a.

Papilledema

b.

Retinopathy

c.

Glaucoma

d.

Cataracts

Feedback
The correct answer is: Retinopathy

Question 42
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To determine if the client has a risk factor related to iron deficiency anemia, the nurse could ask

a.

“Have you ever had any surgery involving your stomach?”

b.

“Have you ever had a cardiac catheterization?”

c.

“Have you had a blood transfusion recently?”

d.

“Have you had a recent episodes of heavy bleeding?”

Feedback
The correct answer is: “Have you had a recent episodes of heavy bleeding?”

Question 43
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The nurse begins to design a nutritional packet of information for a patient diagnosed of iron deficiency
anemia. The nurse would recommend an increase intake of:

a.

Whole grain breads

b.

Organ meats

c.

Milk & cheese

d.

Fresh citrus fruits

Feedback
The correct answer is: Organ meats

Question 44
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The nursing diagnosis that would have priority in the care of a client with aplastic anemia is:

a.

Alteration in bowel elimination: Constipation due to iron overload

b.

Risk for Infection due to decreased leukocyte count

c.

Impaired Gas Exchange due to low RBC count

d.

Potential for Impaired Skin Integrity due to poor nutritional status

Feedback
The correct answer is: Impaired Gas Exchange due to low RBC count

Question 45
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The physician has ordered cyanocobalamin (vitamin B12), 1,000 mg intramuscularly, once a day. An
indication of an effective response is that after 3 days of therapy there is an increase in:

a.

Serum iron levels

b.

The megaloblasts in the peripheral blood

c.

Serum folate levels

d.

The reticulocytes count

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The correct answer is: The reticulocytes count

Question 46
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Which of the following would be most appropriate for a patient who is receiving diuretic therapy for
cardiac failure?

a.

Encourage the patient to spend time outdoors to aid in vitamin D absorption.

b.

Discourage use of potassium.

c.

Monitor for hypotension.

d.

Check laboratory results for creatinine levels.

Feedback
The correct answer is: Monitor for hypotension.

Question 47
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A client is scheduled for cardiac catheterization using a radiopaque dye. Which of the following
assessments is most crucial during the procedure?

a.

Allergy to iodine or shellfish

b.

Height & weight

c.

Baseline peripheral pulse

d.

Intake & output

Feedback
The correct answer is: Allergy to iodine or shellfish

Question 48
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The nurse assigned to care for a patient with aplastic anemia. Based on the diagnosis, the nurse would
anticipate which of the following signs or symptoms upon assessing this patient?

a.

Severe headache
b.

Bleeding gums

c.

Development of DVT

d.

Atypical chest pain

Feedback
The correct answer is: Bleeding gums

Question 49
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The nurse informs a client suspected of pernicious anemia that the lab study that will be helpful in the
diagnosis is:

a.

Hemoglobin levels

b.

Endoscopy

c.

Schilling test

d.

Clotting studies

Feedback
The correct answer is: Schilling test

Question 50
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When a client experiences an adverse reaction to a blood transfusion, the nurse should initially:
a.

Administer oxygen via nasal prongs

b.

Discontinue the transfusion

c.

Raise the head of the bed

d.

Notify the physician

Feedback
The correct answer is: Discontinue the transfusion

Question 51
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In advising a 42-year-old, hypertensive female client who is reluctant to give up smoking, the nurse
would state that nicotine from smoking:

a.

Increases blood pressure immediately for a short time

b.

Does not affect blood pressure but increases risk of cardiovascular disease

c.

Causes immediate vasoconstriction & irreversible changes in blood vessels

d.

Is statistically linked to the development of hypertension

Feedback
The correct answer is: Causes immediate vasoconstriction & irreversible changes in blood vessels

Question 52
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Question text
The nurse should teach a client with pernicious anemia who is being treated with folic acid to report any
manifestations related to the:

a.

Cardiovascular system.

b.

Respiratory system

c.

Gastrointestinal system

d.

Neurologic system

Feedback
The correct answer is: Neurologic system

Question 53
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Question text
The nurse advises a patient that sublingual nitroglycerin should alleviate angina pain within:

a.

10-15 minutes

b.

3-4 minutes

c.

60 minutes

d.

30 minutes

Feedback
The correct answer is: 3-4 minutes

Question 54
Correct
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Which of the following instructions should be included in the discharge teaching of a patient with
transdermal nitroglycerin patch?

a.

"Use the patch all day."

b.

"If you get chest pain, apply a second patch."

c.

"Re apply the patch every 4 hours."

d.

"Apply the patch in the anterior chest wall, non hairy & non fatty."

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The correct answer is: "Apply the patch in the anterior chest wall, non hairy & non fatty."

Question 55
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Question text
Which of the following types of pain is most characteristics of angina?

a.

Tightness

b.

Shooting

c.

Knifelike

d.

Sharp

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The correct answer is: Tightness
Question 56
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For a client who wants to prevent the development of hypertension, the nurse would teach the client to
avoid:

a.

Tangerines

b.

Cereals

c.

Coffee

d.

Alcohol & smoking

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The correct answer is: Alcohol & smoking

Question 57
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The nurse understands that which of the following factors provides a stimulus for the production of red
blood cells (RBCs)?

a.

Tissue hypoxia

b.

Normal kidney function

c.

Decline of B12 levels

d.
Low hgb & hct

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The correct answer is: Tissue hypoxia

Question 58
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Which of the following terms describes the force against which the ventricle must expel blood?

a.

Afterload

b.

Preload

c.

Cardiac output

d.

Overload

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The correct answer is: Afterload

Question 59
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Question text
Hypertension is repeated blood pressure measurement exceeding:

a.

110/80 mmHg

b.

140/90 mmHg

c.

120/80 mmHg
d.

130/90 mmHg

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The correct answer is: 140/90 mmHg

Question 60
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The nurse would remind a client that the cause of sudden death after myocardial infarction is usually:

a.

Dysrhythmias.

b.

Congestive heart failure.

c.

Stroke.

d.

Myocardial ischemia.

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The correct answer is: Myocardial ischemia.

Question 61
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The most common vasodilator used to treat myocardial pain is:

a.

Nitroglycerine

b.

Pavabid HCL

c.
Amyl nitrate

d.

Inderal

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The correct answer is: Nitroglycerine

Question 62
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What ECG findings does the nurse commonly observe to patient who had myocardial infarction?

a.

ST segment elevation

b.

A normal Q wave

c.

T- wave elevation

d.

High P wave

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The correct answer is: ST segment elevation

Question 63
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When administering a thrombolytic drug to the client experiencing an MI, the nurse explains to him that
the purpose of the drug is to:

a.

Help keep him well hydrated

b.
Treat potential cardiac dysrhythmias

c.

Prevent kidney failure

d.

Dissolve clots that he may have

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The correct answer is: Dissolve clots that he may have

Question 64
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After instructing a client with stable angina, the nurse would evaluate that the client has a proper
understanding of the condition when the client says

a.

“If I have chest pain, then I’m probably having another heart attack.”

b.

“Angina pain usually feels like being stabbed with a knife.”

c.

“My chest pain can occur if I overexert myself.”

d.

“Each time I have angina, my heart is damaged.”

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The correct answer is: “My chest pain can occur if I overexert myself.”

Question 65
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An elderly patient presents to the physician’s office with a complain of exhaustion. The nurse is aware of
the most common hematologic condition that affects elderly, knows to check the patients:

a.
Thrombocyte count

b.

Levels of plasma protein

c.

White blood cell count

d.

Red blood cell count

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The correct answer is: Red blood cell count

Question 66
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The most common sign of anemia is:

a.

Bleeding gums

b.

Ecchymosis

c.

Fatigue

d.

Jaundice

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The correct answer is: Fatigue

Question 67
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Question text
The nurse would explain to a female client that the most common cause of secondary hypertension that
is related to estrogen values:

a.

Oral contraceptive use

b.

Chronic renal disease

c.

Primary hyperaldosteronism

d.

Pregnancy-induced hypertension

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The correct answer is: Oral contraceptive use

Question 68
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The nurse is providing education about atherosclerosis to the patient. Which of the following statements
by the patient indicates understanding of the teaching?

a.

“The walls of the arteries are weak.”

b.

“My arteries are narrowing and cannot carry much blood.”

c.

“Atherosclerosis is due to chronic inflammation in my arteries.”

d.

“I can completely reverse the effects of atherosclerosis.”

Feedback
The correct answer is: “My arteries are narrowing and cannot carry much blood.”

Question 69
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The nurse explains that the drug essential for a client with pernicious anemia is

a.

Vitamin B12

b.

Vitamin K

c.

Ferrous gluconate

d.

Ferritin

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The correct answer is: Vitamin B12

Question 70
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During a routine assessment of a patient diagnose of anemia, the nurse notes the patient’s beefy red
tongue. The nurse knows that this is a sign of _____ anemia.

a.

Folate deficiency

b.

Autoimmune

c.

Megaloblastic

d.

Iron deficiency

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The correct answer is: Megaloblastic
Question 71
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A nurse is telephoned by a neighbor who describes non-radiating substernal chest pain that was
precipitated by climbing three flights of stairs. The neighbor has taken one sublingual (SL) nitroglycerin
tablet and asks what he should do since the pain is unrelieved. The nurse’s best response would be:

a.

“Drive to the emergency department at once.”

b.

“I’m not qualified to advise you about this. Let me call your doctor.”

c.

“Take another nitroglycerin tablet in 5 minutes and lie down.”

d.

“Call 911.”

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The correct answer is: “Take another nitroglycerin tablet in 5 minutes and lie down.”

Question 72
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When caring for a patient with anemia, the most important nursing action is to:

a.

Encourage her to have some physical activity

b.

Help her conserve her energy

c.

Maintain her fluid and electrolyte balance

d.
Teach her about her diet

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The correct answer is: Help her conserve her energy

Question 73
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The nurse in a hypertension clinic is caring for a woman who has just been diagnosis as having primary
hypertension. She asks the nurse what causes primary hypertension. The nurse’s best response is:

a.

Diabetic vessel changes

b.

The cause is unknown

c.

Renal disease

d.

Atherosclerosis

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The correct answer is: The cause is unknown

Question 74
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The scientific rationale supporting the administration of beta-adrenergic blockers is the drugs’ ability to:

a.

Increase myocardial contractility

b.

Induce bradycardia

c.
Block sympathetic impulses to the heart

d.

Elevate blood pressure

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The correct answer is: Induce bradycardia

Question 75
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The nurse must assess a patient with folic acid deficiency. Based on the diagnosis, the nurse anticipates
which of the following signs & symptoms during assessment?

a.

Nausea, vomiting, diarrhea

b.

Constipation, anxiety, forgetfulness

c.

Progressive weakness, pallor, shortness of breath

d.

Paresthesia, visual deficits, gait disturbance

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The correct answer is: Progressive weakness, pallor, shortness of breath

Question 76
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A patient is diagnosed with primary spontaneous pneumothorax. Which of the following is NOT a
correct statement about this type of pneumothorax?

a.

It can be caused by the rupture of a pulmonary bleb

b.
Smoking increases the chances of developing spontaneous pneumothorax

c.

It can occur in patients who are young, tall & thin without history of lung disease

d.

It is most likely to occur in patients with COPD, asthma & cystic fibrosis

Question 77
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In advising a client with higher levels of high-density lipoproteins (HDLs) in proportion to low-density
lipoproteins (LDLs), the nurse would state that the client:

a.

Should consider a reduced-fat diet

b.

Initiate a consultation

c.

Is less likely to develop CHD

d.

Buy anticholesterol prescription

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The correct answer is: Should consider a reduced-fat diet

Question 78
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The nurse knows that the basic cause of angina pectoris is believed to be:

a.

Insufficient coronary blood flow

b.
Minute emboli

c.

Dysrhytmia triggered

d.

Spasms of the coronary vessel

Feedback
The correct answer is: Insufficient coronary blood flow

Question 79
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Hypertension is known as the silent killer. This phrase is associated with the fact that hypertension often
goes undetected until symptoms of other system failures occur. This may occur in the form of

a.

Myocardial infarction.

b.

Liver disease.

c.

Cerebrovascular accidents (CVA’s)

d.

Pulmonary disease.

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The correct answer is: Cerebrovascular accidents (CVA’s)

Question 80
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A patient was prescribed of nitroglycerin at her bedside to take PRN. The nurse knows that Nitroglycerin
acts as:

a.
Increases the blood pressure

b.

Causing arterial pooling throughout the body

c.

Dilating the coronary arteries to increase the oxygen supply

d.

Constricting arterioles

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The correct answer is: Dilating the coronary arteries to increase the oxygen supply

Question 81
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Of the following controllable risk factors for coronary artery disease (CAD) appears most closely linked
to the development of the disease?

a.

High cholesterol levels

b.

Age

c.

Medication usage

d.

Gender

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The correct answer is: High cholesterol levels

Question 1
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Question text
A client is admitted with angina complains of severe chest pain & suddenly become unresponsive? What
is the priority nursing action?

a.

Check for signs of circulation

b.

Check breathing

c.

Activate resuscitation team

d.

Open client's airway

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The correct answer is: Open client's airway

Question 2
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What is the primary reason for administering morphine to a client with MI?

a.

To sedate the client

b.

To decrease client's anxiety

c.

To decrease oxygen demand on the client's heart

d.

To decrease the client's pain

Feedback
The correct answer is: To decrease the client's pain

Question 3
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Which of the following activities can risk a patient to develop cardiac dysrhytmias?

a.

Urinating in a bedside commode

b.

Valsalva maneuver

c.

Turning to sides

d.

Lying on bed watching TV

Feedback
The correct answer is: Valsalva maneuver

Question 4
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Briefly describe the procedure CABG.

During the surgery, the chest bone is opened to access the heart. Medicines are given to stop the heart,
and a heart-lung bypass machine is used to keep blood and oxygen moving throughout the body during
surgery. This allows the surgeon to operate on a still heart. After surgery, blood flow to the heart is
restored. Usually, the heart starts beating again on its own. In some cases, mild electric shocks are used
to restart the heart.

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Give at least 2 nursing action for patient undergoing Stress Test.
1. ensure signed inform consent

2. NPO 4 hours prior, no alcohol , caffeine, beta-blockers

Question 6
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What can you do to control high blood pressure?

a.

Exercise regularly

b.

All of the above

c.

Take the blood pressure medicine at all times

d.

Get to stay at a healthy weight

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The correct answer is: All of the above

Question 7
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Which of the following conditions is associated with a predictable level of pain that occurs as a result of
physical or emotional stress?

a.

Unstable angina

b.

Anxiety

c.

Variant angina
d.

Stable angina

Feedback
The correct answer is: Stable angina

Question 8
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An early finding in the ECG of a client with infarcted myocardium would be?

a.

Elevated ST segments

b.

Absent P wave

c.

Flattened T waves

d.

Disappering Q waves

Feedback
The correct answer is: Elevated ST segments

Question 9
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Which of the following actions is the 1st priority of care exhibiting signs & symptoms of CAD?

a.

Administer bsublingual nitroglycerin

b.

Educate the client about symptoms

c.
Decrease anxiety

d.

Enhance myocardial oxygenation

Feedback
The correct answer is: Enhance myocardial oxygenation

Question 10
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Why does reducing how much salt you eat help prevent high blood pressure?

a.

It raises levels of HDL

b.

It reduces fluid build up in the body

c.

It helps keep the heartbeat steady

d.

It allows blood vessel to relax

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The correct answer is: It reduces fluid build up in the body

Question 11
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Patrick who is hospitalized following a myocardial infarction asks the nurse why he is taking morphine.
The nurse explains that morphine:

a.

Prevent shock & relieves pain

b.
Decrease anxiety & restlessness

c.

Dilates coronary blood vessels

d.

Helps prevent fibrillation

Feedback
The correct answer is: Prevent shock & relieves pain

Question 12
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You're educating a patient about causes of myocardial infarction. Which statement by the patient
indicates understanding of the disease?

a.

A coronary dissection can happen in women

b.

Patients with HPN don not develop CAD

c.

Patients who have coronary artery disease are at high risk for developing myocardial infarction

d.

The most common cause of MI is coronary spasm from drug use

Feedback
The correct answer is: Patients who have coronary artery disease are at high risk for developing
myocardial infarction

Question 13
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Which of these can increase your risk of high blood pressure?

a.
All of the above

b.

Obesity

c.

Smoking'

d.

A family history of high blood pressure

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The correct answer is: All of the above

Question 14
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Tissue plasminogen activator (t-PA) is considered for treatment of a patient who arrives in the
emergency room following the onset of MI. Which of the following is a contraindication for treatment
with t-PA?

a.

History of cerebral hemorrhage

b.

Hypertension

c.

History of prior myocradial infarction

d.

Worsening chest pain

Feedback
The correct answer is: History of cerebral hemorrhage

Question 15
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Question text
High blood pressure is the main cause of which of these?

a.

Strokes

b.

MI

c.

Cancer

d.

Diabetes

Feedback
The correct answer is: Strokes

Question 16
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What is the correlation of smoking & hypertension?

The nicotine in cigarette smoke is a big part of the problem. It raises your blood pressure and heart rate,
narrows your arteries and hardens their walls, and makes your blood more likely to clot. It stresses your
heart and sets you up for a heart attack or stroke.

Question 17
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To prevent a valsalva manuever in client recovering from an acute myocardial infarction, the nurse
would?

a.

Maintain the client on strict bedrest

b.
Administer stool softeners everyday as ordered

c.

Give anti dysrhythmics prn as ordered

d.

Assist the client to use bedside commode

Feedback
The correct answer is: Administer stool softeners everyday as ordered

Question 18
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A patient was admitted with a diagnosis of to R/O Myocardial Infarction. Which of the following lab
results will be significant?

a.

CK-MB with in 12-24 hours

b.

LDH after 24 hours

c.

SGOT after 1 hour

d.

CK- MB after 4 weeks

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The correct answer is: CK-MB with in 12-24 hours

Question 19
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Which of the following is the most likely origin of pain the client described as knifelike chest pain that
increases in intensity with inspiration?

a.
Cardiac

b.

Musculoskeletal

c.

Gastrointestinal

d.

Pulmonary

Feedback
The correct answer is: Pulmonary

Question 20
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What causes the pain in angina?

due to coronary heart disease. It occurs when the heart muscle doesn't get as much blood as it needs.
This usually happens because one or more of the heart's arteries is narrowed or blocked, also called
ischemia.

Question 21
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Which of the following types of angina is most likely related to MI?

a.

Angina decubitus

b.

Nocturnal angina

c.

Unstable angina

d.
Chronic stable angina

Feedback
The correct answer is: Unstable angina

Question 22
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Which statement best describes the difference between the pain of angina and pain of myocardial
infarction?

a.

Pain associated with angina is confined in the chest area

b.

Pain associated with angina is relieved by rest

c.

Pain of MI is always on the left side

d.

Pain of MI is less severe

Feedback
The correct answer is: Pain associated with angina is relieved by rest

Question 23
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Which of the following conditions is most commonly responsible for myocardial infarction?

a.

Heart Failure

b.

Heart failure

c.
Coronary artery thrombosis

d.

Aneurysm

Feedback
The correct answer is: Coronary artery thrombosis

Started on Thursday, 3 December 2020, 9:03 AM

State Finished
Completed on Thursday, 3 December 2020, 9:45 AM
Time taken 41 mins 12 secs
Grade 29.00 out of 30.00 (97%)
Question 1
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A patient is is manifesting symptoms of pneumonia. Based on your knowledge which of the following
most likely to cause the infection?

a.

Streptococcus pneumonia

b.

Mycobacterium tuberculli

c.

Fungi

d.

Influenza

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The correct answer is: Streptococcus pneumonia

Question 2
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The nurse caring for a client recently diagnosed with active TB would include in the care plan the
significant information regarding medications that

a.

Clients are usually admitted to the hospital to initiate treatment for TB

b.

TB is usually treated with three or more medications to prevent organism resistance and for adequate
infection control

c.

Medications are generally given for 6 to 8 weeks

d.

Clients must report daily to the health department to receive their medication

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The correct answer is: TB is usually treated with three or more medications to prevent organism
resistance and for adequate infection control

Question 3
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In preventing the spread of the coronavirus which of the following population should we protect the
most?

a.

All of the above

b.

People with underlying disease

c.

Infants

d.

Older people
Feedback
The correct answer is: All of the above

Question 4
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A client with bacterial pneumonia is to be started on intravenous antibiotics. Which of the following
diagnostic tests must be completed before antibiotic therapy begins?

a.

Urinalysis

b.

Chest radiograph

c.

Sputum culture

d.

Red blood cell count

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The correct answer is: Sputum culture

Question 5
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Mr. AA needs to know that the initial intensive treatment is usually given daily for:

a.

4-6 months

b.

2 weeks

c.

2 months
d.

2-4 weeks

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The correct answer is: 4-6 months

Question 6
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What is the best advice you should give to a patient who is high risk of developing COVID 19?

a.

Observe measures to maintain good mental health

b.

Wash hands regularly, wear mask & follow the physical distancing advise

c.

Take anti viral drugs as prophylaxis

d.

Take antibiotics for 7 days

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The correct answer is: Wash hands regularly, wear mask & follow the physical distancing advise

Question 7
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Mr. AA is started on multiple drug regimen. Nursing management includes observing for ototoxicity
when _____________ is used:

a.

Isoniazid

b.

Ethambutol
c.

Streptomycin

d.

Rifampicin

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The correct answer is: Ethambutol

Question 8
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The nurse writing an infection control policy for a home health care agency would include the
information that the rise in TB cases in recent years is related to

a.

The aging of the population

b.

he rise in number of antibiotic-resistant bacteria

c.

The rise in illegal drug use

d.

The rise in HIV infection.

Feedback
The correct answer is: The aging of the population

Question 9
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An elderly client with respiratory complaints came to the emergency room which of the following
manifestation is highly suggestive of pneumonia:

a.

Fever, productive cough & chills

b.

Hemoptysis

c.

Altered mental state

d.

Dyspnea

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The correct answer is: Fever, productive cough & chills

Question 10
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Which of the following is an example of physical distancing?

a.

Talking with family members

b.

Interacting with strangers thru shakehands

c.

Going out with friends

d.

You stop going to crowded places & visiting other people's

Feedback
The correct answer is: You stop going to crowded places & visiting other people's

Question 11
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Which of the following areas has the highest risk of transmission?

a.
Confined or crowded place

b.

Neignborhood

c.

Public transport

d.

Small shops

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The correct answer is: Confined or crowded place

Question 12
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The nurse would explain that the client’s diagnosis of pneumonia means

a.

The alveoli are filled with fluid.

b.

There is an inflammatory response in the tissue surrounding the air space.

c.

The small bronchioles are inflamed.

d.

Pus has accumulated in the major bronchi.

Feedback
The correct answer is: There is an inflammatory response in the tissue surrounding the air space.

Question 13
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Which of the following treatments mostlikely to be prescribed to a patient with pneumonia
a.

Oxygen therapy

b.

Antibiotics

c.

Bronchodilators

d.

Chest tube

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The correct answer is: Antibiotics

Question 14
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Coronavirus can be transmitted from person to perso through:

a.

Eating of contaminated food

b.

Drinking unclean water

c.

Through droplets that come from the mouth or nose when a person coughs or sneeze

d.

Sexual fluids including semen & vaginal fluids

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The correct answer is: Through droplets that come from the mouth or nose when a person coughs or
sneeze

Question 15
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Question text
It is one of the common symptoms of covid 19 that is related to the release of Interleukin chemical
mediator:

a.

Sore throat

b.

Fever

c.

Continuous cough

d.

Tiredness

Feedback
The correct answer is: Fever

Question 16
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The nurse interprets a Mantoux reaction as “0 millimeters,” a negative test. The client tells the nurse,
“It’s good to know that I definitely don’t have TB.” The correct response by the nurse would be

a.

“A negative Mantoux test means that you have not been exposed to TB.”

b.

“A negative test simply means that you do not need treatment at this time.”

c.

“A negative test does not always mean that TB is not present.”

d.

“This means that you do not have active TB at this time.”

Feedback
The correct answer is: “A negative Mantoux test means that you have not been exposed to TB.”

Question 17
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A 44-year-old man with active pulmonary tuberculosis is experiencing hemoptysis, which describes

a.

Chest pain

b.

Bloody sputum

c.

Constant cough

d.

Dyspnea

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The correct answer is: Bloody sputum

Question 18
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A patient is admitted with pneumonia. Sputum cultures show that the patient is infected with a gram
positive bacilli. The patient claims that he is allergic to Penicillin. Which of the following medication
would the patient most likely be prescribed?

a.

Cephalosporin

b.

Amoxcillin

c.

Pen G

d.

Tamiflu
Feedback
The correct answer is: Cephalosporin

Question 19
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In planning for a client diagnosed with TB who is being admitted to the nursing unit, the nurse would
place the client in a room

a.

With two windows

b.

Near the elevator

c.

Near the nurses’ station

d.

With negative air flow

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The correct answer is: With negative air flow

Question 20
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After Mr. AA has undergone series of additional test, the diagnosis is confirmed by:

a.

Acid fast bacilli in sputum smear

b.

A chest radiograph

c.

Repeated Mantoux tests that yield indurations of 10mm or greater

d.

A positive multiple puncture skin test

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The correct answer is: A chest radiograph

Question 21
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A patient was admitted in the hospital 48 hours ago for chest stab wound treatment. Then the patient
suddenly developed productive cough & fever. Upon auscultation, you note crackles in the right lower
lobe. Based on the scenario, this is known to be a case of:

a.

Community acquired pneumonia

b.

Lobar pneumonia

c.

Hospital acquired pneumonia

d.

Ventilator acquired pneumonia

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The correct answer is: Hospital acquired pneumonia

Question 22
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You handled an active TB in the ward. Which of the following symptoms will you expect the patient will
exhibit?

a.

Chills, fever, night sweats & hemoptysis

b.
Chest & lower back pain

c.

Nausea

d.

Fever of 104 degree F

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The correct answer is: Chills, fever, night sweats & hemoptysis

Question 23
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Which of the following pathophysiologic mechanism that describes the pooling of secretions to the lung
parenchyma in cases of pneumonia infection?

a.

Inflammation & Consolidation

b.

Coughing

c.

Bronchiectasis

d.

Atelectasis

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The correct answer is: Inflammation & Consolidation

Question 24
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If a person is with covid which of the following statements is true:

a.
All patients with COVID 19 can be identified easily because they cough a lot

b.

Not everyone with COVID 19 has symptoms

c.

All of the above

d.

A person with covid he does not need to isolate

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The correct answer is: Not everyone with COVID 19 has symptoms

Question 25
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Who among the following patients are at risk to develop COVID 19:

a.

A patient with amoebiasis

b.

A 35 y/o adult with an active lifestyle

c.

A 10 year old kid that stays at home

d.

An HIV patient

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The correct answer is: An HIV patient

Question 26
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Handwashing is one of the best way to control the transmission of corona virus by way of:
a.

Lukewarm water is best

b.

Using running water only

c.

Soap & water is enough

d.

Using a strong bleach

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The correct answer is: Soap & water is enough

Question 27
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The nurse would know that the client most likely to exhibit a a positive Mantoux Test:

a.

A malnourished client

b.

An pneumonia-infected client

c.

A close contact to a patient with pulmonary tuberculosis

d.

A client diagnosed with sickle cell disease

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The correct answer is: A close contact to a patient with pulmonary tuberculosis

Question 28
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Question text
Mr. AA is informed that he will no longer considered infectious after:

a.

Repeat Mantoux tests are negative

b.

Serial chest radiographs show improvement

c.

Two consecutive specimens are negative

d.

All of the above parameters are present

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The correct answer is: All of the above parameters are present

Question 29
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Which of the following measures would most likely be successful in reducing pleuritic chest pain in a
client with pneumonia?

a.

Have the client practice abdominal breathing

b.

Encourage the client to breathe shallowly

c.

Teach the client to splint the rib cage when coughing

d.

Offer the client incentive spirometry

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The correct answer is: Teach the client to splint the rib cage when coughing

Question 30
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Mr. AA’s Mantoux test yields an induration of 10mm. This result is interpreted as:

a.

Preventive treatment should be initiated

b.

Active disease is absent

c.

The reaction is doubtful and should be repeated

d.

Has been exposed to M. tuberculli

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The correct answer is: Has been exposed to M. tuberculli