DAVIS 592. A nurse is caring for a client with type 2 diabetes on a 4.

A nurse is caring for a client with type 2 diabetes on a 4. “I will need to notify the physician because a snack at
telemetry unit. The client is scheduled for cardiac this time will affect the client’s blood glucose level and the
ENDOCRINE rehabilitation exercises (cardiac rehab). The nurse notes next dose of glargine insulin.”
588. A clinic nurse is evaluating a client with type 1 that the client’s blood glucose level is 300 mg/dL and the
urine is positive for ketones. Which nursing action should 595. A nurse is teaching a client who has been newly
diabetes who intends to enroll in a tennis class. Which diagnosed with type 2 diabetes mellitus (DM). Which
statement made by the client indicates that the client be included in the nurse’s plan of care?
teaching point should the nurse emphasize?
understands the effects of exercise on insulin demand? 1. Send the client to cardiac rehab because exercise will
1. Use the arm when self-administering NPH insulin.
1. “I will carry a high-fat, high-calorie food, such as a lower the client’s blood glucose level.
cookie.” 2. Administer insulin and then send the client to cardiac 2. Exercise for 30 minutes daily, preferably after a meal.

2. “I will administer 1 unit of lispro insulin prior to playing rehab with a 15-gram carbohydrate snack. 3. Consume 30% of the daily calorie intake from protein
tennis.” 3. Delay the cardiac rehab because blood glucose levels foods.

3. “I will eat a 15-gram carbohydrate snack before playing will decrease too much with exercise. 4. Eat a 30-gram carbohydrate snack prior to strenuous
tennis.” 4. Cancel the cardiac rehab because blood glucose levels activity.

4. “I will decrease the meal prior to the class by 15-grams will increase further with exercise. 596. A nurse is evaluating a client’s outcome. The client’s
of carbohydrates.” 593. A nurse administers 15 units of glargine (Lantus®) nursing care plan includes the nursing diagnosis of fluid
volume deficit related to hyperosmolar hyperglycemic
589. Two hours after taking a regular morning dose of insulin at 2100 hours to a Hispanic client when the client’s
fingerstick blood glucose reading was 110 mg/dL. At 2300 nonketotic syndrome (HHNS) secondary to severe
Insulin Regular (Humulin R®), a client presents to a clinic hyperglycemia. The nurse knows that the client has a
with diaphoresis, tremors, palpitations, and tachycardia. hours, a nursing assistant reports to the nurse that an
evening snack was not given because the client was positive outcome when which serum laboratory value has
Which nursing action is most appropriate for this client? decreased to a normal range?
sleeping. Which instruction by the nurse is most
1. Check pulse oximetry and administer oxygen at 2 L per appropriate? 1. Glucose
nasal cannula.
1. “You will need to wake the client to check the blood 2. Sodium
2. Administer a baby aspirin, one sublingual nitroglycerin glucose and then give a snack. All diabetics get a snack at
tablet, and obtain an electrocardiogram (ECG). bedtime.” 3. Osmolality

3. Check blood glucose level and provide carbohydrates if 2. “It is not necessary for this client to have a snack 4. Potassium
less than 70 mg/dL (3.8 mmol/L). because glargine insulin is absorbed very slowly over 24 597. A client with type 1 diabetes mellitus is scheduled for
hours and doesn’t have a peak.” a total hip replacement. In reviewing the client’s orders the
4. Check vital signs and administer atenolol (Tenormin®) 25
mg orally if heart rate is greater than 120 beats per 3. “The next time the client wakes up, check a blood evening prior to surgery, a nurse notes that the physician
minute. glucose level and then give a snack.” did not write an order to change the client’s daily insulin
dose. Which nursing action is most appropriate?
1. Notify the physician who wrote the insulin order in the 2. Ensure that the client eats a bedtime snack. 4. Regular insulin infusion per protocol adjusting dose
client’s medical record. based on hourly glucose levels
3. Assess the client’s ability to read small print.
2. Write an order to decrease the morning insulin dose by 602. Which instructions should the nurse provide to a
4. Teach the client how to perform a hemoglobin A1c test.
one-half of the prescribed morning dose. client regarding diabetes management during stress or
5. Instruct the client on storing prefilled syringes in the illness? SELECT ALL THAT APPLY.
3. Do nothing because the physician would want the client
refrigerator.
to receive the usual insulin dose prior to surgery. 1. Notify the health-care provider if unable to keep fluids
6. Teach the client to take one unit of 70/30 insulin after or foods down.
4. Inform the day shift nurse to check the client’s
eating a snack.
fingerstick glucose before surgery and hold the morning 2. Test fingerstick glucose levels and urine ketones daily
dose of insulin. 600. A friend brings an older adult homeless client to a and keep a record.
free health-screening clinic because the friend is unable to
598. A nurse administers a usual morning dose of 4 units of 3. Continue to take oral hypoglycemic medications and/or
regular insulin and 8 units of NPH insulin at 7:30 a.m. to a continue administering the client’s morning and evening insulin as prescribed.
insulin for type 1 diabetes mellitus. When advocating for
client with a blood glucose level of 110 mg/dL. Which
statements regarding the client’s insulin are correct? this client, which action by the nurse is most appropriate? 4. Supplement food intake with carbohydratecontaining
fluids, such as juices or soups.
1. Notify Adult Protective Services about the client’s
1. The onset of the regular insulin will be at 7:45 a.m. and
the peak at 1:00 p.m. condition and living situation. 5. When on an oral agent, administer insulin in addition to
the oral agent during the illness.
2. Ask where the client lives and if someone else can
2. The onset of the regular insulin will be at 8:00 a.m. and
the peak at 10:00 a.m. administer the insulin. 6. A minor illness, such as the flu, usually does not affect
the blood glucose and insulin needs.
3. Contact the unit social worker to arrange for someone
3. The onset of the NPH insulin will be at 8:00 a.m. and the
peak at 10:00 a.m. to give the client’s insulin at a local homeless shelter. 603. A nurse evaluates a client who is being treated for
diabetic ketoacidosis (DKA). Which finding indicates that
4. Have the client return to the screening clinic mornings
4. The onset of the NPH insulin will be at 12:30 p.m. and the client is responding to the treatment plan?
the peak at 11:30 p.m. and evenings to receive the insulin injections.
1. Eyes sunken, skin flushed
601. Which physician’s order should the nurse question for
599. A home-health nurse is planning the first home visit
for a 60-year-old Hispanic client newly diagnosed with type a newly admitted client diagnosed with diabetic 2. Skin moist with rapid elastic recoil
ketoacidosis (DKA)?
2 diabetes mellitus. The client has been instructed to take 3. Serum potassium level is 3.3 mEq/L
70/30 combination insulin in the morning and at 1. D5W at 125 mL per hour
suppertime. Which interventions should be included in the 4. ABG results are pH 7.25, PaCO2 30, HCO3 17
client’s plan of care? SELECT ALL THAT APPLY. 2. KCL 10 mEq in 100 mL NaCl IV now
604. A nurse is documenting nursing diagnoses for a client
1. Instruct the client to inspect the feet daily. 3. Stat arterial blood gases. Administer sodium bicarbonate with elevated growth hormone (GH) levels. Which nursing
if pH is less than 7.0.
diagnosis is least likely to be included in the client’s plan of 3. Fluid restriction of 800 to 1,000 mL per day 3. Report adverse effects of the medication, including
care? weight gain, cold intolerance, and alopecia.
4. 0.3% sodium chloride IV infusion
1. Fluid volume deficit related to polyuria 4. Use levothyroxine sodium (Synthroid®) as a
610. An agitated client is admitted to the emergency replacement hormone for diminished or absent thyroid
2. Insomnia related to soft tissue swelling department (ED) with tachycardia, dyspnea, and function.
intermittent chest palpitations. The client has a blood
3. Impaired communication related to speech difficulties pressure of 170/110 mm Hg and heart rate of 130 beats 5. Have frequent laboratory monitoring to be sure your
4. Disturbed body image related to undersized hands, per minute. The client’s health history reveals thinning levels of T3 and T4 decrease.
feet, jaw, and soft body tissue hair, recent 10-lb. weight loss, increased appetite, fine
hand and tongue tremors, hyperreflexic tendon reflexes, 613. A clinic nurse evaluates that a client’s levothyroxine
605. Which nursing actions are most appropriate when (Synthroid®) dose is too low when which findings are
and smooth moist skin. A physician writes orders for the
caring for a client diagnosed with diabetes insipidus (DI)? client. Which order should the nurse implement first? noted? SELECT ALL THAT APPLY.
SELECT ALL THAT APPLY. 1. Increased appetite
1. Obtain 12-lead electrocardiogram (ECG).
1. Monitoring fingerstick blood glucose before meals and
2. Administer propranolol (Inderal®) 2 mg intravenously 2. Decreased sweating
at bedtime
q10–15min or until symptoms are controlled. 3. Apathy and fatigue
2. Monitoring urine output hourly
3. Administer propylthiouracil (PTU) 600 mg oral loading 4. Paresthesias
3. Checking urine ketones dose followed by 200 mg orally q4h.
5. Fine tremor of fingers and tongue
4. Administering desmopressin acetate (DDAVP) 4. Obtain thyroid-stimulating hormone (TSH), free T4, and
cardiac enzyme levels. 6. Slowed mental processes
5. Monitoring for signs of hyperkalemia
6. Monitoring daily weights 611. A clinic nurse is teaching a client who has been
diagnosed with hypothyroidism. Which instructions should 614. Which nursing diagnosis should a nurse include when
606. A client has developed syndrome of inappropriate the nurse provide regarding the use of levothyroxine developing a plan of care for a client with hypothyroidism?
antidiuretic hormone (SIADH) secondary to a pituitary sodium (Synthroid®)? SELECT ALL THAT APPLY.
tumor. The client’s symptoms include thirst, weight gain, 1. Diarrhea related to gastrointestinal hypermotility
and fatigue. The client’s serum sodium is 127 mEq/L. 1. Take the medication 1 hour before or 2 hours after
breakfast. 2. Imbalance nutrition: less than body requirements
Which physician order should the nurse anticipate when
treating SIADH? related to calorie intake insufficient for metabolic rate
2. Obtain a pulse rate before taking the medication, and
call the clinic if the pulse rate is greater than 100 beats 3. Activity intolerance related to increased metabolic rate
1. Elevate the head of the bed
per minute.
2. Administer vasopressin intravenously (IV) 4. Anxiety related to forgetfulness, slowed speech, and
impaired memory loss
616. A nurse is teaching a client experiencing
hypoparathyroidism resulting from a lack of parathyroid
hormone (PTH) about foods to consume. Which should be
included on a list of appropriate foods for a client
experiencing hypoparathyroidism?
1. Dark green vegetables, soybeans, and tofu
2. Spinach, strawberries, and yogurt
3. Whole grain bread, milk, and liver
4. Rhubarb, yellow vegetables, and fish

621. Which medication should a nurse plan to administer

to a client admitted in Addisonian crisis?
1. Regular insulin
2. Ketoconazole (Nizoral®)
3. Sodium nitroprusside (Nipride®)
4. Hydrocortisone (Solu-Cortef®)
626. A nurse is caring for a client who is experiencing
symptoms associated with pheochromocytoma. Which
intervention should be included in the care of this client?
1. Offer distractions such as television or music.
2. Encourage frequent intake of oral fluids.
3. Assist with ambulation at least three times a day.
4. Administer nicardipine (Cardene®) to control
hypertension.
9
DAVIS NEUROLOGICAL 2. Severe headache 833. A client being admitted for surgery has a vagus nerve
stimulation (VNS) device that was implanted several
828. A client is scheduled for an outpatient 3. Pill-rolling tremor months earlier for seizure management. The nurse
electroencephalogram (EEG). A nurse instructs the client to
4. Photophobia determines that the VNS is working properly when:
prepare for the test by:
5. Fever 1. it stimulates the heart to beat when the client has
1. removing all hair pins. bradycardia during a seizure.
6. Micrographia
2. avoiding eating or drinking at least 6 hours prior to the 2. the client activates the device to stop a seizure from
test. 831. A client is hospitalized with a diagnosis of occurring.
meningococcal meningitis. The client is at risk for the
3. being prepared to have some of the scalp shaved. 3. it defibrillates the client when the client experiences a
complication of septic emboli. Which intervention by a
4. having blood drawn for a glucose level 2 hours before nurse directly addresses this risk? lethal dysrhythmia during a seizure.
the test. 4. the client does not experience any airway obstruction
1. Monitoring vital signs on an hourly basis
829. A client is seen by a primary care provider because of from secretions during a seizure.
2. Administering meningitis polysaccharide vaccine
difficulty walking. A neurological assessment is done. A 834. A client with a history of epilepsy has consecutive
nurse informs the client that which assessment procedure (Menoune®)
seizures lasting more than 5 minutes and is in status
was done to test the functioning of the cerebellum? 3. Assessing neurological function with the Glasgow coma epilepticus. Which interventions should be included in this
1. Ask the client to shut the eyes and distinguish whether scale every 2 hours client’s immediate treatment? SELECT ALL THAT APPLY.
the touch is with a sharp or dull object (either end of a 4. Completing a vascular assessment of all extremities 1. Administer dexamethasone (Decadron®) intravenously.
cotton-tipped applicator). every 2 hours
2. Administer oxygen and prepare for endotracheal
2. Ask the client to hold hands with palms up 832. A client is admitted to an emergency department intubation.
perpendicular to the body with eyes closed. (ED). A nurse in the ED documents that the client is
“postictal upon transfer” as evidenced by which 3. Prepare for immediate defibrillation.
3. Ask the client to grasp and squeeze 2 fingers of each of
the examiner’s hands. observation? 4. Continue to protect the patient from injury.
1. Yellowing of the skin
4. Ask the client to alternate placing hands up and then 5. Administer lorazepam (Ativan®) intravenously.
hands down on thighs as fast as possible. 2. Recently experienced a seizure and is in a drowsy or 6. Transfer to a facility with expertise in treating status
confused state
830. A nurse is admitting a client with a diagnosis of epilepticus.
meningitis. Which of the nurse’s assessment findings 3. Severe itching of the eyes 835. A client has undergone a lumbar laminectomy with
support this diagnosis? SELECT ALL THAT APPLY.
4. Abnormal sensations including tingling of the skin spinal fusion 12 hours earlier. Which assessment finding
1. Nuchal rigidity
should indicate to a nurse that the client has a leakage of 838. A nurse learns in report that a client admitted with a 2. Taking baclofen (Lioresal®) 15 mg 3 times per day
cerebrospinal fluid? vertebral fracture has a halo external fixation device in
place. Based on this information, for which intervention 3. Working 4 to 8 hours per week in the family business
1. Backache not relieved by analgesics should the nurse plan? 4. Stopped taking amytriptyline (Elavil®) 8 weeks earlier.
2. 100 mL of serosanguineous fluid measured from the 1. Ensure the weight with the traction is hanging freely.
Jackson-Pratt® drain since surgery 5. Presence of a cardiac murmur at the fifth intercostal
space to the left of the sternum
2. Remove the vest at bedtime.
3. Clear fluid drainage noted on the surgical dressing
3. Perform pin site care. 6. Leans on cane and right leg weakness noted when
4. Temperature of 101.3°F (38.5°C) walking in room
4. Progressively loosen the pins in the skull each day.
836. A client has had recurrent episodes of low back pain. 841. A client develops muscle weakness and seeks medical
Which statement indicates that the client has incorporated 839. A nurse is caring for a client with a spinal cord injury attention from a primary care provider. The client asks a
positive lifestyle changes to decrease the incidence of at the level of the sixth cervical vertebra. The client is at nurse during the initial assessment if the symptoms
future back problems? risk for the complication of autonomic dysreflexia. For suggest “Lou Gehrig’s” disease. Which is the most
which associated symptoms should a nurse monitor the appropriate response to the client?
1. “I stoop and avoid twisting when I lift objects.” client? SELECT ALL THAT APPLY.
1. “You may have been working too much and that is why
2. “I wear my old comfortable shoes whenever I go for a 1. Sweating you are tired. Let’s not think the worst.”
walk to avoid blisters.”
2. Headache 2. “Tell me what has you thinking that you might have
3. “I walk 5 miles each day on the weekends.” Lou Gehrig’s disease.”
3. Hypotension
4. “I sit as much as possible and elevate my legs.” 3. “Have you been having trouble remembering things
4. Blurred vision
837. A nurse in an emergency department assesses a client along with this weakness?”
injured in a diving accident 2 hours earlier. A computed 5. Anxiety 4. “Well, you are in the right place to figure out what is
tomography (CT) scan reveals a fracture of the C4 cervical
6. Tachycardia going on.”
vertebra. The client is breathing independently but has no
movement or muscle tone from below the area of injury. 840. A client with multiple sclerosis is seen in an office of a 842. A client with a diagnosis of Guillain-Barré syndrome is
The nurse understands that the client: primary care provider. The client states that fatigue is the scheduled to receive plasmapheresis treatments. A nurse
present concern. A nurse performs an assessment and explains to the client’s spouse that the purpose of
1. has suffered a complete spinal cord injury (SCI).
reviews the client’s current medications and blood plasmapheresis is to:
2. is experiencing spinal shock. laboratory results. Which findings by the nurse are most 1. remove excess fluid from the bloodstream.
likely to contribute to the client’s fatigue? SELECT ALL THAT
3. has sustained an upper motor neuron injury. APPLY. 2. restore protein levels in the blood.
4. will be a quadriplegic. 1. Hemoglobin is 9.5 g/dL and hematocrit is 31.8% 3. remove circulating antibodies from the bloodstream.
4. infuse lipoproteins to restore the myelin sheath. 2. Increase in cerebral circulation and perfusion 2. global aphasia.
843. For which associated complication should a nurse 3. Increase in serum pH 3. expressive aphasia.
monitor the client experiencing Guillain-Barré syndrome?
4. Improved brain tissue oxygenation 4. both receptive and expressive aphasia.
1. Autonomic dysreflexia
2. Septic emboli 846. A client who receives a diagnosis of right-sided stroke 848. A client is admitted to the intensive care unit with a
should be assessed for risk factors of stroke during the severe stroke. The client is receiving a continuous
3. Increased intracranial pressure (ICP) initial hospitalization, and measures should be instituted to intravenous insulin infusion titrated according to hourly
lessen the client’s risk. A nurse should address these risk blood glucose results to control hyperglycemia. The client’s
4. Respiratory failure factors as a priority and institute measures because: spouse asks the nurse why the client is receiving insulin
844. A home health nurse evaluates the foot care of a SELECT ALL THAT APPLY. when the client is not diabetic. Which explanations to the
client with peripheral neuropathy. Which client actions in client’s spouse should the nurse include? SELECT ALL THAT
1. one of every four strokes occurs as a recurrent stroke. APPLY
providing foot care are appropriate? SELECT ALL THAT
APPLY. 2. the time period of greatest risk for a second stroke is 1. “The body reacts to stress by producing various
the first 30 days after ischemic symptoms occur. hormones, which results in elevated glucose levels.”
1. Visually inspects the feet on a daily basis including
using a handled mirror to see the bottom of the foot 3. the potential for recovery continues for at least 6 2. “The body has less effective utilization of glucose
months after the initial stroke event. during serious illness.”
2. Applies a lubricating lotion to the feet and legs daily,
but not in between the toes 4. controlling modifiable risk factors is too difficult for 3. “Insulin lessens the likelihood of brain tissue becoming
persons who have already experienced a stroke. swollen.”
3. Goes barefoot in the house to air out the feet
5. the resultant deficit will cause the client to deny or
4. States wearing warm socks and boots when outside in 4. “Use of insulin will decrease the likelihood of the client
minimize that there is a problem. becoming diabetic in the future.”
cold weather
6. most stroke victims develop depression and less interest
5. Tests bath water with a thermometer 5. ‘The stroke affected the part of the brain that controls
in learning preventive measures as the recovery process the release of insulin.”
6. Trims toenails weekly to a rounded contour lengthens.
6. “A side effect of the medications administered is the
845. A nurse is performing hourly neurological assessment 847. A client who has had a stroke stares at a nurse but development of type 1 diabetes mellitus.”
checks on a client who is admitted with changes in mental does not attempt to verbally respond to the nurse’s
status. The nurse understands that frequent assessments questions. The client follows instructions without any 849. A client with a deteriorating mental status after
are used to determine if a client is developing increased problems. The nurse understands that the client is suffering a stroke has a rectal temperature of 102.3°F
intracranial pressure (ICP). Which option correctly displaying symptoms consistent with: (39.1°C). For which reason should a nurse initiate
describes the outcome if ICP is untreated and progresses? interventions to bring the temperature to a normal level?
1. receptive aphasia.
1. Displacement of brain tissue
1. A normal temperature will strengthen the client’s 852. A client is admitted to an intensive care unit because 854. A nurse should plan for which measure to treat an
immune system against infection. of a leaking cerebral aneurysm. A family member asks a elderly client with normal pressure hydrocephalus (NPH)?
nurse why the client is awakened and questioned about his
2. Hyperthermia lowers the incidence of mortality. 1. Carotid endarterectomy
orientation so frequently when he needs to rest. The nurse
3. A normal temperature will decrease the score on the answers the family member based on the knowledge that 2. Ventriculoperitoneal shunt
Glasgow coma scale. the earliest sign of increased intracranial pressure (ICP) is:
3. Lumbar drain
4. Hyperthermia increases the likelihood of a larger area 1. pupillary changes.
of brain infarct. 4. Anticonvulsant medications
2. drop in the blood pressure.
855. Following an industrial accident in which a client
850. A client is diagnosed with a stroke that affects the 3. altered sensation.
right hemisphere of the brain. A nurse, receiving report sustained a severe craniocerebral trauma, the client
develops the complication of diabetes insipidus (DI). A
prior to the care of this client, should expect the client to 4. changes in the level of consciousness.
have which symptom? nurse suspects this complication is occurring when
853. A nurse is orienting a new nurse to a unit. The observing which symptom?
1. Right hemiparesis experienced nurse evaluates that the new nurse
understands information related to a stroke resulting from 1. Hyperglycemia
2. Expressive aphasia a subarachnoid hemorrhage when which points are 2. Large amounts of urinary output
3. Poor impulse control addressed by the new nurse? SELECT ALL THAT APPLY.
3. Elevated urine specific gravity
4. Marked anxiety when learning new tasks 1. Subarachnoid hemorrhage is often associated with a
rupture of a cerebral aneurysm. 4. Decrease in level of consciousness
851. A client seeks medical attention at an emergency
department after experiencing left-sided weakness and 2. Subarachnoid hemorrhage usually occurs while the 856. A client hits her head in a minor motor vehicle
client is sleeping and is noticed when the client awakens. accident and refuses medical attention at the time of the
slurred speech. The client receives a diagnosis with an
ischemic stroke and is evaluated for treatment with accident. The client makes an appointment with a primary
3. Subarachnoid hemorrhage is accompanied by care provider 6 weeks later because of headaches. The
thrombolytic therapy. A definite contraindication for complaints of an extremely severe headache.
thrombolytic therapy is: primary care provider diagnoses the client with mild
traumatic brain injury (TBI). Which details noted by a nurse
4. Subarachnoid hemorrhage may be treated with
1. a normal computed tomography (CT) scan of the brain. thrombolytic therapy if no contraindications exist. in the client’s history of the injury support this diagnosis?
SELECT ALL THAT APPLY.
2. a serious head injury 4 weeks earlier. 5. Subarachnoid hemorrhage often results in bloody
cerebrospinal fluid (CSF). 1. The client has had no episodes of vomiting after the
3. a history of diabetes mellitus. accident.
4. the onset of neurological deficits 2 hours earlier. 6. Subarachnoid hemorrhage causes nuchal rigidity.
2. The client remembers the events leading up to the
accident and what occurred during the accident.
3. The client has experienced episodes of headache and 3. Client who has had a liver transplant 2. The client should stop taking multiple vitamins.
dizziness on a daily basis since the accident.
4. Client with meningitis 3. The medication should not be taken with food.
4. The client has difficulty concentrating and focusing
859. A client who had a craniotomy 2 days earlier is 4. The medication has very few adverse effects.
while at work.
receiving mannitol (Osmitrol®) intravenously to decrease
5. The client reported a loss of consciousness for a few intracranial pressure. Which diagnostic laboratory value
seconds at the time of the injury. should be monitored while the client is receiving this CHILD ENDOCRINE
medication?
6. The client describes a funny taste in the mouth since 1164. A 12-year-old child’s medication regimen for treating
the accident that is “disgusting.” 1. Serum osmolarity type 1 diabetes mellitus is changed from administering
857. An anxious client is seen in a clinic because the client 2. White blood cell (WBC) count NPH and rapid-acting insulin to a basal-bolus insulin
regimen. To achieve tight glucose control and for therapy
suspects that he/she has a brain tumor. The client
questions a nurse about treatment options if tests show 3. Serum cholesterol to be effective, the nurse should instruct that the child
and/or parent to: SELECT ALL THAT APPLY.
the presence of a tumor. The nurse answers the client 4. Erythrocyte sedimentation rate (ESR)
based on the knowledge that treatment of a brain tumor 1. administer a once daily dose of a long-acting insulin
depends on: SELECT ALL THAT APPLY. 860. A client with epilepsy is prescribed phenytoin sodium such as glargine (Lantus®).
(Dilantin®) 100 mg 3 times per day orally as anticonvulsant
1. rate of growth of the tumor. therapy. The most precise method for a nurse to 2. administer rapid-acting insulin such as aspart
determine if this is the proper dose for the client is: (NovoLog®) with each meal and snack based on the
2. whether the tumor is malignant or benign.
carbohydrate grams consumed.
3. cell type from which the tumor originates. 1. observation of the client for seizures.
3. administer extra rapid-acting insulin when the amount
2. observation of the client for adverse effects.
4. location within the brain. of the child’s daily exercise increases.
5. whether the tumor will reoccur. 3. determining whether the client is able to participate in 4. consistently count the amount of carbohydrates the
usual activities. child consumes throughout the day.
6. the client’s age and type of insurance.
4. monitoring serum phenytoin levels. 5. monitor the child’s blood glucose four to eight times a
858. A nurse is caring for a group of clients on a medical
861. An elderly client with Parkinson’s disease is prescribed day.
unit in a rural hospital. Which client would the nurse be
least likely to monitor for the potential complication of a levodopa and carbidopa (Sinemet®). Which point should a 6. monitor the child’s blood glucose at midnight and 3
nurse include in the teaching plan for the client and
brain abscess? a.m. once a week.
spouse?
1. Client with endocarditis 1165. A nurse understands that to modify the risk for early
1. The client is at increased risk for falls due to dizziness cardiovascular disease in children diagnosed with type 1
2. Client with idiopathic epilepsy and orthostatic hypotension. diabetes mellitus a child should:
1. exercise at least 30 minutes every day. insulin storage for the trip. Which response by the nurse is 1. “I can put in the number of carbohydrates that I
most accurate? consume, and the insulin pump will calculate the bolus
2. eat a diet that is low in fat and high in protein. insulin dose that I will receive.”
1. “Because insulin must be refrigerated, you will need to
3. maintain optimal management of blood sugar levels. obtain the medication from a pharmacy at your 2. “I must still check my blood glucose levels with meals
4. have a cardiac workup at each visit for the diabetes. destination.” and snacks and calculate the amount of carbohydrates I
consume to ensure I get the correct bolus dose of insulin.”
1166. A 9-year-old child with a history of type 1 diabetes 2. “Freeze the insulin before you leave home and take it in
mellitus for the past 6 years is admitted with a diagnosis of a cooler; it should be thawed by the time you get to the 3. “As my blood glucose control improves with the use of
diabetic ketoacidosis (DKA). In preparing for the child’s beach.” the insulin pump, I should see a drop in the weight that I
arrival to the nursing unit, the nurse should prepare to: have gained.”
3. “Keep the insulin in a cooler with an ice pack and out
1. add sodium bicarbonate to the current IV fluids. of direct heat and sunlight for the trip. Store unopened 4. “Every 2 to 4 days, I will need to change the syringe,
insulin in the refrigerator at your destination.” catheter, and site moving the site away at least 1 inch from
2. add potassium chloride to the current IV fluids. the last site.”
4. “Because it is illegal to transport needles and syringes
3. use either 0.9% or 0.45% saline for the base IV fluid. across most state lines, you will need to obtain a 1171. A 10-year-old child with a 6-year history of type 1
4. administer insulin by subcutaneous injection. prescription from your doctor and purchase the insulin and diabetes mellitus has been seen in a clinic for enuresis over
the syringes at your destination.” the past 2 weeks. Which conclusion by the nurse regarding
1167. A pediatric nurse is administering metformin the likely cause of the enuresis is correct?
(Glucophage®) to a child at risk for developing type 2 1169. A nurse explains to a parent who has a child with
diabetes mellitus. The nurse understands that an type 1 diabetes mellitus that the most important reason 1. Sustained blood sugar levels lower than normal
important use of metformin in children is to: for counting the child’s grams of carbohydrate intake is to:
2. Acquired adrenocortical hyperfunction
1. delay the development of type 2 diabetes mellitus in 1. lower blood glucose levels.
3. Sustained blood sugar levels higher than normal
high-risk children. 2. supply energy for growth and development.
4. Acquired syndrome of inappropriate antidiuretic
2. restore fertility in adolescent females. 3. provide consistent glucose to prevent hypoglycemia. hormone (SIADH)
3. reduce blood sugars in children who have type 1 4. attain metabolic control of glucose and lipid levels. 1172. Which laboratory test results should a nurse monitor
diabetes mellitus. in evaluating the long-term success of a child’s control of
1170. An adolescent client is taught how to use a
4. restore renal function in children who have type 1 type 1 diabetes mellitus?
continuous subcutaneous insulin infusion pump for tight
diabetes mellitus. glucose control of type 1 diabetes mellitus. Which 1. Hemoglobin A1c levels
1168. The parents of a 7-year-old child diagnosed with statement by the client indicates the need for additional
teaching? 2. Blood insulin levels
type 1 diabetes mellitus are planning to drive 1,200 miles
for a vacation at the beach. They question the nurse about 3. Blood glucose levels
4. Urinary glucose levels before breakfast, and the child did not receive insulin 2. Child’s blood glucose level is 250 mg/dL; vomiting and
before breakfast. The nurse should conclude that: SELECT dizziness; complains of double vision.
1173. A child with a history of type 1 diabetes mellitus ALL THAT APPLY.
presents in the school nurse’s office about an hour before 3. Child’s blood glucose level is 240 mg/dL; large amounts
the lunch period reporting disorientation. Which 1. the total volume of fluid intake should be recorded as of urine output decreasing to 100 mL total output for the
information is most important for the nurse to obtain? 120 mL. last 8 hours.
1. Blood sugar 2. insulin will need to be administered to cover for the 4. Child’s blood glucose level is 300 mg/dL; urine tested
carbohydrates eaten. positive for ketones; skin is hot, flushed, and dry.
2. Temperature
3. insulin will not be needed because the child’s blood 1179. An infant diagnosed with hypothyroidism is
3. Morning insulin dose glucose was normal before breakfast. prescribed levothyroxine sodium (Synthroid®). Which
4. Urine ketones independent nursing intervention would assist the nurse in
4. a double-check of the amounts of carbohydrate eaten evaluating the effectiveness of this medication?
1174. The mother of a 12-year-old child diagnosed with is needed before administering insulin.
type 1 diabetes mellitus asks a nurse what changes in the 1. Monthly assessments of growth and development
5. the child should have received insulin before breakfast
daily routine should be made during attendance at because the blood sugar is elevated. 2. Monthly serum calcium and thyroxin levels
summer camp. The child will be at camp for 4 weeks.
Which is the best response by the nurse? 1177. A health-care provider prescribes glucagon 0.5 mg 3. Bimonthly catecholamine levels and electrocardiogram
subcutaneously for a client with type 1 diabetes mellitus. A (ECG)
1. “The child will have an increased need for insulin due to nurse determines that glucagon is used to treat:
the high carbohydrate content of camp food.” 4. Absence of thyroid excess
1. hypoglycemia resulting from too little food intake.
2. “The child’s food intake should be decreased by 10% 1180. A child is admitted in thyrotoxic crisis. Which
while the insulin should be increased by 10%.” 2. hyperglycemia resulting from too much food intake. manifestations should a nurse expect to observe during
assessment? SELECT ALL THAT APPLY.
3. “The child’s food intake should be increased as activity 3. hypoglycemia resulting from too much insulin intake.
increases; monitor blood glucose levels three to four 1. Delirium
times a day to evaluate results.” 4. hyperglycemia resulting from too little insulin intake.
2. Hypothermia
1178. A child’s parents inform a nurse about how they care
4. “The child’s insulin injection should be given before
every meal and snack to ensure that the food being for their 12-year-old child with type 1 diabetes mellitus, 3. Bradycardia
including sick day management, treating hyperglycemia,
consumed at camp can be utilized by the body.” 4. Nausea
and managing ketosis. In which situation could the parents
1176. A nursing assistant reports to a nurse that a 4-year- safely manage the child’s care at home? 5. Vomiting
old child diagnosed with type 1 diabetes consumed 1 /2
cup of oatmeal, 60 mL of orange juice, and 60 mL of milk 1. Child’s blood glucose level is 280 mg/dL; skin turgor very
poor; lips and mouth parched.
for breakfast. The child’s blood glucose was 150 mg/dL
1181. A nurse is educating the parents of a school-aged 4. Altered sleep and rest 3. Include emergency cortisone treatment for Addisonian
child newly diagnosed with hyperthyroidism. Until the crisis on the school medical care plan.
disease is under control, which instruction should be 1185. An adolescent is admitted with a diagnosis of
suspected Addison’s disease. Which assessment 4. If the child vomits the dose of cortisone within 1 hour,
included in the education provided by the nurse?
manifestations should the nurse expect to find if Addison’s the dose is not repeated but the healthcare provider
1. Discontinue physical education classes at school. disease is the correct diagnosis? notified.
2. Increase stimulation in the school environment. 1. Long history of fatigue, weight loss, and muscle tetany 5. Administer epinephrine subcutaneously immediately if
Addisonian crisis should occur.
3. Restrict the number of calories from carbohydrate 2. Sudden onset of skin hypopigmentation, polydipsia, and
foods. hyperactivity 1188. Glucocorticoids are prescribed for a child diagnosed
with congenital adrenal hyperplasia. Which manifestation
4. Dress your child in cold weather clothing even in warm 3. Gradual onset of salt craving, decreased pubic and should indicate to a nurse that therapy is successful?
weather. axillary hair, and irritability
1. Feminization in girls
1183. Which instruction should a nurse include when 4. Sudden onset of increasing weight gain, hirsurtism, and
teaching parents who have a child diagnosed with skin hyperpigmentation 2. Absence of symptoms of Cushing’s syndrome
hypoparathyroidism?
1186. A nurse teaches the parents of a child diagnosed 3. Precocious penile enlargement in boys
1. Monitor for muscle spasms, tingling around the mouth, with Addison’s disease signs of Addisonian crisis. Which
and muscle cramps. sign identified by the parents indicates that further 4. Increased growth rate in both boys and girls
teaching is needed? 1189. Which nursing diagnosis has the highest priority for
2. Monitor for side effects of excess medication therapy,
including dry, scaly, coarse skin. 1. Severe hypertension an infant diagnosed with congenital adrenal hypoplasia?
1. Disproportionate growth
3. Decrease intake of foods high in calcium and 2. Abdominal pain
phosphorus. 2. Excess fluid volume
3. Seizures
4. Increase environmental stimuli and encourage 3. Impaired parent-infant attachment
participation in high-energy activities. 4. Coma
1187. A nurse instructs the parents of a child diagnosed 4. Knowledge deficit of lifelong medication requirements
1184. Which nursing diagnosis has the highest priority for
a child diagnosed with Addison’s disease? with Addison’s disease. Which instructions should be 1190. Which outcomes should a nurse plan for a child
included by the nurse? SELECT ALL THAT APPLY. diagnosed with adrenal insufficiency? SELECT ALL THAT
1. Potential excess fluid volume APPLY.
1. Have the child wear a medical alert bracelet.
2. Disturbed body image 1. Child demonstrates a positive body image.
2. Encourage the child to ingest adequate fluids,
3. Altered development particularly on hot summer days.
2. Child demonstrates no complications related to 4. Talk to the mother about requesting an Individual
inactivity. Educational Planning (IEP) team to assist in planning school
interventions. 1197. A 6-year-old child is diagnosed with
3. Child responds to oxygen regimes to avoid pheochromocytoma. Which manifestations should lead a
hospitalization. 1194. Which assessment findings should the nurse expect nurse to conclude that this child is in crisis?
for a child diagnosed with diabetes insipidus? SELECT ALL
4. Child and family verbalizes causes of the disease and 1. Systolic blood pressure of 120 mm Hg
THAT APPLY.
treatment regimen.
1. Polydipsia 2. Rhabdomyolysis
5. Child responds to activity restrictions to conserve
3. Urine output of 30 mL/hr
energy. 2. Polyphagia
1191. A 10-year-old child is admitted for testing to 3. Polyuria 4. Hyperexcitability
diagnose Cushing’s syndrome. For which initial test should
a nurse prepare the child and parents? 4. Glycosuria
5. Ketonuria
1. Glucose tolerance test (GTT)
2. Urine or saliva cortisol level 1195. A nurse is assessing a 4-year-old child diagnosed
with precocious puberty. Which physical assessment
3. Dexamethasone suppression test manifestation should the nurse expect to find?
4. Serum 17-hydroxyprogesterone level 1. Short stature
1193. A 12-year-old child is being treated for growth 2. Hypothalmic tumor
hormone deficiency. The child is angry and refusing to go
3. Advanced bone age
to school because all the other children are taller. In
addition, this child is belligerent toward the mother, who 4. Pubic and axillary hair
gives the daily injection of growth hormone. Which initial
intervention should be attempted by the nurse? 1196. An older adolescent is diagnosed with acromegaly.
Which medication should the nurse expect to be
1. Teach the child self-administration of growth hormone. prescribed for this individual?
2. Refer the family for counseling with particular emphasis 1. Somatropin (Genotropin®)
on anger management.
2. Desmopressin (Desmotabs®)
3. Assist the parents to contact the school district so that
home schooling can begin and last until the child has 3. Somatostatin (Sandostatin®)
reached normal height. 4. Clozapine (Clozaril®)
 etiology. Which nursing actions should be initiated by the 2. Spina bifida cystica
nurse? SELECT ALL THAT APPLY.
3. Meningocele
1. Teaching the parents care and safety measures should
4. Myelomeningocele
a seizure occur at home
2. Obtaining an oropharyngeal airway and placing it near 1312. A child with myelodysplasia has a TEV (talipes
equinovarus) repair that requires a cast application. In the
the adolescent’s bed
postoperative period, a nurse notes serosanguineous
3. Padding the side rails on the bed drainage on the cast. What should the nurse do when
making this observation?
4. Placing the adolescent in droplet precaution isolation
1. Cut a window where the drainage is seeping through the
5. Securing a tongue blade to the head of the bed cast
6. Setting up suction equipment in the adolescent’s room 2. Petal the cast to minimize skin irritation and decrease
1310. A nurse is administering multiple anticonvulsant leakage
medications to children. For which medication should a 3. Measure the area of drainage and document this
CHILD NEUROLOGICAL nurse teach the parents about ensuring that their child has finding
good oral care to prevent gingival hyperplasia?
4. Notify the surgeon
1308. A child is being evaluated for possible increased 1. Carbamazepine (Tegretol®)
intracranial pressure following head trauma. Which 1313. A nurse is reinforcing teaching to the parents of a
2. Valproic acid (Depakene®) child with myelomeningocele, which was diagnosed at
assessment finding associated with increased intracranial
pressure (ICP) should a nurse report to a health-care 3. Phenobarbital birth and surgically corrected, about safety considerations.
provider? The nurse’s instructions should include:
4. Phenytoin (Dilantin®)
1. Increasing alertness 1. making sure that braces lie smoothly against the child’s
1311. A woman has just undergone a prenatal screening skin.
2. Widened pulse pressure that indicates that her child might have a neural tube
defect. In response to a question about neural tube 2. teaching the child to shift position at least every 3 hours.
3. Tachycardia defects, a nurse describes one possible defect. Which 3. placing a blanket between the child and the wheelchair.
4. Decreased systolic blood pressure (SBP) neural tube defect is the nurse describing when stating
that the vertebral arch fails to close and the spinal cord 4. checking all of the child’s skin daily for redness or
1309. A nurse is caring for an adolescent diagnosed with and meninges stay within the vertebral canal? irritation.
new-onset generalized tonic-clonic seizures of unknown
1. Spina bifida occulta
1315. A nurse is caring for multiple hospitalized children. In 5. Angioedema 1. Carrying a child in a backpack
which conditions might the nurse assess for the presence
of papilledema? SELECT ALL THAT APPLY. 1318. A health-care provider’s progress notes states that 2. Carrying a child in a frontpack
an infant with meningitis is in an opisthotonus position.
3. Swaddling
1. Eczema The nurse should expect to observe:
2. Craniosynostosis 1. resistance with specific leg movement. 4. Extended time in a car seat
1322. Which screening test is a neonatal nurse likely to use
3. Shaken baby syndrome 2. knee or hip flexion with head flexion.
to detect developmental dysplasia of the hip (DDH)?
4. Hydrocephalus 3. a high-pitched cry with neck flexion.
1. Barlow’s maneuver
5. Chest trauma 4. hyperextension of the head and neck.
2. Pavlik’s maneuver
1316. A nurse is caring for a child immediately following 1319. A child with autism has been admitted to a four-bed
3. Gower’s maneuver
insertion of a ventriculoperitoneal (VP) shunt for ward on a pediatric unit. The nurse admitting the child
treatment of hydrocephalus. The nurse’s postoperative should: 4. Allis’s maneuver
care should include:
1. request that the child be transferred to a private room. 1323. A nurse is educating a family whose child is newly
1. maintaining the head of the bed in an elevated position. diagnosed with scoliosis. The nurse explains that the goal
2. request that the child be transferred to a double room.
of therapy is to:
2. ensuring that the child minimizes movement of the
extremities. 3. admit the child to the assigned room.
1. limit or stop progression of the curvature.
4. request that the child be assigned to an isolation room.
3. providing a pressure dressing over the cephalic insertion 2. prepare the child for surgery.
site. 1320. What is the most important factor for a nurse to
consider when teaching a child with cerebral palsy (CP)? 3. minimize the psychosocial complications of prolonged
4. changing the child’s position every 2 hours. immobilization.
1317. A 7-year-old child may have hydrocephalus 1. Age
4. develop a pain management protocol that will minimize
secondary to a malignancy. Which assessment findings 2. Type of cerebral palsy complications of medications.
should a nurse anticipate? SELECT ALL THAT APPLY.
3. The child’s prior experiences with illness
1. Increased head circumference
4. Developmental level 1324. A nurse is asked to provide education for a 15-year-
2. Headache old who requires surgical treatment for scoliosis. Which
1321. A nurse is developing teaching materials for new should be an appropriate explanation for the adolescent?
3. Personality change mothers. The nurse should include information about “The goal of surgery is to:
4. Vomiting which common practice that can increase the risk for
developmental dysplasia of the hip (DDH)? 1. allow you to be taller.”
2. prevent pain.” 2. valgus knee deformities. 4. “Nothing is likely to happen for a long time; we’ll deal
with it when the time comes.”
3. prevent problems with breathing.” 3. varus ankle deformities.
1330. A child who is crying and in pain is assessed by a
4. allow clothes to fit you better.” 4. valgus ankle deformities. school nurse. The child describes an injury in which
1325. A nurse is completing a thorough assessment of the 1328. A 7-year-old has had hip pain for several months. another student twisted the child’s right arm. The nurse
spine. The nurse is concerned about a curve in a young Because it was mild pain, the parent did not pay a great should: SELECT ALL THAT APPLY.
child and records the exaggerated lumbar curve as: deal of attention. The child was ultimately given a 1. elevate and apply ice at the site of the child’s injury.
diagnosis of Legg-Calvé-Perthes disease. In preparing the
1. scoliosis. child and family for treatment, the nurse should instruct 2. wrap the child’s arm with an elastic bandage.
2. lordosis. the parents that:
3. notify the child’s parent.
3. kyphosis. 1. most of the child’s treatment will be done while the
child is hospitalized. 4. call the child’s health-care provider (HCP).
4. kyphoscoliosis. 5. send the child for an x-ray of the arm.
2. activities that promote hip adduction are encouraged.
1326. A school-aged child has an Ilizarov external fixator
3. treatment is likely to continue for about 6 months. 6. have the student who caused the injury come to the
applied to a lower extremity for bone lengthening. Which nurse’s office for questioning.
action should a nurse include when caring for the child? 4. the desired outcome is a pain-free joint with full range
of motion. 1331. A child is admitted to an emergency department
1. Loosening the bolts and lengthen the rods on the fixator with a dislocated kneecap that occurred while skiing.
every other day 1329. The parents of a child with Duchenne muscular Which most immediate treatment by a healthcare provider
2. Cleansing the pin sites with sterile saline twice daily dystrophy have just learned that children with the disease (HCP) should a nurse anticipate?
have a limited life expectancy. They ask what this means
3. Discouraging the child from bearing any weight on the for how they will raise their son. Which explanation by the 1. Realignment of the kneecap by sliding it back into
involved extremity position in the front of the knee
nurse is best?
4. Removing sections of the fixator apparatus when the 1. “Because he will be cognitively impaired, there is no 2. Open surgical intervention to repair the kneecap
child is positioned in bed reason to deal with the prognosis.” 3. Arthroscopy to surgically repair the torn cartilage
1327. A nurse at the high school works with the trainers to 2. “Throughout his disease, we will focus on maximizing 4. Application of a cast to the affected leg until the
develop early identification of injuries. The nurse teaches his abilities and keeping him comfortable.” kneecap heals
the trainers that adolescent soccer players are at increased
risk for: 3. “There is not enough known about this disease to know 1332. A 13-year-old is brought to the emergency
what will happen to your son.” department following a motor vehicle crash in which the
1. varus knee deformities. child’s head hit the dashboard. The child is diagnosed with
a mild head injury. When assessing the child, which score findings should lead the nurse to decide to withhold the 3. muscular dystrophy (MD).
on the Glasgow coma scale should the nurse expect? dose and contact the health-care provider?
4. osteogenesis imperfecta.
1. 5 1. Urine pH 7.4
1338. A teen is brought to an emergency department with
2. 10 2. Hemoglobin 13 g/dL a likely spinal cord injury. To minimize the damage from
the spinal cord injury, which classification of medications
3. 15 3. Serum creatinine 2.2 mg/dL should a nurse expect a health-care provider to prescribe?
4. 20 4. Alanine aminotransferase (ALT) 1. An antibiotic
1333. A nurse has been asked to continue teaching with a 1336. An infant has been diagnosed with osteogenesis 2. An analgesic
group of parents of children with neurological and imperfecta (OI). The nurse is teaching the parents about
musculoskeletal conditions. For which condition should a how to care for their infant. Which information is most 3. A steroid medication
nurse tell the parents that there is no genetic basis to the important for the nurse to include in the instructions to
condition? the parents? 4. An antihypertensive medication
1339. An adolescent client diagnosed with a T12 spinal
1. Osteomyelitis 1. Check the color of your infant’s nailbeds and mucous
membranes for signs of circulatory impairment. cord injury (SCI) is admitted to a rehabilitation unit. A
2. Muscular dystrophy nurse is teaching the client about the need to be diligent in
2. If you note signs of infection, bring your infant to the skin protection. The nurse explains that the primary reason
3. Spina bifida clinic because the infant has a significant immune for the client’s increased risk for alterations in skin integrity
4. Tourette’s Syndrome dysfunction. is:

1334. A nurse explains to a child’s parents that the role of 3. Protect your infant from injury and handle your baby 1. the inability to perceive extremes in temperature
methotrexate (Rheumatrex®) in treating children with carefully because your infant’s bones can break very leading to burns.
juvenile arthritis is to: easily.
2. the circulatory changes that cause vasoconstriction and
1. decrease the inflammatory response. 4. Notify the health-care provider if your infant does not decreased blood supply.
respond to sound because the infant’s central nervous
2. improve functional ability. 3. the inability to feel skin irritation such as wrinkled
system (CNS) fails to develop completely
clothing.
3. control the febrile response. 1337. During a physical examination of a 1-month-old
4. the increased likelihood of bowel and bladder
4. minimize the effects of uveitis. infant, a nurse notes that the infant has blue sclerae. The
nurse suspects that the infant may have: dysfunction and skin irritation.
1335. A 10-year-old is scheduled to receive methotrexate 1340. An 11-year-old child is hospitalized for elective
(Rheumatrex®) to treat juvenile arthritis. Which laboratory 1. juvenile arthritis.
surgery. The child has a neurogenic bladder from a spinal
2. Tay-Sachs disease. cord injury with a lower motor neuron lesion occurring 2
years previously. In planning care, the nurse considers that 4. Able to perform tasks that requires careful manual
the optimal treatment for neurogenic bladder in the dexterity
hospitalized child is:
1. intermittent catheterization.
2. insertion of a retention catheter.
3. insertion of a suprapubic catheter.
4. administration of an anticholinergic medication.
1341. A pediatric client with a spinal cord injury undergoes
range of motion exercises several times each day. In
teaching the parent how to do range of motion at home,
the nurse observes the client increasing the angle between
the extremity and the midline. The nurse concludes that
the client is safely performing:
1. abduction.
2. adduction.
3. flexion.
4. extension.
1342. When preparing to complete a health history for a 9-
year-old child diagnosed with mental retardation with an
IQ level of 45, which level of participation should a nurse
expect?
1. Able to communicate verbally only with twoletter words
2. Able to read and comprehend simple written instruction
with large letters
3. Able to walk independently to perform a simple skill