COLEGIO de KIDAPAWAN

Paramedical Department
COMPETENCY APPRAISAL 1
SY 2013-2014
1ST YEAR
Midterm Exam
NAME: ____________________

DATE: __________________

GENERAL INSTRUCTIONS:
1. Please use ballpen for your final answers.
2. Make alterations by putting a mark (x) on the initial answer, then write the final answer beside it. Write
legibly.
3. The proctors decision regarding cheating is FINAL.
4. Use of cellular phones is strictly prohibited and should be turned off or put in silent mode.
5. No one is allowed to go out of the classroom once the exam has started.
TEST I. MULTIPLE CHOICE: Encircle the letter of the correct answer.
1. A nurse is preparing a teaching plan for a family member who will be caring for a client with an
abdominal incision. Which of the following concepts would be most important to include in this plan?
A. Surgical asepsis
B. Demonstration in sterile gloving technique
C. Handwashing
D. Signs of healing
2. A client has been admitted to the hospital with leukopenia related to chemotherapy. Which of the
following would be an appropriate nursing diagnosis label that is related to the client's laboratory test
results?
A. Airway clearance: ineffective.
B. Physical mobility, impaired.
C. Risk for fluid imbalance.
D. Risk for infection.
3. A client has been running a fever intermittently for several days. In addition to monitoring the client's
temperature, the nurse should monitor the client for which of the following?
A. Skin breakdown
B. Oral lesions
C. Signs of dehydration
D. Elevated blood pressure
4. The nurse is changing a client's abdominal dressing. Which of the following should the nurse do to
maintain surgical asepsis during the dressing change?
A. Change sterile gloves mid-way through the procedure.
B. Consider objects sterile after they have touched the wound.
C. Consider the 1-inch border of a sterile field to be unsterile.
D. Keep hands sterile with thorough handwashing.
Situation 1. Because of the serious effects of severe burns, management requires a multidisciplinary
approach. You have important responsibilities as a nurse.
5. When caring for PS, who sustained 40% severe flame burn yesterday, which among these
interventions should be your PRIORITY?
A. provide a calm, efficient and safe environment
B. keep the body parts in good alignment to prevent contractures
C. assess for airway, breathing and circulation problems
D. assess the injury for signs of sepsis
6. Your primary therapeutic goal for PS during the ACUTE PHASE is:
A. wound healing
B. emotional support
C. reconstructive surgery
D. fluid resuscitation
7. CV who sustained upper torso and neck burns. Which action is MOST likely to cause a functional
contracture?

A.
B.
C.
D.

hourly hyperextension neck exercises

helping the patient to a position of comfort
encouraging self-care
discouraging pillows behind the head

8. AW, 3 year old boy just sustained full thickness burns of the face, chest and neck. What will be your
PRIORITY nursing action?
A. Risk for infection related to epidermal disruption
B. Impaired urinary elimination related to fluid loss
C. Ineffective airway clearance related to edema
D. Impaired body image related to physical appearance
9. FG, with a full thickness burns involving entire circumference of an extremity will require frequent
peripheral vascular checks to detect:
A. hypothermia
B. arteriosclerotic changes
C. ischemia
D. adequate wound healing
Situation 2: Infection can cause debilitating consequences when hosts resistance is compromised and
environmental factors are favorable. As a nurse you have important roles and responsibilities in infection
control.
10. EF was admitted to the hospital with a tentative diagnosis of acute pyelonephritis. To assess her risk
factors, what question should you ask?
A. Have you taken any analgesic recently?
B. Do you have pain at your back?
C. Do you hold your urine for a long time before voiding?
D. Have you had any sore throat lately?
11. While caring for a patient with an infected surgical incision, you observe for signs of systemic
response. These include all of the following EXCEPT:
A. a febrile state due to release of pyrogens
B. anorexia, malaise, and weakness
C. loss of appetite and pain
D. leukopenia due to increased WBC production
12. One of the MOST effective nursing procedures for reducing nosocomial infection is:
A. proper handwashing technique
B. aseptic wound care
C. control of upper respiratory tract infection
D. administration of prophylactic antibiotic
13. A wound that has hemorrhaged has increased risk for infection because:
A. dead space and dead cells provide a culture medium
B. retrograde bacterial contamination may occur
C. the tissue becomes less resilient
D. of reduced amounts of oxygen and nutrients are available
14. You are instructing EP regarding skin tests for hypersensitivity reactions. You should teach her to:
A. stay out of the sun until the skin tests are read
B. come back on the specified date to have the skin tests read
C. wash skin test areas with soap and water daily
D. keep skin test areas moist with mild lotion.
Situation 3: TR attends a Health Education Class on colostomy care. The following are taken up: types of
ostomies, indications and care.
15. A colostomy can BEST be defined as:
A. cutting the colon and bringing the proximal end through the abdominal wall
B. creating a stomal orifice from the ileum
C. excising a section of the colon and doing an end-to-end anastomosis
D. removing the rectum and suturing the colon to the anus.
16. When an abdominoperineal resection is done, the patient should be informed he/she will have a;
A. temporary colostomy
B. transverse loop colostomy
C. permanent colostomy
D. double-barreled
E.

17. A colostomy patient who wishes to avoid flatulence should not eat the following EXCEPT:
A. corn and peanuts
B. mangoes and pineapples
C. cabbage and asparagus
D. chewing gum and carbonated beverages
18. During the first post operative week, the nurse can BEST help the patient with a colostomy to accept
the change in body image by:
A. changing the dressing just prior to meals
B. encouraging the patient to observe the stoma and its care
C. deodorizing the room periodically with a spray can
D. applying a large bulky dressing over the stoma to decrease odors
Situation 4: These are gastrointestinal disease that can compromise life and that would necessitate
extensive surgical management. You are assigned to take care of a patient with such a condition.
19. BC diagnosed with cancer of the sigmoid colon is to have an abdominoperineal resection with a
permanent colostomy. Before surgery, a low residue diet is ordered. You explain to BC that this is
necessary to:
A. prevent irritation of the intestinal mucosa
B. reduce the amount of stool in the large bowel
C. limit production of flatus in the intestines
D. lower the bacterial count in the GI tract
20. Several days prior to bowel surgery,the patient may be given sulfasuxidine and neomycin, primarily to:
A. soften the stool by retaining water in the colon
B. reduce the bacterial content of the colon
C. empty the bowel of solid waste
D. promote rest of the bowel by minimizing peristalsis
21. To promote perineal wound healing after an abdominoperineal resection, you should encourage BC to
assume:
A. dorsal recumbent position
B. left or right Sims position
C. left or right side lying position
D. knee-chest position
22. BC returns from surgery with a permanent colostomy. During the 24 hours, the colostomy does not
drain. You, as the nurse should realize that this is a result of:
A. the absence of intestinal motility
B. a presurgical decrease in fluid intake
C. proper functioning of the nasogastric tube
D. intestinal edema following surgery
23. On the second day following abdominoperineal resection, you anticipate that the colostomy stoma will
appear:
A. moist, pink, with flushed skin and painful when touched
B. moist, red and raised above the skin surface
C. dry, pale pink and with flushed skin
D. dry, purple and depressed below the skin surface
Situation 5: Specific surgical interventions may be done when lung cancer is detected early. You have
important perioperative responsibilities in caring for patients with lung cancer.
24. GM is scheduled to have lobectomy. The purpose of closed chest drainage following a lobectomy is:
A. expansion of the remaining lung
B. facilitation of coughing
C. prevention of mediastinal shift
D. promotion of wound healing
25. Following thoracic surgery, you can BEST help GM to reduce pian during the deep breathing and
coughing exercises by:
A. splinting the patients chest with both hands during the exercises
B. administering the prescribed analgesic immediately prior to exercises
C. providing rest for 6 hours before exercises
D. placing the patient on his/her operative side during exercises
26. During the immediate post operative period following a pneumonectomy, deep tracheal suction should
be done with extreme caution because:
A. the remaining normal lung needs minimal stimulation
B. the patient will not be able to tolerate coughing
C. the tracheobronchial tree are dry
D. the bronchial suture line maybe traumatized

27. What should you do as a nurse when the chest tubing is accidentally disconnected?
A. reconnect the tube
B. notify the physician
C. change the tubing
D. clamp the tubing
28. Which of the following observations indicates that the closed chest drainage system is functioning
properly?
A. less than 25 ml drainage in the drainage bottle
B. absence of bubbling in the suction-control bottle
C. the fluctuating movement of fluid in the long tube of the water-seal bottle during
inspiration
D. intermittent bubbling through the long tube of the suction control bottle.
Situation 6: Renal stones can cause one of the most excruciating pain experienced by a patient. As a
nurse of BL which of the following nursing diagnosis will be your PRIORITY?
29. BL was brought to the Emergency Room for severe left flunk pain, nausea and vomiting. The
physician gave a tentative diagnosis of right ureterolithiasis. As the nurse of BL which of the following
nursing diagnosis will be your PRIORITY?
A. imbalance nutrition: less than body requirements
B. impaired urinary elimination
C. acute pain
D. risk for infection
30. Which of the following is the appropriate intervention for BL who has ureterolithiasis?
A. inserting an indwelling urinary catheter
B. administering opioid analgesics preferably intravenously
C. administering intravenous solution at a keep vein open rate
D. inserting a nasogastric tube (low suction)
31. You are caring for YA, 30 year old business woman, with renal stones. Her skin and mucous
membranes are dry and her 24 hour intake and output record reveal an oral intake of 900 ml and a
urinary output of 700 ml. Her urine is dark amber. Based on the above data, your nursing diagnosis is:
A. imbalance nutrition, less than body requirements
B. fluid volume deficit
C. impaired urinary elimination
D. knowledge deficit regarding health
32. KJ has an indwelling urinary catheter and she is suspected of having urinary infection. How should
you collect a urine specimen for culture and sensitivity?
A. clump tubing for 60 minutes and insert a sterile needle into the tubing above the clamp to
aspirate urine
B. drain urine from the drainage bag into the sterile container
C. disconnect the tubing from the urinary catheter and let urine flow into a sterile container
D. wipe the self-sealing aspiration port with antiseptic solution and aspirate urine with a
sterile needle
33. You are caring for WE, a 56 year old man who is dehydrated and with urinary incontinent. Upon
physical examination, you noted perineal excoriation. What will be your PRIORITY intervention?
A. orient him to time, person and place
B. offer the bed pan every 4 hours
C. encourage oral fluid intake
D. keep the perineal area clean, and dry
Situation 7: You are caring for several patients with various disease problems.
34. You are obtaining a history of MR. who is admitted with acute chest pain. Which question will be
MOST HELPFUL for you to ask?
A. Why do you think you had a heart attack?
B. Do you need anything now?
C. What seem you doing when the pain started?
D. Has anyone in your family been sick lately?

35. BO who received general anesthesia returns from surgery. Post-operatively, which nursing diagnosis
takes HIGHEST PRIORITY for BO?

A.
B.
C.
D.

impaired physical mobility related to surgery

decrease fluid volume related to blood and fluid loss from surgery
risk for infection related to anesthesia
acute pain related to surgery

36. WW is blind. She is admitted for treatment of gastroenteritis. Which nursing diagnosis takes HIGHEST
PRIORITY for WW?
A. anxiety
B. activity intolerance
C. risk for injury
D. impaired physical mobility
37. You are documenting your care for CC who has iron deficiency anemia. Which nursing diagnosis is
MOST appropriate?
A. ineffective breathing pattern
B. deficient fluid volume
C. impaired gas exchange
D. ineffective airway clearance
38. RR, age 89, has terminal cancer, he demonstrates signs of dementia. You should give HIGHEST
PRIORITY to which nursing diagnosis:
A. risk for injury
B. ineffective cerebral tissue perfusion
C. C bathing or hygiene self care deficit
D. dysfunctional grieving
Situation 8: The physician has ordered 3 units of whole blood to be transfused to WQ following a repair of
a dissecting aneurysm of the aorta.
39. You are preparing the first unit of whole blood for transfusion. From the time you obtain it from the
blood bank, how long should you infuse it?
A. 6 hours
B. 4 hours
C. 1 hour
D. 2 hours
40. What should you do FIRST before you administer blood transfusion?
A. verify client identity and blood product, serial number, blood type, cross matching results,
expiration date
B. verify client identity and blood product serial number, blood type, cross matching results,
expiration date with another nurse
C. check IV site and use appropriate BT set and needle
D. verify physicians order
41. As WQs nurse, what will you do AFTER the transfusion has started?
A. add the total amount of blood to be transfused to the intake and output
B. discontinue the primary IV of Dextrose 5% Water
C. check the vital signs every 15 minutes
D. stay with WQ for 15 minutes to note for any possible BT reactions
42. WQ is undergoing blood transfusions of the first unit. The EARLIEST signs of transfusion reactions
are:
A. oliguria and jaundice
B. hypertension and flushing
C. urticaria and wheezing
D. headache, chills, fever
43. In case WQ will experience an acute hemolytic reaction, what will be your PRIORITY intervention?
A. immediately stop the blood transfusion, infuse Dextrose 5% in Water and call the physician
B. stop the blood transfusion and monitor the patient closely
C. immediately stop the BT, infuse NSS, call the physician, notify the blood bank
D. immediately stop the BT, notify the blood bank and administer antihistamines

Situation 9. The kidneys have very important excretory, metabolic, erythropoietic functions. Any
disruptions in the kidneys functions can cause disease. As a nurse it is important that you understand the
rationale behind the treatment regimen used.

44. PL, who is in acute renal failure, is admitted to the Nephrology Unit. The period of oliguria usually
lasts for about 10 days. Which assessment parameter for kidney function will you use during the oliguric
phase?
A. urine output directly related to the amount of IV fluid infused
B. urine output is less than 400 ml/24 hours
C. urine output of 30-60 ml/hour
D. no urine output, kidneys in a state of suspension
45. During the shock phase, what is the effect of the rennin-aldosterone-angiotensin system on renal
function?
A. increased urine output, increased absorption of sodium and water
B. decreased urine output, decreased absorption of sodium and water
C. increased urine output, decreased absorption of sodium and water
D. decreased urine output, increased absorption of sodium and water
46. As you are caring for PL who has acute renal failure, one of the collaborative interventions you are
expected to do is to start hypertonic glucose with insulin infusion and sodium bicarbonate to treat:
A. hyperkalemia
B. hypokalemia
C. hypercalcemia
D. Hypernatremia
47. BN, 40 year old with chronic renal failure. An arteriovenous fistula was created for hemodialysis in his
left arm. What diet instructions will you need to reinforce prior to his discharge?
A. drink plenty of water
B. monitor your fruit intake and eat plenty of bananas
C. restrict your salt intake
D. be sure to eat meat every meal
48. Nurse Trisha teaches a client with heart failure to take oral Furosemide in the morning. The reason for
this is to help
A. Retard rapid drug absorption
B. Excrete excessive fluids accumulated at night
C. Prevents sleep disturbances during night
D. Prevention of electrolyte imbalance
49. BN, is also advised not to use salt substitute in the diet because:
A. salt substitute contain potassium which must be limited to prevent arrhythmias
B. limiting salt substitutes in the diet prevents a buildup of waste products in the blood
C. fluid retention is enhanced when salt substitutes are included in the diet
D. a substance in the salt substitute interferes with fluid transfer across the capillary
membrane
Situation . You are assigned to take care of a group of elderly patients. Pain and urinary incontinence are
common concerns experienced by them. You should be able to address the concerns in a holistic manner.
50. Pain in the elder persons require careful assessment because they:
A. experienced reduce sensory perception
B. have increased sensory perception
C. are expected to experience chronic pain
D. have a decreased pain threshold
51. Administration of analgesics to the older persons requires careful patient assessment because older
people:
A. are more sensitive to drugs
B. have increased hepatic, renal and gastrointestinal function
C. have increased sensory perception
D. mobilize drugs more rapidly
52. The elderly patient is at higher risk for urinary incontinence because of:
A. increased glomerular filtration
B. decreased bladder capacity
C. diuretic use
D. dilated urethra
53. Which of the following is the MOST COMMON sign of infection among the elderly?
A. decreased breath sounds with crackles
B. pain
C. fever
D. change in mental status
54. Priorities when caring for the elderly trauma patient:

A.
B.
C.
D.

circulation, airway, breathing

airway, breathing, disability (neurologic)
disability (neurologic), airway, breathing
airway, breathing, circulation

55. Nurse Monett is caring for a client recovering from gastro-intestinal bleeding. The nurse should:
A. Plan care so the client can receive 8 hours of uninterrupted sleep each night.
B. Monitor vital signs every 2 hours.
C. Make sure that the client takes food and medications at prescribed intervals.
D. Provide milk every 2 to 3 hours.
56. Mrs. Cruz, 80 years old is diagnosed with pneumonia. Which of the following symptoms may appear
first?
A. Altered mental status and dehydration
B. Fever and chills
C. Hemoptysis and Dyspnea
D. Pleuritic chest pain and cough
57. A male client has active tuberculosis (TB). Which of the following symptoms will be exhibit?
A. Chest and lower back pain
B. Chills, fever, night sweats, and hemoptysis
C. Fever of more than 104F (40C) and nausea
D. Headache and photophobia
58. Mark, a 7-year-old client is brought to the emergency department. Hes tachypneic and afebrile and
has a respiratory rate of 36 breaths/minute and has a nonproductive cough. He recently had a cold. Form
this history; the client may have which of the following conditions?
A. Acute asthma
B. Bronchial pneumonia
C. Chronic obstructive pulmonary disease (COPD)
D. Emphysema
59. Marichu was given morphine sulfate for pain. She is sleeping and her respiratory rate is 4
breaths/minute. If action isnt taken quickly, she might have which of the following reactions?
A. Asthma attack
B. Respiratory arrest
C. Seizure
D. Wake up on his own
60.When caring for a female client who is being treated for hyperthyroidism, it is important to:
A. Provide extra blankets and clothing to keep the client warm.
B. Monitor the client for signs of restlessness, sweating, and excessive weight loss during
thyroid replacement therapy.
C. Balance the clients periods of activity and rest.
D. Encourage the client to be active to prevent constipation.
61. Nurse Audrey is caring for a client who has suffered a severe cerebrovascular accident. During
routine assessment, the nurse notices Cheyne- Strokes respirations. Cheyne-strokes respirations are:
A. A progressively deeper breaths followed by shallower breaths with apneic periods.
B. Rapid, deep breathing with abrupt pauses between each breath.
C. Rapid, deep breathing and irregular breathing without pauses.
D. Shallow breathing with an increased respiratory rate.
62. Nurse Bea is assessing a male client with heart failure. The breath sounds commonly auscultated in
clients with heart failure are:
A. Tracheal
B. Fine crackles
C. Coarse crackles
D. Friction rubs
63. The nurse is caring for Kenneth experiencing an acute asthma attack. The client stops wheezing and
breath sounds arent audible. The reason for thischange is that:
A. The attack is over.
B. The airways are so swollen that no air cannot get through.
C. The swelling has decreased.
D. Crackles have replaced wheezes.

64. For a diabetic male client with a foot ulcer, the doctor orders bed rest, a wetto- dry dressing change
every shift, and blood glucose monitoring before meals and bedtime. Why are wet-to-dry dressings used
for this client?
A. They contain exudate and provide a moist wound environment.
B. They protect the wound from mechanical trauma and promote healing.
C. They debride the wound and promote healing by secondary intention.
D. They prevent the entrance of microorganisms and minimize wound discomfort.
65. Which of the following statements explains the main difference between rheumatoid arthritis and
osteoarthritis?
A. Osteoarthritis is gender-specific, rheumatoid arthritis isnt
B. Osteoarthritis is a localized disease rheumatoid arthritis is systemic
C. Osteoarthritis is a systemic disease, rheumatoid arthritis is localized
D. Osteoarthritis has dislocations and subluxations, rheumatoid arthritis doesnt
66. Mrs. Cruz uses a cane for assistance in walking. Which of the following statements is true about a
cane or other assistive devices?
A. A walker is a better choice than a cane.
B. The cane should be used on the affected side
C. The cane should be used on the unaffected side
D. A client with osteoarthritis should be encouraged to ambulate without the cane
67. A male client with type 1 diabetes is scheduled to receive 30 U of 70/30 insulin. There is no 70/30
insulin available. As a substitution, the nurse may give the client:
A. 9 U regular insulin and 21 U neutral protamine Hagedorn (NPH).
B. 21 U regular insulin and 9 U NPH.
C. 10 U regular insulin and 20 U NPH.
D. 20 U regular insulin and 10 U NPH.
68. Nurse Len should expect to administer which medication to a client with gout?
A. aspirin
B. furosemide (Lasix)
C. colchicines
D. calcium gluconate (Kalcinate)
69. Mr. Domingo with a history of hypertension is diagnosed with primary hyperaldosteronism. This
diagnosis indicates that the client's hypertension is caused by excessive hormone secretion from which of
the following glands?
A. Adrenal cortex
B. Pancreas
C. Adrenal medulla
D. Parathyroid
70. For a diabetic male client with a foot ulcer, the doctor orders bed rest, a wetto- dry dressing change
every shift, and blood glucose monitoring before meals and bedtime. Why are wet-to-dry dressings used
for this client?
A. They contain exudate and provide a moist wound environment.
B. They protect the wound from mechanical trauma and promote healing.
C. They debride the wound and promote healing by secondary intention.
D. They prevent the entrance of microorganisms and minimize wound discomfort.
71. Nurse Zeny is caring for a client in acute addisonian crisis. Which laboratory data would the nurse
expect to find?
A. Hyperkalemia
B. Reduced blood urea nitrogen (BUN)Hypernatremia
C. Hyperglycemia
72. A client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH).
Which nursing intervention is appropriate?
A. Infusing I.V. fluids rapidly as ordered
B. Encouraging increased oral intake
C. Restricting fluids
D. Administering glucose-containing I.V. fluids as ordered

73. A female client tells nurse Nikki that she has been working hard for the last 3 months to control her
type 2 diabetes mellitus with diet and exercise. To determine the effectiveness of the client's efforts, the
nurse should check:
A. urine glucose level.
B. fasting blood glucose level.
C. serum fructosamine level.
D. glycosylated hemoglobin level.
74. Nurse Trinity administered neutral protamine Hagedorn (NPH) insulin to a diabetic client at 7 a.m. At
what time would the nurse expect the client to be most at risk for a hypoglycemic reaction?
a. 10:00 am
b. Noon
c. 4:00 pm
d. 10:00 pm
75. The adrenal cortex is responsible for producing which substances?
a. Glucocorticoids and androgens
b. Catecholamines and epinephrine
c. Mineralocorticoids and catecholamines
d. Norepinephrine and epinephrine
76. A female client whos paralyzed on the left side has been receiving physical therapy and attending
teaching sessions about safety. Which behavior indicates that the client accurately understands safety
measures related to paralysis?
a. The client leaves the side rails down.
b. The client uses a mirror to inspect the skin.
c. The client repositions only after being reminded to do so.
d. The client hangs the left arm over the side of the wheelchair.
77. A 66 year old client has marked dyspnea at rest, is thin and uses accessory muscles to breathe. Hes
tachypneic with a prolonged expiratory phase. He has no cough. He leans forward with his arms braced
on his knees to support his chest and shoulders for breathing. This client has symptoms of which of the
following respiratory disorder?
a.
b.
c.
d.

ARDS
Asthma
Chronic obstructive bronchitis
Emphysema

78. Its highly recommended that clients with asthma, chronic bronchitis and emphysema have pneuvax
and flu vaccinations for which of the following reasons?
a. All clients are recommended to have these vaccines
b. These vaccines produce bronchodilation and improve oxygenation
c. These vaccines help reduce the tachypnea these clients experience
d. Respiratory infections can cause severe hypoxia and possibly death in these clients.
79. Exercise has which of the following effects on client with asthma, chronic bronchitis and
emphysema?
a. It enhances cardiovascular fitness
b. It improves respiratory muscle strength
c. It reduces the number of acute attacks
d. It worsens respiratory function and is discouraged
80. A client with chronic obstructive bronchitis are given diuretic therapy. Which of the following reasons
best explain why?
a. Reducing fluid volume reduce oxygen demand
b. Reducing fluid volume improves clients mobility
c. Restricting fluid volume reduces sputum productivity
d. Reducing fluid volume improves respiratory function
81. A 69 year old client appears thin and achectic. Hes short of breath at rest and his dyspnea increases
with the slightest exertion. His breath sounds are diminished even with deep inspiration. This signs and
symptoms fit which of the following conditions?
a. ARDS
b. Asthma
c. Chronic obstructive bronchitis
d. Emphysema

82. A client with emphysema could received only 1 to 3L/minute of oxygen, if needed, or he may lose his
hypoxic drive which of the following statements is correct about hypoxic drive?
a. The client doesnt notice he needs to breathe
b. The client breathes only when his oxygen levels climb above a certain point
c. The client breathes only when oxygen levels dip below a certain point of view
d. The client breathes only when his carbon dioxide level dip below a certain point
83. Teaching for client with COPD should include which of the following topics?
a. How to have his wife learn to his lungs with a stethoscope from Wal-Mart
b. How to increase his oxygen therapy
c. How to treat respiratory infections without going to the physician
d. How to recognize the signs of an impending respiratory infection
84. Which of the following measures can reduce or prevent the incidence of atelectais in a post operative
client?
a. Chest physiotherapy
b. Mechanical ventilation
c. Reducing oxygen requirements
d. Use of an incentive spirometers
85. Emergency treatment of a client is status asthmaticus includes which of the following medications?
a. Inhaled beta-adrenergic agents
b. Inhaled corticosteroids
c. I.V beta-adrenergic agents
d. Oral corticosteroids
86. Mrs. Chua a 78 year old client is admitted with the diagnosis of mild chronic heart failure. The nurse
expects to hear when listening to clients lungs indicative of chronic heart failure would be:
a. Stridor
b. Crackles
c. Wheezes
d. Friction rubs
87. Patrick who is hospitalized following a myocardial infarction asks the nurse why he is taking morphine.
The nurse explains that morphine:
a. Decrease anxiety and restlessness
b. Prevents shock and relieves pain
c. Dilates coronary blood vessels
d. Helps prevent fibrillation of the heart
88. Which of the following should the nurse teach the client about the signs of digitalis toxicity?
a. Increased appetite
b. Elevated blood pressure
c. Skin rash over the chest and back
d. Visual disturbances such as seeing yellow spots
89. Nurse Trisha teaches a client with heart failure to take oral Furosemide in the morning. The reason for
this is to help
a. Retard rapid drug absorption
b. Excrete excessive fluids accumulated at night
c. Prevents sleep disturbances during night
d. Prevention of electrolyte imbalance
90. What would be the primary goal of therapy for a client with pulmonary edema and heart failure?
a. Enhance comfort
b. Increase cardiac output
c. Improve respiratory status
d. Peripheral edema decreased
91. Nurse Linda is caring for a client with head injury and monitoring the client with decerebrate posturing.
Which of the following is a characteristic of this type of posturing?
a. Upper extremity flexion with lower extremity flexion
b. Upper extremity flexion with lower extremity extension
c. Extension of the extremities after a stimulus
d. Flexion of the extremities after stimulus
92. A female client is taking Cascara Sagrada. Nurse Betty informs the client that the following maybe
experienced as side effects of this medication:
a. GI bleeding
b. Peptic ulcer disease

c. Abdominal cramps
d. Partial bowel obstruction
93. Dr. Marquez orders a continuous intravenous nitroglycerin infusion for the client suffering from
myocardial infarction. Which of the following is the most essential nursing action?
a. Monitoring urine output frequently
b. Monitoring blood pressure every 4 hours
c. Obtaining serum potassium levels daily
d. Obtaining infusion pump for the medication
94. During the second day of hospitalization of the client after a Myocardial Infarction. Which of the
following is an expected outcome?
a. Able to perform self-care activities without pain
b. Severe chest pain
c. Can recognize the risk factors of Myocardial Infarction
d. Can Participate in cardiac rehabilitation walking program
95. A 68 year old client is diagnosed with a right-sided brain attack and is admitted to the hospital. In
caring for this client, the nurse should plan to:
a. Application of elastic stockings to prevent flaccid by muscle
b. Use hand roll and extend the left upper extremity on a pillow to prevent contractions
c. Use a bed cradle to prevent dorsiflexion of feet
d. Do passive range of motion exercise
96. Nurse Liza is assigned to care for a client who has returned to the nursing unit after left nephrectomy.
Nurse Lizas highest priority would be
a. Hourly urine output
b. Temperature
c. Able to turn side to side
d. Able to sips clear liquid
97. A 64 year old male client with a long history of cardiovascular problem including hypertension and
angina is to be scheduled for cardiac catheterization. During pre cardiac catheterization teaching, Nurse
Cherry should inform the client that the primary purpose of the procedure is..
a. To determine the existence of CHD
b. To visualize the disease process in the coronary arteries
c. To obtain the heart chambers pressure
d. To measure oxygen content of different heart chambers
98. During the first several hours after a cardiac catheterization, it would be most essential for nurse
Cherry to
a. Elevate clients bed at 45
b. Instruct the client to cough and deep breathe every 2 hours
c. Frequently monitor clients apical pulse and blood pressure
d. Monitor clients temperature every hour
99. Kate who has undergone mitral valve replacement suddenly experiences continuous bleeding from
the surgical incision during postoperative period. Which of the following pharmaceutical agents should
Nurse Aiza prepare to administer to Kate?
a. Protamine Sulfate
b. Quinidine Sulfate
c. Vitamin C
d. Coumadin
100. In reducing the risk of endocarditis, good dental care is an important measure. To promote good
dental care in client with mitral stenosis in teaching plan should include proper use of
a. Dental floss
b. Electric toothbrush
c. Manual toothbrush
d. Irrigation device