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1. To make a definitive diagnosis of tuberculosis, the nurse understands that the physician must order a:

A. Chest x-ray

B. Tuberculin skin test

C. Pulmonary function test

D. Sputum for acid- fast testing

2. The equipment that will be used by the nurse during central venous catherter site care for a client receiving total     parenteral nutrition is:

A. Double sterile gloves

B. Mask and sterile gloves

C. Gown and sterile gloves

D. Mask, gown, and sterile gloves

3. Before irrigating a client’s nasogastric tube, the nurse must first

A. Assess breath sounds

B. Instill 15 ml. Of normal saline

C. Auscultate for bowel sounds

D. Check the tube for placement

4. A client has a history of progressive carotid and cerebral atherosclerosis and transient ischemic attacks (TIAs).    The nurse understands that TIAs are:

A. Temporary episodes of neurologic dysfunction

B. Transient attacks caused by multiple small emboli

C. Periods of alternating exacerbations and remissions

D. Ischemic attacks that result in progressive neurologic deterioration

5. The nurse knows that a positive diagnosis for HIV infection is made based on:

A. A history of high risk sexual behaviors

B. Positive ELISA and Western Blot Tests

C. Evidence of extreme weight loss and high fever

D. Identification of an associated opportunistic infection

6. An ECG is performed before a client is to have a cardiac catheterization. Hypokalemia is suspected. To confirm the    presence of Hypokalemia, the nurse would expect the physician to order:

A. Blood cultures times 3

B. A complete blood count

C. A Serum Electrolyte level

D. An x-ray film of the long bones

7. A patient diagnosed as having non-insulin dependent diabetes mellitus (NIDDM). The priority teaching goal would be    that the client will be a

A. Perform foot care

B. Administer insulin

C. Test urine for sugar and acetone

D. Identify hypoglycemia/ hyperglycemia

8. A patient returns from cardiac catheterization with a pressure dressing over the left groin. The patient is to be flat in the bed for 6 hours with the leg straight. These measures are important to prevent: 

A. Orthostatic hypotension

B. Headache and disorientation

C. Bleeding at the arterial puncture site

D. Infiltration of radiopaque dye into tissue

9. When a patient with chronic obstructive pulmonary disease (COPD) becomes dyspenic and anxious, the nurse’s    first action to decrease dyspnea should be to:

A. Increase the oxygen as high as it will go

B. Check vital signs, including blood pressure

C. Encourage pursed lip breathing and slowing down of respiration

D. Tell the client that he will be fine and there is nothing to worry about

10. A patient develops subcutaneous emphysema after a laryngectomy. This is most readily detected by:

A. Palpating crackles underneath the surface of the skin

B. Auscultation of the lung fields

D. Evaluating the blood gases

E. Reviewing the chest x-ray

11. The nurse knows that a closed water-seal drainage system connected to a client’s pleural chest tube is      functioning properly when the fluid in the water-seal chamber of the drainage system

A. Contains many small air bubbles

B. Bubbles vigorously on inspiration

C. Rises with inspiration and falls with expiration 

D. Remains at a consistent level during the respiratory cycle

12. A unit of blood is ordered. Which of the following is the most important safeguard prior to administrating blood?

A. Refrigerate until used

B. Agitate the blood so it will mix

C. With another nurse, carefully check the  label against the patient wrist ID band.

D. Infuse through a blood warmer to prevent reaction.

13. Nursing measures related to the inflow of dialysate fluid during peritoneal dialysis include:

A. Infusing the dialysate solution over 2 hours

B. Slightly warming the solution before instilling

C. Positioning the client in the side lying position

D. Withholding medication until all solution is administered

14. The position that would provide for the greatest respiratory capacity for a client with dyspena would be the:

A. Sims' position

B. Supine position

C. Orthopenic position

D. Semi- Fowler's position

15. A male patient with a history of congestive heart failure and atrial fibrillation comes to the clinic for his regular 2      week visit. The patient is 9 pounds heavier than his usual weight. The nurse interprets that the most likely cause      of this sudden weight gain is:

A. Fluid retention

B. Urinary retention

C. Renal insufficiency

D. Abdominal distention

16. Halfway through administration of a unit of blood, a patient complains of lumbar pain. The nurse should :

A. Obtain vital signs

B. Stop the transfusion

C. Asses the pain further

D. Increase the flow of normal saline

17. The nurse is caring for a patient who is about to have a lumbar puncture. Planned care following the procedure       should include:

A. Having the patient lie in the supine position for 6 to 12 hours

B. Encouraging the client to ambulate every hour for 6 to 8 hours

C. Maintaining the client in the Trendelenburg's position for 4 hours

D. Placing patient in High Fowler's position immediately after the procedure

18. The nurse is aware that a patient with a spinal cord injury is developing autonomic dysreflexia when the patient       has

A. Flaccid paralysis and numbness

B. Absence of sweating and pyrexia

C. Escalating tachycardia and shock

D. Paroxysmal hypertension and bradycardia

19. Upon assessment of a patient the nurse recognizes that a pacemaker is indicated when a client is experiencing

A. Angina

B. Chest pain

C. Heart block

D. Tachycardia

20. A patient with cmphysema is short of breath and using accessory muscles of respiration. The nurse recognizes      that the patient’s difficulty in breathing is caused by:

A. Spasm of the bronchi that traps the air

B. An increase in the vital capacity of the lungs

C. A too rapid expulsion of the air from the aveoli

D. Difficulty in expelling the air trapped in the alveoli