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CHM MISC1 Comprehensive Exam. Pitt Community College
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CHM MISC1 Comprehensive Exam. Pitt Community College
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CHM MISC1 Comprehensive Exam. Pitt Community College1. 1.
Enalapril maleate (Vasotec) is prescribed for a hospitalized client. Which
assessment does the nurse perform as a priority before administering the
medication?
A. Checking the client's blood pressure
B. Checking the client's peripheral pulses
C. Checking the most recent potassium level
D. Checking the client's intake-and-output record for the last 24
hours
2. 2.
A client is scheduled to undergo an upper gastrointestinal (GI) series, and the
licensed practical nurse reinforces instructions to the client about the test. Which
statement by the client indicates a need for further instruction?
A. "The test will take about 30 minutes."
B. "I need to fast for 8 hours before the test."
C. "I need to drink citrate of magnesia the night before the
test and give myself a Fleet enema on the morning of the test."
D. "I need to take a laxative after the test is completed, because
the liquid that I’ll have to drink for the test can be constipating."
3. 3.
A nurse on the evening shift checks a physician's prescriptions and notes that the
dose of a prescribed medication is higher than the normal dose. The nurse calls
the physician's answering service and is told that the physician is off for the night
and will be available in the morning. The nurse should:
A. Call the nursing supervisor
B. Ask the answering service to contact the on-call
physician
C. Withhold the medication until the physician can be reached in
the morning
D. Administer the medication but consult the physician when he
becomes available
4. 4.
An emergency department (ED) nurse is monitoring a client with suspected acute
myocardial infarction (MI) who is awaiting transfer to the coronary intensive care
unit. The nurse notes the sudden onset of premature ventricular contractions
(PVCs) on the monitor, checks the client's carotid pulse, and determines that the
PVCs are not resulting in perfusion. The appropriate action by the nurse is:
A. Documenting the findings
,CHM MISC1 Comprehensive Exam. Pitt Community College
B. Asking the ED physician to check the client
C. Continuing to monitor the client's cardiac status
D. Informing the client that PVCs are expected after an MI
5. 5.
NPO status is imposed 8 hours before the procedure on a client scheduled to
undergo electroconvulsive therapy (ECT) at 1 p.m. On the morning of the
procedure, the nurse checks the client's record and notes that the client routinely
takes an oral antihypertensive medication each morning. The nurse should:
A. Administer the antihypertensive with a small sip of
water
B. Withhold the antihypertensive and administer it at bedtime
C. Administer the medication by way of the intravenous (IV) route
D. Hold the antihypertensive and resume its administration on the
day after the ECT
6. 6.
A client who recently underwent coronary artery bypass graft surgery comes to
the physician's office for a follow-up visit. On assessment, the client tells the
nurse that he is feeling depressed. Which response by the nurse is therapeutic?
A. "Tell me more about what you’re feeling."
B. "That’s a normal response after this type of surgery."
C. "It will take time, but, I promise you, you will get over
this depression."
D. "Every client who has this surgery feels the same way for
about a month."
7. 7.
A client in labor experiences spontaneous rupture of the membranes. The nurse
immediately counts the fetal heart rate (FHR) for 1 full minute and then checks
the amniotic fluid. The nurse notes that the fluid is yellow and has a strong odor.
Which of the following actions should be the nurse’s priority?
A. Contacting the physician
B. Documenting the findings
C. Checking the fluid for protein
D. Continuing to monitor the client and the
FHR 8. 8.
A nurse helps provide an educational session to community members about
cancer of the cervix. The nurse informs the group members that an early sign of
this type of cancer is:
A. Dark, foul-smelling vaginal drainage
,CHM MISC1 Comprehensive Exam. Pitt Community College
B. Abdominal pain
C. Constant, profuse bleeding
D. Irregular vaginal bleeding or spotting
9. 9.
A survivor of sexual assault being treated in the emergency department says to
the nurse, "I’m really worried that I’ve got HIV now." What is the appropriate
response by the nurse?
A. "HIV is rarely an issue in survivors of sexual assault."
B. "Every survivor of sexual assault is concerned about HIV."
C. "You’re more likely to get pregnant than to contract HIV."
D. "Let's talk about the information that you need to
determine your risk of contracting HIV."
10. 10.
A client is taking prescribed ibuprofen (Motrin), 300 mg orally four times daily, to
relieve joint pain resulting from rheumatoid arthritis. The client tells the nurse
that the medication is causing nausea and indigestion. The nurse should tell the
client to:
A. Contact the physician
B. Stop taking the medication
C. Take the medication with food
D. Take the medication twice a day instead of four
times 11. 11.
A client's oral intake of liquids includes 120 mL on the night shift, 800 mL on the
day shift, and 650 mL on the evening shift. The client is receiving an intravenous
(IV) antibiotic every 12 hours, diluted in 50 mL of normal saline solution. The
nurse empties 700 mL of urine from the client's Foley catheter at the end of the
day shift. Thereafter, 500 mL of urine is emptied at the end of the evening shift
and 325 mL at the end of the night shift. Nasogastric tube drainage totals 155 mL
for the 24-hour period, and the total drainage from the Jackson-Pratt device is
175 mL. What is the client's total intake during the 24-hour period? Type your
answer in the space provided.
Answer: mL 1670
12. 12.
A client with a diagnosis of anxiety disorder walks into the mental health clinic
saying, "I just can't take the pressure at home, and I came here to get away from
it for a bit." Which of the following is a therapeutic nursing response?
A. We will be able to help you here at the clinic.
, CHM MISC1 Comprehensive Exam. Pitt Community College
B. You made a good decision in coming here.
C. I'm glad you came to see us at this time.
D. Can you tell me what is making you feel so pressured at
home? 13. 13.
A nurse, conducting an assessment of a client being seen in the clinic for
symptoms of a sinus infection, asks the client about medications that he is
taking. The client tells the nurse that he is taking fluoxetine (Prozac). On the
basis of this information, the nurse determines that the client most likely has a
history of:
A. Depression
B. Diabetes mellitus
C. Hyperthyroidism
D. Coronary artery
disease 14. 14.
Phenelzine sulfate (Nardil) is prescribed for a client with depression. The nurse
provides information to the client about the adverse effects of the medication
and tells the client to contact the physician immediately if she experiences:
A. Dry mouth
B. Restlessness
C. Feelings of depression
D. Neck stiffness or soreness
15. 15.
Risperidone (Risperdal) is prescribed for a client hospitalized in the mental health
unit for the treatment of a psychotic disorder. Which finding in the client’s
medical record would prompt the nurse to contact the prescribing physician
before administering the medication?
A. The client has a history of cataracts.
B. The client has a history of hypothyroidism.
C. The client takes a prescribed antihypertensive.
D. The client is allergic to acetylsalicylic acid
(aspirin). 16. 16.
A client who has been undergoing long-term therapy with an antipsychotic
medication is admitted to the inpatient mental health unit. Which of the
following findings does the nurse, knowing that long-term use of an antipsychotic
medication can cause tardive dyskinesia, monitor in the client?
A. Fever
B. Diarrhea
C. Hypertension
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