Perioperative Nursing reviewer/The nurse is preparing a client for surgery Graded A+

1. The nurse is preparing a client for surgery. What is the most effective method for obtaining an accurate blood pressure reading from the client? a. Obtain a cuff that covers the upper one third of the client’s arm. b. Position the cuff approximately 4 inches above the antecubital arm. c. Use a cough that is wide enough to cover the upper two thirds of the client’s arm. d. Identify the Korotkoff sounds, and take a systolic reading. 2. Which of the following items on a client’s pre-surgery laboratory results would indicate a need to contact the surgeon? a. Platelet count of 250,000/cumm b. Total cholesterol of 325nmg/dL c. Blood urea nitrogen (BUN) 17 mg/dL d. Hemoglobin 9.5 mg/dL 3. To prevent complications of immobility, which activities would the nurse plan for the first postoperative day after a colon resection? a. Turn, cough, and deep breathe every 30 minutes. around the clock b. Get the client out of bed and ambulate to a bedside chair. c. Provide passive ROM three times a day. d. It is not necessary to worry about complications of immobility on the first operative day? 4. In the recovery room, the post-operative client suddenly becomes cyanotic. What is the most appropriate nursing action? a. Start administration of oxygen through nasal cannula. b. Call for assistance c. Reposition the head and determine patency of the airway. d. Insert an oral airway and suction the nasopharynx 5. A client is scheduled for surgery in the morning. Preoperative orders have been written. What is the most important to do before surgery. a. Remove all jewelries or tape wedding ring. b. Verify that all laboratory work is complete. c. Inform family or next of kin d. Have all consent forms signed. 6. The nurse is caring for a first-day post-operative surgical client. What is the first type of the client’s diet? a. Full liquid c. Clear liquid b. NPO d. Soft 7. A post-operative client receives a dinner tray with gelatin, pudding, and vanilla ice cream. Based on the foods on the client’s tray, what would the nurse anticipate the client’s current diet order to be? a. Bland diet c. Full liquid diet b. Soft diet d. Regular diet 8. The nurse is preparing the post-operative client for surgery. Select the statement that indicates that the client is not knowledgeable about his impending surgery. a. After surgery, I will need to wear the pneumatic compression device while sitting on the chair. b. The skin prep area is going to be longer and wider than anticipated incision. c. I cannot have anything to drink or eat after midnight on the night before the surgery. d. To ensure my safety a “time out “will be conducted in the operating room. 9. Which of the following is the primary purpose of maintaining NPO for 6-8 hours before surgery? a. To prevent malnutrition c. To prevent aspiration pneumonia b. To prevent electrolyte imbalance d. To prevent intestinal obstruction 10. The nurse will provide preoperative teaching on deep breathing, coughing and turning exercises. When is the best time to provide the operative teachings? a. Before administration of operative medications b. The afternoon or evening prior to surgery c. Several days prior to surgery d. Upon admission of the client in the recovery room 11. Which of the following factors ensure validity of informed written consent except? a. The patient is off legal of age with proper mental disposition b. The consent has been secured within 24 hours before the surgery. c. If the patient is a child, secure consent from the parents or legal guardian. d. The consent is secure just after the administration of preoperative medication. 12.Which of the following drugs is administered to minimize respiratory secretions preoperatively? a. Valium (diazepham) b. Phenergan (promethazine) c. Atropine Sulfate d. Demerol (meperidine) 13. Which of the following is experienced by the patient who is under the third phase of general anesthesia? a. The patient is unconscious b. The patient is awake c. The patient experience slight pain d. The patient experience loss of sensation in the lower half of the body. 14.Which of the following is most dangerous complication during the induction of spinal anesthesia? a. Cardiac arrest b. Hypotention c. Hyperthermia d. Respiratory paralysis 15. Which of the following postoperative patients is at risk for respiratory complications a. The obese patient with long history of smoking who had undergone upper abdominal surgery. b. The patient with normal pulmonary function who had undergone upper abdominal surgery. c. An adolescent patient with diabetes mellitus who has under gone cholecystectomy. d. A football player who had undergone knee replacement surgery. 16. The patient had undergone spinal anesthesia for appendectomy? To prevent spinal headache, the nurse should place the patient in which of the following positions? a. Semi-Fowler’s b. Flat on bed for 6-8 hours c. Prone position d. Modified Trendelenburge position. 17. The nurse is admitting a patient to the operating room. Which of the following nursing actions should be given highest priority by the nurse? a. Assessing the patient’s level of consciousness. b. Checking the patient’s vital signs c. Checking the patient’s identification and correct operative permit. d. Positioning and performing skin preparation to the patient. 18. Which of the following assessment data nis most important to determine when caring for a client who has received spinal anesthesia? a. The time of return of motion and sensation in the patient’s legs and toes. b. The character of the clients respiration c. Patients level of consciousness d. The amount of wound drainage. 19. The nurse is transferring the patient from post anesthesia care unit to the surgical unit. Which of the following. Which of the following is the primary reason for gradual change of position of the patient? a. To prevent muscle injury b. To prevent sudden drop of blood pressure. c. To prevent respiratory distress d. To promote comfort. 20. The nurse is caring for a client who had undergone exploratory laparotomy. Which of the following postop findings should the nurse report to the physician? a. The patient pushes out the oral airway with his tongue. b. The patient’s urine output is 20 ml/hr. for the past two hours. c. The patients’ vital signs are as follows: BP= 110/70 mmHg; PR 95 bpm; RR=9/min; Temperature=36.8 C. d. The patient’s wound drainage. 21. The patient had undergone thyroidectomy. Which of the following are the earliest signs of poor tissue perfusion and poor respiratory function? a. Cyanosis, lethargy b. Fast, thready pulse ,bradypnea c. Apprehension and restlessness d. Faintness, pallor. 22. The diabetic patient who had undergone abdominal surgery experiences wound evisceration.Which of the following is the most appropriate immediate nursing action. a. Cover the wound with sterile gauze moistened with sterile normal saline. b. Cover the wound with sterile gauze. c. Cover the wound with water-soaked gauze. d. Leave the wound uncovered and pull the skin edges together. 23. The patient had undergone total hip replacement. He complains of pain in the operative site. Which of the following is the appropriate initial nursing action? a. Administer the ordered analgesic b. Instruct the patient to deep breathing and coughing exercises. c. Assess the patients pain level and vital signs d. Change the patient’s position. 24. Which among the following are not members of the sterile team in the operating room? a. The surgeon b. The anesthesiologist c. The scrub nurse d. The second assist 25. The best position for kidney, chest or hip surgery is? a. Supine b. Trendelenburg c. Lithothomy d. Lateral 26.Appendectomy is classified as: a. Ablative surgery b. Constructive Surgery c. Reconstructive surgery d. Palliative surgery 27. The worst of all fears among clients undergoing surgery is a. Fear of financial burden b. Fear of death c. Fear of the unknown d. Fear of loss of job 28. The patient has been pacing along the hallways, goes to the bathroom frequently and asks questions repeatedly during preoperative assessment. The most likely cause of the behavior is: a. She is anxious about the surgical procedure. b. She is worried about separation from the family. c. She has urinary tract infection d. She has underlying emotional problem. 29. Which of the following nursing actions would help the patient decrease anxiety during the preoperative period? a. Explaining all procedures thoroughly in chronological order b. Spending time listening to the patient and answering questions c. Encouraging sleep and limiting interruptions d. Reassuring the patient that the surgical staffs are competent professionals. 30.Which of the following characterizes excitement stage of anesthesia a. Occurs from the administration of anesthesia to the loss of consciousness b. Extends from the loss of consciousness to the loss of lid reflex, characterized by struggling and talking. c. From the loss lid reflex to the loss of most reflexes. d. From the loss of most reflexes of most reflexes to respiratory and circulatory failure. 31.The patient who has undergone TAH-BSO (total abdominal hysterectomy and bilateral salpingo-oophorectomy) complains of pain. Which of the following is an initial nursing action? a. Administer the PRN Analgesic b. Instruct to do deep breathing exercises c. Assess VS and position and wound dressing of the patient d. Change the patients position 32. How frequent should the nurse monitor the VS of the patient in the recovery room? a. Every 15 minutes b. Every 30 minutes c. Every 45 minutes d. Every 60 minutes 33. Which of the following drugs is given to relieve nausea and vomiting? a. Mepevacaine b. Aquamephyton c. Nubain d. Plasis 34. The most important factor in the prevention of post op infection is a. Proper administration of antibiotics b. Fluid intake of 2-3 L/day c. Practice strict aseptic technique d. Frequent change of wound dressing 35. Which of the following measures primarily prevents postop complications: a. Adequate fluid intake b. Early ambulation c. Well-balance diet d. Administration of antimicrobials. 36. Regarding the surgical patient, which of the following terms refers to the period of time that constitute the surgical experience? a. Pre-operative phase b. Intraoperative phase c. Postoperative phase d. Perioperative phase 37. When the indication for surgery is without delay the nurse recognizes the surgery will be classified as: a. Emergency b. Urgent c. Required d. Elective 38. Mr. Allan is receiving Total Parenteral Nutrition (TPN).If you will evaluate her nutritional status which of the following indicators would tell you that TPN was effective? a. Laboratory tests b. Adequate hydration c. Weight gain d. Diminish episode of nausea and vomiting 39. A client with liver cirrhosis vomits bright red blood and the physician suspects bleeding esophageal varices. The physician decodes to insert a Sengstaken Blackmore tube. The Nurse should explain to the client that the tube acts? a. To providing a smaller diameter for effective gastric lavage b. Applying direct pressure to the gastric bleeding sites. c. Blocking blood flow to the stomach and esophagus. d. Applying pressure directly to the entire esophagus. 40. When a client developes steatorrhea, the nurse should describe this stool? a. Sterile, greenish-black colored stool. b. Greasy, bulky and foul smelling stool c. Black and blood-streak stool d. Clay colored and pasty stool. 41. The nurse should assess for the development of pernicious anemia when a client has a history? a. Severe bleeding b. Diabetes Insipidus c. Having had a gastrectomy d. Increases intake of water soluble vitamins 42. Rene was diagnosed of Liver Cirrhosis secondary to alcoholism and develops ascites. The following are pathological basis of ascites except? a. Portal hypertension b. Decrease synthesis of Vitamin K c. Hypoalbuminia d. Increase hydrostatic pressure 43. Menopausal women are more prone in developing osteoporosis due to estrogen. Aside from being menopausal which of the following clients are greatest risk of developing osteoporosis? a. A 20 y/o with asthma b. A 28 y/o woman who do regular exercise c. A person with sedentary lifestyle and a long time smoker d. A person that has a well-balanced diet. 44. Which of the following laboratory values would the nurse expect to note in a client with Gouty Arthritis? a. Calcium level of 8.5 mg/dl b. Sodium of 140 meQ/L c. Uric acid level of 9.5 mg/dl d. Phosphorous level of 3 mg/dl 45. A nurse is preparing a list of cast care instructions for a client who had plaster cast applied to his left leg. All instructions that the nurse would include in the list except? a. Leave cast uncovered and should be exposed to air to promote dryness b. Use fans to promote dryness of cast c. Use of stick that will fit under the cast to scratch the skin under the cast. d. Autographing the cast with pen can be allowed. 46. A female client was diagnosed with osteoarthritis and was admitted in the health care facility due to pain. Which of the following clinical manifestation associated with the disorder? a. Morning stiffness that last less than 30 munites b. A decrease sedimentation rate c. Joint pain that increase with rest d. Presence of tophi formation in the pinna of the ear 47. The nurse explains to the client with fracture of lower leg that one of the complications of his condition is pulmonary embolism. All of the following are manifestations of pulmonary embolism secondary to fracture except? a. Sudden dyspnea b. Restlessness c. Oxygen saturation of 93% d. Elevated blood pressure 48. The most common clinical manifestation or feature of Systemic Lupus Erythematosus would be? a. Choasma on the face b. Malar rash on the face c. Mongilian spots d. Petechiae on the face 49. The purpose of applying a dressing over a bleeding wound is to? a. Prevent infection b. Promote hemostatis c. Increase proliferation of puss d. Promote immobilization 50. During emergency situations it is very important for a nurse to know how to do correct bandaging. Which of the following is correct in bandaging? a. Start bandaging from proximal to distal to promote circulation b. Cover the end part of the extremity to be bandage to prevent infection. c. Slightly flex the joints during bandaging d. The bandage should be too tight to immobilize the extremity. 51.It is Excess of isotonic fluid in the extra cellular compartments. a. Water intoxication b. Hypovolemia c. Dehydration d. Hypervolemia 52. The following are TRUE regarding the cause of hypervolemia EXCEPT? a. Excessive fluid and Na intake b. Fluid and Na retention c. Fluids shift into the intravascular spaces d. Diabetes insipidus 53. Occurs when excess fluid moves from the ECS to the ICS. a. Hypovolemia b. Dehydration 54. Causes of Water Intoxication EXCEPT? a. Hyper secretion of the ADH b. Rapid infusion of hypotonic solution c. Rapid infusion of hypertonic solution d. Enema in some cases c. Hypervolemia d. Water intoxication 55. Which of the following is late a manifestation of cerebral edema a. Thirst b. Weight loss c. Dilated pupils d. Headache 56. A nurse directed to administer a hypotonic IV solution. Which of the following solutions should she choose? a. 0.45% NaC l b. 0.9% NaCl c. D5LRS d. 5% dextrose in NSS 57. When the cell presents with the same concentration on the inside and outside with no shifting of fluids this is called? a. Hypotonic b. Hypertonic c. Isotonic d. Osmosis 58. You’re teaching a group of athletes how to prevent excessive fluid loss. you should tell them to consume fluids when they: a. Experience dry mouth b. Feel light-headed or dizzy c. Are thirsty d. Sweaty 59. Is a fluid movement where solutes move from a higher concentration to areas of lower concentration a. Diffusion b. Osmosis c. Active transport d. None of the above 60. A hormone that is responsible for reabsorbing water a. Aldosterone b. Vasopressin c. ANP d. RAAS 61. These hormone is responsible in increasing calcium level in the blood a. Antidiuretic hormone b. Aldosterone c. Calcitonin d. Parathyroid hormone 62. Hypernatremia can lead to dehydration? a. Yes b. Not 63. Which of the following is major extracellular compartment electrolyte c. Potassium d. Phosphates e. Calcium f. Magnesium 64. Which of the following is major intracellular compartment electrolyte a. Calcium b. Bicarbonate c. Chlorine d. Magnesium 65. Which of the following is the most important indicator of fluid volume deficit a. Thirst b. Dry mouth c. Urine output d. Cyanosis 66. Mr. Rham is a 60 years old with chronic obstructive pulmonary disease. He is admitted to the hospital for pneumonia with a chief complaint of shortness of breath and congestion. Using Maslow’s Hierarchy of Needs, the most basic need of Mr. Rham at this point in time would be: a. Safety c. Self-esteem b. Air d. Food 67. During the assessment phase of the nursing process, the nurse would a. Propose hypotheses c. Validate data b. Generate desired outcomes d. Document care 68. The phase of the nursing process known as nursing diagnosis or diagnosing may also be referred to as: a. Analysis c. interpreting b. Defining d. determination 69. An important problem at this point in Mr. Rham’s care would be: a. Altered nutritional status related to inability to swallow b. Potential for depression related to chronic illness c. Inadequate oxygenation related to chronic lung disease d. Impaired circulation related to congestive heart failure 70. His wife reports that he usually sleeps on two or three pillows at home. Which of the following nursing interventions is most appropriate based on this information? a. Have him assume the semi-fowler’s position for sleep b. Allow him to sit in a chair to sleep c. Ambulate three times a day with breathing exercises d. Apply oxygen as needed for dyspnea 71. Which of the following is true about suppositories? a. Are always administered rectally c. Have a base that melts at body temperature b. Produce bowel evacuation d. Are soothing to mucous membranes 72. A medication that consists of a suspension of fat globules and water is classified as a (an): a. Emulsion c. Tincture b. Ointment d. Elixir 73. Pills that are enteric coated are: a. Absorbed through the skin c. Dissolve by gastric acid b. Dissolved by intestinal juices d. Held in the mouth until dissolved 74. When administering a troche or lozenge, the nurse should instruct the patient to: a. Always take it dissolved in water to protect the teeth b. Follow the medication with a full glass of water c. Hold it in the mouth until dissolved d. Take it on an empty stomach 75. A full liquid diet is termed as one that contains: a. Clear liquids at body temperature c. Only liquids that have residue b. Liquids at body temperature d. Only liquids that have no residue 76. When reviewing a patient’s dietary intake, the nurse would identify which nutrient as providing the most concentrated source of energy in the body? a. Protein c. Fats b. Carbohydrates d. Macrominerals 77. To best increase dietary iron content, increase the use of: a. pork, apples, karo, corn b. liver, raisins, molasses, soy beans c. chicken, cranberry juice, honey, tomatoes d. fish, oranges, brown sugar, red beets 78. The minimum fat diet is often used for: a. Colitis c. Gallbladder and cardiac conditions b. Kidney stones d. gout 79. On a low cholesterol diet which of the following foods would be omitted? a. Skim milk c. Oranges b. Eggs d. Peas 80. Which plant protein contains all the essential amino acids necessary to supports growth? a. Grains c. Vegetables b. Soy d. Legumes 81. The prescribed diet for kidney disease would limit the following: a. Glucose c. Fats b. Vitamins d. Proteins 82. Prior to the pelvic exam, the nurse should: a. Have the patient void c. Catheterize the patient b. Administer an enema d. Scrub the perineal area with antiseptic soap 83. The internal structures of the eye can be visualized using which of the following instruments? a. Otoscope c. Stethoscope b. Ophthalmoscope d. Tuning fork 84. Postoperatively, frequent coughing and deep breathing exercises are: a. Prohibited because of the severe pain b. Supervised by the surgeon only c. Needed for adequate ventilation d. Done only if the patient is not in too much pain 85. To prevent the development of pressure ulcers, which of these measures should be included in the care of client on bed rest? a. Massage red areas on bony prominences regularly b. Wash skin with soap and water frequently c. Use a donut-shaped cushion on the sacral area d. Establish an individualized turning schedule 86. When testing for vision in a school aged child, the nurse should use the: a. Rosen baun card c. Ishihara plate b. Jaeger card d. Snellen chart 87. Your client is at risk for aspiration pneumonia. Which of the following nursing interventions will help prevent aspiration pneumonia: a. Keeping the head of the bed elevated in at least 45o angle after giving enteral feedings b. Providing vigorous pulmonary toilet immediately after feeding the client c. Performing mouth care with the client in the supine position d. Auscultating breath sounds when ordered 88. To assess the presence of bowel sounds, the nurse should: a. Auscultate in the left lower quadrant only b. Auscultate for 10 seconds in each quadrant c. Auscultate prior to palpating the abdomen d. Auscultate over the umbilicus 89. An effective nurse-client relationship will be established if the nurse is certain to: a. Be pleasant and helpful at times b. Explain procedures to the client and family c. Incorporate cultural values into care d. Communicate all progress to the provider 90. For a nurse under normal conditions with unsoiled hands, effective hand hygiene between patients requires: a. At least 15 second scrub with plain soap and water b. At least 23 minute scrub with an antimicrobial soap c. Use an alcohol-based antiseptic hand rub d. That a mask be worn when scrubbing 91. To check for the correct for the placement of a nasogastric tube, the most accurate method the nurse should use is: a. X-ray confirmation b. Instill 100 cc of saline and check for residual in 1 hour c. Inject air into the tube and listen for air passing into the stomach with a stethoscope d. Connect the tube to suction and visually examined the drainage 92. To increase stability during patient transfer, the nurse increases the bases of support by: a. Leaning slightly back ward c. Tensing the abdominal muscles b. Spacing the feet further apart d. d. Bending the knees 93. Isotonic exercises such as walking are intended to a. Increase muscle tone c. Increase muscle size b. Increase endurance d. Deplete muscle oxygen 94. Five minutes after the patient’s first postoperative exercise, the patient’s vital signs have not yet returned to baseline. An appropriate nursing diagnosis might be: a. Activity intolerance c. Impaired physical mobility b. Risk for activity intolerance d. Risk for disuse syndrome 95. Which of the following demonstrates proper transfer technique in moving a client from sitting on the side of the bed to a chair? a. Have the client grasp the nurse around the neck for stability while standing b. The nurse rocks from the rear foot to be front foot while standing the client c. Place the chair perpendicular (right angled) to the bed d. Have the client sit first on the edge of the chair and then push back fully 96. Which of the following statements from a client with one weak leg regarding use of crutches when using stairs indicates a need for further teaching? a. “Going up, the strong leg goes first, then the weaker leg with both crutches” b. “Going down, the weaker leg goes first with both crutches, then the strong leg” c. “The weaker leg always goes first with both crutches” d. “A cane or single crutch may be used instead of both crutches” 97. In the situation in which the client is a chronic carrier of infection, in order to prevent the spread of the infection, the most effective action is to: a. Eliminate the reservoir b. Block the portal of exit from the reservoir c. Block the portal of entry into the host d. Decrease the susceptibility of the host 98. Research has shown that the most effective infection control procedure is: a. Hand washing before and after client contact b. Wearing gloves and masks for direct client care c. Isolation precaution d. Broad-spectrum prophylactic antibiotics 99. In caring for a client with a draining infected foot ulcer, correct technique includes: a. Wearing mask during dressing changes b. Providing disposable meal trays and silverware c. Following standard precautions in all interactions with the client d. Using surgical aseptic technique for all direct contact with the client 100. Which of the following person protective equipment may be reused by the same nurse during a single shift caring for a single client? a. Goggles c. Surgical mask b. Gown d. Clean gloves 101. While donning sterile gloves (open method), the cuff of the first glove rolls under itself about ¼ inches. The best action for the nurse is to: a. Remove the glove and start over with a new pair b. Wait until the second glove is in place and then unroll the cuff with the other sterile hand c. Ask colleague to assist by unrolling the cuff d. Leave the cuff rolled under 102. The client should be sitting upright during palpation of which of the following areas? a. Abdomen c. Breast b. Heart d. Head and neck 103. Upon auscultating the abdomen, which finding should be reported to the physician? a. Bruit over the aorta b. Absence of bowel for 60 seconds c. Continuous bowel sound over the ileocecal valve d. Completely irregular pattern of bowel sounds 104. The nurse is unable to locate the client’s popliteal pulse during a routine examination. What would be the appropriate next step? a. Check for pedal pulse b. Check for a femoral pulse c. Take the client’s blood pressure on the thigh d. Ask another nurse to try to locate the pulse 105. Which of the following represents expected findings during assessment of the older adult? a. Facial hair becomes finer and softer b. Decrease peripheral, color and night vision c. Increased sensitivity to odors d. Respiratory rate and rhythm are irregular at rest 106. An elevation of the body temperature above normal is labeled as: a. Pyrexia c. Hypertension b. Hypothermia d. Afebrile 107. In recording a blood pressure of 120/80 mmHg, the 120 represents the: a. Pulse rate c. Systolic pressure b. Diastolic pressure d. Pulse deficit 108. A nurse is planning to reinforce instructions to a client with chronic vertigo about safety measures to prevent worsening of symptoms or injury. The nurse plans to tell the client that it is important to: a. Drive at times when the client does not feel dizzy b. Go to the bedroom and lie down when vertigo is experienced c. Remove rugs and clutter in the home d. Turn the head slowly when spoken 109. A nurse is giving a bed bath to a client who is on strict bed rest. To safely increase venous return. The nurse bathes the client’s extremities by using: a. Long, firm strokes from distal to proximal area b. Firm, circular strokes from proximal to distal areas c. Short, patting stokes from distal to proximal areas d. Smooth, light strokes back and forth from proximal to distal areas 110. A nurse is preparing to give an intramuscular (IM) injection that is irritating to the subcutaneous tissues. The drug reference recommends that it is given using the Z-track technique. Which of the following procedural steps would cause tracking the medication through the subcutaneous tissues? a. Preparing a 0.2 ml air lock in the syringe after drawing up the medication b. Massaging the site after injecting the medication c. Attaching a new sterile needle to the syringe after drawing up the medication d. Retracting the skin to the size before piercing the skin with the needle 111. A nurse is preparing to suction a client’s tracheotomy. In which position should the client be safely placed? a. Supine c. High-Fowler’s b. Lateral d. Semi-Fowler’s 112. The leading cause of accidental death among people 79 years of age and older is: a. Fires c. Drug overdose b. Exposure to temperature extremes d. Falls 113. When a fire occurs in a patient’s room, the nurse’s priority should be: a. Rescue the patient c. Sound the alarm b. Extinguish the fire d. Run for help 114. A nurse is questioning a client about potential hazards in the home environment. Which of the following items in the home if identified by the client is an indication that the client needs instruction about safety? a. Skid resistant, small area rugs in the living room b. Clothes hamper at the end of the hallway c. Area rugs on the stairs d. Carpeted stairs secure with carpet tacks 115. The nurse orients an older patient to the safety features in her hospital room. A vital component of this admission routine is: a. Explain how to use the telephone b. Introduce the patient to her roommate c. Review the hospital policy on visiting hours d. Explain how to operate the call bell QUESTIONS 151-170. (Introduction to Nursing Pharmacology / Implementing Special Nursing Measures in Medication Admin.) 116. How a drug is absorbed or excreted is called: A. Pharmacodynamics B. Pharmacokinetics B. Pharmacotherapeutics D. Drug Interactions 117. What type of drug interaction occurs when two drugs produce the same effect? C. Additive Effect C. Increased Absorption D. Potentiation D. Decreased Effect 118. Expected outcomes are defined as: A. Goals the patient and family ask you to accomplish. B. Goals that are above the level the patient can realistically reach. C. Goals that were met by the patient in the past. D. Goals the patient should reach as a result of planned nursing interventions. 119. The MOST effective method of delivering pain medication during the emergent phase is: A. Intramuscularly C. Orally B. Subcutaneous D. Intravenously 120. A client in the ER is receiving clonidine (Catapres) IV for control of hypertension. Blood pressure before the infusion started, was 150/90. Fifteen minutes after the infusion is started, the BP rises to 180/100. The response to the drug would be described as a(n): A. Synergistic Response C. Allergic Response B. Individual Hypersusceptibility D. Paradoxical Response 121. Which among the following statement(s) is correct when referring to “generic names”? A. Official name of the medication that is never changed and is used in all countries. B. It relates to the chemical formula and is the name under which the medication is listed in official publications. C. A medication can have several trade names but only one generic name. D. All of the above 122. It is the emotional reliance on a drug to maintain sense of well-being accompanied by feelings of need or cravings for the drug: A. Drug Abuse C. Drug Tolerance B. Drug Dependence D. Habituation 123. Which of the following statement best refers to “idiosyncratic effect”? A. It is the increasing response to the repeated doses of a drug that occurs when the rate of administration exceeds the rate of metabolism or excretion. B. It is the unexpected peculiar response to the drug. C. It is the effect of the drug that is unintended. D. A severe allergic reaction which usually occurs immediately following administration of the drug. 124. It is a type of physician’s order that is carried out upon judgment of the nurse, as required by the patient. A. Standing Order C. STAT Order B. Single Order D. PRN Order 125. The most accurate method of identifying a client before drug administration is by: A. Asking the client to state his name. B. Calling the client by his name. C. Asking a relative to identify the client. D. Checking the identification band / bracelet of the client. 126. Which of the following are true in the absorption of medications? 1. Rich blood flow promotes faster absorption of medications. 2. Exercise enhances absorption of oral medications. 3. High concentration of drugs promotes rapid effect. 4. Liquid medications are more rapidly absorbed than solid medications. A. 1, 2 and 3 C. 1, 3 and 4 B. 2, 3 and 4 D. 1, 2, 3 and 4 127. If the label of the drug is erased or contaminated, who is legally responsible to re-label it? A. The pharmacist C. The physician B. The nurse D. The head nurse 128. The following are appropriate nursing actions during medication administration. 1. The nurse who prepares the medication administers it. 2. The nurse never leaves the medication at the bedside. 3. The nurse questions unclear physician’s order. 4. The nurse should keep narcotics in locked cabinets. 5. The nurse repeats dose of oral medications if the client vomits immediately after administration of the medication. 6. The nurse reads the label of the drug 3 times. A. 1, 2, 3, 4 and 6 C. 1, 2, 3 and 4 B. 1, 2, 3, 4 and 5 D. 1, 2, 3, 4, 5 and 6 129. During application of dermatologic medications, the nurse includes the following nursing actions: 1. Clean the area of application before the next dose of the drug. 2. Remove previous application before the next dose of the drug. 3. Apply thick layer of the medication to ensure adequate absorption. 4. Use sterile gauze when applying medication over a large surface of the skin. A. 1 and 3 C. 1 and 4 B. 1 and 2 D. 3 and 4 130. During application of medication into the ear, which of the following is inappropriate nursing action? A. Warm the medication at room or body temperature. B. In an adult, pull the pinna upward. C. Instill the medication directly into the tympanic membrane. D. Press the tragus of the ear a few times to assist flow of medication into the ear canal. 131. During administration of medication into the dorsogluteal site, which of the following nursing actions will minimize the discomfort from the injection? A. Instruct the client to curl his toes inward while in prone position. B. Advise client to tighten the muscles of the buttocks. C. Inject the needle into the muscle slowly. D. Introduce the medication rapidly. 132. How many milliliter(s) of air can cause air embolism in client receiving intravenous injection? A. 50 ml C. 10 ml B. 5 ml D. 100 ml 133. During blood transfusion, which of the following nursing actions are incorrect? 1. Check cross-matching and blood-typing before blood transfusion. 2. Two nurses should check the label of the blood transfusion. 3. Warm blood by placing it under running water. 4. Administer Lactated Ringers in dextrose 5% before, during and after blood transfusion. 5. Administer blood transfusion for 4 hours. A. 1 and 2 C. 3 and 4 B. 2 and 3 D. 3, 4 and 5 134. The client receiving blood transfusion experiences rashes, pruritus and dyspnea. Which of the following is the BEST initial nursing action? A. Stop the transfusion. B. Notify the physician. C. Document the observation. D. Start an IV line of normal saline. 135. A 16-year-old girl has newly diagnosed type 1 diabetes (IDDM). She tells the nurse that she does not want to give herself insulin injections. The girl’s father assures her that he and the girl’s mother will give her any injections she needs. Which of the following approaches by the nurse would be MOST appropriate? A. Teach the girl how to perform insulin injections. B. Tell the father that he is not doing the best thing for his daughter. C. Explain to both parents the importance of their daughter assuming responsibility for her care. D. Tell the girl that the injections are necessary for her own health. QUESTIONS 171-180. (Drug Calculation) The examinee can use a calculator for this part of the examination. Use the back part of the questionnaire as your scrap and for problem solving. ENJOY COMPUTING! 136. A vial of ampicillin contains 500 mg of the medication per 100 ml of solution. If a patient requires a dosage of 2.5 g of ampicillin, how many ml of solution should be administered? A. 100 ml C. 400 ml B. 250 ml D. 500 ml 137. A 24-year-old woman is to receive a total of 900 mg of cimetidine (Tagamet) daily. If a bottle of cimetidine contains 300 mg per 2 ml of solution, how much Tagamet should be administered each day? A. 2 ml C. 4 ml B. 3.5 ml D. 6 ml 138. A 50-year-old man is receiving aminophylline 400 mg every 6 hours. If the ampule contains 500 mg in 20 ml of fluid, how many ml will the man receive per day? A. 64 ml C. 80 ml B. 75 ml D. 96 ml 139. The doctor has prescribed meperidine (Demerol) 100 mg. If the label on the multidose vial of Demerol reads 40 mg / ml, how much solution should the nurse prepare for the patient? A. 1.5 ml C. 4 ml B. 2.5 ml D. 5 ml 140. The nurse is to administer tobramycin (Nebcin) 4 mg / kg TID to a 60-year old man. If the man weighs 72 kg (158 lbs), how many mg should he receive per dose? A. 72 mg C. 288 mg B. 96 mg D. 316 mg 141. A 9-year-old girl is to receive aminophylline 3 mg / kg TID. If the girl weighs 25 kg (55 lbs), how much aminophylline should she receive daily? A. 150 mg C. 250 mg B. 225 mg D. 270 mg 142. A 40-year-old woman is to receive 1,800 ml of IV fluid over 12 hours. If the IV set delivers 10 drops per milliliter, the nurse should regulate the IV set to deliver how many drops per minute? A. 25 gtts C. 35 gtts B. 30 gtts D. 50 gtts 143. A 23-year-old woman is to receive 1,800 ml of TPN solution over the next 15 hours. The IV set delivers 15 drops per milliliter. The nurse should regulate the flow rate so that the woman receives how many drops per minute? A. 25 gtts C. 45 gtts B. 30 gtts D. 75 gtts 144. The following medications are prescribed for a patient: atropine sulfate 0.4 mg IM and meperidine (Demerol) 75 mg IM. Atropine sulfate is available in a multi-dose vial that is labeled 0.6 mg / ml. Demerol is available at 50 mg / ml. How much medication should the patient receive? A. 0.6 ml of atropine sulfate and 1.4 ml of Demerol B. 0.4 ml of atropine sulfate and 1.5 ml of Demerol C. 0.67 ml of atropine sulfate and 0.62 ml of Demerol D. 0.67 ml of atropine sulfate and 1.5 ml of Demerol 145. The physician has prescribed the following medications for a patient: heparin 4,000 U twice daily, and ampicillin 9 g IV daily in six equally divided doses. Heparin is available in 5,000 units / ml, and ampicillin comes in a 500 mg / 100 ml vial. If the patient is scheduled to receive both drugs at 6PM, how much medication should the nurse administer? A. 0.8 ml of heparin and 300 ml of ampicillin B. 1.6 ml of heparin and 1,800 ml of ampicillin C. 1.2 ml of heparin and 300 ml of ampicillin D. 0.8 ml of heparin and 450 ml of ampicillin QUESTIONS 181-200. (Drugs That Affect Various Parts of the Body / Integrated Pharmacological Nursing Interventions and Considerations) 146. A 15-year-old patient has a tonic-clonic seizure disorder and is prescribed phenytoin. Which term best describes the absorption rate of oral phenytoin? A. Rapid C. Erratic B. Slow D. Moderate 147. An 11-year-old patient develops myoclonic seizures. Which potential adverse reaction makes it unlikely that valproate will be prescribed for this patient? A. Liver toxicity C. Respiratory depression B. CNS sedation D. Hyperthermia 148. Anti-convulsants fall into several major classes, including: A. Anti-cholinergics C. Succinimides B. Fluoroquinolones D. Dopaminergics 149. A 48-year-old patient has been prescribed trihexyphenidyl for her Parkinson’s disease. Which adverse reaction to this drug can be dose-related? A. Excessive salivation C. Bradycardia B. Dryness of mouth D. Constipation 150. Which anti-parkinsonian drug is associated with the on-off phenomenon and the wearing- off effect? A. Amantidine C. Levodopa B. Benztropine D. Pramipexole 151. Which of the following drug is not classified as an anti-parkinsonian medication? A. Amantidine HCL C. Trihexyphenidyl (Artane) B. Levodopa D. None of the above 152. A patient asks the nurse, “how does the topical anesthetic benzocaine relieve sunburn pain?” The nurse’s BEST response to the question is: A. “It numbs the skin surface, decreasing the perception of pain.” B. “It freezes the skin, which prevents nerve impulse transmission.” C. “It blocks nerve impulse transmission by preventing nerve cell depolarization.” D. “It occupies sites on specialized receptors, modifying the release of neurotransmitters.” 153. The drug commonly prescribed to treat an opioid overdose is: A. Butorphanol C. Pentazocine B. Naloxone D. Nalbuphine 154. The doctor in the ER ordered aminophylline for a patient in acute asthmatic attack. The nurse understands that when administering this medication, it is also important to: A. Record the patient’s intake and output. B. Encourage the patient to increase fluid intake. C. Monitor the patient’s pulse rate. D. Check the patient for allergy to the drug. 155. In addition to bronchitis and cystic fibrosis, acetylcysteine may also be used to treat: A. Acetaminophen overdose C. Theophylline toxicity B. Allergic rhinitis D. Zollinger-Ellison Syndrome 156. Which administration method for parenteral iron helps avoid leakage into subcutaneous (SQ / SC) tissue? A. Z-track method B. IM into the deltoid C. S.C. injection D. Intradermal injection 157. Which test should the nurse check in his / her assessment of a patient receiving heparin? A. Complete blood count (CBC) C. PT B. PTT D. Arterial blood gas (ABG) 158. What is the most common adverse reaction experienced with anti-platelet drugs? A. Nausea C. Headache B. Joint pain D. Bleeding 159. A patient is admitted to the emergency department with salicylate poisoning. Which drug should the nurse anticipate giving the patient? A. Chlorpromazine C. Magnesium citrate B. Activated charcoal D. Docusate 160. A patient is receiving digoxin for treatment of atrial fibrillation. When you enter the room to give the medication, you find the patient irritable and complaining of nausea and blurred vision. She’s also disoriented to place and time. The most appropriate action at this time is to: A. Attempt to reorient the patient while helping her take the digoxin. B. Return to the room later and see whether the patient will take the medication. C. Withhold the digoxin and notify the prescriber about your assessment findings. D. Check the medication profile for possible drug interactions after giving the digoxin to the patient. 161. A patient comes to the ER complaining of chest pains, which started 1 hour ago while he was mowing the lawn. Nitroglycerin was given sublingually as prescribed. Which of the following adverse reactions would be most likely to occur? A. Hypotension C. GI distress B. Dizziness D. Headache 162. Simvastatin (Zocor) is prescribed to a patient with hypertension. An indication that the drug is effective would be: A. Decreased HDL C. Decreased serum bilirubin B. Decreased LDL D. Decreased aspartate aminotransferase 163. A patient admitted for asthma complained to the nurse of headache. On assessment, the nurse noted the patient’s elevated temperature. Which analgesic-antipyretic medication should the nurse give the patient? A. Aspirin (ASA) B. Motrin (Ibuprofen) 164. Aminophylline was ordered for acute asthmatic attack. The mother asked the nurse what is its indication. The nurse’s BEST response to the question of the will be: A. “It promotes expectoration.” B. “It relaxes smooth muscles of the bronchial airway.” C. “It suppresses cough.” D. “It prevents thickening of secretions.” 165. Isoproterenol (Medihaler-Iso) was prescribed for a patient with asthma. The purpose of the drug is to: A. Relieve bronchospasms C. Reduce inflammation B. Decrease mucus secretion D. Prevent future attacks