NUR 4040 CERTIFICATION EVALUATION TEST
2026 QUESTIONS AND SOLUTIONS VALIDATED
▶ Nurse Joy is caring for a client with an internal radiation implant. When
caring for the client, the nurse should observe which of the following
principles?
A. Limit the time with the client to 1 hour per shift
B. Do not allow pregnant women into the client's room
C. Remove the dosimeter badge when entering the client's room
D. Individuals younger than 16 years old may be allowed to go in the room
as long as they are 6 feet away from the client - Answer: B
Explanation: The time that the nurse spends in a room of a client with an
internal radiation implant is 30 minutes per 8-hour shift. The dosimeter
badge must be worn when in the client's room. Children younger than 16
years of age and pregnant women are not allowed in the client's room.
▶ Mina, who is suspected of an ovarian tumor is scheduled for a pelvic
ultrasound. The nurse provides which preprocedure instruction to the
client?
A. Eat a light breakfast only
B. Maintain an NPO status before the procedure
C. Wear comfortable clothing and shoes for the procedure
D. Drink six to eight glasses of water without voiding before the test -
Answer: D
Explanation: A pelvic ultrasound requires the ingestion of large volumes of
water just before the procedure. A full bladder is necessary so that it will be
visualized as such and not mistaken for a possible pelvic growth. An
abdominal ultrasound may require that the client abstain from food or fluid
for several hours before the procedure. Option C is unrelated to this
specific procedure.
▶ A male client is diagnosed as having a bowel tumor and several
diagnostic tests are prescribed. The nurse understands that which test will
confirm the diagnosis of malignancy?
A. Biopsy of the tumor
B. Abdominal ultrasound
C. Magnetic resonance imaging
D. Computerized tomography scan - Answer: A
,Explanation: A biopsy is done to determine whether a tumor is malignant or
benign. Magnetic resonance imaging, computed tomography scan, and
ultrasound will visualize the presence of a mass but will not confirm a
diagnosis of malignancy.
▶ A female client diagnosed with multiple myeloma and the client asks the
nurse about the diagnosis. The nurse bases the response on which
description of this disorder?
A. Altered red blood cell production
B. Altered production of lymph nodes
C. Malignant exacerbation in the number of leukocytes
D. Malignant proliferation of plasma cells within the bone - Answer: D
Explanation: Multiple myeloma is a B-cell neoplastic condition
characterized by abnormal malignant proliferation of plasma cells and the
accumulation of mature plasma cells in the bone marrow. Options A and B
are not characteristics of multiple myeloma. Option C describes the
leukemic process.
▶ Nurse Bea is reviewing the laboratory results of a client diagnosed with
multiple myeloma. Which of the following would the nurse expect to note
specifically in this disorder?
A. Increased calcium
B. Increased white blood cells
C. Decreased blood urea nitrogen level
D. Decreased number of plasma cells in the bone marrow - Answer: A
Explanation: Findings indicative of multiple myeloma are an increased
number of plasma cells in the bone marrow, anemia, hypercalcemia
caused by the release of calcium from the deteriorating bone tissue, and an
elevated blood urea nitrogen level. An increased white blood cell count may
or may not be present and is not related specifically to multiple myeloma.
▶ A male client is receiving the cell cycle-nonspecific alkylating agent
thiotepa (Thioplex), 60 mg weekly for 4 weeks by bladder instillation as part
of a chemotherapeutic regimen to treat bladder cancer. The client asks the
nurse how the drug works. How does thiotepa exert its therapeutic effects?
A. It interferes with deoxyribonucleic acid (DNA) replication only.
B. It interferes with ribonucleic acid (RNA) transcription only.
C. It interferes with DNA replication and RNA transcription.
D. It destroys the cell membrane, causing lysis. - Answer: C
, Explanation: Thiotepa interferes with DNA replication and RNA
transcription. It doesn't destroy the cell membrane.
▶ The nurse is instructing the 35 year old client to perform a testicular self-
examination. The nurse tells the client:
A. To examine the testicles while lying down
B. That the best time for the examination is after a shower
C. To gently feel the testicle with one finger to feel for a growth
D. That testicular self-examination should be done at least every 6 months
- Answer: B
Explanation: The testicular self-examination is recommended monthly after
a warm bath or shower when the scrotal skin is relaxed. The client should
stand to examine the testicles. Using both hands, with fingers under the
scrotum and thumbs on top, the client should gently roll the testicles,
feeling for any lumps.
▶ Nurse Cindy is caring for a client who has undergone a vaginal
hysterectomy. The nurse avoids which of the following in the care of this
client?
A. Elevating the knee gatch on the bed
B. Assisting with range-of-motion leg exercises
C. Removal of antiembolism stockings twice daily
D. Checking placement of pneumatic compression boots - Answer: A
Explanation: The client is at risk of deep vein thrombosis or
thrombophlebitis after this surgery, as for any other major surgery. For this
reason, the nurse implements measures that will prevent this complication.
Range-of-motion exercises, antiembolism stockings, and pneumatic
compression boots are helpful. The nurse should avoid using the knee
gatch in the bed, which inhibits venous return, thus placing the client more
at risk for deep vein thrombosis or thrombophlebitis.
▶ Gio, a community health nurse, is instructing a group of female clients
about breast self-examination. The nurse instructs the client to perform the
examination:
A. At the onset of menstruation
B. Every month during ovulation
C. Weekly at the same time of day
D. 1 week after menstruation begins - Answer: D
Explanation: The breast self-examination should be performed monthly 7
days after the onset of the menstrual period. Performing the examination
2026 QUESTIONS AND SOLUTIONS VALIDATED
▶ Nurse Joy is caring for a client with an internal radiation implant. When
caring for the client, the nurse should observe which of the following
principles?
A. Limit the time with the client to 1 hour per shift
B. Do not allow pregnant women into the client's room
C. Remove the dosimeter badge when entering the client's room
D. Individuals younger than 16 years old may be allowed to go in the room
as long as they are 6 feet away from the client - Answer: B
Explanation: The time that the nurse spends in a room of a client with an
internal radiation implant is 30 minutes per 8-hour shift. The dosimeter
badge must be worn when in the client's room. Children younger than 16
years of age and pregnant women are not allowed in the client's room.
▶ Mina, who is suspected of an ovarian tumor is scheduled for a pelvic
ultrasound. The nurse provides which preprocedure instruction to the
client?
A. Eat a light breakfast only
B. Maintain an NPO status before the procedure
C. Wear comfortable clothing and shoes for the procedure
D. Drink six to eight glasses of water without voiding before the test -
Answer: D
Explanation: A pelvic ultrasound requires the ingestion of large volumes of
water just before the procedure. A full bladder is necessary so that it will be
visualized as such and not mistaken for a possible pelvic growth. An
abdominal ultrasound may require that the client abstain from food or fluid
for several hours before the procedure. Option C is unrelated to this
specific procedure.
▶ A male client is diagnosed as having a bowel tumor and several
diagnostic tests are prescribed. The nurse understands that which test will
confirm the diagnosis of malignancy?
A. Biopsy of the tumor
B. Abdominal ultrasound
C. Magnetic resonance imaging
D. Computerized tomography scan - Answer: A
,Explanation: A biopsy is done to determine whether a tumor is malignant or
benign. Magnetic resonance imaging, computed tomography scan, and
ultrasound will visualize the presence of a mass but will not confirm a
diagnosis of malignancy.
▶ A female client diagnosed with multiple myeloma and the client asks the
nurse about the diagnosis. The nurse bases the response on which
description of this disorder?
A. Altered red blood cell production
B. Altered production of lymph nodes
C. Malignant exacerbation in the number of leukocytes
D. Malignant proliferation of plasma cells within the bone - Answer: D
Explanation: Multiple myeloma is a B-cell neoplastic condition
characterized by abnormal malignant proliferation of plasma cells and the
accumulation of mature plasma cells in the bone marrow. Options A and B
are not characteristics of multiple myeloma. Option C describes the
leukemic process.
▶ Nurse Bea is reviewing the laboratory results of a client diagnosed with
multiple myeloma. Which of the following would the nurse expect to note
specifically in this disorder?
A. Increased calcium
B. Increased white blood cells
C. Decreased blood urea nitrogen level
D. Decreased number of plasma cells in the bone marrow - Answer: A
Explanation: Findings indicative of multiple myeloma are an increased
number of plasma cells in the bone marrow, anemia, hypercalcemia
caused by the release of calcium from the deteriorating bone tissue, and an
elevated blood urea nitrogen level. An increased white blood cell count may
or may not be present and is not related specifically to multiple myeloma.
▶ A male client is receiving the cell cycle-nonspecific alkylating agent
thiotepa (Thioplex), 60 mg weekly for 4 weeks by bladder instillation as part
of a chemotherapeutic regimen to treat bladder cancer. The client asks the
nurse how the drug works. How does thiotepa exert its therapeutic effects?
A. It interferes with deoxyribonucleic acid (DNA) replication only.
B. It interferes with ribonucleic acid (RNA) transcription only.
C. It interferes with DNA replication and RNA transcription.
D. It destroys the cell membrane, causing lysis. - Answer: C
, Explanation: Thiotepa interferes with DNA replication and RNA
transcription. It doesn't destroy the cell membrane.
▶ The nurse is instructing the 35 year old client to perform a testicular self-
examination. The nurse tells the client:
A. To examine the testicles while lying down
B. That the best time for the examination is after a shower
C. To gently feel the testicle with one finger to feel for a growth
D. That testicular self-examination should be done at least every 6 months
- Answer: B
Explanation: The testicular self-examination is recommended monthly after
a warm bath or shower when the scrotal skin is relaxed. The client should
stand to examine the testicles. Using both hands, with fingers under the
scrotum and thumbs on top, the client should gently roll the testicles,
feeling for any lumps.
▶ Nurse Cindy is caring for a client who has undergone a vaginal
hysterectomy. The nurse avoids which of the following in the care of this
client?
A. Elevating the knee gatch on the bed
B. Assisting with range-of-motion leg exercises
C. Removal of antiembolism stockings twice daily
D. Checking placement of pneumatic compression boots - Answer: A
Explanation: The client is at risk of deep vein thrombosis or
thrombophlebitis after this surgery, as for any other major surgery. For this
reason, the nurse implements measures that will prevent this complication.
Range-of-motion exercises, antiembolism stockings, and pneumatic
compression boots are helpful. The nurse should avoid using the knee
gatch in the bed, which inhibits venous return, thus placing the client more
at risk for deep vein thrombosis or thrombophlebitis.
▶ Gio, a community health nurse, is instructing a group of female clients
about breast self-examination. The nurse instructs the client to perform the
examination:
A. At the onset of menstruation
B. Every month during ovulation
C. Weekly at the same time of day
D. 1 week after menstruation begins - Answer: D
Explanation: The breast self-examination should be performed monthly 7
days after the onset of the menstrual period. Performing the examination
