835
Nursing Licensure examination Comprehensive Exam
Nursing Licensure examination Comprehensive Exam
1.A 72 year-old client is scheduled to have a cardioversion. A nurse reviews the
client's medication administration record.The nurse should notify the health
care provider if the client received which medication during the preceding 24
hours?
A) digoxin (Lanoxin)
B) diltiazam (Cardizem)
C)nitroglycerine ointment
D) metoprolol (Toprol XL)
The correct answer is A:digoxin (Lanoxin) Digoxin increases ventricular irritability and increases the risk of ventricular fibrillation following
cardioversion. The other medications do not increase ventricular irritability
2.Which of these clients,who all have the findings of a board-like abdomen,would the nurse suggest that the health care provider examine
first?
A) An elderly client who stated that "My awful pain in my right side suddenly stopped about 3 hours ago."
B) A pregnant woman of 8 weeks newly diagnosed with an ectopic pregnancy
C) A middle-aged client admitted with diverticulitis and has taken only clear liquids for the past week
D) A teenager with a history of falling off a bicycle and did not hit the handle bars
The correct answer is A:An elderly client who stated that "My awful pain in my right side suddenly stopped about 3hours ago." This client has
the highest risk for hypovolemic and septic shock since the appendix has most likely ruptured as based on the history of the pain suddenly
stopping over three hours ago.Being elderly there,is less reserve for the body to cope with shock and infection over long periods. The others
are at risk for shock also.However,given that they fall in younger age groups, they would more likely be able to tolerate an inbalance in
circulation.A common complication of falling off a bicycle is hitting the handle bars in the upper abdomen often on the left,resulting in a
ruptured spleen.
3.The nurse manager informs the nursing staff at morning report that the clinical nursespecialist will be conducting a research study on staff
attitudes toward client care. All staff are invited to participate in the study if they wish. This affirms the ethical
principle of
A)Anonymity
B)Beneficence
C)Justice
D)Autonomy
The correct answer is D:Autonomy Individuals must be free to make independent decisions about participation in research without
coercion from others.
4.Which statement made by a nurse about the goal of total quality management or continuous quality improvement in a health care setting is
correct?
A)"It is to observe reactive service and product problem solving."
B) Improvement of the processes in a proactive, preventive mode is paramount.
C) A chart audits to finds common errors in practice and outcomes associated with goals.
D) A flow chart to organize daily tasks is critical to the initial stages.
The correct answer is B: Improvement of the processes in a proactive, preventive mode is paramount. Total quality management and
continuous quality improvement have a major goal of identifying ways to do the right thing at the right time in the right way by proactive
problem-solving.
5.A client with chronic obstructive pulmonary disease(COPD) and a history of coronary artery disease is receiving
835
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Aminophylline,25mg/hour.Which one of the following findings by the nurse would require immediate intervention?
A) Decreased blood pressure and respirations.
B)Flushing and headache.
C) Restlessness and palpitations.
D) Increased heart rate and blood pressure.
The correct answer is C: Restlessness and palpitations.Side effects of Aminophylline include restlessness and palpitations
6.When teaching a client about the side effects of fluoxetine(Prozac), which of the following will be included?
A)Tachycardia blurred vision,hypotension,anorexia
B) Orthostatic hypotension, vertigo, reactions to tyramine richfoods
C)Diarrhea,dry mouth,weight loss,reduced libido
D)Photosensitivity,seizures,edema,hyperglycemia
The correct answer is C:Diarrhea,dry mouth,weight loss,reduced libido Commonly reported side effects for fluoxetine (Prozac) are
diarrhea,dry mouth,weight loss and reduced libido
7.The nurse is preparing to administer a tube feeding to a post-operative client. To accurately assess for agastostomy tube placement,the
priority is to
A) Auscultate the abdomen while instilling 10 cc of air into the tube
B) Place the end of the tube in water to check for air bubbles
C) Retract the tube several inches to check for resistance
D) Measure the length of tubing from nose to epigastrium
The correct answer is A:Auscultate the abdomen while instilling 10 cc of air into the tube If a swoosh of air is heard over the abdominal
cavity while instilling air into the gastric tube, this indicates that it is accurately placed in the stomach.The feeding can begin after assessing
the client for bowel sounds
8.Which of these questions is priority when assessing a client with hypertension?
A)"What over-the-counter medications do you take?"
B) "Describe your usual exercise and activity patterns."
C)"Tell me about your usual diet."
D) "Describe your family's cardiovascular history."
The correct answer is A:"What over-the-counter medications do you take?" Over-the-counter medications,especially those that contain
cold preparations can increase the blood pressure to the point of hypertension.
9.The nurse is teaching parents of a 7 month-old about adding table foods. Which of the following is anappropriate finger food?
A)Hot dog pieces
B) Sliced bananas
C) Whole grapes
D)Popcorn
The correct answer is B:Sliced bananas Finger foods should be bite-size pieces of soft food such as bananas. Hot dogs and grapes can
accidentally be swallowed whole and can occlude the airway.
Popcorn is too difficult to chew at this age and can irritate the airway if swallowed
10 client is ordered warfarin sodium (Coumadin) to be continued athome. Which focus is critical to be included in the nurse's discharge
instruction?
836
Nursing Licensure examination Comprehensive Exam
Nursing Licensure examination Comprehensive Exam
1.A 72 year-old client is scheduled to have a cardioversion. A nurse reviews the
client's medication administration record.The nurse should notify the health
care provider if the client received which medication during the preceding 24
hours?
A) digoxin (Lanoxin)
B) diltiazam (Cardizem)
C)nitroglycerine ointment
D) metoprolol (Toprol XL)
The correct answer is A:digoxin (Lanoxin) Digoxin increases ventricular irritability and increases the risk of ventricular fibrillation following
cardioversion. The other medications do not increase ventricular irritability
2.Which of these clients,who all have the findings of a board-like abdomen,would the nurse suggest that the health care provider examine
first?
A) An elderly client who stated that "My awful pain in my right side suddenly stopped about 3 hours ago."
B) A pregnant woman of 8 weeks newly diagnosed with an ectopic pregnancy
C) A middle-aged client admitted with diverticulitis and has taken only clear liquids for the past week
D) A teenager with a history of falling off a bicycle and did not hit the handle bars
The correct answer is A:An elderly client who stated that "My awful pain in my right side suddenly stopped about 3hours ago." This client has
the highest risk for hypovolemic and septic shock since the appendix has most likely ruptured as based on the history of the pain suddenly
stopping over three hours ago.Being elderly there,is less reserve for the body to cope with shock and infection over long periods. The others
are at risk for shock also.However,given that they fall in younger age groups, they would more likely be able to tolerate an inbalance in
circulation.A common complication of falling off a bicycle is hitting the handle bars in the upper abdomen often on the left,resulting in a
ruptured spleen.
3.The nurse manager informs the nursing staff at morning report that the clinical nursespecialist will be conducting a research study on staff
attitudes toward client care. All staff are invited to participate in the study if they wish. This affirms the ethical
principle of
A)Anonymity
B)Beneficence
C)Justice
D)Autonomy
The correct answer is D:Autonomy Individuals must be free to make independent decisions about participation in research without
coercion from others.
4.Which statement made by a nurse about the goal of total quality management or continuous quality improvement in a health care setting is
correct?
A)"It is to observe reactive service and product problem solving."
B) Improvement of the processes in a proactive, preventive mode is paramount.
C) A chart audits to finds common errors in practice and outcomes associated with goals.
D) A flow chart to organize daily tasks is critical to the initial stages.
The correct answer is B: Improvement of the processes in a proactive, preventive mode is paramount. Total quality management and
continuous quality improvement have a major goal of identifying ways to do the right thing at the right time in the right way by proactive
problem-solving.
5.A client with chronic obstructive pulmonary disease(COPD) and a history of coronary artery disease is receiving
835
, 836
Aminophylline,25mg/hour.Which one of the following findings by the nurse would require immediate intervention?
A) Decreased blood pressure and respirations.
B)Flushing and headache.
C) Restlessness and palpitations.
D) Increased heart rate and blood pressure.
The correct answer is C: Restlessness and palpitations.Side effects of Aminophylline include restlessness and palpitations
6.When teaching a client about the side effects of fluoxetine(Prozac), which of the following will be included?
A)Tachycardia blurred vision,hypotension,anorexia
B) Orthostatic hypotension, vertigo, reactions to tyramine richfoods
C)Diarrhea,dry mouth,weight loss,reduced libido
D)Photosensitivity,seizures,edema,hyperglycemia
The correct answer is C:Diarrhea,dry mouth,weight loss,reduced libido Commonly reported side effects for fluoxetine (Prozac) are
diarrhea,dry mouth,weight loss and reduced libido
7.The nurse is preparing to administer a tube feeding to a post-operative client. To accurately assess for agastostomy tube placement,the
priority is to
A) Auscultate the abdomen while instilling 10 cc of air into the tube
B) Place the end of the tube in water to check for air bubbles
C) Retract the tube several inches to check for resistance
D) Measure the length of tubing from nose to epigastrium
The correct answer is A:Auscultate the abdomen while instilling 10 cc of air into the tube If a swoosh of air is heard over the abdominal
cavity while instilling air into the gastric tube, this indicates that it is accurately placed in the stomach.The feeding can begin after assessing
the client for bowel sounds
8.Which of these questions is priority when assessing a client with hypertension?
A)"What over-the-counter medications do you take?"
B) "Describe your usual exercise and activity patterns."
C)"Tell me about your usual diet."
D) "Describe your family's cardiovascular history."
The correct answer is A:"What over-the-counter medications do you take?" Over-the-counter medications,especially those that contain
cold preparations can increase the blood pressure to the point of hypertension.
9.The nurse is teaching parents of a 7 month-old about adding table foods. Which of the following is anappropriate finger food?
A)Hot dog pieces
B) Sliced bananas
C) Whole grapes
D)Popcorn
The correct answer is B:Sliced bananas Finger foods should be bite-size pieces of soft food such as bananas. Hot dogs and grapes can
accidentally be swallowed whole and can occlude the airway.
Popcorn is too difficult to chew at this age and can irritate the airway if swallowed
10 client is ordered warfarin sodium (Coumadin) to be continued athome. Which focus is critical to be included in the nurse's discharge
instruction?
836
