Fundamentals Exam - Version A
Points Awarded 23
Points Missed 50
Percentage 32%
1. The nurse is teaching a client proper use of an inhaler. When should the
client administer the inhaler-delivered medication to demonstrate correct
use of the inhaler?
A. Immediately after exhalation.
B. During the inhalation.
C. At the end of three inhalations.
D. Immediately after inhalation.
The client should be instructed to deliver the medication during the last
part of inhalation (B). After the medication is delivered, the client should
remove the mouthpiece, keeping his/her lips closed and breath held for
several seconds to allow for distribution of the medication. The client should
not deliver the dose as stated in (A or D), and should deliver no more than
two inhalations at a time (C).
Points Earned:
Correct Answer:
Your Response:
2. An IV infusion terbutaline sulfate 5 mg in 500 ml of D5W, is infusing at a
rate of 30 mcg/min prescribed for a client in premature labor. How many
ml/hr should the nurse set the infusion pump?
A. 30
B. 60
C. 120
D. 180
(D) is correct calculation: 180 ml/hr = 500 ml/5 mg × 1mg/1000 mcg × 30
mcg/min × 60 min/hr.
, Points Earned:
Correct Answer:
Your Response:
3. A client is to receive 10 mEq of KCl diluted in 250 ml of normal saline
over 4 hours. At what rate should the nurse set the client's intravenous
infusion pump?
A. 13 ml/hour.
B. 63 ml/hour.
C. 80 ml/hour.
D. 125 ml/hour.
(B) is the correct calculation: To calculate this problem correctly, remember
that the dose of KCl is not used in the calculation. 250 ml/4 hours = 63
ml/hour.
Points Earned:
Correct Answer:
Your Response:
4. When conducting an admission assessment, the nurse should ask the
client about the use of complimentary healing practices. Which statement
is accurate regarding the use of these practices?
A. Complimentary healing practices interfere with the efficacy of the
medical model of treatment.
B. Conventional medications are likely to interact with folk remedies and
cause adverse effects.
C. Many complimentary healing practices can be used in conjunction with
conventional practices.
D. Conventional medical practices will ultimately replace the use of
complimentary healing practices.
Conventional approaches to health care can be depersonalizing and often fail
to take into consideration all aspects of an individual, including body, mind,
and spirit. Often complimentary healing practices can be used in conjunction
with conventional medical practices (C), rather than interfering (A) with
conventional practices, causing adverse effects (B), or replacing conventional
medical care (D).
, Points Earned:
Correct Answer:
Your Response:
5. Seconal 0.1 gram PRN at bedtime is prescribed to a client for rest. The
scored tablets are labeled grain 1.5 per tablet. How many tablets should
the nurse plan to administer?
A. 0.5 tablet.
B. 1 tablet.
C. 1.5 tablets.
D. 2 tablets.
15 gr=1 Gm. Converting the prescribed dose of 0.1 grams to grains requires
multiplying 0.1 × 15 = 1.5 grains. The tablets come in 1.5 grains, so the nurse
should plan to administer 1 tablet (B).
Points Earned:
Correct Answer:
Your Response:
6. During the initial morning assessment, a male client denies dysuria but
reports that his urine appears dark amber. Which intervention should the
nurse implement?
A. Provide additional coffee on the client's breakfast tray.
B. Exchange the client's grape juice for cranberry juice.
C. Bring the client additional fruit at mid-morning.
D. Encourage additional oral intake of juices and water.
Dark amber urine is characteristic of fluid volume deficit, and the client
should be encouraged to increase fluid intake (D). Caffeine, however, is a
diuretic (A), and may worsen the fluid volume deficit. Any type of juice will
be beneficial (B), since the client is not dysuric, a sign of an urinary tract
infection. The client needs to restore fluid volume more than solid foods (C).
Points Earned:
Correct Answer:
Your Response:
7. A hospitalized male client is receiving nasogastric tube feedings via a
, small-bore tube and a continuous pump infusion. He reports that he had a
bad bout of severe coughing a few minutes ago, but feels fine now. What
action is best for the nurse to take?
A. Record the coughing incident. No further action is required at this
time.
B. Stop the feeding, explain to the family why it is being stopped, and
notify the healthcare provider.
C. After clearing the tube with 30 ml of air, check the pH of fluid
withdrawn from the tube.
D. Inject 30 ml of air into the tube while auscultating the epigastrium for
gurgling.
Coughing, vomiting, and suctioning can precipitate displacement of the tip of
the small bore feeding tube upward into the esophagus, placing the client at
increased risk for aspiration. Checking the sample of fluid withdrawn from
the tube (after clearing the tube with 30 ml of air) for acidic (stomach) or
alkaline (intestine) values is a more sensitive method for these tubes, and
the nurse should assess tube placement in this way prior to taking any other
action (C). (A and B) are not indicated. The auscultating method (D) has been
found to be unreliable for small-bore feeding tubes.
Points Earned:
Correct Answer:
Your Response:
8. The healthcare provider prescribes morphine sulfate 4mg IM STAT.
Morphine comes in 8 mg per ml. How many ml should the nurse
administer?
A. 0.5 ml.
B. 1 ml.
C. 1.5 ml.
D. 2 ml.
Using ratio and proportion:
8mg: 1ml :: 4mg:Xml
8X=4
X=0.5
Points Earned:
Points Awarded 23
Points Missed 50
Percentage 32%
1. The nurse is teaching a client proper use of an inhaler. When should the
client administer the inhaler-delivered medication to demonstrate correct
use of the inhaler?
A. Immediately after exhalation.
B. During the inhalation.
C. At the end of three inhalations.
D. Immediately after inhalation.
The client should be instructed to deliver the medication during the last
part of inhalation (B). After the medication is delivered, the client should
remove the mouthpiece, keeping his/her lips closed and breath held for
several seconds to allow for distribution of the medication. The client should
not deliver the dose as stated in (A or D), and should deliver no more than
two inhalations at a time (C).
Points Earned:
Correct Answer:
Your Response:
2. An IV infusion terbutaline sulfate 5 mg in 500 ml of D5W, is infusing at a
rate of 30 mcg/min prescribed for a client in premature labor. How many
ml/hr should the nurse set the infusion pump?
A. 30
B. 60
C. 120
D. 180
(D) is correct calculation: 180 ml/hr = 500 ml/5 mg × 1mg/1000 mcg × 30
mcg/min × 60 min/hr.
, Points Earned:
Correct Answer:
Your Response:
3. A client is to receive 10 mEq of KCl diluted in 250 ml of normal saline
over 4 hours. At what rate should the nurse set the client's intravenous
infusion pump?
A. 13 ml/hour.
B. 63 ml/hour.
C. 80 ml/hour.
D. 125 ml/hour.
(B) is the correct calculation: To calculate this problem correctly, remember
that the dose of KCl is not used in the calculation. 250 ml/4 hours = 63
ml/hour.
Points Earned:
Correct Answer:
Your Response:
4. When conducting an admission assessment, the nurse should ask the
client about the use of complimentary healing practices. Which statement
is accurate regarding the use of these practices?
A. Complimentary healing practices interfere with the efficacy of the
medical model of treatment.
B. Conventional medications are likely to interact with folk remedies and
cause adverse effects.
C. Many complimentary healing practices can be used in conjunction with
conventional practices.
D. Conventional medical practices will ultimately replace the use of
complimentary healing practices.
Conventional approaches to health care can be depersonalizing and often fail
to take into consideration all aspects of an individual, including body, mind,
and spirit. Often complimentary healing practices can be used in conjunction
with conventional medical practices (C), rather than interfering (A) with
conventional practices, causing adverse effects (B), or replacing conventional
medical care (D).
, Points Earned:
Correct Answer:
Your Response:
5. Seconal 0.1 gram PRN at bedtime is prescribed to a client for rest. The
scored tablets are labeled grain 1.5 per tablet. How many tablets should
the nurse plan to administer?
A. 0.5 tablet.
B. 1 tablet.
C. 1.5 tablets.
D. 2 tablets.
15 gr=1 Gm. Converting the prescribed dose of 0.1 grams to grains requires
multiplying 0.1 × 15 = 1.5 grains. The tablets come in 1.5 grains, so the nurse
should plan to administer 1 tablet (B).
Points Earned:
Correct Answer:
Your Response:
6. During the initial morning assessment, a male client denies dysuria but
reports that his urine appears dark amber. Which intervention should the
nurse implement?
A. Provide additional coffee on the client's breakfast tray.
B. Exchange the client's grape juice for cranberry juice.
C. Bring the client additional fruit at mid-morning.
D. Encourage additional oral intake of juices and water.
Dark amber urine is characteristic of fluid volume deficit, and the client
should be encouraged to increase fluid intake (D). Caffeine, however, is a
diuretic (A), and may worsen the fluid volume deficit. Any type of juice will
be beneficial (B), since the client is not dysuric, a sign of an urinary tract
infection. The client needs to restore fluid volume more than solid foods (C).
Points Earned:
Correct Answer:
Your Response:
7. A hospitalized male client is receiving nasogastric tube feedings via a
, small-bore tube and a continuous pump infusion. He reports that he had a
bad bout of severe coughing a few minutes ago, but feels fine now. What
action is best for the nurse to take?
A. Record the coughing incident. No further action is required at this
time.
B. Stop the feeding, explain to the family why it is being stopped, and
notify the healthcare provider.
C. After clearing the tube with 30 ml of air, check the pH of fluid
withdrawn from the tube.
D. Inject 30 ml of air into the tube while auscultating the epigastrium for
gurgling.
Coughing, vomiting, and suctioning can precipitate displacement of the tip of
the small bore feeding tube upward into the esophagus, placing the client at
increased risk for aspiration. Checking the sample of fluid withdrawn from
the tube (after clearing the tube with 30 ml of air) for acidic (stomach) or
alkaline (intestine) values is a more sensitive method for these tubes, and
the nurse should assess tube placement in this way prior to taking any other
action (C). (A and B) are not indicated. The auscultating method (D) has been
found to be unreliable for small-bore feeding tubes.
Points Earned:
Correct Answer:
Your Response:
8. The healthcare provider prescribes morphine sulfate 4mg IM STAT.
Morphine comes in 8 mg per ml. How many ml should the nurse
administer?
A. 0.5 ml.
B. 1 ml.
C. 1.5 ml.
D. 2 ml.
Using ratio and proportion:
8mg: 1ml :: 4mg:Xml
8X=4
X=0.5
Points Earned:
