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UPDATED APRIL 2023
1. Which individual is at greatest risk for developing hypertension?
A. 45-year-old African American attorney
B. 60-year-old Asian American shop owner
C. 40-year-old Caucasian nurse
D. 55-year-old Hispanic teacher
1. Answer: A: 45-year-old African American attorney
The incidence of hypertension is greater among African Americans than other groups in the
US. The incidence among the Hispanic population is rising.
2. A child who ingested 15 maximum strength acetaminophen tablets 45 minutes ago is seen
in the emergency department. Which of these orders should the nurse do first?
A. Gastric lavage PRN
B. Acetylcysteine (Mucomyst) for age per pharmacy
C. Start an IV Dextrose 5% with 0.33% normal saline to keep vein open
D. Activated charcoal per pharmacy
2. Answer: A: Gastric lavage PRN
Removing as much of the drug as possible is the first step in treatment for this drug
overdose. This is best done by gastric lavage. The next drug to give would be activated
charcoal, then mucomyst and lastly the IV fluids.
3. Which complication of cardiac catheterization should the nurse monitor for in the
initial 24 hours after the procedure?
,A. angina at rest
B. thrombus formation
C. dizziness
D. falling blood pressure
3. Answer: B: thrombus formation
Thrombus formation in the coronary arteries is a potential problem in the initial 24 hours after a
cardiac catheterization. A falling BP occurs along with hemorrhage of the insertion site which
is associated with the first 12 hours after the procedure.
,4. A client is admitted to the emergency room with renal calculi and is complaining
of moderate to severe flank pain and nausea. The client’s temperature is 100.8
degrees Fahrenheit. The priority nursing goal for this client is:
A. Maintain fluid and electrolyte balance
B. Control nausea
C. Manage pain
D. Prevent urinary tract infection
4. Answer: C: Manage pain
The immediate goal of therapy is to alleviate the client’s pain.
5. What would the nurse expect to see while assessing the growth of children
during their school age years?
A. Decreasing amounts of body fat and muscle mass
B. Little change in body appearance from year to year
C. Progressive height increase of 4 inches each year
D. Yearly weight gain of about 5.5 pounds per year
5. Answer: D: Yearly weight gain of about 5.5 pounds per year
School age children gain about 5.5 pounds each year and increase about 2 inches in height.
6. At a community health fair, the blood pressure of a 62-year-old client is 160/96
mmHg. The client states “My blood pressure is usually much lower.” The nurse
should tell the client to
A. go get a blood pressure check within the next 48 to 72 hours
B. check blood pressure again in two (2) months
C. see the health care provider immediately
D. visit the health care provider within one (1) week for a BP check
6. Answer: A: go get a blood pressure check within the next 48 to 72 hours
The blood pressure reading is moderately high with the need to have it rechecked in a few days.
The client states it is ‘usually much lower.’ Thus a concern exists for complications such as
stroke. However, immediate check by the provider of care is not warranted. Waiting 2 months
or a week for follow-up is too long.
, 7. The hospital has sounded the call for a disaster drill on the evening shift. Which of
these clients would the nurse put first on the list to be discharged in order to make a
room available for a new admission?
A. A middle-aged client with a history of being ventilator dependent for over seven (7)
years and nmjadmitted with bacterial pneumonia five days ago.
B. A young adult with diabetes mellitus Type 2 for over ten (10) years and
admitted with antibiotic-induced diarrhea 24 hours ago.
C. An elderly client with a history of hypertension, hypercholesterolemia, and lupus, and
was admitted with Stevens-Johnson syndrome that morning.
D. An adolescent with a positive HIV test and admitted for acute cellulitis of the lower leg
48 hours ago.
7. Answer: A: A middle-aged client with a history of being ventilator dependent for
over 7 years and admitted with bacterial pneumonia five days ago
The best candidate for discharge is one who has had a chronic condition and is most
familiar with their care. This client in option A is most likely stable and could continue
medication therapy at home.
8. A client has been newly diagnosed with hypothyroidism and will take
levothyroxine (Synthroid) 50 mcg/day by mouth. As part of the teaching plan, the
nurse emphasizes that this medication:
A. Should be taken in the morning
B. May decrease the client’s energy level
C. Must be stored in a dark container
D. Will decrease the client’s heart rate
8. Answer: A: Should be taken in the morning
Thyroid supplement should be taken in the morning to minimize the side effects of insomnia
9. A 3-year-old child comes to the pediatric clinic after the sudden onset of findings that
include irritability, thick muffled voice, croaking on inspiration, hot to touch, sit
leaning fordward, tongue protruding, drooling and suprasternal retractions. What
should the nurse do first?
A. Prepare the child for X-ray of upper airways
B. Examine the child’s throat
C. Collect a sputum specimen
D. Notify the healthcare provider of the child’s status
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