Exam Comp 2 (09/2024)
1.The nurse is caring for a patient who is to have a MRI scan performed. Which
assessment finding leads the nurse to report that the patient may not be able to have
the test?
A. The patient has an implanted insulin pump
B. The patient is breastfeeding her newborn infant
C. The patient is severely allergic to iodine and latex
D. The patient has profound hearing loss
2.The nurse is caring for a patient who is to collect a 24-hour urine specimen. Which
statement by the patient indicates that additional teaching is required?
A. “I will keep the urine container on ice to keep it chilled until I bring it to the lab”
B. “I will start the test over if I forget and urinate into the toilet during the testing
time”
C. “I will start the test tomorrow after I urinate first thing in the morning”
D. “I will drink extra fluids so that the lab will have a large specimen to test.”
3.The nurse is caring for a patient with a urinary tract infection. Which test will indicate
which antibiotics will be effective to treat the infection?
A. Complete blood count (CBC)
B. Culture and sensitivity (C&S)
C. Renal scan and angiography
D. Radioreceptor assay for HCG
4.The nurse is caring for a patient who has just undergone paracentesis. For which
complication will the nurse carefully monitor?
A. Collapse of the lung with shortness of breath
B. Fecal impaction from retained barium in the colon
C. Cerebrospinal fluid leak resulting in severe headache
D. Perforation of the bowel resulting in abdominal infection
5.The nurse is caring for a patient who reports an urgent need to urinate but is unable to
pass more than a few drops of urine in the toilet. Which is the priority assessment to be
performed by the nurse?
A. Bladder scan to determine the amount of urine in the bladder
B. Auscultation to assess circulation through the right and left renal arteries
C. Bimanual palpation to assess for possible enlargement of the kidneys
D. Calculate the patient’s intake and output to check for fluid volume deficit
6.The nurse is caring for a patient who has urinary retention resulting from benign
prostatic hyperplasia (BPH). The patient requires catheterization in order to drain the
urine from his bladder. Which action will the nurse take to facilitate this procedure?
A. Obtain a Coudé catheter for insertion
, B. Attach a leg bag to the catheter prior to insertion
C. Trim the pubic hair before cleaning the perineal area
D. Wait until the bladder is full to perform catheterization
7.The nurse is placing an indwelling catheter in a female patient. The nurse accidentally inserts
it into the vagina. What is the next action for the nurse to implement?
1.Collect a urine specimen and notify the PCP
2.Leave the catheter in place and insert a new catheter into the urethra
3.Remove the catheter from the vagina and place it into the urethra
4.Ask another nurse to attempt the catheterization of the patient
8.In your assessment of a normal adult, where would you expect to palpate the
apical impulse?
A. Third left intercostal space at the midclavicular line
B. Fourth left intercostal space at the sternal border
C. Fifth left intercostal space at the midclavicular line
D. Fourth left intercostal space at the anterior axillary line
9.You are performing a peripheral vascular assessment on a bedridden patient. You note the
following findings in the right leg: increased warmth, swelling, redness, and tenderness to
palpation. You would:
A. reevaluate the patient in a few hours
B. consider this a normal finding for a bedridden patient
C. seek an immediate referral due to the risk of pulmonary embolism
D. ask the patient to raise his leg off of the bed and check for pain on elevation
10. On inspection if the apical impulse is more vigorous than expected to the chest wall, it is
called a:
A. lift.
B. thrill
C. bruit
D. murmur
11. The structure that carries oxygenated blood to the body from the left ventricle is the:
A. aorta
B. pulmonary artery
C. pulmonary vein
D. superior vena cava
12. During inspection of the precordium of an adult patient, the nurse notices the chest moving
in a forceful manner (heave/lift) along the fourth-fifth left intercostal space at the midclavicular
line. This finding most likely suggests:
1.The nurse is caring for a patient who is to have a MRI scan performed. Which
assessment finding leads the nurse to report that the patient may not be able to have
the test?
A. The patient has an implanted insulin pump
B. The patient is breastfeeding her newborn infant
C. The patient is severely allergic to iodine and latex
D. The patient has profound hearing loss
2.The nurse is caring for a patient who is to collect a 24-hour urine specimen. Which
statement by the patient indicates that additional teaching is required?
A. “I will keep the urine container on ice to keep it chilled until I bring it to the lab”
B. “I will start the test over if I forget and urinate into the toilet during the testing
time”
C. “I will start the test tomorrow after I urinate first thing in the morning”
D. “I will drink extra fluids so that the lab will have a large specimen to test.”
3.The nurse is caring for a patient with a urinary tract infection. Which test will indicate
which antibiotics will be effective to treat the infection?
A. Complete blood count (CBC)
B. Culture and sensitivity (C&S)
C. Renal scan and angiography
D. Radioreceptor assay for HCG
4.The nurse is caring for a patient who has just undergone paracentesis. For which
complication will the nurse carefully monitor?
A. Collapse of the lung with shortness of breath
B. Fecal impaction from retained barium in the colon
C. Cerebrospinal fluid leak resulting in severe headache
D. Perforation of the bowel resulting in abdominal infection
5.The nurse is caring for a patient who reports an urgent need to urinate but is unable to
pass more than a few drops of urine in the toilet. Which is the priority assessment to be
performed by the nurse?
A. Bladder scan to determine the amount of urine in the bladder
B. Auscultation to assess circulation through the right and left renal arteries
C. Bimanual palpation to assess for possible enlargement of the kidneys
D. Calculate the patient’s intake and output to check for fluid volume deficit
6.The nurse is caring for a patient who has urinary retention resulting from benign
prostatic hyperplasia (BPH). The patient requires catheterization in order to drain the
urine from his bladder. Which action will the nurse take to facilitate this procedure?
A. Obtain a Coudé catheter for insertion
, B. Attach a leg bag to the catheter prior to insertion
C. Trim the pubic hair before cleaning the perineal area
D. Wait until the bladder is full to perform catheterization
7.The nurse is placing an indwelling catheter in a female patient. The nurse accidentally inserts
it into the vagina. What is the next action for the nurse to implement?
1.Collect a urine specimen and notify the PCP
2.Leave the catheter in place and insert a new catheter into the urethra
3.Remove the catheter from the vagina and place it into the urethra
4.Ask another nurse to attempt the catheterization of the patient
8.In your assessment of a normal adult, where would you expect to palpate the
apical impulse?
A. Third left intercostal space at the midclavicular line
B. Fourth left intercostal space at the sternal border
C. Fifth left intercostal space at the midclavicular line
D. Fourth left intercostal space at the anterior axillary line
9.You are performing a peripheral vascular assessment on a bedridden patient. You note the
following findings in the right leg: increased warmth, swelling, redness, and tenderness to
palpation. You would:
A. reevaluate the patient in a few hours
B. consider this a normal finding for a bedridden patient
C. seek an immediate referral due to the risk of pulmonary embolism
D. ask the patient to raise his leg off of the bed and check for pain on elevation
10. On inspection if the apical impulse is more vigorous than expected to the chest wall, it is
called a:
A. lift.
B. thrill
C. bruit
D. murmur
11. The structure that carries oxygenated blood to the body from the left ventricle is the:
A. aorta
B. pulmonary artery
C. pulmonary vein
D. superior vena cava
12. During inspection of the precordium of an adult patient, the nurse notices the chest moving
in a forceful manner (heave/lift) along the fourth-fifth left intercostal space at the midclavicular
line. This finding most likely suggests:
