Mosby's 539 Comprehensive Review
Questions Unlock Your Potential:
Comprehensive Exam Study Guide
Which of the following would be of concern to the practical nurse when providing postoperative care to
Mr. Rutlege?
1. Urinary output of less than 30 mL per hour
2. Absent bowel sounds
3. Pain from the incision site
4. Scant serosanguinous drainage from the incision - ✔ ✔ 1. Urinary output of less than 30 mL per
hour
Which of the following would be of most concern to the practical nurse if noted in an 8-year-old child
after he fell from his bike and hit his head?
1. Nausea
2. Memory loss for familiar surroundings and objects
3. Swelling and aching pain at the site of injury
4. Blood pressure changing from 100/60 to 110/70 mm Hg - ✔ ✔ 2. Memory loss for familiar
surroundings and objects
Which of the following would be part of a normal respiratory assessment for neonate Perlstein?
1. Observation of abdominal breathing
2. Obtaining a respiratory rate of 70 breaths per minute
3. Noting a breathing pattern that is regular, with an even rate
4. Assessing that the baby is primarily mouth-breathing rather than nose-breathing - ✔ ✔ 1.
Observation of abdominal breathing
,Which of the following would be the best heart-healthy lunch menu?
1. Purchased chicken soup and a bagel
2. Delicatessen luncheon meat sandwich and a Caesar salad
3. Purchased bran muffin and cheddar cheese slices
4. Grilled chicken, lettuce, and tomato sandwich on whole-grain bread - ✔ ✔ 4. Grilled chicken,
lettuce, and tomato sandwich on whole-grain bread
Which of the following would be the correct procedure when taking the blood pressure of a
hypertensive client who is monitored at the clinic once a week?
1. Ensure that the client has not had caffeine within the last 5 hours.
2. Allow the client to rest for 5 minutes prior to taking the blood pressure.
3. Use manual rather than electronic blood pressure devices.
4. Alternate arms for each visit. - ✔ ✔ 2. Allow the client to rest for 5 minutes prior to taking the
blood pressure.
Which pulse would be of most concern to the practical nurse?
1. Two-month-old infant: 110 bpm at rest
2. Ten-year-old boy: 104 bpm after exercise
3. Seventeen-year-old athlete: 50 bpm at rest
4. Five-day-old infant: 70 bpm after crying - ✔ ✔ 4. Five-day-old infant: 70 bpm after crying
(This is bradycardia in a 5-day-old infant. Although there are wide variations published as normal
neonatal heart rates that range from approximately 100-160, this rate, especially after crying, is below
normal).
Which statement best supports a practical nurse providing advocacy during a multidisciplinary team
meeting?
,1. Symptoms of mental illnesses are not influenced by a person's culture.
2. Obsessive-compulsive disorder and hoarding have similar cultural issues.
3. Cultural healing therapies will have little affect a person's mental illness.
4. Assessment findings in mental illness are reflective of the persons cultural background. - ✔ ✔ 4.
Assessment findings in mental illness are reflective of the persons cultural background.
Why do individuals who have been treated with cortisone preparations for an extended period of time
have an increased risk of developing infections?
1. Cortisone attracts microbes into the body.
2. Cortisone suppresses the body's normal immune response.
3. Cortisone therapy suppresses the body's natural bacteria.
4. Cortisone causes increased capillary permeability. - ✔ ✔ 2. Cortisone suppresses the body's
normal immune response
21. Mr. Lewis reports that he takes a combination inhaler that contains a long-acting beta2-agonist as
well as a steroid. What is the therapeutic action of these two medications?
1. The medications act in combination to decrease airway inflammation.
2. They work in combination to decrease airway bronchoconstriction.
3. They provide bronchodilation and reduced airway inflammation.
4. The two medications potentiate each other and provide longer-acting symptom control. - ✔ ✔ 3.
They provide bronchodilation and reduced airway inflammation.
A 2-day-old 36-week gestation infant is receiving oxygen in the neonatal intensive care unit. He is not
able to tolerate oral feeds as yet. His mother is upset as she had planned to breastfeed. What would be
appropriate for the practical nurse to say to her?
1. "I will bring you the electric breast pump so that you may start pumping your breasts for when your
baby can start feedings."
2. "Your baby will probably need feeds through an intravenous infusion for several weeks and perhaps
after that you may be able to provide him with breast milk."
, 3. "It is best to give premature infants formula when they start feedings as the exact amounts of milk
can be determined."
4. "As soon as the baby is out of oxygen, you will be able to put him to breast." - ✔ ✔ 1. "I will bring
you the electric breast pump so that you may start pumping your breasts for when your baby can start
feedings."
A 2-year-old child in respiratory distress has the following physician order: "Give oxygen by face mask to
keep the O2 saturation above 95%." The nurse notes that the oxygen saturation has fallen to 80%. What
should be the initial action by the practical nurse?
1. Double-check the order with the physician.
2. Administer additional oxygen.
3. Arrange for arterial blood gases to confirm the O2 saturation reading.
4. Perform a chest assessment. - ✔ ✔ 2. Administer additional oxygen.
A 6-year-old has been admitted to the pediatric unit with a new diagnosis of type1 diabetes mellitus.
A family visits the child health clinic. The father tells the practical nurse, "I have read on several Web
sites that there is scientific evidence vaccines are not effective, so I will not consent to immunizing my
child." What would be the best response by the practical nurse?
1. "Has your child, or any child you know, ever had a serious adverse effect after an immunization?"
2. "Do you have any cultural, religious, or personal beliefs regarding immunization?"
3. "Which vaccines have you read about that are not effective?"
4. "I agree there is much conflicting information. Can you tell me more about what you read?" - ✔ ✔
4. "I agree there is much conflicting information. Can you tell me more about what you read?"
A first-year practical nursing student about to enter her first clinical practice experience has artificial
nails. Her nursing professor tells her the policy states she must have the nails removed. What is the most
appropriate rationale for this policy?
1. Artificial nails are too long and may injure the client.
2. Artificial nails may accidentally be ripped off during client care, injuring the nurse.
Questions Unlock Your Potential:
Comprehensive Exam Study Guide
Which of the following would be of concern to the practical nurse when providing postoperative care to
Mr. Rutlege?
1. Urinary output of less than 30 mL per hour
2. Absent bowel sounds
3. Pain from the incision site
4. Scant serosanguinous drainage from the incision - ✔ ✔ 1. Urinary output of less than 30 mL per
hour
Which of the following would be of most concern to the practical nurse if noted in an 8-year-old child
after he fell from his bike and hit his head?
1. Nausea
2. Memory loss for familiar surroundings and objects
3. Swelling and aching pain at the site of injury
4. Blood pressure changing from 100/60 to 110/70 mm Hg - ✔ ✔ 2. Memory loss for familiar
surroundings and objects
Which of the following would be part of a normal respiratory assessment for neonate Perlstein?
1. Observation of abdominal breathing
2. Obtaining a respiratory rate of 70 breaths per minute
3. Noting a breathing pattern that is regular, with an even rate
4. Assessing that the baby is primarily mouth-breathing rather than nose-breathing - ✔ ✔ 1.
Observation of abdominal breathing
,Which of the following would be the best heart-healthy lunch menu?
1. Purchased chicken soup and a bagel
2. Delicatessen luncheon meat sandwich and a Caesar salad
3. Purchased bran muffin and cheddar cheese slices
4. Grilled chicken, lettuce, and tomato sandwich on whole-grain bread - ✔ ✔ 4. Grilled chicken,
lettuce, and tomato sandwich on whole-grain bread
Which of the following would be the correct procedure when taking the blood pressure of a
hypertensive client who is monitored at the clinic once a week?
1. Ensure that the client has not had caffeine within the last 5 hours.
2. Allow the client to rest for 5 minutes prior to taking the blood pressure.
3. Use manual rather than electronic blood pressure devices.
4. Alternate arms for each visit. - ✔ ✔ 2. Allow the client to rest for 5 minutes prior to taking the
blood pressure.
Which pulse would be of most concern to the practical nurse?
1. Two-month-old infant: 110 bpm at rest
2. Ten-year-old boy: 104 bpm after exercise
3. Seventeen-year-old athlete: 50 bpm at rest
4. Five-day-old infant: 70 bpm after crying - ✔ ✔ 4. Five-day-old infant: 70 bpm after crying
(This is bradycardia in a 5-day-old infant. Although there are wide variations published as normal
neonatal heart rates that range from approximately 100-160, this rate, especially after crying, is below
normal).
Which statement best supports a practical nurse providing advocacy during a multidisciplinary team
meeting?
,1. Symptoms of mental illnesses are not influenced by a person's culture.
2. Obsessive-compulsive disorder and hoarding have similar cultural issues.
3. Cultural healing therapies will have little affect a person's mental illness.
4. Assessment findings in mental illness are reflective of the persons cultural background. - ✔ ✔ 4.
Assessment findings in mental illness are reflective of the persons cultural background.
Why do individuals who have been treated with cortisone preparations for an extended period of time
have an increased risk of developing infections?
1. Cortisone attracts microbes into the body.
2. Cortisone suppresses the body's normal immune response.
3. Cortisone therapy suppresses the body's natural bacteria.
4. Cortisone causes increased capillary permeability. - ✔ ✔ 2. Cortisone suppresses the body's
normal immune response
21. Mr. Lewis reports that he takes a combination inhaler that contains a long-acting beta2-agonist as
well as a steroid. What is the therapeutic action of these two medications?
1. The medications act in combination to decrease airway inflammation.
2. They work in combination to decrease airway bronchoconstriction.
3. They provide bronchodilation and reduced airway inflammation.
4. The two medications potentiate each other and provide longer-acting symptom control. - ✔ ✔ 3.
They provide bronchodilation and reduced airway inflammation.
A 2-day-old 36-week gestation infant is receiving oxygen in the neonatal intensive care unit. He is not
able to tolerate oral feeds as yet. His mother is upset as she had planned to breastfeed. What would be
appropriate for the practical nurse to say to her?
1. "I will bring you the electric breast pump so that you may start pumping your breasts for when your
baby can start feedings."
2. "Your baby will probably need feeds through an intravenous infusion for several weeks and perhaps
after that you may be able to provide him with breast milk."
, 3. "It is best to give premature infants formula when they start feedings as the exact amounts of milk
can be determined."
4. "As soon as the baby is out of oxygen, you will be able to put him to breast." - ✔ ✔ 1. "I will bring
you the electric breast pump so that you may start pumping your breasts for when your baby can start
feedings."
A 2-year-old child in respiratory distress has the following physician order: "Give oxygen by face mask to
keep the O2 saturation above 95%." The nurse notes that the oxygen saturation has fallen to 80%. What
should be the initial action by the practical nurse?
1. Double-check the order with the physician.
2. Administer additional oxygen.
3. Arrange for arterial blood gases to confirm the O2 saturation reading.
4. Perform a chest assessment. - ✔ ✔ 2. Administer additional oxygen.
A 6-year-old has been admitted to the pediatric unit with a new diagnosis of type1 diabetes mellitus.
A family visits the child health clinic. The father tells the practical nurse, "I have read on several Web
sites that there is scientific evidence vaccines are not effective, so I will not consent to immunizing my
child." What would be the best response by the practical nurse?
1. "Has your child, or any child you know, ever had a serious adverse effect after an immunization?"
2. "Do you have any cultural, religious, or personal beliefs regarding immunization?"
3. "Which vaccines have you read about that are not effective?"
4. "I agree there is much conflicting information. Can you tell me more about what you read?" - ✔ ✔
4. "I agree there is much conflicting information. Can you tell me more about what you read?"
A first-year practical nursing student about to enter her first clinical practice experience has artificial
nails. Her nursing professor tells her the policy states she must have the nails removed. What is the most
appropriate rationale for this policy?
1. Artificial nails are too long and may injure the client.
2. Artificial nails may accidentally be ripped off during client care, injuring the nurse.
