Evolve: Comprehensive Exam 2 questions and
answers 2024\2025 A+ Grade
1. A parent whose 12-year-old child has been inhaling paint fumes asks the nurse, "Can he become
addicted to paint fumes?" What is the best response for the nurse to provide?
A. Any time you use an illegal substance, you are abusing drugs.
B. Tell me what you think may have caused him to start inhaling paint fumes.
C. Only hard drugs like cocaine and heroin can cause problems with addiction.
D. Abuse of any of the inhalants can eventually lead to addiction.
- correct answer D. Abuse of any of the inhalants can eventually lead to addiction.
Any inhalant can become addictive. Any substance that is used to alter perception can be addictive and
is not limited to the common street drugs.
2. A young adult female is brought to the emergency room by family members who report that she
ingested a large quantity of acetaminophen (Tylenol). The nurse should prepare for which treatment to
be implemented?
A. Gastric lavage with normal saline.
B. IV administration of Narcan.
C. Syrup of ipecac per nasogastric tube.
D. Acetylcysteine (Mucomyst) 140 mg/kg.
- correct answer - Acetylcysteine (Mucomyst) 140 mg/kg.
Mucomyst (D) is the antidote for acute acetaminophen (Tylenol) poisoning and is the treatment of
choice for an overdose. (B) is used for an overdose of narcotics. (C) is used for ingestion of non-corrosive
products such as iron tablets. (A) might also be implemented, depending on the amount of drugs
ingested and the time elapsed since ingestion.
,3. An 8-year-old male client with nephrotic syndrome is in remission following treatment with
prednisone (Deltasone). The nurse should teach the child to check his urine for which finding?
A. Ketones.
B. Protein.
C. White blood cells.
D. Glucose.
- correct answer B. Protein.
Children should be taught to check for protein (albumin) (B) in the urine daily, because a positive
reading for protein in the urine is often the only indicator of a relapse of nephrotic syndrome. (C) is an
indication of infection. (A and D) should be assessed while the child is receiving corticosteroid therapy,
since corticosteroids increase blood glucose.
4. When making a home visit to a family with a teething 4-month-old, what information is most
important for the nurse to provide the parents?
A. No action is required for the common symptoms associated with teething, which include drooling,
irritability, and poor sleeping.
B. A slight fever is often associated with teething, but a fever lasting more than three days requires
medical attention.
C. Though child development is characterized by individual differences, first teeth usually erupt during
the seventh month.
D. Providing cooled teething toys can help decrease the discomfort associated with tooth eruption.
- correct answer B. A slight fever is often associated with teething, but a fever lasting more than three
days requires medical attention.
A slight fever that persists longer than three days is likely to be associated with a pathological process,
not teething, and the parents should seek the attention of their healthcare provider if it occurs (B). (A, C,
and D) provide useful information about teething, but do not have the priority of (B).
5. To treat cystitis, a 14-day course of treatment with cephalexin (Ceclor) is prescribed for a client
residing in a long-term care facility. Which action is most important for the nurse to take prior to
administering the first dose of this medication?
,A. Take the client's vital signs prior to the first dose and once daily for 14 days.
B. Determine if the client has ever had a hypersensitivity reaction to penicillins.
C. Review the client's fasting blood glucose levels for a hyperglycemic trend.
D. Restrict the use of dairy products in the client's diet for the next 3 weeks.
- correct answer B. Determine if the client has ever had a hypersensitivity reaction to penicillins.
Most individuals who have an allergy to penicillins (B) are at risk of hypersensitivity to cephalosporins.
To prevent a potential hypersensitivity reaction that could cause a life-threatening episode of
anaphylactic shock, the nurse must determine if the client has a known penicillin allergy before giving
the client a cephalexin (Ceclor) dose. (A, C, and D) are not required interventions for the administration
of cephalexin (Ceclor).
6. A staff member tells the charge nurse that a float nurse assigned to work on the unit has made
several medication errors in the past, but is currently working with the education department to
improve this skill. What action is best for the charge nurse to take?
A. Arrange for someone to be available to assess and assist the float nurse.
B. Assign the float nurse to function as a UAP for the day.
C. Dismiss the staff nurse's report about the float nurse because it may be just gossip.
D. Call the nursing supervisor and request a different employee be sent to the unit.
- correct answer A. Arrange for someone to be available to assess and assist the float nurse.
The float nurse is receiving education, but careful assessment of her or his skills and assistance, as
needed, is still warranted, so (A) is the best choice. Though the staff member's report may indeed be
gossip, failure to pay attention to the information could constitute negligence on the part of the charge
nurse (C). (D) is not the best way to manage the unit. (B) is not the best use of a licensed person and
would also eliminate the float nurse's opportunity to improve medication administration skills.
7. The blood pressure readings obtained by a unlicensed assistive personnel (UAP) are consistently
different from those obtained by other staff members. What action should the charge nurse take first?
A. Ask the education department to provide additional training for the UAP.
, B. Observe the UAP performing blood pressure measurements.
C. Make staff members aware of the possible errors in blood pressure readings.
D. Counsel the UAP about the inaccurate blood pressure readings.
- correct answer B. Observe the UAP performing blood pressure measurements.
The charge nurse should first observe the UAP's performance (B), then take appropriate action, which
might include (A, C and D).
8. A client at 13-weeks' gestation is scheduled for an amniocentesis in one week. The nurse knows that
the primary reason for conducting this procedure is to obtain what information?
A. Quantification of alpha-fetoprotein levels.
B. Level of fetal lung maturity.
C. Presence of genetic disorders.
D. Determination of gestational age.
- correct answer C. Presence of genetic disorders.
Amniocentesis is done at 14 to 16 weeks' gestation to determine chromosomal, genetic, and metabolic
disorders (C). Amniocentesis in the third trimester assesses fetal lung maturity (B) by evaluating the
lecithin/sphingomyelin (L/S) ratio and the presence of phosphatidylglycerol (PG). Amniocentesis is
performed to quantify alpha-fetoprotein levels (A) after abnormal maternal serum alpha-fetoprotein
levels (done at 15 to 18 weeks) are found. While specific levels of creatinine, bilirubin, and lipid cells are
present in amniotic fluid only after 35 to 36 weeks' gestation, gestational age (D) is commonly evaluated
by ultrasound.
9. A hospitalized 5-year-old boy recovering from surgery refuses to drink fluids. Which intervention is
best for the nurse to implement?
A. Ask the parents to participate in encouraging the child's fluid intake.
B. Offer the child a popsicle and allow him to pick the flavor he prefers.
C. Tell the child he can go outside after he drinks a full glass of water.
D. Make a game of seeing who can finish a glass of water first--the nurse or the child.
- correct answer B. Offer the child a popsicle and allow him to pick the flavor he prefers.
answers 2024\2025 A+ Grade
1. A parent whose 12-year-old child has been inhaling paint fumes asks the nurse, "Can he become
addicted to paint fumes?" What is the best response for the nurse to provide?
A. Any time you use an illegal substance, you are abusing drugs.
B. Tell me what you think may have caused him to start inhaling paint fumes.
C. Only hard drugs like cocaine and heroin can cause problems with addiction.
D. Abuse of any of the inhalants can eventually lead to addiction.
- correct answer D. Abuse of any of the inhalants can eventually lead to addiction.
Any inhalant can become addictive. Any substance that is used to alter perception can be addictive and
is not limited to the common street drugs.
2. A young adult female is brought to the emergency room by family members who report that she
ingested a large quantity of acetaminophen (Tylenol). The nurse should prepare for which treatment to
be implemented?
A. Gastric lavage with normal saline.
B. IV administration of Narcan.
C. Syrup of ipecac per nasogastric tube.
D. Acetylcysteine (Mucomyst) 140 mg/kg.
- correct answer - Acetylcysteine (Mucomyst) 140 mg/kg.
Mucomyst (D) is the antidote for acute acetaminophen (Tylenol) poisoning and is the treatment of
choice for an overdose. (B) is used for an overdose of narcotics. (C) is used for ingestion of non-corrosive
products such as iron tablets. (A) might also be implemented, depending on the amount of drugs
ingested and the time elapsed since ingestion.
,3. An 8-year-old male client with nephrotic syndrome is in remission following treatment with
prednisone (Deltasone). The nurse should teach the child to check his urine for which finding?
A. Ketones.
B. Protein.
C. White blood cells.
D. Glucose.
- correct answer B. Protein.
Children should be taught to check for protein (albumin) (B) in the urine daily, because a positive
reading for protein in the urine is often the only indicator of a relapse of nephrotic syndrome. (C) is an
indication of infection. (A and D) should be assessed while the child is receiving corticosteroid therapy,
since corticosteroids increase blood glucose.
4. When making a home visit to a family with a teething 4-month-old, what information is most
important for the nurse to provide the parents?
A. No action is required for the common symptoms associated with teething, which include drooling,
irritability, and poor sleeping.
B. A slight fever is often associated with teething, but a fever lasting more than three days requires
medical attention.
C. Though child development is characterized by individual differences, first teeth usually erupt during
the seventh month.
D. Providing cooled teething toys can help decrease the discomfort associated with tooth eruption.
- correct answer B. A slight fever is often associated with teething, but a fever lasting more than three
days requires medical attention.
A slight fever that persists longer than three days is likely to be associated with a pathological process,
not teething, and the parents should seek the attention of their healthcare provider if it occurs (B). (A, C,
and D) provide useful information about teething, but do not have the priority of (B).
5. To treat cystitis, a 14-day course of treatment with cephalexin (Ceclor) is prescribed for a client
residing in a long-term care facility. Which action is most important for the nurse to take prior to
administering the first dose of this medication?
,A. Take the client's vital signs prior to the first dose and once daily for 14 days.
B. Determine if the client has ever had a hypersensitivity reaction to penicillins.
C. Review the client's fasting blood glucose levels for a hyperglycemic trend.
D. Restrict the use of dairy products in the client's diet for the next 3 weeks.
- correct answer B. Determine if the client has ever had a hypersensitivity reaction to penicillins.
Most individuals who have an allergy to penicillins (B) are at risk of hypersensitivity to cephalosporins.
To prevent a potential hypersensitivity reaction that could cause a life-threatening episode of
anaphylactic shock, the nurse must determine if the client has a known penicillin allergy before giving
the client a cephalexin (Ceclor) dose. (A, C, and D) are not required interventions for the administration
of cephalexin (Ceclor).
6. A staff member tells the charge nurse that a float nurse assigned to work on the unit has made
several medication errors in the past, but is currently working with the education department to
improve this skill. What action is best for the charge nurse to take?
A. Arrange for someone to be available to assess and assist the float nurse.
B. Assign the float nurse to function as a UAP for the day.
C. Dismiss the staff nurse's report about the float nurse because it may be just gossip.
D. Call the nursing supervisor and request a different employee be sent to the unit.
- correct answer A. Arrange for someone to be available to assess and assist the float nurse.
The float nurse is receiving education, but careful assessment of her or his skills and assistance, as
needed, is still warranted, so (A) is the best choice. Though the staff member's report may indeed be
gossip, failure to pay attention to the information could constitute negligence on the part of the charge
nurse (C). (D) is not the best way to manage the unit. (B) is not the best use of a licensed person and
would also eliminate the float nurse's opportunity to improve medication administration skills.
7. The blood pressure readings obtained by a unlicensed assistive personnel (UAP) are consistently
different from those obtained by other staff members. What action should the charge nurse take first?
A. Ask the education department to provide additional training for the UAP.
, B. Observe the UAP performing blood pressure measurements.
C. Make staff members aware of the possible errors in blood pressure readings.
D. Counsel the UAP about the inaccurate blood pressure readings.
- correct answer B. Observe the UAP performing blood pressure measurements.
The charge nurse should first observe the UAP's performance (B), then take appropriate action, which
might include (A, C and D).
8. A client at 13-weeks' gestation is scheduled for an amniocentesis in one week. The nurse knows that
the primary reason for conducting this procedure is to obtain what information?
A. Quantification of alpha-fetoprotein levels.
B. Level of fetal lung maturity.
C. Presence of genetic disorders.
D. Determination of gestational age.
- correct answer C. Presence of genetic disorders.
Amniocentesis is done at 14 to 16 weeks' gestation to determine chromosomal, genetic, and metabolic
disorders (C). Amniocentesis in the third trimester assesses fetal lung maturity (B) by evaluating the
lecithin/sphingomyelin (L/S) ratio and the presence of phosphatidylglycerol (PG). Amniocentesis is
performed to quantify alpha-fetoprotein levels (A) after abnormal maternal serum alpha-fetoprotein
levels (done at 15 to 18 weeks) are found. While specific levels of creatinine, bilirubin, and lipid cells are
present in amniotic fluid only after 35 to 36 weeks' gestation, gestational age (D) is commonly evaluated
by ultrasound.
9. A hospitalized 5-year-old boy recovering from surgery refuses to drink fluids. Which intervention is
best for the nurse to implement?
A. Ask the parents to participate in encouraging the child's fluid intake.
B. Offer the child a popsicle and allow him to pick the flavor he prefers.
C. Tell the child he can go outside after he drinks a full glass of water.
D. Make a game of seeing who can finish a glass of water first--the nurse or the child.
- correct answer B. Offer the child a popsicle and allow him to pick the flavor he prefers.
