Version 6(V6) Actual Authentic Exam
With Multiple Choices 2025
1. A mother runs into the emergency department with a toddler in her arms and
tells the nurse that her child got into some cleaning products. the child smells
of chemicals on the hands, face, and on the front of the child's clothes. after
ensuring the airway is patent, what action should the nurse implement first?
a. Assess the child for altered sensorium
b. Determine type of chemical exposure
c. Obtain equipment for gastric lavage
d. Call poison control emergency number
- ANS- b. Determine type of chemical exposure
2. Which conditions are most likely to respond to treatment with
antihistamines? Select all that apply.
a. Bronchitis
b. Allergic rhinitis
c. Otitis media
d. Contact dermatitis
e. Myocarditis
- ANS- b. Allergic rhinitis
d. Contact dermatitis
3. An older client's daughter calls the home health nurse and reports that her
mother has become forgetful and is very confused at night. The daughter
states that her mother's behavior changed suddenly a few days ago and is
now getting worse. Which action should the nurse take? Select all that apply.
a. Ask if the mother is experiencing any pain with urination
b. Encourage increased intake of high protein foods
c. Instruct the daughter to check her mother's temperature
d. Review the client's current food and medication allergies
e. Determine if the mother has recently experienced a fall
- ANS- a. Ask if the mother is experiencing any pain with urination
,c. Instruct the daughter to check her mother's temperature
e. Determine if the mother has recently experienced a fall
4. The nurse is assessing a male with a history of Addison's disease. The client
has flu-like symptoms and nausea with vomiting over the past week. The
client's spouse reports that he acted confused and was extremely weak when
he awoke this morning. The client is febrile and has tachycardia. The health
care provider diagnoses acute adrenal insufficiency. Which medication will
most likely be prescribed?
a. Hypertonic saline solution at 100 ml/hr until all edema disappears
b. Hydrocortisone 100 mg IV every six hours until systolic BP reaches 110
mmHg
c. Potassium chloride 20 mEq IV to infuse over 2 hours until confusion
resolves
d. Regular insulin drip to keep blood glucose around 100 mg/dl (5.55
mmol/L)
- ANS- b. Hydrocortisone 100 mg IV every six hours until systolic BP reaches 110
mmHg
5. A client with a history of mitral valve prolapse is admitted because of fever
and dyspnea on exertion, and is diagnosed with acute infective endocarditis.
During the admission assessment, the nurse observes multiple areas of
petechiae on the client's skin. Which intervention should the nurse include in
the client's plan of care? Select all that apply.
a. Monitor cardiac rhythm via telemetry
b. Report changes in pre-existing murmurs
c. Schedule rest periods between activities
d. Maintain record of fluid intake and output
e. Initiate contact transmission precautions
- ANS- a. Monitor cardiac rhythm via telemetry
b. Report changes in pre-existing murmurs
6. The nurse is planning an educational session for new parents on ways to
prevent sudden infant death syndrome (SIDS). Which information is most
important to provide parents of newborns and infants?
a. Remove pillows and soft toys from the crib at bedtime
b. Keep a bulb syringe accessible for use for an infant
c. Position the infant in a supine position while sleeping
d. Do not prop bottles for an infant during naps and bedtime
- ANS- c. Position the infant in a supine position while sleeping
,7. The healthcare provider prescribes methylergonovine maleate for a
postpartum client with uterine atony. What findings should indicate to the
nurse to withhold the next dose of medication?
a. Hypertension
b. Difficulty locating the uterine fundus
c. Saturation of more than one pad per hour
d. Excessive lochia
- ANS- a. Hypertension
8. The nurse notes that an older adult client has a moist cough that increases in
severity during and after meals. Based on this finding, which action should
the nurse take?
a. Collect a sputum specimen immediately
b. Request a consultation to confirm dysphasia
c. Offer the client additional clear liquids frequently
d. Encourage the client to do deep breathing exercises daily
- ANS- b. Request a consultation to confirm dysphasia
9. A multiparous client who delivered her infant 3 hours ago asks the nurse if
she can take a warm sitz bath because it helped reduce perennial pain after
her last delivery. What action should the nurse implement?
a. Using analgesic spray to the perennial area to reduce pain
b. Apply an ice pack to the perineum for the first 24 hours
c. Teach the client how to practice Kegel exercises
d. Review the use of sitz bath equipment with the client
- ANS- d. Review the use of sitz bath equipment with the client
10.When the parents of a 6-year-old boy with a brain tumor are told that his
condition is terminal, the mother shouts at the father, "This is your fault! It
never would have happened if we sought treatment sooner!" Which
intervention is best for the nurse to implement?
a. Refer the parents to the chaplain to provide grief counseling
b. Assure the parents that a terminal diagnosis was inevitable
c. Tell the parents that blame each other will not change the situation
d. Explain to the parents that anger is a common response to grief
- ANS- d. Explain to the parents that anger is a common response to grief
11.The wife of a newly diagnosed client with Parkinson's disease asks the nurse
if alternative or complementary medical therapies might cure the disease.
, Which response should the nurse provide?
a. Complete a list of alternative medications that are effective in curing
Parkinson's disease
b. Explain there are no known conventional, alternative, or
complementary therapies that cure Parkinson's disease
c. Encourage the wife to ventilate her feelings about having a husband
with Parkinson's disease
d. Tell the wife that her husband's neurologist just would know more
about alternative treatments to cure Parkinson's
- ANS- b. Explain there are no known conventional, alternative, or
complementary therapies that cure Parkinson's disease
12.An IV antibiotic is prescribed for a client with a post operative infection. The
medication is to be administered in 4 divided doses. What schedule is best for
administering this prescription?
a. 1000, 1600, 2200, 0400
b. 0800, 1200, 1600, 2000
c. Administer with meals and a bedtime snack
d. Given equally divided doses during waking hours
- ANS- a. 1000, 1600, 2200, 0400
13.The mother of a child with cerebral palsy (CP) asks the nurse if her child's
impaired movements will worsen as the child grows. Which response provides
the best explanation?
a. Continued development of the brain lesion determines the child's
outcome
b. Brain damage with CP is not progressive but it does have variable
course
c. CP is one of the most common permanent physical disability in children
d. Severe motor dysfunction determines the extent of successful
habilitation
- ANS- b. Brain damage with CP is not progressive but it does have variable course
14.The nurse is preparing a teaching plan for an older female client diagnosed
with osteoporosis. Which expected outcome has the highest priority for this
client?
a. Identifies 2 treatments for constipation due to immobility
b. Names 3 home safety hazards to be resolved immediately
c. States 4 risk factors for the development of osteoporosis