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RN 127 MIDTERM QUESTIONS
1. You are the nurse caring for a client, who recently had a radioactive implant placed in
the vagina to treat cervical cancer. Which observation made by you indicates a radiation
hazard?
a. The nurse checks the applicator’s position every 4 hours
b. The client is maintained on strict bedrest
c. The client receives a complete bed bath each morning
d. The head of the bed is at least 30 – degree angle
RATIONALE: During this treatment, the client should remain on strict bedrest. The head
of the bed may be raised to 30 – 45 degrees. The client shouldn’t be bathed below the
waist because doing so puts the nurse at risk for radiation exposure. The nurse should
check the applicator’s position every 4 hours to ensure that it remains in the proper
place.
The correct answer is: c. The client receives a complete bed bad each morning
2. Conduction of impulse through the bundle of HIS is represented by which phase of the
cardiac cycle?
a. P Wave
b. QRS Complex
c. T Wave
d. Q – T Interval
RATIONALE: The QRS Complex on the ECG strip represents the conduction of impulses
through the bundle of HIS to the perkenji fibers causing contraction of the ventricles
The correct answer is: b. QRS Complex
3. Student nurse Gilligan is caring for a client with the following blood gas results. Gilligan
knows that of the following values the value that represents partially compensated
metabolic alkalosis is?
a. pH 7.28, HCO3- 19 mEq/L, PCO2 48mm Hg, P02 96 mm Hg
b. pH 7.48, HCO3- 29 mEq/L, PCO2 47, PO2 92 mm Hg
c. pH 7.48, HCO3- 28 mEq/L, PCO2 38, PO2 98 mm Hg
, 2
d. pH 7.32, HCO3- 17 mEq/L, PCO2 25, PO2 98 mm Hg
RATIONALE: For full compensation the pH must be within the normal range of 7.35 –
7.45. Metabolic alkalosis with partial compensation. The pCO2 is trying to compensate.
The correct answer is: b. pH 7.48, HCO3- 29 mEq/L, PCO2 47, PO2 92 mm Hg
4. Nurse Kendrick RN, is caring for a client admitted with complaints of chest pain and
nausea. The ECG shows ST segment depression. The laboratory results are: increased
homocysteine, normal C – reactive protein, increased low – density lipoprotein,
decreased hemoglobin, and high triglycerides. The nurse knows that of the laboratory
results, the one’s that increases the client’s risk for an acute cardiac event are?
a. Normal C – reactive protein, increase low – density lipoproteins, and increase
homocysteine
b. Increase homocysteine, decrease hemoglobin, and increase low – density
lipoprotein
c. Increase homocysteine, high triglycerides, and increase low – density lipoprotein
d. Increase homocysteine, normal C – reactive protein, and high triglycerides
RATIONALE: Hemoglobin is not a risk factor for MI. C – reactive protein is increase in
CAD. The triglycerides are abnormal. Increase low – density lipoprotein is a risk factor
for CAD
The correct answer is: Increase homocysteine, high triglycerides, and increase low –
density lipoprotein
5. A client with multiple sclerosis (MS) has a nursing diagnosis of urinary retention related
to sensorimotor deficits. An appropriate nursing intervention for this problem is to
a. Suggest the use of incontinence briefs for nighttime use only
b. Teach the client how to use the Crede method
c. Decrease fluid intake in the evening
d. Assist the client to the commode every 2 hours during the day
RATIONALE: The crede method can be used to improve bladder emptying. Decreasing
fluid intake will not improve bladder emptying and may increase risk for urinary tract
infection (UTI) and dehydration. The use of incontinence briefs and frequent toileting
will not improve bladder emptying
The correct answer is: Teach the client how to use the Crede method
, 3
6. Nurse Ethel is conducting a home visit for a client who received chemotherapy within
the past 24 hours. Nurse Ethel observes a small child playing in the bathroom, where
the toilet lid has been left up. Based on these observations, the nurse modifies the
client’s teaching plan to include:
a. Expected chemotherapy – related adverse effects
b. Reinforcement of the client’s medication regimen
c. Chemotherapy exposure and risk factors
d. Signs and symptoms of chemo therapy side effects
RATIONALE: The raised toilet lid exposes the child playing in the bathroom to the risk of
inhaling or ingesting chemotherapy agents. Because the client has received
chemotherapy, the plan should already include information about expected adverse
effects. The nurse should modify her teaching plan to include content related to
chemotherapy exposure and its associated risk factors.
The correct answer is: Chemotherapy exposure and risk factors
7. The student nurse is caring for a client who develops chest pain three days after a
myocardial infarction (MI). The pain increases when the client takes a deep breath and
is relieved by leaning forward. What action should the nurse take next?
a. Auscultate for a pericardial friction rub
b. Palpate the radial pulses bilaterally
c. Assess the feet for peripheral edema
d. Check the cardiac monitor for dysrhythmias
RATIONALE: The client’s symptoms are consistent with the development of pericarditis,
a possible complication of MI. The other assessments listed are not consistent with the
description of the client’s symptoms.
The correct answer is: a. Auscultate for a pericardial friction rub
8. A post-operative client who is receiving nasogastric suction is complaining of anxiety and
incisional pain. The client’s respiratory rate is 32 breaths/minute and the arterial blood
gases (ABG’s) indicate respiratory alkalosis. Which action should the nurse take first?
a. Discontinue the nasogastric suction for a few hours
b. Give the client the PRN morphine sulfate 4 mg intravenously
c. Notify the health care provider about the ABG result
RN 127 MIDTERM QUESTIONS
1. You are the nurse caring for a client, who recently had a radioactive implant placed in
the vagina to treat cervical cancer. Which observation made by you indicates a radiation
hazard?
a. The nurse checks the applicator’s position every 4 hours
b. The client is maintained on strict bedrest
c. The client receives a complete bed bath each morning
d. The head of the bed is at least 30 – degree angle
RATIONALE: During this treatment, the client should remain on strict bedrest. The head
of the bed may be raised to 30 – 45 degrees. The client shouldn’t be bathed below the
waist because doing so puts the nurse at risk for radiation exposure. The nurse should
check the applicator’s position every 4 hours to ensure that it remains in the proper
place.
The correct answer is: c. The client receives a complete bed bad each morning
2. Conduction of impulse through the bundle of HIS is represented by which phase of the
cardiac cycle?
a. P Wave
b. QRS Complex
c. T Wave
d. Q – T Interval
RATIONALE: The QRS Complex on the ECG strip represents the conduction of impulses
through the bundle of HIS to the perkenji fibers causing contraction of the ventricles
The correct answer is: b. QRS Complex
3. Student nurse Gilligan is caring for a client with the following blood gas results. Gilligan
knows that of the following values the value that represents partially compensated
metabolic alkalosis is?
a. pH 7.28, HCO3- 19 mEq/L, PCO2 48mm Hg, P02 96 mm Hg
b. pH 7.48, HCO3- 29 mEq/L, PCO2 47, PO2 92 mm Hg
c. pH 7.48, HCO3- 28 mEq/L, PCO2 38, PO2 98 mm Hg
, 2
d. pH 7.32, HCO3- 17 mEq/L, PCO2 25, PO2 98 mm Hg
RATIONALE: For full compensation the pH must be within the normal range of 7.35 –
7.45. Metabolic alkalosis with partial compensation. The pCO2 is trying to compensate.
The correct answer is: b. pH 7.48, HCO3- 29 mEq/L, PCO2 47, PO2 92 mm Hg
4. Nurse Kendrick RN, is caring for a client admitted with complaints of chest pain and
nausea. The ECG shows ST segment depression. The laboratory results are: increased
homocysteine, normal C – reactive protein, increased low – density lipoprotein,
decreased hemoglobin, and high triglycerides. The nurse knows that of the laboratory
results, the one’s that increases the client’s risk for an acute cardiac event are?
a. Normal C – reactive protein, increase low – density lipoproteins, and increase
homocysteine
b. Increase homocysteine, decrease hemoglobin, and increase low – density
lipoprotein
c. Increase homocysteine, high triglycerides, and increase low – density lipoprotein
d. Increase homocysteine, normal C – reactive protein, and high triglycerides
RATIONALE: Hemoglobin is not a risk factor for MI. C – reactive protein is increase in
CAD. The triglycerides are abnormal. Increase low – density lipoprotein is a risk factor
for CAD
The correct answer is: Increase homocysteine, high triglycerides, and increase low –
density lipoprotein
5. A client with multiple sclerosis (MS) has a nursing diagnosis of urinary retention related
to sensorimotor deficits. An appropriate nursing intervention for this problem is to
a. Suggest the use of incontinence briefs for nighttime use only
b. Teach the client how to use the Crede method
c. Decrease fluid intake in the evening
d. Assist the client to the commode every 2 hours during the day
RATIONALE: The crede method can be used to improve bladder emptying. Decreasing
fluid intake will not improve bladder emptying and may increase risk for urinary tract
infection (UTI) and dehydration. The use of incontinence briefs and frequent toileting
will not improve bladder emptying
The correct answer is: Teach the client how to use the Crede method
, 3
6. Nurse Ethel is conducting a home visit for a client who received chemotherapy within
the past 24 hours. Nurse Ethel observes a small child playing in the bathroom, where
the toilet lid has been left up. Based on these observations, the nurse modifies the
client’s teaching plan to include:
a. Expected chemotherapy – related adverse effects
b. Reinforcement of the client’s medication regimen
c. Chemotherapy exposure and risk factors
d. Signs and symptoms of chemo therapy side effects
RATIONALE: The raised toilet lid exposes the child playing in the bathroom to the risk of
inhaling or ingesting chemotherapy agents. Because the client has received
chemotherapy, the plan should already include information about expected adverse
effects. The nurse should modify her teaching plan to include content related to
chemotherapy exposure and its associated risk factors.
The correct answer is: Chemotherapy exposure and risk factors
7. The student nurse is caring for a client who develops chest pain three days after a
myocardial infarction (MI). The pain increases when the client takes a deep breath and
is relieved by leaning forward. What action should the nurse take next?
a. Auscultate for a pericardial friction rub
b. Palpate the radial pulses bilaterally
c. Assess the feet for peripheral edema
d. Check the cardiac monitor for dysrhythmias
RATIONALE: The client’s symptoms are consistent with the development of pericarditis,
a possible complication of MI. The other assessments listed are not consistent with the
description of the client’s symptoms.
The correct answer is: a. Auscultate for a pericardial friction rub
8. A post-operative client who is receiving nasogastric suction is complaining of anxiety and
incisional pain. The client’s respiratory rate is 32 breaths/minute and the arterial blood
gases (ABG’s) indicate respiratory alkalosis. Which action should the nurse take first?
a. Discontinue the nasogastric suction for a few hours
b. Give the client the PRN morphine sulfate 4 mg intravenously
c. Notify the health care provider about the ABG result
