LATEST UPDATE| REAL EXAM QUESTIONS AND
VERIFIED CORRECT ANSWERS WITH RATIONALES|
EXCLUSIVE STUDY GUIDE|GRADED A+
The RN teaches a pt newly dx'd with DM1 about storing Humulin N insulin. Which
statement indicates to the RN that the pt understood the d/c teaching?
a) "I would keep the insulin in the cabinet during the day only."
b) "I know I have to keep my insulin in the refrigerator at all times."
c) "I can store the open insulin bottles in the kitchen cabinet for 1 month."
d) "The best place for my insulin is on the windowsill, but in the cupboard is just as
good." - CORRECT ANSWERS c) "I can store the open insulin bottles in the kitchen
cabinet for 1 month."
Rationale:
An insulin vial in current use can be kept at room temperature for 1 month without
significant loss of activity. Direct sunlight and heat must be avoided. Therefore, options 1, 2,
and 4 are incorrect.
The RN is caring for a pt scheduled for a transsphenoidal hypophysectomy. The pre-op
teaching instructions would include which statement?
a) "Your hair will need to be shaved."
b) "You will receive spinal anesthesia."
c) "You will need to ambulate after surgery."
d) "Brushing your teeth needs to be avoided for at least 2 weeks post-op." -
CORRECT ANSWERS d) "Brushing your teeth needs to be avoided for at least 2
weeks post-op."
Rationale:
A transsphenoidal hypophysectomy is a surgical approach that uses the nasal sinuses and
nose for access to the pituitary gland. Based on the location of the surgical procedure,
spinal anesthesia would not be used. In addition, the hair would not be shaved. Although
ambulating is important, specific to this procedure is avoiding brushing the teeth to
prevent disruption of the surgical site.
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,During a routine prenatal visit, a pt complains of easily bleeding gums when brushing.
The RN does an assessment & teaches the pt about proper nutrition to minimize this
problem. Which pt statement indicates an understanding?
a) "I will drink 8 oz of water with each meal."
b) "I will eat 3 servings of cracked wheat bread each day."
c) "I will eat 2 saltine crackers before I get up each morning."
d) "I will eat fresh fruits & veggies for snacks & for dessert each day."
e) CORRECT ANSWERS
d) "I will eat fresh fruits & veggies for snacks & for dessert each day."
Rationale:
Fresh fruits and vegetables provide vitamins and minerals needed for healthy gums.
Drinking water with meals has no direct effect on gums. Cracked wheat bread may abrade
the tender gums. Eating saltine crackers can also abrade the tender gums.
A 6 yo child was just dx'd with Hodgkin's disease & chemo is planned to begin
immediately. The parent asks the RN why XDR was not ordered as part of tx. The RN
should make which response?
a) "It's very costly & chemo works just as well."
b) "I'm not sure. I'll discuss it with the HCP."
c) "Sometimes age has to do with the decision for XDR."
d) "The HCP would prefer that you discuss the tx options with the oncologist." -
CORRECT ANSWERS c) "Sometimes age has to do with the decision for XDR."
Rationale:
Radiation therapy is usually delayed, whenever possible, until a child is 8 years old to
prevent retardation of bone growth and soft tissue development. Options 1, 2, and 4 are
inappropriate responses to the parent and place the parent's question on hold.
The RN is doing an initial assessment on a newborn infant. When assessing the infant's
head, the RN notes that the ears are low-set. Which RN action is most appropriate?
a) Document the findings.
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,b) Arrange for a hearing test.
c) Notify the pediatrician.
d) Cover the ears with gauze pads. - CORRECT ANSWERS c) Notify the pediatrician.
Rationale:
Low or oddly placed ears are associated with various congenital defects and need to be
reported immediately. Although the findings need to be documented, the most appropriate
action would be to notify the pediatrician. Options 2 and 4 are inaccurate and
inappropriate nursing actions.
What PO2 value indicates respiratory failure in adults? - CORRECT ANSWERS PO2
< 60 mmHg
What blood value indicates hypercapnia? - CORRECT ANSWERS PCO2 > 45 mmHg
What condition occurs when the PO2 is < 60 mmHg (acute hypoxemia), the CO2 tension
rises > 50 mmHg (acute hypercarbia, hypercapnia) & the pH drops < 7.35, or both? -
CORRECT ANSWERS Acute respiratory failure
What are the S/S of respiratory failure in adults? - CORRECT ANSWERS Dyspnea,
SOB Tachypnea
Intercostal & sternal retractions
Cyanosis
Tachycardia
Cough that produces sputum
Fatigue
Fever
Crackles, wheezes
Chest pain (especially when trying to deep breathe)
Hypotension
Confusion
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, Agitation, restlessness
What are the common causes of respiratory failure in peds?
CORRECT ANSWERS- CHD RDS
Infection, sepsis
NM diseases
Trauma, burns
Aspiration
FVO & dehydration Anesthesia
& narcotic OD
Structural anomalies resulting in airway obstruction
What percentage of O2 should a child in severe respiratory distress receive? -
CORRECT ANSWERS 100% O2
What is shock? - CORRECT ANSWERS Widespread, serious reduction of tissue
perfusion, which leads to generalized impairment of cellular function.
What is the most common cause of shock? - CORRECT ANSWERS Hypovolemia
What causes septic shock? - CORRECT ANSWERS Release of endotoxins from
bacteria, which act on the nerves in peripheral vascular spaces, causing vascular
pooling, reduced venous return, decreased CO & results in poor systemic perfusion.
What is the goal of tx for hypovolemic shock? - CORRECT ANSWERS Quick
restoration of CO & tissue perfusion.
It's important to differentiate between hypovolemic & cardiogenic shock. How might the
RN determine the existence of cardiogenic shock? - CORRECT ANSWERS H/o MI with
LV failure or possible cardiomyopathy, with S/S of pulmonary edema.
If a pt is in cardiogenic shock, what might result from administration of volume-expanding
fluids, and what intervention can the RN expect to perform in the event of such an
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