ACTUAL EXAM WITH LATEST EXAM
QUESTIONS AND CORRECT ANSWERS
WITH DETAILED RATIONALLES GRADED
A+
A nurse is providing teaching to a client who has a new
diagnosis of myasthenia gravis (MG). Which of the following
pieces of information should the nurse include?
A. Use enemas to treat constipation caused by daily
medications
B. Take a hot bath when muscles ache
C. Eat a low-calorie diet
D. Set an alarm to ensure medication dosages are taken on
time Correct Answer D. Set an alarm to ensure medication
dosages are taken on time
The nurse should instruct the client to take medication dosages
on time to maintain a therapeutic blood level. Dosages should
not be missed or postponed because this can cause an
exacerbation of the disease.
A nurse is teaching a client who has a new diagnosis of primary
open-angle glaucoma (POAG). Which of the following pieces of
information should the nurse include in the teaching? (Select all
that apply.)
A. Lost vision can improve with eye drops.
B. Administer eye drops as needed for vision loss.
C. Glasses will be necessary to correct the accompanying
presbyopia.
,D. Driving can be dangerous due to the loss of peripheral
vision.
E. Laser surgery can help reestablish the flow of aqueous
humor. Correct Answer D. Driving can be dangerous due to
the loss of peripheral vision.
E. Laser surgery can help reestablish the flow of aqueous
humor.
A nurse is assessing a client who has a fractured left femur and
is in skeletal traction. Which of the following findings should the
nurse report to the provider?
A. Ecchymosis of the thigh
B. Serous drainage at the pin site
C. Chest petechiae
D. Muscle spasms in the left leg Correct Answer C. Chest
petechiae
The nurse should identify chest petechiae as an indication of fat
embolism syndrome. Clients who have fractures of the long
bones such as the femur are at increased risk of fat emboli. Fat
emboli typically occur 12 to 48 hours after the injury when fat
droplets from the marrow enter into the systemic circulation and
are deposited in the lungs. The nurse should immediately notify
the provider because the client could progress to acute
respiratory failure.
A nurse is assessing a client who has Kaposi's sarcoma. Which
of the following findings should the nurse expect?
A. Nonproductive cough, fever, and shortness of breath
B. Lesions on the retina that produce blurred vision
C. Onset of progressive dementia
D. Reddish-purple skin lesions Correct Answer D. Reddish-
purple skin lesions
,Kaposi's sarcoma is commonly associated with AIDS and
manifests as hyperpigmented multicentric lesions that can be
firm, flat, raised, or nodular. Following a biopsy, the lesions are
treated with radiation and/or chemotherapy.
A nurse is completing an assessment for a client who has a
history of unstable angina. Which of the following findings
should the nurse expect?
A. Chest pain is relieved soon after resting.
B. Nitroglycerin relieves chest pain.
C. Physical exertion does not precipitate chest pain.
D. Chest pain lasts for longer than 15 min. Correct Answer D.
Chest pain lasts for longer than 15 min.
A client who has unstable angina will have chest pain lasting
longer than 15 minutes. This is due to reduced blood flow in a
coronary artery from atherosclerotic plaque and thrombus
formation causing partial arterial obstruction or from an artery
spasm.
InCorrect Answer s:
A. A client who has unstable angina will have chest pain even
while resting because of insufficient blood flow to the coronary
arteries and a decreased oxygen supply. Chest pain at rest is a
condition called variant
(Prinzmetal's) angina and is caused by an arterial spasm.
B. A client who has unstable angina will have minimal, if any,
relief of chest pain with nitroglycerin.
C. A client who has unstable angina will report chest pain or
discomfort with exertion, which can limit the client's activity.
A nurse is assessing a client with a closed head injury who has
received mannitol for manifestations of increased intracranial
, pressure (ICP). Which of the following findings indicates that
the medication is having a therapeutic effect?
A. The client's serum osmolarity is 310 mOsm/L.
B. The client's pupils are dilated.
C. The client's heart rate is 56/min.
D. The client is restless. Correct Answer A. The client's serum
osmolarity is 310 mOsm/L.
Mannitol is an osmotic diuretic used to reduce cerebral edema
by drawing water out of the brain tissue. A serum osmolarity of
310 mOsm/L is desired. A decrease in cerebral edema should
result in a decrease in ICP.
A nurse is planning care for a client who has AIDS and has
developed stomatitis. Which of the following interventions
should the nurse include in the plan of care?
A. Rinse the mouth with chlorhexidine solution every 2 hr
B. Limit fluid intake with meals
C. Provide oral hygiene with a firm-bristled toothbrush after
each meal
D. Avoid salty foods Correct Answer D. Avoid salty foods
Stomatitis is an inflammation of the mucosa of the mouth,
usually with ulcerations. Foods that are spicy, acidic, or salty
should be avoided to prevent further irritation and damage to
the oral mucosa.
A nurse is caring for a client who had a left lower lobectomy to
treat lung cancer. Which of the following factors will have a
significant impact on the plan of care for this client?
A. The client will need intensive smoking-cessation education.
B. After surgery, the prognosis for clients with lung cancer is
usually good.