Evolve Comprehensive Exam Nursing Questions and Answers, Exams of Nursing

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□ Questions □ 1.A client with asthma receives a prescription for high blood pressure during a clinic visit. Which prescription should the nurse anticipate the client to receive that is least likely to exacerbate asthma? Pindolol (Visken). Carteolol (Ocupress). Metoprolol tartrate

(Lopressor). Propranolol hydrochloride (Inderal). □ □ 2.A male client who has been taking propranolol (Inderal) for 18 months tells the nurse that the healthcare provider discontinued the medication because his blood pressure has been normal for the past three months. Which instruction should the nurse provide? Report any uncomfortable symptoms after stopping the medication. Stop the medication and keep an accurate record of blood pressure. Ask the healthcare provider about tapering the drug dose over the next week. Obtain another antihypertensive prescription to avoid withdrawal symptoms. □ □ 3.A client who is taking clonidine (Catapres, Duraclon) reports drowsiness. Which additional assessment should the nurse make? How long has the client been taking the medication? Does the client use any tobacco products? Has the client experienced constipation recently? Did the client miss any doses of the medication? □

□ 4.The nurse is preparing to administer atropine, an anticholinergic, to a client who is scheduled for a cholecystectomy. The client asks the nurse to explain the reason for the prescribed medication. What response is best for the nurse to provide? Provide a more rapid induction of anesthesia.

Decrease the risk of bradycardia during surgery. Induce relaxation before induction of anesthesia. Minimize the amount of analgesia needed postoperatively. □ □ 5.An 80 - year-old client is given morphine sulphate for postoperative pain. Which concomitant medication should the nurse question that poses a potential development of urinary retention in this geriatric client? Insuli n. Antaci ds. Tricyclic antidepressants. Nonsteroidal antiinflammatory agents. □ □ 6.A client with osteoarthritis is given a new prescription for a nonsteroidal antiinflammatory drug (NSAID). The client asks the nurse, "How is this medication different from the acetaminophen I have been taking?" Which information about the therapeutic action of NSAIDs should the nurse provide? Are less expensive. Provide antiinflammatory response. Cause

gastrointestinal bleeding. Increase hepatotoxic side effects. □ □ 7.A client with cancer has a history of alcohol abuse and is taking acetaminophen (Tylenol) for pain. Which organ function is most important for the nurse to monitor? Liver. Kidne y. Sens ory. Cardiorespiratory. □ □ 8.The nurse obtains a heart rate of 92 and a blood pressure of 110/76 prior to administering a scheduled dose of verapamil (Calan) for a client with atrial flutter. Which action should the nurse implement? Administer the dose as prescribed. Withhold the drug and notify the healthcare provider. Give intravenous (IV) calcium gluconate.

Recheck the vital signs in 30 minutes and then administer the dose. □ □ 9.A client is admitted to the hospital with a diagnosis of Type 2 diabetes mellitus and influenza. Which categories of illness should the nurse develop goals for the client's plan of care? Two acute illnesses. Two chronic illnesses. One chronic and one acute illness. One acute and one infectious illness. □ □ 10.Following an emergency Cesarean delivery, the nurse encourages the new mother to breastfeed her newborn. The client asks why she should breastfeed now. Which information should the nurse provide? Initiate the lactation process. Prevent neonatal hypoglycemia. Stimulate contraction of the uterus. Facilitate maternal-infant bonding. □ □ 11.Which intervention should the nurse include in the plan of care for a female client with severe postpartum

depression who is admitted to the inpatient psychiatric unit? Full rooming-in for the infant and mother. Restrict visitors who irritate the client. Supervised and guided visits with infant. Daily visits with her significant other. □ □ 12.A 16-year-old male client is admitted to the hospital after falling off a bike and sustaining a fractured bone. The healthcare provider explains the surgery needed to immobilize the fracture. Which action should be implemented to obtain a valid informed consent? Instruct the client sign the consent before giving medications. Obtain the permission of the custodial parent for the surgery. Obtain the signature of the client’s stepfather for the surgery.

Notify the non-custodial parent to also sign a consent form. □ □ 13.During a client assessment, the client says, "I can't walk very well." Which action should the nurse implement first? Identify the problem. Consider alternatives. Predict the likelihood of the outcome. Choose the most successful approach. □ □ 14.The nurse identifies a client's needs and formulates the nursing problem of, "Imbalanced nutrition: less than body requirements, related to mental impairment and decreased intake, as evidenced by increasing confusion and weight loss of more than 30 pounds over the last 6 months." Which short-term goal is best for this client? Eat 50 % of six small meals each day by the end of one week. Meals prepared during hospitalization will be fed by the nurse. Verbalize understanding of plan and of intention to eat meals. Demonstrate progressive weight gain toward the ideal weight. □

□ 15.A male client is angry and is leaving the hospital against medical advice (AMA). The client demands to take his chart with him and states the chart is "his" and he doesn' t want any more contact with the hospital. How should the nurse respond? Because you are leaving against medical advice, you may not have your chart. The information in your chart is confidential and cannot leave this facility legally. This hospital does not need to keep it if you are leaving and not returning here. The chart is the property of the hospital but I will see that a copy is made for you. □ □ 16.The nurse manager is assisting a nurse with

improving organizational skills and time management. Which nursing activity is the priority in pre-planning a schedule for selected nursing activities in the daily assignment? Medication administration. Client personal hygiene. Colostomy care instruction. Tracheostomy tube suctioning. □ □ 17.What nursing delivery of care provides the nurse to plan and direct care of a group of clients over a 24- hour period? Team nursing. Primary nursing. Case management. Functional nursing. □ □ 18.Two unlicensed assistive personnel (UAP) are arguing on the unit about who deserves to take a break first. What is the most important basic guideline that the nurse should follow in resolving the conflict? Deal with issues and not

personalities. Require the UAPs to reach a compromise. Weigh the consequences of each possible solution. Encourage the two to view the humor of the conflict. □ □ 19.The nurse is caring for a client who is unable to void. The plan of care establishes an objective for the client to ingest at least 1000 mL of fluid between 7:00 am and 3:30 pm. Which client response should the nurse document that indicates a successful outcome? Demonstrates adequate fluid intake and output. Voids at least 1000 mL between 7 am and 3 pm. Verbalizes abdominal comfort without pressure. Drinks 240 mL of fluid five times during the shift. □ □ 20.The nurse plans a teaching session with a client but postpones the planned session based on which nursing problem? Activity intolerance related to postoperative pain.

Noncompliance with prescribed exercise plan. Ineffective management of treatment regimen. Knowledge deficit regarding impending surgery. □ □ 21.A client who has active tuberculosis (TB) is admitted to the medical unit. What action is most important for the nurse to implement? Place an isolation cart in the hallway. Fit the client with a respirator mask. Don a clean gown for client care. Assign the client to a negative air-flow room. □ □ 22.A client is receiving atenolol (Tenormin) 25 mg PO after a myocardial infarction. The nurse determines the client's apical pulse is 65 beats per minute. What action should the nurse implement next? Notify the healthcare provider. Measure the blood pressure. Administer the medication. Reassess the apical pulse. □

□ 23.The nurse is assessing a client and identifies a bruit over the thyroid. This finding is consistent with which interpretation? Thyroid cyst. Thyroid cancer. Hypothyroi dism. Hyperthyroi dism. □ □ 24.A 6-year-old child is alert but quiet when brought to the emergency center with periorbital ecchymosis and ecchymosis behind the ears. The nurse suspects potential child abuse and continues to assess the child for additional manifestations of a basilar skull fracture. What assessment finding would be consistent with a basilar skull fracture? Asymmetry of the face and eye movements. Abnormal position and movement of the arm. Hematemesis and abdominal distention.

Rhinorrhoea or otorrhoea with Halo sign. □ □ 25.The nurse is assessing a client who complains of weight loss, racing heart rate, and difficulty sleeping. The nurse determines the client has moist skin with fine hair, prominent eyes, lid retraction, and a staring expression. These findings are consistent with which disorder? Grave's disease. Cushing syndrome. Multiple sclerosis. Addison's disease. □ □ 26.The nurse is assessing an older client and determines that the client's left upper eyelid droops, covering more of the iris than the right eyelid. Which description should the nurse use to document this finding? Ptosis on the left eyelid. A nystagmus on the left. Astigmatism on the right. Exophthalmos on the right. □

□ 27.The nurse is assessing a child's weight and height during a clinic visit prior to starting school. The nurse plots the child's weight on the growth chart and notes that the child's weight is in the 95th percentile for the child's height. What action should the nurse take? Recommend a daily intake of at least four glasses of whole milk. Encourage giving two additional snacks each day to the child. Question the type and quantity of foods eaten in a typical day. Assess for signs of poor nutrition, such as a pale appearance. □ □ 28.A child is receiving maintainance intravenous (IV) fluids at the rate of 1000 mL for the first 10 kg of body weight, plus 50 mL/kg per day for each kilogram between 10 and

20. How many milliliters per hour should the nurse program the infusion pump for a child who weighs 19. 5 kg?

(Enter numeric value only. If rounding is required, round to the nearest whole number.) 61 □ □ 29.The nurse obtains the pulse rate of 89 beats/minute for an infant before administering digoxin (Lanoxin). Which action should the nurse take? Assess respiratory rate for one minute next. Give the medication dosage as scheduled. Wait 30 minutes and give half of the dosage of medication. Withhold the medication and contact the healthcare provider. □ □ 30.The nurse is developing a teaching plan for an adolescent with a Milwaukee brace. Which instruction should the nurse include? Remove the brace just before going to bed. Dress with the brace over regular clothing. Shower with the brace directly against the skin. Wear the brace over a T-shirt 23 hours per day. □ □ 31.A 9-year-old is hospitalized for neutropenia and is placed in reverse isolation. The child asks the nurse, "Why do you have to wear a gown and mask

when you are in my room?" How should the nurse respond? “There are many forms of bacteria and germs in the hospital.” “To protect you because you can get an infection very easily.” “After taking medication for 24 hours a gown and mask won't be needed.” "Your condition could be spread to staff and other clients in the hospital.” □ □ 32.The nurse is giving discharge instructions to the parents of a newborn with a prescription for home phototherapy. Which statement by a parent indicates understanding of the phototherapy? “I need to change the baby’s position every four hours.”

“I should leave the baby under the light all of the time.” “I will keep the baby’s eyes covered when the baby is under the light.” “I should dress the baby in light clothing when the baby is under the light.” □ □ 33.A male client who had abdominal surgery has a nasogastric tube to suction, oxygen per nasal cannula, and complains of dry mouth. Which action should the nurse implement? Put petroleum jelly on the lips and around the nasogastric tube. Allow the client to drink water and record on the I and O record. Offer the client ice chips and instruct client to spit out the water. Apply a water soluble lubricant to the lips, oral mucosa and nares. □ □ 34.The nurse is assessing the laboratory results for a client who is admitted with renal failure and osteodystrophy. Which findings are consistent with this client's clinical picture? Blood urea nitrogen 40 m and creatinine 1.

Cloudy, amber urine with sediment, specific gravity of 1. 040. Serum potassium of 5. 5 mEq and total calcium of 6 mg/dl. Hemoglobin of 10 g and

hypophosphatemia. □ □ 35.Which information should the nurse give a client with chronic kidney disease (CKD)? Restrict calcium-rich foods. Obtain monthly B1 2 injections. Avoid salt substitutes. Increase daily intake of fiber. □ □ 36.A nurse is answering questions about breast cancer at a hospital- sponsored community health fair. A woman asks the nurse to explain the use of tamoxifen (Nolvadex). Which response should the nurse provide?

Low doses of tamoxifen prevent menopausal hot flashes. An used to reduce the risk of breast cancer for all women. This anti-estrogen drug inhibits malignancy growth. Part of a combination of chemotherapeutic agents used to treat tumors. □ □ 37.A 56-year-old female client is receiving intracavitary radiation via a radium implant. Which nurse should be assigned to care for this client? The nurse who is caring for another client receiving intracavitary radiation. A nurse with Marfan's syndrome who is postmenopausal. A nurse with oncology experience who may be pregnant. The nurse who is caring for another client who has Clostridium difficile. □ □ 38.Which information should the nurse provide a client who has undergone cryosurgery for Stage 1A cervical cancer? Notify the healthcare provider if heavy vaginal discharge occurs. Use condoms for sexual intercourse during the next week. Flat subclinical mucosal lesions are a common harmLess side effect. Use a sanitary napkin instead of a tampon.

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□ 39.Which nurse follows a client from admission through discharge or resolution of illness and coordinates the client's care between healthcare providers? Case manager. Nurse- manager. Quality manager. Discharge manager. □ □ 40.The nurse is preparing a client for a scheduled surgical procedure. What client statement should the nurse report to the healthcare provider? Expresses fear about the surgical procedure. Recalls drinking a glass of juice after midnight.

Reports a history of hives after eating shellfish. States has a history of post-operative nausea. □ □ 41.The parents of a 14-year-old boy express concern about their son's behavior, which ranges from clean- cut and personable to "grungy" and sullen. They have tried talking with him and disciplining him, but he continues to demonstrate confusing behaviors. Which information is best for the nurse to provide? Adolescents who demonstrate labile behaviors are at risk for self-injury. Rebelliousness requires consequences to prevent socially deviant behavior. Early adolescence is a developmental stage of normal experimentation. The parents should consider hospitalization to prevent self injury. □ □ 42.The nurse is interviewing a female client whose spouse is present. During the interview, the spouse answers most of the questions for the client. Which action is best for the nurse to implement? Direct the questions to the spouse whenever possible. Repeat each question and tell the client to speak up. Ask another nurse to complete the interview.

Ask the spouse to step out for a few minutes. □ □ 43.The nurse determines that a client's body weight is 105 % above the standardized height-weight scale. Which related factor should the nurse include in the nursing problem, "Imbalanced nutrition: more than body requirements?" Morbidly obese. Markedly obese. Inadequate lifestyle changes in diet and exercise. Increased morbidity and mortality risks. □ □ 44.The nurse is assessing a client and identifies the presence of petechiae. Which documentation best

describes this finding? Purplish-red pinpoint lesions of the skin. Purple to bluish discoloration of the skin. Small circumscribed elevations containing purulent fluid. Generalized reddish discoloration of an area of skin. □ □ 45.The nurse is inspecting the external eye structures for a client. Which finding is a normal racial variation? A Hispanic client may have inward-turned eyelashes. An Asian client may have a horizontal palpebrale fissure. An African-American client may have slightly yellow sclerae. A Caucasian client may have a slightly protruding eyeball. □ □ 46.During the physical assessment, which finding should the nurse recognize as a normal finding? Regular pulsation at the epigastric area when the client is supine. Apical pulse noted over an area 4 to 5 centimeters with a duration of 2 seconds. Jugular venous pressure palpable with the client in an upright position. Point of maximal impulse at the third intercostal space in the right midclavicular line.

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□ 47.The nurse is monitoring neurological vital signs for a male client who lost consciousness after falling and hitting his head. Which assessment finding is the earliest and most sensitive indication of altered cerebral function? Unequal pupils. Loss of central reflexes. Inability to open the eyes. Change in level of consciousness. □ □ 48.When documenting assessment data, which statement should the nurse record in the narrative nursing notes? Hair is within normal limits. Most all permanent teeth are present.