Nursing Practice Exam: Comprehensive Predictor Retake 2019, Exams of Nursing

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Comprehensive predictor retake 2019

1. A nurse is assessing a client who has received an antibiotic. The nurse should identify which of the following findings as an indication of a possible allergic reaction to the medication? A. Bradycardia B. Headache C. Joint pain D. Hypotension
2. A nurse on a mental health unit is caring for a client who has schizophrenia and is experiencing auditory hallucinations telling them to hurt others. The client is refusing to take anti-psychotic medication. Which of the following responses should the nurse make? A. “You should plan to take this medication for a few weeks.” B. “You will regret it if you do not take this medication.” C. “This medication will help you respond to the voices. D. “This medication will help you stop the voices you are hearing.”
3. A nurse is providing care for a patient who has depression and is to have electroconvulsive therapy. Which of the following conditions should the nurse identify as increasing the client’s risk for complications? A. Hyperthyroidism B. Renal calculi C. Diabetes mellitus D. Cardiac dysrhythmias
4. A nurse is reviewing the laboratory results of a client who has rheumatoid arthritis. Which of the following findings should the nurse report to the provider? A. WBC count 8,000/mm B. Platelets 150,000/mm C. Aspartate aminotransferase 10 units/L D. Erythrocyte sedimentation 75 mm/hr
5. A nurse is suctioning the airway of a client who is receiving mechanical ventilation via an endotracheal tube. Which of the following findings should the nurse identify as an indication that suctioning has been effective? A. Presence of a productive cough B. Decreased peak inspiratory pressure C. Thinning of mucous secretions D. Flattening of the artificial airway cuff

6. A nurse is caring for a client who is in a seclusion room following violent behavior. The client continues to display aggressive behavior. Which of the following actions should the nurse take? A. Stand within 30cm (1 ft) of the client when speaking with them. B. Express sympathy for the client’s situation. C. Confront the client about his behavior. D. Speak assertively to the client.
7. A nurse is caring for a client who is immediately postoperative following an adrenalectomy to treat Cushing’s disease. Which of the following actions is the nurse’s priority? A. Reposition the client for comfort every 2 hours B. Observe for any indications of infection C. Document amount and color of the incisional drainage. D. Monitor the client’s fluid and electrolyte status.
8. A nurse is caring for a client who is scheduled for a surgical procedure and states, “I don’t want to have this surgery anymore.” Which of the following responses should the nurse make? A. “We can manage your care following the procedure without complications.” B. “You have the right to refuse the procedure.” C. “Your doctor thinks the surgery is necessary.” D. “Let me review the procedure so you can understand what is going to happen.”
9. A nurse is evaluating a client who has borderline personality disorder. Which of the following behaviors indicates an improvement in the client’s condition? A. Impulsive behaviors B. Decreased clinging behavior C. Liability of mood D. Dependent behavior
10. A nurse is teaching a group of school-age children about healthy snack options. Which of the following snacks should the nurse include? A. Air-popped popcorn B. Milkshake made with whole milk. C. Baked potato chips D. Cheesecake
11. A nurse is providing teaching to a client who has a new prescription for enoxaparin. Which of the following medications for pain relief should the nurse include in the teaching that can be taken concurrently with enoxaparin? A. Naproxen sodium

A. Clamp the catheter tubing for 30 min B. Initiate continuous bladder irrigation C. Obtain a urine specimen for culture and sensitivity D. Administer a fluid bolus

17. A nurse is caring for a client who has experienced a stillbirth. Which of the following actions should the nurse take during the initial grieving process? A. Avoid talking to the client about the newborn B. Discourage the client from allowing friends to see the newborn C. Offer to take pictures of the newborn for the client D. Assure the client that she can have additional children
18. A nurse is caring for a client who has a major burn injury. Which of the following actions is the nurse’s priority to prevent wound infection? A. Use sterile dressings for wound care B. Apply topical antibiotics to the client’s wounds. C. Place the client in protective isolation. D. Maintain consistent hand washing by staff.
19. A nurse is speaking with the caregiver of a client who has Alzheimer’s disease. The caregiver states, “Providing constant care is very stressful and is affecting all areas of my life.” Which of the following actions should the nurse take? A. Discuss methods of how to communicate with the client about problem solving behaviors. B. Suggest that the caregiver seek a prescription for an antipsychotic medication for the client. C. Assist the caregiver to arrange a daycare program for the client. D. Recommend allowing the client to have time alone in their room throughout the day.
20. A nurse is caring for a client who is 1 hr postpartum and unable to urinate. Which of the following actions should the nurse take? A. Administer a benzodiazepine B. Perform a fundal massage C. Place an ice pack on the client’s perineum D. Place the client’s hand in warm water
21. A nurse on a medical-surgical unit is performing medication reconciliation for a newly admitted client. Which of the following actions should the nurse take? A. Compare a list of common medications to treat a condition to the actual prescriptions B. Compare the prescription to the allergy history of the client

C. Compare the medication label to the provider’s prescription on three occasions before administration D. Compare the client’s list of home medications to the admission prescriptions written for the client.

22. A nurse is preparing to administer betamethasone to a client who is 25 weeks of gestation and has preterm labor. Which of the following findings should the nurse identify as an adverse effect of this medication? A. Hyperglycemia B. Uterine contractions C. Proteinuria D. Hypotension
23. A nurse is preparing to obtain a blood sample from a client who has a central venous catheter. Which of the following actions should the nurse take? (SATA) A. Apply a tourniquet above the catheter insertion site. B. Access the catheter using a large bore needle. C. Aspirate for blood return to access catheter patency. D. Flush the catheter with 0.9% sodium chloride. E. Apply force when resistance is met while flushing the catheter.
24. A nurse is preparing to perform a dressing change on a preschooler. Which of the following actions should the nurse take to prepare the child for the procedure? A. Explain in simple terms how the procedure will affect the child. B. Ask the parents to wait outside the room during the procedure. C. Limit teaching sessions about the procedure to 20 min. D. Instruct the child in deep-breathing methods prior to the procedure.
25. A nurse is performing wound care for a client who has an abdominal incision. Which of the following techniques should the nurse implement? A. Irrigate the wound using a 10-mL syringe. B. Cleanse the wound starting at the bottom and moving upward. C. Cleanse the insertion site of the drain using a circular motion towards the center. D. Irrigate the wound with a low-pressure flow of solution.
26. A nurse on an antepartum unit is prioritizing care for multiple clients. Which of the following clients should the nurse see first? A. A client who is at 36 weeks of gestation and has a biophysical profile score of
    8. B. A client who has preeclampsia and reports a persistent headache.

32. A nurse is reviewing home recommendations with a client who is postoperative following knee surgery. Which of the following recommendations should the nurse make? A. Place a handrail in the entryway of the house. B. Place a towel on the floor outside of the shower. C. Ensure that all area rugs are rubber-backed. D. Wear slippers with cloth soles.
33. A nurse is caring for a client who is postoperative following total hip arthroplasty. Which of the following actions should the nurse take to prevent dislocation of the prosthesis? A. Raise the head of the client’s bed to a high-fowler’s position. B. Elevate the client’s effected leg on a pillow when in bed. C. Position the client’s knees slightly higher than the hips when up in a chair. D. Keep an abduction pillow between the client’s legs.
34. A nurse in a pediatric clinic is teaching a newly hired nurse about the varicella zoster virus. Which of the following information should the nurse include? A. Children who have varicella should be placed on droplet precautions. B. Children who have varicella are contagious 4 days before the first vesicle eruption. C. Children who have varicella are contagious until the vesicles are crusted. D. Children who have varicella should receive the herpes zoster vaccine.
35. A nurse is caring for a client who is experiencing a panic attack. Which of the following actions should the nurse take? A. Teach the client how to meditate B. Sit with the client to provide a sense of security. C. Encourage the client to watch television. D. Administer a dose of atomoxetine to decrease anxiety.
36. A nurse is teaching a newly licensed nurse about ergonomic principles. Which of the following actions by the newly licensed nurse indicates an understanding of the teaching? A. Stands with feet together when lifting a client up in bed. B. Places a gait belt around the client’s upper chest before assisting a client to stand. C. Uses a mechanical lif t device to move a client from the bed to the chair. D. Raises the client’s head of the bed before pulling the client up.
37. A nurse is teaching a client about condom use. Which of the following client statements should the nurse identify as an understanding of the teaching?

A. “I can use petroleum jelly as a lubricant with the condom.” B. “I can re-use the condom one time after initial use.” C. “I can use natural-skin condoms to prevent sexually transmitted infections.” D. “I can store the condoms in the drawer of my night-stand.”

38. A nurse is planning care for a client who has a chest tube. Which of the following interventions should the nurse include in the plan? (SATA) A. Maintain the collection chamber above the level of the client’s waist. B. Mark the drainage output on the collection chamber hourly. C. Clamp the chest tube every 2 hours to assess the amount of drainage. D. Add water to the water seal chamber as it evaporates. E. Strip the chest tube vigorously to dislodge blood clots.
39. The nurse is reviewing a medical record of a client who has a prescription for intermittent heat therapy for a foot injury. Which of the following findings should the nurse identify as a contraindication to heat therapy? A. Osteoarthritis B. Peripheral neuropathy C. Abdominal aortic aneurysm D. Phlebitis
40. A charge nurse is recommending postpartum clients for discharge following a local disaster. Which of the following client’s should the nurse recommend for discharge first? A. A 15-year-old client who delivered via emergency cesarean birth 1 day ago B. A 42-year-old client who has preeclampsia and a BP of 166/110 mm Hg C. A client who delivered precipitously and has a second-degree perineal laceration D. A client who has received 2 units of RBCs 6 hr ago for a postpartum hemorrhage
41. A nurse is providing teaching about crutch safety to a client. Which of the following client actions indicates an understanding of the teaching? A. The client flexes her elbows 10 degrees when supporting weight by using the handgrips. ATI page 222 Fundy. IT HAS TO BE 30 DEGREE B. The client places the crutches 30 cm (12 in) to the front and side of each foot while standing C. The client leans on both crutches to support body weight. D. The client keeps her axillae free of pressure.
42. A nurse is preparing the body of a client who has died for the family to view. Which of the following actions should the nurse take? A. Place a pillow under the client’s head.

48. A nurse is performing a gait assessment on a client to evaluate the client’s ability to perform ADLs. Which of the following findings indicates a standard gait? A. The client looks at the floor when walking. B. The client’s shoulders are rounded slightly forward. C. The client’s heels touch the ground before their toes. D. The client’s dominant foot bears more weight.
49. A nurse on a mental health unit is caring for a client who has suicidal ideation. Which of the following actions should the nurse take? A. Place the client in a group therapy session. B. Avoid discussing suicidal thoughts with the client. C. Give the client a radio to listen to in his room. D. Establish a no-suicide contract with the client.
50. A nurse is providing teaching about nutrition therapy to a client who is experiencing anorexia due to chemotherapy treatment. Which of the following statements should the nurse make? A. “Snack frequently on fresh fruit.” B. “Add water to soups to increase volume.” C. “Avoid adding butter to foods.” D. “Add grated cheese to vegetable dishes.”
51. A nurse is providing teaching to a client who has a new diagnosis of type 1 diabetes mellitus about administering NPH and regular insulin together in one injection. Which of the following instructions should the nurse include? A. Inject into the vastus lateralis. B. Draw up the regular insulin prior to NPH. C. Use a 15-degree angle for the injection. D. Roll the syringe gently to ensure mixture of the insulins.
52. A nurse is caring for a client who has a calcium level of 8 mg/dL. Which of the following actions should the nurse take? A. Request a prescription for magnesium citrate. B. Request a prescription for furosemide. C. Place the client on a low-calcium diet. D. Place the client on seizure precautions.

53. A nurse is caring for a client who has schizophrenia and is experiencing delusions. Which of the following actions should the nurse take? A. Encourage the client to rest quietly in bed twice per day. B. Direct long conversations about the delusions toward reality-based topics. C. Allow the client unlimited time to discuss the delusions when they occur. D. Avoid assessing the client’s delusions.
54. A nurse is conducting a health promotion class about the use of oral contraceptives. Which of the following disorders is a contraindication for oral contraceptive use? A. Asthma B. Fibromyalgia C. Hypertension D. Fibrocystic breast condition
55. A nurse in the emergency department is triaging victims of a house fire. Which of the following clients should the nurse prioritize as emergent? A. Client who has a compound fracture of the femur B. Client who has hypertension and reports chest pain C. Client who has severe abdominal pain D. Client who has a deep laceration on both thighs
56. A nurse is planning care for a group of clients. Which of the following methods should the nurse use to manage time effectively? A. Gather supplies prior to completing a dressing change. B. Complete partial assessments on all clients before planning the day. C. Prioritize activities based on the nurse’s needs. D. Use break time to perform documentation.
57. A nurse on a mental health unit is planning room assignments for four clients. Which of the following clients should the nurse assign to room near the nurse’s station? A. A client who has a somatic symptom disorder and reports chronic pain. B. A client who has an anxiety disorder and is experiencing moderate anxiety. C. A client who has bipolar disorder and impaired social interactions. D. A client who has a depressive disorder and reports feeling hopeless.
58. A nurse is assessing coping strategies of a client whose partner has alcohol use disorder. Which of the following findings indicates that the client is coping effectively? A. The client utilizes strategies to enhance codependent behaviors. B. The client attends regular counseling sessions.

64. A nurse in a clinic is reviewing the health history of a client during her first prenatal visit. Which of the following findings indicates a risk for gestational diabetes mellitus? A. 1-hr glucose tolerance test if 128 mg/dL B. Previous miscarriage C. Delivery of a low birth-weight infant D. BMI of 31
65. A nurse is caring for a client who is incontinent and has a stage II pressure injury on their coccyx. Which of the following interventions should the nurse implement? A. Apply lotion to the skin every 4 hr. B. Reposition the client every 3 hr. C. Position the client laterally at 30 degrees. D. Have two facility personnel help to slide the client up in bed.
66. A nurse manager is developing a protocol for an urgent care clinic that often cares for clients who do not speak the same language as the clinic staff. Which of the following instructions should the nurse include? A. Offer clients translation services for a nominal fee. B. Use clients’ children to provide interpretation. C. Evaluate clients’ understanding at regular intervals. D. Direct questions to a medical interpreter.
67. A nurse is caring for an infant who is in contact isolation and received a blood transfusion. Which of the following actions is appropriate for the nurse to provide cost-effective care? A. Leave the unused infusion pump in the room until discharge. B. Bring in formula as needed. C. Return unopened equipment to the supply center. D. Stock the room with a 2-day supply of disposable diapers.
68. A nurse is caring for a client who has acute exacerbation of multiple sclerosis. Which of the following prescriptions should the nurse expect the provider to prescribe? A. Interferon beta-1a B. Enoxaparin C. Atorvastatin D. Amoxicillin
69. A nurse is speaking with the partner of a client who is in the early stage of Alzheimer’s disease. The partner tells the nurse that she is able to manage the client’s physical care, but she doesn’t want to

leave him home alone while she travels for work. Which of the following referrals should the nurse make? A. Respite care B. Restorative care C. Hospice D. Rehabilitation facility

70. A nurse is assessing a school-age child who has moderate dehydration due to diarrhea and vomiting. Which of the following manifestations should the nurse expect? A. Orthostatic hypotension B. Decreased respirations C. Polyuria D. Bradycardia
71. A nurse is caring for a client who is at 14 weeks of gestation and reports feelings of ambivalence about being pregnant. Which of the following responses should the nurse make? A. “When did you start having these feelings?” B. “Have you discussed these feelings with your partner?” C. “You should discuss your feelings about being pregnant with your provider.” D. “Describe your feelings to me about being pregnant.”
72. A nurse manager is planning to promote client advocacy among staff on a medical unit. Which of the following actions should the nurse plan to take? A. Instruct unit staff to share personal experiences to help clients make decisions. B. Encourage staff to implement the principle of paternalism when a client is having difficulty making a choice. C. Develop a system for staff members to report safety concerns in the client care environment. D. Tell staff to explain procedures to clients before obtaining informed consent.

73. A nurse received a telephone call from a parent reporting that their school-age child has

a nosebleed and that they cannot stop the bleeding. Which of the following instructions

should the nurse provide for the parent?

A. “Place a warm, wet washcloth over your child’s forehead and the bridge of their nose.”

B. “Tell your child to blow their nose gently, and then sit down and tilt their

head backward.”

C. “Use your thumb and forefinger to apply pressure to the sides of your child’s nose.”

D. “Have your child lie down and turn their head to the side for 10 minutes.”

D. Listen to the client’s lung sounds.

79. A nurse in an acute mental health facility is prioritizing care for multiple clients. Which of

the following clients should the nurse see first?

A. A client who has obsessive-compulsive disorder and is upset about change in

daily routine

B. A client who has depressive disorder and requires assistance with ADLs

C. A client who has narcissistic personality disorder and is mocking others during

group therapy

D. A client who is taking clozapine to treat schizophrenia and reports a sore throat

80. A charge nurse is educating a group of unit nurses about delegating client tasks to assistive

personnel (AP). Which of the following statements should the nurse include in the

teaching? A. “The RN evaluates client needs to determine tasks to delegate.”

B. “An AP can perform tasks outside of his range of function if he has been trained.”

C. “An experienced AP can delegate tasks to another AP.”

D. “The RN is legally responsible for the actions of the AP.”

81. A nurse in an emergency department is caring for a client who reports cocaine use 1 hr

ago. Which of the following findings should the nurse expect?

A. Memory loss

B. Hypotension

C. Elevated temperature

D. Slurred speech

82. A nurse administered 400mg of ibuprofen to a client 2 hr ago to treat pain following a

biopsy. The client is crying and states, “It really still hurts a lot.” Which of the

following actions should the nurse take?

A. Administer an additional dose of ibuprofen to the client.

B. Request a prescription for an opioid pain medication for the client.

C. Report this client finding to the provider.

D. Ask the client to rate their pain on a scale of 0 to 10.

83. A nurse is planning care for an older adult client who has dementia. Which of the

following interventions should the nurse include in the plan of care? (SATA)

A. Allow the client to choose among a variety of activities each day.

B. Refute the client’s delusions using logic.

C. Establish eye contact when communicating with the

client. D. Reinforce orientation to time, place, and person.

E. Give the client one simple direction at a time.

84. A nurse is providing nutritional teaching to a client who is experiencing severe nausea.

Which of the following responses by the client indicates an understanding of the

teaching?

A. “I should increase my intake of liquids with

meals.” B. “I should focus on eating complex

carbohydrates.”

C. “I should lie down after my meals.”

D. “I should sip on clear carbonated beverages that have gone flat.”

85. A nurse is providing teaching about disulfiram to a client who has alcohol use

disorder. Which of the following statements should the nurse make?

A. “Wait at least 12 hr after your last drink to take this medication.”

B. “Alcohol should not be consumed for 3 days following your last dose.”

C. “This medication will decrease your risk for delirium during your withdrawal

from alcohol.”

D. “This medication will prevent seizures during your withdrawal from alcohol.”

86. A nurse is assessing a client following an ischemic stroke. Which of the following findings

is the priority for the nurse to report to the provider?

A. The client reports a metallic taste in his mouth.

B. The client has poor-fitting dentures.

C. The client reports a decreased

appetite. D. The client coughs after

swallowing.

87. A nurse is creating a plan of care for a client who has paranoid personality disorder

and refuses to take their medication. Which of the following interventions should the

nurse include in the plan?

A. Limit the client’s opportunities to socialize with others.

B. Mix the medication with the client’s food items.

C. Rotate staff members caring for the client.

D. Speak in a neutral tone when addressing the client.

D. Obtain the client’s magnesium level.

93. A nurse is reviewing the laboratory results of a client who is taking cyclosporine following

a kidney transplant. Which of the following findings should the nurse report to the

provider?

A. BUN mg/dL

B. Urine specific gravity 1.

C. Serum creatinine 1.6 mg/dL

D. Urine pH 6.

94. A nurse is caring for a client who is on fall precautions. Which of the following actions

should the nurse take?

A. Allow the client to walk unassisted near the nursing

station. B. Establish an elimination schedule for the client.

C. Silence the bed alarm when visitors are at the client’s bedside.

D. Raise all four bed rails on the client’s bed.

95. A nurse on a medical-surgical unit is caring for a client who states that she plans to leave

the facility against medical advice. For which of the following actions by the nurse should

the charge nurse intervene?

A. Asks security to detain the client until the provider is notified.

B. Asks the client what her plans are for follow-up care.

C. Shows the client her abnormal laboratory results.

D. Asks the client to sign a form releasing the hospital from legal responsibility.

96. A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone

(SIADH). Which of the following nursing interventions should the nurse include in the plan

of care for this client?

A. Flush IV tubing with hypotonic solution.

B. Encourage oral hydration of 1,800mL

daily C. Perform neurologic checks.

D. Weigh the client weekly.

97. A nurse is using an IV pump for a newly admitted client. Which of the following

actions should the nurse take?

A. Check the cords of the IV pump for fraying.

B. Grasp the IV pump cord when unplugging it from the electrical outlet.

C. Remove the safety inspection sticker before plugging in the IV pump.

D. Ensure that the electric outlet has two prongs for the IV pump.

98. A nurse manager is planning to teach staff about critical pathways. Which of the

following information should the nurse plan to include?

A. Nurses should discontinue the critical pathway if variances occur.

B. Nurses’ notes are used to create the critical pathway.

C. Critical pathways should reduce health care costs.

D. Critical pathways have an unlimited timeframe for completion.

99. A nurse is providing teaching to a client who has otitis media and is 1 hr postoperative

following a myringotomy. Which of the following statements should the nurse include in

the teaching?

A. “You should not drink through a straw for 2 weeks.”

B. “You can wash your hair 3 days after the procedure.”

C. “You should blow your nose with your mouth closed.”

D. “You should expect excessive ear drainage for about 48 hours.”

100. A nurse is teaching a newly licensed nurse about incidents reports. Which of

the following statements by the newly licensed nurse indicates an understanding of

the teaching?

A. “They assist with unit quality improvement.”

B. “They are used as a disciplinary tool for nurse evaluations.”

C. “They assist the facility to achieve benchmark goals.”

D. “They are mandatory government documentation.”

101. A nurse is caring for a client who has experienced a stroke and is moving in with their

adult child. Which of the following actions should the nurse encourage the client and

family to take as they adjust to their new roles?

A. Decrease socialization with extended relatives until roles are identified.

B. Encourage authoritative communication from the adult child.

C. Minimize open discussion regarding the changes to avoid

embarrassment. D. Implement firm but flexible boundaries in their

relationship.