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NUR112 Final Exam Practice

Total questions: 169

Worksheet time: 2hrs 59mins

Name
Class
Date
1.

An accumulation of tissue fluid in the alveoli of the lungs:

a)

pulmonary edema

b)

pneumonia

c)

pleural effusion

d)

pulmonary thromboembolism

2.

Inelasticity of the lungs due to chronic inflammation and scarring of the lung tissue:

a)

pleuritis/pleurisy

b)

pneumothorax

c)

pneumonia

d)

emphysema

3.

Disease characterized by inflamed, narrow airways that make it difficult for air to pass through.

a)

COPD

b)

Pulmonary Edema

c)

Pneumothorax

d)

Asthma

4.

what are the first symptoms of pneumonia?

a)

chest pain when you breathe or cough, confusion or changes in mental awareness, cough that will include phlegm, fatigue, fever, sweating and shaking chills, lower than normal body temp, nausea, vomiting, diarrhea, and shortness of breath

b)

chess pain when u breathe or cough, confusion or changes in mental awareness, cough that will include phlegm, fatigue, fever, sweating and shaking chills, lower than normal body temp, nausea, vomiting, diarrhea, and shortness of breath

c)

chest pain when you breathe or coff, confusion or changes in mental awareness, coff that will include phlegm, fatigue, fever, sweating and shaking chills, lower than normal body temp, nausea, vomiting, diarrhea, and shortness of breath

d)

chest pain when you breathe or cough, confusion or changes in mental awareness, cough that will include phlegm, fatigue, fever, sweating and shaking chills, lower than normal body temp, nausea, vomiting, diarrhea

5.

What is pleuritic chest pain?

a)

Pain that worsens when you sit down

b)

Pain that hurts when you poke your chest

c)

Pain that hurts more on the affected side

d)

Pain that gets worse when breathing

6.
Which of the following products blocks the production of stomach acid? 
a)
Zantac (ranitidine)
b)
Tums (Calcium carbonate)
c)
Pepto Bismol (Bismuth subsalicylate)
d)
Mylanta (Aluminum hydroxide) 
7.
Which of the following medications has the longest duration of action? 
a)
Magnesium hydroxide + aluminum hydroxide
b)
Ranitidine
c)
Omeprazole + sodium bicarbonate
d)
Famotidine + Calcium Carbonate
8.
Which medication can start working within 5 minutes?
a)
Ranitidine
b)
Esomeprazole
c)
Cimetidine 
d)
Calcium carbonate
9.

Which medication has an onset of action of 30 minutes?

a)

Famotidine

b)

Omeprazole

c)

Sodium Bicarbonate

d)

Calcium Carbonate

10.

Most common etiologic factor for appendicitis

a)

tumors

b)

lymphoid hyperplasia

c)

fecalith

d)

vascular compromise

11.

In this step, the patient's identification, surgical site marking, signed consent and procedure to be done are all verified

a)

time out

b)

consent

c)

anethesia record

d)

operating technique

12.

You are the recovery room nurse who is admitting a patient from the OR. What is the first assessment you would make on a newly admitted patient?

a)

heart rate

b)

nail perfusion

c)

airway patency

d)

core temperature

13.

You admit a patient to the PACU who has undergone a surgical procedure that required the use of general anesthesia. What is the patient most at risk for following general anesthesia?

a)

Anemia

b)

Dehydration

c)

Atelectasis

d)

Peripheral edema

14.

You admit a patient to the postanesthesia care unit with a blood pressure of 130/90 and a pulse of 68 beats per minute. After 30 minutes, the patient's blood pressure is 120/65, and the pulse is 100. You document the patient's skin as cold, moist, and pale. What is the patient showing signs of?

a)

Hypothermia

b)

Hypovolemic shock

c)

Neurogenic shock

d)

Malignant hypothermia

15.

You are the nurse caring for 82-year-old women in the PACU. The woman begins to awaken and responds to her name but is confused, restless, and agitated. What are you aware of?

a)

Postoperative confusion is an indication of an oxygen problem or possibly a stroke during surgery.

b)

Confusion, restlessness, and agitation are normal postoperative findings and will diminish in time.

c)

Postoperative confusion is common in the elderly, but it could also indicate a significant blood loss.

d)

Confusion, restlessness, and agitation indicate inadequate pain management, and analgesics will help.

16.

A 38-year-old patient has just been admitted to the PACU following abdominal surgery. As the patient begins to awaken, he is restless and asking for "a drink of water." The nurse checks his skin and it is cold, moist, and pale. What is the nurse concerned the patient may be at risk for?

a)

Hemorrhage and shock

b)

Loss of airway and hypotension

c)

Pain and anxiety

d)

Hypertension and dysrhythmias

17.

What things must you take into consideration while anesthetizing a patient? More than one answer is possible.

a)

Pregnancy

b)

Age

c)

Social history

d)

Psychological diagnostic

e)

Medical History

18.

Because general anesthetics affect the CNS, patients may feel:

a)

normal immediately after awakening from anesthesia

b)

overly alert and excited after anesthesia

c)

drowsy, weak, or tired for as long as a few days after having general anesthesia

d)

drowsy, weak, or tired for up to 24 hours after having general anesthesia

19.

When teaching a patient about foods high in magnesium, the nurse would include:

a)

Green vegetables

b)

Butter

c)

Cheese

d)

Tomatoes

20.

The type of fluid used to manipulate fluid shifts among compartments states is:

a)

Whole Blood

b)

Total Parentral Nutrition

c)

Albumin

d)

Ensure

21.

A nurse is reviewing lab reports. The nurse recalls blood plasma is located in which of the following fluid compartments?

a)

Intracellular fluid (ICF)

b)

Extracellular fluid (ECF)

c)

Interstitial fluid

d)

Intravascular fluid

22.

While planning care for elderly individuals, the nurse remembers the elderly are at a higher risk for developing dehydration because they have a(n):

a)

Higher total body water volume

b)

Decreased muscle mass

c)

Increase in thirst

d)

Increased tendency towards developing edema

23.

Water movement between the ICF and ECF compartments is determined by:

a)

Osmotic forces

b)

Plasma oncotic pressure

c)

Antidiuretic hormone

d)

Buffer systems

24.

When planning care for a dehydrated patient, the nurse remembers the principle of water balance is closely related to _____ balance.

a)

Potassium

b)

Chloride

c)

Bicarbonate

d)

Sodium

25.

A nurse is teaching the staff about antidiuretic hormone (ADH). Which information should the nurse include? Secretion of ADH is stimulated by:

a)

Increased serum potassium

b)

Increased plasma osmolality

c)

Decreased renal blood flow

d)

Generalized edema

26.

Which statement by the staff indicates teaching was successful concerning aldosterone? Secretion of aldosterone results in:

a)

Decreased plasma osmolality

b)

Increased serum potassium levels

c)

Increased blood volume

d)

Localized edema

27.

A 5-year-old male presents to the ER with delirium and sunken eyes. After diagnosing him with severe dehydration, the primary care provider orders fluid replacement. The nurse administers a hypertonic intravenous solution. Which of the following would be expected?

a)

Symptoms subside quickly

b)

Increased ICF volume

c)

Decreased ECF volume

d)

Intracellular dehydration

28.

Which of the following patients is the most at risk for developing hypernatremia? A patient with:

a)

Vomiting

b)

Diuretic use

c)

Dehydration

d)

Hypoaldosteronism

29.

A 60-year-old female is diagnosed with hyperkalemia. Which assessment finding should the nurse expect to observe?

a)

Weak pulse

b)

Excessive thirst

c)

Oliguria

d)

Constipation

30.

Which of the following buffer pairs is considered the major plasma buffering system?

a)

Which of the following buffer pairs is considered the major plasma buffering system?

b)

Carbonic acid/bicarbonate

c)

Sodium/potassium

d)

Amylase/albumin

31.

For a patient experiencing metabolic acidosis, the body will compensate by:

a)

Excreting H+ through the kidneys

b)

Hyperventilating

c)

Retaining CO2 in the lungs

d)

Secreting aldosterone

32.
Hypernatremia due to all the list below, except
a)
Excess water intake
b)
Sweating
c)
Diabetes insipidus
d)
Burns
33.

Renal failure would likely lead to

a)

volume depletion.

b)

hypotonicity.

c)

volume excess.

d)

hypertonic ascites.

34.

The stimuli that trigger the release of ADH are

a)

high blood pressure, high blood volume, and high blood osmolarity.

b)

high blood pressure, low blood volume, and low blood osmolarity.

c)

low blood pressure, low blood volume, and high blood osmolarity.

d)

low blood pressure, high blood volume, and high blood osmolarity.

35.

When comparing a lean adult female to a lean adult male, which will most likely have a higher percentage of body fluid?

a)

MALE

b)

FEMALE

36.

The bicarbonate system is composed of H2CO3 and HCO3-. Which statement accurately describes these molecules?

H2CO3 is a strong base, and HCO3- is a weak acid.

a)

H2CO3 and HCO3- are both weak acids.

b)

H2CO3 is a weak acid, and HCO3- is a weak base.

c)

H2CO3 is a weak base, and HCO3- is a weak acid.

d)

H2CO3 and HCO3- are both strong bases.

e)

H2CO3 is a strong base, and HCO3- is a weak acid.

37.

When blood starts to become too acidic, the kidneys respond by

a)

synthesizing and secreting bicarbonate ions while reabsorbing H+.

b)

synthesizing and reabsorbing H+ while filtering bicarbonate ions.

c)

synthesizing and reabsorbing bicarbonate ions while secreting H+.

d)

decreasing filtration rate and increasing reabsorption of both bicarbonate ions and H+.

e)

increasing filtration rate and increasing reabsorption of H+.

38.

If someone begins to hyperventilate due to anxiety, the CO2 concentration in their blood decreases; this causes __________ in blood pH.

a)

an increase

b)

a decrease

c)

no change

39.

The most abundant anion in the extracellular fluid is

negatively charged proteins.

a)

phosphate.

b)

chloride.

c)

hydrogen.

d)

acetic acid.

40.

The plasma of our blood constitutes ______ than half of the fluid in our body; plasma is part of the _____________ fluid.

a)

more; intracellular

b)

more; extracellular

c)

less; intracellular

d)

less; extracellular

41.

In this pH scale, the pH is 7.0

a)

Neutral

b)

Acidic

c)

Basic/Alkaline

42.

In this pH scale, have an equal concentration of H+ and OH-

a)

Neutral

b)

Acidic

c)

Basic/Alkaline

43.

In this pH scale, has a pH below 7.0

a)

Neutral

b)

Acidic

c)

Basic/Alkaline

44.

In this pH scale, has a greater number of H+

a)

Neutral

b)

Acidic

c)

Basic/Alkaline

45.

In this pH scale, has a pH above 7.0

a)

Neutral

b)

Acidic

c)

Basic/Alkaline

46.

In this pH scale, has fewer H+

a)

Neutral

b)

Acidic

c)

Basic/Alkaline

47.

How does body maintain pH

a)

Buffer System

b)

Respiration

c)

Kidneys

d)

Liver

48.

this pH balance system ____________ secretes H+ and regulates H+ in blood and pH is regulated

a)

Buffer System

b)

Respiration

c)

Kidneys

d)

Liver

49.

In pH balance of Respiration, cells produce CO2 which is dissolved in the blood and forms...

a)

carbonic acid

b)

Bicarbonate

c)

H+

d)

H-

50.

In pH balance of Respiration, cells produce CO2 which is dissolved in the blood and forms carbonic acid and it _______ blood pH

a)

Lowers

b)

raises

51.

In pH balance of Respiration, cells produce CO2 which is dissolved in the blood and forms carbonic acid and it lowers blood pH which stimulates.......

a)

breathing

b)

RBC production

c)

carbon dioxide

d)

H2O

52.

what is true about buffers when maintaining pH

a)

buffers are weak acids

b)

buffers are weak bases

c)

They release H+

d)

They accept H+

e)

The prevent changes in pH

53.

in pH balance system, Carbonic acid-bicarbonate is an example of...

a)

Buffer System

b)

Respiration

c)

Kidneys

d)

Liver

54.

What is true about carbonic acid-bicarbonate buffering system [in maintaining pH balance]

a)

Most common buffering system in blood and other body fluids

b)

Carbonic acid (h2CO3) is a weak acid that releases H+ when pH is rising

c)

Bicarbonate (HCO3-) is a weak base that accepts H+ when pH is dropping

d)

Carbonic acid (h2CO3)is a weak base that accepts H+ when pH is dropping

e)

Bicarbonate (HCO3-) is a weak acid that releases H+ when pH is rising

55.
Which two electrolytes are involved in bone strength, health and development? 
a)
Calcium & Phosphate
b)
K+ and Cl- 
c)
Calcium & Magnesium 
d)
Sodium & Phosphate 
56.

Hypovolemia refers to a condition resulting from:

a)

dehydration caused by loss of intracellular and extracellular fluids

b)

water losses that are greater than electrolyte losses

c)

excessive loss of equal proportions of extracellular fluid and electrolytes

d)

excessive loss of electrolytes in greater proportions than the loss of fluids

57.

Prime the blood transfusion set with:

a)

Ringer’s Lactate

b)

D5 1/2 Normal Saline

c)

0.9% Normal Saline

d)

0.45% Normal Saline

58.

The duration of a transfusion should not exceed "x" hours post issue from the blood bank

a)

3

b)

3.5

c)

4

d)

4.5

59.

If you suspect a transfusion reaction, your first steps are to

a)

stop the transfusion and flush the tubing with 10cc NS and call the provider.

b)

reduce the rate of transfusion to < 2.5 mLs/kg/hr and complete an assessment and then call the provider.

c)

stop the transfusion, disconnect the tubing, and flush at the hub.

d)

reduce the rate of transfusion to KVO and call the provider.

60.

Signs and symptoms of Transfusion Associated Circulatory Overload (TACO) include

a)

sudden shortness of breath, acute cyanosis and cardiac arrhythmia.

b)

fever, urticaria, bronchospasm and local edema.

c)

dyspnea, cough, tachycardia, and hypertension.

61.

The "Four Checks" completed at the bedside are: Order, Product, Patient, Pump.

a)

True

b)

False

62.

Is known as a Long Basal Acting Insulin?

a)

Gargline

b)

Detemir

c)

NPH

d)

Lispro

63.

Is Known As a Basal Intermediate Acting Insulin

a)

Regular Insulin

b)

Gargline

c)

NPH

d)

Lispro

64.

Is consider as a Postpandrial short acting insulin

a)

Lispro

b)

Degludec

c)

Aspart

d)

Gargline

e)

Regular Insulin

65.

Her onset is 15-30 minutes and peak is 0.5-1.5 hours with a duration of 3-5 hours.

a)

Regular insulin

b)

NPH

c)

Lispro

d)

Gargline

66.

her onset is 30-60 minutes her peak is 1-5 hours and has a duration of 6-10 hours?

a)

Isophane

b)

Lispro

c)

Regular

d)

Gargline

67.

Has a onset of 3-4 hours, does not have any peak and a duration of 24 hours.

a)

Lispro

b)

Isophane

c)

Aspart

d)

Gargline

68.

Which Insulin is known as Cloudy Insulin?

a)

Regular

b)

Gargline

c)

NPH

d)

Aspart

69.

How to prepare the insulin using Humalin R and Humalin N

a)

1-Inject Air into Humalin NPH Cloudy Solution.

2-Draw up Humalin Regular  (Clear solution)

3-Inject Air in the Humalin Regular Clear Solution.

4-Draw Up Humalin NPH  (Cloudy Solution)

b)

1-Inject Air into Humalin NPH Cloudy Solution.

2-Draw up Humalin Regular  (Clear solution)

3-Draw Up Humalin NPH  (Cloudy Solution)

4-Inject Air in the Humalin Regular Clear Solution.

c)

1-Inject Air in the Humalin Regular Clear Solution.

2-Draw up Humalin Regular  (Clear solution)

3-Draw Up Humalin NPH  (Cloudy Solution)

4-Draw up Humalin Regular  (Clear solution)

d)

1-Inject Air into Humalin NPH Cloudy Solution.

2-Inject Air in the Humalin Regular Clear Solution.

3-Draw Up Humalin NPH  (Cloudy Solution)

4-Draw up Humalin Regular  (Clear solution)

e)

1-Inject Air into Humalin NPH Cloudy Solution.

2-Inject Air in the Humalin Regular Clear Solution.

3-Draw up Humalin Regular  (Clear solution)

4-Draw Up Humalin NPH  (Cloudy Solution)

70.
Masculinization of females
a)
Hirsutism
b)
Virilism
c)
Goiter
d)
Cushing's
71.
Autoimmune disease of the thyroid
a)
Cushing's
b)
Hashimoto's
c)
Addisons
d)
Graves disease
72.
Excess urine production and extreme thirst due to undersecretion of ADH
a)
Cushing's
b)
diabetes insipidus
c)
Graves disease
d)
acromegaly
73.
Hypersecretion of adrenal cortex. Bronze skin, water and electrolyte problems.
a)
Cushing's 
b)
Addisons
c)
Graves
d)
Hashimoto's
74.
Hypersecretion of  adrenal cortex hormone, leading to moon face, high blood pressure, hyperglycemia, and diabetes, 
a)
Addison's
b)
Cushing's
c)
Hashimoto's
d)
Grave's
75.
Hypersecretion of thyroid hormones in an adult. Leads to high metabolism and bulging eyes.
a)
Addison's
b)
Cushing's
c)
Grave's
d)
Hashimoto's
76.
a)
Grave's
b)
Cushing's
c)
Addison's
d)
Goiter
77.
a)
too much cortisol
b)
not enough cortisol
c)
too much thyroxine (T4)
d)
too much calcitonin
78.

Insulin inhibits the release of what

a)

Glucagon

b)

ADH

c)

Beta cells

d)

Somatostatin

79.

in a diet for diabetes you must limit your intakes of..(choose 3)

a)

salt

b)

sugar

c)

Simple carbohydrates

d)

carbohydrates

e)

Saturated fats

80.

If you suspect a transfusion reaction, your first steps are to

a)

stop the transfusion and flush the tubing with 10cc NS and call the provider.

b)

reduce the rate of transfusion to < 2.5 mLs/kg/hr and complete an assessment and then call the provider.

c)

stop the transfusion, disconnect the tubing, and flush at the hub.

d)

reduce the rate of transfusion to KVO and call the provider.

81.

The doctor must inform the patient about surgery and obtain written consent.

a)

True

b)

False

82.

The handoff report to the PACU nurse should include which of the following?

a)

Patient Name

b)

Surgical Procedure

c)

Current Medications and Allergies

d)

All Of The Above

83.

The PACU nurse assess the patient's:

a)

Airway

b)

Breathing

c)

Circulation

d)

All Of The Above

84.

Which health care provider informs the patient of the benefits and risks of surgery prior to going to surgery?

a)

Registered Nurse

b)

Surgeon

c)

OR administrator

d)

Licensed Physicians Assistant

85.

Deep breathing is an important pre-operative teaching area. Which one of the following would be included in your teaching for the pre-operative patient?

a)

Take a deep breath and hold for 5 seconds, repeat 15 times twice daily

b)

Take a deep breath and hold for 10 seconds

c)

Take a deep breath and hold for 3 seconds, repeat 15 times twice daily

d)

Take a deep breath and hold for 5 seconds, repeat 5 times twice daily

86.

The patient who is considered at risk for surgical complications is...

a)

A patient with arthritis

b)

A patient with HTN (hypertension)

c)

A dehydrated patient

d)

A patient who smokes

87.

Which of the following are goals of Preoperative Evaluation?

a)

Identification of comorbid conditions

b)

Assessment of perioperative risk

c)

Procurement of informed consent

d)

All of the following

88.

Informatics is the use of information and technology to (Choose all that apply)

a)

Communicate

b)

Manage knowledge

c)

Mitigate error

d)

Support decision making

89.

Solution used for IV fluid replacement fall into 2 categories

(i) Crytalloids

(ii) Colloids

a)

True

b)

False

90.

Crystalloids are solution with small molecules that flow easily from the bloodstream into the tissues. Examples: isotonic, hypotonic & hypertonic

a)

True

b)

False

91.
Isotonic solutions are good for
a)
dehydration
b)
rescusistation
c)
repalcement
d)
all of the above
92.
The most abundant extracellular electrolyte
a)
Cl
b)
HCO3-
c)
Na
d)
Mg
93.

Complications of IV therapy include infiltration, extravasation, phlebitis, thrombophlebitis, localized infection, septicemia, severed cannula, air embolism, circulatory fluid overload, and speed shock.

a)

T

b)

F

94.

The difference(s) between a primary IV administration set and a secondary IVPB administration set include(s) which of the following?

a)

The secondary IVPB administration set is used for administering IV push medication.

b)

The primary IV administration set always has a drop factor of 60.

c)

The primary IV administration set is longer than the secondary IVPB administration set.

d)

The secondary IVPB administration set has a drip chamber for visualizing the drip rate, while the primary administration set does not.

e)

There is no difference except the drop factor.

95.

Hypovolemia refers to a condition resulting from:

a)

dehydration caused by loss of intracellular and extracellular fluids

b)

water losses that are greater than electrolyte losses

c)

excessive loss of equal proportions of extracellular fluid and electrolytes

d)

excessive loss of electrolytes in greater proportions than the loss of fluids

96.
The most commonly used type of fluid is
a)
crystalloid
b)
colloid
c)
plasma
d)
vetstarch
97.
Crystalloids are classified as
a)
isotonic
b)
hypotonic
c)
hypertonic
d)
all of the above
98.
Hypotonic fluids
a)
are maintained in the vasculature
b)
move out to the cells
c)
stay equally in the vascualture and cells
d)
go the third spaces
99.
Hypertonic solutions are not good for
a)
dehydrated patients
b)
hypotensive patients
c)
hemoorhaging patients
d)
head trauma
100.
Colloids are
a)
large particles
b)
stay in the vasculature
c)
help with vascular volume
d)
all of the above
101.
______________________ is the amount of force required to keep water in a compartment
a)
tonicitiy
b)
osmotic pressure
c)
osmolality
d)
hydrostatic
102.
The major osmotically active particle is
a)
chloride
b)
potassium
c)
magnesium
d)
sodium
103.
Maintenance fluids have ___________ sodium than plasma
a)
more
b)
less
c)
equal
d)
no
104.

A nurse is reviewing lab reports. The nurse recalls blood plasma is located in which of the following fluid compartments?

a)

Intracellular fluid (ICF)

b)

Extracellular fluid (ECF)

c)

Interstitial fluid

d)

Intravascular fluid

105.

While planning care for elderly individuals, the nurse remembers the elderly are at a higher risk for developing dehydration because they have a(n):

a)

Higher total body water volume

b)

Decreased muscle mass

c)

Increase in thirst

d)

Increased tendency towards developing edema

106.

A 5-year-old male presents to the ER with delirium and sunken eyes. After diagnosing him with severe dehydration, the primary care provider orders fluid replacement. The nurse administers a hypertonic intravenous solution. Which of the following would be expected?

a)

Symptoms subside quickly

b)

Increased ICF volume

c)

Decreased ECF volume

d)

Intracellular dehydration

107.

Which of the following patients is the most at risk for developing hypernatremia? A patient with:

a)

Vomiting

b)

Diuretic use

c)

Dehydration

d)

Hypoaldosteronism

108.

Which of the following patients is the most at risk for developing hypernatremia? A patient with:

a)

Vomiting

b)

Diuretic use

c)

Dehydration

d)

Hypoaldosteronism

109.

A 60-year-old female is diagnosed with hyperkalemia. Which assessment finding should the nurse expect to observe?

a)

Weak pulse

b)

Excessive thirst

c)

Oliguria

d)

Constipation

110.

Which of the following buffer pairs is considered the major plasma buffering system?

a)

Which of the following buffer pairs is considered the major plasma buffering system?

b)

Carbonic acid/bicarbonate

c)

Sodium/potassium

d)

Amylase/albumin

111.

For a patient experiencing metabolic acidosis, the body will compensate by:

a)

Excreting H+ through the kidneys

b)

Hyperventilating

c)

Retaining CO2 in the lungs

d)

Secreting aldosterone

112.

The appropriate fraction of body weight that is attributed to water is more than:

a)

one-fourth

b)

one half

c)

two-thirds

d)

three-fourths

113.

The normal serum pH is:

a)

7.25 to 7.35

b)

7.35 to 7.45

c)

8.15 to 8.35

d)

8.35 to 8.55

114.

An elevated serum pH causes a condition known as:

a)

alkalosis

b)

acidosis

c)

equal bicarbonate

d)

neutral carbonic acid

115.

The acid-base balance is regulated by the lungs and the:

a)

cerebellum

b)

electrolytes

c)

kidneys

d)

liver

116.

The shift of calcium excess into the bone creates a condition known as:

a)

hyperkalemia

b)

hypervolemia

c)

hypocalcemia

d)

hyponatremia

117.

The patient with excess fluid volume will have blood pressure that is:

a)

elevated

b)

normal

c)

lowered

d)

even

118.

The nurse is aware that an infant is more at risk for dehydration because the infant:

a)

has kidneys that reabsorb water from the intravascular space.

b)

has a larger body surface compared with body weight.

c)

urinates more frequently.

d)

has fat that absorbs water.

119.

A patient has been identified as having a dietary deficiency of vitamin D. The nurse understands that this patient is also at risk for having a deficiency of:

a)

calcium.

b)

magnesium.

c)

sodium.

d)

potassium.

120.

A patient who is experiencing severe diarrhea is losing excessive bicarbonate ions. This patient is at risk for developing:

a)

respiratory alkalosis.

b)

respiratory acidosis.

c)

metabolic alkalosis.

d)

metabolic acidosis

121.

The body responds to low body fluid levels and increased osmolality with what actions?

a)

Diarrhea

b)

Diuresis

c)

Tears

d)

Thirst

122.

A patient with a chest tube has no fluctuation of water in the water seal chamber. What could be the cause of this?

a)

This is an expected finding.

b)

The lung may have re-expanded or there is a kink in the system.

c)

The system is broken and needs to be replaced.

d)

There is an air leak in the tubing.

123.

For a pneumothorax, a chest tube is inserted where?

a)

The eighth intercostal space

b)

The second intercostal space.

c)

On the proximal portion of the fifth intercostal space

d)

Distal to the injury

124.

During transport the chest tube gets disconnected from the CDU and cannot be reconnected, the nurse should immediately…

a)

Leave in place and contact the HCP

b)

Wrap in sterile gauze and secure with tape

c)

Immediately immerse in (2cm) sterile water

d)

Lift exposed in above the level of the patient's heart

125.

Tidaling is an expected finding in which chamber of CDU?

a)

Tidaling is an emergency and the HCP should be notified

b)

Water-seal chamber

c)

Suction control chamber

d)

Collection chamber

126.

Chest tubes reestablish what type of pressure?

a)

Peer pressure

b)

Positive pressure

c)

Med-Surg pressure

d)

Negative pressure

127.

What nursing intervention will you perform pre-and post suctioning in regard to Oxygen delivery?

a)

Hyperoxygenation

b)

Suction

c)

Nebulization

128.

Vigorous coughing, or manipulation of the tracheostomy can cause what complication?

a)

tachycardia

b)

infection

c)

accidental decannulation

129.

The rationale for providing adequate hydration for a client with a tracheostomy is...

a)

to prevent heart failure.

b)

to provide essential electrolytes.

c)

to thin the mucous secretions.

d)

to suppress the patients cough reflex.

130.
You are reviewing the results of an ABG. When the pH and the PaCO2 values are moving in opposite directions, the primary problem is: 
a)
Respiratory
b)
Renal
c)
Metabolic
d)
Compensation
131.
Which of the following may be a reason to order an ABG on a patient?
a)
The patient suddenly develops shortness of breath
b)
An asthmatic is starting to show signs of tiring
c)
A diabetic has developed Kussmaul respirations
d)
All of the above
132.
pH 7.38 pCO2 38 HCO3 24
a)
Respiratory alkalosis
b)
Normal
c)
Metabolic alkalosis
d)
None of the above
133.

Lab values: 7.25, paCO2 55, HCO3 45

a)

Respiratory acidosis

b)

Respiratory alkalosis

c)

Metabolic acidosis

d)

metabolic alkalosis

134.

What is the condition when you compensate by hyperventilating?

a)

Respiratory Acidosis

b)

Metabolic Acidosis

c)

Respiratory Alkalosis

d)

Metabolic Alkalosis

135.

What is the body's compensation when having Respiratory Acidosis?

a)

The kidney's excretes HCO3-

b)

Your lungs will hyperventilate

c)

The kidney's will reabsorb HCO3-

d)

Your lungs will hypoventilate

136.

pH= 7.55; pCO2= 55; HCO3= 55

a)

respiratory acidosis

b)

respiratory alkalosis

c)

metabolic acidosis

d)

metabolic alkalosis

137.

pH= 7.32; PCO2= 22; HCO3= 20

a)

respiratory acidosis

b)

respiratory alkalosis

c)

metabolic acidosis

d)

metabolic alkalosis

138.

pH= 7.28; pCO2= 48; HCO3= 25

a)

respiratory acidosis

b)

respiratory alkalosis

c)

metabolic acidosis

d)

metabolic alkalosis

139.

pH= 7.38 ; PCO3= 28; HCO3= 26

a)

respiratory acidosis

b)

respiratoty alkalosis

c)

metabolic acidosis

d)

metabolic alkalosis

140.
When an acid-base imbalance is caused by a metabolic disturbance, the pH and the HCO3 will move:
a)
In opposite directions
b)
Totally independent of each other 
c)
In the same direction
141.

Which abnormal value indicates a respiratory problem?

a)

pH

b)

HCO3-

c)

paCO2

142.

Which abnormal value indicates a metabolic problem?

a)

pH

b)

HCO3-

c)

paCO2

143.

Normal values for HCO3- or bicarbonate is:

a)

7.35-7.45

b)

22-26

c)

35-45

d)

4-5

144.

Normal values for paCO2 is:

a)

7.35-7.45

b)

22-26

c)

35-45

d)

4-5

145.

. Christoff is diagnosed with hypermagnesemia. Symptoms of her condition may include:

a)

hypertension

b)

tachycardia

c)

hyperactive deep-tendon reflex

d)

cardiac arrhythmias

146.

The nurse administers furosemide (Lasix) to treat a client with heart failure. This adverse effect must the nurse watch for most carefully.

a)

Increase in blood pressure

b)

Increase in blood volume

c)

Low serum potassium level

d)

High serum sodium level

147.

Tom is ready to be discharged from medical -surgical unit after 5 days of hospitalization. This statement indicates, Tom understands the discharge teaching given by the nurse.

a)

“I do not have to see my doctor unless I have problems”.

b)

“I can stop taking my antibiotics once I am feeling better”.

c)

“If I have redness, drainage or fever, I should call my healthcare provider.”

d)

“I can return to my normal activities as soon as I go home”.

148.

The most common reasons for IV therapy include all of these, EXCEPT

a)

To replace fluids and electrolytes

b)

To administer diagnostic reagants

c)

To restores circulating volumes

d)

To follow hospital policy when patient admit to the hospital.

149.

Postoperatively, a patient's fingers are cold and pale. What action should the nurse take?

a)

apply warm blankets

b)

check o2 saturation on finger

c)

encourage deep breathing

d)

check blood sugar

150.

A client with diabetes has a blood sugar of 300mg/dL and an Na+ of 133. What nursing intervention is indicated to manage the sodium with this lient

a)

Pad the side rails to protect from injury during possible seizure

b)

Notify dietary department to send salt tablets

c)

encourage the client to drink water

d)

monitor Na+ return to normal with lowering of blood sugar.

151.

What action is appropriate if a client has a K+ of 8 mEq/L ?

a)

NO change is required

b)

restrict intake of K+ and or give sodium polystyrene sulfonate (kayexalate)

c)

Restrict fluids to reduce K+

d)

Give Insulin, glucose, calcium and or bicarbonate STAT as ordered

152.

Which client has the GREATEST need for K+ replacement?

a)

A client with renal failure with a post-dialysis serum K+ of 3.4

b)

A patient with a large NG output who is receiving kayexalate with a serum K+ of 5.5

c)

A client with cardiac disease who is about to recieve furosemide with a K+ of 3.5

d)

A client with cardiac disease who is about to receive spironolactone with a K+ of 3.5

153.

Which aspect of care is most important for a client with diabetic neuropathy?

a)

Teach the client to inspect the feet using a mirror

b)

Teach the client to wash feet, then pat dry

c)

Have client moisturize feet with lotion to prevent dryness

d)

Teach the client to cut toenails straight across

154.

A client with diabetic ketoacidosis has been treated with an insulin drip for the past 3 hours. Which imbalance is this client at greatest risk for?

a)

hypovolemia

b)

hypokalemia

c)

hyponatremia

d)

hypoglycemia

155.

A nurse is observing a client for possible complications of postoperative peritonitis, which manifestations are MOST indicative of peritonitis? (select all that apply)

a)

Hyperactive bowel sounds

b)

Localized or diffuse pain

c)

abdominal rigidity

d)

shallow respirations

e)

Temperature over 102 F

156.

A client is admitted with mild symptoms of novel H1N1 Flu. Which family member is at greatest risk for developing the infection?

a)

The elderly grandmother

b)

A 6 yr old daughter

c)

the healthy 45 yr old spouse

d)

the 13 yr old son with asthma

157.

Which is the most common treatment for a client in addisonian crisis?

a)

IV normal saline and glucocorticoids

b)

IV lactated ringers and packed cells

c)

IV 5% dextrose in normal saline and dopamine

d)

IV total partenteral nutrion and insulin coverage

158.

When a client is on chemotherapy for which manifestations of bone marrow depression should a nurse continuously asses?

a)

Night sweats and fatigue

b)

Loss of skin turgor and weight loss

c)

low urine output and elevated BUN levels

d)

Ecchymosis, weakness, and fatigue

159.

A client is admitted to the hospital in a terminal stage of illness. At this time a nurse who is planning end of life care, should recognize that the client is most likely to fear:

a)

The terminal diagnosis

b)

Further chemotherapy

c)

being socially inadequate

d)

dying alone and in pain

160.

A client returns from an operating room. The client's IV is running at 150ml/hr; pulse is 90 and full; respirations are moist and wheezy. A nurse's INITIAL action should be to:

a)

speed up the IV and call the MD

b)

check the electrolyte levels

c)

report the IV rate to the charge nurse

d)

Slow down the IV and call the physician

161.

An indicator of worsening hypovolemic shock related to GI bleeding would be:

a)

decreased level of conciousness (LOC)

b)

complaints of abd pain with hematemisis

c)

deepening, rapid respirations

d)

increasinly rapid, thready pulse

162.

A nurse should expect that a client with a severe loss of potassium (hypokalemia) from diarrhea, will have:

a)

Fatigue, tetany, cardiac standstill

b)

Kussmaul's respirations, thirst, furrowed tongue

c)

muscle weakness, cramps, cardiac irritability

d)

Confusion, pitting edema, irregular pulse

163.

To promote maximum ventilation in a client who is postoperative, the nurse should:

a)

Auscultate breath sounds bilaterally

b)

Give humidified oxygen via nasal cannula

c)

maintain placement of airway until the client is awake

d)

position the client on the side with the neck extended

164.

The nurse should assess for hypercalcemia by checking a client for:

a)

Chvostek's sign

b)

Trousseau's sign

c)

Deep tendon reflex

d)

Babinski reflex

165.

Which nursing intervention should a nurse complete first for a client experiencing addisonian crisis?

a)

maintain a quiet nonstressful environment

b)

take measures to avoid exertion by the client

c)

administer hormone replacement as prescribed

d)

IV administraton of fluid glucose and electrolytes

166.

A client who is malnourished is admitted with a serum calcium level of 7.5. The nurse should:

a)

Administer glucocorticoids as ordered

b)

check urine for ketones

c)

check the serum albumin lab results

d)

administer neutra-phos as ordered

167.

Following a thyroidectomy, a nurse assesses for complications related to damage or removal of the parathyroid. The nurse should asses for:

a)

hypertension

b)

numbness around the mouth

c)

polyuria

d)

muscle weakness

168.

Which finding is consistent with a client developing fluid overload?

a)

pulse over 100

b)

pulmonary crackles that clear with deep breathing

c)

concentrated urine

d)

o2 saturation of less than 92%on 40% o2 via facemask

169.

A client with diabetes and hypertension has returned from surgery. Which nursing intervention will most likely reduce the risk of wound infection?

a)

monitor blood sugar and keep it under 200

b)

place the client in contact isolation

c)

administer prophylactic antibiotics 48 hours preoperatively as ordered

d)

administer glucocorticoid stress hormone replacements post op as orderd