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WorksheetsActivity Finals
Total questions: 80
Worksheet time: 7hrs 40mins
A diabetic ketoacidosis patient suddenly becomes drowsy. What is the nurse’s FIRST action?
Check blood glucose
Assess airway patency
Prepare IV fluids
Administer insulin
A postpartum woman with fever suspected of developing infection states she wants to breastfeed. What should the nurse do FIRST?
Encourage breastfeeding with proper hygiene
Assess severity of fever
Evaluate infant’s condition
Instruct on handwashing
A child with nephrotic syndrome has periorbital edema + decreased urine output. Which is PRIORITY?
Daily weights
Monitor respiratory effort
Evaluate proteinuria
Assess sodium intake
A patient receiving vancomycin develops flushing and hypotension. The nurse should FIRST:
Stop the infusion and assess the patient
Administer antihistamines
Increase the infusion rate
Call the physician immediately
A patient undergoing TURP reports bladder spasms. What is the BEST action?
Check catheter for kinks
Administer antispasmodic
Assess urine output
Encourage relaxation techniques
A patient with ulcerative colitis has abdominal distention + rigid abdomen. What should the nurse do FIRST?
Assess vital signs
Notify provider
Prepare for possible NG tube
Document findings
Which teaching is MOST important for a patient receiving prednisone?
Do not stop abruptly
Monitor for infection
Take with meals
Expect mood changes
A patient with suspected stroke arrives. FIRST action?
Slow the infusion
Stop the infusion
Assess airway
Check for wheezing
What is the best initial action to take in this scenario?
Check blood glucose
Establish last known well
Assess ABCs
Notify stroke team
A patient with thyroid storm is most at risk for:
High fever
Tachyarrhythmias
Heart failure
Seizures
A patient receiving blood transfusion develops chills. FIRST?
Stop transfusion
Maintain IV line with NS
Assess vital signs
Call physician
The MOST important reason to rotate insulin injection sites is to:
Prevent lipodystrophy
Promote insulin absorption
Reduce pain
Ensure optimal blood sugar control
Rheumatoid arthritis morning stiffness occurs because:
Overnight inflammation
Reduced joint movement
Autoimmune synovial damage
Joint effusion
The hallmark of multiple sclerosis is:
Demyelination
Autoimmune destruction
CNS plaques
Intermittent neurologic deficits
Priority teaching for a lupus patient?
Avoid sun exposure
Report sudden weight gain
Monitor for infection
Take meds as prescribed
BPH leads to urinary retention PRIMARILY due to:
Urethral compression
Increased prostate tissue
Smooth muscle hypertrophy
Age-related changes
UC patients often have bloody stools due to:
Ulceration
Increased motility
Bacterial infection
Medication side effects
Which of the following is the BEST answer?
Ulceration
Mucosal inflammation
Loss of protective lining
Capillary fragility
Transplant rejection occurs due to:
T-cell activation
MHC mismatch
Immune recognition of foreign tissue
Cytotoxic response
Type I hypersensitivity is mediated by:
IgE
Histamine
Mast cells
Basophils
Prostate cancer commonly metastasizes to:
Bone
Lymph nodes
Liver
Lung
The earliest sign of acute glomerulonephritis is usually:
Hematuria
Periorbital edema
Hypertension
Decreased urine output
A child with acute glomerulonephritis gained 1.5 kg overnight. FIRST action?
Assess lung sounds
Notify provider
Restrict fluids
Monitor BP
A lupus patient with facial rash is crying. Best immediate response?
Encourage expression
Provide sunscreen teaching
Assess for depression
Offer emotional support
MS patient reports blurred vision after exercising. Nurse should FIRST:
Encourage rest
Assess temperature
Provide cooling measures
Document symptoms
A diabetic patient about to exercise with glucose of 80 mg/dL should FIRST:
Take 15g carbohydrates
Recheck glucose after exercise
Delay exercise
Eat a full meal after exercise
UC patient on steroids is irritable and hungry. Best action?
Explain common side effects
Encourage small snacks
Assess sleep pattern
Check glucose
A BPH patient suddenly develops severe suprapubic pain. FIRST?
Assess for bladder distention
Insert catheter
Offer warm compress
Notify provider
A woman with PID has rebound tenderness. FIRST?
Assess for peritonitis
Check vitals
Prepare for IV antibiotics
Ask about last menstrual period
What is the best action to take?
Report immediately
Hold biologic therapy
Avoid crowds
Increase rest
A transplant patient misses 2 doses of tacrolimus. FIRST action?
Assess for rejection symptoms
Notify transplant team
Give missed dose
Check drug levels
A lung cancer patient suddenly becomes confused. FIRST action?
Check oxygen saturation
Assess medication list
Check glucose
Notify provider
A colon cancer post-op patient hasn't passed gas for 3 days. FIRST?
Assess bowel sounds
Encourage ambulation
Notify provider
Continue clear liquids
A stomach cancer patient vomiting blood should FIRST:
Assess hemodynamic status
Prepare for blood transfusion
Insert NG tube
Keep NPO
A Type 1 DM child vomits twice. Parent should FIRST:
Check ketones
Monitor glucose
Push fluids
Give insulin
A leukemia patient with ANC 400 develops fever. FIRST?
Initiate neutropenic precautions
Get blood cultures
Administer antibiotics
Assess vital signs
A thyroid cancer patient complains of numbness around mouth post-thyroidectomy. FIRST?
Check calcium
Assess airway
Notify surgeon
Provide calcium supplement
A prostate cancer patient has new severe back pain. FIRST?
Assess for spinal cord compression
Administer analgesics
Order MRI
Check bowel and bladder function
A lupus patient on steroids has black tarry stool. FIRST action?
Assess for GI bleeding
Stop steroids
Notify provider
Check hemoglobin
A UC patient having 15 stools/day. FIRST?
Assess hydration status
Review medications
Notify provider
Check electrolytes
A transplant patient with BP 90/50 + low urine output. FIRST?
Assess for rejection
Check hydration
Call transplant team
Review immunosuppressants
A MS patient with progressive weakness. FIRST?
Assess respiratory effort
Notify neurology
Encourage rest
Administer steroids
A patient undergoing breast cancer chemo asks, “Why do I need a central line?” The BEST response explains:
Reduced vein irritation
Long-term drug access
Ability to give vesicants safely
Easier blood draws
A patient with leukemia reports gum bleeding. Nurse must analyze FIRST:
Platelet count
Neutrophil count
Hemoglobin
Medication list
A SLE patient asks how to prevent flares. BEST advice:
Avoid sun
Reduce stress
Sleep adequately
Avoid infections
MS patient’s priority discharge teaching?
Avoid overheating
Pace activities
Prevent infections
Type 1 DM adolescent wants to skip insulin for weight loss. BEST response?
Discuss risk of DKA
Assess emotional state
Notify provider
Provide education
Evaluate which intervention is MOST effective for UC remission maintenance:
Consistent medication use
Balanced diet
Stress management
Adequate hydration
Which plan is BEST for preventing AGN complications?
Sodium restriction
BP monitoring
Daily weights
Infection prevention
Hypersensitivity patient with urticaria after antibiotics: BEST long-term prevention?
Avoidance of the offending antibiotic
Desensitization to the antibiotic
Use of antihistamines
Corticosteroid therapy
A. Document allergy clearly B. Wear medical alert bracelet C. Educate on avoidance D. Report to pharmacist
Document allergy clearly
Wear medical alert bracelet
Educate on avoidance
Report to pharmacist
RA patient choosing joint replacement. BEST pre-op teaching priority?
Infection prevention
Pain expectations
Post-op mobility
Medication management
Ovarian cancer patient with ascites: BEST long-term management plan?
Monitor abdominal girth
Restrict sodium
Prepare for paracentesis
Assess breathing
A patient with BPH reports new severe flank pain. What should the nurse suspect FIRST?
Hydronephrosis
Kidney stones
Urinary retention
Infection
A lupus patient develops dark urine and periorbital edema. FIRST concern?
Lupus nephritis
Fluid overload
Renal inflammation
Reduced GFR
An MS patient reports a sudden inability to move their right leg. Priority?
Assess for new lesions
Check for infection
Evaluate temperature
Assess muscle strength
A Type 1 DM patient with Kussmaul respirations is receiving IV fluids. Which intervention must occur FIRST?
Check potassium
Give IV regular insulin
Monitor glucose hourly
Initiate cardiac monitoring
A UC patient on sulfasalazine reports orange urine. Best nurse action?
Explain common effect
Assess hydration
Check liver enzymes
Encourage fluid intake
A patient with AGN has a BP of 160/110 mmHg. Priority action?
Assess for headache/LOC
Give antihypertensive
Restrict sodium
Monitor urine output
A patient with multiple food allergies reports lip tingling after eating salad. FIRST?
Assess airway
Administer epinephrine
Apply oxygen
Notify provider
A rheumatoid arthritis patient reports morning stiffness lasting more than 3 hours. What does this MOST likely indicate?
Disease flare
Increased inflammation
Medication failure
A heart transplant patient has a fever of 38.3°C and fatigue. FIRST action?
Assess for infection
Assess for rejection
Draw CBC
Notify transplant team
Which finding BEST indicates possible breast cancer metastasis to bone?
Lower back pain
Elevated calcium
Weakness
Limited mobility
A lung cancer patient suddenly develops hoarseness. The nurse suspects involvement of:
Recurrent laryngeal nerve
Nerve compression
Tumor metastasis
Local invasion
A colon cancer patient has ribbon-like stools. This suggests:
Obstruction
Tumor infiltration
Reduced lumen size
Advanced disease
A liver cancer patient has tense ascites. Which assessment is PRIORITY?
Respiratory rate
Abdominal girth
Skin integrity
Nutrition
A cervical cancer patient test positive for high-risk HPV. MOST important teaching?
Importance of pap smears
Infection transmission
Condom use
Vaccination of relatives
A patient after prostate cancer brachytherapy must be taught FIRST to:
Avoid close contact with pregnant women
Use condoms for a time
Strain urine
Hydrate well
A leukemia patient on chemotherapy has mouth ulcers. FIRST action?
Assess for neutropenia
Provide oral rinses
Encourage soft foods
Evaluate hydration
A thyroid cancer post-operative patient has stridor. FIRST action?
Prepare tracheostomy tray
Elevate HOB
Administer oxygen
Call rapid response
A stomach cancer patient becomes pale and dizzy. FIRST?
Check vital signs
Assess stool
Prepare fluids
Ensure safety
An ovarian cancer patient has new-onset SOB. Priority?
Assess for fluid overload
Evaluate ascites pressure
Assess lung sounds
Position upright
A PID patient is unable to tolerate food + severe abdominal tenderness. Priority?
Assess for peritonitis
Start IV fluids
Record abdominal girth
Provide analgesia
A BPH patient with continuous bladder irrigation has bright red urine. FIRST action?
Increase irrigation rate
Assess for clots
Notify provider
Assess vital signs
An SLE pregnant patient develops sudden RUQ pain. FIRST suspicion?
A. HELLP syndrome
B. Lupus flare
C. Preeclampsia
D. Hepatitis
MS patient on interferon therapy reports flu-like symptoms. Best action?
Teach pre-medication with NSAIDs
Evaluate injection technique
Assess hydration
Encourage rest
Type 1 DM patient becomes disoriented during exercise. FIRST?
Give fast carbs
Check glucose
Stop exercise
Call help
RA patient on long-term steroids should receive what annual screening FIRST?
Bone density testing
Eye exam
CBC
LFTs
Post-renal transplant patient has weight gain of 4 kg in 2 days. First step?
Assess for fluid retention
Assess graft tenderness
Check urine output
Review labs
A smoker with lung cancer reports shoulder pain radiating down the arm. Suggests:
Pancoast tumor
Locally advanced disease
Brachial plexus involvement
