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Worksheetsadult two Rn nursing final fall 2025
Total questions: 150
Worksheet time: 1hrs 15mins
Which feature best distinguishes Type 1 Diabetes from Type 2 Diabetes?
Autoimmune beta-cell destruction causing insulin deficiency
Initial therapy with oral antihyperglycemics
Progressive insulin resistance with lifestyle factors
Onset in adulthood with obesity and genetics
Which statement accurately characterizes Type 2 Diabetes?
Sudden onset in childhood with ketoacidosis
Progressive insulin resistance with decreased insulin production
Autoimmune process requiring lifelong exogenous insulin
Complete absence of circulating insulin at diagnosis
Which insulin is described as long-acting in the material?
Glargine Lantus long acting
Regular insulin short acting
Premixed 70/30 intermediate
Lispro Novolog rapid acting
For patients starting pharmacologic management of Type 2 Diabetes, what typical sequence is described?
Begin sliding scale, then add oral agents
Start oral antihyperglycemics, then sliding scale
Immediate basal-bolus insulin regimen
Diet only until A1C normalizes
When a hospitalized patient is NPO, how should mealtime insulin be handled?
Continue prandial insulin only
Hold insulin set around mealtimes
Switch to oral agents temporarily
Double basal insulin dose
What blood glucose level triggers the Rule of 15 for hypoglycemia?
Under 70 mg/dL
Under 80 mg/dL
Under 90 mg/dL
Under 60 mg/dL
Which is an appropriate initial treatment under the Rule of 15?
30g complex carbs with protein
15g fast sugar like 4 oz juice
10g fiber with whole grains
IV dextrose for all cases
After giving 15g of fast-acting carbohydrate, what is the next step?
Recheck glucose in 5 minutes
Recheck glucose in 15 minutes
Administer IM glucagon immediately
Contact physician without recheck
If hypoglycemia persists after two to three cycles of the Rule of 15, what should be done?
Contact the physician for further orders
Begin IV insulin infusion
Stop treatment and observe
Switch to complex carbohydrates only
Which option is listed as a nursing intervention for hypoglycemia in the hospital?
Increase basal insulin overnight
High-protein snack without sugar
Glucose tablets or IM glucagon
IV insulin bolus to stabilize BG
For blood glucose under 40 mg/dL, which treatment is indicated?
Oral complex carbohydrates
IV dextrose is required
Give long-acting insulin
Increase basal insulin dose
Which pathophysiologic statement best describes DKA?
Excess insulin drives glucose into cells rapidly
Lack of insulin prevents glucose entry, fat breakdown yields ketones
High insulin causes hepatic glycogenolysis and lactic acidosis
Hyperglycemia from oral agents leads to osmotic diuresis only
Which clinical signs are associated with DKA in the material?
Polys, weight loss, ketone breath, AMS
Hypertension and fluid overload
Hypothermia and miosis
Bradycardia and pinpoint pupils
Which respiratory pattern is classically noted in DKA?
Cheyne–Stokes respirations
Kussmaul’s deep rapid breathing
Biot’s irregular respirations
Apneustic prolonged inspiration
Which lab or monitoring caution is highlighted in DKA care?
Monitor calcium; falsely low in acidosis
Monitor potassium; may be falsely elevated
Monitor sodium; always normal in DKA
Avoid frequent blood glucose checks
Which is a priority treatment step in DKA management listed?
Fluid replacement then IV insulin
High-protein diet before insulin
Restrict fluids to prevent edema
Immediate long-acting insulin injection
Which vascular complication of diabetes is mentioned?
Pulmonary embolism from DVT
Cerebral hemorrhage from aneurysm
Temporal arteritis with vision loss
Arteriosclerosis leading to MI
Which microvascular complication may result in blindness?
Diabetic retinopathy
Peripheral angiopathy
Autonomic neuropathy
Diabetic nephropathy
Which complication is linked to poor wound healing and possible amputation?
Hyperthyroidism and weight gain
Polycythemia causing thrombosis
Migraine headaches from vasospasm
Immunosuppression and infection risk
Which fasting plasma glucose range best represents normal values for adults without diabetes?
70–99 mg/dL
100–125 mg/dL
140–160 mg/dL
126–139 mg/dL
At what A1C value is diabetes diagnosed in most adults?
6.5% or higher
6.4%
7.5% or higher
5.7%
Which A1C range is typically classified as prediabetes?
7.1–7.5%
6.5–7.0%
5.7–6.4%
4.0–5.6%
Which sign is most characteristic of pneumonia sputum?
Thick white sputum
Clear thin sputum
Bloody frothy sputum
Green or rust-colored sputum
An older, debilitated patient with pneumonia is most likely to present with which atypical feature?
Early confusion or stupor
Persistent nasal discharge
Marked bradycardia
Severe pleuritic pain
Which nursing action helps prevent pneumonia in at-risk adults?
Routine vitamin C
Daily bronchoscopy
Annual chest CT
Vaccination against pneumococcus
Antibiotic treatment for bacterial pneumonia typically reduces temperature and improves breathing within what timeframe?
5–7 days
24–36 hours
48–72 hours
12–24 hours
Which nursing measure supports secretion clearance in pneumonia?
Adequate hydration and intake monitoring
Fluid restriction
High-dose diuretics daily
NPO until afebrile
Which COPD symptom pattern is most typical during exertion?
Dyspnea improves on exertion
Breathlessness only when supine
No breathlessness but chest pain
Dyspnea occurs and progressively worsens
Which physical finding aligns with advanced COPD?
Barrel chest and tripod position
Pectus excavatum and bradycardia
Kyphosis with clear lungs
Sunken chest with hyperventilation
Which complication of COPD is linked to pulmonary hypertension leading to right-sided heart failure?
Left ventricular failure
Cardiogenic shock
Aortic stenosis
Cor pulmonale
During COPD exacerbation, which medication class provides rapid bronchodilation as first-line therapy?
Nitrate vasodilator
Systemic antifungal agent
Short-acting beta agonist
Long-acting beta agonist
For stable COPD, which oxygen saturation target is commonly used to avoid CO2 retention risk?
SpO2 80–84%
SpO2 96–100%
SpO2 88–92%
SpO2 92–96%
Which nutrition advice is appropriate for COPD to reduce fatigue during meals?
Large meals high in fiber
Small frequent high-calorie meals
Skip meals before exercise
Low-calorie liquid diet only
Which statement best defines pneumothorax?
Fluid in pleural space
Air entering pleural cavity
Collapse from mucus plugs
Blood filling alveoli
Which scenario describes an open pneumothorax?
Shift of mediastinum to opposite side
Rupture of a bleb internally
No external wound present
Opening in chest wall allowing air
A penetrating trauma with a sucking chest wound corresponds to which type of pneumothorax?
Spontaneous pneumothorax
Open pneumothorax
Closed pneumothorax
Iatrogenic pneumothorax
Which cause is most consistent with a spontaneous pneumothorax?
Gunshot to chest wall
Central line placement
Rupture of a subpleural bleb
Ventilator barotrauma
Which finding signals a tension pneumothorax requiring emergent decompression?
Small apical bleb only
Minimal pleural air without shift
Mediastinal shift with tracheal deviation
Stable mediastinal position
For suspected tuberculosis, which nursing precaution is essential during patient care?
Airborne isolation with N95 respirator
Droplet isolation with surgical mask
Contact isolation with gown only
Protective isolation with HEPA room
Which diagnostic test directly confirms active pulmonary tuberculosis by detecting acid-fast bacilli?
PPD skin test induration measure
Chest X-ray for cavitary lesions
Sputum smear and culture for Mycobacterium
Interferon gamma release assay
A patient taking rifampin reports orange urine and tears. What is the best nursing response?
Reassure as expected harmless effect
Stop drug due to renal toxicity
Increase fluid intake aggressively
Collect urine for culture testing
During thoracentesis, which nursing action is a priority before the procedure?
Place patient supine with legs raised
Administer diuretics to reduce fluid
Start high-flow oxygen immediately
Verify informed consent and explain
Which position best facilitates thoracentesis for pleural fluid removal?
Left lateral decubitus fully recumbent
Prone with pillow under abdomen
Sitting upright leaning on bedside table
Supine with head elevated
After thoracentesis, which finding requires urgent provider notification?
New hypoxia and absent breath sounds
Mild site tenderness without crepitus
Slight cough with clear sputum
Low-grade fever resolving overnight
What is a primary indication for thoracentesis in a patient with pleural effusion?
Assess diaphragmatic movement by ultrasound
Measure cardiac output using thermodilution
Evaluate airway edema after intubation
Obtain fluid specimens or instill medications
In flail chest, which clinical sign reflects paradoxical chest wall motion?
Segment moves inward on inspiration
Segment bulges outward on inspiration
Entire chest expands symmetrically
No movement with deep breathing
Immediate management priorities for flail chest focus on which goals?
Early ambulation, incentive spirometry only
Broad antibiotics, sputum induction, bronchoscopy
Aggressive diuresis, fluid restriction, bed rest
Adequate ventilation, lung expansion, pain control
Which oxygen delivery device typically provides 1–6 L/min flow?
Venturi mask precise fixed flow
Nasal cannula standard low flow
Nonrebreather mask high flow
Simple face mask moderate flow
A simple face mask generally delivers what flow range for oxygen therapy?
Six to ten liters per minute
One to two liters per minute
Ten to fifteen liters per minute
Three to four liters per minute
Which device is used when high concentration oxygen is urgently needed?
Nonrebreather mask at ten to fifteen
Nasal cannula at one to three
Simple mask at four to six
Face tent at low variable
Which pathophysiology best characterizes Graves' disease in hyperthyroidism?
Pituitary failure causing low TSH secretion
Iodine deficiency leading reduced hormone levels
Viral thyroiditis causing transient inflammation
Autoimmune antibodies stimulate hormone overproduction
Which symptom cluster aligns with hypermetabolic hyperthyroidism presentation?
Myxedema, hyporeflexia, hoarseness
Weight gain, constipation, fatigue
Cold intolerance, bradycardia, dry skin
Heat intolerance, tremor, exophthalmos
Which nursing strategy helps minimize energy expenditure in severe hyperthyroidism?
Promote rest and limit stimulation
Encourage strenuous exercise daily
Provide high-caffeine beverages
Increase room temperature markedly
Which medication pair is commonly used to block thyroid hormone synthesis in hyperthyroidism?
Methimazole and propylthiouracil
Hydrocortisone and fludrocortisone
Levothyroxine and liothyronine
Metformin and acarbose
After thyroidectomy for Graves' disease, which teaching is accurate for long-term care?
Periodic short courses of antithyroid drugs
Lifelong thyroid hormone replacement required
Stop all thyroid medications immediately
Avoid all iodine-containing foods forever
When using radioactive iodine ablation, which home precaution reduces exposure to others?
Flush toilet twice and separate laundry
Share utensils to maintain intake
Sleep closely with children at night
Stop handwashing to protect skin
Which presentation most suggests thyroid storm emergency in hyperthyroidism?
Mild fever, nasal congestion, myalgia
Profound hypothermia, bradycardia, lethargy
Severe hyperthermia, delirium, tachyarrhythmia
Localized rash, pruritus, mild swelling
In thyroid storm with abdominal pain and chest pain, which supportive measure is appropriate while awaiting definitive therapy?
Acetaminophen for fever and cool bath
Aspirin to reduce fever and pain
Warm blankets to prevent chills
High-dose beta-carotene infusion
Which symptom profile most strongly suggests hypothyroidism in an adult patient?
Hypertension, jitteriness, insomnia
Bradycardia, cold intolerance, weight gain
Tachycardia, heat intolerance, oily skin
Polyuria, polydipsia, fruity breath
A patient with hypothyroidism develops myxedema coma. Which immediate nursing action is most appropriate?
Provide warm blankets and oral fluids
Initiate IV levothyroxine and support ventilation
Administer oral levothyroxine at bedtime
Restrict fluids and give loop diuretics
Which finding is characteristic of Cushing's disease due to excess cortisol?
Moon face, buffalo hump, central obesity
Tetany, carpopedal spasm, low calcium
Severe weight loss, salt craving, hypotension
Dry brittle hair, hyperpigmentation patches
Which diagnostic approach aligns with nursing care for suspected Cushing's disease?
High-dose dexamethasone suppression test
Random fasting capillary glucose testing
Morning serum T3 and T4 comparison
Electrolyte panel only without cortisol
Which medication regimen is part of medical management for Cushing's disease?
Ketoconazole or mitotane therapy
Metformin with basal insulin
Fludrocortisone with salt tablets
Levothyroxine titration weekly
Which symptom cluster best indicates Addison's disease (primary adrenal insufficiency)?
Hyperpigmentation, low blood pressure, weight loss
Hypertension, truncal obesity, thin skin
Palpitations, exophthalmos, heat intolerance
Edema, moon face, purple striae
Which test result pattern is consistent with primary adrenal insufficiency using ACTH stimulation testing?
Secondary rise greater than baseline
Primary rise in cortisol after ACTH
No significant rise in cortisol after ACTH
Immediate overshoot and hypertension
During an adrenal crisis, which immediate treatment priority is correct?
Start beta-blocker and restrict sodium foods
Administer thiazide diuretic and monitor ECG
Give IV dextrose and hydrocortisone replacement
Begin radiation and ketoconazole therapy
Which nursing intervention prevents DVT most effectively in the first 24 hours after surgery?
Strict bed rest with leg elevation only
Use warm packs on calves routinely
Apply sequential compression devices early
Limit ambulation until day three
Which action supports prevention of postoperative pneumonia?
Avoid coughing to reduce incision pain
Encourage deep breathing and incentive spirometry
Restrict fluids to limit secretions accumulation
Delay ambulation until chest x-ray is clear
Which is a recognized risk factor for developing DVT or PE?
Young age with daily running
Recent surgery or hospitalization
Routine multivitamin supplementation
High-fiber diet and hydration
Which postpartum consideration increases risk for venous thromboembolism?
Frequent ambulation with baby
Physiologic hypercoagulability state
Breastfeeding dehydration risk
Low estrogen in lactation
Which patient characteristic increases DVT risk and warrants prophylaxis?
Vegetarian diet preference
Adolescent without comorbidities
Long-distance runner weekly
Older adult with immobility
Which family history detail raises concern for future PE risk?
Sibling with previous DVT events
Aunt with resolved ankle sprain
Parent with seasonal allergies only
Grandparent with dental caries
Which medication class can elevate risk for DVT formation?
Probiotics for gut flora
Topical antifungals for nails
Estrogen-containing therapies
Antihistamines for rhinitis
Which clinical signs most strongly indicate acute DVT in a lower extremity?
Cool pale foot with weak pulses
Swelling, pain, warmth, redness
Numbness without visible changes
Dry skin with pruritus patches
A postoperative patient has SCDs applied. Which additional action enhances DVT prevention?
Apply ice packs to calves
Use cough suppressants routinely
Maintain NPO for 48 hours
Ambulate early and frequently
Which nursing monitoring priority supports early pneumonia detection after surgery?
Inspect incision every shift only
Record BMI at discharge only
Check urine output every four hours
Assess mentation and lung sounds regularly
A patient on prolonged bed rest reports calf tenderness and warmth. What is the best immediate nursing response?
Apply high heat packs to the area
Encourage brisk ambulation right away
Massage the calf to relieve pain
Stop activity and notify the provider
Which combination best represents comprehensive postoperative DVT prophylaxis?
High-dose diuretics, strict NPO status
Bed rest, fluid restriction, leg elevation
Reposition Q2H, early ambulation, SCDs
Heat therapy, calf massage, opioid use
A patient develops sudden shortness of breath, chest pain, tachycardia, and coughs up blood after surgery. Which complication is most likely?
Atelectasis due to shallow breathing only
Aspiration pneumonia with alveolar collapse
Pneumothorax from central line insertion
Pulmonary embolism causing impaired perfusion
Which finding best indicates wound dehiscence in a postoperative patient?
Large raised hypertrophic scar
Pink serosanguineous drainage
Intestines protruding from incision
Separation of approximated wound edges
Evisceration is most accurately described as which event?
Abnormal passage between organs
Bands of scar tissue forming
Excess granulation above surface
Protrusion of intestines from wound
Which wound complication involves an abnormal passage between the skin and internal organs?
Fistula formation connecting tissues
Adhesions causing tissue bands
Contractions leading deformity
Infection with local erythema
Which wound discharge is correctly paired with its description?
Purulent indicates clear watery
Serous indicates thick purulent
Serousanguineous indicates green
Sanguineous indicates bloody fluid
A postoperative dressing shows clear watery fluid. Which discharge type is this?
Serous drainage with minimal cells
Serosanguineous mixed pink
Sanguineous from capillary bleed
Purulent from draining abscess
Which color of drainage most likely suggests a gallbladder source?
Green or bile-stained output
Yellow straw-colored serum
Brown fecal-contaminated fluid
Blue dye from sentinel node
Normal arterial pH range is best recalled as which values?
7.35 to 7.45 physiologic range
7.25 to 7.35 stable range
7.45 to 7.55 alkaline range
7.10 to 7.20 acid range
A pH of 7.30 indicates which acid–base status?
Fully compensated physiology
Acidosis below normal limit
Alkalosis above expected range
Metabolic balance without change
Which parameter is primarily respiratory in the acid–base system?
Serum HCO3 of 22–26
PaCO2 values of 35–45
Oxygen saturation 95–100
Arterial pH of 7.35–7.45
Which bicarbonate range reflects normal metabolic component?
O2 between 90–94 percent
HCO3 between 22–26 mEq/L
pH between 7.45–7.55
CO2 between 35–45 mmHg
In metabolic acidosis, which initial compensatory direction should ventilation take?
Administer oxygen to fix bicarbonate
Hold breath to raise bicarbonate
Reduce respiratory rate to retain CO2
Increase respiratory rate to blow off CO2
Which electrolyte disturbance is characterized by numbness and tingling around the mouth, stridor, dysphagia, and dysrhythmias?
Hypocalcemia causing neuromuscular irritability
Hypernatremia causing fluid deficit
Hypokalemia causing muscle weakness
Hypercalcemia causing confusion
Which is a common cause of hypercalcemia in adults?
Massive blood transfusion only
Severe hyponatremia episodes
Chronic loop diuretic therapy
Hyperparathyroidism or malignancy
Which nursing consideration best addresses severe hypercalcemia?
Administer potassium supplements
Dilute IV magnesium slowly
Restrict fluids and give NS 3%
Hydrate and consider bisphosphonates
Which symptom cluster most aligns with hyponatremia from fluid overload?
Weight gain, hallucinations, polyuria
Thirst, restlessness, lethargy, coma
Headache, irritability, confusion, seizures
Muscle cramps, tetany, stridor signs
Which intervention is appropriate for severe symptomatic hyponatremia?
Large free water intake at once
Fluid restriction and hypertonic saline
Administer bisphosphonates IV
Increase potassium-rich foods
Which findings most suggest hypernatremia due to fluid volume deficit?
Weakness, polyuria, bone pain
Perioral tingling, stridor, tetany
Bradycardia, hypotension, diarrhea
Thirst, AMS, drowsy, restlessness
Which clinical picture fits hypokalemia?
Hyperreflexia and hallucinations
Muscle weakness and dysrhythmias
Bradykinesia with confusion
Polyuria with high calcium
What is a key nursing consideration when giving IV potassium for hypokalemia?
Always dilute and use infusion pump
Give rapid IV push if severe
Administer intramuscular bolus
Withhold fluids to concentrate
Which clinical picture most strongly indicates hyperkalemia requiring urgent management?
Bradycardia, tetany cramps, dry skin
Tall peaked T waves, muscle cramps, diarrhea
Flat T waves, ileus, weak reflexes
Hypotension, flushing, diminished reflexes
Initial pharmacologic intervention for severe hyperkalemia with ECG changes is most appropriate with which combination?
Oral phosphate binder plus calcium gluconate
IV insulin with dextrose plus cardiac monitoring
IV magnesium sulfate plus fluid bolus
PO calcium carbonate with loop diuretic
Hypophosphatemia commonly presents with which constellation of findings?
Hypotension, flushing, impaired deep tendon reflexes
Tetany cramps, hypotension, seizures
CNS depression, muscle weakness, respiratory failure risk
Fatigue, confusion, tetany, muscle cramps
Hyperphosphatemia is most often associated with what underlying condition and complication?
Malnutrition causing CNS depression
Chronic alcohol use leading to hypocalcemia
Diuretic therapy causing muscle paralysis
Acute kidney injury causing tetany cramps
A patient with chronic alcoholism presents with fluid loss and starvation. Which electrolyte imbalance is likely and how does it mimic another?
Hypophosphatemia that looks like hypercalcemia
Hyperphosphatemia that looks like hyponatremia
Hypomagnesemia that looks like hypocalcemia
Hypermagnesemia that mimics hyperkalemia symptoms
Which findings are most consistent with hypermagnesemia?
Peaked T waves, muscle cramps, diarrhea
CNS depression, respiratory failure risk
Hypotension, flushing, diminished reflexes
Tetany cramps, hypotension, seizures
Key property of chemotherapy agents relevant to administration safety is best described as:
Systemic non-cytotoxic drugs targeting hair follicles
Local cytotoxic medications damaging cell DNA
Immune modulators enhancing neutrophil counts
Radiation beams shrinking tumors preoperatively
Which tissue systems are most commonly affected by chemotherapy toxicity?
Endocrine glands, cartilage, ocular lens
Mucosal lining, gastrointestinal tract, bone marrow
Peripheral nerves, liver parenchyma, spleen
Renal cortex, myocardium, pancreas
Best practice when handling vesicant chemotherapeutic drugs includes which action?
Remove gloves to improve dexterity
Draw up meds at bedside without a hood
Crush PO pills using a pill crusher
Avoid skin contact and use central line
Which statement about oral chemotherapy handling is correct?
Do not crush pills to avoid exposure risk
Split tablets to adjust daily dosing
Always crush pills to ease swallowing
Open capsules to reduce mucosal toxicity
Which requirement is essential for nurses administering chemotherapy?
Chemotherapy administration certification
Advanced cardiac life support certification
Phlebotomy technician credential
Radiation safety operator license
Radiation therapy uses which core mechanism to target malignant cells?
Ionizing radiation to damage cellular DNA
Thermal ablation to coagulate proteins
Ultrasound waves to disrupt membranes
Phototherapy to induce apoptosis
Teletherapy is best described as which radiation modality?
Internal administration of radioactive pellets
External beam radiation delivered from a machine
Surface brachytherapy using topical sources
Systemic radioisotopes circulating in blood
Which adverse effects are commonly associated with external beam radiation?
Tetany cramps, hypotension, seizures
Peaked T waves, abdominal cramps, diarrhea
Hypertension, flushing, hyperreflexia
Skin changes, hair loss, debilitating fatigue
Brachytherapy differs from external beam radiation in that it:
Delivers internal radiation to tumor tissues
Uses systemic agents to increase ANC
Shrinks tumors before surgery externally
Applies non-ionizing radiation to skin only
Which safety instruction is critical for staff if a brachytherapy pellet dislodges?
Flush it down the toilet immediately
Place it in patient’s pocket for transport
Do not touch; call radiation safety
Pick it up quickly with bare hands
Neutropenic precautions should begin when ANC falls below which threshold?
800 cells per microliter
1500 cells per microliter
1200 cells per microliter
1000 cells per microliter
Which measure is appropriate for transporting a patient with neutropenia?
Patient wears a mask during transport
No mask; avoid hand hygiene
Staff restrict masks to visitors only
Use gloves but avoid patient masking
Dietary teaching for a patient on oral chemotherapy with neutropenia should prioritize:
Avoiding unwashed fruits and raw meats
Fasting one day weekly to rest gut
Increasing uncooked seafood for protein
Consuming raw eggs to boost immunity
Which visitor policy aligns with neutropenic precautions?
Encourage all visitors without screening
Restrict visitors who are ill or contagious
Allow children visitors preferentially
Permit unlimited visitors in small rooms
Which element is included in the five rights of delegation?
Right medication brand selection
Right diagnosis for the care plan
Right insurance coverage for patient
Right person for the specific task
Which task is appropriate to delegate to another RN rather than a CNA?
Interpret telemetry for rhythm changes
Measure blood pressure post-surgery assessment
Perform sterile wound dressing change
Feed pudding containing crushed medications
Which task is appropriate for a CNA/assistive personnel under delegation?
Administer IV insulin for hyperkalemia
Monitor ECG for peaked T waves
Feed a patient pudding with no medications
Start chemotherapy via central line
Which feature best distinguishes acute pain from chronic pain in clinical assessment?
Always neuropathic with allodynia present
Persists over six months with sudden onset
Occurs intermittently with no identifiable triggers
Duration less than three months with clear cause
A patient reports pain at 4/10 and requests medication. Which initial action aligns with safe pain management?
Delay treatment until pain reaches 8/10
Assess pain characteristics before administering
Administer opioid immediately without assessment
Offer chocolate pudding for distraction
Which statement about chronic pain is most accurate?
Often starts gradually with flares and isolation
Always has a well-defined biologic cause
Never associated with depression or anxiety
Resolves completely within three months
Which medication is an opioid analgesic commonly used for severe pain?
Acetaminophen for neuropathic pain
Morphine for severe nociceptive pain
Aspirin for procedural sedation
Ibuprofen for breakthrough cancer pain
Which non-opioid is over-the-counter for mild pain management?
Oxycodone immediate-release for fever
Fentanyl transdermal for mild pain
Hydromorphone prescription-only opioid
Acetaminophen available over-the-counter
Which adverse effect is most associated with opioid therapy requiring monitoring?
Tinnitus with prolonged use
Hypoglycemia after meals
Photosensitivity during summer
Respiratory depression after dosing
A patient-controlled analgesia (PCA) device requires which safety feature?
Lockout interval to prevent overdosing
Dual tubing for faster infusion
Continuous boluses by caregiver
Unlimited dosing on demand
Which monitoring priority applies to a patient using PCA with opioids?
Assess sedation and respiratory rate regularly
Avoid documenting pain scores
Encourage family to press the button
Restrict fluids to avoid hypotension
Using the ABC prioritization, which patient should be seen first?
Hypertension after medication
Fever 38.3°C without distress
Stridor with cyanosis and dyspnea
Request for restroom assistance
Which finding indicates a breathing problem needing urgent attention?
Accessory muscle use with decreased O2
Mild ankle edema after walking
Warm skin and bounding pulses
Normal respiratory rate and SpO2
Which circulation assessment suggests compromised perfusion?
Strong peripheral pulses
Stable heart sounds throughout
Pallor with cool clammy skin
Pink warm skin tone
A CAN caring for eight patients hears screaming from a room. Which action reflects correct prioritization?
Check the screaming patient immediately
Continue passing water to stable clients
Deliver chocolate pudding to another patient
Empty a foley bag first for routine care
Which PPE is required for airborne precautions?
Gloves only for varicella
Gown only for MRSA
Surgical mask for influenza
N95 respirator for TB care
Which illnesses require droplet precautions with masks and gloves?
VRE colonization
Influenza and pertussis cases
C. difficile with diarrhea
TB and measles patients
Which organisms call for contact precautions including gowns and gloves?
C. difficile, MRSA, VRE
Mumps, rubella, varicella
Measles, varicella, TB
Influenza, pertussis, RSV
Which sequence represents the nursing process?
Diagnose plan evaluate assess chart
Evaluate assess implement diagnose act
Plan implement diagnose assess treat
Assess diagnose plan implement evaluate
Which step is critical before administering blood products?
Verify patient identity and product
Preload with opioid analgesia
Avoid baseline vital signs
Use droplet PPE routinely
Who is the universal red cell donor for transfusions?
Type B negative universal donor
Type AB positive universal donor
Type O negative universal donor
Type A positive universal donor
Which blood type is the universal plasma recipient?
A negative as universal recipient
O negative as universal recipient
B positive as universal recipient
AB positive as universal recipient
Which initial step is essential before starting a blood transfusion?
Start transfusion at full rate
Verify consent and blood band
Warm the blood to body temp
Give diuretics prophylactically
Which fluid should be used to prime IV tubing for blood transfusion?
Sterile water
Lactated Ringer’s
Dextrose five percent
Normal saline only
What is the recommended initial infusion rate when starting packed red blood cells?
Titrate to patient urine output
Run slowly at 50–75 mL/h
Begin at 150–200 mL/h
Bolus first 250 mL fast
Within what time frame should a standard blood transfusion be completed?
Within four hours total
Within eight hours total
Over two separate days
Within one hour total
During the first 15 minutes of a transfusion, what nursing action is required?
Increase rate to target flow
Prepare next blood unit
Leave to obtain medications
Stay at bedside to monitor
Which set of symptoms most strongly suggests an acute transfusion reaction?
Fever, chills, itching, dyspnea
Nausea, diarrhea, myalgias
Polyuria, thirst, confusion
Bradycardia, pallor, tinnitus
After stopping a transfusion for reaction, which priority is correct?
Switch to dextrose infusion
Remove IV catheter promptly
Maintain IV access with NS
Start oral fluids and rest
Which medication set is commonly used to treat mild transfusion reactions?
Acetaminophen and diphenhydramine
Furosemide and digoxin
Morphine and ondansetron
Prednisone and metformin
Which finding is most characteristic of iron deficiency anemia?
Chronic blood loss etiology
Vitamin B12 excess cause
Renal failure pathogenesis
Hemolysis due to antibodies
Which clinical sign is commonly associated with iron deficiency anemia?
Pica and glossitis present
Jaundice and pruritus
Petechiae and hemarthrosis
Tetany and hyperreflexia
