Font size
Worksheets2121 Exam 1 OT pt.1
Total questions: 100
Worksheet time: 50mins
A nurse is assessing a 6-year-old with recurrent nosebleeds. Which finding is the most common cause of epistaxis in children?
Digital trauma from nose picking
Esophageal varices
Ruptured cerebral aneurysm
Hemophilia A
A client with COPD reports worsening symptoms. Which finding is expected?
Bradycardia with bounding pulse
Chronic productive cough
Inspiratory stridor with drooling
Sudden pleuritic chest pain after immobilization
A client’s calcium level is 7.6 mg/dL. Which manifestation should the nurse expect?
Constipation and lethargy
Flaccid weakness with hyporeflexia
Perioral tingling and muscle spasms
Polyuria with renal calculi
A nurse suspects fluid volume deficit in an older adult. Which assessment finding supports this?
Jugular venous distention
Crackles in both lung bases
Bounding peripheral pulses
Orthostatic hypotension
Which situation places a client at greatest risk for metabolic alkalosis?
Prolonged vomiting and NG suction
Diabetic ketoacidosis
Profuse diarrhea
Renal failure with uremia
A client receiving magnesium sulfate IV develops toxicity. Which assessment finding is most concerning?
Hyperactive deep tendon reflexes
Respiratory depression
Abdominal cramping
Tremors and tingling
A postoperative client has ABGs: pH 7.30, PaCO2 52 mm Hg, HCO3- 24 mEq/L. Which interpretation is correct?
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
A nurse is teaching a client about obstructive sleep apnea (OSA). Which statement indicates understanding?
“Antibiotics will cure my airway obstruction.”
“I should avoid exercise to prevent fatigue.”
“A bronchodilator is my first-line long-term treatment.”
“Using CPAP can help keep my airway open at night.”
A client reports new “curtain-like” vision loss in one eye. What is the nurse’s priority action?
Prepare the client for urgent ophthalmic evaluation
Teach the client to use artificial tears
Place a warm compress over the eye
Encourage the client to rest the eyes and reassess later
ABGs show: pH 7.50, PaCO2 28, HCO3- 24. Which imbalance is present?
Respiratory acidosis
Respiratory alkalosis
Metabolic alkalosis
Metabolic acidosis
A nurse is teaching about hearing changes in older adults. Which finding is most consistent with presbycusis?
Sudden hearing loss after a blast injury
Conductive loss from fluid in the middle ear
Gradual sensorineural hearing loss related to aging
Hearing loss that resolves after cerumen removal
Which description best explains the pathophysiology of primary open-angle glaucoma?
Sudden complete blockage of aqueous outflow
Inflammation of the optic nerve from infection
Increased tear production causing corneal edema
Decreased aqueous humor outflow at the trabecular meshwork
A client has sodium 122 mEq/L and is confused. Which provider order should the nurse implement first?
Initiate seizure precautions
Encourage oral free water intake
Administer hypotonic IV fluids
Place the client in Trendelenburg position
When performing the Rinne test, which result suggests conductive hearing loss in the tested ear?
Air conduction (AC) > bone conduction (BC)
AC = BC
BC > AC
No sound is heard by AC or BC
A child has fever, sore throat, and strawberry tongue. Which organism is most associated with this presentation?
Respiratory syncytial virus
Group A β-hemolytic streptococci
Mycoplasma pneumoniae
Candida albicans
A child is 8 hours postoperative after tonsillectomy. Which finding is most concerning for hemorrhage?
Refusal to drink cool liquids
Complaint of sore throat
White patches at tonsillar sites
Frequent swallowing and throat clearing
A client reports episodic vertigo, tinnitus, and a feeling of ear fullness. Which condition is most likely?
Ménière’s disease
Acute otitis media
Acute angle-closure glaucoma
Allergic rhinitis
A client is having an acute asthma attack with wheezing and dyspnea. Which medication should the nurse anticipate for rapid relief?
Montelukast
Fluticasone inhaler
Albuterol inhaler
Salmeterol inhaler
A client with COPD has thick secretions and difficulty expectorating. Which order best helps thin bronchial secretions?
Encourage increased oral fluids if not contraindicated
Restrict fluids to 1 L/day
Administer an antitussive routinely
Limit humidification to prevent infection
A client has potassium 6.2 mEq/L with peaked T waves. Which medication should the nurse expect first to stabilize cardiac membranes?
Sodium bicarbonate
Regular insulin with dextrose
Sodium polystyrene sulfonate
IV calcium gluconate
A client reports tingling around the mouth and has positive Trousseau sign after total thyroidectomy. Which complication is occurring?
Hyperkalemia
Hypocalcemia
Hypermagnesemia
Respiratory alkalosis
Which client is at highest risk for metabolic acidosis?
A client with prolonged vomiting
A client receiving loop diuretics
A client with acute anxiety and hyperventilation
A client with diabetic ketoacidosis
A client is prescribed a low-potassium diet. Which food should the client avoid?
White rice
Applesauce
Baked potato
Cucumber slices
A client has potassium 2.9 mEq/L. Which instruction is priority to include?
“Limit foods high in potassium.”
“Increase intake of potassium-rich foods.”
“Stop all cardiac monitoring.”
“Expect diarrhea and abdominal cramping.”
A school-age child has repeated epistaxis in winter. Which prevention teaching is best?
Apply a thin layer of petroleum jelly inside the nares
Use aspirin for pain to reduce inflammation
Forcefully blow the nose after bleeding stops
Pack the nostrils tightly with cotton daily
A client with COPD is most likely to report which symptom pattern?
Sudden onset high fever and pleuritic pain
Chronic cough and exertional dyspnea
Intermittent wheezing only with allergens
Inspiratory crackles that resolve with antibiotics
Which ECG change is most associated with hypocalcemia?
Shortened QT interval
Peaked T waves
Prolonged QT interval
Widened QRS with sine wave pattern
Which finding is most consistent with fluid volume deficit?
Increased skin turgor
Elevated BNP
Crackles and pink frothy sputum
Tachycardia with weak, thready pulse
Which medication history increases risk for metabolic alkalosis due to potassium depletion?
Chronic loop diuretic use
Metformin therapy
Heparin infusion
Acetaminophen use
A client on magnesium sulfate has absent patellar reflexes. Which medication should the nurse anticipate?
Sodium bicarbonate
Naloxone
Calcium gluconate
Potassium chloride
A postoperative client receiving opioids is somnolent with RR 8/min. Which acid-base change is most likely?
Respiratory acidosis from hypoventilation
Respiratory alkalosis from hyperventilation
Metabolic acidosis from diarrhea
Metabolic alkalosis from antacid use
Which client statement about OSA requires further teaching?
“Weight loss can improve my symptoms.”
“CPAP can reduce daytime sleepiness.”
“Alcohol at bedtime can worsen apnea.”
“Sleeping supine always prevents airway collapse.”
A client with suspected retinal detachment reports flashing lights and floaters. Which instruction is priority?
Avoid strenuous activity and seek urgent care today.
Use OTC antihistamine drops for itching.
Apply warm compresses four times daily.
Wear dark glasses and wait 48 hours.
ABGs: pH 7.20, PaCO2 58, HCO3− 24. Which imbalance is present?
Metabolic acidosis
Respiratory acidosis
Metabolic alkalosis
Respiratory alkalosis
Which client is at greatest risk for hearing impairment related to ototoxicity?
A client taking a loop diuretic
A client taking calcium carbonate
A client taking psyllium
A client taking sucralfate
Which manifestation is most associated with chronic open-angle glaucoma?
Sudden severe eye pain with nausea
Fixed mid-dilated pupil
Gradual peripheral vision loss
Rapid onset photophobia and purulent drainage
A client has sodium 118 mEq/L. Which provider order should the nurse question?
Seizure precautions
Fluid restriction
IV 3% sodium chloride as ordered
Encourage hypotonic fluids between meals
In a normal Rinne test, which finding should the nurse expect?
Bone conduction louder than air conduction
Air conduction louder than bone conduction
No sound heard by either method
Equal air and bone conduction
A child with confirmed group A strep pharyngitis is prescribed antibiotics. What is the primary purpose?
Prevent rheumatic fever
Prevent otitis externa
Prevent allergic rhinitis
Prevent cataracts
A child returns home after tonsillectomy. Which instruction is priority to reduce bleeding risk?
Use a straw for all liquids
Take ibuprofen every 6 hours scheduled
Perform vigorous gargling after meals
Avoid coughing, clearing the throat, and nose blowing
Which manifestation is most consistent with Ménière’s disease?
Vertigo with tinnitus and ear fullness
Purulent ear drainage with fever
Sudden complete loss of vision with pain
Unilateral facial droop with slurred speech
A client with acute asthma exacerbation is tachypneic and wheezing. Which order should the nurse implement first?
Administer albuterol via nebulizer
Teach pursed-lip breathing
Obtain a sputum culture
Encourage oral fluids
A client with COPD asks how to loosen secretions. Which teaching is best?
Increase daily water intake unless contraindicated.
Restrict fluids to reduce swelling.
Use cold, dry air at home to limit moisture.
Avoid humidification and coughing exercises.
A client has symptomatic hypercalcemia. Which provider order should the nurse anticipate?
Oral calcium carbonate
Vitamin D supplements
Restrict oral and IV fluids
IV normal saline and loop diuretics
A client develops numbness and tingling with tetany. Which lab result is most likely?
Calcium 7.8 mg/dL
Calcium 11.2 mg/dL
Sodium 150 mEq/L
Magnesium 2.0 mEq/L
Which condition is a risk factor for metabolic acidosis?
Excess antacid ingestion
Prolonged vomiting
Diuretic-induced potassium loss
Lactic acidosis from shock
A client is teaching low-potassium choices. Which meal selection is best?
Banana and orange juice
Tomato soup and baked potato
Grilled chicken with white rice
Spinach salad with avocado
A client with hypokalemia is receiving IV potassium chloride. Which action is required?
Give IV push for rapid correction
Administer undiluted in a syringe pump
Infuse using an infusion pump
Mix with dextrose only and run wide open
A child with epistaxis is actively bleeding. Which nursing action is priority?
Have the child sit upright and lean forward
Place the child supine with head extended
Pack the nostrils with dry gauze immediately
Insert an oral airway
Which assessment finding supports COPD rather than asthma?
Reversible symptoms triggered by allergens
Episodic symptoms with symptom-free intervals
Chronic productive cough with long smoking history
Onset in childhood with eczema history
A client with hypocalcemia is at highest risk for which complication?
Seizures
Renal calculi
Constipation
Bone fractures from hypercalcemia
Which finding is expected with fluid volume deficit from hemorrhage?
Decreased hematocrit
Decreased serum osmolality
Decreased urine specific gravity
Bradycardia with hypertension
Which client is most likely to develop metabolic alkalosis?
A client with prolonged NG suction
A client with severe diarrhea
A client with DKA
A client with renal failure
A client has magnesium toxicity. Which assessment finding should the nurse report immediately?
Hyperactive bowel sounds
Increased blood pressure
Positive Chvostek sign
Hypotension and muscle weakness
A postoperative client’s ABGs show pH 7.57, PaCO2 46, HCO3− 38. Which imbalance is present?
Respiratory alkalosis
Metabolic alkalosis
Respiratory acidosis
Metabolic acidosis
A nurse is reinforcing teaching to reduce OSA complications. Which instruction is most appropriate?
Sleep with multiple pillows to flex the neck
Stop CPAP once symptoms improve
Avoid sedatives and alcohol near bedtime
Take aspirin nightly to improve airway patency
A client with glaucoma asks why vision is affected. Which explanation is best for open-angle glaucoma?
“Increased IOP damages the optic nerve over time.”
“Sudden blockage causes acute pain and redness.”
“Vision loss occurs from retinal detachment episodes.”
“The lens becomes opaque and scatters incoming light.”
ABGs: pH 7.18, PaCO2 38, HCO3− 15. Which imbalance is present?
Respiratory alkalosis
Respiratory acidosis
Metabolic alkalosis
Metabolic acidosis
A nurse suspects presbycusis in an older adult. Which statement is most expected?
“I slowly have trouble hearing high-pitched sounds.”
“I have sudden severe vertigo with vomiting.”
“My hearing improves after I yawn.”
“I have ear pain and purulent drainage.”
A client with severe hyponatremia becomes increasingly restless. Which intervention is priority?
Encourage increased oral water intake
Place on seizure precautions
Administer hypotonic IV fluids
Give potassium supplements
A nurse is teaching the purpose of the Rinne test. Which statement is correct?
“It compares air conduction to bone conduction.”
“It measures intraocular pressure.”
“It detects retinal detachment.”
“It measures visual acuity.”
A child with suspected streptococcal pharyngitis has a throat culture pending. Which action is appropriate?
Start aspirin therapy for fever control
Teach that antibiotics are never indicated
Obtain the culture before starting antibiotics if possible
Discontinue fluids to reduce throat irritation
A post-tonsillectomy child is bleeding. Which action should the nurse take first?
Place the child prone
Offer red popsicles to assess bleeding
Prepare for discharge teaching
Notify the surgeon immediately
Which finding most strongly supports Ménière’s disease rather than BPPV?
Vertigo triggered by rolling over in bed
Nystagmus with head movement
Tinnitus with ear fullness and hearing loss
Lightheadedness that improves with sitting
A client with acute asthma attack is prescribed a short-acting beta agonist. What is the expected action?
Rapid bronchodilation
Long-term airway remodeling prevention
Decreased mucus viscosity by hydrating secretions
Suppression of cough reflex
A client with COPD is prescribed a mucolytic. What is the primary expected benefit?
Decrease airway inflammation permanently
Cure emphysema
Reverse chronic bronchitis pathology
Break up/thin thick mucus for easier expectoration
A client has hyperkalemia. Which teaching is appropriate?
Avoid potassium-containing salt substitutes
Increase bananas and oranges
Hold diuretics and increase spironolactone
Use potassium supplements daily
A client has hypocalcemia. Which intervention should the nurse anticipate?
Restrict dietary calcium
Administer calcitonin
Encourage high-dose thiazide diuretics
Administer IV calcium gluconate via infusion pump if severe
Which client is at highest risk for metabolic acidosis?
Client with prolonged diarrhea
Client with recurrent vomiting
Client using antacids daily
Client on loop diuretics
A client on a low-potassium diet asks which snack is best. Which is correct?
Dried apricots
Avocado slices
Apple slices
Baked sweet potato
A client with hypokalemia is at risk for which cardiac complication?
Dysrhythmias such as ventricular tachycardia
Peaked T waves
Widened QRS from hyperkalemia
Severe hypertension with bounding pulse
A child has epistaxis. Which action is appropriate during active bleeding?
Tilt the head backward
Apply pressure to the soft part of the nose
Insert a nasopharyngeal airway
Encourage forceful nose blowing
Which COPD finding is expected on assessment?
Chronic dyspnea and decreased exercise tolerance
Sudden onset drooling and tripod positioning
High-pitched inspiratory stridor only
Fine crackles that clear with coughing only
A client has calcium 12.0 mg/dL. Which manifestation should the nurse expect?
Tetany
Hyperactive bowel sounds with diarrhea
Constipation and fatigue
Positive Trousseau sign
A nurse is caring for a client with fluid volume deficit. Which provider order is most appropriate initially?
Isotonic IV fluids as prescribed
Loop diuretic therapy
Fluid restriction
Hypertonic saline bolus for all clients
Which assessment finding is most consistent with metabolic alkalosis?
Kussmaul respirations
Numbness/tingling with muscle weakness
Warm, flushed skin with fruity breath
Deep rapid breathing with hypotension
A client receiving magnesium sulfate is being monitored. Which finding suggests worsening toxicity?
Decreased respiratory rate
Hyperactive reflexes
Abdominal cramping
Tremors
A postoperative client is at risk for acid-base changes. Which monitoring is most appropriate when respiratory depression is suspected?
Serum sodium every hour
Stool guaiac testing
Peak flow measurement
ABG evaluation and continuous pulse oximetry
Which teaching best helps a client with OSA reduce nighttime obstruction?
“Avoid sedatives at bedtime.”
“Drink alcohol before sleep to relax.”
“Stop CPAP when you feel better.”
“Sleep flat on your back every night.”
A client’s ABGs show pH 7.33, PaCO2 67, HCO3− 37. Which interpretation is correct?
Uncompensated metabolic acidosis
Compensated respiratory acidosis
Uncompensated respiratory alkalosis
Compensated metabolic alkalosis
An older adult reports difficulty hearing in crowded rooms. Which nursing action best supports communication?
Face the client, speak clearly, and reduce background noise
Speak loudly from behind the client
Use medical jargon to avoid repetition
Turn on the television for distraction
A client with chronic open-angle glaucoma is prescribed timolol eye drops. What is the primary goal?
Paralyze the ciliary body
Dilate the pupil for exam
Decrease intraocular pressure
Treat bacterial conjunctivitis
A client with sodium 124 mEq/L is lethargic. Which order should the nurse anticipate?
Fluid restriction
Hypotonic IV fluids
Encourage free water
High-dose potassium supplements
Which finding is expected with conductive hearing loss on Rinne testing?
Air conduction greater than bone conduction
Bone conduction greater than air conduction
No sound heard by either method
Equal air and bone conduction in both ears
A child with strep throat is being monitored for complications. Which complication is most important to prevent with timely antibiotics?
Rheumatic fever
Cataracts
Ménière’s disease
COPD
Which assessment finding after tonsillectomy requires immediate intervention?
Small amounts of old dark blood in saliva
Frequent swallowing and tachycardia
Mild throat pain rated 4/10
White fibrin tissue at incision sites
Which statement best explains Ménière’s disease manifestations?
Inner ear fluid accumulation disrupts hearing and balance
Middle ear infection causes tympanic membrane rupture
Outer ear inflammation blocks sound transmission
Excess cerumen permanently damages the cochlea
A client in acute asthma exacerbation has an order set. Which medication is for immediate relief?
Inhaled corticosteroid daily
Leukotriene modifier nightly
Short-acting beta agonist
Long-acting beta agonist only
A client with COPD is receiving guaifenesin. Which outcome indicates effectiveness?
Sputum is thinner and easier to expectorate
Respiratory rate decreases to 8/min
Wheezing stops permanently
ABGs normalize immediately
A client has hyperkalemia. Which medication removes potassium through the GI tract?
Sodium bicarbonate
Regular insulin
IV calcium gluconate
Sodium polystyrene sulfonate (Kayexalate)
A client develops hypocalcemia after thyroidectomy. Which complication is the priority concern?
Laryngospasm causing airway compromise
Constipation
Polyuria
Bone fractures
Which finding is a risk factor for metabolic acidosis based on decreased bicarbonate?
Prolonged diarrhea
Excess antacid ingestion
NG suction
Loop diuretic therapy
A nurse is evaluating a low-potassium diet plan. Which client choice shows correct understanding?
“I’ll choose applesauce instead of orange juice.”
“I’ll use salt substitutes to season food.”
“I’ll eat baked potatoes more often.”
“I’ll snack on bananas daily.”
A client with hypokalemia is being discharged. Which statement requires follow-up?
“I will report palpitations right away.”
“I will take potassium exactly as prescribed.”
“I will increase foods like bananas and oranges.”
“If I miss a dose, I’ll double my next potassium dose.”
A child has recurrent epistaxis and nasal itching. Which cause is most likely?
Allergic irritation with frequent rubbing
Acute hemolytic transfusion reaction
Pneumothorax
Acute angle-closure glaucoma
Which COPD assessment finding is most consistent with chronic bronchitis?
Chronic productive cough
Sudden onset stridor
High fever and pleuritic chest pain
Purulent conjunctival drainage
A client with hypocalcemia receives IV calcium gluconate. Which monitoring is priority?
Cardiac rhythm monitoring
Visual acuity testing
Throat culture
Peak flow measurement
A nurse suspects fluid volume deficit. Which lab trend supports this?
Decreased hematocrit
Decreased BUN
Increased BUN
Decreased urine specific gravity
Which cause is most associated with metabolic alkalosis in a hospitalized client?
Nasogastric suctioning
Lactic acidosis
Renal failure
Profuse diarrhea
A client is receiving magnesium sulfate and shows toxicity. Which intervention is the priority?
Increase the infusion rate
Place in Trendelenburg position
Administer oral magnesium supplements
Stop the infusion and prepare to give calcium gluconate
