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Worksheets2121 Exam 1 OT pt.2
Total questions: 99
Worksheet time: 50mins
A school-age child experiences frequent nosebleeds during winter months. Which factor most commonly contributes to epistaxis in this age group?
Hypertension
Digital trauma combined with dry nasal mucosa
Esophageal varices
Platelet dysfunction
A nurse is assessing a client with long-standing COPD. Which symptom pattern is most characteristic?
Intermittent wheezing with complete symptom resolution
Sudden onset dyspnea with fever
Chronic productive cough and exertional dyspnea
Inspiratory stridor relieved by antibiotics
A client’s serum calcium level is 7.5 mg/dL. Which clinical manifestation should the nurse anticipate?
Polyuria and kidney stones
Constipation and lethargy
Decreased deep tendon reflexes
Perioral numbness and muscle spasms
Which assessment finding best supports a diagnosis of fluid volume deficit?
Jugular venous distention
Crackles at lung bases
Orthostatic hypotension
Peripheral edema
A client has continuous nasogastric suction postoperatively. Which acid–base imbalance is the nurse most concerned about?
Metabolic acidosis
Respiratory alkalosis
Metabolic alkalosis
Respiratory acidosis
A client receiving IV magnesium sulfate becomes lethargic with a respiratory rate of 10/min. Which finding is most concerning?
Mild nausea
Hyperactive reflexes
Decreased urine output
Respiratory depression
ABGs show pH 7.29, PaCO2 55 mm Hg, HCO3− 25 mEq/L. Which imbalance is present?
Metabolic alkalosis
Respiratory acidosis
Metabolic acidosis
Respiratory alkalosis
Which client statement demonstrates correct understanding of obstructive sleep apnea?
“Antibiotics will correct my airway problem.”
“Sleeping flat on my back prevents obstruction.”
“CPAP helps keep my airway open while I sleep.”
“Avoiding exercise will reduce my symptoms.”
A client reports sudden painless vision loss described as a “curtain coming down.” What is the nurse’s priority action?
Apply warm compresses
Encourage eye rest
Administer artificial tears
Prepare for urgent ophthalmic evaluation
ABGs reveal pH 7.49, PaCO2 29, HCO3− 23. Which imbalance is present?
Respiratory alkalosis
Metabolic alkalosis
Respiratory acidosis
Metabolic acidosis
Which finding is most consistent with presbycusis?
Sudden unilateral hearing loss
Conductive hearing loss from fluid
Gradual age-related sensorineural hearing loss
Hearing loss relieved by cerumen removal
What best explains the pathophysiology of primary open-angle glaucoma?
Sudden closure of the anterior chamber angle
Optic nerve infection
Excess tear production
Impaired aqueous humor outflow causing increased IOP
A confused client has a sodium level of 121 mEq/L. Which order should the nurse implement first?
Encourage free water intake
Initiate seizure precautions
Administer hypotonic IV fluids
Place client in Trendelenburg
During a Rinne test, which finding indicates conductive hearing loss?
Air conduction louder than bone conduction
No sound heard by either method
Bone conduction louder than air conduction
Equal air and bone conduction
A child presents with fever, sore throat, and strawberry tongue. Which organism is most likely responsible?
Mycoplasma pneumoniae
Candida albicans
Respiratory syncytial virus
Group A β-hemolytic streptococci
Eight hours after tonsillectomy, which finding most strongly suggests hemorrhage?
Mild throat pain
White patches at incision site
Refusal to drink fluids
Frequent swallowing and throat clearing
Vertigo, tinnitus, and ear fullness are classic findings of which disorder?
Otitis media
Allergic rhinitis
Ménière’s disease
Acute glaucoma
Which medication provides rapid relief during an acute asthma attack?
Fluticasone
Salmeterol
Montelukast
Albuterol
Which intervention best helps thin bronchial secretions in a client with COPD?
Fluid restriction
Routine antitussives
Increased hydration if not contraindicated
Avoid humidification
A client has potassium 6.4 mEq/L with ECG changes. Which medication stabilizes cardiac membranes first?
Regular insulin
Sodium bicarbonate
Calcium gluconate
Kayexalate
Perioral tingling and a positive Trousseau sign after thyroidectomy indicate which complication?
Hypermagnesemia
Hypocalcemia
Hyperkalemia
Respiratory alkalosis
Which client is at highest risk for metabolic acidosis?
Client with prolonged vomiting
Client with loop diuretic use
Client with anxiety-induced hyperventilation
Client with diabetic ketoacidosis
Which food should be avoided on a low-potassium diet?
Applesauce
White rice
Baked potato
Cucumber
A client’s potassium level is 2.8 mEq/L. Which instruction is priority?
Limit potassium-rich foods
Discontinue cardiac monitoring
Expect diarrhea
Increase dietary potassium intake
Which prevention strategy best reduces recurrent epistaxis in children?
Aspirin for inflammation
Petroleum jelly applied inside nares
Daily nasal packing
Forceful nose blowing
Which symptom pattern supports COPD rather than asthma?
Childhood onset
Allergy-triggered episodes
Chronic cough with smoking history
Complete symptom resolution between attacks
Which ECG change is associated with hypocalcemia?
Short QT interval
Peaked T waves
Prolonged QT interval
Widened QRS
Which finding best supports fluid volume deficit?
Elevated BNP
Weak, rapid pulse
Crackles with frothy sputum
Peripheral edema
Chronic use of which medication increases risk for metabolic alkalosis?
Metformin
Heparin
Acetaminophen
Loop diuretics
A client with absent patellar reflexes on magnesium sulfate should receive which medication?
Naloxone
Calcium gluconate
Sodium bicarbonate
Potassium chloride
A somnolent post-op client has RR 8/min. Which acid–base change is most likely?
Metabolic alkalosis
Respiratory alkalosis
Respiratory acidosis
Metabolic acidosis
Which statement indicates a need for further teaching about OSA?
“Weight loss can help.”
“CPAP reduces daytime sleepiness.”
“Alcohol can worsen apnea.”
“Sleeping on my back prevents airway collapse.”
Which symptom is most consistent with chronic open-angle glaucoma?
Sudden eye pain
Purulent drainage
Gradual peripheral vision loss
Fixed dilated pupil
ABGs show pH 7.22, PaCO2 60, HCO3− 26. Which imbalance is present?
Metabolic acidosis
Respiratory acidosis
Metabolic alkalosis
Respiratory alkalosis
Which medication class is associated with ototoxicity?
Calcium supplements
Fiber laxatives
Loop diuretics
Antacids
A sodium level of 118 mEq/L is noted. Which order should the nurse question?
Seizure precautions
Fluid restriction
Hypertonic saline
Encourage free water
A normal Rinne test result shows:
Bone conduction > air conduction
Air conduction > bone conduction
No sound heard
Equal conduction bilaterally
Antibiotics are prescribed for strep throat primarily to prevent:
Otitis externa
Cataracts
Rheumatic fever
Ménière’s disease
Which discharge instruction is most important after tonsillectomy?
Use a straw
Take ibuprofen around the clock
Gargle vigorously
Avoid coughing and throat clearing
A client with Ménière’s disease reports sudden severe vertigo. Which nursing action is the priority to reduce injury risk?
Assist the client to lie down and implement fall precautions
Encourage the client to ambulate to “retrain balance”
Provide bright lighting to improve visual orientation
Initiate chest physiotherapy
A client with COPD is using pursed-lip breathing. Which outcome indicates the technique is effective?
Increased inspiratory wheezing
Decreased anxiety only
Prolonged exhalation with improved ventilation
Increased respiratory rate with shallow breaths
A client has serum calcium 12.1 mg/dL. Which assessment finding is most consistent with hypercalcemia?
Hyperactive bowel sounds and diarrhea
Constipation and lethargy
Perioral tingling and tetany
Positive Trousseau sign
A nurse suspects fluid volume deficit. Which additional finding best supports this diagnosis?
Weight gain of 2 kg in 24 hr
Bounding pulses
Urine specific gravity 1.030
Jugular venous distention
A client has been vomiting for 2 days. Which ABG trend is most likely?
pH ↓, HCO3− ↓
pH ↑, HCO3− ↑
pH ↓, PaCO2 ↑
pH ↑, PaCO2 ↓
A client receiving magnesium sulfate for a clinical condition develops diminished deep tendon reflexes. Which action is most appropriate?
Increase the infusion rate
Administer naloxone
Stop the infusion and prepare to administer calcium gluconate
Give potassium chloride
A postoperative client is hypoventilating after opioid administration. Which ABG is most expected initially?
pH 7.28, PaCO2 58, HCO3− 24
pH 7.52, PaCO2 28, HCO3− 24
pH 7.48, PaCO2 32, HCO3− 22
pH 7.18, PaCO2 38, HCO3− 14
A client with OSA asks what change is most important to avoid worsening nighttime obstruction. Which instruction is best?
“Take a sedative at bedtime to reduce awakenings.”
“Avoid alcohol and sedatives near bedtime.”
“Sleep flat on your back to keep your airway straight.”
“Stop CPAP once symptoms improve.”
A client with suspected retinal detachment reports floaters and flashes after eye trauma. Which action is priority?
Provide antibiotic eye drops
Instruct the client to avoid urgent care unless pain develops
Arrange immediate ophthalmic evaluation
Apply warm compresses every 4 hours
ABGs: pH 7.33, PaCO2 62, HCO3− 32. Which interpretation is correct?
Uncompensated respiratory acidosis
Compensated respiratory alkalosis
Compensated respiratory acidosis
Metabolic alkalosis with no compensation
An older adult reports gradual difficulty hearing high-pitched voices. Which change is most consistent with presbycusis?
Progressive sensorineural hearing loss associated with aging
Conductive hearing loss from otitis media
Hearing loss that resolves after irrigation
Sudden unilateral deafness after trauma
A client with chronic open-angle glaucoma asks why treatment is lifelong. Which response is best?
“Treatment prevents bacterial infection from spreading.”
“Glaucoma is cured once pressure normalizes.”
“Managing IOP reduces ongoing optic nerve damage.”
“Treatment restores lost peripheral vision permanently.”
A client has sodium 119 mEq/L with headache and confusion. Which nursing action is the priority?
Encourage oral free water
Initiate seizure precautions
Provide potassium-rich foods
A nurse performs a Rinne test. Which result indicates normal hearing?
BC > AC
AC = BC
AC > BC
No sound by AC or BC
A client with suspected streptococcal pharyngitis is being evaluated. Which action is appropriate?
Start antibiotics before collecting a throat specimen
Obtain ordered throat culture/rapid test before antibiotics when possible
Treat with aspirin for fever reduction
Teach that antibiotics are never indicated
A child 10 hours post-tonsillectomy is restless and swallowing repeatedly. Which action is priority?
Offer red popsicles to assess bleeding amount
Document as expected post-op behavior
Notify the provider immediately for suspected hemorrhage
Encourage vigorous gargling
A client with Ménière’s disease asks what causes the classic symptoms. Which explanation is best?
Fluid accumulation in the inner ear disrupts hearing and balance.
Infection of the middle ear destroys the ossicles.
Overgrowth of cerumen blocks the cochlea.
Cerebral vasospasm reduces blood flow to the retina.
A nurse is preparing medications for an acute asthma exacerbation. Which medication is the priority for rapid bronchodilation?
Montelukast
Fluticasone
Salmeterol
Albuterol
A COPD client has thick, tenacious sputum. Which intervention is most effective to support secretion clearance?
Restrict oral fluids to reduce sputum production
Encourage hydration and provide humidification if not contraindicated
Administer sedating antitussives routinely
Maintain strict bedrest to reduce oxygen demand
A client has potassium 6.9 mEq/L. Which provider order should the nurse anticipate to shift potassium into cells?
Sodium polystyrene sulfonate
IV furosemide
Regular insulin with dextrose
Oral potassium supplement
Twelve hours after total thyroidectomy, a client develops tingling and audible stridor. Which complication is the nurse most concerned about?
Hypocalcemia causing laryngospasm
Hyperkalemia causing constipation
Hypernatremia causing edema
Respiratory alkalosis causing diarrhea
Which client condition is most strongly associated with metabolic acidosis?
Prolonged vomiting
Nasogastric suction
Severe diarrhea
Excess antacid use
A client is prescribed a low-potassium diet. Which selection should the nurse instruct the client to avoid?
Banana
Applesauce
White rice
Cucumber slices
A client with potassium 2.7 mEq/L is prescribed IV potassium chloride. Which action is required?
Administer IV push for rapid correction
Infuse using an IV pump and never give IV push
Mix with sterile water only
Run the infusion wide open
A child has an active nosebleed. Which instruction is correct?
Tilt the head back and swallow blood
Lie supine with head extended
Sit upright, lean forward, and pinch the soft part of the nose
Blow the nose forcefully to clear clots
Which clinical finding is most consistent with chronic bronchitis-type COPD?
Chronic productive cough
Sudden pleuritic chest pain with absent breath sounds
Fever with rusty sputum
Inspiratory stridor with drooling
A client with hypocalcemia is at greatest risk for which complication?
Renal calculi
Constipation
Seizures
Hypertension
A client with fluid volume deficit is expected to have which lab trend?
Decreased BUN
Increased BUN
Decreased hematocrit
Decreased serum osmolality
A nurse is assessing a client for metabolic alkalosis. Which history most supports this diagnosis?
Prolonged diarrhea
Diabetic ketoacidosis
Recurrent vomiting
Acute renal failure
A client receiving magnesium sulfate shows toxicity. Which finding is most urgent?
Respiratory rate 10/min
Absent deep tendon reflexes
Urine output 20 mL/hr
Blood pressure 140/90 mm Hg
ABGs: pH 7.52, PaCO2 46, HCO3− 36. Which interpretation is correct?
Respiratory alkalosis
Metabolic alkalosis
Respiratory acidosis
Metabolic acidosis
A client with OSA asks why CPAP is prescribed. Which response is best?
It prevents infection in the airway.
It increases mucus clearance from the lungs.
It splints the airway open during sleep.
It cures apnea so lifestyle changes aren’t needed.
A client on timolol eye drops for glaucoma has a history of asthma. Which action is most appropriate?
Teach the client to use the drops more frequently
Assess for bronchospasm and notify the provider about the history
Tell the client asthma is unrelated to eye medications
Hold all glaucoma medications permanently without notification
ABGs: pH 7.36, PaCO2 60, HCO3− 33. Which interpretation is correct?
Compensated respiratory acidosis
Uncompensated respiratory acidosis
Compensated metabolic alkalosis
Uncompensated metabolic alkalosis
Which teaching best supports communication with an older adult who has hearing loss?
Speak quickly to shorten the interaction
Face the client and reduce background noise
Speak loudly from behind the client
Use complex terms to avoid repeating yourself
Which finding is most consistent with chronic open-angle glaucoma?
Sudden severe eye pain and halos
Rapid onset unilateral headache with vomiting
Gradual peripheral vision loss
Purulent discharge and crusting
A client with sodium 120 mEq/L is nauseated and confused. Which order should the nurse question?
Fluid restriction
Neuro checks
Seizure precautions
Encourage oral free water intake
Which Rinne test result is consistent with conductive hearing loss?
AC > BC
AC = BC
BC > AC
No sound heard by AC or BC
A client treated for streptococcal pharyngitis asks why finishing antibiotics matters. Which response is best?
It prevents rheumatic fever and other complications.
It prevents COPD from developing.
It prevents cataracts.
It cures Ménière’s disease.
A child is discharged after tonsillectomy. Which instruction is priority to reduce bleeding risk?
Use a straw for all fluids
Avoid coughing, throat clearing, and nose blowing
Perform vigorous gargling after meals
Take ibuprofen on a schedule
A client reports tinnitus and episodic vertigo. Which additional finding best supports Ménière’s disease?
Ear fullness and fluctuating hearing loss
Purulent ear drainage and fever
Sudden severe eye pain
Nosebleeds with bruising
A client in acute asthma distress arrives with audible wheezing and accessory muscle use. Which action is priority?
Provide detailed inhaler teaching
Administer a rescue bronchodilator as prescribed
Schedule spirometry
Obtain routine labs first
A client with COPD is prescribed guaifenesin. Which outcome indicates the medication is effective?
Respiratory rate drops to 8/min
Wheezing stops permanently
Sputum becomes thinner and easier to expectorate
ABGs normalize immediately
A client has symptomatic hypocalcemia. Which provider order should the nurse anticipate if symptoms are severe?
IV calcium gluconate with cardiac monitoring
Oral vitamin D only
Restrict calcium intake
Administer calcitonin
Which client is at highest risk for metabolic acidosis due to bicarbonate loss?
Client with prolonged diarrhea
Client with prolonged vomiting
Client with NG suction
Client taking loop diuretics
A client on magnesium sulfate has diminished reflexes. What is the nurse’s priority action?
Increase infusion rate
Stop the infusion and notify the provider
Encourage ambulation
Give oral magnesium
A nurse suspects postoperative hypoventilation. Which ABG change occurs first?
HCO3− falls
PaCO2 rises
pH rises
PaCO2 falls
Which non-pharmacologic intervention is most important for long-term improvement of OSA?
Weight loss when appropriate
Drinking alcohol to sleep deeper
Sleeping supine nightly
Using sedatives at bedtime
A client reports slowly worsening peripheral vision loss with no pain. Which disorder is most likely?
Acute otitis media
Open-angle glaucoma
Ménière’s disease
Allergic rhinitis
ABGs: pH 7.24, PaCO2 24, HCO3− 10. Which imbalance is present?
Respiratory alkalosis
Respiratory acidosis
Metabolic acidosis
Metabolic alkalosis
An older adult asks why hearing aids help with presbycusis. Which explanation is best?
They amplify sound to compensate for decreased sensorineural function
They cure inner-ear degeneration
They drain middle ear fluid permanently
They reverse blast injury damage
A nurse explains open-angle glaucoma. Which statement is accurate?
“It is typically painless and can progress silently.”
“It always causes sudden severe pain.”
“It is caused by bacterial infection.”
“It resolves without treatment.”
A client with sodium 121 mEq/L is restless and nauseated. Which action is appropriate?
Encourage free water intake
Implement seizure precautions and frequent neuro checks
Administer hypotonic IV fluids
Provide potassium supplements first
A nurse documents Rinne results: “AC > BC bilaterally.” What does this indicate?
Conductive hearing loss
Sensorineural hearing loss
Normal finding
Severe otitis media
A child treated for strep throat develops joint pain and chest discomfort 2 weeks later. Which complication is most concerning?
Rheumatic fever
Cataracts
Ménière’s disease
COPD
A child post-tonsillectomy vomits bright red blood. What is the nurse’s best action?
Offer clear liquids and reassess in 30 minutes
Notify the surgeon immediately and prepare for intervention
Document as expected post-op finding
Encourage gargling to clear blood
Which symptom cluster most strongly supports Ménière’s disease?
Episodic vertigo + tinnitus + ear fullness/hearing loss
Sudden severe eye pain + halos + nausea
Nosebleeds + petechiae + bruising
Wheezing + hives + lip swelling
A nurse is prioritizing interventions for an acute asthma attack. Which action should occur first?
Teach trigger avoidance
Administer a rescue bronchodilator
Provide long-term controller education
Schedule pulmonary testing
Which client instruction best supports COPD secretion clearance at home?
“Restrict fluids to dry up secretions.”
“Use controlled coughing and drink fluids if allowed.”
“Avoid humidification to prevent infection.”
“Take sedating cough suppressants routinely.”
A client is following a low-potassium diet. Which snack is best?
Orange slices
Baked sweet potato
Banana
Apple slices
