Are you preparing for the RN NCLEX or an upcoming nursing exam? Assess your readiness with this free nurse test bank. This test bank includes 10 questions with detailed answers provided at the end of this test.
Question 1
The clinic nurse notes that the primary health care provider has documented a diagnosis of herpes zoster (shingles) in the client's chart. Based on an understanding of the cause of this disorder, the nurse determines that this definitive diagnosis was made by which diagnostic test?
A. Positive patch test
B. Positive culture results
C. Abnormal biopsy results
D. Wood's light examination indicative of infection
Question 2
The nurse is creating a plan of care for the client with multiple myeloma and includes which priority intervention in the plan?
A. Encouraging fluids
B. Providing frequent oral care
C. Coughing and deep breathing
D. Monitoring the red blood cell count
Question 3
The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching is necessary related to colorectal cancer if the client identifies which item as an associated risk factor?
A. Age younger than 50 years
B. History of colorectal polyps
C. Family history of colorectal cancer
D. Chronic inflammatory bowel disease
Question 4
The nurse is assessing a client who has a new ureterostomy. Which statement by the client indicates the need for more education about urinary stoma care?
A. "I change my pouch every week."
B. "I change the appliance in the morning."
C. "I empty the urinary collection bag when it is two-thirds full."
D. "When I'm in the shower, I direct the flow of water away from my stoma."
Question 5
A client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate postoperative period for which most frequent complication of this type of surgery?
A. Folate deficiency
B. Malabsorption of fat
C. Intestinal obstruction
D. Fluid and electrolyte imbalance
Question 6
As part of chemotherapy education, the nurse teaches a female client about the risk for bleeding and self-care during the period of greatest bone marrow suppression (the nadir). The nurse understands that further teaching is needed if the client makes which statement?
A. "I should avoid blowing my nose."
B. "I may need a platelet transfusion if my platelet count is too low."
C. "I'm going to take aspirin for my headache as soon as I get home."
D. "I will count the number of pads and tampons I use when menstruating."
Question 7
Laboratory studies are performed for a client suspected to have iron deficiency anemia. The nurse reviews the laboratory results, knowing that which result indicates this type of anemia?
A. Elevated hemoglobin level
B. Decreased reticulocyte count
C. Elevated red blood cell count
D. Red blood cells that are microcytic and hypochromic
Question 8
The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse specifically note as a result of the massive cell destruction that occurred from the chemotherapy?
A. Anemia
B. Decreased platelets
C. Increased uric acid level
D. Decreased leukocyte count
Question 9
An external insulin pump is prescribed for a client with diabetes mellitus. When the client asks the nurse about the functioning of the pump, the nurse bases the response on which information about the pump?
A. It is timed to release programmed doses of either short-duration or NPH insulin into the bloodstream at specific intervals.
B. It continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels.
C. It is surgically attached to the pancreas and infuses regular insulin into the pancreas. This releases insulin into the bloodstream.
D. It administers a small continuous dose of short-duration insulin subcutaneously. The client can self-administer an additional bolus dose from the pump before each meal.
Question 10
A client is admitted to a hospital with a diagnosis of diabeticketoacidosis (DKA). The initial blood glucose level is 950 mg/dL (52.9 mmol/L). A continuous intravenous (IV) infusion of short-acting insulin is initiated, along with IV rehydration with normal saline. The serum glucose level is now decreased to 240 mg/dL (13.3 mmol/L). The nurse would next prepare to administer which medication?
A. An ampule of 50% dextrose
B. NPH insulin subcutaneously
C. IV fluids containing dextrose
D. Phenytoin for the prevention of seizures
Answer Key
Question 1 Answer - B
Rationale: With the classic presentation of herpes zoster, the clinical examination is diagnostic. However, a viral culture of the lesion provides the definitive diagnosis. Herpes zoster (shingles) is caused by a reactivation of the varicella zoster virus, the virus that causes chickenpox. A patch test is a skin test that involves the administration of an allergen to the surface of the skin to identify specific allergies. A biopsy would provide a cytological examination of tissue. In a Wood's light examination, the skin is viewed under ultraviolet light to identify superficial infections of the skin.
Question 2 Answer - A
Rationale:Hypercalcemia caused by bone destruction is a priority concern in the client with multiple myeloma. The nurse should administer fluids in adequate amounts to maintain a urine output of 1.5 to 2 L/day; this requires about 3 L of fluid intake per day. The fluid is needed not only to dilute the calcium
overload but also to prevent protein from precipitating in the renal tubules. Options 2, 3, and 4 may be components of the plan of care but are not the priority in this client.
Question 3 Answer - A
Rationale: Colorectal cancer risk factors include age older than 50 years, a family history of the disease, colorectal polyps, and chronic inflammatory bowel disease.
Question 4 Answer - C
Rationale: The urinary collection bag should be changed when it is one-third full to prevent pulling of the appliance and leakage. The remaining options identify correct statements about the care of a urinary stoma.
Question 5 Answer - D
Rationale:A frequent complication that occurs following ileostomy is fluid and electrolyte imbalance. The client requires constant monitoring of intake and output to prevent this from occurring. Losses require replacement by intravenous infusion until the client can tolerate a diet orally. Intestinal obstruction is a less frequent complication. Fat malabsorption and folate deficiency are complications that could occur later in the postoperative period.
Question 6 Answer - C
Rationale: During the period of greatest bone marrow suppression (the nadir), the platelet count may be low, less than 20,000 cells mm3 (20.0 × 109/L). The correct option describes an incorrect statement by the client. Aspirin and nonsteroidal anti-inflammatory drugs and products that contain aspirin should be avoided because of their anti-platelet activity. Options 1, 2, and 4 are correct statements by the client to prevent and monitor bleeding.
Question 7 Answer - D
Rationale: In iron deficiency anemia, iron stores are depleted, resulting in a decreased supply of iron for the manufacture of hemoglobin in red blood cells. The results of a complete blood cell count in clients with iron deficiency anemia show decreased hemoglobin levels and microcytic and hypochromic red blood cells. The red blood cell count is decreased. The reticulocyte count is usually normal or slightly elevated.
Question 8 Answers - C
Rationale: Hyperuricemia is especially common following treatment for leukemias and lymphomas because chemotherapy results in massive cell kill. Although options 1, 2, and 4 also may be noted, an increased uric acid level is related specifically to cell destruction.
Question 9 Answer - D
Rationale: An insulin pump provides a small continuous dose of short-duration (rapid- or short-acting) insulin subcutaneously throughout the day and night. The client can self-administer an additional bolus dose from the pump before each meal as needed. Short-duration insulin is used in an insulin pump. An external pump is not attached surgically to the pancreas.
Question 10 Answer - C
Rationale: Emergency management of DKA focuses on correcting fluid and electrolyte imbalances and normalizing the serum glucose level. If the corrections occur too quickly, serious consequences, including hypoglycemia and cerebral edema, can occur. During management of DKA, when the blood glucose level falls to 250 to 300 mg/dL (13.9 to 16.7 mmol/L), the IV infusion rate is reduced and a dextrose solution is added to maintain a blood glucose level of about 250 mg/dL (13.9 mmol/L), or until the client recovers from ketosis. Fifty percent dextrose is used to treat hypoglycemia. NPH insulin is not used to treat DKA. Phenytoin is not a usual treatment measure for DKA.
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