Nurs- 406 Practicum

Prof. Cristina V. Lebron Arroyo

Exam # 1
Students
Name__________________________________
Value 100pts.
Date______________________________
Select the best answer.
1. The nurse is preparing to obtain a culture from a patient who has a possible
fungal infection in the groin area. Which action is appropriate?
a.
b.
c.
d.
2.

Apply a topical anesthetic before obtaining the culture.

Use sterile gloves to squeeze the lesion and obtain exudate.
Swab the infected area with a sterile cotton-tipped applicator.
Scrape the area gently with a razor blade to obtain a specimen.

The nurse notes several angiomas on the legs of a 73-year-old patient.

Which action should the nurse take next?
a. Assess the patient for evidence of liver disease.
b. Discuss the adverse effects of sun exposure on the skin.
c. Educate the patient about possible skin changes with aging.
d. Suggest that the patient make an appointment with a dermatologist.

3. During assessment of the patients skin, the nurse observes a ring of small,
raised, discrete lesions filled with serous fluid on the patients right temple.
When documenting the lesions, the nurse will describe the lesions as
a. Grouped
b. Confluent.
c. Zosteriform.
d. Generalized.
4. A patient has a circular, flat, reddened lesion about 5 cm in diameter on his
ankle. To determine whether the lesion is related to blood vessel dilation, the
nurse will
a.
b.
c.
d.

Elevate the patients leg.

Press firmly on the lesion.
Check the temperature of the skin around the lesion.
Palpate the dorsalis pedis and posterior tibial pulses.

5. When the nurse is assessing a 42-year-old woman, the patient states that she
is using topical fluorouracil (Efudex, Fluoroplex) to treat actinic keratoses on

her face. Which additional information will be most important for the nurse to
obtain?
a.
b.
c.
d.

Method of birth control the patient is using

History of extensive sun exposure by the patient
Length of time the patient has used the medication
Appearance of the treated areas on the patients face

6. A father calls because his son has head lice. He reports that he used that
special medicated shampoo three times, but nothing happened. He wants to
know what to do now. What will the nurse advice first?
a. It sounds like you need a prescription for a second product,
malathion.
b. Try one of the lotion products instead.
c. Use a nit comb to remove nits from the hair shafts.
d. Try combing through the hair with mineral oil to loosen the lice from
the hair shafts.
7. The preoperative nurse is ready to perform a skin prep with povidone-iodine
(Betadine) on a patient who is about to have abdominal surgery. Which
allergies, if present, would be a contraindication to the Betadine prep?
a.
b.
c.
d.

Peanuts
Shellfish
Adhesives
Latex

8. A woman suffered a second-degree burn of the skin on her arm and hand
while cooking breakfast. After examination in the urgent care center, silver
sulfadiazine cream (Silvadene) is ordered for the burned area. The nurse will
apply the medication using which procedure?
a. Gently patting a moderate amount over the burned area.
b. Massaging the cream completely into the wound
c. Applying a thick layer over the burned area, and then leaving the area
open
d. Applying a thin layer with a sterile, gloved hand to clean and debrided
areas
9. A child has been diagnosed with impetigo, a skin infection. The nurse
anticipates that which drug will be used to treat this condition?
a.
b.
c.
d.

spinosad (Natroba)
nystatin (Mycostatin)
acyclovir (Zovirax)
bacitracin

10.The nurse is reviewing laboratory results for a patient and notes that the
patient has positive results for nasal colonization by methicillin-resistant
Staphylococcus aureus (MRSA). The nurse anticipates an order for which
medication?
a. acyclovir (Zovirax)
b. mupirocin (Bactroban)
c. clindamycin (Cleocin T)
d. clotrimazole (Lotrimin)
11.A patient is admitted to the hospital for possible septicemia. He has a large
pressure ulcer on his heel that is open and includes necrotic tissue. However,
his PT/INR values are too high to permit surgical dbridement at this time.
The nurse expects that which wound-care product will be used to treat the
wound?
a. cadexomer iodine (Iodosorb)]
b. Biafine topical emulsion
c. povidone-iodine (Betadine)
d. collagenase (Santyl)
12.One patient has cancer of the bone; another has cancer in the connective
tissues of the thigh muscles; a third patient has cancer in the vascular
tissues. These patients have a type of tumor referred to as a
a.
b.
c.
d.

Sarcoma.
Leukemia.
Carcinoma.
Lymphoma.

13.A patient is receiving her third course of 5-fluorouracil therapy and knows
that stomatitis is a potential adverse effect of antineoplastic therapy. What
will the nurse teach her about managing this problem?
a.
b.
c.
d.

You can take aspirin to prevent stomatitis.

Be sure to watch for and report black, tarry stools immediately.
You need to increase your intake of foods containing fiber and citric acid
Be sure to examine your mouth daily for bleeding, painful areas, and
ulcerations.

14.A patient is receiving high doses of methotrexate and is experiencing severe

bone marrow suppression. The nurse expects which intervention to be
ordered with this drug to reduce this problem?

a.
b.
c.
d.

A transfusion of whole blood

Leucovorin rescue
Therapy with filgrastim (Neupogen)
Administration of allopurinol (Zyloprim)

15.A patient is receiving doxorubicin (Adriamycin) as part of treatment for

ovarian cancer. Which nursing diagnosis is related to this antineoplastic drug?
a. Decreased cardiac output related to the adverse effect of cardiotoxicity
b. Ineffective breathing pattern related to the adverse effect of pulmonary
toxicity
c. Risk for injury related to the effects of neurotoxicity (ataxia, numbness of
hands and feet)
d. Impaired urinary elimination pattern related to hyperuricemia
16.The nurse is teaching a class about the various chemotherapy drugs and
explains that alkylating drugs are also called cell cyclenonspecific drugs
because they are
a.
b.
c.
d.

Cytotoxic during a specific cell cycle.

Cytotoxic in any phase of the cell cycle
Effective against several types of neoplasms.
More highly differentiated than cell cyclespecific drugs.

17.What is the nurses priority action if extravasation of an antineoplastic drug

occurs during intravenous (IV) administration?
a. Reduce the infusion rate.
b. Discontinue the IV, and apply warm compresses.
c. Stop the infusion immediately, but leave the IV catheter in place.
d. Change the infusion to normal saline, and inject the area with
hydrocortisone.
18.When evaluating the laboratory results for a patient with increased secretion
of the anterior pituitary hormones, the nurse would expect to find
a.
b.
c.
d.

Decreased serum thyroxine levels.

Elevated serum aldosterone levels.
An increase in urinary free cortisol.
Low urinary excretion of catecholamines.

19.A patient has a total serum calcium level of 13.3 mg/dL (3.3 mmol/L). The
nurse will anticipate the need to teach the patient about testing for
a. Calcitonin levels.
b. Catecholamine levels.
c. Thyroid hormone levels.

d. Parathyroid hormone levels.

20.When a patient has clinical manifestations of hypothyroidism, which
laboratory value should the nurse review to determine whether the
hypothyroidism is caused by a problem with the anterior pituitary gland or
with the thyroid gland?
a.
b.
c.
d.

Thyroxine (T4) level

Triiodothyronine (T3) level
Thyroid-stimulating hormone (TSH) level
Thyrotropin-releasing hormone (TRH) level

21.When caring for a patient having a water deprivation test, which finding is
most important for the nurse to communicate to the health care provider?
a. The patient complains of intense thirst.
b. The patient has a 5-lb (2.3 kg) weight loss
c. The patient feels dizzy when sitting up on the edge of the bed.
d. The patients urine osmolality does not change after antidiuretic hormone
(ADH) is given.
22.A patient who is hospitalized with watery, incontinent diarrhea is diagnosed
with Clostridium difficile. Which action will the nurse include in the plan of
care?
a.
b.
c.
d.

Order a diet with no dairy products for the patient.

Place the patient in a private room with contact isolation
Teach the patient about why antibiotics are not being used.
Educate the patient about proper food handling and storage.

23.Two days after an exploratory laparotomy with a resection of a short segment

of small bowel, a patient complains of gas pains and abdominal distention.
Which nursing action is best to take at this time?
a.
b.
c.
d.

Give a return-flow enema.

Assist the patient to ambulate.
Administer the ordered IV morphine sulfate.
Insert the ordered promethazine (Phenergan) suppository

24.A patient who has blunt abdominal trauma after an automobile accident is
complaining of severe pain. A peritoneal lavage returns brown drainage with
fecal material. Which action will the nurse plan to take next?
a.
b.
c.
d.

Auscultate the bowel sounds.

Prepare the patient for surgery
Check the patients oral temperature.
Obtain information about the accident

25.Which nursing action will be included in the plan of care for a patient with
bowel irregularity and a new diagnosis of irritable bowel syndrome (IBS)?
a. Encourage the patient to express feelings and ask questions about IBS.
b. Suggest that the patient increase the intake of milk and other dairy
products.
c. Educate the patient about the use of alosetron (Lotronex) to reduce
symptoms.
d. Teach the patient to avoid using nonsteroidal anti-inflammatory drugs
(NSAIDs).
26.A patient contracts hepatitis from contaminated food. During the acute
(icteric) phase of the patients illness, the nurse would expect serologic
testing to reveal
a.
b.
c.
d.

Antibody to hepatitis D (anti-HDV).

Hepatitis B surface antigen (HBsAg).
Anti-hepatitis A virus immunoglobulin G (anti-HAV IgG).
Anti-hepatitis A virus immunoglobulin M (anti-HAV IgM).

27.A patient with cirrhosis has 4+ pitting edema of the feet and legs. The data
indicate that it is most important for the nurse to monitor the patients
a.
b.
c.
d.

Hemoglobin.
Temperature.
Activity level.
albumin level

28.A patient who has advanced cirrhosis is receiving lactulose (Cephulac). Which
finding by the nurse indicates that the medication is effective?
a.
b.
c.
d.

The
The
The
The

patient is alert and oriented.

patient denies nausea or anorexia.
patients bilirubin level decreases.
patient has at least one stool daily

29.When obtaining a health history from a patient with acute pancreatitis, the
nurse asks the patient specifically about a history of
a.
b.
c.
d.

Alcohol use.
Diabetes mellitus.
High-protein diet.
Cigarette smoking.

30.When reviewing the health history of a patient who will be receiving antacids,
the nurse recalls that antacids containing magnesium need to be used
cautiously in patients with which condition?

a.
b.
c.
d.

Peptic ulcer disease

Renal failure
Hypertension
Heart failure

31. The nurse is reviewing the medication orders for a patient who will be taking
an H2 antagonist. Which drug may have an interaction if taken along with the
H2 antagonist?
a. ibuprofen (Motrin)
b. ranitidine (Zantac)
c. tetracycline (Doryx)
d. ketoconazole (Nizoral)
32.A 75-year-old woman comes into the clinic with complaints of muscle
twitching, nausea, and headache. She tells the nurse that she has been
taking sodium bicarbonate 5 or 6 times a day for the past 3 weeks. The nurse
will assess for which potential problem that may occur with overuse of
sodium bicarbonate?
a.
b.
c.
d.

Constipation
Metabolic acidosis
Metabolic alkalosis
Excessive gastric mucus

33.A patient with acute shortness of breath is admitted to the hospital. Which
action should the nurse take during the initial assessment of the patient?
a. Complete a full physical examination to determine the systemic effect of
the respiratory distress.
b. Obtain a comprehensive health history to determine the extent of any
prior respiratory problems
c. Delay the physical assessment and ask family members about any history
of respiratory problems.
d. Perform a respiratory system assessment and ask specific questions about
this episode of respiratory distress.
34.A patient is admitted with a metabolic acidosis of unknown origin. Based on
this diagnosis, the nurse would expect the patient to have

a.
b.
c.
d.

intercostal retractions
Kussmaul respirations.
a low oxygen saturation (SpO2).
a decrease in venous O2 pressure.

35.The nurse palpates the posterior chest while the patient says 99 and notes
that no vibration is felt. How should this be charted?
a.
b.
c.
d.

Diminished expansion
Dullness to percussion
Absent tactile fremitus
Decreased breath sounds

36.On auscultation of a patients lungs, the nurse hears short, high-pitched

sounds during exhalation in the lower 1/3 of both lungs. The nurse records
this finding as
a.
b.
c.
d.

expiratory crackles at the bases

expiratory wheezes in both lungs
Abnormal lung sounds in the bases of both lungs.
Pleural friction rub in the right and left lower lobes.

37.An RN is observing a nursing student who is suctioning a hospitalized patient

with a tracheostomy in place. Which action by the student requires the RN to
intervene?
a. The student preoxygenates the patient for 1 minute before suctioning.
b. The student puts on clean gloves and uses a sterile catheter to suction.
c. The student inserts the catheter about 5 inches into the tracheostomy
tube.
d. The student applies suction for 10 seconds while withdrawing the
catheter.
38.The nurse obtains the following assessment data in a 76-year-old patient who
has influenza. Which information will be most important to communicate to
the health care provider?
a.
b.
c.
d.

Fever of 100.4 F (38 C)

Diffuse crackles in the lungs
Sore throat and frequent cough
Myalgia and persistent headache

39.A patient is in an urgent-care center with an acute asthma attack. The nurse
expects that which medication will be used for initial treatment?
a.
b.
c.
d.

An anticholinergic such as ipratropium (Atrovent)

A short-acting beta2 agonist such as albuterol (Proventil)
A long-acting beta2 agonist such as salmeterol (Serevent)
A corticosteroid such as fluticasone (Flovent)

40.
The nurse is reviewing medications for the treatment of asthma. Which
drugs are used for acute asthma attacks? (Select all that apply.)
a.
b.
c.
d.
e.
f.

salmeterol (Serevent) inhaler

albuterol (Proventil) nebulizer solution
epinephrine
montelukast (Singulair)
fluticasone (Flovent) Rotadisk inhaler
aminophylline IV infusion