CRNE Q & A 1.

Melody, a three week old infant, is referred to the radiology department with diagnosis of ventricular septal defect (VSD). The nurse understands that the most common complaint by parents about infants with VSD is that they have 1. Reduced growth rate 2. Difficulty feeding 3. Development failure 4. Frequent respiratory tract infections Answer: 2 2. Mr. Parsons, 83 years old, has been diagnosed with acute myocardial infarction (MI). The following biomarkers have been described in association with acute myocardial infarction. Which of the following biomarkers is most indicative of MI? 1. Elevated Myoglobin 2. Elevated CK 3. Elevated Troponin 4. Elevated lactic dehydrogenase (LDH) and serum aspartate aminotransferase (AST) Answer: 3 3. Caroline is a 5-year-old admitted to the unit for a third-degree burns on the posterior thorax and legs. The nurse who is assisting in caring for Caroline would monitor for which of the following during the first 24 hours after the burn injury? a. Elevated hematocrit levels b. Increased urinary output c. Decreased heart rate and increased blood pressure d. Increased renal perfusion Answer: a 4. Ms. Baker, a middle-age female client, is seeking advice from her nurse concerning problems associated with menopausal symptoms. Ms. Baker asks her nurse what causes hot flashes. The

nurse explains that a primary cause of hot flashes is: 1. vasomotor instability caused by increased estrogen levels. 2. thyroid hyperactivity. 3. psychological instability caused by increased hormone surges. 4. vasomotor instability caused by decreased estrogen levels. Answer: 4 5. Following major abdominal surgery, Mrs. Abraha, was started on morphine sulfate via peripheral intravenous infusion. The nurse is inspecting the intravenous infusion dressing. The insertion date on the dressing is September. 3rd. The nurse calculates that the dressing should be changed on which of the following dates? a. September 3rd, within 24 hours b. September 4th c. September 6th d. September 7th Answer: C 6. Ms. Stanley, a 63-year-old woman, is receiving IV fluids following her surgery. The nurse is monitoring the fluid status. Which of the following symptoms would suggest to the nurse that Ms. Stanley has fluid volume overload? a. Ms. Stanley complaints of a headache, abdominal pain, and lethargy. b. Urinary output 720cc/24h, central venous pressure (CVP) of 5, and nystagmus. c. Cool skin, respiratory crackles, pulse 85 and bounding. d. Temperature 38.4oC, BP 95/62, pulse 95 and thready. Answer: C 7. Mrs. McCaffrey is a 69-year-old client admitted with a diagnosis of possible pulmonary tuberculosis. Mrs. McCaffrey has been placed in a negative pressure isolation room. What precautions should the nurse take when caring for Mrs.

McCaffrey? 1. Wear a face mask when entering Mrs. McCaffreys room 2. Wear a face mask, gown and gloves when in direct contact with McCaffrey 3. Wear a face mask, gown when entering Mrs. McCaffreys room 4. Wear a face mask, gown and gloves when entering negative pressure isolation room Answer: 1 8. Ellie, a 2-year-old girl has been diagnosed with immunemediated diabetes. A nurse must begin the educational process for Ellie and her family. Which one of the following teaching methods should the nurse use with Ellie? a. Individual Role-playing exercises b. Cooperative learning c. Independent learning d. Simple explanations and pictures Answer: A 9. A nurse is assigned to care for Mrs. Moalin, a 61-year-old client with aphasia. How can the nurse enhance nursing care and communication with Mrs. Moalin? a. Use visual pictures and objects b. Speak up and repeat him/herself frequently c. Refer to a speech therapist d. Ask pre-suppositional questions. Answer: A 10. A community health nurse is caring for a 68-your-old woman in her home. When teaching the client how to prevent constipation, which of the following instructions should be the most appropriate? 1. Adding 5 grams bran to your breakfast helps prevent constipation. 2. Regular walking exercise helps prevent constipation. 3. Drink at least 1200ml of fluid each day. 4. Avoid wheat-containing foods. Answer: 2

11. The registered nurse will be assisting in admitting Ms. McNamara for observation and postprocedure care after undergone esophagogastroduodenoscopy (EGD). The nurse would plan to do which of the following first once Ms. McNamara arrives? 1. Measure Ms. McNamaras temperature 2. Monitor Ms. McNamara for complaints of heartburn 3. Monitor Ms. McNamara for return of gag reflex 4. Give Ms. McNamara warm gargles for sore throat Answer: 3 12. Mr. Gutierrez is diagnosed with myocardial infarction (MI). He asks the nurse, What is the most common symptom of myocardial infarction? How should the nurse respond? 1. Heartburn is the most common symptom of MI 2. Heart palpitations is the most common symptom of MI 3. Dyspnea is the most common symptom of MI 4. Chest pain is the most common symptom of MI Answer: 4 13. A nurse works directly under doctors in hospital emergency room. Which of the following patients should the nurse place in highest priority for medical attention? a. A 19-year-old with came in for prescription of birth control pill. b. An 18-year-old with nose bleeding of 10-minute-duration. c. A 29-year-old who came in with blood pressure 80/60, pulse rate 132, respiratory rate 36. d. A 14-year-old with high fever Answer: C 14. Mr. Gutierrez is diagnosed with myocardial infarction (MI). Which

of the following symptoms is the most likely origin of pain when Mr. Gutierrez describes having knife like chest pain that increases in intensity with inspiration? 1. Cardiac pain 2. Gastrointestinal pain 3. Chest pain 4. Pulmonary pain Answer: 4 15. A physician orders digoxin (Lanoxin) 0.25 mg IV stat to a client with congestive heart failure. Available is an ampule of Lanoxin labeled 0.5 mg in 1 mL. How many milliliters should you administer? a. 1.5 ml b. 2 ml c. 1 ml d. 0.5 ml Answer: 0.5 ml 16. The physician orders doxycycline, 0.2 g PO q8h. The medication label states doxycycline, 100-mg capsules. The nurse prepares to administer how many tablets for one dose? 1. 0.5 tablet 2. 1 tablet 3. 2 tablets 4. 0.2 tablet 2tab 17. Mr. Suboh is in the post-anesthesia care unit (PACU) following his hemicolectomy. While in the PACU, the nurse will: 1. Monitor his vital signs continuously. 2. Monitor his vital signs every 5 minutes. 3. Monitor his vital signs every 15 minutes. 4. Monitor his vital signs on a PRN basis Answer 3 18. Ms. Baybayon, age 77 years, has a subtotal gastrectomy for cancer of the stomach. After surgery, she

returns to the unit with an IV and a nasogastric tube. Two hours after the subtotal gastrectomy, the nurse notices that drainage from Ms. Baybayons nasogastric tube is bright red. What should the nurse do? a. Notify the physician immediately b. Clamp the nasogastric tube immediately c. Inform the client that this is an expected finding d. Irrigate the nasogastric tube with saline Answer c 19. Mr. Suboh is in the post-anesthesia care unit (PACU) following his hemicolectomy. While in the PACU, the nurse will: 1. Monitor his vital signs continuously. 2. Monitor his vital signs every 5 minutes. 3. Monitor his vital signs every 15 minutes. 4. Monitor his vital signs on a PRN basis. Answer: 3 20. Ms. Baybayon, age 77 years, has a subtotal gastrectomy for cancer of the stomach. After surgery, she returns to the unit with an IV and a nasogastric tube. Two hours after the subtotal gastrectomy, the nurse notices that drainage from Ms. Baybayons nasogastric tube is bright red. What should the nurse do? a. Notify the physician immediately b. Clamp the nasogastric tube immediately c. Inform the client that this is an expected finding d. Irrigate the nasogastric tube with saline. Answer: c 21. Mrs. Harris, a 48 years old bank teller, is admitted to the surgical

unit for her left endocapsular cataract extraction. During the early postoperative period, Mrs. Harris tells the nurse: I have pain over my left eye and I feel nauseated. The most appropriate nursing response is: a. I will notify your physician right now b. I need to turn you on your right side c. This is normal after the endocapsular cataract extraction d. I will give you the ordered main medication and antiemetic. Answer:A 22. Mr. Suboh appears restless and anxious. His breathing is rapid and his pulse is weak. The nurse recognizes that Mr. Suboh is going into shock. What should the nurse do? 1. Remain calm and monitor Mr. Subohs vital signs. Position Mr. Suboh in reverse Trendelenburg position. 2. Reassure Mr. Suboh and repeat vital signs. 3. Administer oxygen and place bed in Trendelenburg position. Prepare a second I.V. line immediately. answer: 3 23. Elizabeth, a new nurse, has a multiple client assignment. When beginning her shift, Elizabeth needs to set priorities so she can effectively plan and manage her assignment. Which one of the following clients needs nursing intervention first? a. Ella, a 13-year-old teenage with high fever, possible tonsillitis. b. Dylan, a 21-year-old with a rash over the body. c. Mr. Alvarez, a 46-year-old complains of bladder distention, history of spinal injury. d. Mrs. Harris, a 56-year-old

complaining of intermittent vaginal bleeding. Answer: c 24. Mrs. Rideout, a 59-year-old patient with diabetes mellitus, develops ketoacidosis. The arterial blood gas report that is representative of diabetic ketoacidosis is: a. pCO2 49; HCO3 -- 32; pH7.50. b. pCO2 26; HCO3 -- 28; pH7.52. c. pCO2 54; HCO3 -- 28; pH7.30. d. pCO2 28; HCO3 -- 18; pH7.28. answer: d 25. Mrs. Stewart has developed pneumonia, and her temperature is 38.6C. Mrs. Stewart is shivering and feels distressed and uncomfortable. Which one of the following actions should the nurse take? a. Increase oral fluid consumption to 3 L per day. b. Provide extra blankets. c. Wrap the axilla and groin. d. Notify the physician. 26. A frail, malnourished older client has been having constipation. which of the following would be most likely ordered by the physician? 1. Bisacodyl ( Dulcolax) 2. Docusate sodium ( Colace) 3. Mineral Oil ( Haley's M-O) 4. Magnesium hydroxide ( Milk of magnesium/ MOM ) 27. Mason, an 18-month-old toddler has been hospitalized and placed in an isolation room. The nurse observes that Mason ignores his mother when she returns to visit him after work. The mother is worried by this behavior and asks if she should buy some new toy cars. The nurse recognizes Masons behavior as a normal response to a feeling of: a. Stimuli attention deficit b. Estrangement from parents

c. Abandonment d. Being beleaguered