RESPIRATORY TRACT EXERCISES:

1. The exchange of gases between blood and cells is called

a. pulmonary ventilation
b. internal respiration
c. external respiration
d. cellular respiration

Ans: B

2. The nose serves all the following functions EXCEPT:

a. as the initiator of the cough reflex
b. warming and humidifying the air
c. cleansing the air
d. as a passageway for air movement

Ans: A

3. Surface tension of the alveolar fluid is reduced by the presence of

a. mucus
b. sebum
c. surfactant
d. water

Ans: C

4. When the diaphragm and external intercostals muscles contract, which of the
following actions does NOT occur?
a. air moves into the lung
b. the intrapleural pressure increases
c. the diaphragm moves inferiorly
d. the intrapulmonary pressure decreases

Ans: B

5. When we inhale
a. alveolar pressure decreases and intrapleural pressure increases
b. both alveolar pressure and intrapleural pressure increase
c. both alveolar pressure and intrapleural pressure decrease
 d. alveolar pressure increases and intrapleural pressure decreases

Ans: C

6. Which of the body systems listed below cooperate to supply O2 to cells and eliminate
CO2?
1) digestive system
2) cardiovascular system
3) urinary system
4) respiratory system
5) endocrine system
a. 3, 5
b. 2, 4
c. 1, 2
d. 1, 2, 4

Ans: B

7. In the lungs
a. PCO2 in the alveoli is the same as that in the capillaries
b. PO2 in the alveoli is the same as that in the capillaries
c. PCO2 in the alveoli is higher than that in the capillaries
d. PCO2 in the alveoli is lower than that in the capillaries

Ans: D

8. As blood enters the systemic capillaries

a. PO2 in the blood is the same as PCO2 in the tissues
b. PO2 in the blood is higher than that in the tissues
c. PO2 in the blood is lower than that in the tissues
d. PO2 in the blood is the same as that in the tissues

Ans: B

9. During swallowing, the glottis is covered by

a. false vocal cord
b. true vocal cord
c. epiglottis
d. Adam’s apple

Ans: C

10. Which of the following describes a correct order of structures in the respiratory
passageways?
a. pharynx, trachea, larynx, bronchi, bronchioles
b. larynx, pharynx, trachea, bronchioles, bronchi
 c. trachea, pharynx, larynx, bronchi, bronchioles
d. pharynx, larynx, trachea, bronchi, bronchioles

Ans: D

11. The volume of air that can be exhaled after normal exhalation is the
a. tidal volume
b. residual volume
c. inspiratory reserve volume
d. expiratory reserve volume

Ans: D

12. The primary chemical stimulus for breathing is the concentration of

a. carbon monoxide in the blood
b. carbon dioxide in the blood
c. oxygen in the blood
d. carbonic acid in the blood

Ans: B

13. During internal and external respiration, gases move by

a. osmosis
b. active transport
c. diffusion
d. endocytosis

Ans: C

14. Most oxygen in the blood is transported

a. as gas dissolved in plasma
b. as oxyhemoglobin
c. as carboxyhemoglobin
d. as bicarbonate

Ans: B

UPPER RESPIRATORY TRACT DISORDER EXERCISES

1. What preventive measures can be taken to prevent broken nose?
a. Wear a seat belt while driving
b. Wear a protective helmet if riding a bike
c. Wear the right head and face protective gear if playing contact sports or sports
like cricket, hockey or baseball
d. All of the above
Ans: A

2. How should I treat a broken nose at home?

a. Treat by applying ice wrapped towel for 15 minutes to half-an-hour. If you have
undue pain and nasal congestion you could use over-the-counter pain
medications and nasal decongestants. If symptoms persist, it is better to see
a doctor.
b. Broken nose cannot be treated at home
c. Place a torniquet on the affected area and bring the client to the ED
d. None of the above because it will heal on its own

Ans: A

3. I had a blow on my nose and it is swollen, when should I seek an opinion of a

specialist?
a. You should seek advice of a specialist immediately: If you felt a crack when
you were hit, which means you have a fracture and find your nose to be
crooked or deformed
b. If you have a persistent nosebleed or watery discharge for more than 10 to 15
minutes and you are experiencing difficulty in breathing through your nose.
c. If you are experiencing headache that maybe accompanied by vomiting,
and/or feeling of giddiness or loss of consciousness and if you experience
extreme pain and bruising around the nose.
d. All of the above

Ans: D

4. How long does it generally take for the swelling and bruises on the nose to clear after
an injury?
a. The swelling and bruises may last for one to two weeks; however, if the nose
is bent – it will not straighten on its own unless it is corrected.
b. A couple of days
c. 6 months
d. 1 year

Ans: A

5. A patient was seen in the clinic for an episode of epistaxis, which was controlled by
placement of anterior nasal packing. During discharge teaching, the nurse instructs
the patient to:
a. Use aspirin for pain relief
b. Remove the packing later that day
c. Skip the next dose of antihypertensive medication
d. Avoid vigorous nose blowing and strenuous activity

Ans: D
6. A patient with allergic rhinitis reports severe nasal congestion; sneezing; and watery,
itchy eyes and nose at various time of the year. To teach the patient to control these
symptoms, the nurse advises the patient to
a. Avoid all intranasal sprays and oral antihistamines
b. Limit the usage of nasal decongestant spray to 10 days
c. Use oral decongestants at bedtime to prevent symptoms during the night
d. Keep a diary of when the allergic reaction occurs and what precipitates it

Ans: C

7. A patient is seen at the clinic with fever, muscles aches, sore throat with yellowish
exudate, and headache. The nurse anticipates that the collaborative management will
include (select all that apply)
a. Antiviral agents to treat influenza
b. Treatment with antibiotics starting ASAP
c. A throat culture or rapid strep antigen test
d. Supportive care, including cool, bland liquids
e. Comprehensive history to determine possible etiology

Ans: C,D,E

8. A 24-year-old lady presents to her GP with nasal congestion, bilateral clear

rhinorrhea, sneezing and itchy eyes. The most likely diagnosis is?
a. CSF leak
b. Chronic rhinosinusitis
c. Rhinitis medicamentosa
d. Acute rhinosinusitis
e. Allergic rhinitis

Ans: E

9. A 40-year-old man presents with a 4-month history of bilateral episodic facial pain,
nasal congestion and thick green nasal discharge. What is the most likely diagnosis?
a. Acute rhinosinusitis
b. Allergic rhinitis
c. Chronic rhinosinusitis
d. Common cold
e. Sinus malignancy

Ans: C

10. A nurse assesses a client who reports waking up feeling very tired, even after 8
hours of good sleep. Which action should the nurse take first?
a. Contact the provider for a prescription for sleep medication.
b. Tell the client not to drink beverages with caffeine before bed.
 c. Educate the client to sleep upright in a reclining chair.
d. Ask the client if he or she has ever been evaluated for sleep apnea.

Ans: D

11. A nurse is caring for a client who has sleep apnea and is prescribed modafinil
(Provigil). The client asks, "How will this medication help me?" How should the
nurse respond?
a. "This medication will treat your sleep apnea."
b. "This sedative will help you to sleep at night."
c. "This medication will promote daytime wakefulness."
d. "This analgesic will increase comfort while you sleep."

Ans: C

12. The most effective treatments for sleep apnea include all of the following EXCEPT:
a. weight loss.
b. the use of stimulant drugs.
c. the use of a continuous positive airway pressure (CPAP) mask.
d. surgery for breathing obstructions.

Ans: B

13. Signs and symptoms of sleep apnea include which of the following?
a. Loud snoring
b. Difficulty falling asleep
c. Headache in the evening
d. Nighttime sleepiness

Ans: A

14. What is the rationale for using CPAP to treat sleep apnea?
a. positive air pressure holds the airway open
b. negative air pressure holds the airway closed
c. delivery of oxygen facilitates respiratory effort
d. alternating waves of air stimulate breathing

Ans: A

15. A 32-year-old morbidly obese male complains of excessive fatigue, snoring, and
awakening in the middle of the night, which prevents restorative sleep. He is
sluggish during the day due to the lack of sleep and feels like he is going "fall asleep
at the wheel" when driving to work.
Occupation: dishwasher.
Medical history includes hypertension and type 2 diabetes.
Current medications include ACE inhibitor and metformin. Denies use of alcohol,
 tobacco, or drugs.
On physical examination, the patient is afebrile, pulse 88, respiratory rate is 20/min, BP
178/95. BMI is 45. These are signs and symptoms of:
a. Obstructive sleep apnea
b. Primary insomnia
c. Heart failure
d. All of the above

Ans: A

16. The nurse is admitting a client with a diagnosis of rule out cancer of the larynx.
Which information should the nurse teach?
a. Demonstrate the proper method of gargling with normal saline.
b. Perform voice exercises for 30 minutes three (3) times a day.
c. Explain that a lighted instrument will be placed in the throat to biopsy the area.
d. Teach the client to self-examine the larynx monthly.

Ans: C

18. The client is diagnosed with cancer of the larynx and is to have radiation therapy to
the area. For which prophylactic procedure will the nurse prepare the client?
a. Removal of the teeth
b. Taking anti-emetic medications every four (4) hours.
c. Wearing sunscreen on the area at all times.
d. Placement of a PEG tube.

Ans: B

19. The nurse is writing a care plan for a client newly diagnosed with cancer of the
larynx. Which problem would have the highest priority?
a. Wound infection.
b. Hemorrhage.
c. Respiratory distress.
d. Knowledge deficit
Ans: C

module 5

1. Which of the following is a priority goal for the client with COPD?
a. Maintaining functional ability.
b. Minimizing chest pain.
c. Increasing carbon dioxide levels in the blood.
d. Treating infectious agents.

Ans: A
2. A client’s arterial blood gas levels are as follows: pH 7.31; PaO2 80 mm Hg, PaCO2
65 mm Hg; HCO3- 36 mEq/L. Which of the following signs or symptoms would the
nurse expect?
a. Cyanosis
b. Flushed skin
c. Irritability
d. Anxiety

Ans: B

3. When teaching a client with COPD to conserve energy, the nurse should teach the
client to lift objects:
a. While inhaling through an open mouth.
b. While exhaling through pursed lips.
c. After exhaling but before inhaling
d. While taking a deep breath and holding it.

Ans: B

4. Which of the following diets would be most appropriate for a client with COPD?
a. Low fat, low cholesterol
b. Bland, soft diet
c. Low-Sodium diet
d. High calorie, high-protein diet

Ans: D

5. The nurse is planning to teach a client with COPD how to cough effectively. Which of
the following instructions should be included?
a. Take a deep abdominal breath, bend forward, and cough 3 to 4 times on
exhalation.
b. Lie flat on back, splint the thorax, take two deep breaths and cough.
c. Take several rapid, shallow breaths and then cough forcefully.
d. Assume a side-lying position, extend the arm over the head, and alternate
deep breathing with coughing.

Ans: A

6. The nurse would anticipate which of the following ABG results in a client experiencing
a prolonged, severe asthma attack?
a. Decreased PaCO2, increased PaO2, and decreased pH.
b. Increased PaCO2, decreased PaO2, and decreased pH.
c. Increased PaCO2, increased PaO2, and increased pH.
d. Decreased PaCO2, decreased PaO2, and increased pH.
Ans: B

7. A client with acute asthma is prescribed short-term corticosteroid therapy. What is the
rationale for the use of steroids in clients with asthma?
a. Corticosteroids promote bronchodilation
b. Corticosteroids act as an expectorant
c. Corticosteroids have an anti-inflammatory effect
d. Corticosteroids prevent development of respiratory infections.

Ans: C

8. Immediately following a thoracentesis, which clinical manifestations indicate that a

complication has occurred and the physician should be notified?
a. Serosanguineous drainage from the puncture site.
b. Increased temperature and blood pressure.
c. Increased pulse and pallor.
d. Hypotension and hypothermia.

Ans: C

9. Aminophylline (theophylline) is prescribed for a client with acute bronchitis. A nurse

administers the medication, knowing that the primary action of this medication is to:
a. Promote expectoration.
b. Suppress the cough
c. Relax smooth muscles of the bronchial airway.
d. Prevent infection

Ans: C

10. A client is receiving isoetharine hydrochloride (Bronkosol) via a nebulizer. The nurse
monitors the client for which side effect of this medication?
a. Constipation
b. Diarrhea
c. Bradycardia
d. Tachycardia

Ans: D

11. A nurse teaches a client about the use of a respiratory inhaler. Which action by the
client indicated a need for further teaching?
a. Removes the cap and shakes the inhaler well before use.
b. Press the canister down with your finger as he breathes in
c. Inhales the mist and quickly exhales.
d. Waits 1 to 2 minutes between puffs if more than one puff has been prescribed.

Ans: C
12. A female client is scheduled to have a chest radiograph. Which of the following
questions is of most importance to the nurse assessing this client?
a. “Is there any possibility that you could be pregnant?”
b. Are you wearing any metal chains or jewelry?”
c. “Can you hold your breath easily?”
d. “Are you able to hold your arms above your head?”

Ans: A

13. Dr. Jones prescribes albuterol sulfate (Proventil) for a patient with newly diagnosed
asthma. When teaching the patient about this drug, the nurse should explain that it
may cause:
a. Nasal congestion
b. Nervousness
c. Lethargy
d. Hyperkalemia

Ans: B

14. Miriam, a college student with acute rhinitis sees the campus nurse because of
excessive nasal drainage. The nurse asks the patient about the color of the
drainage. In acute rhinitis, nasal drainage normally is:
a. yellow
b. green
c. clear
d. gray
Ans: C

15. On auscultation, which finding suggests a right pneumothorax?

a. Bilateral inspiratory and expiratory crackles.
b. Absence of breaths sound in the right thorax.
c. Inspiratory wheezes in the right thorax.
d. Bilateral pleural friction rub.

Ans: B

16. Rhea, confused and short breath, is brought to the emergency department by a
family member. The medical history reveals chronic bronchitis and hypertension. To
learn more about the current respiratory problem, the doctor orders a chest x-ray
and arterial blood gas (ABG) analysis. When reviewing the ABG report, the nurses
see many abbreviations. What does a lowercase “a” in ABG value present?
a. Acid-base balance
b. Arterial Blood
c. Arterial oxygen saturation
d. Alveoli
Ans: B

17. A male patient is admitted to the healthcare facility for treatment of chronic
obstructive pulmonary disease. Which nursing diagnosis is most important for this
patient?
a. Activity intolerance related to fatigue
b. Anxiety related to actual threat to health status.
c. Risk for infection related to retained secretions.
d. Impaired gas exchange related to airflow obstruction.

Ans: D

18. Nurse Ruth assessing a patient for tracheal displacement should know that the
trachea will deviate toward the:
a. Contralateral side in a simple pneumothorax
b. Affected side in a hemothorax
c. Affected side in a tension pneumothorax
d. Contralateral side in hemothorax.

Ans: D

19. When caring for a male patient who has just had a total laryngectomy, the nurse
should plan to:
a. Encourage oral feeding as soon as possible.
b. Develop an alternative communication method.
c. Keep the tracheostomy cuff fully inflated.
d. Keep the patient flat in bed.

Ans: B

20. For a patient with advanced chronic obstructive pulmonary disease (COPD), which
nursing action best promotes adequate gas exchange?
a. Encouraging the patient to drink three glasses of fluid daily.
b. Keeping the patient in semi-Fowler's position.
c. Using a high-flow venturi mask to deliver oxygen as prescribed.
d. Administering a sedative, as prescribed.

Ans: C

21. For a female patient with chronic obstructive pulmonary disease, which nursing
intervention would help maintain a patent airway?
a. Restricting fluid intake to 1,000 ml per day.
b. Enforcing absolute bed rest.
c. Teaching the patient how to perform controlled coughing.
d. Administering prescribed sedatives regularly and in large amounts.
Ans: C

22. Nurse Lei, caring for a client with a pneumothorax and who has had a chest tube
inserted, continues gentle bubbling in the suction control chamber. What action is
appropriate?
a. Do nothing, because this is an expected finding.
b. Immediately clamp the chest tube and notify the physician.
c. Check for an air leak because the bubbling should be intermittent.
d. Increase the suction pressure so that the bubbling becomes vigorous.

Ans: A

23. An emergency room nurse is assessing a male client who has sustained a blunt
injury to the chest wall. Which of these signs would indicate the presence of a
pneumothorax in this client?
a. A low respiratory rate.
b. Diminished breath sounds.
c. The presence of a barrel chest.
d. A sucking sound at the site of injury.

Ans: B

24. Nurse Reese is caring for a client hospitalized with acute exacerbation of chronic
obstructive pulmonary disease. Which of the following would the nurse expect to
note on assessment of this client?
a. Hypocapnia
b. A hyperinflated chest noted on the chest x-ray.
c. Increased oxygen saturation with exercise.
d. A widened diaphragm noted on the chest x-ray.

Ans: B

25. A nurse is caring for a male client with emphysema who is receiving oxygen. The
nurse assesses the oxygen flow rate to ensure that it does not exceed:
a. 1 L/min
b. 2 L/min
c. 6 L/min
d. 10 L/min

Ans: B

26. A nurse instructs a female client to use the pursed-lip method of breathing and the
client asks the nurse about the purpose of this type of breathing. The nurse
responds, knowing that the primary purpose of pursed-lip breathing is to:
a. Promote oxygen intake
 b. Strengthen the diaphragm
c. Strengthen the intercostal muscles.
d. Promote carbon dioxide elimination

Ans: D

27. The nurse is teaching a male client with chronic bronchitis about breathing
exercises. Which of the following should the nurse include in the teaching?
a. Make inhalation longer than exhalation.
b. Exhale through an open mouth.
c. Use diaphragmatic breathing.
d. Use chest breathing.

Ans: C

28. The nurse assesses a male client’s respiratory status. Which observation indicates
that the client is experiencing difficulty breathing?
a. Diaphragmatic breathing
b. Use of accessory muscles
c. Pursed-lip breathing
d. Controlled breathing

Ans: B

29. A nurse is assessing a client with chronic airflow limitation and notes that the client
has a “barrel chest.” The nurse interprets that this client has which of the following
forms of chronic airflow limitation?
a. Chronic obstructive bronchitis
b. Emphysema
c. Bronchial asthma
d. Bronchial asthma and bronchitis

Ans: B

30. Which of the following would be an expected outcome for a client recovering from
an upper respiratory tract infection? The client will:
a. Maintain a fluid intake of 800 ml every 24 hours
b. Experience chills only once a day.
c. Cough productively without chest discomfort.
d. Experience less nasal obstruction and discharge.

Ans: D

31. A client with allergic rhinitis asks the nurse what he should do to decrease his
symptoms. Which of the following instructions would be appropriate for the nurse to
give the client?
 a. “Use your nasal decongestant spray regularly to help clear your nasal
passages.”
b. “Ask the doctor for antibiotics. Antibiotics will help decrease the secretion.”
c. “It is important to increase your activity. A daily brisk walk will help promote
drainage.”
e. “Keep a diary when your symptoms occur. This can help you identify what
precipitates your attacks.”

Ans: E

32. A client with COPD reports steady weight loss and being “too tired from just
breathing to eat.” Which of the following nursing diagnoses would
be most appropriate when planning nutritional interventions for this client?
a. Altered nutrition: Less than body requirements related to fatigue.
b. Activity intolerance related to dyspnea.
c. Weight loss related to COPD.
d. Ineffective breathing pattern related to alveolar hypoventilation.

Ans: A

33. Which of the following physical assessment findings would the nurse expect to find
in a client with advanced COPD?
a. Increased anteroposterior chest diameter.
b. Underdeveloped neck muscles
c. Collapsed neck veins
d. Increased chest excursions with respiration.

Ans: A

34. Which of the following is the primary reason to teach pursed-lip breathing to clients
with emphysema?
a. To promote oxygen intake.
b. To strengthen the diaphragm.
c. To strengthen the intercostal muscles.
d. To promote carbon dioxide elimination.

Ans: D

Module 6
1. The nurse assesses a patient for a possible pulmonary embolism. The nurse
looks for the most frequent sign of:
A. Cough
B. Hemoptysis
C. Syncope
D. Tachypnea.
Ans: D

2. The following are nursing interventions to assist in the prevention of

pulmonary embolism in a hospitalized patient include all except:
A. A liberal fluid intake.
B. Assisting the patient to do leg elevations above the level of the heart.
C. Encouraging the patient to dangle his or her legs over the side of the bed for
30 minutes, four times a day.
D. The use of elastic stockings, especially when decreased mobility would
promote venous stasis.

Ans: C

3. Which of the following is a type of embolism?

A. Travelling emboli.
B. Fat emboli.
C. Burn emboli.
D. Diabetic emboli.

Ans: B

4. The following are diagnostic tests for a patient with pulmonary embolism
except:
A. Chest x-ray
B. ECG
C. ABG analysis
D. Pulmonary function tests

Ans: D

5. What are the possible complications in a patient with pulmonary embolism?

A. Right ventricular failure
B. Cardiogenic shock
C. Septic shock
D. Both A and B.

6. A female patient suffers acute respiratory distress syndrome as a consequence of

shock. The patient’s condition deteriorates rapidly, and endotracheal intubation and
mechanical ventilation are initiated. When the high-pressure alarm on the mechanical
ventilator, alarm sounds, the nurse starts to check for the cause. Which condition
triggers the high-pressure alarm?
A. Kinking of the ventilator tubing
B. A disconnected ventilator tube.
C. An endotracheal cuff leak.
D. A change in the oxygen concentration without resetting the oxygen level
alarm.
 Ans. A

7. A male patient’s X-ray result reveals bilateral white-outs, indicating acute respiratory
distress syndrome (ARDS). This syndrome results from:
A. Cardiogenic pulmonary edema
B. Respiratory alkalosis
C. Increased pulmonary capillary permeability
D. Renal failure

Ans. C

8. A nurse is caring for a male client with acute respiratory distress syndrome. Which of
the following would the nurse expect to note in the client?
A. Pallor
B. Low arterial PaO2
C. Elevated arterial PaO2
D. Decreased respiratory rate

Ans. B

9. A male adult client is suspected of having a pulmonary embolism. A nurse assesses

the client, knowing that which of the following is a common clinical manifestation of
pulmonary embolism?
A. Dyspnea
B. Bradypnea
C. Bradycardia
D. Decreased respirations

Ans. A

10. Which of the following is considered the most widely accepted definition of
normal pulmonary arterial pressure?A. Less than or equal to 20 mm Hg
A. Less than or equal to 20 mm Hg
B. Less than or equal to 25 mm Hg
C. Less than or equal to 30 mm Hg
D. Less than or equal to 40 mm Hg

Ans. A

11. You’re providing care to a patient who is being treated for aspiration pneumonia.
The patient is on a 100% non-rebreather mask. Which finding below is a
HALLMARK sign and symptom that the patient is developing acute respiratory
distress syndrome (ARDS)?
A. The patient is experiencing bradypnea.
B. The patient is tired and confused.
 C. The patient’s PaO2 remains at 45 mmHg.
D. The patient’s blood pressure is 180/96.

Ans. C

12. You’re teaching a class on critical care concepts to a group of new nurses. You’re
discussing the topic of acute respiratory distress syndrome (ARDS). At the
beginning of the lecture, you assess the new nurses understanding about this
condition. Which statement by a new nurse demonstrates he understands the
condition?
A. “This condition develops because the exocrine glands start to work incorrectly
leading to thick, copious mucous to collect in the alveoli sacs.”
B. “ARDS is a pulmonary disease that gradually causes chronic obstruction of
airflow from the lungs.”
C. “acute respiratory distress syndrome occurs due to the collapsing of a lung
because air has accumulated in the pleural space.”
D. “This condition develops because alveolar capillary membrane permeability
has changed leading to fluid collecting in the alveoli sacs.”

Ans. D

13. During the exudative phase of acute respiratory distress syndrome (ARDS), the
patient’s lung cells that produce surfactant have become damaged. As the nurse
you know this will lead to?
A. bronchoconstriction
B. atelectasis
C. upper airway blockage
D. pulmonary edema

Ans. B

14. A patient has been hospitalized in the ICU for a near drowning event. The patient’s
respiratory function has been deteriorating over the last 24 hours. The physician
suspects acute respiratory distress syndrome. A STAT chest x-ray is ordered. What
finding on the chest x-ray is indicative of ARDS?
A. infiltrates only on the upper lobes
B. enlargement of the heart with bilateral lower lobe infiltrates
C. white-out infiltrates bilaterally
D. normal chest x-ray

Ans. C

15. Which patient below is at MOST risk for developing ARDS and has the worst
prognosis?
A. A 52-year-old male patient with a pneumothorax.
B. A 48-year-old male being treated for diabetic ketoacidosis.
 C. A 69-year-old female with sepsis caused by a gram-negative bacterial
infection.
D. A 30-year-old female with cystic fibrosis.

Ans. C

16. A patient is experiencing respiratory failure due to pulmonary edema. The physician
suspects ARDS but wants to rule out a cardiac cause. A pulmonary artery wedge
pressure is obtained. As the nurse you know that what measurement reading
obtained indicates that this type of respiratory failure is NOT cardiac related?
A. >25 mmHg
B. <10 mmHg
C. >50 mmHg
D. <18 mmHg

Ans. D

Module 7

EXERCISES:
1. A patient with a history of gastric bypass surgery 6 months ago reports feeling very
fatigued and is having food cravings for clay and dirt. On assessment, you note the
patient has nail changes that look “spoon-shaped”. This spoon-shaped appearance of
the nails is called?
A. Terry’s Nails
B. Onychoschizia
C. Koilonychias
D. Leukonychia

Ans. C

2. The physician orders a patient with suspected iron-deficiency anemia a blood smear
test to assess the quality of the red blood cells. How would the red blood cells
appear if the patient had iron- deficiency anemia?
A. Hyperchromic and macrocytic
B. Hypochromic and microcytic
C. Hyperchromic and macrocytic
D. Hypochromic and macrocytic

Ans. B

3. You’re providing education to a patient about how to take their prescribed iron
supplement. Which statement by the patient requires you to re-educate the patient
on how to take this supplement?
 A. “I will take this medication on an empty stomach.”
B. “I will avoid taking this medication with orange juice.”
C. “I will wait and take my calcium supplements 2 hours after I take my iron
supplement.”
D. “This medication can cause constipation. So, I will drink plenty of fluids and
take a stool softer as needed.”

Ans. B

4. A patient is admitted with iron- deficiency anemia and has been receiving iron
supplementation. The patient voices concern about how their stool is dark black. As
the nurse you would?
A. Notify the doctor
B. Hold the next dose of iron
C. Reassure the patient this is a normal side effect of iron supplementation
D. None of the options are correct

Ans. C

5. You are providing diet teaching to a patient with low iron levels. Which foods would
you encourage the patient to eat regularly?
A. herbal tea, apples, and watermelon
B. Sweet potatoes, artichokes, and packaged meat
C. Egg yolks, beef, and legumes
D. Chocolate, cornbread, and cabbage

Ans. C

6. A child with hemophilia who has been in a motor vehicle crash is admitted to the
pediatric unit. What should the nurse do in the care of this child?
A. The nurse should place the child on bleeding precautions and monitor for
bleeding
B. The nurse should monitor vital signs and monitor for joint pain.
C. The neurological status should be checked because the child is at risk for
intracranial hemorrhage, and the nurse should monitor the urine for
hematuria.
D. All of the above

7. The nurse analyzes the laboratory results of a child with hemophilia. The nurse
understands that which result will most likely be abnormal in this child?
A. Platelet count
B. Hematocrit level
C. Hemoglobin level
D. Partial thromboplastin time
Ans. D

8. The nurse is providing home care instructions to the parents of a 10-year-old child
with hemophilia. Which sport activity should the nurse suggest for this child?
A. Soccer
B. Basketball
C. Swimming
D. Field hockey

Ans. C

9. The nursing student is presenting a clinical conference and discusses the cause of β-
thalassemia. The nursing student informs the group that a child at greatest risk of
developing this disorder is which of these?
A. A child of Mexican descent
B. A child of Mediterranean descent
C. A child whose intake of iron is extremely poor
D. A breast-fed child of a mother with chronic anemia

Ans. B

10. A child with β-thalassemia is receiving long-term blood transfusion therapy for the
treatment of the disorder. Chelation therapy is prescribed as a result of too much
iron from the transfusions. Which medication should the nurse anticipate to be
prescribed?
A. Fragmin
B. Meropenem
C. Metoprolol
D. Deferoxamine

Ans. D

11. The clinic nurse instructs parents of a child with sickle cell anemia about the
precipitating factors related to sickle cell crisis. Which, if identified by the parents as
a precipitating factor, indicates the need for further instruction?
A. Stress
B. Trauma
C. Infection
D. Fluid overload

Ans. D

12. A 10-year-old child with hemophilia A has slipped on the ice and bumped his knee.
The nurse should prepare to administer which prescription?
A. Injection of factor X
B. Intravenous infusion of iron
 C. Intravenous infusion of factor VIII
D. Intramuscular injection of iron using the Z-track method

Ans. C

13. The nurse is instructing the parents of a child with iron deficiency anemia regarding
the administration of a liquid oral iron supplement. Which instruction should the
nurse tell the parents?
A. Administer the iron at mealtimes.
B. Administer the iron through a straw.
C. Mix the iron with cereal to administer.
D. Add the iron to formula for easy administration.

Ans. B

14. Laboratory studies are performed for a child 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

Ans. D

15. The nurse is reviewing a health care provider’s prescriptions for a child with sickle
cell anemia who was admitted to the hospital for the treatment of vaso-occlusive
crisis. Which prescriptions documented in the child’s record should the nurse
question? Select all that apply.
A. Restrict fluid intake.
B. Position for comfort.
C. Avoid strain on painful joints.
D. Apply nasal oxygen at 2 L/minute.
E. Provide a high-calorie, high-protein diet.
F. Give meperidine, 25 mg intravenously, every 4 hours for pain.

Ans. A, F,

16. The nurse is conducting staff in-service training on von Willebrand’s disease. Which
should the nurse include as characteristics of von Willebrand’s disease? Select all
that apply.
A. Easy bruising occurs.
B. Gum bleeding occurs.
C. It is a hereditary bleeding disorder.
D. Treatment and care are similar to that for hemophilia.
E. It is characterized by extremely high creatinine levels.
 F. The disorder causes platelets to adhere to damaged endothelium.

Ans. A, B, C, D, F

Module 8

1. The results of an adult patient’s blood pressure screening on three occasions

are: 120/80 mmHg, 130/76 mmHg, and 118/86 mmHg. How will the
healthcare provider interpret this information?
A. Hypertension stage 2
B. Prehypertension
C. Hypertension stage 1
D. Normal blood pressure

Ans. B

2. A patient is diagnosed with primary hypertension. When taking the patient’s history,
the healthcare provider anticipates the patient will report which of the following?
A. “Every once in a while I wake up at night covered in sweat.”
B. “Sometimes I get pain in my lower legs when I take my daily walk.”
C. “I have not noticed any significant changes in my health.”
D. “I’m starting to get out of breath when I go up a flight of stairs.”

Ans. C

3. A patient is prescribed a thiazide diuretic for the treatment of hypertension. When

teaching the patient about the medication, which of the following will the healthcare
provider include?
A. “Take this medication each day with a large glass of water after your evening
meal.”
B. “Be sure to include a number of foods that are rich in potassium in your diet.”
C. “Stop taking this medication if you notice changes in how much you urinate.”
D. “I’ll teach you how to take your radial pulse before taking the medication.”

Ans. B

4. When discussing hypertension with a student, which of the following will the
healthcare provider identify as a factor related to hypertension?
A. Increased afterload
B. Decreased cardiac output
C. Hypovolemia

Ans. A

5. A woman in her second trimester of pregnancy is diagnosed with preeclampsia.

Which of the following statements about preeclampsia will guide the care provided to
this patient?
 A. Preeclampsia is the most common cause of delivery after 40 weeks gestation.
B. The patient should not be concerned because the disorder will not affect the
fetus.
C. If untreated, preeclampsia may result in fetal growth restriction.
D. The most serious problem with preeclampsia is edema, which is treated with
diuretics.

Ans. C

6. A patient presents to the emergency department with a blood pressure of 180/130

mmHg, headache, and confusion. Which additional finding is consistent with a
diagnosis of hypertensive emergency?
A. Retinopathy
B. Urinary retention
C. Jaundice
D. Bradycardia

Ans. A

7. A patient is prescribed a new medication for the treatment of hypertension. While

supine, the patient’s blood pressure is 112/70 mmHg and the heart rate is 80/minute.
The healthcare provider assesses the patient when the patient changes to a sitting
position. Which of the following indicates the patient is experiencing orthostatic
hypotension?
A. BP 100/66, HR 90
B. BP 90/60, HR 68
C. BP 88/62, HR 100
D. BP 120/84, HR 82

Ans. C

8. A patient is prescribed a calcium channel blocker to treat primary hypertension. When

teaching the patient about the medication, which of these foods will the healthcare
provider advise the patient to avoid?
A. Grapefruit
B. Eggs
C. Bananas
D. Oranges

Ans. A

9. A patient who is newly diagnosed with stage 1 hypertension is being evaluated by a

healthcare provider. Which of the following laboratory tests would indicate organ
damage that may result from hypertension?
A. Coagulation panel
 B. Serum aldosterone
C. Complete blood count
D. Urinalysis

Ans. D
10. A patient tells the healthcare provider, “I stopped taking my medication because it
kept me up at night with a dry cough.” When reviewing the patient’s medical record,
which of these antihypertensive medications will the healthcare provider identify as
the likely cause of this patient’s report?
A. Angiotensin-converting enzyme (ACE) inhibitor
B. Beta blocker
C. Loop diuretic
D. Calcium channel blocker

Ans. A

11. A patient is being discharged home on Hydrochlorothiazide (HCTZ) for treatment of

hypertension. Which of the following statements by the patient indicates they
understood your discharge teaching about this medication?
A. I will make sure I consume foods high in potassium.
B. I will only take this medication if my blood pressure is high.
C. I understand a dry cough is a common side effect with this medication.
D. I will monitor my glucose levels closely because this medication may mask
symptoms of hypoglycemia.

Ans. A

12. Which of the following patients does not have a risk factor for hypertension?
A. A 25 year old male with a BMI of 35.
B. A 35 year old female with a total cholesterol level of 100.
C. A 68 year old male who reports smoking 2 packs of cigarettes a day.
D. A 40 year old female with a family history of hypertension and diabetes.

Ans. B

13. A patient with hypertension is started on a new medication for treatment and is
reporting a continuous dry cough. Which of the following medications do you
suspect is causing this problem?
A. Lisinopril
B. Labetalol
C. Losartan
D. Hydrochlorothiazide

Ans. A

14. Which of the following patients is not a candidate for a beta blocker medication?
 A. A 45-year-old male with angina.
B. A 39-year-old female with asthma.
C. A 25-year-old female with migraines.
D. A 55-year-old male with a history of two heart attacks.

Ans. B

15. Which family of drugs are the following medications considered: Amlodipine,
Verapamil, Diltiazem?
A. Beta blockers (BB)
B. ACE Inhibitors (ACEI)
C. Angiotension Receptor Blockers (ARBs)
D. Calcium Channel Blockers (CCBs)

Ans. D

16. Which of the following systems of the body are affected by hypertension?
A. Cardiovascular, brain, kidney, eyes
B. Cardiovascular, gastrointestinal, reproductive, and kidney
C. Brain, respiratory, kidney, cardiovascular
D. None of the above

Ans. A

17. Non-pharmacological techniques can help lower blood pressure. Which of the
following is not considered one of these types of techniques?
A. Dietary changes
B. Multivitamins
C. Smoking cessation
D. Limiting caffeine

Ans. B

18. A patient is scheduled to take Captopril. When is the best time to administer this
medication?
A. 30 minutes after a meal
B. At bedtime
C. In the morning
D. 1 hour before a meal

Ans. D

19. True or False: Most patients with hypertension are asymptomatic.

Ans. True
20. Which of the following drugs is NOT considered an Angiotension Receptor Blocker
(ARBs) medication used in hypertension?
A. Catapres
B. Losartan
C. Benicar
D. Valsartan

Ans. A

Module 9

1. What are the anti-aginal actions of organic nitrates?

a. Increase O2 consumption; redistribution of coronary flow to infarct areas; relief of
coronary spasm; improve perfusion to other organs
b. Decrease O2 consumption; redistribution of coronary flow to ischemic areas;
relief of coronary spasm; improve perfusion
c. Decrease O2 consumption; redistribution of coronary flow to infarct areas; relief
of coronary spasm; improve perfusion

Ans. B

2. Which of the following conditions is most closely associated with weight gain, nausea,
and a decrease in urine output?
a. Angina pectoris
b. Cardiomyopathy
c. Left-sided heart failure
d. Right-sided heart failure

Ans. D

3. A patient with stable angina is more likely to experience chest pain when the heart
needs extra oxygen. During which of the following situations does the heart need
extra oxygen?
a. Smoking a cigarette
b. Eating and digesting a heavy meal
c. Running up the stairs or other physical activity
d. All of the above

Ans. D

4. Which of the following terms refers to chest pain brought on by physical or emotional
stress and relieved by rest or medication?
a. angina pectoris
b. atherosclerosis
 c. atheroma
d. ischemia

ans. A

5. What are the effects of organic nitrates?

a. Vasodilation; dilation of large veins results in decreased after-load and
decreased cardiac output
b. Vasodilation; dilation of large veins results in decreased pre-load and decreased
cardiac output
c. Vasodilation; dilation of large veins results in decreased pre-load and decreased
blood pressure

Ans. B

6. A patient with angina pectoris is being discharged home with nitroglycerine tablets.
Which of the following instructions does the nurse include in the teaching?
a. “When your chest pain begins, lie down, and place one tablet under your tongue.
If the pain continues, take another tablet in 5 minutes.”
b. “Place one tablet under your tongue. If the pain is not relieved in 15 minutes, go
to the hospital.”
c. “Continue your activity, and if the pain does not go away in 10 minutes, begin
taking the nitro tablets one every 5 minutes for 15 minutes, then go lie down.”
d. “Place one Nitroglycerine tablet under the tongue every five minutes for three
doses. Go to the hospital if the pain is unrelieved.

Ans. D

7. To enhance the percutaneous absorption of nitroglycerine ointment, it would be

MOST important for the nurse to select a site that is
a. muscular.
b. near the heart.
c. non-hairy.
d. over a bony prominence.

Ans. C

8. What causes unstable angina?

a. Atherosclerosis which ruptures, thrombus forms on top, often leading to complete
occlusion
b. Atherosclerosis which reduces O2 to tissue
c. Atherosclerosis which ruptures, thrombus forms on top, always followed by
breaking up and embolus formation leading to complete occlusion and infarction

Ans. C
9. Which of the following symptoms should the nurse teach the client with unstable
angina to report immediately to her physician?
a. A change in the pattern of her pain.
a. Pain during sex
b. Pain during an argument with her husband
c. Pain during or after an activity such as lawn mowing.

Ans. A

10. The physician refers the client with unstable angina for a cardiac catheterization.
The nurse explains to the client that this procedure is being used in this specific
case to:
a. Open and dilate the blocked coronary arteries.
b. Assess the extent of arterial blockage.
c. Bypass obstructed vessels.
d. Assess the functional adequacy of the valves and heart muscle

Ans. B

11. Sublingual nitroglycerin tablets begin to work within 1 to 2 minutes. How should the
nurse instruct the client to use the drug when chest pain occurs?
a. Take one (1) tablet every two (2) to five (5) minutes until the pain stops
b. Take one (1) tablet and rest for ten (10) minutes. Call the physician if pain
persists after ten (10) minutes.
c. Take one (1) tablet, then an additional tablet every 5 minutes for a total of three
(3) tablets. Call the physician if pain persists after three (3) tablets.
d. Take one (1) tablet. If pain persists after five (5) minutes, take two (2) tablets. If
pain persists five (5) minutes later, call the physician.

Ans. C

12. When do coronary arteries primarily receive blood flow?

a. During inspiration
b. During diastolic
c. During expiration
d. During systole

Ans. B

13. Which of the following types of pain is most characteristic of angina?

a. Knifelike
b. Sharp
c. Shooting
d. Tightness

Ans. D
14. Following a treadmill test and cardiac catheterization, the client is found to have
coronary artery disease, which is inoperative. He is referred to the cardiac
rehabilitation unit. During his first visit to the unit he says that he doesn’t understand
why he needs to be there because there is nothing that can be done to make him
better. The best nursing response is:
a. “Cardiac rehabilitation is not a cure but can help restore you to many of your
former activities
b. “Here we teach you to gradually change your lifestyle to accommodate your heart
disease.”
c. “You are probably right but we can gradually increase your activities so that you
can live a more active life.”
d. “Do you feel that you will have to make some changes in your life now?”

Ans. A

Module 10

1. A client is admitted to the emergency department with chest pain that is consistent
with myocardial infarction based on elevated troponin levels. Heart sounds are
normal and vital signs are noted on the client’s chart. The nurse should alert the
health care provider because these changes are most consistent with which
complication?
a. Cardiogenic shock
b. Cardiac tamponade
c. Pulmonary embolism
d. Dissecting thoracic aortic aneurysm

Ans. A

2. A client with myocardial infarction suddenly becomes tachycardic, shows signs of air
hunger, and begins coughing frothy, pink-tinged sputum. Which finding would the
nurse anticipate when auscultating the client’s breath sounds?
a. Stridor
b. Crackles
c. Scattered rhonchi
d. Diminished breath sounds

Ans. B

3. A client with myocardial infarction is developing cardiogenic shock. Because of the

risk of myocardial ischemia, what condition should the nurse carefully assess the
client for?
a. Bradycardia
b. Ventricular dysrhythmias
c. Rising diastolic blood pressure
 d. Falling central venous pressure

Ans. B

4. The nurse should visit which of the following clients first?

a. The client with diabetes with a blood glucose of 95mg/dL
b. The client with hypertension being maintained on Lisinopril
c. The client with chest pain and a history of angina
d. The client with Raynaud’s disease

Ans. C

5. What is the primary reason for administering morphine to a client with myocardial
infarction?
a. To sedate the client
b. To decrease the client’s pain
c. To decrease the client’s anxiety
d. To decrease oxygen demand on the client’s heart

Ans. D

6. A patient arrives in the emergency department with symptoms of myocardial

infarction, progressing to cardiogenic shock. Which of the following symptoms should
the nurse expect the patient to exhibit with cardiogenic shock?
a. Hypertension.
b. Bradycardia.
c. Bounding pulse.
d. Confusion.

Ans. D

7. In order to be effective, Percutaneous Transluminal Coronary Angioplasty (PTCA)

must be performed within what time frame, beginning with arrival at the emergency
department after diagnosis of myocardial infarction?
a. 60 minutes
b. 30 minutes
c. 9 days
d. 6-12 months

Ans. A

8. Helen, a nurse from the maternity unit is floated to the critical care unit because of
staff shortage on the evening shift. Which client would be appropriate to assign to this
nurse? A client with:
a. Dopamine drip IV with vital signs monitored every 5 minutes
b. myocardial infarction that is free from pain and dysrhythmias
 c. tracheotomy of 24 hours in some respiratory distress
d. pacemaker inserted this morning with intermittent capture

ans. B

9. Tissue plasminogen activator (t-PA) is considered for treatment of a patient who

arrives in the emergency department following onset of symptoms of myocardial
infarction. Which of the following is a contraindication for treatment with t-PA?
a. Worsening chest pain that began earlier in the evening.
b. History of cerebral hemorrhage.
c. History of prior myocardial infarction.
d. Hypertension.

Ans. B

10. A patient admitted to the hospital with myocardial infarction develops severe
pulmonary edema. Which of the following symptoms should the nurse expect the
patient to exhibit?
a. Slow, deep respirations.
b. Stridor.
c. Bradycardia.
d. Air hunger.

Ans. D

11. Which of the following is the most common symptom of myocardial infarction?
a. Chest pain
b. Dyspnea
c. Edema
d. Palpitations

Ans. A

12. The nurse is giving discharge teaching to a client 7 days post myocardial infarction.
He asks the nurse why he must wait 6 weeks before having sexual intercourse.
What is the best response by the nurse to this question?
a. “You need to regain your strength before attempting such exertion.”
b. “When you can climb 2 flights of stairs without problems, it is generally safe.”
c. “Have a glass of wine to relax you, then you can try to have sex.”
d. “If you can maintain an active walking program, you will have less risk.”

Ans. B

13. Following myocardial infarction, a hospitalized patient is encouraged to practice

frequent leg exercises and ambulate in the hallway as directed by his physician.
Which of the following choices reflects the purpose of exercise for this patient?
 a. Increases fitness and prevents future heart attacks.
b. Prevents bedsores.
c. Prevents DVT (deep vein thrombosis).
d. Prevent constipations.

Ans. C

14. Which statement best describes the difference between the pain of angina and the
pain of myocardial infarction?
a. Pain associated with angina is relieved by rest.
b. Pain associated with myocardial infarction is always more severe.
c. Pain associated with angina is confined to the chest area.
d. Pain associated with myocardial infarction is referred to the left arm.

Ans. A

15. Patrick who is hospitalized following a myocardial infarction asks the nurse why he
is taking morphine. The nurse explains that morphine:
a. Decrease anxiety and restlessness
b. Prevents shock and relieves pain
c. Dilates coronary blood vessels
d. Helps prevent fibrillation of the heart

Ans, b

Module 11

1. Which of the following symptoms is most commonly associated with left-sided heart
failure?
a. Crackles
a. Arrhythmias
b. Hepatic engorgement
c. Hypotension

Ans: A

2. Which of the following symptoms might a client with right-sided heart failure exhibit?
a. Adequate urine output
b. Polyuria
c. Oliguria
d. Polydipsia

Ans: C
3. Which of the following classes of medications maximizes cardiac performance in
clients with heart failure by increasing ventricular contractibility?
a. Beta-adrenergic blockers
 b. Calcium channel blockers
c. Diuretics
d. Inotropic agents

Ans: D

4. Which of the following conditions is most closely associated with weight gain, nausea,
and a decrease in urine output?
a. Angina pectoris
b. Cardiomyopathy
c. Left-sided heart failure
d. Right-sided heart failure

Ans: D

5. Dyspnea, cough, expectoration, weakness, and edema are classic signs and
symptoms of which of the following conditions?
a. Pericarditis
b. Hypertension
c. MI
d. Heart failure

Ans: D

Module 12

1. A client with atherosclerosis asks a nurse which factors are responsible for this
condition. What is the nurse’s best response?
a. “Injury to the arteries causes them to spasm, reducing blood flow to the
extremities.”
b. “Excess fats in your diet are stored in the lining of your arteries, causing them
to constrict.”
c. “A combination of platelets and fats accumulate, narrowing the artery and
reducing blood flow.”
d. “Excess sodium from hypertension causes direct injury to the arteries,
reducing blood flow and eventually causing obstruction.”

Ans: C

2. The nurse recognizes which client is at greatest risk for developing intimal injury
leading to atherosclerosis?
a. A client with diabetes who also smokes one pack of cigarettes daily
b. A client with decreased low-density lipoprotein (LDL) and increased high-
density lipoprotein (HDL) levels
c. A client with inherited hypolipidemia
d. A client with a sedentary lifestyle
Ans: A

3. A client with hyperlipidemia, who is being treated with dietary fat restrictions and an
exercise program, asks the nurse why his serum lipid levels are still elevated. What is
the nurse’s best response?
a. “You may need to restrict your fat intake to less than 30% of total calories.”
b. “You may have a genetic predisposition to hyperlipidemia.”
c. “Your arteries may already be damaged.”
d. “You may need to lose some weight to lower your cholesterol levels.”

Ans: B

4. On auscultation of the carotid arteries of a client with atherosclerosis, the nurse hears
a swishing sound over the right carotid. Which would be the nurse’s best action?
a. Performing carotid massage
b. Notifying the health care provider
c. No action is necessary because this is a normal finding.
d. Simultaneously palpating the carotid arteries bilaterally

Ans: B

5. During an assessment of a patient’s abdomen, a pulsating abdominal mass is noted

by the healthcare provider. Which of the following should be the healthcare
provider’s next action?
a. Ask the patient to perform a Valsalva maneuver
b. Obtain a bladder scan
c. Measure the abdominal circumference
d. Assess femoral pulses

Ans: D

6. An unconscious patient arrives at the emergency department. Periumbilical (Cullen’s

sign) and flank ecchymosis (Grey Turner’s sign) is noted, and a ruptured abdominal
aortic aneurysm (AAA) is suspected. Which of these additional assessment findings
will the healthcare provider anticipate?
a. Pale, clammy skin
b. Expiratory wheezes
c. Decorticate posturing
d. Pinpoint pupils

Ans: A

7. A 76 year old man enters the ER with complaints of back pain and feeling fatigued.
Upon examination, his blood pressure is 190/100, pulse is 118, and hematocrit and
hemoglobin are both low. The nurse palpates the abdomen which is soft, non-tender
 and auscultates an abdominal pulse. The most likely diagnosis is:
a. Buerger’s disease
b. CHF
c. Secondary hypertension
d. Aneurysm

Ans: D

8. Which of the following is not directly related with Buerger’s disease?

a. Claudication
b. Thromboangitis obliterans
c. Night sweats
d. Poor tolerance of cold

Ans: C

9. A client has been diagnosed with thromboangiitis obliterans (Buerger ’s disease). The
nurse is identifying measures to help the client cope with lifestyle changes needed to
control the disease process. The nurse plans to refer the client to a:
a. Dietitian
b. Smoking cessation program
c. Pain management clinic
d. Medical Social worker

Ans: B

10. A patient has an arterial ulcer on the lower extremity. What risk factors for peripheral
arterial disease are in the patient’s health history? Select all that apply:
a. Pregnancy
b. Being Female
c. High Cholesterol
d. Diabetes Mellitus
e. Uncontrolled hypertension
f. Varicose veins
g. Smoking

Ans: C,D,E,G

11. A patient is diagnosed with Raynaud’s Disease. Which explanations below most
accurately describe this condition? Select all that apply:
a. Raynaud’s Disease is triggered by cold temperatures or stress.
b. Raynaud’s Disease occurs due to a vasospasm of the peripheral veins.
c. Raynaud’s Disease affects the toes, fingers, and sometimes the ears and nose.
d. Raynaud’s Disease is prevented by glucose control.

Ans: A,C
12. The MOST common cause of peripheral arterial disease is?
a. Diabetes
b. Deep vein thrombosis
c. Atherosclerosis
d. Pregnancy

Ans: C

13. Your patient reports experiencing dull and achy sensations in the lower extremities.
You note that the lower extremities have edema and brownish pigmentation. Pulses
are present bilaterally and the extremities feel warm to the touch. To help alleviate
the patient’s symptoms, the nurse will position the lower extremities in the?
a. Dependent position
b. Horizontal position
c. Elevated position above heart level
d. Knee-flexed position

Ans: C

14. You’re assessing a patient’s health history for peripheral vascular disease. What
signs and symptoms reported by the patient would indicate the patient may be
experiencing peripheral arterial disease? Select all that apply:
a. “I often wake up at night with leg pain and have to dangle my leg out of the bed
to ease the pain.”
b. “If I stand or sit too long my legs start to feel heavy and achy.”
c. “It hurts to elevate my legs.”
d. “Sometimes when I’m walking my legs start to cramp and tingle to the point
where I can’t walk until the pain goes away.”

Ans: A,C,D

Module 13

1. Which of the following types of cardiomyopathy can be associated with childbirth?

a. Dilated
b. Hypertrophic
c. Myocarditis
d. Restrictive

Ans: A

2. Septal involvement occurs in which type of cardiomyopathy?

a. Congestive
b. Dilated
 c. Hypertrophic
d. Restrictive

Ans: C

3. Which of the following recurring conditions most commonly occurs in clients with
cardiomyopathy?
a. Heart failure
b. Diabetes
c. MI
d. Pericardial effusion

Ans: A

4. In which of the following types of cardiomyopathy does cardiac output remain

normal?
a. Dilated
b. Hypertrophic
c. Obliterative
d. Restrictive

Ans: B

5. Which of the following classes of drugs is most widely used in the treatment of
cardiomyopathy?
a. Antihypertensives
b. Beta-adrenergic blockers
c. Calcium channel blockers
d. Nitrates

Ans: B

6. If medical treatments fail, which of the following invasive procedures is necessary for
treating cariomyopathy?
a. Cardiac catherization
b. Coronary artery bypass graft (CABG)
c. Heart transplantation
d. Intra-aortic balloon pump (IABP)

Ans: C

7. A 22 year old patient with rheumatic fever has subcutaneous nodules, erythema
marginatum, and polyarthritis of multiple joints. An appropriate nursing diagnosis
based on these findings is:
a. Activity intolerance related to arthralgia
b. Risk for infection related to open skin lesions.
 c. Risk for impaired skin integrity related to pruritus and scratching.
d. Risk for impaired physical mobility related to permanent joint fixation

Ans: A

8. A patient is hospitalized with infective endocarditis and develops sharp left flank pain
and hematuria. The nurse notifies the physician, recognizing that these symptoms
may indicate:
a. Vegetative embolization to the kidneys.
b. Colonization of micro organization in the kidneys.
c. Septicemia resulting in decreased urine output.
d. Hemolysis of red blood cells by microorganisms.

Ans: A

9. The nurse identifies the nursing diagnosis of decreased cardiac output related to
valvular insufficiency for the patient with infective endocarditis based on the
assessment finding of
a. Fever, chills, and diaphoresis
b. Capillary refill time of 5 seconds.
c. Petechiae of the buccal mucosa and conjunctiva.
d. An increase in pulse rate of 20 with activity

Ans: B

10. When obtaining a nursing history from a 23-year-old man with rheumatic fever, the
nurse recognizes that the most significant information related by the patient is that
he:
a. Has used illicit intravenous drugs within the last 3 months.
b. Has been unemployed for 6 months and has been eating poorly.
c. Suffered chest trauma with a fractured rib during a fight 2 weeks ago.
d. Had an upper respiratory infection with a sore throat about 3 weeks ago.

Ans: D

11. A patient is hospitalized with chronic pericarditis. On assessment, you note the
patient has pitting edema in lower extremities, crackles in lungs, and dyspnea on
excretion. The patient's echocardiogram shows thickening of the pericardium. This
is known as what type of pericarditis?
a. Pericardial effusion
b. Acute pericarditis
c. Constrictive pericarditis
d. Effusion-Constrictive pericarditis

Ans: C
12. Select-all-that-apply: Which of the following are NOT typical signs and symptoms of
pericarditis?
a. Fever
b. Increased pain when leaning forward
c. ST segment depression
d. Pericardial friction rub
e. Radiating substernal pain felt in the left shoulder
f. Breathing in relieves the pain

Ans: B, C, F

13. You are providing care to a patient experiencing chest pain when coughing or
breathing in. The patient has pericarditis. The physician has ordered the patient to
take Ibuprofen for treatment. How will you administer this medication?
a. strictly without food
b. with a full glass of juice
c. with a full glass of water
d. with or without food

Ans: C

14. On physical assessment of a patient with pericarditis, you may hear what type of
heart sound?
a. S3 or S4
b. mitral murmur
c. pleural friction rub
d. pericardial friction rub

Ans: D

15. A patient is admitted with myocarditis. While performing the initial assessment,
which clinical signs and symptoms might the nurse find (select all that apply)?
a. angina
b. pleuritic chest pain
c. splinter hemorrhages
d. pericardial friction rub
e. presence of Osler's nodes

Ans: A,B,D

module 14

1. The nurse is reading a health care provider’s (HCP’s) progress notes in the client’s
record and reads that the HCP has documented “insensible fluid loss of
 approximately 800 mL daily.” The nurse makes a notation that insensible fluid loss
occurs through which type of excretion?
a. Urinary output
b. Wound drainage
c. Integumentary output
d. The gastrointestinal tract

Ans: C

2. A 12-year-old boy was admitted to the hospital two days ago due to hyperthermia.
His attending nurse, Dennis, is quite unsure about his plan of care. Which of the
following nursing interventions should be included in the care plan for the client?
a. Room temperature reduction
b. Fluid restriction of 2,000 ml/day
c. Axillary temperature measurements every 4 hours
d. Antiemetic agent administration

Ans: A

3. Patient X is diagnosed with constipation. As a knowledgeable nurse, which nursing

intervention is appropriate for maintaining normal bowel function?
a. Assessing dietary intake
b. Decreasing fluid intake
c. Providing limited physical activity
d. Turning, coughing, and deep breathing

Ans: A

4. A 36-year-old male client is about to be discharged from the hospital after 5 days due
to surgery. Which intervention should be included in the home health care nurse’s
instructions about measures to prevent constipation?
a. Discouraging the client from eating large amounts of roughage-containing foods
in the diet.
b. Encouraging the client to use laxatives routinely to ensure adequate bowel
elimination.
c. Instructing the client to establish a bowel evacuation schedule that changes
every day.
d. Instructing the client to fill a 2-L bottle with water every night and drink it the next
day.

Ans: D

5. Lisa, a client with altered urinary function, is under the care of nurse Tine. Which
intervention is appropriate to include when developing a plan of care for Lisa who is
experiencing urinary dribbling?
a. Inserting an indwelling Foley catheter.
 b. Having the client perform Kegel exercises.
c. Keeping the skin clean and dry.
d. Using pads or diapers on the client.

Ans: B

6. A 22-year-old lady is displaying facial grimaces during her treatment in the hospital
due to burn trauma. Which nursing intervention should be included for reducing pain
due to cellular injury?
a. Administering anti-inflammatory agents as prescribed.
b. Elevating the injured area to decrease venous return to the heart.
c. Keeping the skin clean and dry.
d. Applying warm packs initially to reduce edema.

Ans: A

7. Jeron is admitted to the hospital due to bacterial pneumonia. He is febrile,

diaphoretic, and has shortness of breath and asthma. Which goal is
the most important for the client?
a. Prevention of fluid volume excess
b. Maintenance of adequate oxygenation
c. Education about infection prevention
d. Pain reduction

Ans: B

8. A patient with tented skin turgor, dry mucous membranes, and decreased urinary
output is under nurse Mark’s care. Which nursing intervention should be included in
the care plan of Mark for his patient?
a. Administering I.V. and oral fluids.
b. Clustering necessary activities throughout the day.
c. Assessing color, odor, and amount of sputum.
d. Monitoring serum albumin and total protein levels.

Ans: A

9. Mang Teban has a history of chronic obstructive pulmonary disease and has the
following arterial blood gas results: partial pressure of oxygen (PO2), 55 mm Hg, and
partial pressure of carbon dioxide (PCO2), 60 mm Hg. When attempting to improve
the client’s blood gas values through improved ventilation and oxygen therapy, which
is the client’s primary stimulus for breathing?
a. High PCO2
b. Low PO2
c. Normal pH
d. Normal bicarbonate (HCO3)
Ans: B

10. Which electrolyte would the nurse identify as the major electrolyte responsible for
determining the concentration of the extracellular fluid?
a. Potassium
b. Phosphate
c. Chloride
d. Sodium

Ans: D

Module 15

1. The nurse is caring for a client with heart failure. On assessment, the nurse notes
that the client is dyspneic, and crackles are audible on auscultation. What additional
manifestations would the nurse expect to note in this client if excess fluid volume is
present?
a. Weight loss and dry skin
b. Flat neck and hand veins and decreased urinary output
c. An increase in blood pressure and increased respirations
d. Weakness and decreased central venous pressure (CVP)

Ans: C

2. The nurse is assigned to care for a group of clients. On review of the clients’ medical
records, the nurse determines that which client is most likely at risk for a fluid volume
deficit?
a. A client with an ileostomy
b. A client with heart failure
c. A client on long-term corticosteroid therapy
d. A client receiving frequent wound irrigations

Ans: A

3. The nurse caring for a client who has been receiving intravenous (IV) diuretics
suspects that the client is experiencing a fluid volume deficit. Which assessment
finding would the nurse note in a client with this condition?
a. Weight loss and poor skin turgor
b. Lung congestion and increased heart rate
c. Decreased hematocrit and increased urine output

Ans: A

4. On review of the clients’ medical records, the nurse determines that which client is at
 risk for fluid volume excess?
a. The client taking diuretics and has tenting of the skin
b. The client with an ileostomy from a recent abdominal surgery
c. The client who requires intermittent gastrointestinal suctioning
d. The client with kidney disease and a 12-year history of diabetes mellitus

Ans: D

5. A client with a very dry mouth, skin, and mucous membranes is diagnosed with
dehydration. Which intervention should the nurse perform when caring for a client
diagnosed with fluid volume deficit?
a. Assessing urinary intake and output
b. Obtaining the client’s weight weekly at different times of the day
c. Monitoring arterial blood gas (ABG) results
d. Maintaining IV therapy at the keep-vein-open rate

Ans: A

6. Frankie Chan is suffering from fluid volume deficit (FVD), which of the following
symptoms would the nurse expect to assess in the patient?
a. Rales
b. Bounding pulse
c. Tachycardia
d. Bulging neck veins

Ans:

7. John Reid is admitted to the hospital and is currently receiving hypertonic fluids.
Nursing management for the client includes monitoring for all of the following
potential complications except:
a. Water intoxication
b. Fluid volume excess (FVE)
c. Cellular dehydration
d. Cell shrinkage

Ans: A

8. Mr. Wenceslao is scheduled to receive an isotonic solution; which one of the

following is an example of such a solution?
a. D10% W
b. 0.45% saline
c. 0.9% saline
d. 3% normal saline W

Ans: C
9. Which of the following statements provides the rationale for using a hypotonic
solution for a patient with FVD?
a. A hypotonic solution provides free water to help the kidneys eliminate the solute.
b. A hypotonic solution supplies an excess of sodium and chloride ions.
c. Excessive volumes are recommended in the early postoperative period.
d. A hypotonic solution is used to treat hyponatremia.

Ans: A

10. When assessing a patient’s total body water percentage, the nurse is aware that all
of the following factors influence this except:
a. Age
b. Fat tissue
c. Muscle mass
d. Gender

Ans: D

Module 16

1. The nurse is preparing to care for a client with a potassium deficit. The nurse reviews
the client’s record and determines that the client is at risk for developing the
potassium deficit because of which situation?
a. Sustained tissue damage
b. Requires nasogastric suction
c. Has a history of Addison’s disease
d. Uric acid level of 9.4 mg/dL (559 µmol/L)

Ans: B

2. The nurse reviews a client’s electrolyte laboratory report and notes that the
potassium level is 2.5 mEq/L (2.5 mmol/L). Which patterns should the nurse watch
for on the electrocardiogram (ECG) as a result of the laboratory value? Select all that
apply.
a. U waves
b. Absent P waves
c. Inverted T waves
d. Depressed ST segment
e. Widened QRS complex

Ans: A, D, E

3. Potassium chloride intravenously is prescribed for a client with hypokalemia. Which

actions should the nurse take to plan for preparation and administration of the
potassium? Select all that apply.
 a. Obtain an intravenous (IV) infusion pump.
b. Monitor urine output during administration.
c. Prepare the medication for bolus administration.
d. Monitor the IV site for signs of infiltration or phlebitis.
e. Ensure that the medication is diluted in the appropriate volume of fluid.
f. Ensure that the bag is labeled so that it reads the volume of potassium in the
solution.

Ans: A, B, D, E ,F

4. The nurse provides instructions to a client with a low potassium level about the foods
that are high in potassium and tells the client to consume which foods? Select all that
apply.
a. Peas
b. Raisins
c. Potatoes
d. Cantaloupe
e. Cauliflower
f. Strawberries

Ans: B,C,D,F

5. The nurse is reviewing laboratory results and notes that a client’s serum sodium level
is 150 mEq/L (150 mmol/L). The nurse reports the serum sodium level to the health
care provider (HCP) and the HCP prescribes dietary instructions based on the
sodium level. Which acceptable food items does the nurse instruct the client to
consume? Select all that apply.
a. Peas
b. Nuts
c. Cheese
d. Cauliflower
e. Processed oat cereals

Ans: A, B, D

6. The nurse reviews the electrolyte results of an assigned client and notes that the
potassium level is 5.7 mEq/L (5.7 mmol/L). Which patterns would the nurse watch for
on the cardiac monitor as a result of the laboratory value? Select all that apply.
a. ST depression
b. Prominent U wave
c. Tall peaked T waves
d. Prolonged ST segment
e. Widened QRS complexes

Ans: C, E
7. Which client is at risk for the development of a sodium level at 130 mEq/L (130
mmol/L)?
a. The client who is taking diuretics
b. The client with hyperaldosteronism
c. The client with Cushing’s syndrome
d. The client who is taking corticosteroids

Ans: C

8. The nurse is caring for a client with heart failure who is receiving high doses of a
diuretic. On assessment, the nurse notes that the client has flat neck veins,
generalized muscle weakness, and diminished deep tendon reflexes. The nurse
suspects hyponatremia. What additional signs would the nurse expect to note in a
client with hyponatremia?
a. Muscle twitches
b. Decreased urinary output
c. Hyperactive bowel sounds
d. Increased specific gravity of the urine

Ans: C

9. Which client is at risk for the development of a potassium level of 5.5 mEq/L (5.5
mmol/L)?
a. The client with colitis
b. The client with Cushing’s syndrome
c. The client who has been overusing laxatives
d. The client who has sustained a traumatic burn

Ans: D

Module 17

1. The nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which

clinical manifestation would the nurse expect to note in the client?
A. Twitching
B. Hypoactive bowel sounds
C. Negative Trousseau’s sign
D. Hypoactive deep tendon reflexes

Ans: A

2. The nurse is caring for a client with hypocalcemia. Which patterns would the nurse
watch for on the electrocardiogram as a result of the laboratory value? Select all that
apply.
A. U waves
B. Widened T wave
C. Prominent U wave
 D. Prolonged QT interval
E. Prolonged ST segment

Ans: D,E

3. The nurse reviews a client’s laboratory report and notes that the client’s serum
phosphorus (phosphate) level is 1.8 mg/dL (0.45 mmol/L). Which condition most
likely caused this serum phosphorus level?
A. Malnutrition
B. Renal insufficiency
C. Hypoparathyroidism
D. Tumor lysis syndrome

Ans: A

4. The type of fluid used to manipulate fluid shifts among compartments states is:
A. Whole blood
B. TPN
C. Albumin
D. Ensure

Ans: C

5. When teaching a patient about foods high in magnesium, the nurse would include:
A. Green vegetables
B. Butter
C. Cheese
D. Tomatoes

Ans: A

6. Christoff is diagnosed with hypermagnesemia. Symptoms of her condition may

include:
A. Hypertension
B. Tachycardia
C. Hyperactive deep-tendon reflex
D. Cardiac arrhythmias

Ans: D

7. Magnesium reabsorption is controlled by:

A. Loop of Henle
B. Glomerulus
C. Pituitary
D. Parathyroid hormone
Ans: A

8. Etiologies associated with hypomagnesemia include:

A. Decreased vitamin D intake
B. Constipation
C. Malabsorption syndrome
D. Renal failure

Ans: C

9. Magnesium performs all of the following functions except:

A. Contributing to vasoconstriction
B. Assisting in cardiac muscle contraction.
C. Facilitating sodium transport.
D. Assisting in protein metabolism

Ans: A

10. Which of the following electrolytes are lost as a result of vomiting?

A. Bicarbonate and calcium
B. Sodium and hydrogen
C. Sodium and potassium
D. Hydrogen and potassium

Ans: D

11. Hypophosphatemia may result from which of the following diseases?

A. Liver cirrhosis
B. Renal failure
C. Paget’s disease
D. Alcoholism

Ans: D

12. A patient with which of the following disorders is at high risk for developing
hyperphosphatemia?
A. Hyperkalemia
B. Hyponatremia
C. Hypocalcemia
D. Hyperglycemia

Ans: C

13. Normal calcium levels must be analyzed in relation to:

A. Sodium
B. Glucose
 C. Protein
D. Fats

Ans: C

14. Calcium is absorbed in the GI tract under the influence of:

A. Vitamin D
B. Glucose
C. HCl
D. Vitamin C

Ans: A

15. Which of the following diagnoses is most appropriate for a patient with
hypocalcemia?
A. Constipation, bowel
B. High risk for injury: bleeding
C. Airway clearance, ineffective
D. High risk for injury: confusion

Ans: B

16. When serum calcium levels rise, which of the following hormones is secreted?
A. Aldosterone
B. Renin
C. Parathyroid hormone
D. Calcitonin

Ans: D

17. Nursing intervention for the patient with hyperphosphatemia includes encouraging
intake of:
A. Vitamin D
B. Fleets phospho-soda
C. Milk
D. Amphojel

Ans: D

18. Etiologies associated with hypocalcemia may include all of the following except:
A. Renal failure
B. Inadequate intake calcium
C. Metastatic bone lesions
D. Vitamin D deficiency

Ans: C
19. Which of the following findings would the nurse expect to assess in hypercalcemia?
A. Prolonged QRS complex
B. Tetany
C. Petechiae
D. Urinary calculi

Ans: D

20. Which of the following is not an appropriate nursing intervention for a patient with
hypercalcemia?
A. Administering calcitonin
B. Administering calcium gluconate
C. Administering loop diuretics
D. Encouraging ambulation

Ans: B

21. A patient in which of the following disorders is at high risk to develop

hypermagnesemia?
A. Insulin shock
B. Hyperadrenalism
C. Nausea and vomiting
D. . Renal failure

Ans: D

22. For a patient with hypomagnesemia, which of the following medications may
become toxic?
A. Lasix
B. Digoxin
C. Calcium gluconate
D. CAPD

Ans: B

Module 18

1. The nurse reviews the arterial blood gas results of a client and notes the following:
pH 7.45, PaCO2 of 30 mm Hg (30 mm Hg), and HCO3 À of 20 mEq/L (20 mmol/L).
The nurse analyzes these results as indicating which condition?
a. Metabolic acidosis, compensated
b. Respiratory alkalosis, compensated
c. Metabolic alkalosis, uncompensated
d. Respiratory acidosis, uncompensated

Ans: B
2. The nurse is caring for a client with a nasogastric tube that is attached to low suction.
The nurse monitors the client for manifestations of which disorder that the client is at
risk for?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis

Ans: B

3. A client with a 3-day history of nausea and vomiting presents to the emergency
department. The client is hypoventilating and has a respiratory rate of 10
breaths/minute. The electrocardiogram (ECG) monitor displays tachycardia, with a
heart rate of 120 beats/ minute. Arterial blood gases are drawn and the nurse reviews
the results, expecting to note which finding?
a. A decreased pH and an increased PaCO2
b. An increased pH and a decreased PaCO2
c. A decreased pH and a decreased HCO3-
d. An increased pH and an increased HCO3-

Ans: D

4. The nurse is caring for a client having respiratory distress related to an anxiety attack.
Recent arterial blood gas values are pH: 7.53, PaO2: 72 mm Hg (72 mm Hg),
PaCO2: 32 mm Hg (32 mm Hg), and HCO3 - : 28 mEq/L(28 mmol/L). Which
conclusion about the client should the nurse make?
a. The client has acidotic blood.
b. The client is probably overreacting.
c. The client is fluid volume overloaded.
d. The client is probably hyperventilating.

Ans: D

5. The nurse is caring for a client with diabetic ketoacidosis and documents that the
client is experiencing Kussmaul’s respirations. Which patterns did the nurse
observe? Select all that apply.
a. Respirations that are shallow
b. Respirations that are increased in rate
c. Respirations that are abnormally slow
d. Respirations that are abnormally deep
e. Respirations that cease for several seconds

Ans: B,D
6. A client who is found unresponsive has arterial blood gases drawn and the results
indicate the following: pH is 7.12, PaCO2 is 90 mm Hg (90 mm Hg), and HCO3 - is 22
mEq/L (22 mmol/L). The nurse interprets the results as indicating which condition?
a. Metabolic acidosis with compensation
b. Respiratory acidosis with compensation
c. Metabolic acidosis without compensation
d. Respiratory acidosis without compensation

Ans: D

7. The nurse notes that a client’s arterial blood gas (ABG) results reveal a pH of 7.50
and a PaCO2 of 30 mm Hg (30 mm Hg). The nurse monitors the client for which
clinical manifestations associated with these ABG results? Select all that apply.
a. Nausea
b. Confusion
c. Bradypnea
d. Tachycardia
e. Hyperkalemia
f. Lightheadedness

Ans: A,B,D,F

8. The nurse reviews the blood gas results of a client with atelectasis. The nurse
analyzes the results and determines that the client is experiencing respiratory
acidosis. Which result validates the nurse’s findings?
a. pH 7.25, PaCO2 50 mm Hg (50 mm Hg)
b. pH 7.35, PaCO2 40 mm Hg (40 mm Hg)
c. pH 7.50, PaCO2 52 mm Hg (52 mm Hg)
d. pH 7.52, PaCO2 28 mm Hg (28 mm Hg)

Ans: A

9. The nurse is caring for a client who is on a mechanical ventilator. Blood gas results
indicate a pH of 7.50 and a PaCO2 of 30 mm Hg (30 mm Hg). The nurse has
determined that the client is experiencing respiratory alkalosis. Which laboratory
value would most likely be noted in this condition?
a. Sodium level of 145 mEq/L (145 mmol/L)
b. Potassium level of 3.0 mEq/L (3.0 mmol/L)
c. Magnesium level of 1.3 mEq/L (0.65 mmol/L)
d. Phosphorus level of 3.0 mg/dL (0.97 mmol/L)

Ans: B

10. The nurse is caring for a client with several broken ribs. The client is most likely to
experience what type of acid-base imbalance?
a. Respiratory acidosis from inadequate ventilation
 b. Respiratory alkalosis from anxiety and hyperventilation
c. Metabolic acidosis from calcium loss due to broken bones
d. Metabolic alkalosis from taking analgesics containing base products

Ans: A

Module 19

1. A client with acute kidney injury has a serum potassium level of 7.0 mEq/L (7.0
mmol/L). The nurse should plan which actions as a priority? Select all that apply.
A. Place the client on a cardiac monitor.
B. Notify the health care provider (HCP).
C. Put the client on NPO (nothing by mouth) status except for ice chips.
D. Review the client’s medications to determine if any contain or retain potassium.
E. Allow an extra 500 mL of intravenous fluid intake to dilute the electrolyte
concentration.

Ans: A,B,D

2. A client arrives at the emergency department with complaints of low abdominal pain
and hematuria. The client is afebrile. The nurse next assesses the client to
determine a history of which condition?
A. Pyelonephritis
B. Glomerulonephritis
C. Trauma to the bladder or abdomen
D. Renal cancer in the client’s family

Ans: C

3. A client is admitted to the emergency department following a fall from a horse and the
health care provider (HCP) prescribes insertion of a urinary catheter. While preparing
for the procedure, the nurse notes blood at the urinary meatus. The nurse should
take which action?
A. Notify the HCP before performing the catheterization.
B. Use a small-sized catheter and an anesthetic gel as a lubricant.
C. Administer parenteral pain medication before inserting the catheter.
D. Clean the meatus with soap and water before opening the catheterization kit.

Ans: A

4. The nurse is reviewing a client’s record and notes that the health care provider has
documented that the client has chronic renal disease. On review of the laboratory results, the
nurse most likely would expect to note which finding?
A. Elevated creatinine level
B. Decreased hemoglobin level
C. Decreased red blood cell count
D. Increased number of white blood cells in the urine
Ans: A

5. A client with chronic kidney disease returns to the nursing unit following a hemodialysis
treatment. On assessment, the nurse notes that the client’s temperature is 38.5 °C (101.2
°F).
Which nursing action is most appropriate?
A. Encourage fluid intake.
B. Notify the health care provider.
C. Continue to monitor vital signs.
D. Monitor the site of the shunt for infection.

Ans: B

6. The client newly diagnosed with chronic kidney disease recently has begun
hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, the nurse
should assess the client during dialysis for which associated manifestations?
A. Hypertension, tachycardia, and fever
B. Hypotension, bradycardia, and hypothermia
C. Restlessness, irritability, and generalized weakness
D. Headache, deteriorating level of consciousness, and twitching

Ans: D

7. The nurse reviews the record of a child who is suspected to have glomerulonephritis.
Which statement by the child’s parent should the nurse expect that is associated with
this diagnosis?
A. “I’m so glad they didn’t find any protein in his urine.”
B. “I noticed his urine was the color of coca-cola lately.”
C. “His health care provider said his kidneys are working well.”
D. “The nurse who admitted my child said his blood pressure was low.”

Ans: B

8. The nurse performing an admission assessment on a 2-year-old child who has been
diagnosed with nephrotic syndrome notes that which most common characteristic is
associated with this syndrome?
A. Hypertension
B. Generalized edema
C. Increased urinary output
D. Frank, bright red blood in the urine

Ans: B

9. The nurse is planning care for a child with hemolytic-uremic syndrome who has been
anuric and will be receiving peritoneal dialysis treatment. The nurse should plan to
implement which measure?
 A. Restrict fluids as prescribed.
B. Care for the arteriovenous fistula.
C. Encourage foods high in potassium.
D. Administer analgesics as prescribed.

Ans: A

10. Which question should the nurse ask the parents of a child suspected of having
glomerulonephritis?
A. “Did your child fall off a bike onto the handlebars?”
B. “Has the child had persistent nausea and vomiting?”
C. “Has the child been itching or had a rash anytime in the last week?”
D. “Has the child had a sore throat or a throat infection in the last few weeks?”

Ans: D

11. The nurse is performing an assessment on a child admitted to the hospital with a
probable diagnosis of nephrotic syndrome. Which assessment findings should the
nurse expect to observe? Select all that apply.
A. Pallor
B. Edema
C. Anorexia
D. Proteinuria
E. Weight loss
F. Decreased serum lipids

Ans: A,B,C,D