A client with ulcerative colitis is chatting with the nurse. Which of the following statements indicates the client understands the lifestyle modifications he needs to make?
  A. "I will have to stop smoking. "
  B. "I can eat popcorn for an evening snack. "
  C. "I may have coffee with my meals. "
  D. "I am allowed to have alcohol as long as I only drink wine. \

The client is taking medication to control his cancer pain. Which of the following statements indicates that the client needs further instruction?
  A. "I should take my medication around-the-clock to control my pain. "
  B. "I should skip doses periodically so I don't get hooked on my drugs. "
  C. "It is okay to take my pain medication even if I am not having any pain. "
  D. "I should contact the oncology nurse if my pain is not effectively controlled. \

Which of the following interventions would likely be most effective for the client to use at home when managing the discomfort of rhinoplasty the initial 2 days after surgery?
  A. Applying ice compresses.
  B. Applying warm, moist compresses.
  C. Lying in a prone position.
  D. Blowing the nose gently.

The client is advised by the physician to have mammography screening annually. Which of the following is the best measure to improve adherence with mammography screening?
   A. Making sure that the individual barriers to screening are minimized.
   B. Emphasizing that mammography screening can prevent breast cancer.
   C. Emphasizing that mammography screening is a low-cost approach to cancer prevention.
  D. Informing the client that she is at high risk for breast cancer and needs to follow the physician's recommendation.

The client is taking carbamazepine (Tegretol) to treat his trigeminal neuralgia. While preparing the client's teaching plan, which of the following instructions should the nurse include?
  A. Limit physical activity while taking the drug.
  B. Eliminate caffeine from the diet while taking drug.
  C. Arrange to have a CBC drawn weekly.
  D. Take the drug on an empty stomach.

A preschool-aged child who is hospitalized with gastroenteritis has been NPO. The physician has written an order to advance the diet as tolerated. Which of the following food is the most appropriate for the first feeding the nurse should offer the child?
  A. Clear lemon carbonated beverage.
  B. Toast.
  C. Cooked cereal.
  D. Ice cream shake.

The nurse is caring for a child with leukemia. Which of the following should the nurse priority pay more attention to?
  A. Preventing injury.
  B. Monitoring the child's platelet count.
  C. Monitoring the child's temperature.
  D. Encouraging increased fluid intake.

A client has been placed on levodopa to treat his Parkinson's disease. Which of the following is a common side effect of levodopa that the nurse should include in the client's teaching plan?
  A. Pancytopenia.
  B. Peptic ulcer.
  C. Orthostatic hypotension.
  D. Weight loss.

Three weeks after the application of the spica cast following surgery for an infant, the mother told the nurse that the infant's toes are swollen and cool to the touch. Which of the following would the nurses suspect?
  A. Cotton wadding lining of the cast has shrunk.
  B. An infection has developed under the cast.
  C. Child's feet were in a dependent position.
  D. Child has outgrown the spica cast.

A client is prescribed Gentamycin (Garamycin) IV to treat infection. It is important to monitor the client for the development of which of the following side effects from the medication?
  A. Ascites.
  B. Confusion.
  C. Ototoxicity.
  D. Cardiac dysrhythmias.

Mrs. S with preterm labor will be under Terbutaline (Brethine) therapy. Before beginning the therapy, which of the following assessments would be most important?
  A. Estimated fetal size.
  B. Maternal heart rate.
  C. Contraction intensity.
  D. Deep tendon reflexes.

While managing the separation anxiety during hospitalization for a two-year-old boy, which of the following suggestions would be most helpful to the parents?
  A. Tell the child the time they are leaving and returning.
  B. Bring the child's favorite toys from home.
  C. Leave while the child is sleeping.
  D. Keep the visit time short.

The nurse is evaluating the effectiveness of airway suctioning. Which of the following outcome criteria is most appropriate?
  A. Respirations unlabored.
  B. Decreased mucus production.
  C. Hollow sound on chest percussion.
  D. Breath sounds clear on auscultation.

Positive symptoms of schizophrenia include which of the following?
   A. Waxy flexibility, alogia, and apathy.
   B. Flat affect, avolition, and anhedonia.
   C. Hallucinations, delusions, and disorganized thinking.
   D. Somatic delusions, echolalia, and a flat affect.

The development of laryngeal cancer is most clearly linked to which of the following factors?
  A. High-fat, low-fiber diet.
  B. Alcohol and tobacco use.
  C. Low socioeconomic status.
  D. Overuse of artificial sweeteners.

One-year-old Susan, the second child to have sickle cell disease in a family of five children, is admitted to the hospital with sickle cell crisis. When preparing the plan of care for her, which of the following treatments would the nurse most likely expect to include in the plan?
  A. Intravenous fluid therapy.
  B. Fast-acting anticoagulant therapy.
  C. Parenteral iron therapy.
  D. Exchange transfusion.

A young man is remanded by the courts for psychiatric treatment. From his police record the nurse notices that the client has records of delinquency, running away, auto theft, and vandalism in his early teenage years. He dropped out of school at age 16 and has been living on his own since then. His history suggests maladaptive coping. Which of the following problems is most associated with maladaptive coping?
  A. Antisocial personality disorder.
  B. Borderline personality disorder.
  C. Obsessive-compulsive personality disorder.
  D. Narcissistic personality disorder.

A client has had a cerebrovascular accident (CVA). Because the CVA affected the left side of the client's brain, the nurse should anticipate that the client would most likely experience
  A. dyslexia.
  B. apraxia.
  C. agnosia.
  D. expressive aphasia.

The most significant sign of acute renal failure is
  A. elevated body temperature.
  B. increased blood pressure.
  C. decreased urine output.
  D. increased urine specific gravity.

Trimethobenzamide (Tigan) 150 mg IM has been ordered to treat a client's nausea and vomiting. The nurse has an ampule of Tigan labeled 200 mg/mL. How many mL should the nurse prepare to give the client?
  A. 0.50 mL.
  B. 0.75 mL.
  C. 1.0 mL.
  D. 1.5 mL.

An adolescent is admitted to the hospital for headaches. She approaches the nurse and confides that she is being sexually abused by a family friend. Which of the following would be the nurse's best initial response?
  A. "Can you tell me what happened?"
  B. "I believe you; you were right to tell me. "
  C. "Have you told your mother and father about this?"
  D. "Who else have you told about this?\

When caring for an adolescent client diagnosed with depression, the nurse should remember that depression manifests differently in adolescents and adults. In an adolescent, signs and symptoms of depression are likely to include which of the following?
  A. Helplessness, hopelessness, hypersomnolence, and anorexia.
  B. Truancy, a change of friends, social withdrawal, and oppositional behavior.
  C. Curfew breaking, stealing from family members, truancy, and oppositional behavior.
  D. Hypersomnolence, obsession with body image, and valuing of peers' opinions.

During the assessment stage, a client with schizophrenia leaves his arm in the air after the nurse has taken his blood pressure. Which of the following explains his action?
  A. Somatic delusions.
  B. Waxy flexibility.
  C. Neologisms.
  D. Nihilistic delusions.

The nurse noticed that an 8-month-old child's posterior fontanel is slightly open. Which of the following should the nurse do next?
  A. Check the child's head circumference.
  B. Question the mother about the child's delivery.
  C. Schedule an X-ray of the child's head.
  D. Document this as a normal finding.

A mother of an ill child tells the nurse that her child "isn't eating well. " Which of the following strategies devised by the mother to help increase the child's intake is not appropriate?
  A. Asking the child to say why he is not eating.
  B. Telling the child he must eat or else he will not get better.
  C. Allowing the child to choose his meals from an acceptable list of foods.
  D. Letting the child to substitute items on his tray for other nutritious foods.

The client with a head injury receives mannitol (Osmitrol) during surgery to help decrease intracranial pressure. Which of the following nursing observations would most likely indicate that the drug is having the desired effect?
  A. Urine output increases.
  B. Pulse rate decreases.
  C. Blood pressure decreases.
  D. Muscular relaxation increases.

A 9-year-old child is in diabetes. The nurse offers to meet with the mother and the child's teacher before school to discuss the teacher's responsibilities in relation to the child's diabetes. Which of the following would the nurse expect to discuss in this meeting?
  A. How to perform a glucometer test.
  B. How to give an insulin injection.
  C. Signs and symptoms of hypoglycemia.
  D. The American Diabetic Association (ADA) diet.

The nurse is caring for a client in the first 4 weeks of pregnancy. The nurse should expect to collect which assessment findings?
  A. Presence of menses.
  B. Uterine enlargement.
  C. Breast sensitivity.
  D. Fetal heart tones.

Which of the following fluid and electrolyte imbalances would the nurse anticipate that the client would be particularly susceptible to in the emergent phase of burn care?
  A. Metabolic alkalosis.
  B. Hemodilution.
  C. Hypernatremia.
  D. Hyperkalemia.

To encourage adequate nutritional intake for a client with Alzheimer's disease, what should the nurse do?
  A. Stay with the client and encourage him to eat.
  B. Help the client fill out his menu.
  C. Give the client privacy during meals.
  D. Fill out the menu for the client.

The parents of a child being discharged from the day surgery center after insertion of tympanostomy tubes ask the nurse. "What will happen to the tubes in my child's ears?" Which of the following would be the nurse's best response?
   A. "The tubes usually dissolve on their own in about 1 year. "
   B. "The tubes must remain permanently in place. "
   C. "You'll probably see them fall out in about 6 months. "
   D. "Call for an appointment to have them removed in about 6 months. \

To assess the client's dorsalis pedis pulse, the nurse should palpate the
  A. medial surface of the ankle.
  B. lateral surface of the ankle.
   C. ventral aspect of the top of the foot.
   D. medial aspect of the dorsum of the foot.

Which of the following is an appropriate health promotion activity to reduce the incidence of osteoporosis?
   A. Teaching women to maintain adequate calcium intake.
   B. Teaching women how to administer pain medication safely.
   C. Avoiding estrogen replacement therapy when postmenopausal.
   D. Teaching women to increase caffeine intake as a preventive measure.

A client is admitted to the psychiatric unit with a diagnosis of anorexia nervosa. Although she is 5'7" and weighs only 100 lb, she keeps on telling the nurse about how fat she is. What should the nurse do first?
  A. Discuss cultural stereotypes regarding thinness and attractiveness.
  B. Explore the reasons why the client doesn't eat.
  C. Teach the client about nutrition, calories, and a balanced diet.
  D. Establish a trusting relationship with the client.

To obtain a good monitor tracing on a client in labor, the mother lies on her back. Suddenly, she complains of feeling light-headed and becomes diaphoretic. Which of the following should be the nurse's first action?
  A. Reposition the client to her left side.
  B. Immediately take the client's blood pressure and call the physician.
  C. Start oxygen at 6 L via nasal cannula.
  D. Increase the IV fluids to correct the client's dehydration.

A hospitalized client craves a drink while withdrawing from alcohol. Which of the following measures is the best way to help the client resist the urge to drink?
  A. A routine search of visitors.
  B. A locked-door policy.
  C. One-to-one supervision by the staff.
  D. Support from other alcoholic clients.

Which nursing diagnosis would the nurse anticipate as having the highest priority for the client with gestational diabetes in labor?
  A. Risk for infection related to invasive procedures during labor.
  B. Risk for injury to fetus related to the effects of diabetes on uteroplacental functioning.
  C. Deficient knowledge related to lack of information about care during labor.
  D. Interrupted family processes related to diabetes increasing the client's risk of complications.

Sedative-hypnotic drugs are used to treat which of the following problems?
  A. Hallucinations and delusions.
  B. Anxiety and insomnia.
  C. Obsessive-compulsive disorder (OCD).
  D. Attention deficit hyperactivity disorder (ADHD).

In developing a plan of care for a client with rheumatoid arthritis, the nurse should consider that clients with rheumatoid arthritis should be positioned so as to
   A. prevent flexion deformities of the joints.
   B. decrease edema around the joints.
   C. promote maximum comfort.
   D. prevent venous stasis.

When caring for a client during the second stage of labor, which action would be least appropriate?
  A. Assisting the client with pushing.
  B. Ensuring the client's legs are positioned appropriately.
  C. Allowing the client clear liquids.
  D. Monitoring the fetal heart rate.

Nitroglycerin is also available in ointment or paste form. Before applying nitroglycerin ointment, what should the nurse do first?
  A. Cleanse the skin with alcohol where the ointment will be placed.
  B. Obtain the client's pulse rate and rhythm.
  C. Remove the ointment previously applied."
  D. Instruct the client to expect pain relief in the next 15 minutes.

Of the following signs and symptoms of bowel obstruction, which is related primarily to small bowel obstruction rather than large bowel obstruction?
  A. Profuse vomiting.
  B. Cramping abdominal pain.
  C. Abdominal distention.
  D. High-pitched bowel sounds above the obstruction.

A client who was found huddled in her apartment by the police is admitted to the clinic. The client stares toward one corner of the room and seems to be responding to something not visible to others. She appears hyperalert and scared. Which of the following conclusion by the nurse is most appropriate according to the situation?
  A. Nothing is wrong because the client isn't a threat to society.
  B. The client is malingering.
  C. The client may be hallucinating.
  D. The client is suicidal.

When developing the postoperative plan of care for a child who is scheduled to have a tympanostomy tubes inserted into the right ear, which of the following interventions would the nurse identify to accomplish the goal of facilitating drainage?
  A. Applying warm compresses to the right ear.
  B. Applying a gauze dressing to the left ear.
  C. Applying an ice pack to the left ear.
  D. Positioning the child to lie on the right side.

On initial assessment of a 7-year-old with rheumatic fever, which of the following would require the nurse to contact the physician immediately?
  A. Heart rate of 150 bpm.
  B. Twitching in the extremities.
  C. Red rash on the trunk.
  D. Swollen and painful knee joints.

The infant's skin is inelastic and the upper abdomen is distended. To palpate the olive like mass most easily, the nurse palpates the epigastrium just to the right of the umbilicus at which of the following times?
  A. Just before the infant vomits.
  B. While the infant is eating.
  C. When infant is lying on the left side.
  D. When the stomach is empty.

Which of the following signs or symptoms would be of least importance when the nurse evaluates the client for postoperative peripheral nerve damage?
  A. Pain.
  B. Bleeding.
  C. Altered sensation.
  D. Pulselessness.

Which assessment would the nurse perform to validate that the membranes are ruptured?
   A. Observe for a pink, mucus vaginal discharge.
   B. Test the leaking fluid with nitrazine paper.
   C. Assess the client's temperature, pulse, and blood pressure.
   D. Send a urine specimen from the client to be cultured.

Assessment of a client in active labor reveals meconium-stained amniotic fluid and fetal heart sounds in the upper right quadrant. Which of the following is the most likely cause of this situation?
  A. Breech position.
  B. Late decelerations.
  C. Entrance into the second stage of labor.
  D. Multiple gestation.

After a gastrectomy, the client will have a nasogastric tube in place for several days postoperatively. The nurse explains to the client that the nasogastric tube is for which of the following reasons?
   A. Prevent excessive pressure on suture lines.
   B. Prevent the development of ascites.
   C. Provide enteral feedings in the immediate postoperative period.
   D. Enable administration of antacids to promote healing of the anastomosis.

A client diagnosed with schizoaffective disorder is suffering from schizophrenia with elements of which of the following disorders?
  A. Thought disorder.
  B. Amnestic disorder.
  C. Personality disorder.
  D. Mood disorder.

The nurse is interviewing a client who is currently under the influence of a controlled substance and shows signs of becoming agitated. Which measure should the nurse take first when caring for this client?
  A. Be aware of hospital security.
  B. Communicate a scolding attitude to intimidate the client.
  C. Use confrontation.
  D. Express disgust with the client's behavior.

A 15-year-old girl with anorexia refuses to eat in a mental health unit. Which of the following statements is the best response from the nurse?
  A. "Why do you think you're fat? You're underweight. Here--look in the mirror. "
  B. "You really look terrible at this weight. I hope you'll eat. "
  C. "You don't have to eat. It's your choice. "
  D. "I hope you'll eat your food by mouth. Tube feedings and IV lines can be uncomfortable. \