FUNDAMENTALS OF NURSING

Practice Exam (50 questions)

1. A client who received general anesthesia returns from surgery.
Postoperatively, which nursing diagnosis takes highest priority for this client?
a. Acute pain related to surgery
b. Deficit fluid volume related to blood and fluid loss from surgery
c. Impaired physical mobility related to surgery
d. Ineffective airway clearance related to anesthesia

2. They physician prescribes an infusion of 2,400 ml of IV fluid over 24 hrs, with

half this amount to be infused over the first 10 hrs. During the first 10 hrs, the
client should received how many milliliters of IV fluid per hour?
a. 50 ml/hr
b. 100 ml/hr
c. 120 ml/hr
d. 240 ml/hr

3. A client with burns on his groin has developed blisters. As the client is
bathing, a few blisters break. The best action for the nurse to take would be
to:
a. Remove the raised skin because the blisters has already taken
b. Wash the area with soap and water to disinfect it
c. Apply a weakened alcohol solution to clean the area
d. Clean the area with normal saline solution and cover it with a
protective dressing

4. Which type of evaluation occurs continuously throughout the teaching and

learning process?
a. Formative
b. Retrospective
c. Summative
d. Informative

5. A Client Self-Determination Act of 1990 requires all hospitals to inform clients

of advance directives. What should the nurse tell the client about such
directives as living wills and health care power of attorney?
a. They guide the client’s treatment in certain health care situations
b. They can’t provide DNR orders for clients with terminal illnesses
c. They allow physicians to make decisions about treatment
d. They permit physicians to give verbal DNR orders

6. Which laboratory test result is the most important indicator of malnutrition in a

client with a wound?
a. Serum potassium level
b. Lymphocyte count
 c. Albumin level
d. Differential count

7. The nurse is administering two drugs concomitantly to a client. Which

interaction occurs when two drugs with the same qualitative effects produce
response when given together greater than either drug produces when given
alone?
a. Tolerance
b. Antagonism
c. Hyporeactivity
d. Synergism

8. The nurse is giving nutritional counseling to the mother of a child with celiac
disease. Which statement by the mother would indicate understanding?
a. My son can’t eat wheat, rye, oats or barley
b. My son needs a diet rich in gluten
c. My son must avoid potatoes, rice and cornstarch
d. My son can safely eat frozen and packaged foods

9. To assess effectiveness of incentive spirometry, the nurse can use a pulse

oximeter to monitor the client’s:
a. O2 saturation
b. Hgb level
c. Partial pressure of CO2 (PaCO2)
d. Partial pressure of O2 (PaO2)

10. After assessing a client, the nurse formulates relevant nursing diagnoses.
Which of the following is a complete nursing diagnosis statement?
a. Ineffective airway clearance r/t mucus plugs and nonreproductive
cough
b. Hyperventilation r/t anxiety
c. Tachycardia
d. Shortness of breath r/t anxiety

11. The nurse is caring for a 3-year old child admitted to the pediatric unit with
acetaminophen (Tylenol) poisoning. The nurse administers syrup of ipecac by
acetylcysteine (Mucomyst) every 4 hrs. for 72 hrs. Which laboratory findings
confirm the effectiveness of the drug therapy?
a. Alanine aminotransferase and aspartate aminotransferase
b. Creatinine kinase-MB
c. Blood urea nitrogen and serum creatinine
d. Complete blood count

12. Which intervention should the nurse try first for a client who exhibits signs of
sleep disturbance?
 a. Administer sleeping medication before bedtime
b. Ask the client each morning to describe the quality of sleep during the
previous night
c. Teach the client relaxation technique, such as guided imagery,
meditation, and progressive muscle relaxation
d. Provide the client with normal sleep aids such as pillows, back
rubs and snacks

13. During gentamicin therapy, the nurse should monitor a client’s:

a. Serum potassium level
b. Serum glucose level
c. Partial thromboplastin time (PTT)
d. Serum creatinine level

14. Why shouldn’t the nurse palpate both carotid arteries at one time?
a. The pulse can’t be assessed accurately unless the arteries are
palpated one at a time
b. It may cause transient hypertension
c. It may cause severe bradycardia
d. It may cause severe tachycardia

15. A client twists the right ankle while playing basketball and seeks care for
ankle pain and swelling. After the nurse applies ice tot the ankle for 30
minutes, which statement by the client suggests that ice application has been
effective?
a. I need something stronger for pain relief
b. My ankle looks less swollen now
c. My ankle appears redder now
d. My ankle feels very warm

16. The nurse reviews the ABG values of a client admitted with pneumonia: pH
7.51; PaCO2 28 mmHg; and HCO3 24mEq/L. What do these values indicate?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis

17. A client who suffered a stroke has a nursing diagnosis of Ineffective airway
clearance. The goal of care for this client is to mobilize pulmonary secretions.
Which intervention would help meet this goal?
a. Repositioning the client every 2 hrs
b. Restricting fluids to 1,000 ml/24 hrs
c. Administering O2 by nasal cannula as ordered
d. Keeping the head of the bed at 30-degree angle
18. On admission, the client has the following ABG values: PaO2 50 mmHg,
PaCO2 70 mmHg, pH 7.20, HCO3 28 mEq/L. Based on these values, the
nurse should formulate which nursing diagnosis for this client?
a. Risk for deficient fluid volume
b. Deficient fluid volume
c. Impaired gas exchange
d. Metabolic acidosis

19. Before preparing a client for surgery, the nurse assists in developing a
teaching plan. What is the primary purpose of preoperative teaching?
a. To determine whether the client is psychologically ready for the
surgery
b. To express concerns to the client about the surgery
c. To reduce the risk of postoperative complications
d. To explain the risks and obtain informed consent

20. The nurse encourages a client with a would to consume foods high in Vit C
because this vitamin:
a. Restores the inflammatory response
b. Enhances O2 transport to tissues
c. Reduces edema
d. Enhances protein synthesis

21. A client with AIDS develops Pneumocytosis carinii pneumonia. Which

nursing diagnosis has the highest priority?
a. Impaired gas exchange
b. Impaired oral mucous membranes
c. Imbalanced nutrition: Less than body requirements
d. Activity intolerance

22. A pediatric nurse is asked to work temporarily (float) in the ICU because there
are few clients in the pediatric unit. The nurse has never worked in ICU and
has no critical care experience. Which action is most appropriate for this
nurse?
a. Refuse to float to ICU
b. Notify the nursing supervisor that she feels unqualified and
untrained for the assignment
c. Go to ICU and take a total client assignment, ask the critical care
nurses for assistance when necessary
d. Go to ICU, tell the ICU nurses she has never worked in ICU, and let
the nurses decide what tasks she can perform

23. The nurse-manager of an outpatient physical medicine and rehabilitation

facility isn’t satisfied with the policies and procedures governing discharge
planning. The manager knows other managers at several similar facilities that
 are regarded as the “best” in the country. As part of a continuous quality-
improvement process, the nurse-manager decides to take which steps?
a. Contact the nurse-managers at the best facilities and compare
their discharge planning policies with those of her facility
b. Ask her staff nurses to investigate discharge policies and procedures
at other outpatient rehabilitation facilities and provide recommendation
for changes
c. Contact the nurse-managers at the best facilities and ask for their
policies and procedures so she can adopt them
d. Ask the staff nurses to perform a task force for the review and revision
of the discharge policies and procedures currently in use.

24. A client, age 75, is admitted to the facility. Because of the client’s age, the
nurse should modify the assessment by:
a. Shortening it
b. Talking in a loud voice
c. Addressing the client by the first name
d. Allowing extra time for the assessment

25. A child with rheumatic fever complains of painful joints. What

nonpharmacologic measures should the nurse use to reduce the child’s pain?
a. Perform gentle passive ROM exercise
b. Gently massage the painful joints
c. Use a bed cradle to keep linens off the child’s joints
d. Encourage the child to change position in bed every 2 hrs

26. When a central venous catheter dressing becomes moist or loose, what
should the nurse do first?
a. Draw a circle around the moist spot and note the date and time
b. Notify the physician
c. Remove the catheter, check for catheter integrity, and send the tip for
the culture
d. Remove the dressing, clean the site, and apply a new dressing

27. The nurse is assessing a client’s abdomen. Which examination technique

should the nurse use first?
a. Auscultation
b. Inspection
c. Percussion
d. Palpation

28. The client is to receive an IV infusion of 3,000 ml of dextrose and normal

saline solution over 24 hrs. The nurse observes that the rate is 150 ml/hr. if
the solution runs continuously at this rate, the infusion will be completed in:
a. 12 hrs
b. 20 hrs
 c. 24 hrs
d. 50 hrs

29. Each morning, the nurse-manager assigns clients and additional tasks for the
staff nurses to complete that day. During the shift, a crisis develops and one
staff nurse doesn’t complete the additional task. The next day, the nurse-
manager reprimands this nurse. When the nurse tries to explain, the nurse-
manger interrupts, saying that the tasks should have been completed
anyway. Which leadership style is the nurse-manager exhibiting?
a. Democratic
b. Permissive
c. Laissez-faire
d. Authoritarian

30. In planning a presentation that advocates a decrease in the client-to-nurse

ratio from 8:1 to 6:1, a nurse should emphasize its effect on:
a. Institutional resources
b. Standards of practice
c. Client-care quality
d. Nursing recruitment

31. The nurse is performing a preoperative assessment. Which statement by the

client would alert the nurse to the presence of risk factors for postoperative
complications?
a. I haven’t been able to eat anything solid for the past 2 days
b. I’ve never had surgery before
c. I had an operation 2 years ago, and I don’t want to have another one
d. I’ve cut my smoking down from two packs to one pack a day

32. The nurse uses a stethoscope to auscultate a client’s chest. Which statement
about a stethoscope with a bell and diaphragm is true?
a. The bell detects high-pitched sounds best
b. The diaphragm detects high-pitched sounds best
c. The bell detects thrills best
d. The diaphragm detects low-pitched sounds best

33. Which of the following is an appropriate nursing diagnosis?

a. Administer a sedative at bedtime
b. Pupils round, reactive to light and accommodation
c. Client will demonstrate subcutaneous injection independently
d. Impaired gas exchange

34. When following standard precautions, the nurse’s responsibility is to:

a. Wear gloves for all contact with the client
b. Consider all body substances potentially infectious
c. Place a body substance isolation sign on the client’s door
 d. Wear gloves and a gown if the client is in respiratory isolation

35. As the nurse helps a client ambulate, the client says, “I had trouble sleeping
last night.” Which action should the nurse take first?
a. Recommending warm milk or a warm shower at bedtime
b. Gathering more information about the sleep problem
c. Determining whether the client is worried about something
d. Finding out whether the client is taking medication that may impede
sleep.

36. Why would the nurse be interested in a client’s dietary history when
administering drugs?
a. Vegetarian diets can cause more adverse drug reactions than diets
containing meat
b. The number of calories consumed can alter a drug’s metabolism
c. Dietary intake can alter the effectiveness of some drugs
d. High sodium diets can increase the half-life of some drugs

37. A newly hired charge nurse assesses the staff nurses as competent
individually but ineffective and nonproductive as a team. In addressing her
concern, the charge nurse should understand that the usual reason for such a
situation is:
a. Unhappiness about the change in leadership
b. Unexpressed feelings and emotions among the staff
c. Fatigue from overwork and understaffing
d. Failure to incorporate staff in decision making

38. The label of a drug package reads “meperidine hydrochloride (Demerol), 50

mg/ml.” how many milliliters would the nurse give a client for a 30mg dose?
1.6 ml
1 ml
0.6 ml
0.5 ml

39. A nurse is caring for a client with a diagnosis of Impaired gas exchange.
Which outcome us most appropriate based upon this nursing diagnosis?
a. The client maintains a reduced cough effort to lessen fatigue
b. The client restricts fluid intake to prevent Overhydration
c. The client reduces daily activities to a minimum
d. The client has normal breath sounds in all lung fields

40. A nurse is caring for a client with a history of GI bleeding, sickle cell disease
and platelet count of 22,000/ul. The client is dehydrated and receiving
dextrose 5% in half-normal saline solution at 150 ml/hr. the client complains
of severe bone pain and is scheduled to receive a dose of morphine sulfate.
In administering the medication, the nurse should avoid which route?
 a. Oral
b. IV
c. IM
d. Subcutaneous (SC)

41. A primary nurse in the unit tells the nurse-manager that a newly hired
registered nurse needs an additional week of orientation in order to function
effectively on the staff. Which action is most appropriate for the nurse-
manager?
a. Tell the primary nurse that the new nurse must finish orientation in 6
weeks of a staffing shortage
b. Meet the new nurse and the primary nurse and help set up an
additional week of orientation
c. Fire the new nurse because the unit is short-staffed and nurses who
can complete the orientation process in the normal length of time are
needed
d. Schedule a staff meeting to find out if there are problems with the
orientation process

42. To give a Z-track injection, the nurse measures the correct medication dose
and then draws a small amount of air into the syringe. What is the rationale
for this action?
a. Adding air decreases pain caused by the injection
b. Adding air prevents the drug from flowing back into the needle
track
c. Adding air prevents the solution from entering a blood vessel
d. Adding air ensures that the client receives the entire dose

43. A client comes to the emergency department complaining of a fast and

irregular hearthbeat. After examining the client, the physician gives a verbal
order of digoxin (Lanoxin), 1 mg in four divided doses over the next 24 hrs,
starting the first does stat. how should the nurse respond to this order?
a. Write and sign the order as dictated, and then repeat it aloud for
the physician’s verification
b. Verbally repeat the order to the physician for verification
c. Insist that the physician write the order, then administer the drug
d. Refuse to carry out the order

44. The physician prescribes an infusion of 2,400 ml of IV fluid over 24 hrs with
half of this amount to be infused over the first 10 hrs. During the first 10 hrs,
the client should receive how many milliliters of IV fluid per hour?
a. 50 ml
b. 100 ml
c. 120 ml
d. 240 ml
45. A client with toxoplasmosis and cytomegalovirus is confused and has been
dislodging his IV access device. He is scheduled to receive amphotericin B
(Amphotec) IV. Which action would be most appropriate for the nurse to take?
a. Place bilateral wrist restraints on the client
b. Ask the physician to prescribe sedation for the client
c. Delay giving the drug until the client’s confusion ceases
d. Tell a nursing assistant to stay with the client during the infusion

46. When leaving the room of a client with strict isolation, the nurse should
remove which protective equipment first?
a. Cap
b. Mask
c. Gown
d. Gloves

47. When should the nurse check a client with rebound tenderness?
a. Near the beginning of the examination
b. Before doing anything else
c. Anytime during the examination
d. At the end of the examination

48. Which of the following clients would qualify for hospice care?
a. A client with late-stage AIDS
b. A client with left-sided paralysis resulting from a stroke
c. A client who’s undergoing treatment for heroin addiction
d. A client who had a coronary artery bypass surgery 2 weeks before

49. A client complains of dyspnea. To correct this problem, the nurse should
place the client in which position?
a. Trendelenburg
b. Sim’s
c. Fowler’s
d. Supine

50. A client is admitted completely immobilized by an acute exacerbation of

multiple sclerosis. Two days later, the client cries frequently and refuses to
see family members. The nurse formulates a nursing diagnosis of
hopelessness. To address this diagnosis, the nurse should include which
intervention in the care plan?
a. Obtaining an order for sedation
b. Limiting visitors to 15 minutes per day
c. Encouraging the client to verbalize feelings
d. Reinforcing the client’s responsibility to the family