1.

The code is concerned about focusing on which of the following criteria

A – Clinical expertise
B – Conduct, behavior, ethics & professionalism
C - Hospital policies
D – Disciplinary actions

2. When communicating with a client who speaks a different language , which best practice should
the nurse implement?
A. Speak loudly & slowly
B. Arrange for an interpreter to translate
C. Speak to the client & family together
D. Stand close to the client & speak loudly

3. A nurse is not trained to do the procedure of IV cannulation , stil she tries to do the procedure .
You are the colleague of this nurse . what will be your action ?
A – You should tell that nurse to not to do this again
B – You should report the incident to someone in authority
C – you must threaten the nurse, that you will report this to the authority
D – you should ignore her act
4. An antihypertensive medication has been prescribed for a client with HTN. The client tells the
clinic nurse that they would like to take an herbal substance to help lower their BP . The nurse
should take which action?
A. Tell the client that herbal substances are not safe & should never be used.
B. Teach the client how to take their BP so that it can be monitored closely
C. Encourage the client to discuss the use of an herbal substance with the health care
provider
D. Tell the client that if they take the herbal substance they will need to have their BP
checked frequently
5. Which professional organizations are responsible for establishing the code?
A. NHS
B. NMC
C. American Nurses Association, National League of Nursing, and American Association of
Nurse Executives
D. State Boards of Nursing, state and national organizations, and specialty organizations
6. Nurses who seek to enhance their cultural-competency skills and apply sensitivity
toward others are committed to which professional nursing value?
A. Autonomy
B. Strong commitment to service
C. Belief in the dignity and worth of each person
D. Commitment to education
7. When trying to make a responsible ethical decision , what should the nurse understand as the
basis for ethical reasoning ?
A. Ethical principles & code
B. The nurse’s experience
C. The nurse’s emotional feelings
D. The policies & practices of the institution

8. A fully alert & competent 89 year old client is in end stage liver disease . The client says , “I’m
ready to die,” & refuses to take food or fluids . The family urges the client to allow the nurse to
insert a feeding tube. What is the nurses moral responsibility ?
A. The nurse should obtain an order for a feeding tube
B. The nurse should encourage the client to reconsider the decision
C. The nurse should honor client’s decision
D. The nurse must consider that the hospital can be sued if she honors the client’s request

9. A mentally competent client with end stage liver disease continues to consume alcohol after
being informed of the consequences of this action. What action best illustrates the nurse’s role
as a client advocate?
A. Asking the spouse to take all the alcohol out of the house
B. Accepting the patient’s choice & not intervening
C. Reminding the client that the action may be an end-of life decision
D. Refusing to care for the client because of the client’s noncompliance

10. A client is diagnosed with methicillin resistant staphylococcus aureus pneumonia. What type
of isolation is MOST appropriate for this client?
1) Reverse isolation
2) Respiratory isolation
3) Standard precautions
4) Contact isolation
11. Several clients are admitted to an adult medical unit. The nurse would ensure airborne
precautions for a client with which of the following medical conditions?
1) A diagnosis of AIDS and cytomegalovirus
2) A positive PPD with an abnormal chest x-ray
3) A tentative diagnosis of viral pneumonia
4) Advanced carcinoma of the lung
12. A young adult is being treated for second and third degree burns over 25% of his body and is
now ready for discharge. The nurse evaluates his understanding of discharge instructions
 relating to wound care and is satisfied that he is prepared for home care when he makes
which statement?
1) “I will need to take sponge baths at home to avoid exposing the wounds to unsterile
bath water.”
2) “If any healed areas break open I should first cover them with a sterile dressing and
then report it.”
3) “I must wear my Jobst elastic garment all day and can only remove it when I’m going
to bed.”
4) “I can expect occasional periods of low-grade fever and can take Tylenol every 4
hours.”
13. Contact precautions are initiated for a client with a health care associated infection caused by
MRSA. Which protective equipments the nurse should wear while providing colostomy care?
1) Gloves & gown
2) Gloves & goggles
3) Gloves, gowm & shoe protecters
4) Gloves , gown , goggle & face shield
14. The charge nurse observes a new staff nurse who is changing a dressing on a surgical
wound. After carefully washing her hands the nurse dons sterile gloves to remove the old
dressing. After removing the dirty dressing, the nurse removes the gloves and dons a new
pair of sterile gloves in preparation for cleaning and redressing the wound. The most
appropriate action for the charge nurse is to:
1) interrupt the procedure to inform the staff nurse that sterile gloves are not needed to
remove the old dressing.
2) congratulate the nurse on the use of good technique.
3) discuss dressing change technique with the nurse at a later date.
4) interrupt the procedure to inform the nurse of the need to wash her hands after
removal of the dirty dressing and gloves.

15. The Nurse is caring for a patient with heart failure . On

Assessment , the nurse notes that the patient is dyspnoiec &
crackles are audible on auscultation . What additional signs
would the nurse expect to note in this client if excess fluid
volume is present?
A. Weight loss
B. Flat neck & hand veins
C. An increase in BP
D. Decreased central venous pressure (CVP)

16. The nurse is preparing to care for a patient with a

potassium deficit. The nurse reviews the patient’s record &
 determines that the client was 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. Is taking a potassium –retaining diuretic

17. A 27- year old adult male is admitted for treatment of

Crohn’s disease . Which information is most significant when
the nurse assesses his nutritional health?
A. Anthropometric measurements
B. Bleeding gums
C. Dry skin
D. Facial rubor
18. An adult woman is admitted with metabolic acidosis .
Which set of arterial blood gases should the nurse expect to
find in a client with metabolic acidosis?
A. Ph 7.28 ; pCO2 -55; HCO3 -26
B. Ph 7.50 ; pCO2 -40 ; HCO3 -31
C. Ph 7.48 ; pCO2 -30 ; HCO3 -22
D. Ph 7.30 ; pCO2 -36 ; HCO3 -18
19. The nurse is assigned to care for a group of patients. On
review of the patient’s medical records the nurse determines
that which patient is at risk for fluid volume excess?
A. The patient taking diuretics
B. The patient with kidney disease
C. The patient with an ileostomy
D. The patient who requires gastrointestinal suctioning
20. An adult who has gastroenteritis & is on digitalis has lab
values of ; K 3.2 mEq/L , Na 136 mEq/L, Ca 4.8 mEq/L , & Cl
98 mEq/L. The nurse puts which of the following on patient’s
plan of care?
A. Monitor for hyperkalemia
B. Avoid foods rich in potassium
 C. Observe for digitalis toxicity
D. Observe for Trousseau’s & Chvostek’s signs
21. The nurse is reading a health care provider’s ( HCP)
progress notes in the patient’s record & reads that the HCP
has documented “ insensible fluid loss of approx 800 ml daily”
. The nurse interprets that this type of fluid loss can occur
through which route?
A. The skin
B. Urinary output
C. Wound drainage
D. The gastrointestinal tract

22. The nurse is preparing to change the parenteral nutrition

(PN) solution bag & tubing . The patient’s central venous line
is located in the right subclavian vein. The nurse asks the
client to take which essential action during the tubing change?
A. Breathe normally
B. Turn the head to the right
C. Exhale slowly & evenly
D. Take a deep breath, hold it ,& bear down
23. Which of the following actions would place a client at the greatest
risk for a shearing force injury to the skin?
1) Walking without shoes

2) Sitting in Fowler's position

3) Lying supine in bed

4) Using a heating pad

24. The client at greatest risk for postoperative wound infection is:
1) A 3-month-old infant postoperative from pyloric stenosis repair

2) A 78-year-old postoperative from inguinal hernia repair

3) An 18-year-old drug user postoperative from removal of a bullet in the leg

4) A 32-year-old diabetic postoperative from an appendectomy

25.
Black wounds are treated with debridement. Which type of debridement is most
selective and least damaging?
1) Debridement with scissors

2) Debridement with wet to dry dressings

3) Mechanical debridement
4)
Chemical debridement
26. A client's wound is draining thick yellow material. The nurse correctly
describes the drainage as:
1) Sanguineous

2) Serous-sanguineous

3) Serous

4) Purulent

27. The nurse cares for a client with a wound in the late regeneration
phase of tissue repair. The wound may be protected by applying a:
1) Transparent film

2) Hydrogel dressing

3) Collogenase dressing

4) Wet to dry dressing

28. A client has a diabetic stasis ulcer on the lower leg. The nurse uses a
hydrocolloid dressing to cover it. The procedure for application includes:

1) Cleaning the skin and wound with betadine

2) Removing all traces of residues for the old dressing

3) Choosing a dressing no more than quarter-inch larger than the wound size
4) Holding in place for one minute to allow it to adhere

29.
A client is admitted to the Emergency Department after a motorcycle
accident that resulted in the client's skidding across a cement parking
lot. Since the client was wearing shorts, there are large areas on the
legs where the skin is ripped off. This wound is best described as:
1) Abrasion

2) Unapproximated

3) Laceration

4) Eschar
 30. TRUE/FALSE
1. Standard precautions are the daily practices (e.g. hand washing, use of personal
protective equipment, cleansing of equipment) that will reduce the transmission of
infections.

2. Gowns and gloves should not be worn in common use areas such as nursing stations,
eating areas, and elevators.

3. Masks and goggles must be worn for care activities such as care of patients who have a
cough or are vomiting.

4. The use of gloves is an effective substitute for hand washing.

5. You must wash your hands after removing your gloves.

6. In a hospital, routine precautions are the responsibility of doctors and nurses only.

MULTIPLE CHOICE – Choose the MOST CORRECT response.

31. . The objective of standard precautions is to prevent the spread of infection within
the health care institution:
a. From patient to patient.
b. From patient to staff.
c. From staff to patient.
d. From staff to staff.
e. All of the above.

32. The most important procedure for the prevention of infection from germs and
viruses is:
a. Wearing gloves.
b. Properly bagging used linen.
c. Effective hand washing.
d. Wearing protective eyewear.

33. Which of the major theories of aging suggests that older adults may
decelerate the aging process?
1) Disengagement theory

2) Activity theory

3) Immunology theory

4) Genetic theory

34. Which of the following is a guiding principle for the nurse in

distinguishing mental disorders from the expected changes associated with
aging?
 1) A competent clinician can readily distinguish mental disorders from the expected
changes associated with aging.

2) Older people are believed to be more prone to mental illness than young people.

3) The clinical presentation of mental illness in older adults differs from that in other age
groups.

4) When physical deterioration becomes a significant feature of an elder’s life, the risk of
comorbid psychiatric illness rises.

35. A normal sign of aging in the renal system is

1) Intermittent incontinence
2) Concentrated urine
3) Microscopic hematuria
4) A decreased glomerular filtration rate
36. A 76 year old man who is a resident in an extended care
facility is in the late stages of Alzheimer’s disease . He tells his
nurse that he has sore back muscles from all the construction
work he has been doing all day . Which response by the nurse is
most appropriate ?
1) “ you know you don’t work in construction anymore”
2) “ what type of motion did you do to precipitate this
soreness?”
3) “ you’re 76 years old & you’ve been here all day. You
don’t work in construction anymore.”
4) “would you like me to rub your back for you?”
37. An 86 year old male with senile dementia has been
physically abused & neglected for the past two years by his live in
caregiver . He has since moved & is living with his son & daughter-
in-law. Which response by the client’s son would cause the nurse
great concern?
1) “ How can we obtain reliable help to assist us in taking
care of Dad? We can’t do it alone.”
 2) “ Dad used to beat us kids all the time . I wonder if he
remembered that when it happened to him?”
3) “I’m not sure how to deal with Dad’s constant repetition
of words.”
4) “I plan to ask my sister & brother to help my wife & me
with Dad on the weekends.”
38. Knowing the difference between normal age- related
changes & pathologic findings , which finding should the nurse
identify as pathologic in a 74 year old patient?
1) Increase in residual lung volume
2) Decrease in sphincter control of the bladder
3) Increase in diastolic BP
4) Decreased response to touch , heat & pain .

39. Convert 40mg into gram

40. Digoxin 400 mcg is prescribed, the ampule of digoxin is labeled 250mcg/ml. How many
mls will you draw up .
41. Which of the following is an important principle of delegation?
1) No transfer of authority exists when delegating.
2) Delegation is the same as work allocation.
3) Responsibility is not transferred with delegation
4) When delegating, you must transfer authority.

42. A staff nurse has delegated the ambulating of a new post-op patient to a
new staff nurse. Which of the following situations exhibits the final stage in
the process of delegation?
1) Having the new nurse tell the physician the task has been completed
2) Supervising the performance of the new nurse
3) Telling the unit manager the task has been completed
4) Documenting that the task has been completed
43. Which of the following is a specific benefit to an organization when
delegation is carried out effectively?
1) Delegates gain new skills facilitating upward mobility
2) The client feels more of their needs are met.
3) Managers devote more time to tasks that cannot be delegated.
4) The organization benefits by achieving its goals more efficiently
44. To prepare a client for discharge home from an acute care facility, a nurse
knows that the planning process must begin at what point?
1) The night before discharge.
2) Upon admission to the hospital.
3) Prior to discharge.
4) When the client indicates the readiness for discharge planning and teaching.
45. What is likely to be true of a nurse's duties when she acts as a case
manager providing community-based nursing services to a specific group of
individuals?
1) The nurse will care for clients at the center, in their homes, and in the hospital.
2) The nurse sees only clients who come to the office.
3) The nurse works independently of other health care professionals.
4) The nurse will not continue client care if it involves long-term needs.
46. A client is to be discharged home from a hospital using crutches or a
wheelchair. The client lives alone with three cats. Which assessment
parameter is most important on the initial home visit?
1) Whether the client will be able to keep medical appointments
2) Whether the client desires spiritual counseling
3) Whether the home has stairs and/or throw rugs
4) Whether the client has financial resources for payment
47. A nurse demonstrates patient advocacy by becoming involved in which of
the following activities?
1) Taking a public stand on quality issues and educating the public on "public interest"
issues
2) Teaching in a school of nursing to help decrease the nursing shortage
3) Engaging in nursing research to justify nursing care delivery
4) Supporting the status quo when changes are pending

48. In the role of patient advocate, the nurse would do which of the following?
1) Emphasize the need for cost-containment measures when making health care
decisions
2) Override a patient's decision when the patient refuses the recommended treatment.
3) Support a patient's decision, even if it is not the decision desired by the nurse.
4) Foster patient dependence on health care providers for decision making.

49.A patient is recovering from surgery has been advanced from a clear liquid
diet to a full liquid diet . The patient is looking forward to the diet change
because he has been “bored “ with the clear liquid diet. The nurse should
offer which full liquid item to the patient?
1) Tea
2) Gelatin
3) Custard
4) Ice pop
50.Before administering a tube feeding the nurse knows to perform which of
the following assessments?
 1) The gastrointestinal tract , including bowel sounds ,last BM , &
distention.
2) The client’s neurologic status , especially gag reflex
3) The amount of air in stomach
4) That the formula is used directly from the refrigerator

51. A client, who has had visitors the last two evenings during the unit's
regular evening visitors hours, 6:00 p.m. to 8:00 p.m., asks, "What time
can I have visitors this evening?" Which of the following would be the
best response to this question?
1) "Don't you remember what time you visitor have been coming?"
2) "You are worried about visiting hours."
3) "You want to know when you can have visitors?"
4) "Visiting hours are from 6:00 p.m. to 8:00 p.m."
52. A client breathes shallowly and looks upward when listening to the
nurse. Which sensory mode should the nurse plan to use with this
client?
1) Auditory
2) Kinesthetic
3) Touch
4) Visual
53. A nurse has been told that a client's communications are tangential. The
nurse would expect that the clients verbal responses to questions would
be
1) long and wordy
2) loosely related to the questions.
3) rational and logical
4) simplistic, short, and incomplete.
54. Which of the following statements by a nurse would indicate an
understanding of intrapersonal communications?
1) "Intrapersonal communications occur between two or more
people."
2) "Intrapersonal communications occurs within a person"
3) "Interpersonal communications is the same as intrapersonal
communications."
 4) "Nurses should avoid using intrapersonal communications."
55. According to the therapeutic communication theory, what criteria must be
met for successful communication?
1) The communication needs to be efficient, appropriate, flexible, and include feedback.
2) The individuals communicating with each other must share a similar perception of the
conversation.
3) The communication must be intrapersonal, interpersonal, group, or societal in nature.
4) Nonverbal communication is consistent with verbal communication.
56. The nonverbal communication that expresses emotion is:
1) Body positioning.
2) Eye contact
3) Cultural artifacts.
4) Facial expressions.
57. The nurse is interacting with a client and observes the client’s eyes moving
from side to side prior to answering a question. The nurse interprets this
behavior as:
1) The client being bored with the interaction.
2) The client processing auditory information.
3) The client engaging in intrapersonal communication.
4) The client responding to auditory hallucinations
58. To provide effective feedback to a client, the nurse will focus on:
1) The present and not the past.
2) Making inferences of the behaviors observed.
3) Providing solutions to the client.
4) The client.
59. After the death of a 46 year old male client, the nurse approaches the family
to discuss organ donation options. The family consents to organ donation
and the nurse begins the process. Which of the following would be most
helpful to the grieving family during this difficult time?
1) calling the client a "donor"
2) provide care to the deceased client in a careful and loving way
3) encourage the family to make a quick decision
4) tell them that there is no time to call other family members for advice
60.

. A critically ill client asks the nurse to help him die. Which of the following
would be an appropriate response for the nurse to give this client?
1) tell me why you feel death is your only option
2) how would you like to do this
3) everyone dies sooner or later
4) assisted suicide is illegal in this state

61. A 42 year old female has been widowed for 3 years yet she becomes very
anxious, sad, and tearful on a specific day in June. Which of the following is
this widow experiencing?
1) preparatory depression
 2) psychological isolation
3) acceptance
4) anniversary reaction
62. The 4 year old son of a deceased male is asking questions about his father.
Which of the following activities would be beneficial for this young child to
participate in?
1) nothing because he is too young to understand death
2) tell him his father has gone away, never to return
3) tell him his father is sleeping
4) explain that his father has died and give him the option of attending the funeral
63. The hospice nurse has been working for two weeks without a day off.
During this time, she has been present at the deaths of seven of her clients.
Which of the following might be beneficial for this nurse?
1) Nothing
2) provide her with an assistant
3) suggest she take a few days off
4) assign her to clients that aren't going to die for awhile
64. The wife of a recently deceased male is contacting individuals to inform
them of her husband's death. She decides, however, to drive to her parent's
home to tell them in person instead of using the telephone. Of what benefit
did this communication approach serve?
1) she needed to get out of the house
2) for the family to gain support from each other
3) no benefit
4) she was having a pathological grief response
65. While providing care to a terminally ill client, the nurse is asked questions
about death. Which of the following would be beneficial to support the
client's spiritual needs?
1) Nothing
2) ask if they want to die
3) ask if they want anything special before they die
4) provide support, compassion, and love
66. An emergency room nurse is working when an Amtrak train derails. The
emergency room nurse knows that reverse triage may need to be instituted.
What is the rationale for using reverse triage?
1) Mass casualty is an event with greater than 20 victims
2) A very basic reverse triage system is to categorize or label victims needing the most
support and emergency care as red.
3) Victims most likely to survive are color coded as black.
4) Reverse triage works on the principle of the greatest good for the greatest number.
67. Which of the following would be an appropriate strategy in reorienting a confused
patient to where her room is?
1) Place pictures of her family on the bedside stand
2) Put her name in large letters on her forehead
3) Remind the patient where her room is
 4) Let the other residents know where the patient’s room is
68. Which therapeutic communication technique is being used in this nurse-
client interaction?
Client: "When I get angry, I get into a fistfight with my wife or I take it out on
the kids."
Nurse: "I notice that you are smiling as you talk about this physical violence."
1) Encouraging comparison
2) Exploring
3) Formulating a plan of action
4) Making observations

69. Which therapeutic communication technique is being used in this nurse-

client interaction?
Client: "My father spanked me often."
Nurse: "Your father was a harsh disciplinarian."
1) Restatement
2) Offering general leads
3) Focusing
4) Accepting

70. Which therapeutic communication technique is being used in this nurse-

client interaction?
Client: "When I am anxious, the only thing that calms me down is alcohol."
Nurse: "Other than drinking, what alternatives have you explored to decrease
anxiety?"
1) Reflecting
2) Making observations
3) Formulating a plan of action
4) Giving recognition

71. The nurse is interviewing a newly admitted psychiatric client. Which nursing
statement is an example of offering a "general lead"?
1) "Do you know why you are here?”
2) "Are you feeling depressed or anxious?"
3) "Yes, I see. Go on."
4) "Can you chronologically order the events that led to your
admission?"

72. A nurse maintains an uncrossed arm and leg posture. This nonverbal behavior
is reflective of which letter of the SOLER acronym for active listening?

1) S
2) O
3) L
 4) E
5) R

73. What is the purpose of a nurse providing appropriate feedback?

1) To give the client good advice
2) To advise the client on appropriate behaviors
3) To evaluate the client's behavior
4) To give the client critical information

74. Which example of a therapeutic communication technique would be effective

in the planning phase of the nursing process?
1) "We've discussed past coping skills. Let's see if these coping skills can be
effective now."
2) "Please tell me in your own words what brought you to the hospital."
3) "This new approach worked for you. Keep it up."
4) "I notice that you seem to be responding to voices that I do not hear."

75. During a nurse-client interaction, which nursing statement may belittle the
client's feelings and concerns?
1) "Don't worry. Everything will be alright."
2) "You appear uptight."
3) "I notice you have bitten your nails to the quick."
4) "You are jumping to conclusions."