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The ABC’s of PASSING FOREIGN NURSING EXAMS…………...…As prepared by R.A. Gapuz

PART IX REVIEW BULLETS

MS SIGNS AND SYMPTOMS ¾ Which symptom is related to loss of fluid due to profuse diarrhea? Flushed dry skin ¾

Common sign of cardiac valvular disease: Nocturnal dyspnea

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Common sign of hypoxia: Restlessness

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Early sign of thyroid crisis after a thyroidectomy: Tachycardia

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Most common complain of patients with Crohn’s disease: Crampy abdominal pain

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Manifestation of duodenal ulcer: Pain relieved after eating

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Common manifestation of BPH: Nocturia

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In liver cirrhosis, there is a deficiency of vitamin K, which symptom is related to this deficiency: Ecchymosis

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Typical symptom of pernicious anemia

Copyright © 2005 by Ray A. Gapuz. Unauthorized reproduction (including photocopying) of any part of this book may result in criminal prosecution and/or civil liability.

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The ABC’s of PASSING FOREIGN NURSING EXAMS……………...As prepared by R.A. Gapuz

Beefy red tongue ¾

In patients with elevated serum ammonia, the nurse will note: Flapping tremors

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In patients with chest trauma there is: Mediastinal shift

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CVP that is continuously elevated, the nurse should observe for : Distended jugular vein

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Manifestation of mastitis: Pain and fever

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Manifestation of meningitis: Resistance to neck flexion (+) brudzinski’s sign

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Manifestation on Coarctation of aorta: Lower blood pressure in the lower extremities and high blood pressure in the upper extremities

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Manifestation of cholelithiasis: Yellowish sclera

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Manifestation of laryngeal edema: Inspiratory stridor

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Early sign of hepatic encephalopathy: Personality changes

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Manifestation of shaken baby syndrome: Retinal hemorrhage

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Manifestation of Iron deficiency anemia: Pallor of the mucus membrane


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Manifestation of pyloric stenosis: Projectile vomiting

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Sign of increased ICP: Widening pulse pressure

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Manifestation of bleeding post tonsillectomy: Frequent swallowing

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Manifestation of DKA: Fruity breath odor

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Sign of hyperthyroidism: Loss of weight

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Manifestation of meniere’s disease: Vertigo- described as “the room is spinning”

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Sign of myasthenia gravis: Ptosis

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Sign of dehydration in one month old, infant: Sunken eyeballs

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Sign of cataract: Blurring of vision

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Sign of cancer of the esophagus: Dysphagia

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Sign of end stage renal disease: Nausea and vomiting

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Sign of salmonella food poisoning: Diarrhea


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THERAPEUTIC DIETS ¾

A patient is given instruction about his bland diet, additional health teaching would be needed if the patient tolerated which of the following foods: Lettuce and tomato salad

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Which of the following is highest in protein content: Baked custard

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Which of the following has the least sodium content: Apple juice

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An adolescent on a regular diet refused to eat her breakfast, she tells the nurse that she wants the pizza brought by her parents last night, what should the nurse do: Let her eat the pizza

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In a patient with cystic fibrosis, the appropriate diet is: High sodium, high calorie, low fat

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Low sodium diet is indicated for a patient with congestive heart failure. What should the nurse assess during admission: Diet history

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In cirrhosis of the liver, the appropriate diet is: Low protein

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In patient with hyperthyroidism which diet is indicated: High calorie


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In a patient receiving Lasix, the appropriate nursing intervention is to serve food which are high in: Potassium

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In a patient with peptic ulcer, which statement indicates that he understood the instruction: “I will have small frequent meals during the day.”

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Patient was diagnosed with diverticulitis, which statement indicates needs for further assessment: “I love vegetable salad as my dessert.”

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A patient with renal failure should not be given which of the following: Canned vegetables

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For a patient with hypertension which type of diet is appropriate: Low sodium, low cholesterol diet

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For a patient with Meniere’s disease which is the appropriate diet Low sodium

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In a manic patient which of the following can be given: Meat sandwiches

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High fat low cholesterol dry is indicated for: Dumping syndrome


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POSITIONING ¾

Right side lying position: Indicated for right pneumonectomy

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Post supratentorial craniotomy patient should be positioned in: Low fowler’s

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How should the patient with rales at the left lower lobe of the lungs be positioned for chest drainage: Right side with hips slightly higher than the head

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When inserting a central venous catheter, the patient should be placed in which position: Trendelenburg

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How should the nurse position a patient who is suspected to be in hypovolemic shock: Flat with legs slightly elevated

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Immediately after supratentorial craniotomy, in what position should the patient be placed: Semi-Fowler’s

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After surgery for hip dislocation, a patient is discharged from the hospital, which statement made by the patient would indicate a need for further instructions: “I will make sure to separate my legs when I bend to tie my shoelaces.”

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A patient should be positioned after cataract extraction, on the unoperative side, in order to:


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minimize edema ¾

Trendelenburg is the position of choice for cardiac catheterization in order to: Prevent air embolism

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How should the nurse position a patient who is to undergo thoracentesis: Sitting with his arms resting on the overbed table

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Which position is contraindicated in a patient after femoro-popliteal bypass: Side-lying

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After liver biopsy was done, which of the following should be included in the patients’ care plan: Turn the patient on his abdomen with small pillow under the sub-coastal area

PHARMACOLOGY ¾

Accutane causes: Birth defects

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A common adverse effect of allopurinol is: Agranulocytosis

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The therapeutic level of Aminophylline is: 10 -20 mg/dl

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Amphogel is given to a patient with renal failure in order to: Facilitate the excretion of phosphorus


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Antabuse acts to cause an unpleasant reaction when combined with: Alcohol

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The desired effect of aspirin in a patient with rheumatic fever is: Anti-inflammatory

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Atrophine sulfate causes facial flushing because of: Dilation of peripheral blood vessels

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Treatment with AZT begins when CD4 cell count is: Below 300

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In a preterm delivery Celestone, is administered how many hours before delivery: 48 hours, to promote fetal lung maturity

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In a patient taking Coumadin, the nurse should monitor the patient’s: Prothrombin time

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A patient who is taking Dalmane (anti-anxiety) should: Avoid alcohol and caffeine

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Diabinase acts to stimulate the pancreas to: Secrete insulin

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The purpose of giving Diamox in a patient with glaucoma is to: Decrease IOP

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The antidote of Lanoxin is: Digibind


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A common side effect of Dilantin is: Gingivitis

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Elavil causes: Tachycardia

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Epogen is administered in a patient with renal failure in order to: Increase RBC production

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Ferrous sulfate is best taken with: Orange juice

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Gentamicin causes: Ototoxicity, nephrotoxicity and neurotoxicity

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Haldol decreases: Hallucinations

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Heparin prolongs: Partial thromboplastin time

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INH is given with vitamin B6 in order to prevent: Peripheral neuritis

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Kwell is administered for how many times: Not more than twice in a week

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Lasix causes: Hypokalemia

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The therapeutic level of lithium is: .5 – 1.5 mEq/L

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The antidote of magnesium sulfate is: Calcium gluconate


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Mannitol is given to a patient with cerebral edema in order to: Decrease IOP

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Mestinon is the drug of choice for: Myasthenia gravis

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Morphine is not given to a patient with pancreatitis because: It increases the spasms of the sphincter of Odi thereby aggravating pain

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Nardil causes: Hypertensive crisis

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Neomycin sulfate is administered before bowel surgery in order to: Decrease bacterial flora in the intestine

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Burning sensation under the tongue after sublingual nitroglycerine indicates: Potency of the drug

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Pancreatin is best given with: Each meal

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Probenecid is given in gouty arthritis in order to Promote excretion of uric acid

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PTU causes: Agranulocytosis

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Rhogam is administered when a baby is : Rh+ Coombs (-)


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Ritalin causes: Growth suppression

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Robaxin is given post-spinal fusion in order to: Decrease muscle spasm

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Streptomycin causes: Ototoxicity, nephrotoxicity and neurotoxicity

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For how long should a patient take synthroid? Lifetime

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Tagamet is best taken: With meals

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Timolol maleate (Timoptic) is administered in the: Lower conjunctival sac

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Tofranil causes: Tachycardia / palpitation

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MMR is not given to a child who has an: Allergy to eggs

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Valium should always be given separately because it is: Incompatible with any drug

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Vancomycin is the drug of choice for: MRSA (Methicillin Resistant Staphylococcus Aureus)

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Yutopar is given to treat: Preterm labor

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In a patient taking synthroid, which of the following symptoms needs to be reported to the doctor? Change in energy level.


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A nursing diagnosis for a patient on a long term steroid therapy? Risk for injury.

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The best site to administer vitamin K is the: Vastus lateralis muscle.

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Eye ointment is applied at the: Lower conjunctival sac.

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Analgesics should be given around the clock in patients with: Cancer

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To prevent the loss of calcium in the bones of a patient with hyperparathyroidism, the nurse will anticipate the doctor will order: CALCITONIN

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Decreased tolerance to narcotics is usually common among: The elderly.

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The appropriate nursing action when a doctor orders enteric coated medication in a patient with gastrostomy is to: Request for a change in form.

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To facilitate the removal of potassium from the large intestines, the nurse would anticipate the doctor to order: Kayexalate.

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When a patient with Parkinson’s disease who is taking levodopa losses his appetite, the nurse should:


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Report the symptom to the doctor. ¾

Which statement of a parent is indicative of digoxin toxicity in her child? “My daughter does not seem to be hungry most of the time.”

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In a burn patient the best way to administer the correct dosage of narcotic is thru a: Pump.

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Which of the following drugs is contraindicated in a patient with shock: Propanolol.

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A common sign of gonorrhea is: Pain on voiding.

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Oxytocin infusion is terminated in a patient in labor if: The patient’s contraction lasts 100 seconds or more.

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Pancrease is given to a patient with cystic fibrosis in order to: Increase absorption of nutrients.

PROCEDURES ¾

Which indicates arterial occlusion in the lower extremities? Lack of hair in the legs.


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Which of the following findings needs re-evaluation in a patient with water seal drainage system? The third rod in the third bottle is immersed in 25 cm of water.

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Itching experienced by a patient during intravenous pyelogram indicates: Anaphylaxis

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Which statement indicate an understanding of the instruction when preparing a patient for thoracentesis? I will sit on the side of the bed with my arm resting on an overbed table.

¾ To check if the lungs of the patient with a three bottle chest drainage system has re-expanded, the nurse will anticipate that the doctor will order: Chest x-ray. ¾ ECT is indicated in major depression to: Decrease the symptoms of depression. ¾ When dislodge of the chest tube of a patient with a chest drainage system occurs, the nurse should initially: Cover the chest wound with a vaselinized gauze. ¾ When a patients’ nasogastric tube is suctioned, there is a risk for: Metabolic alkalosis. ¾ Oxygen therapy is effective: O2 saturation is 96%.


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¾ Which patient statement indicates understanding of the procedure involved in the use if an incentive spirometer: “I will take a slow deep breath into the mouthpiece of the spirometer then exhale.” ¾ The best time to perform a postural drainage is: Before meals. ¾ A male patient understands the procedures involved in cystoscopy if he says: A tube will be passed through the penis into the bladder to visualize the interior wall of the bladder.

INTEGRATED ¾

A patient with diabetes mellitus should be referred to an: Opthalmologist.

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The mother of a hospitalized two-year-old child tells the nurse, that she will go home for a while. What should the nurse ask the child? “Did you tell the child that you are going home?”

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Which statement made by a patient child is diagnosed with PKU, indicates an understanding of the disease: “I’m glad that we live in a community having a program about mentally retarded children.”

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To promote drying of a cast, the nurse should: Turn the patient frequently.


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To check if an adolescent has scoliosis, instruct the nurse to: Observe the patients back as she bends over.

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To increase the self esteem of a patient with anorexia, the nurse should refer the patient for: A one on one counseling.

¾ Which intervention is appropriate when a child is suffering from lead poisoning: “Assess the child’s development every month.” ¾ A depressed patient who is slow moving doesn’t want to eat his meal. Which response is appropriate for the nurse to say: “It’s lunchtime, I’ll accompany you to the dining room.” ¾ A depressed patient tells the nurse that she can’t walk because her legs are too weak. What should the nurse do initially? Determine the cause of the patient’s complaint. ¾ A common sign of leukemia is: Fever. ¾ To prevent suicide in a depressed patient, the nurse should: Visit in addition to the scheduled activities of care. ¾ Herbal antidepressant, which is contraindicated in pregnancy? St. John’s wort. Copyright © 2005 by Ray A. Gapuz. Unauthorized reproduction (including photocopying) of any part of this book may result in criminal prosecution and/or civil liability.

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¾ When Asians nod, it means: They understand instructions. ¾ A 14-year-old pregnant patient is prone to develop: Iron deficiency anemia. ¾ Simean crease in a neonate could be indicative of: Congenital heart defect. ¾ In a patient with manifestations of hypovolemic shock, the best position is: Supine with the legs elevated. ¾ Which statement of a staff nurse is indicative of a positive outcome of conflict resolution? “I am willing to hear feedback from my head nurse without taking it personally.” ¾ Cushing’s syndrome can cause: Metabolic alkalosis. ¾ Diabetes mellitus can cause: Metabolic acidosis. ¾ Collection of fluids in the pleural space leads to: Pleural effusion. ¾ The best room for a manic patient is: A room with subdued lighting and neutral colon. ¾ When a depressed patient gave away her wedding ring to another patient, the nurse should: Report it to the doctor. ¾ Excessive facial hair is indicative of: Cushing’s syndrome. Copyright © 2005 by Ray A. Gapuz. Unauthorized reproduction (including photocopying) of any part of this book may result in criminal prosecution and/or civil liability.

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¾ In a patient with multiple myeloma. The priority nursing diagnosis is: Risk for injury. ¾ Buck’s traction is applied to a patient with fracture in order to: Decrease muscle spasm. ¾ A late sign of lead poisoning is: SEIZURE. ¾ Cancer of the larynx is usually associated with: Alcoholism. ¾ Which statement of a patient with ulcerative colitis reflects a need for further instruction? “I’m not expecting for a possibility of future surgery.” ¾ If the environmental temperature is 26 °C and an old man wears a suit and a topcoat, this indicates: Impaired judgment. ¾ When a patient attempts to give $100 to a nurse, the best response of the nurse is: “Thank you, but I can not accept it.” ¾ The appropriate diet for a patient with Hepatitis A is: High protein, high calorie. ¾ Example of a high protein diet: Fruit salad and yogurt. ¾ In a patient admitted for overdose of pills, which question should the nurse ask the patient? Copyright © 2005 by Ray A. Gapuz. Unauthorized reproduction (including photocopying) of any part of this book may result in criminal prosecution and/or civil liability.

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What makes you feel that you want to take your life? ¾ A possible complication of thoracic surgery is: Mediastinal shift. ¾ To prevent easy transfer of infection, the nurse should perform: Handwashing. ¾ In a patient with mitral valve disease. The appropriate nursing diagnoses is: Fluid volume excess. ¾ The development of peptic ulcer disease is related to: Helicobacter pylori infection. ¾ Which statement made by a patient post cataract extraction indicates an understanding of the surgical intervention? “The surgery will allow light rays to enter my eyes.” ¾ Which statement made by a patient with cystitis indicates correct understanding of the health teachings for prevention of recurrence? “I will take a bath in a shower rather than in a bath tub.” ¾ Post open heart surgery, the priority for the patient is: Oxygenation. ¾ Which question is appropriate to ask a patient who is admitted with alcoholism. “When was your last drink.”


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¾ After abdominal surgery, the patient passes out flatus, which activity is appropriate for the nurse to implement? Ambulate the patient. ¾ A statement of a patient with anxiety that indicates panic is: “I feel like I’m losing control.” ¾ An elevated BP in a patient post liver transplant is indicative of: Transplant rejection. ¾ To prevent escalation of anxiety of an obsessivecompulsive patient, the nurse should: Allow the patient to perform the ritual. ¾ What is the purpose of the hot sitz bath in a patient with herpes zoster? To promote comfort. ¾ A systemic disorder affecting the connective tissues of the joint is: Rheumatoid arthritis. ¾ A common complication of endometriosis is: Infertility. ¾ In a patient with anorectal fistula, the goal of care is to: Maintain body weight. ¾ When admitting a patient with history of suicide, the nurse should initially: Make a safety contract.


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¾ Therapeutic interventions for a patient with hiatal hernia is effective, when the patient says: “I don’t have heartburn anymore.” ¾ A common sign of esophageal varices is: Hematemesis. ¾ A psychiatric patient says, “I don’t want to take pills, you are poisoning me.” The most appropriate response of the nurse is: “It seems very frightening when you think someone is trying to hurt you?” ¾ The treatment goal for a patient with conduct disorder is to: Increase the patient’s internal locus of control. ¾ A common sign of alcohol withdrawal is: Tachycardia and agitation. ¾ A common finding in the history of a patient with mitral valve disease is: Sore throat. ¾ When providing health teaching to a patient regarding colostomy irrigation, the nurse should consider: The patient’s previous elimination pattern. ¾ Which statement if made by a patient with diabetes mellitus reflects a need for further instructions: “I will increase my insulin before exercise.” ¾ Tardive dyskinesia is manifested by: Lip grimacing and tongue protrusion. Copyright © 2005 by Ray A. Gapuz. Unauthorized reproduction (including photocopying) of any part of this book may result in criminal prosecution and/or civil liability.

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¾ A common sign of end stage renal disease is: Vomiting. ¾ An appropriate solution to use when performing oral care is: Hydrogen peroxide. ¾ Common cause of mortality in twins: Prematurity. ¾ Which manifestation is abnormal in a 7-month-old child: Head lag. ¾ Which statement of a pediatric patient indicates understanding of instruction related to cast care? “I will tell mother if my toes tingle.” ¾ The pain experienced by a patient with ectopic pregnancy is: Intermittent stabbing knife like abdominal pain. ¾ A three-month-old child with 45 cm. Head circumference and bulging fontanel is suspected to be suffering from: Increased intracranial pressure. ¾ An 18-month-old child who is still bottle fed is prone to develop: Iron deficiency anemia. ¾ Newborns from diabetic mothers will usually exhibit: Tremors. ¾ In a 10-month-old child with head injury, the appropriate position for the patient is: Semi-sitting. Copyright © 2005 by Ray A. Gapuz. Unauthorized reproduction (including photocopying) of any part of this book may result in criminal prosecution and/or civil liability.

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¾ An 8-year-old with white specks on the shaft of her hair is a suspected case of: Pediculosis. ¾ During admission assessment a nurse finds that a child has welts and bruises at the back and the shoulder’s. The nurse should: Report the case to the child abuse authority. ¾ A child should use the child seatbelt at the back center seat until there is: Head control. ¾ To prevent the development of dental caries in children, the nurse should instruct the mother to: Avoid giving juices while the child is bottle fed at night. ¾ An appropriate play material for a 1-month-old child: Large picture books. ¾ Dark spots near the buttocks of an African-American patient is considered: Normal. ¾ A common finding in an 8-month-old child is: Ability to sit without support. ¾ An 8-month-old child was admitted due to projectile vomiting, which other symptoms supports a diagnosis of pyloric stenosis? Possible gastric peristaltic waves. ¾ The mother of a child with PKU makes the following statements, which one indicates a need for further instruction: “My child loves to drink milkshake.”


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