- A patient tells you that her urine is starting to look discolored. If you believe this change is due to medication, which of the following medications can you rule out as being the cause?
- Sulfasalazine
- Levodopa
- Phenolphthalein
- Aspirin
Certain medications can cause urine discoloration. Sulfasalazine can cause an orange tint, levodopa may turn urine brown or black, and phenolphthalein can cause red or pink urine.
Aspirin does not typically alter urine color, though high doses can affect kidney function.
- You are responsible for reviewing the nursing unit’s refrigerator. If you find _________ in the refrigerator, it should be removed from the refrigerator’s contents.
- Corgard
- Humulin
- Urokinase
- Epogen
Corgard (nadolol) should not be refrigerated; it is stored at room temperature. Humulin (insulin), urokinase, and Epogen (epoetin alfa) require refrigeration to maintain stability and potency.
- A 34-year-old female has recently been diagnosed with an autoimmune disease. She has also recently discovered that she is pregnant. Which of the following is the only immunoglobulin that will provide protection to the fetus in the womb?
- IgA
- IgD
- IgE
- IgG
IgG is the only immunoglobulin that crosses the placenta to provide passive immunity to the fetus. IgA is found in secretions like breast milk, IgE mediates allergic reactions, and IgD helps activate B cells.
- A second-year nursing student has just suffered a needlestick while working with a patient who is HIV-positive. Which of the following is the most important action that the nursing student should take?
- Immediately see a social worker
- Start HIV post-exposure prophylaxis (PEP) promptly
- Start prophylactic pentamidine treatment
- Seek counseling
After a needlestick exposure to HIV, antiretroviral prophylaxis should begin as soon as possible to reduce infection risk. Counseling and follow-up testing are also important but secondary.
- A 35-year-old male has been an insulin-dependent diabetic for five years and is now unable to urinate. Which of the following conditions would you most likely suspect?
- Atherosclerosis
- Diabetic nephropathy
- Autonomic neuropathy
- Somatic neuropathy
Long-term diabetes can damage autonomic nerves, affecting bladder control and causing urinary retention. Diabetic nephropathy involves kidney filtration issues, not bladder emptying.
- You are taking the history of a 14-year-old girl who has a BMI of 18. The girl reports an inability to eat, induced vomiting, and severe constipation. Which of the following would you most likely suspect?
- Multiple sclerosis
- Anorexia nervosa
- Bulimia
- Systemic sclerosis
Anorexia nervosa is marked by self-starvation, distorted body image, and symptoms like constipation, amenorrhea, and low BMI. Bulimia involves bingeing and purging but usually with a normal or slightly low BMI.
- A 24-year-old female is admitted to the emergency room for confusion. The patient has a history of multiple myeloma, constipation, intense abdominal pain, and polyuria. Which of the following would you most likely suspect?
- Diverticulosis
- Hypercalcemia
- Hypocalcemia
- Irritable bowel syndrome
Multiple myeloma often causes high calcium levels due to bone breakdown. Symptoms include confusion, abdominal pain, constipation, and polyuria.
- RhoGAM is most often used to treat ______ mothers who have an ______ infant.
- Rh-positive, Rh-positive
- Rh-positive, Rh-negative
- Rh-negative, Rh-positive
- Rh-negative, Rh-negative
RhoGAM prevents Rh incompatibility when an Rh-negative mother carries an Rh-positive fetus, which can otherwise cause hemolytic disease in future pregnancies.
- A new mother has some questions about phenylketonuria (PKU). Which of the following statements made by a nurse is not correct regarding PKU?
- A Guthrie test can check the necessary lab values.
- The urine has a high concentration of phenylpyruvic acid.
- Mental deficits are often present with PKU.
- The effects of PKU are reversible.
PKU is a genetic disorder causing buildup of phenylalanine. The effects are not reversible once neurological damage occurs. Early dietary management can prevent but not reverse effects.
- A patient has taken an overdose of aspirin. Which of the following should a nurse most closely monitor for during the acute management of this patient?
- Onset of pulmonary edema
- Metabolic alkalosis
- Respiratory alkalosis
- Parkinson-like symptoms
In acute salicylate toxicity, aspirin stimulates the respiratory center, leading to hyperventilation and respiratory alkalosis. Later, metabolic acidosis may develop, but early monitoring focuses on respiratory changes.
- A 50-year-old blind and deaf patient has been admitted to your floor. As the charge nurse, your primary responsibility for this patient is to:
- Let others know about the patient’s deficits.
- Communicate your concerns to your supervisor.
- Continuously update the patient on the social environment.
- Provide a secure environment for the patient.
Safety is the top priority for patients with sensory deficits. Ensuring a secure environment prevents injury and helps the patient adapt to surroundings.
- A patient is being discharged from a skilled nursing facility. The patient has a history of severe COPD and PVD and is primarily concerned about breathing easily. Which of the following would be the best instruction for this patient?
- Use deep-breathing techniques to increase oxygen levels.
- Cough regularly and deeply to clear airway passages.
- Cough after using a bronchodilator.
- Decrease CO2 levels by increasing oxygen intake during meals.
For patients with COPD, coughing after bronchodilator use helps clear secretions effectively, improving airway patency. Deep breathing alone may not be sufficient.
- A nurse is caring for an infant who has recently been diagnosed with a congenital heart defect. Which of the following clinical signs would most likely be present?
- Slow pulse rate
- Weight gain
- Decreased systolic pressure
- Irregular WBC count
Infants with heart defects often have fluid retention and poor circulation, leading to weight gain, tachypnea, and difficulty feeding.
- A mother has recently been informed that her child has Down syndrome. You are assigned to care for the child at shift change. Which of the following characteristics is not associated with Down syndrome?
- Simian crease
- Brachycephaly
- Oily skin
- Hypotonicity
Common traits of Down syndrome include hypotonia, a simian crease, and brachycephaly. Oily skin is not characteristic of the condition.
- A patient has recently experienced a myocardial infarction (MI) within the last four hours. Which of the following medications would most likely be administered?
- Streptokinase
- Atropine
- Acetaminophen
- Coumadin
Streptokinase is a thrombolytic that dissolves clots in acute MI if given soon after onset. Atropine and acetaminophen do not treat myocardial infarction, and Coumadin is for long-term anticoagulation.
- A patient tells a nurse, “My doctor recommended that I increase my intake of folic acid.” What types of foods contain folic acid?
- Green vegetables and liver
- Yellow vegetables and red meat
- Carrots
- Milk
Leafy greens and liver are rich in folate. Folic acid is vital for DNA synthesis and preventing neural tube defects during pregnancy.
- A nurse is putting together a presentation on meningitis. Which of the following microorganisms has not been linked to meningitis in humans?
- S. pneumoniae
- H. influenzae
- N. meningitidis
- C. difficile
Common causes of meningitis include S. pneumoniae, H. influenzae, and N. meningitidis. C. difficile causes pseudomembranous colitis, not meningitis.
- A nurse is administering blood to a patient who has a low hemoglobin count. The patient asks, “How long do red blood cells last in my body?” What is the correct response?
- The life span of red blood cells is 45 days.
- The life span of red blood cells is 60 days.
- The life span of red blood cells is 90 days.
- The life span of red blood cells is 120 days.
Red blood cells circulate for approximately 120 days before being destroyed in the spleen. Shorter lifespans are seen in certain anemias.
- A 65-year-old man has been admitted to the hospital for spinal stenosis surgery. When does discharge training and planning begin for this patient?
- Following surgery
- Upon admission
- Within 48 hours of discharge
- During the preoperative discussion
Discharge planning starts at admission to ensure a safe transition and continuity of care. Early planning identifies needs and coordinates resources.
- A child is 5 years old and has been recently admitted to the hospital. According to Erikson, which of the following stages is the child in?
- Trust vs. mistrust
- Initiative vs. guilt
- Autonomy vs. shame and doubt
- Intimacy vs. isolation
Preschool-aged children (3–6 years) develop initiative by exploring and making decisions. Overcontrol by adults may lead to guilt or fear of punishment.
- A toddler is 16 months old and has been recently admitted to the hospital. According to Erikson, which of the following stages is the toddler in?
- Trust vs. mistrust
- Initiative vs. guilt
- Autonomy vs. shame and doubt
- Intimacy vs. isolation
Toddlers (1–3 years) develop independence through exploration and self-care. Criticism or restriction fosters shame and doubt.
- A young adult is 20 years old and has been recently admitted to the hospital. According to Erikson, which of the following stages is the adult in?
- Trust vs. mistrust
- Initiative vs. guilt
- Autonomy vs. shame and doubt
- Intimacy vs. isolation
Young adulthood focuses on forming close, meaningful relationships. Failure to do so may lead to isolation or loneliness.
- A nurse is making rounds to take vital signs. Which of the following sets of vital signs is abnormal?
- 11-year-old male — 90 bpm, 22 resp/min, 100/70 mm Hg
- 13-year-old female — 105 bpm, 22 resp/min, 105/60 mm Hg
- 5-year-old male — 102 bpm, 24 resp/min, 90/65 mm Hg
- 6-year-old female — 100 bpm, 26 resp/min, 90/70 mm Hg
A heart rate of 105 bpm is high for a 13-year-old (normal: 70–100 bpm). The other readings fall within age-appropriate ranges.
- While taking a patient’s history, she tells you that she has been depressed and is dealing with an anxiety disorder. Which of the following medications would the patient most likely be taking?
- Elavil
- Calcitonin
- Pergolide
- Verapamil
Elavil (amitriptyline) is a tricyclic antidepressant used for depression and sometimes anxiety. The other drugs treat unrelated conditions.
- Which of the following conditions would a nurse not administer erythromycin for?
- Campylobacterial infection
- Legionnaires’ disease
- Pneumonia
- Multiple sclerosis
Erythromycin is an antibiotic effective for respiratory and bacterial infections. It is not used for neurological disorders like multiple sclerosis.