You know you are a nurse if ...

RENAL

100

In planning the diet teaching for a child in the early stage of nephritic syndrome, the nurse would discuss with the parents the following dietary changes: 1. Adequate protein intake, low sodium 2. Low protein, low potassium 3. Low potassium, low calorie 4. Limited protein, high carbohydrate

1.This is the one kidney disease where they can have more protein

200

Which of the following clients is a likely candidate for developing acute renal failure? 1. A female with recent ileostomy due to ulcerative colitis 2. Middle age male with elevated temperature and chronic pancreatitis 3. Teenager in hypovolemic shock following a crushing injury to the chest 4. Child with compound fracture of right femur and massive laceration to left arm

3. All I have to see is one word “shock”. Shock kills kidneys

300

A client is experiencing severe pain from renal calculi. Which of the following is a priority in the nursing care plan? 1. Administer pain medication as often as needed according to doctors orders 2. Encourage fluid intake to help flush the stone through 3. Assist the client to ambulate to promote draining the bladder 4. Irrigate the bladder to maintain urinary patency

1. Identify what the problem is pain, so pick the answer that deals with pain

400

In order to maintain asepsis, the client on home peritoneal dialysis should be taught to: 1. Drink only distilled water 2. Cap the Tenchkoff catheter when not in use 3. Boil the dailysate one hour prior to a pass 4. Clean the arteriovenous fistula with hydrogen peroxide daily

2. Cap the Tenchkoff catheter when not in use

500

A client has a history of oliguria, hypertension, and peripheral edema. Current lab values include BUN 25, K 5.0. Which nutrients should be restricted in this client’s diet? 1. Protein 2. Fats 3. Carbohydrates 4. Magnesium

1. When someone is in renal failure what do nutrients do you have to worry about?

CARDIOVASCULAR

100

During the procedure, the physcian threads the heart catheter through the femoral artery. After the coronary arteriogram, the nurse must keep the client flat in bed with the affected leg in which position? 1. extended 2. flexed 3. abducted 4. adducted

1. extended; after the procedure, the catheterized leg is extended to prevent flexing of the hip.

200

Which of the following signs indicate effective CPR? 1. Adequate capillary refill 2. Normal skin color 3. Symmetrically dilated pupils 4. Palpable carotid pulse

4. Palpable carotid pulse

300

A permanent demand pacemaker set at a rate of 72 is implanted in a client for persistent third degree block. Which of the following nursing interventions would indicate a pacemaker dysfunction? 1. Pulse rate of 88 and irregular 2. Apical pulse rate regular at 68 3. Blood pressure of 110/80, pulse of 78 4. Tenderness at site of pacemaker implant

2. You should always worry if rate to drop below set rate.

400

A client with an irregular pulse rate of 181 and a K level of 3.0 mEq/L has Lanoxin ordered. The nurse should: 1. Give the digoxin since the pulse is within normal limits 2. Holds the digoxin since the pulse is irregular 3. Call the doctor to report the potassium 4. Hold the digoxin since toxicity occurs with high potassium levels

3. If the problem is hypokalemia then do something to fix the problem. This is the only answer that addresses the problem

500

The nurse has administered sublingual nitroglycerin (Nitrostat) to a client complaining of chest pain. Which of the following observations is most important for the nurse to report to the next shift? 1. The client indicates the need to use the bathroom 2. Blood pressure has decreased from 140/80 to 90/60 3. Respiratory rate has increased from 16 to 24 4. The client indicates the chest pain has subsided

2. Blood pressure decreased too much. Nurse should not leave patient until it comes up and next nurse should be made aware of the drop.

ENDOCRINE 1

100

A patient is admitted with diabetic ketoacidosis. You note his respiratory rate to be 38. Considering his condition you are aware that this increased rate is a result of: 1. An effort by the body to compensate for respiratory acidosis 2. An effort by the body to remove excess acid from the body 3. An effort by the body to supply more oxygen to the depleted tissues 4. An effort by the body to conserve CO2

2. An effort by the body to remove excess acid from the body

200

The client is admitted with acute hypoparathyroidism. To maintain client safety, which item is most important to have available? 1. Tracheostomy set 2. Cardiac monitor 3. IV monitor 4. Heating pad

1. If applicable, airway always comes first.

300

In planning care for the client with hyperthyroidism, the nurse would anticipate the client to require: 1. Extra blankets for warmth 2. Ophthalmic drops on a regular basis 3. Increased sensory stimulation 4. Frequent low calorie snacks

2. Patient will have exothalmus and need eye drops

400

The nurse is aware that which of the following statements made by the client indicates a correct understanding of steroid therapy for Addison’s Disease? 1. “I’ll take the medicine in the morning because if I take it at night it might keep me awake.” 2. “I’ll take the same amount from now on.” 3. “I’ll increase my potassium by eating more bananas.” 4. I’ll be eating foods low in carbohydrates and salt.”

1. Steroids, in some people, cause insomnia

500

Which nursing action has the highest priority in caring for the client with hypoparathyroidism? 1. Develop a teaching plan 2. Plan measures to deal with cardiac arrhythmias 3. Take measures to prevent a respiratory infection 4. Assess laboratory results

2. Arrhythmias are the most life threatening

HEMA/IMMUNE

100

The nurse observes that the client performs the Buerger-Allen exercise correctly when the client lies flat with the legs elevated for several minutes and then performs which action? 1. sits on the edge of the bed 2. stands and touches the toes 3. jogs in place at the bedside 4. pretends to climb stairs

1. Buerger-Allen exercises help improve and promote collateral circulation and should be done several times per day by the client with Buerger's disease.

200

The physician tells a client that 2 units of packed blood cells will be administered. The client verbalizes concern about becoming human immunodeficiency virus (HIV) positive from receiving transfusions of publicly donated blood. Which response by the nurse is the most appropriate response to the client's comment? 1. "Blood donors are tested for HIV before their blood is accepted." 2. "Donated blood no longer contains the HIV virus." 3. "Donated blood is tested for HIV antibodies after collection." 4. "There's no way to identify the AIDS virus in blood yet."

3. After it is collected, all donated blood is tested for HIV antibodies.

300

The schilling test confirms that the client has pernicious anemia. When the client asks the nurse how the disorder will be treated, which response by the nurse is most appropriate? 1. "The physician will probably prescribe blood transfusions." 2. "The physician will most likely prescribe iron medications." 3. "The physician will probably prescribe vitamin B12 injections." 4. "The physician will probably prescribe vitamin K injections."

3. Pernicious anemia is incurable, but the manifestations of the disease can be treated by lifelong injections of vitamin B12.

400

How can the nurse be best protected form acquired immunodeficiency syndrome (AIDS) when caring for a client wiht an unknown infectious status? 1. wear a face mask when changing dressings 2. refrain from capping needles after injections 3. wear a cover -gown when giving a bed bath 4. put on gloves before taking the client's vital signs

2. Standard precautions are used when a person's infectious status is unknown. In ALL situations, it is important to avoid recapping needles because this will prevent an accidental needle-stick injury.

500

The nurse reviews the hereditary implications and precipitating factors of sickle cell anemia with the client. The nurse teaches the client that the sickle cell crisis was most likely triggered by which precipitating factors? Select all that apply. 1. low blood glucose level 2. fatigue 3. overexertion 4. overhydration 5. fever 6. smoking

3. overexertion, 5. fever, 6. smoking A sickle cell crisis occurs when the client has high demand for oxygen. Although the client becomes fatigued during a crisis, this is not a precipitating event.

ENDOCRINE 2

100

The nurse documents that the client with Addison's disease has recurrent episodes of hypoglycemia. If a regular diet is ordered, which in-between meal snack should the nurse offer to help regulate the client's blood glucose level? 1. lemonade and peanuts 2. cola and potato chips 3. coffee and a muffin 4. milk and crackers

4. Clients with Addison's disease are prone to developing low blood glucose levels. Snacks such as milk and crackers contain complex carbohydrates that take longer to metabolize than simple sugars. Therefore, they are more likely to help maintain a stable blood glucose level. To reduce episodes of hypoglycemia, it is appropriate to schedule at least six small meals per day or between-meal snacks.

200

The client has 3 of the 4 lobes of parathyroid gland surgically removed. After the client returns from surgery and resumes eating, the nurse should encourage the client to eat foods from which food groups? 1. bread and cereals 2. milk and cheese 3. meat and seafood 4. fruit and vegetables

2. Postoperatively, it is therapeutic to include sources of calcium in the client's diet because the function of the parathyroid gland is suddenly and severely compromised.

300

Which nursing interventions are most appropriate in managing a client in thyroid crisis? Select all that apply. 1. Take the client's vital signs at least every hour. 2. Assess Trousseau's sign every shift. 3. Limit the client's activity. 4. Administer antipyretics per order. 5. Encourage a diet high in iodized salt. 6. Make sure I.V. calcium gluconate is available.

1. Take the client's vital signs at least every hour. 3. Limit the client's activity. 4. Administer antipyretics per order. The nurse should monitor the client's vital signs at least hourly, paying close attention to the client's temperature (which is elevated), heart rate and rhythm. Tachycardia and cardiac arrhythmias are common manifestations. Because of the increased metabolism, the heart has to work harder; unless managed, this could result in cardiac arrest.

400

The healthcare provider prescribes lypressin (Diapid) to be admininstered p.r.n. When instructing the client about how to take this drug at home, the nurse tells the client to administer the drug when experiencing which sign or symptom? 1. increased thirst 2. onset of a headache 3. dark yellow urine 4. a runny nose

1. The need to administer additional doses is based on the increased thirst and frequency of urination.

500

The nurse knows the diabetic client understands what "free" foods on the exchange list means if the client excludes which one of the following from a meal plan? 1. iced tea 2. flavored water 3. light beer 4. club soda

3. "Lite" or "light" is a food-labeling term that means the product contains one-third fewer calories than a similar unaltered form. The other selections are considered "free" and do not contain calories.