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SAMPLE NURSING EXAMS

Steven, an athletic 20-year-old collegestudent, suffered a fractured shoulderand sprained wrist in a fall at a skiresort.

1. In developing Steven's care plan

following surgery, which of thefollowing typical problems would youanticipate?

A. He will undergo an alteration inself-concept.B. He will experience anxiety as aresult of flashbacks about the skiingaccident.C. He will have impaired mobilitycaused by immobilization of upperextremity.D. There will be abnormal tissueperfusion caused by swelling.

Jean Thomas is a 25-year-oldsecretary admitted to the emergencyroom with diaphoresis,hyperventilation, palpitations, andtrembling. Jean tells the nurse thatshe has been "very upset andnervous" over a poor employmentevaluation. A tentative diagnosis ofacute anxiety episode is made.

2. Which of the following acid-baseimbalances would likely occur as aresult of Jean's hyperventilation?

A. Respiratory acidosisB. Respiratory alkalosisC. Metabolic acidosisD. Metabolic alkalosis

Mrs. Durham is recovering from acolon resection for removal of amalignant mass in the large bowel.Following breakfast one morning, shetold the nurse, "I'm tired of waiting, Iwant my bath now. You're never herewhen I need you."

3. Which of the following responses bythe nurse is most appropriate?

A. What do you mean, I'm never here?I spent all three hours with youyesterday, Mrs. Durham.B. I'm sorry you've been waiting Mrs.

Durham. Let's get you comfortablenow and I'll be back in twenty minutesto give you a bath.C. I'm doing my best, Mrs. Durham.You know I have three other patientsto take care of today, besides you.D. I must see Mrs. Jones right now,Mrs. Durham. She's really sick today.I'll be back as soon as I can.

Brian, aged 4 years, is sitting in thepediatric day room with Michael,another patient. He suddenly realizesthat he has wet his pants and runs tothe nurse, crying.

4.The most appropriate initialresponse by the nurse is:

A. Why, Brian, what happened? Whydid you wet your pants?B. You know better than this, Brian;next time you'll get a good spanking.C. Let's take off those wet pants,Brian, and put on something dry soyou'll be more comfortable.D. Wait until I tell Michael what youdid. Aren't you ashamed of yourself?

Margaret O'Hara, a 30-year-old knowndiabetic, is brought to the emergencydepartment by ambulance. Theparamedic team reports symptoms ofapparent hyperglycemia. Stat bloodglucose is 640.

5. The nurse is aware that excessserum glucose acts to draw fluidsosmotically with resultant polyuria. Inaddition to increased urinary output,the nurse should expect to observe

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which of the following sets ofsymptoms in Margaret?

A. Polydipsia, diaphoresis, bradycardiaB. Thirst, dry mucous membranes, hotdry skinC. Hypotension, bounding pulse,headache

D. Nervousness, rapid respirations,diarrhea

Molly Flannery is a 67-year-old femalewith chronic congestive heart failureand hypertension. She is beingevaluated for complaints of muscularweakness and general fatigue.

6. Molly's serum electrolyte studies

reveal a K+ level of 2.9. Which of thefollowing medications taken by thepatient at home contributed most toher hypokalemic state?

A. Digoxin, .125 mg, PO, dailyB. Lasix, 80 mg, PO, dailyC. Aldomet, 250 mg, PO, tidD. Aspirin, 10 grains, bid

Mr. Robert Bacchus is a 63-year-oldretired business executive who comesto the emergency room withcomplaints of dyspnea, shortness ofbreath, and chest pain radiating to theleft arm.

7. The nurse caring for Mr. Bacchusshould implement which of thefollowing actions FIRST?

A. Administer prescribed painmedicationB.. Apply oxygen per nasal cannula asorderedC. Assess vital signsD. Apply electrocardiogram electrodesto the patient's chest

Loberta Jackson, a 21-year-old college

student, is admitted to a medical unitwith diagnosis of uncontrolleddiabetes, acute hypoglycemicreaction.

8. Loberta explains to the admittingnurse that she had been feeling "sickto my stomach, like I was coming

down with the flu" for the past 48hours. She has continued to take herusual daily dosage of insulin. Notingthat Loberta has been admitted with ablood-glucose value of 46, which ofthe following assessment questionswould provide the most valuableinformation about Loberta's status?

A.. "Have you been under a great dealof stress lately, Loberta?"

B. "Were you having difficulty sleepingafter this illness started?"C. "Have you eaten anything in thepast 48 hours?"D. "Did you take any medications forthis illness other than your insulin?"

Jerry is a 32-year-old white male. Hehas been married for 10 months, andhe and his wife, Sue, are expectingtheir first child in 6 months. Prior tomarrying Sue, Jerry was sexuallyactive and nonmonogamous. He hasbeen sexually active since the age of18. Recently Jerry has complained ofpersistent dry cough, night sweats,and a temperature over 100?F.AlthoughJerry is concerned about his weightand watches his diet, he has lost 15pounds without even trying. Uponassessing Jerry, he admits to havinghad sexual intercourse withprostitutes, both male and female,during the last 10 years.

9. Jerry's symptoms of elevatedtemperature, chills, and dry cough areprobably related to whichundiagnosed condition?

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A. Alteration in tissue perfusionB. An infection, etiology unknownC. Indigestion from too frequenttravelingD. Lack of knowledge related tofrequent travel

Mrs. Brown's husband was admitted to

the emergency room in deliriumtremens (DTs). This admission is histhird visit in 2 weeks. While waiting tosee her husband, Mrs. Brown said tothe nurse, "What in the world can I doto help Joe get over this drinkingproblem?"

10. The best initial response for thenurse is:

A. Don't feel guilty, Mrs. Brown; I knowthis must be difficult for you.B. Let's go into the lounge so we cantalk more about your concern, Mrs.Brown.C. You need to convince Joe to seekprofessional help, Mrs. Brown.D. How long has your husband beendrinking, Mrs. Brown?

Amy Stevens is a 17-year-old studentadmitted for evaluation of lowerabdominal pain. She tells the nurse, "Iwish my friends would come to visitme. I don't like being here alone."

11. Which of the following would bethe most appropriate response of thenurse?

A. "You sound very lonely. Shall I staywith your for awhile?"B. "I'm sure your friends will come tosee you soon."C. "It's a little too early for visitinghours. You'll have to wait until thisafternoon."D. "It's hard to be alone. Would youlike me to stay with you?"

Patty Daniels is a 25-year-old whitefemale, pregnant with her first child.She is being seen in the obstetricalclinic for her first prenatal visit.

12. Patty tells the nurse, "I drank aglass of wine at a party before I foundout that I was pregnant. I'm worried

that I might have hurt the baby."Based on an understanding of alcoholuse in pregnancy, which of thefollowing responses is the mostappropriate?

A. "We don't really know how muchalcohol is too much during pregnancy.Don't drink anymore and try not toworry about it."B. "As long as your drinking is

moderate, I wouldn't worry about it.There were plenty of healthy babiesborn to drinking mothers before theyever discovered fetal alcoholsyndrome."C. "An occasional drink shouldn't hurtthe baby. Research has shown thatthe risk to the fetus increases as theamount and frequency of alcoholconsumption increases."D. "I can understand why you're soupset, but an occasional drinkshouldn't hurt the baby."

Kelly Jones, aged 3 years, is broughtto the emergency room by her motherfollowing an accidental ingestion ofacetaminophen. When questioned,Mrs. Jones states that she believesthat Kelly ingested approximately 20tablets. She further states that shebelieves that the ingestion occurredwithin the last hour.

13. Immediately upon arrival in theemergency room the nurse should:

A. Assess vital signsB. Administer O2C. Start IV fluidsD. Perform an arterial puncture for

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blood gases